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   2013| May-June  | Volume 5 | Issue 3  
    Online since July 13, 2017

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Dispensing practices, attitudes and knowledge of pharmacists towards herbal products in palestine
Waleed M Sweileh, Enass M Abu Arrah, Adham S Abu Taha, Ansam F Sawalha, Ola A Salah, Raniah M Jamous, Deema Adawi
May-June 2013, 5(3):123-130
Background and Objectives: With the global rise in the use of herbal products; pressure is increasing on pharmacists to have more knowledge about herbal medicine. We assessed pharmacists' dispensing practices, attitudes, and knowledge regarding herbal products. Methods: A cross sectional study was carried out among community pharmacists in north Palestine using a questionnaire. A convenience sample of 100 community pharmacists was included in the study. The mean age of participants was 33±11 years. Results: Dispensing of herbal products was common. The majority of participants (91%) believed that herbal products were beneficial and 61% believed these had fewer side effects than conventional medicines. Most participants thought they have good knowledge of herbal preparations. However, their actual knowledge in response to factual questionnaire was low. The lowest score was observed for herbal drug interactions domain. Conclusions: Although herbal products are commonly dispensed in Palestine, community pharmacists have poor knowledge about these medicines. Continuing pharmacy education in general is needed for community pharmacists to qualify them to provide a better pharmaceutical care.
[ABSTRACT]   Full text not available  [PDF] [CITATIONS]
  963 133 3
New frontiers in the management of patients with chronic kidney disease
Abdel Basset El Essawy, Salem A Beshyah
May-June 2013, 5(3):166-171
New Frontiers in the management of patients with chronic kidney diseases was a the third in a series of one day symposium held in the Medical College of Ras Al-Khaimah University of Medicine and Health Sciences on the 16th of March 2013 to mark the world Kidney Day. Local, regional and international experts considered various diagnostic and management challenges in the areas of chronic kidney disease covering such wide spectrum of subjects ranging from pre-diabetes, diabetes kidney disease, glomerulonephritis, arterial hypertension and management of hypertension in patients with chronic kidney disease to mesenchymal stem cell therapy, pancreatic transplantation and gene polymorphism profiling in clinical practice. The concise abstracts of all the presentations are presented here to extend the benefit from the meeting to all those who did not attend the live event.
[ABSTRACT]   Full text not available  [PDF]
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Anesthesiologist-surgeon conflicts at the workplace: An exploratory single-center study from Egypt
Ragaa El-Masry, Tarek Shams, Hamed Al-Wadani
May-June 2013, 5(3):148-156
Background: Professional relationships, in particular between anesthesiologists and surgeons, have been identified as a major source of conflict at the work place. Aims: We explored some of the perceived causes of conflict between the surgeons and anesthesiologists in a single center in Egypt. Method: A cross-sectional study of 67 anesthesiologists and 50 surgeons at Mansoura University Hospital, Mansoura, Egypt was conducted between March and June 2011. A self-reported questionnaire explored 4 domains including 24 items covering causes of conflict. Results: There was a highly significant difference between the number of anesthesiologists and surgeons who considered the working relationships between them as disturbed (76.6% vs. 13.3%, p <0.001 respectively). The most powerful significant predictors of conflicts between surgeons and anesthesiologists were: patient pressure on surgeons, lack of regard to anesthesiologists' instructions, patients' unawareness of the role of anesthesiologists, poor information about patients, decision about the urgency of operations, lack of departmental coordination regarding surgical priorities, lack of an out-patient anesthesia clinic and finally shortage of work facilities. Conclusions: We identified some causes that were perceived by participants to trigger conflicts between them. Attention to these issues may help bring about more harmony between surgeons and anesthesiologists at the work place.
[ABSTRACT]   Full text not available  [PDF]
  737 97 -
Pathogenesis of psoriasis: Comparison of natural killer cells, interleukin-18, intercellular adhesion molecule-1, interleukin-2-receptoralpha and sCD44 status in patients and controls
Mabrouk M Ghonaim, Rawhia H El-Edel, Osama M Abo-Salem, Mohammed A Basha
May-June 2013, 5(3):114-122
Background: Interleukin-18 (IL-18), soluble interleukin-2 receptor-alpha (sIL-2Rα), soluble intercellular adhesion molecule-1 (sICAM-1), soluble CD44 (sCD44) may have a role in psoriasis. Objectives: We aimed to investigate the role of these cytokines, adhesion molecules and soluble receptors in this disease. Patients and Methods: Seventy psoriasis patients and 20 healthy controls were included in this study. Severity of the disease was determined by estimation of psoriasis area severity index (PASI). Serum levels of IL-18, sIL-2Rα, sICAM-1 and sCD44 were determined by enzyme immunoassay. Enumeration of circulating NK cells was performed by flow cytometry. Results: Psoriasis patients had significantly (P<0.001) higher levels of IL-18, sIL-2Rα and sICAM-1 and significantly (P<0.01) lower percentages of NK cells (CD56+, CD56+CD3- and CD56+CD3+) as compared to controls. There were no significant differences in the levels of sCD44. IL-18 was significantly (P<0.01) higher among patients with severe as compared to mild and moderate psoriasis. Levels of sIL-2Rα and sICAM-1 were significantly (P<0.05) higher among patients with severe as compared to mild psoriasis. The percentage of NK-cells and the level of sCD44 were non-significantly related to severity of the disease. There were significant (P<0.01) positive correlations between serum levels of IL-18, sIL- 2Rα and sICAM-1. There were also positive correlations (P<0.05) between PASI score and IL-18 and sICAM-1 levels. Conclusion: Increased IL-18 and sICAM-1 levels and their correlation with severity of psoriasis suggest that IL-18 may lead to increased Th1 response and up-regulation of ICAM-1 on monocytes culminating in increased cell infiltration and keratinocyte proliferation. IL-18 and sICAM-1 may serve as useful markers of psoriasis severity and targeting of both cytokines may be useful in treatment of the disease.
