Optical Based Surface Plasmon Resonance Sensor for the Detection of the Various Kind of Cancerous Cell.

This research explores a novel biosensor design that exhibits much higher sensitivity compared to conventional biosensors. The biosensor's uniqueness originated from its innovative structure, which incorporates N-FK51A/Ag/AlON/BlueP materials, as well as its cutting-edge fabrication method. The refractive index component was considered when designing the SPR biosensor, which was developed from the angular analysis of the attenuated total reflection (ATR) approach for cancer detection. For instance, the resonance angle shifts by 15.57 deg when the refractive index changes from 1.360 to 1.401, demonstrating the sensor's responsiveness to variation in the refractive index. The sensitivities for skin (basal), cervical (HeLa), blood (Jurkat), adrenal gland (PC12), and breast (MDA-MB-231 and MCF-7) cancer cells were 197.65, 243.66, 255.36, 302.71, 372.57, and 416.85 deg/RIU, respectively. Also, the detection accuracy (DA), the figure of merit (FoM), and the quality factor were 0.37/deg, 155.94 (deg/RIU), and 26.71 RIU-1. We also examine the effects of substituting the noble, dielectric, 2D material layer with conventional biosensor materials for six cancers. Each time, the Ag/AION/BlueP layered structure performed best in distinguishing cancer cells from healthy cells. We also study the prism effects. The proposed biosensor, with a RI of 1.29-1.40, has a linear regression coefficient of R2 of 0.96094.

Implications of the medication regimen complexity index score on hospital readmissions in elderly patients with heart failure: a retrospective cohort study.

BACKGROUND: The likelihood of elderly patients with heart failure (HF) being readmitted to the hospital is higher if they have a higher medication regimen complexity index (MRCI) compared to those with a lower MRCI. The objective of this study was to investigate whether there is a correlation between the MRCI score and the frequency of hospital readmissions (30-day, 90-day, and 1-year) among elderly patients with HF. METHODS: In this single-center retrospective cohort study, MRCI scores were calculated using a well-established tool. Patients were categorized into high (≥ 15) or low (< 15) MRCI score groups. The primary outcome examined the association between MRCI scores and 30-day hospital readmission rates. Secondary outcomes included the relationships between MRCI scores and 90-day readmission, one-year readmission, and mortality rates. Multivariate logistic regression was employed to assess the 30- and 90-day readmission rates, while Kaplan-Meier analysis was utilized to plot mortality. RESULTS: A total of 150 patients were included. The mean MRCI score for all patients was 33.43. 90% of patients had a high score. There was no link between a high MCRI score and a high 30-day readmission rate (OR 1.02; 95% CI 0.99-1.05; p < 0.13). A high MCRI score was associated with an initial significant increase in the 90-day readmission rate (odd ratio, 1.03; 95% CI, 1.00-1.07; p < 0.022), but not after adjusting for independent factors (odd ratio, 0.99; 95% CI, 0.95-1.03; p < 0.487). There was no significant difference between high and low MRCI scores in their one-year readmission rate. CONCLUSION: The study's results indicate that there is no correlation between a higher MRCI score and the rates of hospital readmission or mortality among elderly patients with HF. Therefore, it can be concluded that the medication regimen complexity index does not appear to be a significant predictor of hospital readmission or mortality in this population.

Favipiravir-induced nephrotoxicity in a patient with COVID-19: A case report.

This report describes a case of 45 years old male patient who tested positive for COVID-19 presented to the emergency department on March 2021 complaining of fever, cough, runny nose, and shortness of breath. The patient denied any history of nausea or diarrhea who has eventually developed favipiravir-induced nephrotoxicity.

Prescribing Pattern of Proton Pump Inhibitors in Qatar Rehabilitation Institute: A Retrospective Study.

OBJECTIVE: Proton pump inhibitors (PPIs) are still widely used despite increasing reports of their adverse events. This drug use evaluation study was conducted to assess the prescribing pattern of PPIs for patients admitted to the Qatar Rehabilitation Institute (QRI). METHODS: An observational, retrospective, patients' chart-based study included all patients who received a PPI in QRI between April 1, 2017, and October 1, 2017. A standardized tool was prepared and reviewed by the involved clinical pharmacists to collect appropriate data for the evaluation. Statistical analysis was performed using the 25th Version of the Statistical Package of the Social Sciences (SPSS®). FINDINGS: A total of 119 patients received PPIs during the audit period, of which esomeprazole was the most frequently prescribed (34%). Majority of the patients (94%) were started on PPI without further investigations for confirming the indication, and the indication was not documented in 78% of the participants. Nonsteroidal anti-inflammatory drugs were the most commonly co-prescribed medications with PPIs (59%). Pantoprazole was co-prescribed with clopidogrel in 42% of the patients. CONCLUSION: This drug utilization study shows the need for a proper prescribing practice considering a clear indication and recommendations about the duration of therapy and the need for reassessment in QRI.

