Patterns of prescribing and utilization of asthma medications in a tertiary hospital in Dubai, United Arab Emirates

Purpose: To assess the prescribing patterns of asthma medications in a hospital in Dubai, United Arab Emirates (UAE) with regard to the demographic pattern of the population.Methods: One hundred fifty four patients, 83 male and 71 female, were randomly selected from the outpatient respiratory diseases clinic of a tertiary hospital in Dubai, UAE over a 3-month period. Patients were asked to complete a structured questionnaire and data were analyzed using STATA 12 software.Results: Most of the patients were within the age range of 0 – 10 years. About 86 % of the patients were overweight. Half of the patients were non-smokers while 51 % of them had a family history of asthma. About 54 % of the patients received multiple drug therapy of which two-drug combinations were widely prescribed (31 %). The most utilized drug classes were short acting β-agonists (42 %), xanthine drugs (16 %), leukotriene modifiers (14 %) and oral and intravenous corticosteroids (13 %). Statistical significant differences among the age groups (F = 2.33, p = 0.0275) were found.Conclusion: Primary prevention to reduce the level of exposure to common risk factors for asthma would be a vital step to control the disease. More resources should be channeled into educating physicians and patients on rational drug utilization to improve the quality of patients’ care.Keywords: Asthma, utilization of medicines, β-agonists, Xanthines, Leukotriene modifiers, Rational drug utilizatio

Development of coated beads for oral controlled delivery of cefaclor: In vitro evaluation

The aim of the present study was to develop and characterize coated chitosan-alginate beads containing cefaclor as controlled release delivery system. Coated cefaclor beads were prepared by solvent evaporation techniques. Beads were found to be intact and spherical in shape. Their particle size range was 1.05 to 2.06. The loading efficiency showed maximum value when the concentration of cefaclor, chitosan and PEG 400 was 10 % (m/V), 0.5 % (m/V) and 2 % (V/V), respectively. Best retardation of cefaclor release from chitosan-alginate beads was achieved by coating with 15 % of shellac in formula F19. A significant antimicrobial activity (p < 0.05) against Staphylococcus aureus and Klebsiella pneumoniae was observed for formula F19 compared to the standard antibiotic disc. Furthermore, the simulated plasma profile showed the superiority of F19 in sustaining drug release for more than 12 h. Therefore, shellac coated chitosan-alginate beads could be considered as a successful controlled release oral cefaclor dosage form

Development of novel spray coated soft elastic gelatin capsule sustained release formulations of nifedipine, bioavailability and bioequivalence of verapamil HCL controlled release formulations, pharmacokinetics of terbinafine after single oral doses in raptors

This dissertation describes the development of a new sustained release formulation of nifedipine. The new formulation was developed by coating commercially available immediate release soft elastic gelatin capsules using a spray coating technique with two different polymeric combinations. Dissolution studies were conducted and showed that controlled release of nifedipine was obtained by increasing the ratio of the water insoluble polymer in the coat and increasing the percent weight gain of the coating. Simulated plasma concentration versus time profiles after administration of 30 mg dose of selected formulations showed a prolonged nifedipine release with concentrations above the minimum effective concentration for up to 12 hours. Bioavailability and bioequivalence of tableted test formulation of verapamil HCL was determined in 8 volunteers and compared to Covera HS® under fed and fasting conditions. The 90% confidence intervals for individual percent ratios of the Cmax, AUC₀₋₅₈ and AUC₀ were not within the range of 80 - 125% in both fed fasted states, suggesting that these formulations are not bioequivalent. the bioavailability of verapamil from the new formulation was higher state but this effect was not statistically significant. Pharmacokinetics of terbinafine administered orally at single doses of 15, 30, 60 and 120 mg were determined in raptors to recommend an appropriate dosing scheduled for terbinafine in the treatment of Aspergillosis. Calculation of steady state trough terbinafine plasma concentration after administration of daily doses of 15 or 30 mg/day showed that 30 mg daily dose of terbinafine administered orally in raptors produces a steady state trough terbinafine plasma concentration above the minimum inhibitory concentration (MIC) of(0.8 1.6) µg/ml against aspregillus fumigatus. From the data, 30 mg per day oral dose of terbinafine should be the recommended dose for treatment of aspergillosis in raptors. Approximate pharmacokinetic linearity of terbinafine was demonstrated for AUC[subscript 0-t] in the dose range of 15 120 mg while non-linearity for Cmax in the same dose range was demonstrated using the power model

