Medication prescribing errors in a pediatric inpatient tertiary care setting in Saudi Arabia

<p>Abstract</p> <p>Background</p> <p>Medication errors (MEs) are among the most common types of medical errors and one of the most common and preventable causes of iatrogenic injuries. The aims of the present study were; (i) to determine the incidence and types of medication prescribing errors (MPEs), and (ii) to identify some potential risk factors in a pediatric inpatient tertiary care setting in Saudi Arabia.</p> <p>Findings</p> <p>A five-week retrospective cohort study identified medication errors in the general pediatric ward and pediatric intensive care unit (PICU) at King Abdulaziz Medical City (KAMC) through the physical inspection of physician medication orders and reviews of patients' files. Out of the 2,380 orders examined, the overall error rate was 56 per 100 medication orders (95% CI: 54.2%, 57.8%). Dose errors were the most prevalent (22.1%). These were followed by route errors (12.0%), errors in clarity (11.4%) and frequency errors (5.4%). Other types of errors were incompatibility (1.9%), incorrect drug selection (1.7%) and duplicate therapy (1%). The majority of orders (81.8%) had one or more abbreviations. Error rates were highest in prescriptions for electrolytes (17.17%), antibiotics (13.72%) and bronchodilators (12.97%). Medication prescription errors occurred more frequently in males (64.5%), infants (44.5%) and for medications with an intravenous route of administration (50.2%). Approximately one third of the errors occurred in the PICU (33.9%).</p> <p>Conclusions</p> <p>The incidence of MPEs was significantly high. Large-scale prospective studies are recommended to determine the extent and outcome of medication errors in pediatric hospitals in Saudi Arabia.</p

The Impact of an Educational Program Based on Brain-Based Learning in Improving the Skills of Creative Thinking and Achievement in Social and National Education in Jordan

This study aimed to investigate the impact of an educational program based on brain-based learning in improving the creative thinking and academic achievement in the social studies and civics education among the third basic grade students in Jordan. The researcher adopted the semi-experimental method, and the study sample consisted of 50 third grade students of Omar Ibn Al-Khattab basic public school for Boys. The sample was purposive sample and then was assigned randomly into two the experimental and control groups. The experimental group which was provided the developed study unit consisted of 25 students, and similarly, the control group, which was presented the regular method. The study results showed statistically significant differences (=.05) in creative thinking skills: fluency, flexibility and authenticity, as well as academic achievement in the social studies and civic education among the third-graders in favor of the experimental group. The difference may be attributed to the brain-based education program

Effect of lung compliance and endotracheal tube leakage on measurement of tidal volume

INTRODUCTION: The objective of this laboratory study was to measure the effect of decreased lung compliance and endotracheal tube (ETT) leakage on measured exhaled tidal volume at the airway and at the ventilator, in a research study with a test lung. METHODS: The subjects were infant, adult and pediatric test lungs. In the test lung model, lung compliances were set to normal and to levels seen in acute respiratory distress syndrome. Set tidal volume was 6 ml/kg across a range of simulated weights and ETT sizes. Data were recorded from both the ventilator light-emitting diode display and the CO(2)SMO Plus monitor display by a single observer. Effective tidal volume was calculated from a standard equation. RESULTS: In all test lung models, exhaled tidal volume measured at the airway decreased markedly with decreasing lung compliance, but measurement at the ventilator showed minimal change. In the absence of a simulated ETT leak, calculation of the effective tidal volume led to measurements very similar to exhaled tidal volume measured at the ETT. With a simulated ETT tube leak, the effective tidal volume markedly overestimated tidal volume measured at the airway. CONCLUSION: Previous investigators have emphasized the need to measure tidal volume at the ETT for all children. When ETT leakage is minimal, it seems from our simulated lung models that calculation of effective tidal volume would give similar readings to tidal volume measured at the airway, even in small patients. Future studies of tidal volume measurement accuracy in mechanically ventilated children should control for the degree of ETT leakage

Liver diseases in pregnancy and outcomes: A retrospective study from Saudi Arabia

