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Case Description <p style="direction: rtl;">السلام عليكم ورحمة الله ابغي اقدم شكوة بخصوص مركز نعيم الصحي ، مو متوفرة اي خدمات ، الدكاترة دايما غير موجودين و تتاخر المواعيد بالاضافة الى عدم توفر الادوية ، يخلون المريض يشتري من الخارج بعذر ماعندنا هل نوع من الدواء ، الخدمات جدا سيئة وارجو اتخاذ قرار او ارسال احد من موظفين وزارة الصحة لرقابة وجزاكم الله خيرا .</p>

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Admin Comments <p>Patient, Maimoona Alhamed was seen on 8 October 2023 by Dr.Eman Alsoomi, Fprp year 4 resident. Her appointment time was 11:30 am, however she was seen half an hour BEFORE her appointment time at 10: 54 am.</p> <p>She came with a complaint of runny nose and dry cough for 2 days. On further history she stated that she suffers from chronic runny nose and has been using OTRIVIN nasal drops for almost 8 months. She took out a bottle of otrivin from her bag stating that this is the only thing that relieves her symptoms. She stated that she cannot sleep at night without using Otrivin drops and demanded the doctor prescribe her otrivin drops.</p> <p>The patient denied having fever, body weakness, ear pain or any other symptoms. The patient stated that she has a pet cat at home. Dr. Eman examined her throat, nose and ears and checked her temperature, and concluded that she has allergic rhinitis secondary to excessive otrivin use (rhinitis medicamentosa) which may be further exacerbated by the presence of the cat at home.</p> <p>Dr. Eman explained to the patient that Otrivin should not be used for months as it is a cause of rhinitis and refused to prescribe it to her. Dr. Eman came to me, Dr Sarah Sarwani (tutor Fprp) for advice and I told her to prescribe intranasal steroids. I explained to the resident that nasal irrigation or normal saline spray to remove any crusts/clear the mucous followed by use of intranasal steroid spray can produce better results.</p> <p>Dr. Eman then tried to explain this to the patient, but the patient got offended as she wanted OTRIVIN, saying no other spray works for her. Dr. Eman offered her intranasal steroid from the health center, but as nasal irrigation is not available in the health center asked her if she could purchase Rhinomere nasal spray from outside. The patient took a picture of the spray from her phone and agreed to take cetirizine with follow up on Thursday but refused to accept nasal spray other than OTRIVIN.</p> <p style="direction: rtl;">قامت الطبيبة المسئولة بالاتصال بالمريضة عدة مرات ولكنها كانت لا ترد وتغلق الهاتف دون الرد</p>