In Vitro Dissolution and In Vivo Bioavailability of Six Brands of Ciprofloxacin Tablets Administered in Rabbits and Their Pharmacokinetic Modeling

This study was undertaken to assess the in vitro dissolution and in vivo bioavailability of six brands of ciprofloxacin oral tablets available in the UAE market using rabbits. The in vitro dissolution profiles of the six ciprofloxacin products were determined using the USP dissolution paddle method. Pharmacokinetic modeling using compartmental and noncompartmental analysis was done to determine the pharmacokinetic parameters of ciprofloxacin after single-dose oral administration. In vitro release study revealed that the amount of ciprofloxacin released in 20 minutes was not less than 80% of the labeled amount which is in accordance with the pharmacopoeial requirements. All tested products are considered to be very rapid dissolving except for formulae A and D. Ciprofloxacin plasma concentration in rabbits was best fitted to a two-compartment open model. The lowest bioavailability was determined to be for product A (93.24%) while the highest bioavailability was determined to be for product E (108.01%). Postmarketing surveillance is very crucial to ensure product quality and eliminating substandard products to be distributed and, consequently, ensure better patient clinical outcome. The tested ciprofloxacin generic products distributed in the UAE market were proven to be of good quality and could be used interchangeably with the branded ciprofloxacin product

Adherence to Surgical Site Infection Guidelines in Cardiac Surgery in a Tertiary Hospital in Dubai, United Arab Emirates

Purpose: To assess the appropriateness and compliance of antibiotic prophylaxis practices in cardiac surgery in a tertiary hospital in United Arab Emirates (UAE) using three international guidelines. Methods: A retrospective study was performed by reviewing patients' files admitted for cardiac surgery between January 2008 and February 2010. The study evaluated the adherence of health care professionals to three international guidelines with regard to antibiotic prophylaxis. The guidelines were National Surgical Infection Prevention Project (NSIPP), Society of Thoracic Surgeons (STS) and American College of Cardiology/American Heart Association (ACC/AHA). Patients’ records were reviewed for antibiotics used for prophylaxis, frequency of administration, timing and number of doses. Results: A total of 92 patients were included in the study. Based on the international guidelines, only 89.1 and 79.3% of the patients received the recommended pre- and post-operative antibiotics, respectively. On the other hand, 93.5% of the patients received the right antibiotic dose while the total duration of all antimicrobial agents used for prophylaxis was concordant with the guidelines (48 h) in only 67.4% of the patients. Conclusion: Adherence to international antimicrobial prophylaxis guidelines for cardiac surgery was found to be suboptimal in the study hospital in Dubai. Various interventions are needed via developing local evidence-based protocols in collaboration with surgeons, and also to strengthen regulations for ensuring adherence to these guidelines

Deregulation of Mitosis Progression and Cytotoxic Effect Triggered in Allium Cepa L. Roots by Rubus Sancatus Schreber Extract

