Clinical And Toxicological Aspects Associated With Paracetamol Poisoning And Predictors Of Its Outcomes

Paracetamol is a common source of poisoning, and early identification of patients with more severe poisoning is the key to improving outcomes. Many aspects of paracetamol toxicity and treatment remain poorly understood. To improve knowledge about paracetamol poisoning, the current 5-year, hospital-based study was carried out with the following primary objectives (1) to determine the pattern of paracetamol poisoning among patients who were admitted to Hospital Pulau Pinang (HPP); and (2) to identify indicators of poor prognosis at first hospital presentation for improving clinical care and determining intervention targets for prevention, early detection, diagnosis and treatment. This is an observational retrospective cohort study of hospital admissions for acute paracetamol poisoning between 1 January 2004 and 31 December 2008. Overall, 305 patients met the inclusion criteria. Gastrointestinal (GI) manifestations were common in patients who reported ingestion of ≥ 8 g of paracetamol, and whose latency was longer than 8 hours; and both of these factors were identified as strong independent predictors of the presence of GI manifestations, especially nausea/vomiting. The presence of GI symptoms was a significant marker of poor outcomes and increased hospital stays. Additionally, hypokalaemia is highly associated with paracetamol poisoning. Specific clinical characteristics upon first presentation to the hospital, such as vomiting, psychiatric illness, and reported paracetamol dose ingested, can be used to identify patients at increased risk for hypokalaemia. Importantly, long hospital stays were significantly less frequent when IV-NAC therapy was administered within 8 hours of paracetamol ingestion (p = 0.006)

Antidote Stocking at Hospitals in North Palestine

Objective: The purpose of this study was to determine the availability and adequacy of antidote stocking at hospitals in north Palestine based on published guidelines for antidote stocking. Methodology: This study is a cross sectional survey of all hospitals at north Palestine (n=11) using a questionnaire which was completed by the director of the pharmacy department at each hospital. The questionnaire was divided into 2 parts. The first part contained a list of 25 antidotes while the second part contained a list of 12 antidotes. This classification is based on the guideline proposed by the British Association for Emergency Medicine (BAEM). The net antidote stock results were compared with the American guidelines as well. Result: The overall availability of each antidote in the first list varied widely from zero for glucagon to 100% for atropine. The number antidotes of the first list that were stocked in the 11 hospitals ranged from 5 to 12 antidotes but none of the hospitals stocked all the 25 antidotes. Additionally, availability of antidotes in the second list varied widely from zero for polyethylene glycol to 100% for dobutamine. The number of antidotes stocked ranged from 5 to 9 but none of the hospitals stocked all the 12 antidotes. Discussion and Conclusion: hospitals in north Palestine do not have adequate stock of antidotes. Raising awareness of the importance of antidotes by education, regular review of antidote storage, distribution plans, and appropriate legislation might provide solutions. Coordination between Palestinian hospitals and the PCDIC at An-Najah National University is also important

Sleep habits and sleep problems among Palestinian students

<p>Abstract</p> <p>Aim</p> <p>The aim of this study was to describe sleep habits and sleep problems in a population of undergraduates in Palestine. Association between self-reported sleep quality and self-reported academic achievement was also investigated.</p> <p>Methods</p> <p>Sleep habits and problems were investigated using a convenience sample of students from An-Najah National University, Palestine. The study was carried out during spring semester, 2009. A self-administered questionnaire developed based on The Diagnostic and Statistical Manual of Mental Disorders IV criteria and Pittsburgh Sleep Quality Index was used.</p> <p>Results</p> <p>400 students with a mean age of 20.2 ± 1.3 were studied. Reported mean duration of night sleep in the study sample was 6.4 ± 1.1 hours. The majority (58.3%) of students went to bed before midnight and 18% of the total sample woke up before 6 am. Sleep latency of more than one hour was present in 19.3% of the students. Two thirds (64.8%) of the students reported having at least one nocturnal awakening per night. Nightmares were the most common parasomnia reported by students. Daytime naps were common and reported in 74.5% of the study sample. Sleep quality was reported as "poor" in only 9.8% and was significantly associated with sleep latency, frequency of nocturnal awakenings, time of going to bed, nightmares but not with academic achievement.</p> <p>Conclusion</p> <p>Sleep habits among Palestinian undergraduates were comparable to those reported in European studies. Sleep problems were common and there was no significant association between sleep quality and academic achievement.</p

Fish oil supplements, oxidative status, and compliance behaviour: Regulatory challenges and opportunities.

BackgroundFish oil supplements that are rich in omega-3 long-chain polyunsaturated fatty acids (n-3 PUFAs). PUFAs are among the most widely-used dietary supplements globally, and millions of people consume them regularly. There have always been public concerns that these products should be guaranteed to be safe and of good quality, especially as these types of fish oil supplements are extremely susceptible to oxidative degradation.ObjectivesThe aim of the current study is to investigate and examine the oxidation status of dietary supplements containing fish oils and to identify important factors related to the oxidation status of such supplements available in the United Arab Emirates (UAE).MethodsA total of 44 fish oil supplements were analysed in this study. For each product, the oxidative parameters peroxide value (PV), anisidine value (AV), and total oxidation (TOTOX) were calculated, and comparisons were made with the guidelines supplied by the Global Organization for EPA and DHA Omega-3s (GOED). Median values for each of the above oxidative parameters were tested using the Kruskal-Wallis and Mann-Whitney U tests. P values ResultsThe estimate for the average PV value was 6.4 with a 95% confidence interval (CI) [4.2-8.7] compared to the maximum allowable limit of 5 meq/kg. The estimate for the average P-AV was 11 with a 95% CI [7.8-14.2] compared to the maximum allowable limit of 20. The estimate for the average TOTOX value was 23.8 meq/kg with a 95% CI [17.4-30.3] compared to the maximum allowable limit of 26 according to the GOED standards.ConclusionThis research shows that most, although not all, of the fish oil supplements tested are compliant with the GOED oxidative quality standards. Nevertheless, it is clear that there should be a high level of inspection and control regarding authenticity, purity, quality, and safety in the processes of production and supply of dietary supplements containing fish oils

Pharmaceutical health services, medicines and practices available at airport-based pharmacies; implications for the future

The role of airport pharmacies have grown in recent years to provide a range of services to travelers including OTC and prescription medicines as well as advice on prevention of infectious and other diseases. Prevention, including protective equipment, is especially important during pandemics as seen with the recent COVID-19 pandemic. In addition, offering vaccinations where appropriate. However, this is not universal and there are currently no acknowledged guidelines for pharmacists operating within airports. In addition, research into their role as well as potential ways to improve this is lacking. This is a concern with community pharmacists playing a valuable role during the COVID-19 pandemic. Potential ways forward including greater research into activities to enhance their role and address challenges including issues of brand names and language, as well as encouraging travel pharmacy in future university curricula. In addition, producing guidelines for their activities and monitoring their implementation. This can help build a greater role for their services benefiting airport staff and travelers in the future

Shedding light on community pharmacist–directed point-of-care screening and education for patients with kidney stones : implications and future research

Kidney function reduces progressively from age 30 as part of the normal aging process, with a decline in function of around 1 mL/min, which accelerates after age 65 [1, 2]. A silent kidney disease, kidney stones (KS) can develop in this population, occupying the hollow spaces inside the kidney. Comprising hard salt or mineral deposits, KS can occasionally remain inside the kidney and cause no complications [3]. KS are most commonly made of calcium, but uric acid, struvite, and cystine stones can also occur [3]. Globally, the rate of KS development is growing, with the US reporting a prevalence of 8.8% in 201