SIMPLE METHOD FOR OPTIMIZATION OF HEPARIN AND ENOXAPARIN DETECTION USING AGAROSE GEL ELECTROPHORESIS

Objective: A simple gel electrophoresis method for low-molecular-weight heparins (LMWH) is required for use in a variety of laboratories to allow further identification and purification. This study aimed to optimize the detection of heparin and enoxaparin (low-molecular-weight heparin by gel electrophoresis. Methods: Several gel electrophoresis conditions were tested to optimize the detection of enoxaparin by using a simple method with a modified Volpi’s approach. Multiple gel thicknesses, voltage settings, and enoxaparin concentrations were tested in the optimization procedure. Enoxaparin was purchased from a local supplier as pre-filled pharmaceutical injections. Highly purified 0.5% and 1.0% agarose gels were prepared and a series of enoxaparin concentrations was added to both gels for comparison and optimization. The 0.2% toluidine blue stain was prepared by the addition of 1 ml in an ethanol-water-acetic acid mixture (50:49:1; v/v/w). The staining process comprised two steps: first, toluidine blue was added for 30 min and destained overnight in the solvent mixture. Subsequently, the following morning, the second step was conducted, in which the gel was restained for 30 min with the same concentration of toluidine blue. We continued to stain the gel until the bands were visible. Results: The gel electrophoresis results showed that clearest and sharpest bands were obtained using 65–75 mAh and 85 V settings. At 95 mAh, the bands were slightly washed out. Conclusion: This study successfully facilitated the detection of enoxaparin, a LMWH, and heparin in the laboratory by using simple tools and techniques available in most laboratories

Strategic analysis of clinical pharmacy education in Saudi Arabia

Purpose: To analyze the strategic position of clinical pharmacy education in Saudi Arabia and ensure that it meets the needs of the current industry in the country.Methods: A comprehensive and structured analysis of strengths, weaknesses, opportunities, and threats (SWOT) was performed with more than 100 clinical pharmacists, academic staff, and students as participants. An internal factor evaluation (IFE), external factor evaluation (EFE), and SWOT matrix were conducted to compare the provisions of the current system with market needs.Results: The analysis involved more than 40 academic staff members, 35 clinical pharmacists, 50 students, and several administrative staff members. The EFE and IFE were calculated as 2.06 and 2.2, respectively, and were lower than the accepted international standard. The internal and external analyses involved 37 and 20 items, respectively. Finally, a SWOT matrix was constructed to help for proposing the strategies. Several strategies were recommended to address eventual shortcomings.Conclusion: The great paradigm shifts in the pharmaceutical market warrant an equal paradigm shift in clinical pharmacy education. More strategic data are needed to further analyze the market in the next five to ten years. Adopting the current educational modality to best match the needs of the pharmaceutical market is also essential. Keywords: Clinical pharmacy, Education, SWOT analysis, Strategic plannin

Impact of Computer-Aided Warfarin Dosing in a Saudi Arabian Cardiac Centre

Purpose: To compare the efficacy of computer-aided dosing using Coagclinic (a web-based software) with physician dosing in patients receiving warfarin for various cardiac indications.Methods: In order to calculate the effectiveness of physician managed anticoagulation dosing, we calculated the “percentage of time international normalized ratio, INR, was in the therapeutic range" (TTR) for a random sample of 70 patients in the center. For each patient, 4 INR values were taken at 4 consecutive visits, before and after the installation of Coagclinic. Data on the doses given by physicians were collected at each visit and c omp ar ed them with the pharmacy-based computer aided dosing system data.Results: After performing paired samples t-test of doses based on the physician group with those based on the computer system (mean -1.5654 ± 2.09 ), a statistically significant difference was found (p < 0.015). Furthermore, the patients kept at TTR by physicians amounted to 26 % compared to 70 % by the software.Conclusion: The difference between TTR managed by physicians and those managed using CoagClinic™ software is statistically significant. It appears that the software improves the effectiveness of warfarin dosing in patients.Keywords: Anticoagulation, Computer dosing, Physician dosing, Cardiac, Warfarin

Cost Analysis of Medications Used in Upper Respiratory Tract Infections and Prescribing Patterns in University Sans Malaysia, Penang, Malaysia

