The questionnaire comprised items on: demographics (age, gender), current medications, find more frequency of ibuprofen use, medical consultations, reading manufacturer’s printed dosage/warning instructions, sources from which drug information was gathered and understanding of common indications for ibuprofen. Key findings Sixty per cent of patients (n= 110/183), predominantly females, were currently on other medications and 64.5% of patients (n= 118/183) did not seek medical advice before using non-prescription ibuprofen. Seventy-one per cent (n= 130) of these patients had used ibuprofen for more than a year. The majority

of patients did not provide precise answers for the common indications of ibuprofen. Sixty-six per cent of patients (n= 110) reported rarely or never reading manufacturer’s printed warning instructions on the potential drug interactions or adverse effects associated with the use of the product. Conclusions Many patients are unaware that non-presciption analgesics such as ibuprofen can cause potentially serious adverse effects when used in combination

with other common Thiazovivin datasheet medications. “
“Objective  To assess the level of the current knowledge and understanding of cardiovascular disease (CVD) among Jordan’s general public, their behaviour towards CVD and the factors associated with different CVD knowledge levels. Methods  The data in the present study

ZD1839 mw were collected using an interview-administered questionnaire. One thousand members of the general public were interviewed face to face. CVD knowledge was computed as a continuous variable. Key findings  The present study reports limited public knowledge and awareness of CVD. Participants were more likely to have better CVD knowledge scores if they were non-smokers, always or often paid attention to their diet, reported having an ‘about right’ weight, occupied a very high socioeconomic level, held a university degree and had positive family history of CVD. Participants indicated that the community pharmacists had to play a role in helping patients manage their prescribed medicines; however, they did not recognise the community pharmacists’ role in other areas of CVD prevention and management. Conclusion  The present study reports that the general public in Jordan has limited knowledge and awareness of CVD. In planning to positively impact CVD prevention and management, community pharmacists must develop and promote effective and accessible services. “
“Collaborative care between physicians and pharmacists has the potential to improve the process of care and patient outcomes.

coli strains. The strains E. coli W4680AE (ΔacrA, ΔacrB, ΔacrE, and ΔacrF) and E. coli strain 5X RND (ΔacrB, ΔacrD, ΔacrF, ΔmdtF, and ΔmdtBC) were used for further analysis in addition to E. coli W4680AD. Escherichia coli W4680AD expressing

the gold-efflux system from pGesAB exhibited strong resistance toward 12 chemicals (Table 2). The classes of compounds included β-lactams, the bacteriostatics chloramphenicol and thiamphenicol, several other antimicrobials, a surfactant, and a protein kinase C inhibitor. Although the cloning vector contained coding sequences for β-lactamase and chloramphenicol acetyltransferase (Soncini et al., 1995), the resistance observed for β-lactams, chloramphenicol, and thiamphenicol was much greater than the empty vector control. Moderate resistance was detected in approximately the same BYL719 cost number of chemicals and consisted mostly of antibiotics, fungicides, a cationic surfactant, and a DNA mutagen. Of the chemicals initially identified from the Biolog screen, chloramphenicol, chlorquinaldol, and dichlofluanid were chosen for further analysis. Methylene blue and crystal violet were previously reported to be substrates of GesABC in Salmonella typhimurium (Nishino et al., 2006; Pontel et al., 2007), and were also tested here. All three E. coli strains expressing GesAB showed chloramphenicol resistance in the liquid

media tests (Fig. S3). MIC analysis Buparlisib molecular weight showed that the level of resistance increased fourfold in E. coli strain 5X RND and eightfold in strains W4680AD and W4680AE (Table 4). Chloramphenicol had not been identified as a substrate of the Ges system previously. Moreover,

chlorquinaldol resistance was detected in all the tested strains expressing GesAB in liquid media tests (data cAMP not shown). Escherichia coli strains W4680AD and W4680AE carrying pGesAB were resistant to chlorquinaldol with a twofold increase MIC value, via the agar results. The discrepancy between growth in the Biolog assay and MIC assays in LB medium could be attributed to differing growth conditions (media, incubation time, detection method). Crystal violet and methylene blue, which was not present in the Biolog panels, were tested because GesABC conferred resistance to both compounds in Salmonella (Nishino et al., 2006; Pontel et al., 2007). Previous studies have shown that the MIC values for crystal violet and methylene blue are 8- and 16-fold greater when the gold efflux system is overexpressed in a ΔgesABC, ΔacrB knockout (Nishino et al., 2006). Here, only the MIC value of E. coli W4680AD containing pGesAB exposed to crystal violet was greater than the control, but gesAB expressed in E. coli strains W4680AE and 5X RND did not show any difference from the vector control. It is possible that the level of expression of gesAB in these backgrounds is not sufficient to detect a difference in the MIC values when compared with the vector controls.