A case of probable piperacillin/tazobactam-induced bone marrow suppression in a pregnant woman.

Piperacillin/tazobactam is a bacteriolytic combined antibiotic. The least common reported adverse reactions of piperacillin/tazobactam are haematological reactions (<1%). The use of piperacillin/tazobactam during pregnancy is considered to be moderately safe (pregnancy category B) for the human embryo-foetus. This is a case of a pregnant patient (22 weeks of gestation) who was admitted to the Women's Hospital, Doha, Qatar and was treated for preterm premature rupture of membrane with erythromycin for 10 days. Afterwards, she was treated with piperacillin/tazobactam for asymptomatic urinary tract infection (pseudomonas species). After 15 days, she developed fever, leucopenia, neutropenia and thrombocytopenia. These adverse reactions were reversed after the discontinuation of piperacillin/tazobactam combination. In Qatar and worldwide, there are few reported cases regarding bone marrow suppression or fever induced by piperacillin/tazobactam in general and during pregnancy. Using the Naranjo Adverse Drug Reaction Probability scales, the score was found to be 8, representing a probable adverse drug reaction.

Instructional design and assessment of an elective course on the use of drugs in sport.

BACKGROUND AND PURPOSE: The use and misuse of drugs in sport is becoming increasingly important globally, and the role of pharmacists is evolving in this regard. This paper describes the design and implementation of an elective course "Drugs in Sport" in an undergraduate pharmacy curriculum. EDUCATIONAL ACTIVITY AND SETTING: The elective course was designed to introduce BSc pharmacy students to an evidence-based approach to safe, effective, and legal use of drugs in sport. The course covered why athletes take drugs, evolution of doping in sport, the international regulations regarding doping and anti-doping in sport including the World Anti-doping Agency Prohibited List, as well as testing and monitoring for drug use in sport. It also included the role of athlete support personnel (ASP) in preventing the use of prohibited substances by athletes. A web-based survey was conducted at the end of the course to assess the students' perspectives of the course. FINDINGS: Students provided an evaluation of the course in terms of its content, methods of delivery, and assessment. Overall, the students demonstrated competence. They gained insight into international and national regulations regarding doping and anti-doping in sport and the potential role of pharmacists as ASP in providing support and advice for athletes and the public. SUMMARY: Designing and implementing an evidence-based course on the use of drugs in sport customized for pharmacy students was achieved successfully. Such courses could provide an opportunity to advance the scope of pharmacy practice and possibly provide a new career path for future pharmacists.

A case of probable oxybutynin-induced increase in liver enzymes.

We describe the case of a 49-year-old male who presented to the emergency department with right-sided weakness and inability to speak. He was diagnosed with stroke and was admitted to Qatar Rehabilitation Institute after he was treated for the acute phase at Hamad General Hospital. As part of his management, he was started on oxybutynin 5 mg orally twice daily for the treatment of overactive bladder. Within a week, his liver enzymes started to increase. After a thorough medication review, oxybutynin was suspended as it was the only suspected medication to be responsible of this elevation in liver enzymes. When Naranjo Adverse Drug Reaction Probability Scale was used to assess the probability of an adverse drug reaction (ADR), a score of 6 was obtained indicating a "Probable" ADR. In conclusion, this is the first published report of oxybutynin-induced elevation in liver enzymes. Further reports are required to highlight this probable ADR and alert all health professionals about it.

Misoprostol for miscarriage management in a woman with previous five cesarean deliveries: a case report and literature review.

