El patrón de prescripción de los fármacos antihipertensivos en los pacientes diabéticos de la Provincia del Sur, Reino de Arabia Saudita

Background. Hypertension is extremely prevalent in patients with diabetes. Limited data exist on utilizationpatterns of antihypertensive in this population are consistent with evidence-based practice guidelines.Objective. To evaluate utilization patterns of antihypertensive agents among diabetic patients with hypertension.Design. Retrospective descriptive cross sectional.Patients / Participants. 149 patients with diabetes and hypertension from outpatient department at FamilyMedicine Hospital, Ahaderfieda. Khamis Mushait, K.S.A.Results. Over 43% of patients were receiving calcium channel blockers (CCB), 36.2 % of received angiotensinconverting enzyme inhibitors (ACEI), followed by angiotensin receptor blockers (ARBs) (34.9%),diuretics (34.2%) and β -blockers (16.2%). Patients on monotherapy were mostly receiving CCB (34.3%)and ACEI (29.9%). The majority (55.03%) of treated patients were on multidrug regimens. In patientswith coronary artery disease (CAD), a diuretic with ACEI (25%) and calcium channel blocker with angiotensinreceptor blocker (25%) was most commonly prescribed.Conclusions. Patterns of antihypertensive therapy were generally consistent with international guidelines.Areas of improvement include increasing ACEI/ARB and diuretic use, decreasing the number ofuntreated patients, and increasing the proportion of patients with controlled BP in this population.Antecedentes. La hipertensión es muy frecuente en los pacientes con diabetes. Existen datos limitadossobre los patrones de utilización de antihipertensivos en esta población consistentes con las guías depráctica basadas en la evidencia.Objetivo. Evaluar los patrones de utilización de antihipertensivos en los pacientes diabéticos con hipertensión.Diseño. Estudio retrospectivo descriptivo transversalPacientes / Participantes. 149 pacientes con diabetes e hipertensión, del departamento de pacientes ambulatoriosen el Hospital de Medicina Familiar, Ahaderfieda. Khamis Mushait, K.S.A.Resultados. Más del 43% de los pacientes estaban recibiendo bloqueadores del canal de calcio (CCB),el 36,2% recibían inhibidores de la enzima convertidora de angiotensina (IECA), seguido de los bloqueadoresde los receptores de angiotensina (BRA) (34,9%), diuréticos (34,2%) y bloqueadores β (16,2 %).Los pacientes en monoterapia fueron la mayoría recibiendo CCB (34,3%) e IECA (29,9%). La mayoría(55,03%) de los pacientes tratados se encontraban en regímenes de múltiples fármacos. En los pacientes con enfermedad de la arteria coronaria (CAD), se les prescribió con mayor frecuencia diurético con IECA (25%) y bloqueador de canales de calcio con bloqueador del receptor de angiotensina (25%).Conclusiones. Los patrones de utilización de antihipertensivos fueron generalmente consistentes con las directrices internacionales. Las áreas de mejora incluyen el aumento de IECA / ARB y el uso de diuréticos, disminuyendo el número de pacientes no tratados, y el aumento de la proporción de pacientes con PA controlada en esta población

Hepatoprotective effect of combined extracts of Andrographis paniculata, Boerhaviadiffusa, Eclipta alba and Picrorhiza kurroa on carbon tetrachloride andparacetamol-induced hepatotoxicity in rats

Extracts obtained from Andrographis paniculata, Boerhavia diffusa, Eclipta alba and Picrorhiza kurroa were mixed in an equal ratio and the combined extract was evaluated for the hepatoprotective activity against carbon tetrachloride and paracetamol induced hepatotoxicity in rats. The hepatotoxicants increased the levels of transaminases, total bilirubin, triglycerides and decreased the level of albumin in the serum of rat. Liver homogenate of the rats showed an increase in the lipid peroxidation level and reduction in the levels of glutathione. The rats administered with the combined extract reversed the biochemical parameters reflecting the liver function. The combined extract showed significant (P < 0.05) dose dependent hepatoprotective activity against the toxicants as it was evident from the values of biochemical parameters when compared to silymarin administered animals. The results showed that the recovery exhibited by the combined extract at 400 mg/kg dose level was highest among other doses tested and was well comparable to silymarin treated rats

Association between Diabetes Consequences and Quality of Life among Patients with Diabetes Mellitus in the Aseer Province of Saudi Arabia

