Medication errors in the Middle East countries: a systematic review of the literature

Background: Medication errors are a significant global concern and can cause serious medical consequences for patients. Little is known about medication errors in Middle Eastern countries. The objectives of this systematic review were to review studies of the incidence and types of medication errors in Middle Eastern countries and to identify the main contributory factors involved. Methods: A systematic review of the literature related to medication errors in Middle Eastern countries was conducted in October 2011 using the following databases: Embase, Medline, Pubmed, the British Nursing Index and the Cumulative Index to Nursing & Allied Health Literature. The search strategy included all ages and languages. Inclusion criteria were that the studies assessed or discussed the incidence of medication errors and contributory factors to medication errors during the medication treatment process in adults or in children. Results: Forty-five studies from 10 of the 15 Middle Eastern countries met the inclusion criteria. Nine (20%) studies focused on medication errors in paediatric patients. Twenty-one focused on prescribing errors, 11 measured administration errors, 12 were interventional studies and one assessed transcribing errors. Dispensing and documentation errors were inadequately evaluated. Error rates varied from 7.1% to 90.5% for prescribing and from 9.4% to 80% for administration. The most common types of prescribing errors reported were incorrect dose (with an incidence rate from 0.15% to 34.8% of prescriptions), wrong frequency and wrong strength. Computerised physician rder entry and clinical pharmacist input were the main interventions evaluated. Poor knowledge of medicines was identified as a contributory factor for errors by both doctors (prescribers) and nurses (when administering drugs). Most studies did not assess the clinical severity of the medication errors. Conclusion: Studies related to medication errors in the Middle Eastern countries were relatively few in number and of poor quality. Educational programmes on drug therapy for doctors and nurses are urgently needed

SIMIND Monte Carlo simulation of a single photon emission CT

In this study, we simulated a Siemens E.CAM SPECT system using SIMIND Monte Carlo program to acquire its experimental characterization in terms of energy resolution, sensitivity, spatial resolution and imaging of phantoms using ^99m Tc. The experimental and simulation data for SPECT imaging was acquired from a point source and Jaszczak phantom<b> .</b> Verification of the simulation was done by comparing two sets of images and related data obtained from the actual and simulated systems. Image quality was assessed by comparing image contrast and resolution.<b> </b> Simulated and measured energy spectra (with or without a collimator) and spatial resolution from point sources in air were compared. The resulted energy spectra present similar peaks for the gamma energy of ^99m Tc at 140 KeV. FWHM for the simulation calculated to14.01 KeV and 13.80 KeV for experimental data, corresponding to energy resolution of 10.01and 9.86&#x0025; compared to defined 9.9&#x0025; for both systems, respectively. Sensitivities of the real and virtual gamma cameras were calculated to 85.11 and 85.39 cps/MBq, respectively. The energy spectra of both simulated and real gamma cameras were matched. Images obtained from Jaszczak phantom, experimentally and by simulation, showed similarity in contrast and resolution. SIMIND Monte Carlo could successfully simulate the Siemens E.CAM gamma camera. The results validate the use of the simulated system for further investigation, including modification, planning, and developing a SPECT system to improve the quality of images

Dynamic Contrast Magnetic Resonance Imaging (DCE-MRI) and Diffusion Weighted MR Imaging (DWI) for Differentiation between Benign and Malignant Salivary Gland Tumors

Background: Salivary gland tumors form nearly 3% of head and neck tumors. Due to their large histological variety and vicinity to facial nerves, pre-operative diagnosis and differentiation of benign and malignant parotid tumors are a major challenge for radiologists. Objective: The majority of these tumors are benign; however, sometimes they tend to transform into a malignant form. Functional MRI techniques, namely dynamic contrast enhanced (DCE-) MRI and diffusion-weighted MRI (DWI) can indicate the characteristics of tumor tissue. Methods: DCE-MRI analysis is based on the parameters of time intensity curve (TIC) before and after contrast agent injection. This method has the potential to identify the angiogenesis of tumors. DWI analysis is performed according to diffusion of water molecules in a tissue for determination of the cellularity of tumors. Conclusion: According to the literature, these methods cannot be used individually to differentiate benign from malignant salivary gland tumors. An effective approach could be to combine the aforementioned methods to increase the accuracy of discrimination between different tumor types. The main objective of this study is to explore the application of DCE-MRI and DWI for assessment of salivary gland tumor types