ASSESSMENT OF THE PERCEPTION AND SATISFACTION OF THE GENERAL PUBLIC OF THE NORTHERN BORDER REGION OF SAUDI ARABIA TOWARDS THE RESPONSIBILITIES AND SERVICES PROVIDED BY THE PHARMACISTS

The objective of this study was to assess the general public’s perception and satisfaction on the roles, responsibilities and services provided by pharmacists in the Northern Border Region of Saudi Arabia. This cross-sectional study using a pretested and structured questionnaire was carried out from October 1, 2016 to January 31, 2017 among the general public (N = 600) of the Northern Border Region of the Kingdom of Saudi Arabia. The questionnaire was developed according to the scientific literature published worldwide. The questionnaire included questions related to the demographics of the participants, perception related questions and satisfaction related questions. A total of 600 participants were studied in this study. It was observed that the participants had a good level of perception regarding the roles and responsibilities of the pharmacists. The level of satisfaction with the services provided by the pharmacists was moderate to good. It was observed that about 34% of the population were not interested in discussing matters related to drugs with their pharmacist; about 50% of the participants consider a pharmacist a mere vendor / dispenser of drugs; and about 20% of the population did not provide the response with surety for questions related to perception and satisfaction. It has been concluded that the public of the Northern Border Region of Saudi Arabia has a good level of perception regarding the roles and responsibilities of the pharmacists. The level of satisfaction with the services provided by the pharmacists was moderate to good, and needs improvement. There is a need to organize pharmacy related seminars / workshops / awareness programs to improve the knowledge of the public of the studied region with respect to the perception of the pharmacy profession. Keywords: Perception, satisfaction, general public, Saudi Arabia, pharmacist

AWARENESS ABOUT THE DRUG SAFETY AND MEDICATION USE AMONG THE PREGNANT WOMEN OF THE NORTHERN BORDER REGION OF SAUDI ARABIA

The inappropriate drug use during the pregnancy may cause serious complications. However, the consumption of drugs during the pregnancy cannot be totally avoided because of the existing chronic illness that may require continuous treatment or the development of new medical conditions during pregnancy that require therapeutic intervention. The main objective of this study was to evaluate the awareness about the drug safety and medication use among the pregnant women of the Northern Border Region of the Kingdom of Saudi Arabia. This cross-sectional study was carried out using a pretested and structured questionnaire among the pregnant women (N = 50) of the rural area, near Arar City and Rafha City, of the Northern Border Region of the Kingdom of Saudi Arabia. The data obtained was analyzed using the Statistical Package for Social Sciences (SPSS) version 19. It was surprising to note that neither doctors nor the pharmacists provided full information about the medicine to more than 3/4th of the patients. This type of practice by the doctors and pharmacist may pose pregnancy related problems to the expecting mothers and may lead to serious consequences. There is an urgent need to take remedial actions regarding this issue by the concerned authorities of the Northen Border Region of the Kingdom of Saudi Arabia. Keywords: Awareness, Safety, Drug, Pregnancy, Northern Border, Saudi Arabia

Multiple Origins and Regional Dispersal of Resistant dhps in African Plasmodium falciparum Malaria

Cally Roper and colleagues analyze the distribution of sulfadoxine resistance mutations and flanking microsatellite loci to trace the emergence and dispersal of drug-resistant Plasmodium falciparum malaria in Africa

Raised plasma insulin level and homeostasis model assessment (HOMA) score in cerebral malaria: evidence for insulin resistance and marker of virulence