BACKGROUND: Diabetes mellitus (DM) is a major health-care burden worldwide. AIM: The aim of the study was to explore how the quality of life (QoL) of DM patients could be affected in the Aseer Province of the Kingdom of Saudi Arabia (KSA). METHODS: A cross-sectional, multicenter study in DM patients of both sexes and all age groups in Aseer Province were done using a validated self-administered questionnaire. The study was conducted between April 1, 2018 and November 25, 2018. RESULTS: A total of 418 patients completed our questionnaire, of which 240 (58%) were male and 178 (42%) were female. Furthermore, 50.23% were married and 104 (24.16%) were illiterate. We found that 403 (96.42%) respondents had type-2 DM and 315 (75.35%) had a family history of DM. In addition, 132 (31.57%) respondents were on monotherapy whereas only 61 (14.59%) were using combination therapy. Hypertension was the most prevalent comorbidity (166, 39.71%) and peripheral neuropathy the most prevalent complication of DM (157, 37.56%). CONCLUSION: DM had a significant impact on QoL among patients from Aseer Province in KSA. Our study underscores the importance of generating data on QoL among DM patients

Hepatoprotective effect of combined extracts of Andrographis paniculata, Boerhavia diffusa, Eclipta alba and Picrorhiza kurroa on carbon tetrachloride and paracetamol-induced hepatotoxicity in rats

545-551Extracts obtained from Andrographis paniculata, Boerhavia diffusa, Eclipta alba and Picrorhiza kurroa were mixed in an equal ratio and the combined extract was evaluated for the hepatoprotective activity against carbon tetrachloride and paracetamol-induced hepatotoxicity in rats. The hepatotoxicants increased the levels of transaminases, total bilirubin, triglycerides and decreased the level of albumin in the serum of rat. Liver homogenate of the rats showed an increase in the lipid peroxidation level and reduction in the levels of glutathione. The rats administered with the combined extract reversed the biochemical parameters reflecting the liver function. The combined extract showed significant (p<0.05) dose-dependent hepatoprotective activity against the toxicants as it was evident from the values of biochemical parameters when compared to silymarin administered animals. The results showed that the recovery exhibited by the combined extract at 400 mg/kg dose level was highest among other doses tested and was well comparable to silymarin-treated rats

El patrón de prescripción de los fármacos antihipertensivos en los pacientes diabéticos de la Provincia del Sur, Reino de Arabia Saudita

Background. Hypertension is extremely prevalent in patients with diabetes. Limited data exist on utilization patterns of antihypertensive in this population are consistent with evidence-based practice guidelines. Objective. To evaluate utilization patterns of antihypertensive agents among diabetic patients with hypertension. Design. Retrospective descriptive cross sectional. Patients / Participants. 149 patients with diabetes and hypertension from outpatient department at Family Medicine Hospital, Ahaderfieda. Khamis Mushait, K.S.A. Results. Over 43% of patients were receiving calcium channel blockers (CCB), 36.2 % of received angiotensin converting enzyme inhibitors (ACEI), followed by angiotensin receptor blockers (ARBs) (34.9%), diuretics (34.2%) and β -blockers (16.2%). Patients on monotherapy were mostly receiving CCB (34.3%) and ACEI (29.9%). The majority (55.03%) of treated patients were on multidrug regimens. In patients with coronary artery disease (CAD), a diuretic with ACEI (25%) and calcium channel blocker with angiotensin receptor blocker (25%) was most commonly prescribed. Conclusions. Patterns of antihypertensive therapy were generally consistent with international guidelines. Areas of improvement include increasing ACEI/ARB and diuretic use, decreasing the number of untreated patients, and increasing the proportion of patients with controlled BP in this population. Keywords: Hypertension, Diabetes, Antihypertensive agents.Antecedentes. La hipertensión es muy frecuente en los pacientes con diabetes. Existen datos limitados sobre los patrones de utilización de antihipertensivos en esta población consistentes con las guías de práctica basadas en la evidencia. Objetivo. Evaluar los patrones de utilización de antihipertensivos en los pacientes diabéticos con hipertensión . Diseño. Estudio retrospectivo descriptivo transversal. Pacientes / Participantes. 149 pacientes con diabetes e hipertensión, del departamento de pacientes ambulatorios en el Hospital de Medicina Familiar, Ahaderfieda. Khamis Mushait, K.S.A. Resultados. Más del 43% de los pacientes estaban recibiendo bloqueadores del canal de calcio (CCB), el 36,2% recibían inhibidores de la enzima convertidora de angiotensina (IECA), seguido de los bloqueadores de los receptores de angiotensina (BRA) (34,9%), diuréticos (34,2%) y bloqueadores β (16,2 %). Los pacientes en monoterapia fueron la mayoría recibiendo CCB (34,3%) e IECA (29,9%). La mayoría (55,03%) de los pacientes tratados se encontraban en regímenes de múltiples fármacos. En los pacientes con enfermedad de la arteria coronaria (CAD), se les prescribió con mayor frecuencia diurético con IECA (25%) y bloqueador de canales de calcio con bloqueador del receptor de angiotensina (25%). Conclusiones. Los patrones de utilización de antihipertensivos fueron generalmente consistentes con las directrices internacionales. Las áreas de mejora incluyen el aumento de IECA / ARB y el uso de diuréticos, disminuyendo el número de pacientes no tratados, y el aumento de la proporción de pacientes con PA controlada en esta población

