Development of Clinical Pharmacy services at King Khalid University Hospital and its impact on the quality of healthcare provided

AbstractClinical Pharmacy is a unique service provided by the leading pharmacy departments in the United States. The concept of Clinical Pharmacy evolved after the significant increase in number of pharmaceuticals in the market and the increasing potential of drug interactions. However, the Clinical Pharmacist is not merely an individual who advises on drug interactions. There are a number of functions which include but are not limited to; the design of appropriate drug therapy, such as Pharmacokinetic assessment and evaluation to optimize drug therapy, drug information dissemination to the physicians and other healthcare providers and participation as a toxicology consultant in Poison management.At the King Khalid University Hospital (KKUH) the first Clinical Pharmacy services program began in 1983. The aim of this study is to evaluate the impact of our Clinical Pharmacy program on the patients’ care as well as its perception by the Medical staff that came from different parts of the world.Our Clinical Pharmacists were asked to record any suggestions or interventions in the form. The forms were all collected at the end of each day and entered into a database for analysis. Each intervention was analyzed in order to assess the merit of the action in terms of the therapeutic, financial and direct cost impact.The study showed a positive impact on the patients’ care as well as on the economy of the drugs prescribed. Meanwhile, the service was very much appreciated by the Medical staff as well as other healthcare providers

Effects of Head Motion on Postural Stability in Participants with Chronic Motion Sensitivity

Background: Motion sensitivity, or motion sickness, is common among individuals in modern vehicular and visually stimulating environments; notably, people with normal vestibular function are susceptible to this condition. Motion-provoked dizziness often causes postural instability. Purposes: This study aimed to compare the effects of head motion on postural stability in healthy adults with and without chronic motion sensitivity (CMS) and to determine the effects of head motion direction (horizontal versus vertical) on postural stability. Methods: Sixty healthy adult males and females aged 20 to 40 years old were assigned to two groups, 30 participants with CMS and 30 participants without CMS. Pre-data collection, all participants were trained on specific parameters of cervical rotation, flexion, and extension. Then, postural stability measurements were taken during three conditions (static, horizontal, and vertical head movements) using the Bertec Balance Advantage Dynamic Computerized Dynamic Posturography (CDP). Results: There was a significant difference between the CMS and non-CMS groups in mean postural stability during head movement in both horizontal and vertical head motions (p = 0.005 and p = 0.024, respectively); however, no significant difference was shown in mean postural stability between horizontal and vertical head motions within each group (p = 0.297 in CMS group and p = 0.179 in non-CMS group). Conclusions: The results indicate that healthy young adults without CMS have better postural stability during head motion than those with CMS, and that head motion direction (horizontal versus vertical) does not influence postural stability within each study group

Comparison of acute physiological effects between alternating current and pulsed current electrical muscle stimulation

Electrical muscle stimulation (EMS) is widely used in rehabilitation and sport training, and alternating current and pulsed current EMS are commonly used. However, no systematic comparison between alternating and pulsed current EMS has been made in the previous studies. The main aim of this research was to compare acute physiological responses between the alternating and pulsed current EMS. The secondary purpose of the research was to investigate further muscle damage induced by EMS-evoked isometric contractions. Three experimental studies were conducted in the thesis project together with literature review about EMS

Is Your Student Fit For That College? A Study of the Factors That Contribute to Students’ Academic Performance in College

The purpose of this study was to expand the extent of available literature in regard to the factors that contribute to students’ academic performance in college. It focused on a neglected segment of the student population, which is Saudi Arabian students studying in the United States. This study utilized a nonexperimental quantitative research design in order to investigate the relationship between the independent variables (the characteristics of the student, the characteristics of the program, and the academic and social integration between the student and the program) and the dependent variables (degree GPA, ability to graduate within academic program time frame, or dropout). The data were collected from Saudi Arabian students who previously enrolled in the King Abdullah Scholarship Program (KASP) and had graduated or dropped out between the period of 2005 to 2016. A Web-based electronic survey was sent and made available for Saudi students who entered KASP via any of the entry methods in the United States. There were 1,020 students who participated in the survey, and only 543 of them fully completed the survey. Only completed surveys were considered for analysis. The results showed that some students’ characteristics, some program characteristics, and some academic and social integration attributes were strongly correlated with students’ academic performance in college. This study presented empirical evidence about which factors can impact students’ performance in college. It provided some answers to why some students succeed, while others fail. It also offered insights and recommendations for higher education policymakers as well as for scholars in the field of higher education policy, especially those concerned with admission policies of academic programs

Comparison of Computer-Based and Optical Face Recognition Paradigms

The main objectives of this thesis are to validate an improved principal components analysis (IPCA) algorithm on images; designing and simulating a digital model for image compression, face recognition and image detection by using a principal components analysis (PCA) algorithm and the IPCA algorithm; designing and simulating an optical model for face recognition and object detection by using the joint transform correlator (JTC); establishing detection and recognition thresholds for each model; comparing between the performance of the PCA algorithm and the performance of the IPCA algorithm in compression, recognition and, detection; and comparing between the performance of the digital model and the performance of the optical model in recognition and detection. The MATLAB © software was used for simulating the models. PCA is a technique used for identifying patterns in data and representing the data in order to highlight any similarities or differences. The identification of patterns in data of high dimensions (more than three dimensions) is too difficult because the graphical representation of data is impossible. Therefore, PCA is a powerful method for analyzing data. IPCA is another statistical tool for identifying patterns in data. It uses information theory for improving PCA. The joint transform correlator (JTC) is an optical correlator used for synthesizing a frequency plane filter for coherent optical systems. The IPCA algorithm, in general, behaves better than the PCA algorithm in the most of the applications. It is better than the PCA algorithm in image compression because it obtains higher compression, more accurate reconstruction, and faster processing speed with acceptable errors; in addition, it is better than the PCA algorithm in real-time image detection due to the fact that it achieves the smallest error rate as well as remarkable speed. On the other hand, the PCA algorithm performs better than the IPCA algorithm in face recognition because it offers an acceptable error rate, easy calculation, and a reasonable speed. Finally, in detection and recognition, the performance of the digital model is better than the performance of the optical model

Bacterial Chondronecrosis with Osteomyelitis in broilers: genomics, phylogenomics, and methods to detect specific pathogens during outbreaks.