Objective: To study the glycaemic profile of patients with severe malaria (SM). Methods: For this purpose, 110 SM patients were recruited. Pre-treatment random blood glucose and plasma insulin were measured in a subset of donors. An ex-vivo experiment was developed for estimation of glucose consumption by parasitized erythrocytes. Results: Hyperglycaemia was frequent in SM but more commonly associated with cerebral malaria (CM), while hyperinsulinaemia was recognized in severe-malarial-hypotension (median, 25 %-75 %, 188.2, 93.8-336.8 pmol/L). The plasma insulin level was positively correlated with age (CC = 0.457, p < 0.001) and negatively with parasitaemia (CC = -0.368, p = 0.045). Importantly, fatal-CM was associated with hyperglycaemia (12.22, 6.5-14.6 mmol/L), hyperinsulinaemia (141.0, 54.0-186.8 pmol/L) and elevated homeostasis model assessment (HOMA) values. However, there was a trend of higher glucose consumption by parasites in CM compared with that in uncomplicated malaria (UM). Conclusion: Hyperglycaemia, hyperinsulinaemia and elevated HOMA are evidence for insulin resistance and possibly pancreatic B-cell dysfunction in fatal-CM

The implication of <it>dihydrofolate reductase </it>and <it>dihydropteroate synthetase </it>gene mutations in modification of <it>Plasmodium falciparum </it>characteristics

Abstract Background The Plasmodium falciparum dihydrofolate reductase (DHFR) and dihydropteroate synthetase (DHPS) are enzymes of central importance in parasite metabolism. The dhfr and dhps gene mutations are known to be associated with sulphadoxine/pyrimethamine (SP) resistance. Objective To investigate the effects of dhfr/dhps mutations on parasite characteristics other than SP resistance. Method Parasite infections obtained from 153 Sudanese patients with uncomplicated falciparum malaria treated with SP or SP + chloroquine, were successfully genotyped at nine codons in the dhfr/dhps genes by PCR-ELISA. Results & conclusion Mutations were detected in dhfr at N51I, S108N and C59R, and in at dhps at A/S436F, A437G, K540E and A581G, the maximum number of mutations per infection were five. Based on number of mutant codons per infection (multiplicity of mutation, MOM), the infections were organized into six grades: wild-types (grade 0; frequency, 0.03) and infections with MOM grades of 1 to 5, with the following cumulative frequency; 0.97, 0.931, 0.866, 0.719, 0.121, respectively. There was no significant association between the MOM and SP response. Importantly, immunity, using age as a surrogate marker, contributed significantly to the clearance of parasites with multiple dhfr/dhps mutations. However, these mutations have a survival advantage as they were associated with increased gametocytogenesis. The above implications of dhfr/dhps mutations were associated with MOM 2 to 5, regardless of the gene/codon locus.</p

The implication of dihydrofolate reductase and dihydropteroate synthetase gene mutations in modification of <em>Plasmodium falciparum</em> characteristics

BACKGROUND: The Plasmodium falciparum dihydrofolate reductase (DHFR) and dihydropteroate synthetase (DHPS) are enzymes of central importance in parasite metabolism. The dhfr and dhps gene mutations are known to be associated with sulphadoxine/pyrimethamine (SP) resistance. OBJECTIVE: To investigate the effects of dhfr/dhps mutations on parasite characteristics other than SP resistance. METHOD: Parasite infections obtained from 153 Sudanese patients with uncomplicated falciparum malaria treated with SP or SP + chloroquine, were successfully genotyped at nine codons in the dhfr/dhps genes by PCR-ELISA. RESULTS & CONCLUSION: Mutations were detected in dhfr at N51I, S108N and C59R, and in at dhps at A/S436F, A437G, K540E and A581G, the maximum number of mutations per infection were five. Based on number of mutant codons per infection (multiplicity of mutation, MOM), the infections were organized into six grades: wild-types (grade 0; frequency, 0.03) and infections with MOM grades of 1 to 5, with the following cumulative frequency; 0.97, 0.931, 0.866, 0.719, 0.121, respectively. There was no significant association between the MOM and SP response. Importantly, immunity, using age as a surrogate marker, contributed significantly to the clearance of parasites with multiple dhfr/dhps mutations. However, these mutations have a survival advantage as they were associated with increased gametocytogenesis. The above implications of dhfr/dhps mutations were associated with MOM 2 to 5, regardless of the gene/codon locus