Prescribing pattern of antihypertensive drugs in diabetic patients of Southern Province, Kingdom of Saudi Arabia

Background: Hypertension is extremely prevalent in patients with diabetes. Limited data exist on utilization patterns of antihypertensive in this population are consistent with evidence-based practice guidelines. Objective: To evaluate utilization patterns of antihypertensive agents among diabetic patients with hypertension. Design: Retrospective descriptive cross sectional. Patients / Participants: 149 patients with diabetes and hypertension from outpatient department at Family Medicine Hospital, Ahaderfieda. Khamis Mushait, K.S.A. Results: Over 43% of patients were receiving calcium channel blockers (CCB), 36.2 % of received angiotensin converting enzyme inhibitors (ACEI), followed by angiotensin receptor blockers (ARBs) (34.9%), diuretics (34.2%) and β -blockers (16.2%). Patients on monotherapy were mostly receiving CCB (34.3%) and ACEI (29.9%). The majority (55.03%) of treated patients were on multidrug regimens. In patients with coronary artery disease (CAD), a diuretic with ACEI (25%) and calcium channel blocker with angiotensin receptor blocker (25%) was most commonly prescribed. Conclusions: Patterns of antihypertensive therapy were generally consistent with international guidelines. Areas of improvement include increasing ACEI/ARB and diuretic use, decreasing the number of untreated patients, and increasing the proportion of patients with controlled BP in this population

THERAPEUTIC MANAGEMENT OF HYPERTENSION AND HYPERLIPIDEMIA IN TYPE-2 DIABETES MELLITUS PATIENTS IN SOUTHWESTERN REGION OF SAUDI ARABIA: A PHARMACIST PERSPECTIVE

  Objective: The main objective of this study was to evaluate the therapeutic management of hypertension (HTN) and hyperlipidemia in Type 2 diabetes mellitus (T2DM) patients in Aseer Diabetic Center, southwestern region of Saudi Arabia.Methods: This is a cross-sectional retrospective study in adult T2DM patients. A total number of 343 patient's records was randomly selected from the patient medical records section. Among the 343 T2DM patients, all were hyperlipidemics, and only 228 patients were Hypertensive. The collected raw data were recorded and statistically analyzed with Windows Microsoft Excel 2007. Descriptive statistics of mean, standard deviation, and frequencies were performed on the sample, one-way ANOVA was used to analyze the continuous data by using Graphpad software version-5; p≤0.05 was considered statistically significant.Result: The systolic blood pressure (BP) was found to have statistically significant difference (p≤0.0320) after treatment, but there is no statistical difference in diastolic BP. Glycemic control was found to have statistically significant difference (p≤0.0039). Most of the patients were treated with captopril -25 mg (angiotensin-converting enzyme inhibitor class drug). All the lipid profile high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and total cholesterol showed statistically significant difference after treatment except triglycerides. Most of the patients were prescribed with statins for hyperlipidemia.Conclusion: In this study, systolic HTN is better controlled with statistically significant difference compared to diastolic HTN. In the current study, lipid control was better than glycemic control. Updating of the drug formulary to have new therapeutic agents can improve the current status.Keywords: Hyperlipidemia, Hypertension, Saudi Arabia Southwestern region, Therapeutic management, Type 2 diabetes

Comparing knowledge, attitudes, and practices in cardiovascular disease prevention and health promotion between community and hospital pharmacists in Saudi Arabia: A cross-sectional study