Purpose: To conduct a cost analysis, a narrow cost-utility study, for upper respiratory tract infection medications in University Sans Malaysia’s clinics.Methods: Retrospective analysis was done for all medical claims of upper respiratory tract infections in the period 2008 - 2009. The study was done in the clinics under University Sains Malaysia. A total of 302 patients  suffering from upper respiratory tract infection were enrolled. Cost analysis of the pattern of antibiotic prescriptions for upper respiratory tract infections was done. For cost analysis, costs were calculated based on the acquisition cost from the perspective of the medical center (USM) as the provider.Results: The research results states that there were 90% among the patients were prescribed an antibiotic, 81 percent were prescribed an  antihistamine, 81 percent were prescribed an analgesic, and 21 percent were prescribed a mucolytic or an expectorant.Conclusion: In comparison to the previously revised researchers, the percentage of the prescribed antibiotics is very high which is unacceptable. A tremendous amount of expenditure and other adverse events can be avoided by halting this behavior. A local guideline for prescribing antibiotics and implementing the same is the need of the hour.Keywords: Prescribing patterns, Cost analysis, Upper respiratory tract,  Infections, Antibiotic

Prescribing Practices and Cost of Drugs for Peptic Ulcer in a Primary Health Center in Pulau Penang, Malaysia

Purpose: Description of the prescribing patterns of gastric acid suppressant treatment in peptic ulcer disease and the cost analysis in a tertiary health center in MalaysiaMethods: A cross sectional retrospective study was conducted at a Universiti Sans Malaysia (USM) Health Center, Clinic, Malaysia. Convenience sampling was used to include 100 peptic ulcer patients.Results: Sixty three percent of the patients were male and 37 % female. The majority of the patients were Malay (71 %) and mean age was 46 ± 9.7 years. The most frequently prescribed monotherapy antiulcer drugs were ranitidine (83 %) and omeprazole (17 %), while for combination therapy (with antacids), it was ranitidine (85 %). The average cost of anti-ulcer drug therapy was 15.54 Ringgit Malaysian (RM), i.e., (USD 4.98) for omeprazole and RM 4.62 (USD 1.48) for ranitidine.Conclusion: The practitioners in this study preferred to prescribe ranitidine much more frequently than omeprazole. Considering the cost burden of proton pump inhibitors (PPIs) and their relatively more adverse effects, this may be a cost-effective strategy, but the benefits of ranitidine in terms of therapeutic efficacy need to be ascertained.Keywords: Peptic ulcer, Gastric acid suppressant, H2 receptor antagonist, Proton pump inhibito

Reducing out-of-vocabulary in morphology to improve the accuracy in Arabic dialects speech recognition

This thesis has two aims: developing resources for Arabic dialects and improving the speech recognition of Arabic dialects. Two important components are considered: Pronunciation Dictionary (PD) and Language Model (LM). Six parts are involved, which relate to building and evaluating dialects resources and improving the performance of systems for the speech recognition of dialects. Three resources are built and evaluated: one tool and two corpora. The methodology that was used for building the multi-dialect morphology analyser involves the proposal and evaluation of linguistic and statistic bases. We obtained an overall accuracy of 94%. The dialect text corpora have four sub-dialects, with more than 50 million tokens. The multi-dialect speech corpora have 32 speech hours, which were collected from 52 participants. The resultant speech corpora have more than 67,000 speech files. The main objective is improvement in the PDs and LMs of Arabic dialects. The use of incremental methodology made it possible to check orthography and phonology rules incrementally. We were able to distinguish the rules that positively affected the PDs. The Word Error Rate (WER) improved by an accuracy of 5.3% in MSA and 5% in Levantine. Three levels of morphemes were used to improve the LMs of dialects: stem, prefix+stem and stem+suffix. We checked the three forms using two different types of LMs. Eighteen experiments are carried out on MSA, Gulf dialect and Egyptian dialect, all of which yielded positive results, showing that WERs were reduced by 0.5% to 6.8%

Factors associated with the willingness to quit smoking among a cohort of university students in the KSA