Resistance to at least one PI was observed by RNA but not DNA genotyping in 50% of patients (78 of 156) and by DNA but not RNA genotyping in 7% of patients (11 of 156). The median (IQR) GSS was 1.5 (1.0, 1.5) based on RNA genotyping and 2.0 (1.5, 3.0) based on DNA genotyping (P < 0.001). The GSS was 2 or more in 18% and 58% of patients based on RNA and DNA genotyping, respectively,

suggesting that 20% of patients had at least two active drugs in their regimen (excluding enfuvirtide) based on previous RNA genotyping, compared with 58% of patients based on current DNA genotyping (Table 1). RNA genotyping showed that 160 (95%) of the 169 patients harboured triple-class-resistant viruses, compared with 42 (35%) of Afatinib ic50 the 121 patients with assessable DNA genotypes. Among age, gender, Centers for Disease Control and Prevention (CDC) status, nadir click here and baseline CD4 cell counts, and total duration of antiretroviral treatment, only a lower nadir CD4 cell count was significantly associated with triple-class resistance based on DNA genotyping vs. no resistance to at least one of the 3-class (26 vs. 88 cells/μL; P = 0.001). The efficacy of switch drugs for patients receiving a virologically effective regimen depends mainly

on the number and nature of resistance mutations archived in the proviral reservoir following previous Nintedanib (BIBF 1120) therapeutic failures [2-7, 10, 11]. Viraemia is suppressed by the antiretroviral regimen in these patients, so resistance genotyping must be performed only on cell-associated HIV-1 DNA. Here we compared DNA genotyping results at randomization among 169 patients on successful highly active antiretroviral therapy (HAART) enrolled in the ANRS 138-EASIER switch trial [8] with the results of historical RNA genotyping in the same patients. We found that DNA genotyping

detected significantly fewer resistance mutations in the RT and PR genes than previous RNA genotyping. Indeed, mutations conferring resistance to at least one antiretroviral drug were detected exclusively by RNA genotyping or exclusively by DNA genotyping in 63% and 13% of patients for NRTIs, 47% and 1% of patients for NNRTIs and 50% and 7% of patients for PIs, respectively. Despite frequently suboptimal therapy in the past, only 35% of patients harboured triple-class-resistant archived viral DNA, a situation associated with a lower CD4 cell nadir. Our study confirmed the findings of a recent study showing, in a large number of patients with undetectable or low level viral load under an antiretroviral regimen, that the concordance between DNA and RNA was 46.7% for NRTI mutations, 26.3% for NNRTI mutations and 43.7% for PI mutations [12].

During the 2-year of the follow-up period, five patients in the study group and six patients in the control group became pregnant again. No complication during their pregnancies and second cesarean operation were encountered. With the Turan technique, the uterine incision length becomes shorter, and the frequency of uterine scar defect is lower regarding short-term results. More data is needed for long-term results. ClinicalTrials.gov NCT01287611 “
“Aim:  The best treatment option for cervical intraepithelial neoplasia 2 (CIN2) is controversial and there is a lack of studies in value-based

medicine. This multicenter comparative study was undertaken to evaluate the effectiveness, cost-effectives and quality of life (QOL) of loop electrosurgical excision Epacadostat ic50 procedure (LEEP) and CO2 laser vaporization

for the treatment of CIN2. Material and Methods:  A database of LEEP and laser vaporizations performed at three research centers was created. Patients with colposcopic-histopathologically confirmed CIN2 were randomly submitted to LEEP and laser vaporization. Cytology, human papilloma virus (HPV) DNA test and histology were check details performed, and a questionnaire on QOL was filled out during follow-up. Effectiveness, cost-effectives and QOL were analyzed. Results:  Three hundred and thirty-eight women with CIN2 were included in the study. Frequencies of remission, and persistent and recurrent CIN were 89.2%, 7.2%, and 3.6% for LEEP, and 86.7%, 12.6%, 0.70% for laser, respectively. There was no significant difference in remission and persistence of CIN. There was a significant difference in the number of operations, recovery time and costs. Women treated with two methods showed relatively identical QOL. Conclusion:  Both LEEP and CO2 laser vaporization are effective and reliable treatments for CIN2, whereas cervical tissue can be obtained for histology by LEEP. Preoperative evaluation and postoperative follow-up