Lameness is a major issue in animal welfare and the broiler industry. Bacterial chondronecrosis with osteomyelitis (BCO) is one of the main causes of lameness. Many staphylococcal species, including Staphylococcus agnetis isolate 908, have been isolated from the bones and blood of lame broilers at the University of Arkansas. Staphylococcus agnetis is a coagulase-variable, Gram-positive bacterial species that has been previously associated with subclinical or mild clinical cases of mastitis in dairy cattle. The annotated complete genome of hypervirulent strain 908 was published at NCBI. In this study, it has been compared to nine genomes we assembled for hypervirulent isolates in dairy cattle. Phylogenomic analyses of chicken and cattle isolates of S. agnetis and Staphylococcus hyicus suggest a very close relationship between the cattle and chicken isolates. The hypervirulent chicken isolate, 908, clustered with two of the cattle isolates, including strain 1379. A catalogue of gene differences between the cattle and chicken isolates was constructed using reciprocal blast analyses at the nucleotide and polypeptide level. More than 40 genes and 3 plasmids from strain 908 are absent or poorly conserved in any of the cattle S. agnetis isolates. No transformation protocol has been described for S. agnetis. Subsequently, an electroporation procedure has been optimized for DNA transformation of Staphylococcus agnetis. Therefore, we have optimized an electroporation method for DNA transformation so that we regularly obtain 10 to 20 transformants per ng using a Gram+/Gram- shuttle vector. Moreover, among the BCO pathogens isolated from the lame broilers, there are a number of Staphylococcus species, such as, S. agnetis, S. hyicus, S. chromogenes, S. aureus, S. cohnii, S. saprophyticus, S. epidermidis, and S. capitis, which are hard to accurately identify based just on genes like 16S rDNA. Therefore, using pfbA gene, a novel PCR assay was optimized for Staphylococcus species discrimination and strain typing. Moreover, extraction of bacterial DNA for subsequent molecular diagnostic applications remains a costly and time-consuming operation. We developed a technique for rapidly extracting genomic DNA from the BCO pathogens and other environmental bacteria based on sodium hydroxide cell lysis with or without magnetic bead capture. Finally, the BCO pathogens are transmitted via air. Our efficient air sampling system was designed for the quick screening of these airborne BCO pathogens and is transferable to monitor agriculturally important pathogenic bacteria

Type 2 Bovine Viral Diarrhea Virus N\u3csup\u3epro\u3c/sup\u3e Suppresses Type I Interferon Pathway Signaling in Bovine Cells and Augments Bovine Respiratory Syncytial Virus Replication

Bovine viral diarrhea virus (BVDV) and bovine respiratory syncytial virus (BRSV) infections contribute to the bovine respiratory disease complex (BRDC), which is a multi-factorial disorder involving co-infections of viruses and bacteria including mycoplasma. BRDC causes great economic losses to the United States feedlot industry. BVDV infection induces immunosuppression in infected animals. BVDV Npro binds and degrades the transcription factor interferon regulatory factor-3 (IRF-3) and effectively blocks type I interferon (type I IFN) expression in host cells. BRSV nonstructural proteins, NS1 and NS2, block activation of IRF-3. In calves, concurrent infection with BVDV and BRSV resulted in more severe clinical signs of disease and extensive lung lesions than infection with either virus alone. The objective of this study was to extend the understanding of the role of the Npro of noncytopathic BVDV-2 (pestivirus B) on type I IFN pathway signaling in bovine turbinate (BT) cells during single and co-infection with BRSV. Based on real-time quantitative-reverse transcription-polymerase chain reaction, the BVDV-2 mutant with dysfunctional Npro (BVDV2-E) significantly up-regulated protein kinase R (PKR), TANK-Binding Kinase 1, IRF-3, IRF-7, and interferon-β (IFN-β) mRNAs compared to BVDV-2 wild-type (BVDV2-wt) and BRSV in single and co-infected BT cells. BRSV-infected cells expressed significantly up-regulated PKR, IRF-3, IRF-7, and IFN-β mRNAs, whereas BVDV2-wt, but not BVDV2-E, abolished this up-regulation in co-infection. No significant differences were observed in mitochondrial antiviral signaling, Nuclear Factor-κB (NF-κB), and NIMA-Interacting 1 mRNAs. A dual-luciferase reporter assay showed that BVDV2-wt significantly increased NF-κB activity compared to BVDV2-E, while BVDV2-E significantly increased IFN-β activity compared to BVDV2-wt. BT cells infected with BVDV2-E produced more IRF-3 protein compared to cells infected with BRSV or BVDV2-wt. The BRSV titer and RNA levels significantly increased in cells co-infected with BRSV/BVDV2-wt compared to cells co-infected with BRSV/BVDV2-E or infected with BRSV alone. BVDV2-E single and co-infected cells synthesized type I IFN significantly higher than BVDV2-wt single and co-infected BT cells. These findings are useful in defining the role of the intact BVDV-2 Npro on type I IFN pathway signaling and support the understanding of the mechanism underlying the synergistic action of BVDV2-wt and BRSV inhibition of type I IFN. The inhibition of BRSV-induced signals by BVDV augments BRSV infection. Advisor: Clayton L. Kelling, Ph.D