DRUG UTILIZATION PATTERN IN AN INTENSIVE CARE UNIT AT A TERTIARY CARE TEACHING HOSPITAL IN OMAN

Objectives: To evaluate the drug prescribing trends in the ICU department and correlate them with the disease patterns and patients' outcomes.Methods: The case records of patients admitted to the ICU at Sultan Qaboos University Hospital (SQUH), a teaching hospital in Oman, during a 5-month period between June 1st to October 31st 2013 were analyzed. The variables collected included demographic and clinical characteristics as well as duration of hospitalization, indications and utilization of different drugs.Results: A total of 138 patients were evaluated with an average of age ‎46±19‎ years. The average length of stay at ICU‎ was ‎4.5±3.5 days. The‎ average number of drugs per prescription was ‎8.0±4.6‎. The most common route used was the parenteral route (66%) followed by the enteral route (25%). Anti-infective drugs were the most commonly prescribed class of drugs (25%) followed by gastrointestinal drugs (20%). Antibiotics accounted for 12% of the total drugs prescribed. Trauma was the most common indication for the admission to the ICU (22%).Conclusion: Drugs prescription patterns in the ICU appeared to be similar to those reported in previous studies. However, prescription protocols need to be addressed to guide appropriate use of drugs in the ICU setting.Â

Sensory texture of date fruits as a function of physicochemical properties and its use in date classification

Eight descriptive sensory textural attributes of whole date fruit were evaluated by twenty trained panel members and correlated with sixteen physicochemical properties. All sensory parameters, except gumminess, significantly correlated (Ps<0.05) with pectin, crude fibre, and moisture content. In addition, sensory hardness, cohesiveness, elasticity, and resilience correlated significantly with length of whole fruit (P<0.05), sensory adhesiveness with glucose content (P<0.05), sensory chewiness with mass of whole fruit (P<0.05), and sensory gumminess with fructose, glucose, and total sugar content (P<0.10). Sweetness, however, correlated only with moisture content (P<0.05). CA and the biplot (i.e. including all products, their sensory texture and physicochemical attributes) generated through PCA recognized three groups of dates as hard-chewy, soft-(medium-chewy), and soft-(non-adhesive)

Combination therapy: the next opportunity and challenge of medicine

From an historical point of view, combination therapy was the basis for the care of important diseases like infection diseases or cancer. Today the "cocktail drug" of the Highly Active Anti Retroviral Therapy (HAART) has reduced the death for HIV infection changing the outcome of such disease. Moreover, the combination of different strategies changed the course of transplants (both in haematology and surgical transplant). Different diseases with high social impact including cardiovascular, metabolic (obesity, hypercholesterolaemia and diabetes) and autoimmune diseases, have better results with combinations of different drug classes of drugs. After recent successes in the immunotherapy field (Sepuleucel-T, ipilimumab) and the new promising small molecule therapies, cancer should be the next challenge for combination strategies

A survey of community members' perceptions of medical errors in Oman

<p>Abstract</p> <p>Background</p> <p>Errors have been the concern of providers and consumers of health care services. However, consumers' perception of medical errors in developing countries is rarely explored. The aim of this study is to assess community members' perceptions about medical errors and to analyse the factors affecting this perception in one Middle East country, Oman.</p> <p>Methods</p> <p>Face to face interviews were conducted with heads of 212 households in two villages in North Al-Batinah region of Oman selected because of close proximity to the Sultan Qaboos University (SQU), Muscat, Oman. Participants' perceived knowledge about medical errors was assessed. Responses were coded and categorised. Analyses were performed using Pearson's χ², Fisher's exact tests, and multivariate logistic regression model wherever appropriate.</p> <p>Results</p> <p>Seventy-eight percent (n = 165) of participants believed they knew what was meant by medical errors. Of these, 34% and 26.5% related medical errors to wrong medications or diagnoses, respectively. Understanding of medical errors was correlated inversely with age and positively with family income. Multivariate logistic regression revealed that a one-year increase in age was associated with a 4% reduction in perceived knowledge of medical errors (CI: 1% to 7%; p = 0.045). The study found that 49% of those who believed they knew the meaning of medical errors had experienced such errors. The most common consequence of the errors was severe pain (45%). Of the 165 informed participants, 49% felt that an uncaring health care professional was the main cause of medical errors. Younger participants were able to list more possible causes of medical errors than were older subjects (Incident Rate Ratio of 0.98; p < 0.001).</p> <p>Conclusion</p> <p>The majority of participants believed they knew the meaning of medical errors. Younger participants were more likely to be aware of such errors and could list one or more causes.</p

A single-center comparative study of lung ultrasound versus chest computed tomography during the COVID-19 era

Background: Lung ultrasound (LUS) is a bedside imaging tool that has proven useful in identifying and assessing the severity of pulmonary pathology. The aim of this study was to determine LUS patterns, their clinical significance, and how they compare to CT findings in hospitalized patients with coronavirus infection. Methods: This observational study included 62 patients (33 men, age 59.3±15.9 years), hospitalized with pneumonia due to COVID-19, who underwent chest CT and bedside LUS on the day of admission. The CT images were analyzed by chest radiographers who calculated a CT visual score based on the expansion and distribution of ground-glass opacities and consolidations. The LUS score was calculated according to the presence, distribution, and severity of anomalies. Results: All patients had CT findings suggestive of bilateral COVID-19 pneumonia, with an average visual scoring of 8.1±2.9%. LUS identified 4 different abnormalities, with bilateral distribution (mean LUS score: 26.4±6.7), focal areas of non-confluent B lines, diffuse confluent B lines, small sub-pleural micro consolidations with pleural line irregularities, and large parenchymal consolidations with air bronchograms. LUS score was significantly correlated with CT visual scoring (rho = 0.70; p<0.001). Correlation analysis of the CT and LUS severity scores showed good interclass correlation (ICC) (ICC =0.71; 95% confidence interval (CI): 0.52–0.83; p<0.001). Logistic regression was used to determine the cut-off value of ≥27 (area under the curve: 0.97; 95% CI: 90-99; sensitivity 88.5% and specificity 97%) of the LUS severity score that represented severe and critical pulmonary involvement on chest CT (CT: 3-4). Conclusion: When combined with clinical data, LUS can provide a potent diagnostic aid in patients with suspected COVID-19 pneumonia, reflecting CT findings. n-commercial use o. ©Copyright: the Author(s), 202