are important. Gynecologists should pay attention to QOL of patients with CIN. “
“Aim:  The aim of this study was to investigate the expression levels of hepatocyte growth factor (HGF) and thrombospondin-1 (TSP-1) with the clinical pathological Farnesyltransferase factors in ovarian cancer, and the correlation between HGF and TSP-1 expression at the protein level. Material and Methods:  Immunohistochemistry was applied to detect the location and expression of HGF and TSP-1 protein in ovarian cancer and benign ovarian tumor tissue. Real-time quantitative polymerase chain reaction was applied to detect HGF and TSP-1 gene mRNA expression in ovarian cancer and benign ovarian tumor tissue. Results:  The level and positive expression rate of HGF mRNA in ovarian cancer tissue was significantly higher than in ovarian adenoma tissues.

, 2007). Secondly, PFGE experiments have suggested that Actinoplanes philippinensis, Amycolatopsis orientalis, Micromonospora chalcea, Nocardia asteroides,

Rhodococcus opacus and Streptoverticillium abikoense have linear chromosomes (Redenbach et al., 2000). Linearity is supported by sequencing in the case of R. opacus (http://www.expasy.ch/sprot/hamap/RHOOB.html) and Rhodococcus jostii (McLeod et al., 2006), whereas Rhodococcus erythropolis (http://www.expasy.ch/sprot/hamap/RHOE4.html), Amycolatopsis mediterranei (Zhao et al., 2010), Nocardia farcinica (Ishikawa et al., 2004) and many other species are described as circular based on chromosome sequencing. These findings indicate that chromosome linearity in the Actinomycetales is not limited

Selleck Doxorubicin to the Streptomyces, as was suggested might be the case by Oliynyk et al. (2007), but that there is heterogeneity in some genera; this includes Rhodococcus and Nocardia at least and perhaps many other genera. Thirdly, if the available information on the chromosome sequences of Actinomycetales is examined (Table 1), a number of trends can be identified, even though many of the sequences are not fully annotated. Most Streptomyces have homologues of tpg, tap and ttr, which are genes directly or indirectly associated with chromosomal linearity (Bey et al., 2000; Bao & Cohen, 2001, 2003; Yang et al., 2002). This implies that the chromosomes with these genes are linear or have been linear in the recent past. Circularization of linear Streptomyces chromosomes is a relatively common occurrence in the laboratory

this website and is effectively nonreversible, except possibly if another linear plasmid or another linear chromosome becomes involved (Volff et al., 1997). The absence of recognized terminal repeat sequences in the unpublished Streptomyces chromosomes is not unexpected, as a special approach is needed to obtain the sequences at the ends of the linear chromosome due to the presence of the covalently bound terminal protein that inhibits cloning. Furthermore, even in the absence of a cloning step, whole genome sequencing by the Roche 454 sequencing system will not obtain sequences from fragments that are covalently bound to a protein or peptide. It is expected that Dynein if and when these sequences are completely finished, most if not all will have recognized terminal repeats to which the Tpg protein will be covalently attached. The exceptions within the Streptomyces that lack tpg and tap are Streptomyces albus, Streptomyces sp. C and Streptomyces sviceus (Table 1). There are three possibilities with these strains: (1) the sequencing is incomplete, particularly in the terminal regions where the tpg, tap and ttr genes generally reside; (2) these chromosomes are circular and therefore tpg, tap and ttr are absent; or (3) the tpg and tap homologues are highly divergent from the typical proteins encoded by these genes in most Streptomyces.