Purpose: Saudi Arabia is one of the leading nations in the world in terms of the high frequency of chronic diseases and their associated risk factors. Knowledge and awareness are crucial for pharmacists to play an active role in the prevention of cardiovascular diseases (CVD). The current study assessed the pharmacists' knowledge, attitude, and practice to determine the potential differences with respect to their respective practice settings toward CVD prevention and related health promotions. Methods: It is a cross-sectional study targeted the registered pharmacists in the Kingdom of Saudi Arabia. An online questionnaire was prepared, and the link was circulated through various social media platforms. Descriptive statistics, multivariate linear regression analysis and chi square test were used to analyze the data accordingly. Results: A total of 324 pharmacists were included in the study. Among these, 157 (48.4 %) were community pharmacists, and the remaining were hospital pharmacists (51.6 %). No significant differences in knowledge scores were observed between community and hospital pharmacists. The mean attitude score among community and hospital pharmacists was found to be 26.40 ± 5.125 and 25.09 ± 5.393 respectively, which was statistically significant (p = 0.026). Similarly, the total practice scores across the settings were statistically significant (p = 0.02). Gender plays a significant role in terms of knowledge scores among both community and hospital pharmacists (p = 0.016 &amp; 0.029). Gender, professional practice experience, and number of prescriptions handled and prescriptions with CVD medications showed significant differences in the distribution of positive attitudes and good practice frequency between community and hospital pharmacists. Conclusion: It is evident that there is a deficiency in knowledge among hospital pharmacists compared to community pharmacists. Which indicates that there is a need for a rigorous continuous pharmacy education covering the fundamental aspects of CVD primary prevention and health promotion among pharmacists, given more focus on hospital pharmacists

School-Based Exercise and Life Style Motivation Intervention (SEAL.MI) on Adolescent’s Cardiovascular Risk Factors and Academic Performance: Catch Them Young

There are shreds of evidence of shared biological mechanisms between obesity and hypertension during childhood intoadulthood, and loads of research literature has proven that it will profoundly cost nations’ economies and health if neglected. The prevention and early diagnosis of cardiovascular risk factors such as overweight and hypertension is an essential strategy for control, effective treatment and prevention of its’ complications. The study aims to assess the effect of school-based Exercise and Lifestyle Motivation Intervention (SEAL-MI) on adolescents’ cardiovascular risk factors and academic performance. An experimental study was conducted among 1005 adolescents—520 and 485 were randomly selected for the control and study groups, respectively.A structured interview questionnaire was used to collect demographic details and data related to dietary habits, physical activity, sleep qualityand academic performance. The study group adolescents were given the SEAL-MI for six months, including a school-based rope exercise for 45 min per day for 5 days a week and a motivation intervention related to dietary habits, physical activity, and sleep. Post tests-1 and 2 were done after 3 and 6 months of intervention.The prevalence of overweight among adolescents was 28.73%, and prehypertension was 9.26%. Among overweight adolescents, the prevalence of prehypertension was found to be very high (32.25%). There was a significant weight reduction in post-intervention B.P. (p = 0.000) and improvement in dietary habits, physical activity, sleep (p = 0.000), and academic performance. A significant positive correlation was found between BMI and SBP (p = 0.000) and BMI and academic performance (p = 0.003). The linear regression analyses revealed that the gender (ß: 0.47, 95% CI: 0.39, 0.81), age (ß: 0.39, 95% CI: 0.17, 0.46), family income (ß: 0.2, 95% CI: 0.41, 0.5), residence (ß: 0.19, 95% CI: 0.01, 0.27), and type of family (ß: 0.25, 95% CI: 0.39, 0.02) had the strongest correlation with the BMI of the adolescents. Additionally, Mother’s education (ß: 0.35, 95% CI: 0.18, 0.59) had the strongest correlation with the SBP of the adolescents. In contrast, the DBP was negatively persuaded by age (ß: −0.36, 95% CI: 1.54, 0.29) and gender (ß: −0.26, 95% CI: 1.34, 0.12) of the adolescents. Regular practice of rope exercise and lifestyle modification such as diet, physical activity, and quality sleep among adolescents prevent and control childhood CVD risk factors such asoverweight and hypertension. The SEAL-MI may lead to age-appropriate development of adolescents as well as improve their academic performance and quality of life. Giving importance to adolescents from urban habitats, affluent, nuclear families, and catching them young will change the disease burden significantly