Liver diseases unique to pregnancy are common causes of both maternal and fetal mortality and morbidity. We retrospectively studied liver diseases unique to pregnancy, including hyperemesis gravidarum (HG); intrahepatic cholestasis of pregnancy; eclampsia; preeclampsia; hemolysis, elevated liver enzymes, and a low platelets (HELLP) syndrome; and acute fatty liver of pregnancy. We collected data including maternal age, gestational weeks at presentation and at delivery, mode of delivery, number of parity, and laboratory markers at 0, 1 week, and within 24 hours after delivery; from 112 patients (mean age, 29.8 years) from April 2015 - March 2017. SPSS 22 was used for statistical analysis. We The commonest liver disease in pregnancy was pre-eclampsia followed by HG. HG patients were younger compared with those with eclampsia and preeclampsia (P=0.025). Gestational week at presentation and the week of delivery were significantly greater for preeclampsia/eclampsia and HELLP patients compared to HG. Primigravida represented 42.9% of our patients. Fetal complications were reported in 29 (26%) of cases. Of those, 17 had fetal or neonatal death. Fourteen mothers (12.5%) had ICU admission. Pregnancy related liver diseases are important causes for fetal mortality and morbidity. Maternal age and gestational weeks are important predictors of fetal and maternal outcomes. &nbsp; Les maladies du foie propres à la grossesse sont des causes courantes de mortalité et de morbidité maternelles et foetales. Nous avons étudié rétrospectivement les maladies du foie propres à la grossesse, y compris l'hyperemesis gravidarum (HG); cholestase intrahépatique de la grossesse; éclampsie; prééclampsie; hémolyse, élévation des enzymes hépatiques et syndrome de bas taux de plaquettes (HELLP); et stéatose hépatique aiguë de la grossesse. Nous avons recueilli des données comprenant l'âge maternel, les semaines de gestation à la présentation et à l'accouchement, le mode d'accouchement, le nombre de parité et les marqueurs de laboratoire à 0, 1 semaine et dans les 24 heures suivant l'accouchement; de 112 patients (âge moyen, 29,8 ans) d'avril 2015 à mars 2017. SPSS 22 a été utilisé pour l'analyse statistique. Nous La maladie hépatique la plus courante pendant la grossesse était la pré-éclampsie suivie de l'HG. Les patients atteints de HG étaient plus jeunes que ceux atteints d'éclampsie et de prééclampsie (P = 0,025). La semaine gestationnelle lors de la présentation et la semaine de l'accouchement étaient significativement plus importantes pour les patients prééclampsie / éclampsie et HELLP par rapport à HG. Primigravida représentait 42,9% de nos patients. Des complications foetales ont été rapportées dans 29 (26%) des cas. Parmi ceux-ci, 17 ont eu un décès foetal ou néonatal. Quatorze mères (12,5%) ont été admises à l'USI. Les maladies hépatiques liées à la grossesse sont des causes importantes de mortalité et de morbidité foetales. L'âge maternel et les semaines de gestation sont des prédicteurs importants des issues foetales et maternelles. &nbsp

Viridiflorol Induces Anti-Neoplastic Effects on Breast, Lung, and Brain Cancer Cells Through Apoptosis

All active natural molecules are not fully exploited as therapeutic agents, causing delays in the advancement of anticancer drug discovery. Viridiflorol is a natural volatile element that may work as anti-cancer compound. We tested the anticancer properties of viridiflorol at different concentrations ranging from 0.03 to 300 μM in vitro on three cancer cells including breast (MCF-7), lung (A549) and brain (Daoy). The cancer cells responses were documented after treatment using MTT and Annexin V assays. Viridiflorol showed cytotoxic effects against all tested cell lines, reducing cell viability in a concentration-dependent manner with variable IC50 values. Daoy and A549 cell lines were more sensitive to viridiflorol when compared with temozolomide and doxorubicin, respectively. Viridiflorol demonstrated the highest anticancer activity against the Daoy cells with an estimated IC50 of 0.1 µM followed by MCF-7 at 10 µM, and A549 at 30 µM. In addition, upon exposure to concentrations ranging from 30 µM to 300 µM of viridiflorol, early and late apoptotic cell death was induced in a concentration dependent manner in Daoy (55.8%-72.1%), MCF-7 (36.2%-72.7%) and A459 (35%-98.9%) cell lines, respectively. In conclusion, viridiflorol demonstrates cytotoxic and apoptotic ability in three different cancer cell lines (brain, breast and lung)

Is diagnosing exposed dentine a suitable tool for grading erosive loss?