, 2007). Secondly, PFGE experiments have suggested that Actinoplanes philippinensis, Amycolatopsis orientalis, Micromonospora chalcea, Nocardia asteroides,

Rhodococcus opacus and Streptoverticillium abikoense have linear chromosomes (Redenbach et al., 2000). Linearity is supported by sequencing in the case of R. opacus (http://www.expasy.ch/sprot/hamap/RHOOB.html) and Rhodococcus jostii (McLeod et al., 2006), whereas Rhodococcus erythropolis (http://www.expasy.ch/sprot/hamap/RHOE4.html), Amycolatopsis mediterranei (Zhao et al., 2010), Nocardia farcinica (Ishikawa et al., 2004) and many other species are described as circular based on chromosome sequencing. These findings indicate that chromosome linearity in the Actinomycetales is not limited

CHIR-99021 to the Streptomyces, as was suggested might be the case by Oliynyk et al. (2007), but that there is heterogeneity in some genera; this includes Rhodococcus and Nocardia at least and perhaps many other genera. Thirdly, if the available information on the chromosome sequences of Actinomycetales is examined (Table 1), a number of trends can be identified, even though many of the sequences are not fully annotated. Most Streptomyces have homologues of tpg, tap and ttr, which are genes directly or indirectly associated with chromosomal linearity (Bey et al., 2000; Bao & Cohen, 2001, 2003; Yang et al., 2002). This implies that the chromosomes with these genes are linear or have been linear in the recent past. Circularization of linear Streptomyces chromosomes is a relatively common occurrence in the laboratory

Trametinib nmr and is effectively nonreversible, except possibly if another linear plasmid or another linear chromosome becomes involved (Volff et al., 1997). The absence of recognized terminal repeat sequences in the unpublished Streptomyces chromosomes is not unexpected, as a special approach is needed to obtain the sequences at the ends of the linear chromosome due to the presence of the covalently bound terminal protein that inhibits cloning. Furthermore, even in the absence of a cloning step, whole genome sequencing by the Roche 454 sequencing system will not obtain sequences from fragments that are covalently bound to a protein or peptide. It is expected that G protein-coupled receptor kinase if and when these sequences are completely finished, most if not all will have recognized terminal repeats to which the Tpg protein will be covalently attached. The exceptions within the Streptomyces that lack tpg and tap are Streptomyces albus, Streptomyces sp. C and Streptomyces sviceus (Table 1). There are three possibilities with these strains: (1) the sequencing is incomplete, particularly in the terminal regions where the tpg, tap and ttr genes generally reside; (2) these chromosomes are circular and therefore tpg, tap and ttr are absent; or (3) the tpg and tap homologues are highly divergent from the typical proteins encoded by these genes in most Streptomyces.

Several proposed mechanisms of implantation failure in women with endometriosis have

been reported elsewhere including GSK2118436 nmr progesterone resistance and alteration in PR-A to PR-B ratio.[61] Endometriosis-associated infertility can be explained by one of the several mechanisms shown in Figure 2. The increased infiltration of macrophages and other immune cells may have twofold effects on the endometrial bed in women with endometriosis: (i) direct phagocytosis of implanting embryos; and (ii) indirect impairment in the process of implanted blastocyst. These hazardous effects of Mφ can be contributed to by producing some biological mediators such as ROS or by induction of humoral immune response.[60, 62, 63] A moderate to severe inflammatory reaction in the pelvic environment

leads to the formation of tubo-ovarian adhesion or peritubal adhesion finally resulting in narrowing or occlusion of the fallopian tube.[64] On the other hand, bacterial endotoxin (LPS) derived from Gram-negative bacteria may directly cause endometrial or tubal damage. Endotoxin has been found to be deleterious in pre-implantation stage embryos.[65] The presence of endotoxin in in vitro fertilization (IVF) culture media results in high rate of polyspermy, decreased embryo cleavage rate and blastocyst formation in human and bovine species. Endotoxins also possess the capacity to induce apoptosis of cells impairing sperm motility and induce spermicidal activity.[62-65] A recent Akt inhibitor assisted reproductive technology clinical trial has demonstrated that pregnancy rate after IVF embryo transfer was significantly higher in women with an endotoxin level of less than 200 pg/mL in menstrual fluid, than that in women with an endotoxin level of more than 200 pg/mL.[66] In addition to women,

bacterial infections of the genital tract are one of the most serious causes of infertility in men. A recent study detected a Gram-negative bacteria factor, LPS, and Gram-positive bacteria factor, peptidoglycan, in human semen and demonstrated expression of TLR4 and TLR2, peptidoglycan receptor, in human and mouse sperm.[67] selleck chemicals They found that addition of endotoxin in the absence of leukocytes directly and significantly reduced the motility and increased the apoptotic rate of both human and mouse sperm and suppressed fertilization by sperm both in vivo and in vitro.[67] These findings further strengthened the detrimental effect of bacterial endotoxin on reproductive outcome. Many of the biological effects of bacterial endotoxin are mediated by pro-inflammatory cytokines such as IL-1, IL-6 and TNF-α. One recent study demonstrated that adding recombinant IL-6 to culture media suppressed the rate of blastocyst formation in mouse embryos and reduced the percentage of motile human spermatozoa.[68] Higher concentrations of TNF-α possess apoptosis- and necrosis-inducing activity on a variable type of cells including sperm, ova and endometrial cells.