AbstractObjectivesThe aim of this study was to determine the predictors of the willingness to quit smoking among a cohort of male Saudi students.MethodsIn this cross-sectional study, a questionnaire was administered to a cohort of male students that were recruited from three institutes of higher education. Using the retrieved data, bivariate analysis and logistic regression tests were performed to assess the factors associated with the willingness to quit smoking.ResultsOf 467 participants, 24% of respondents were current smokers, while 65% of these smokers were willing to quit smoking. In the bivariate analysis, past attempts to quit smoking and the anti-smoking messages on TV and in newspapers were significantly associated with the willingness to quit smoking. Only one variable – past attempts to quit smoking – was a significant predictor of the willingness to quit smoking, as shown by the multivariate logistic regression analysis.ConclusionThe findings of this study indicate that Saudi male students who smoke are willing to quit smoking; having unsuccessfully attempted to quit smoking in the past, they are willing to try again. Successful programs should be developed for male university students in KSA to assist them in their quest to quit smoking and maintain cessation

Methadone Maintenance Therapy (MMT) in Malaysia: An observational clinical study

Background Methadone is widely used to treat opiate addiction, in particular heroin. Proper administration via drug optimisation is the only way to achieve net clinical outcomes. Aims This is an observational cross-sectional study, sought to observe the clinical response to a methadone maintenance therapy (MMT) program. Methods Setting: Four treatment clinics in Kuala Lumpur, Malaysia. Patients and methods: One-hundred and twenty-two methadone patients. Their demographic characteristics, medical history, methadone doses, duration in the program, and compliance rates were recorded. Main outcome measures: The opiate withdrawal scale was used to assess the severity of withdrawal symptoms. Results The mean methadone dose was 50mg (range, 20–160mg). The minimum recorded duration in the MMT program was three months, the maximum was 40 months, and the mean was seven months. 90 per cent of the patients were addicted to multiple substances; of those, 70 per cent were addicted to three or more substances. Many patients reported cravings and seeking behaviours while on methadone. Conclusion Gradual increments in methadone doses are relatively safe, but patients should be monitored daily. Doses should be increased to control withdrawal symptoms. Despite optimal dosing, cravings and drug-seeking behaviours may not be controlled in some patients, and an alternative to methadone may be an option

A cross-sectional study of the actual use of eye drops in a Saudi community

Purpose: To investigate the actual use of eye drops with respect to their administration, storage, and disposal in a community in Saudi Arabia.Methods: A cross-sectional observational survey was conducted online. All the relevant data were collected using a standardized questionnaire. The questionnaire consisted of three sections: demographic characteristics of the participants, attitude of participants with respect to the administration and storage of eye drops, and the participants’ understanding of the role of pharmacist in enhancing patients’ compliance with eye drop regimens.Results: A total of 720 participants were included in the study, viz, 229 males (31.8 %) and 491 females (68.2 %). Majority of the participants (82.5 %) indicated that they avoided touching their eyes with the bottle tip. Likewise, most participants (90.8 %) reported that they applied eye ointment after administering eye drops while 30.6 % allowed an interval of < 5 min between eye drop and ointment administration. However, 30.5 % of the participants gave an interval of 5 – 10 min between eye drop and ointment treatment. Furthermore, 32.5 % reported that they consistently washed their hands before administering eye drops, while only 29.6 % occasionally washed their hands.Conclusion: These results indicate that all the patients used eye drops improperly at some point in time, and thus, there is a need for counselling on the appropriate use of eye drops as an essential step towards successful treatment.Keywords: Eye drops, Ophthalmic preparations, Adherence, Instillatio

INVESTIGATION OF THE CLINICAL SIGNIFICANCE OF ESCITALOPRAM-INDUCED ELECTROCARDIOGRAPHIC CHANGES IN MEN: A PILOT OBSERVATIONAL STUDY

Objective: We sought to investigate the clinical significance of secondary electrocardiographic (ECG) changes in men after using escitalopram. Methods: This pilot observational cohort study recruited male patients taking escitalopram for at least 6 mo in Mental Hospital of Qassim. All patients underwent a 12-lead ECG examination. We also measured the heart rate (HR), QTc, and QRS interval. Data on all related medical conditions and medications were recorded. Results: Fifty-three men were recruited, with a mean age of 37.39±8.39 y: 34.4% and 31.1% of these patients were taking escitalopram for depression and anxiety, respectively. The mean dose of escitalopram was 14.35 mg. Observations showed that 20.9% of the patients taking escitalopram had a fast HR (>100 beats/min [bpm]), indicative of sinus tachycardia, whereas 11.4% of patients had a slow HR (<60 bpm). The mean QT and QTc in patients taking escitalopram were 366.62±28.69 and 398.92±16.15 ms, respectively. Conclusion: Low doses of escitalopram resulted in minimal clinically significant changes. Thus, patients should be monitored when doses are escalated further