Quantifying tooth wear in general and erosion in particular mostly is made by distinguishing between lesions restricted to enamel and lesions reaching the underlying dentine. Various scores for grading have been used, but in all systems, higher scores are given in cases of exposed dentine, thus, indicating a more severe stage of the condition. Clinical diagnosis of exposed dentine is made by assessing changes in colour or optical properties of the hard tissues. This paper aims to review the literature and discuss critically problems arising form this approach. It appears that classifying the severity of erosion by the area or depth of exposed dentine is difficult and poorly reproducible, and taking into account the variation of enamel thickness, the amount of tissue lost often is not related simply to the area of exposed dentine. There has still been very little longitudinal investigation of the significance of exposed dentine as a prognostic indicator. Further work and discussion is needed to reevaluate the explanative power of current grading procedures

The availability of novelty sweets within the high school fringe

Background Reducing sugar consumption is a primary focus of current global public health policy. Achieving 5% of total energy from free sugars will be difficult acknowledging the concentration of free sugars in sugar sweetened beverages, confectionery and as hidden sugars in many savoury items. The expansion of the novelty sweet market in the UK has significant implications for children and young adults as they contribute to dental caries, dental erosion and obesity. Objective To identify the most available types of novelty sweets within the high school fringe in Cardiff, UK and to assess their price range and where and how they were displayed in shops. Subjects and methods Shops within a ten minute walking distance around five purposively selected high schools in the Cardiff aea representing different levels of deprivation were visited. Shops in Cardiff city centre and three supermarkets were also visited to identify the most commonly available novelty sweets. Results The ten most popular novelty sweets identified in these scoping visits were (in descending order): Brain Licker, Push Pop, Juicy Drop, Lickedy Lips, Big Baby Pop, Vimto candy spray, Toxic Waste, Tango candy spray, Brain Blasterz Bitz and Mega Mouth candy spray. Novelty sweets were located on low shelves which were accessible to all age-groups in 73% (14 out of 19) of the shops. Novelty sweets were displayed in the checkout area in 37% (seven out of 19) shops. The price of the top ten novelty sweets ranged from 39p to £1. Conclusion A wide range of acidic and sugary novelty sweets were easily accessible and priced within pocket money range. Those personnel involved in delivering dental and wider health education or health promotion need to be aware of recent developments in children's confectionery. The potential effects of these novelty sweets on both general and dental health require further investigation

The prevalence of dental erosion and associated risk factors in 12-13-year-old school children in Southern China

<p>Abstract</p> <p>Background</p> <p>Dental erosion has been investigated in developed and developing countries and the prevalence varies considerably in different countries, geographic locations, and age groups. With the lifestyle of the Chinese people changing significantly over the decades, dental erosion has begun to receive more attention. However, the information about dental erosion in China is scarce. The purpose of this study was to explore the prevalence of dental erosion and associated risk factors in 12-13-year-old school children in Guangzhou, Southern China.</p> <p>Methods</p> <p>This cross-sectional survey was performed by two trained, calibrated examiners. A stratified random sample of 12-13-year-old children (774 boys and 725 girls) from 10 schools was examined for dental erosion using the diagnostic criteria of Eccles and the index of O'Sullivan was applied to record the distribution, severity, and amount of the lesions. Data on the socio-economic status, health behaviours, and general health involved in the etiology of dental erosion were obtained from a self-completed questionnaire. The analyses were performed using SPSS software.</p> <p>Results</p> <p>At least one tooth surface with signs of erosion was found in 416 children (27.3%). The most frequently affected teeth were the central incisors (upper central incisors, 16.3% and 15.9%; lower central incisors, 17.4% and 14.8%). The most frequently affected surface was the incisal or occlusal edge (43.2%). The loss of enamel contour was present in 54.6% of the tooth surfaces with erosion. Of the affected tooth surfaces, 69.3% had greater than one-half of the tooth surface was affected. The results from logistic regression analysis demonstrated that the children who were female, consumed carbonated drinks once a week or more, and those whose mothers were educated to the primary level tended to have more dental erosion.</p> <p>Conclusions</p> <p>Dental erosion in 12-13-year-old Chinese school children is becoming a significant problem. A strategy of offering preventive care, including more campaigns promoting a healthier lifestyle for those at risk of dental erosion should be conducted in Chinese children and their parents.</p