repeated deviant), repetition probability (high vs. low) and temporal regularity (anisochronous vs. isochronous). To check for differences in the distribution of MMN as a function of repetition and/or repetition probability, four regions of interest (ROIs) were defined: left (F5,

FC5, C5); center-left (F1, FC1, C1); center-right (F2, FC2, C2); and right (F6, FC6, C6). Scalp potential (SP) measures and scalp current density (SCD) values were computed for each ROI as the mean across electrode locations. Voltage measures were transformed into current density estimates by computing the second spatial derivative of the interpolated voltage distribution (Perrin et al., 1989, 1990), with maximum degree of Legendre polynomials selleck chemical set to 50, order of splines (m) equal to 4, and a smoothing parameter of 10−5. This way we obtained reference-free distribution maps of local current sources/sinks (radial current flow through the skull measured in mA/m3; Bcl-2 inhibitor Srinivasan, 2005). Four-way anovas with factors repetition, repetition probability, laterality (central vs. lateral) and side (left vs. right) were separately run for each temporal regularity condition on SP measures and SCD estimates. IBM SPSS Statistics for Windows, Version 20.0 (IBM; Armonk, NY, USA) was used for statistical analyses. Brain electrical tomographic procedures

were applied to detect the presence of differences in MMN generator location, using the distributed inverse solution VARETA approach (Variable Resolution Electrical Tomography; Bosch-Bayard et al., 2001). VARETA reconstructs brain sources by estimating the spatially smoothest intracranial primary current density (PCD) distribution that is compatible with the observed scalp voltages, and restricts the allowable solutions to the gray matter on the basis of probabilistic Montréal Neurological before Institute (MNI) 3D brain tissue maps (Evans et al., 1993; Trujillo-Barreto et al., 2004). Statistical parametric maps (SPMs) of the PCD estimates were then constructed based

on a voxel by voxel Hotelling T2 test against zero (threshold: P < 10−4) to determine the sources of the MMN component separately for each condition and for the relevant contrast between solutions. The PCD is a vector quantity, that is, at each voxel the three projections of the PCD vector onto the three orthogonal directions in the 3D Cartesian space are estimated. This asks for a multivariate T2 statistic at each voxel to test for changes in magnitude as well as orientation of the PCD vector. Significance threshold correction to account for spatial dependencies between voxels was calculated by means of random field theory (Worsley et al., 1996). Results are shown as 3D images. To verify if indeed a slower stimulus rate (SOA = 600 ms, 1.

If the heterogeneity was above 50% or the P-value was less than 0.10, Dasatinib mw we planned to explore for the source of heterogeneity and perform appropriate sensitivity analyses. The presence of publication bias was assessed by visual inspection of funnel plots, generated by revman 5, of the primary outcomes reported in the included studies. Subgroup analyses with summary effects were performed for each GH axis drug studied. As depicted in Table 1, all 10 included studies were randomized double-blinded placebo-controlled

studies. The duration of the intervention in the studies ranged from 12 to 26 weeks. Six studies evaluated GH as their primary intervention, four studies evaluated tesamorelin, one study evaluated GHRH, and one evaluated IGF-1. One article compared two interventions (GH and IGF-1) vs. a placebo group. As can be seen in Figure 1, the summary effect shows that GH axis drugs produced a significant reduction in VAT compared with placebo (WMD –25.20 cm2; 95% CI −32.18 to –18.22 cm2; P<0.001). Statistically significant reductions were found for GH (WMD −32.61 cm2; 95% CI −41.82 to –23.40 cm2; P<0.001) and tesamorelin

(WMD −22.65 cm2; 95% CI −32.67 to −12.64 cm2; P<0.001). GHRH Epigenetic inhibitors library treatment did not result in a statistically significant decrease in VAT (WMD −21.50 cm2; 95% CI −44.28 to 1.28 cm2; P=0.06). As shown in Figure 2, compared with placebo, GH axis drugs significantly reduced SAT mass (WMD –3.94 cm2; 95% CI −10.88 to 3.00 cm2; P=0.02). Subgroup analyses showed that no significant decrease in SAT mass was found with tesamorelin (WMD 1.02 cm2; 95% CI –8.21 to 6.16 cm2; P=0.78) or GHRH (WMD –1.40 cm2; 95% CI –13.55 to 10.75 cm2; acetylcholine P=0.82).