Abstract: Background and Aims: Medicinal plant extracts have been traditionally used in curing several diseases in folk medicine but several of them proved to cause cellular changes in many vital systems. Family Rosaceae demonstrated different biological activities in several previous investigations. The present study aims to assess the cytological and cellular effect of different concentrations of Rubus sanctus Schreber aqueous alcoholic extract (RsAAE) on Allium cepa L. root meristems using different techniques. Material and Methods: Cytological and cellular effect of different concentrations (1, 5&amp; 10 mg mL -1 ) of RsAAE for different duration of administration (3, 6&amp; 12h) on A. cepa L. root cells were studied using mitotic, ultrastructural and biochemical analyses. Result: The administration of different concentrations of RsAAE for different periods of exposure exhibited suppression of the mitotic and cell cycle progression on A. cepa root meristems. Several mitotic abnormalities were recorded. RsAAE enhanced deleterious changes on the cellular organelles of A. cepa root meristems leading to autolysis of the cells. Gene expression was changed as 10 de novo bands were produced as well as several bands were disappeared, these alterations were associated with a drastic inhibition of protein content. Discussion: The present study declared the prevalence mitostatic and cytotoxic effect of RsAAE on A. cepa root meristems. In spite of R. sanctus has valuable effects as a medicinal herb, it can enhance severe complications and destruction on the normal cells when it is used indecorously. [Sobieh Shaimaa Selmi, Tawab Sahar Abdelfattah and Fahmy Dina Mostafa. Deregulation of Mitosis Progression and Cytotoxic Effect Triggered in Allium Cepa L. Roots by Rubus Sancatus Schreber Extract. Life Sci J 2014;11(11

Influenza Vaccination: Healthcare Workers Attitude in Three Middle East Countries

Background: Healthcare workers (HCWs) pose a potential risk of transmitting communicable diseases in the hospital settings where they usually work. This study aims to determine the current influenza vaccination rates among HCWs in three Middle East countries namely United Arab Emirates (UAE), Kuwait and Oman, and also to identify the different variables associated with the noncompliance of HCWs to the recommendations of the Advisory Committee on Immunization Practices (ACIP) set in those countries. Methods: 1500 questionnaires were distributed to health care workers in the three countries during the period of July-October 2009. Results: Among 993 respondents, the vaccination rate was 24.7%, 67.2% and 46.4% in UAE, Kuwait and Oman, respectively. The different motivating factors that influenced the health care workers to take the vaccine was assessed and found that the most common factor that influenced their decision to take the vaccine was for their self protection (59%). On the other hand, the most common reason that discouraged HCWs to take the vaccine was &#8220;lack of time&#8221; as reported by 31.8% of the respondents. Other reasons for not taking the vaccine were unawareness of vaccine availability (29.4%), unavailability of vaccine (25.4%), doubts about vaccine efficacy (24.9%), lack of information about importance (20.1%) and concerns about its side effects (17.3%). Conclusions: influenza immunization by healthcare workers in the studied countries was suboptimal which could be improved by setting different interventions and educational programs to increase vaccination acceptance among HCWs.</p

Attitudes and Perceptions of Healthcare Providers and Medical Students Towards Clinical Pharmacy Services in United Arab Emirates

Purpose: To explore healthcare providers' (HCPs) and medical students’ attitudes to, and perceptions of the pharmaceutical services that clinical pharmacists can provide in United Arab Emirates. Methods: A total of 535 participants (265 HCPs and 270 medical students) were asked to complete a questionnaire over a period of three months (January through March 2009). Results: Almost three quarters of the students perceived that the clinical pharmacist is an important part of the healthcare team while 82% believed that clinical pharmacists can help improve the quality of medical care in hospitals. Eighty one percent of medical students expressed confidence in the ability of clinical pharmacists to minimize medication errors. Although slightly more than half of the respondents (53%) reported that they did not have clinical pharmacy services in their institutions, there was substantial willingness among physicians and nurses to cooperate with clinical pharmacists. The majority of physicians (92%) and nurses (87%) expressed the view that the clinical pharmacist is an important integral part of the healthcare team. Conclusion: The HCPs and medical students in the study setting valued the role of clinical pharmacists in healthcare delivery. However, new developments in pharmacy services in the UAE hospital setting is recommended for adoption in hospitals