Admissions for drug-related problems at the Emergency Department of a University Hospital in the Kingdom of Saudi Arabia.

BACKGROUND AND AIM: Medication Errors can result in drug-related problems (DRPs). Insight into the frequency, type, and severity of DRPs could help reduce their incidence. The aim of the present study was to estimate the prevalence of admissions as a result of DRPs at the Emergency Department (ED) of a university hospital in the Kingdom of Saudi Arabia. MATERIALS AND METHODS: Files of suspected cases of DRPs reporting to ED in the year 2012 were scrutinized. Suspicion arose from the hospital record system based on Diagnosis Code Numbers (ICD-9-CM, Professional 2010) and from triggers, such as some drugs, laboratory tests, and signs and symptoms pointing to DRPs. RESULTS: Of 5574 admissions, 253 (4.5%) were DRPs and were categorized as: Overdose toxicity and side effects of drugs 50 (19.8%), drug-interactions 29 (11.5%), accidental and suicidal drug ingestions 26 (10.3%), drug abuse 18 (7.1%), drug allergy 10 (4%), super-infections 8 (3.2%), and noncompliance to treatment 112 (44.3%). About 70% of DRPs were preventable; 67 (26.5%) required hospital admission for 7-102 days and 10 (4%) died. CONCLUSIONS: Noncompliance to treatment, overdose toxicity, drug interactions, and drug abuse are important causes of hospital admissions as a result of DRPs. Awareness of prescribers to the problem and their education would help to prevent them and improve patient care.

Synthesis, morphology and antifungal activity of nano-particulated amphotericin-B, ketoconazole and thymoquinone against Candida albicans yeasts and Candida biofilm.

In the current study, nano-particulated drugs-Amphotericin-B, Ketoconazole and Thymoquinone (an active ingredient of Nigella sativa)-were prepared using the ball milling technique, and their particle sizes were examined by transmission electron microscopy (TEM) and using a particle size analyzer. The grain sizes of the prepared compounds were found in between 5 to 20 nm, and exhibited quasi-spherical morphology. The antifungal activity of each nano-particulated drug was investigated in vitro against Candida albicans yeasts and Candida biofilm, and compared with their micro-structured conventional forms. Nano-sized drugs were found to be two to four times more effective in disinfecting both the Candida yeasts and Candida biofilm. The study is a first of its kind as nano-forms of drugs have not been studied against Candida and Candida biofilm before. Further investigations are required for the determination of the clinical significance of the nano-formulation of antifungal substances.

An effective and physiological lifestyle change for management of gastroesophageal reflux disease.

Proton pump inhibitors (PPIs) are commonly used in the treatment of gastro-oesophageal reflux disease (GERD). Some disadvantages of these acid- suppressing drugs circulate and patients ask for alternatives. Transient lower oesophageal sphincter relaxations (TLESRs) are important cause of reflux. Gastric distension in upper stomach are strongest stimulus for generation of TLESRs and is aggravated by intake of food in between meals. In the light of pathophysiological mechanisms it is suggested that increasing interval between meals and only soft drinks in between will reduce reflux episodes. The hypothesis was tested in 4 patients with endoscopically proven reflux oesophagitis and/or typical reflux symptoms. Three patients followed our advice to eat twice a day, with soft drinks in between. One patient had a light breakfast but increased the interval between lunch and dinner to 8 hours. All cases were relieved from repeated reflux episodes, in 1-2 weeks, without any medication.

Morphology and antifungal effect of nano-ZnO and nano-Pd-doped nano-ZnO against Aspergillus and Candida.

The present work was aimed to study the activity of nano-particulated ZnO and nano Pd doped nano-ZnO against Aspergillus and Candida species, commonly contaminating the water supply systems. Micro-ZnO was purchased from the market (Aldrich, USA) while nano ZnO were synthesized using sole gel and precipitation methods and their morphology was determined using XRD and TEM techniques. The average grain size of nano-ZnO estimated by these techniques was 30 nm and 20 nm, respectively. The doping of nano-ZnO with 5 % Pd was achieved by a thermal decomposition method and its morphology; as characterized by XRD, TEM and FESEM techniques; gave an average grain size of 35 nm. Serial dilutions of nano-ZnO doped with 5 % Pd, pure nano-ZnO and micro-ZnO (as a control) were prepared from 10 mg/mL stock solution of each in dermasel agar (OXOID), inoculated with standard strains of Candida albicans and Aspergillus niger and incubated at 37°C for 24 and 48 hours, respectively. Their antimicrobial effect was compared by the minimal inhibitory concentration (MIC), determined as the dilution giving a negligible growth of microorganism. Nano-ZnO doped with 5 % nano-Pd, pure nano-ZnO and micro-ZnO, showed antifungal activity against Aspergilus niger with an MIC of 1.25, 2.5 and 5mg/mL, respectively. However, Candida albicans yeasts were relatively resistant to these compounds, with an MIC of 2.5, 5 and 10 mg/mL for Pd doped nano-ZnO, nano-ZnO and micro-ZnO, respectively. Thus nano-ZnO was twice as potent in killing Aspergillus, as compared to its non-nano-counterpart and loading of nano-ZnO with 5 % nano-Pd further increased its activity, four times that of micro-ZnO. Further investigations are needed to confirm the potential use of nano-ZnO and its doping with nano-Pd in the treatment of water supply systems and food preservation.