However, GH treatment did result in a statistically significant decrease in SAT compared with placebo (WMD –16.02 cm2; 95% CI –24.08 to –7.97 cm2; P<0.001). As shown in Figure 3, GH axis drugs produced a significant change in LBM compared with placebo (WMD 1.31 kg; 95% CI 1.00 to 1.61 kg; P<0.001). Subgroup analysis showed that there was a significant increase in LBM with tesamorelin (WMD 1.35 kg; 95% CI 1.03 to 1.66 kg; P<0.001) and GHRH (WMD 0.78 kg; 95% CI –0.39 to 1.95 kg; P=0.019), while GH (WMD 1.51 kg; 95% CI –0.22 to 3.24 kg; P=0.09) and IGF-1 (WMD 2.05 kg; 95% CI –0.08 to 4.18 kg; P=0.06) did not produce a significant gain. GH axis drugs had an overall effect of increasing fasting plasma glucose (WMD 2.88 mg/dL; 95% CI 1.10 to 4.65 mg/dL; P=0.001), decreasing waist circumference (WMD −1.61 cm; 95% CI –2.33 to –0.89 cm; P<0.001), decreasing extremity fat (WMD –0.25 kg; 95% CI –0.49 to 0.01 kg; P=0.04), and decreasing triglycerides (WMD –25.37 mg/dL; 95% CI –46.84 to –3.89 mg/dL; P=0.02).

When it says in the leaflet that it can cause irreversible muscle damage and may result in hospitalisation, that’s enough to focus my mind! 005: (78). Male, 56 years old, ABS 17, NABS 5 I think the β-blockers seem to make me a bit sleepy. I mean that if I said I would phone someone in the evening, I might be asleep and didn’t phone, that sort of thing.

Other than that it doesn’t hamper me. 004: (5). Female, 59 years old, ABS 18, NABS 8 The importance of the difference between the terms compliance and adherence is demonstrable when considering the quotes and TABS scores of patients 004 and 005 above. While the TABS scores indicate the potential for poor adherence the nature of that association can be further explored by considering the AC220 solubility dmso reason for the scores. In these instances the knowledge of ADRs may influence a patient’s decision as to whether they wish to be or can be adherent; that is, intentional non-adherence as the result of experiencing an ADR.

Thirteen patients discussed the impact that having an understanding of the indication has for adherence. These ideas varied greatly between patients. After an operation especially [PCI], I think people have got to understand that certain pills do certain things to the body selleckchem that helps them, but if they are a bit wary of pills then they are not inclined to take them unless it is explained why they are taking them [and] why they are to take them. 002: (157). Female, 70 years old, ABS 20, NABS 7 Another patient (008) with high ABS and low NABS admitted to not understanding what his medication was prescribed for. However, critically, his adherence remained high because he had rationalised

the need for additional medication and therefore perceived a health Linifanib (ABT-869) benefit with the medication. I know that these tablets are being prescribed for a reason and probably the truth is, what each tablet does for the body, I don’t really know, but obviously I have had to receive another couple because obviously number 1 for example doesn’t do what number 2 and 3 does otherwise I perhaps wouldn’t be on a second or a third, but I do understand that I have to take that medicine. 008: (17). Male, 54 years old, ABS 19, NABS 7 There was a higher frequency of quotes for this code than any other. In total 17 patients offered ideas about the doctor–patient relationship. Of the 17 patients, 16 noted good relationships with their general practitioner (GP). Patient 019 (low ABS and high NABS) described a poor working relationship but was still of the belief that a good relationship was desirable. A number of patients were also of the opinion that if a medication was prescribed for you by a doctor then it should be taken regardless. Well to me it is common sense. If the doctor says you need it then you need it so you should take it. 009: (133).