BACKGROUND: Misoprostol is an effective medical method for the management of pregnancy loss. However, data on its efficacy and safety in women with previous cesarean deliveries are limited. CASE PRESENTATION: We report a 36-year-old patient, gravida 11 para 6, with a diagnosis of missed miscarriage at 15 weeks of gestation. The patient had a significant obstetric history of previous five cesarean deliveries and uterine rupture. Following patient counseling about the medical and surgical options of managing her miscarriage, the patient opted for medical method. Low-dose misoprostol of 100 µg was inserted vaginally and repeated again after 6 hours. The patient had an uneventful complete miscarriage following the second dose of misoprostol. No uterine rupture, no extra vaginal bleeding, and no blood transfusion were observed. CONCLUSION: We conclude that adopting a low-dose misoprostol protocol could be potentially safe and effective in managing second trimester missed miscarriage in women with repeated cesarean deliveries and/or uterine rupture history. Further studies are needed to confirm these results.

Misoprostol use in medical evacuation of spontaneous miscarriage: Pilot drug use evaluation study at the Women's Hospital in Qatar.

BACKGROUND: Misoprostol is a synthetic prostaglandin E1 that induces cervical effacement and uterine contractions at all gestational ages, thus facilitating uterine evacuation and pregnancy termination. Successful medical evacuation of spontaneous miscarriage with minimal adverse effects can be performed using misoprostol-only regimen if given as indicated and if the administered dose, frequency of the dosage, and number of total doses are appropriate. AIM: To conduct a drug use evaluation by investigating indications, appropriateness of dosing, and clinical outcome of misoprostol-only regimen when used for medical evacuation of spontaneous miscarriage at the Women's Hospital in Doha, Qatar. MATERIALS AND METHODS: A retrospective descriptive drug use evaluation was conducted on women with spontaneous miscarriage who received misoprostol for medical evacuation during August 2013. The current practice at the Women's Hospital was compared with the recommendation from the World Health Organization (WHO). Patients were stratified into three groups based on weeks of amenorrhea. RESULTS: A total of 107 patients received misoprostol during August 2013, of which 33 (31%) were included in the study. In these patients, the main indication for misoprostol use was missed miscarriage (54.5%). In the group of patients at ≤ 9 weeks of gestation, 80% received an initial dose of 800 µg, 80% received frequency within the WHO recommendation, and the majority had surgical evacuation (80%). In the group of patients at 10-12 weeks of gestation, more than 80% received an initial dose of 800 µg, 6% received frequency within the WHO recommendation, and more than 75% had successful medical evacuation. In the group of patients at 13-22 weeks of gestation, more than 80% received an initial dose of 400 µg, more than 80% received frequency within the WHO recommendation, and 54% had successful medical evacuation. Overall, more than 70% of the patients received ≤ 3 total doses of misoprostol and more than 60% had successful medical evacuation as a clinical outcome. CONCLUSIONS: Despite the current practice at the Women's Hospital not always being in accordance with the WHO recommendation, successful medical evacuation was achieved in most patients.

A retrospective drug use evaluation of cabergoline for lactation inhibition at a tertiary care teaching hospital in Qatar.

BACKGROUND: Breastfeeding is considered as gold standard for infant nutrition and should be interrupted only when a compelling indication exists. Certain medical conditions such as abortion, stillbirth, HIV infection, or infant galactosemia and certain medications such as chemotherapy necessitate lactation inhibition to protect the health of mother and infant. Drug use evaluation (DUE) studies are done to explore the current practice in a setting and help to identify areas in which further information and education may be needed by clinicians. OBJECTIVE: The aim of this study was to conduct a DUE of cabergoline to assess indications for lactation inhibition, dosage regimen, and its safety. METHOD: A retrospective cross-sectional DUE study was conducted over a period of 4 months from September 1, 2013, till December 31, 2013, at the Women's Hospital, Qatar. All cabergoline prescriptions written for lactation inhibition within 10 days of delivery or abortion were included in the study. A descriptive data analysis was undertaken. RESULTS: Of the 85 patients included, stillbirth (50.6%) was considered as the main reason for lactation inhibition, followed by abortion (27.1%) and neonatal death (12.9%). The remaining 9.4% of the patients had live baby, and the majority of them were prescribed cabergoline for lactation inhibition because their maternal medical conditions required the use of drugs with insufficient safety data (n=6). Seventy-four percent of patients received cabergoline at accurate time and dose. However, 14% of the patients had preexisting hypertensive disorder and 58.3% of them were diagnosed as uncontrolled hypertension. CONCLUSION: The current DUE study found that cabergoline was mainly used to inhibit lactation for patients with stillbirth, abortion, and neonatal death. In mothers who use medications for other medical conditions, benefits and risks of breastfeeding should be carefully balanced before prescribing cabergoline. Current prescribing pattern can be further enhanced through informing health care providers regarding appropriate cabergoline dosage regimen and its safety in patients with uncontrolled hypertension.