[ABSTRACT]   Full text not available  [PDF]
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Left ventricle posterior wall aneurysms with calcified thrombus in the aneurysmal area
Gulacan Tekin, Yusuf Kenan Tekin, Ali Rıza Erbay, Hasan Turhan
May-June 2013, 5(3):162-165
Aneurysms can be seen as complications of myocardial infarctions. They are generally located in the apical and anterior segments but left ventricular inferoposterior wall aneurysms are rare. After a myocardial infarction, left ventricular aneurysms can cause symptomatic intractable ventricular arrhythmias. We report a rare case of a left ventricular posterior wall aneurysm containing a calcified thrombus that caused ventricular tachycardia.
[ABSTRACT]   Full text not available  [PDF]
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McCune albright syndrome with severe facial disfigurement
Farida Chentli, Yamina Zentar, Nora Soumeya Fedala, Said Azzoug
May-June 2013, 5(3):157-161
Introduction: McCune Albright syndrome (MAS) is a rare disease due to post zygotic somatic activating mutation in the Gs protein. It includes skin patches, bone dysplasia, and hyperfunctioning endocrinopathies. Our objective is to report an unusual disfiguring form with precocious pseudo puberty (PPP), and hot thyroid nodule. Case report: A 19 year-old girl was hospitalized for the first time at the age of 5.5 years for breast development and vaginal bleeding which began when she was 6 months old. The diagnosis was PPP due to MAS. In addition to ovarian hyperfunction, there were multifocal disfiguring bone dysplasia, and brown skin patches. As aromatase inhibitors were not available, she was treated by cyproterone acetate, which was efficient on the ovarian function, but not on bone maturation (final height: 1.35m, bone deformities, and recurrent fractures). Fortunately, bone dysplasia was stabilized under biphosphonates. But, ovarian hyper functioning relapsed, because of polycystic ovaries. Following that, a hot thyroid nodule with normal thyroid function appeared. Conclusion: This patient has MAS with severe bone dysplasia leading to a disfiguring face, hot thyroid nodule, and ovarian hyper function causing PPP then polycystic ovaries. So, in future checking for tumours development due to estrogens excess is mandatory.
[ABSTRACT]   Full text not available  [PDF]
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Analyses of evidence for hierarchy and levels of evidence: An exploratory quantitative synthesis
Senthil P Kumar, Vaishali Sisodia
May-June 2013, 5(3):131-139
Background: Among the recognized steps in EBP, evaluating and critically appraising research evidence on effectiveness of an intervention is an essential step that acts as a determinant in forming the link between obtained evidence and implementation in practice. Objective: To critically summarize and identify the results of analyses of levels of evidence published in journals indexed in PubMed. Methods: A systematic overview and quantitative analysis of selected 45 published reviews was performed to identify relevant themes in levels of evidence. The types of analyses (specialty-based, practice-based, journal-based, and conference-based) were categorized and sub-categorized for the studies on levels of evidence. Results: Of the 45 included studies, specialty-based analysis for levels of evidence were done in 12 articles, journal-based analysis in 5 articles, practice-based analysis in 25 articles, and conference- based analysis in 3 articles. Among the practice-based articles, 10 were on assessment and 15 were on treatment. Urology had more studies on analysis of levels of evidence, and very few studies analyzed journals and their content for the same. Three studies were analyses of conference abstracts, all of them in the field of orthopedics. Conclusion: There were greater number of studies on practice, in Urology, multiple journals, biomarkers in assessment, and equal representation of pharmacological and allied treatments. There is need for future reviews and analysis of levels of evidence in many unexplored areas of relevance
[ABSTRACT]   Full text not available  [PDF]
  688 94 -
Knowledge of and adherence to health advice among adults with diabetes in Libya
Walid M Elkharam, Rose Khatri, Akhtar H Wallymahmed, Ivan Gee, Tawfeg Elhisadi
May-June 2013, 5(3):140-147
Background: Non-adherence to medical and health care advice is a common problem, though reasons for non-adherence can differ across different groups and societies as well as between individuals. Objective: to examine diabetes knowledge among people with both type1 and type2 diabetes in Libya and explore any other factors that enhance adherence to treatment and management of the condition. Methods: A cross-sectional survey design was used to collect data from adults with type1 or type2 diabetes who have been diagnosed for 12 months or more, in Benghazi Diabetes Centre, which is one of the oldest and largest diabetes registries in Libya. A total of 855 participants were asked to fill in two questionnaires; the “Michigan Diabetes Knowledge Test” to investigate the level of diabetes knowledge and the Confidence in Diabetes Self-care Scale to assess self-efficacy. For the purpose of the study descriptive statistics and inferential statistical tests were conducted. Results: Diabetes knowledge is very poor especially among females and those classed as illiterate within the sample. The mean HbA1c of 9.4 was higher than the recommended levels. Four variables namely knowledge about diabetes, duration of illness, family history and self-efficacy significantly predicted levels of HbA1c. Conclusion: Based on the above findings, two different program of diabetes education would be recommended. The first would target those with inadequate levels of knowledge about diabetes, particularly women and people with long duration diabetes. The second would be for both healthcare professionals and people with type 1 and type 2 diabetes considering the psychological factors that are involved in diabetes management.
[ABSTRACT]   Full text not available  [PDF] [CITATIONS]
  634 109 2