Perspective of pharmacists in Qatar regarding doping and anti-doping in sports.

BACKGROUND: The aim of this study was to evaluate the current knowledge and perceptions of pharmacists in Qatar with regard to the use of drugs in sport and to explore their views on the introduction of education and training in the area of sports pharmacy. METHODS: A cross-sectional survey was conducted targeting both hospital and community pharmacists in Qatar. A questionnaire consisting of three domains pertaining to participants' knowledge, perceived role of healthcare professionals, and attitudes towards educational needs on the use of drugs in sports was developed and validated. The online survey link and paper-based questionnaires were distributed to the target population. Data analyses were performed using IBM SPSS Statistics. Descriptive and inferential statistics were utilized for the analyses, where P<0.05 indicates statistical significance. RESULTS: A total of 300 pharmacists responded to the survey. Respondents had a limited awareness of doping and anti-doping and achieved an average knowledge score of 53.2% regarding the prohibited status of drugs that may be used by athletes, particularly with respect to over-the-counter medicines and supplements. The majority (81.7%) of the pharmacists expressed an interest in receiving education and training on sports pharmacy. CONCLUSIONS: Specialized training programs are warranted to ensure that pharmacists have the knowledge and skills required to provide athletes with accurate information about anti-doping issues and the safe and effective use of medicines in sport. The development of these programs should be supported by national pharmacy policy makers and designed in collaboration with anti-doping agencies and sports pharmacy experts and educators.

Knowledge and Perceptions of Pharmacy Students in Qatar on Anti-Doping in Sports and on Sports Pharmacy in Undergraduate Curricula.

Objective. To assess pharmacy students' knowledge and perceptions of doping and anti-doping in sports and to explore the curricular needs for undergraduate pharmacy in the field of sports pharmacy. Methods. A cross-sectional, descriptive, web-based survey of pharmacy students was conducted at Qatar University College of Pharmacy from March to May 2014. Data were analyzed using descriptive and inferential statistics. Results. Eighty respondents completed the online survey (80% response rate). Sixty percent were unaware of the World Anti-Doping Agency, and 85% were unaware of the International Pharmaceutical Federation's statement on the pharmacist's role in anti-doping. Students' knowledge score regarding the prohibited status of drugs that may be used by athletes was around 50%. Fourth-year pharmacy students had significantly higher knowledge scores than the other groups of students. Respondents acknowledged the important role of health care professionals, including pharmacists, as advisors on the safe and effective use of drugs in sports. Ninety percent of the students supported the inclusion of sports pharmacy in the curriculum. Conclusion. Pharmacy students indicated a strong desire to play a role in doping prevention and ensure safe and rational use of drugs among athletes. They suggested requiring an education and training strategy for sports pharmacy in undergraduate pharmacy curricula.

A case of probable labetalol induced hyperkalaemia in pre-eclampsia.

CASE DESCRIPTION: Hyperkalemia can cause altered cardiac electrical conduction resulting in death. We describe a case of a 23-year old pregnant patient who presented with severe epigastric pain and vomiting. She was severely pre- eclamptic and received initial treatment with intravenous labetalol and decision was taken to deliver. She quickly became hyperkalaemic (serum potassium level 6.4 mmol/L) and labetalol was discontinued and intravenous hydralazine commenced. Post-surgery, her potassium levels were normal but due to rapidly rising blood pressure labetalol was recommenced, resulting in elevated potassium levels. Labetolol was discontinued, hydralazine prescribed, and potassium levels normalised. The adverse reaction was classified as 'probably' due to labetolol using the Naranjo Adverse Drug Reaction scale. CONCLUSION: This is the first reported case of labetolol induced hyperkalaemia in pregnancy, with life threatening consequences and hence all health professionals should be alert to this potential effect.

Clinico-pathologic conference: 12-year-old girl with fatigue, anemia, weight loss, abdominal distention, and occasional nausea and vomiting.

A clinicopathologic case is presented. The patient was a 12-year-old white girl with a history of fatigue and dizziness, occasional nausea and vomiting, and anemia, who showed abdominal distention, especially in the epigastrium. An epigastric mass was palpable. Gastroscopy was done, and surgery followed. Pertinent laboratory findings are presented, and clinical discussion follows. The pathology is then presented and discussed.