Insights on Protective Effect of Platelet Rich Plasma and Tadalafil on Testicular Ischemia/Reperfusion Injury in Rats Exposed to Testicular Torsion/Detorsion.

BACKGROUND/AIMS: Ischemic reperfusion (I-R) injury is greatly influenced by the testicular torsion/detorsion process (TDP). In this instance, the anti-inflammatory properties of plateletrich plasma (PRP) combined with tadalafil (Td) significantly promote tissue healing in the I-R injury model. METHODS: Five groups of rats were created: the control group, the I-R group not receiving any therapy, the I-R group receiving a single dosage of Td (0.25 mg/kg, I.P.), the I-R group receiving a single dose of PRP (80 l, intratesticular), and the I-R group receiving both Td and PRP. Sperm morphology, motility, and histology were assessed. The levels of TNF-, BAX, antioxidant status, and testosterone were measured. Additionally, E-selectin expression was done. RESULTS: PRP reduced oxidative stress, inflammation, and apoptosis while also boosting testosterone levels, which alleviated I-R injury. Otherwise, PRP reduces E-selectin expression, which modifies the pathways that control endothelial function. Td also partially demonstrated its testicular-protective activity at the same time. CONCLUSION: PRP's proven anti-inflammatory, antioxidant, and antiapoptotic potentials make it a natural treatment for testicular harm caused by tadalafil. For the first time, it was demonstrated that PRP therapy restored the functionality of the vascular endothelium, specifically the control of E-selectin expression. Combining Td and PRP therapy may be a promising strategy for improving response to PDE5 inhibitors.

Prescribing of potentially inappropriate medications among the elderly population in an ambulatory care setting in a Saudi military hospital: trend and cost.

AIM: To explore the prevalence of potentially inappropriate medication (PIM) use in the elderly, to identify the trends and the patterns of prescribing such medication, and to calculate the associated direct medication cost of such practice in a Saudi hospital. METHODS: This was a retrospective cross-sectional study of patients who were aged 65 years or older on at least one PIM. The source of our data was outpatient pharmacy prescription records at Riyadh Military Hospital (RMH) for 2002, 2003 and 2004. Beers' explicit criteria for PIM was used to identify these medications. RESULTS: A total of 20521 PIM were identified. The prevalence of PIM for 2002, 2003 and 2004 was 2.5%, 2.3% and 2.1%, respectively. A total of 43.6% of the patients had filled a prescription of one PIM, 18% filled two PIM and 38.4% filled three or more PIM. Digoxin accounted for 23.7% of these PIM. The most commonly prescribed medications were cardiovascular medications at 26.7%. The total direct cost that was associated with inappropriate prescribing was 518314 Saudi Riyals (US$138217) during the study period. CONCLUSION: PIM prescribing in RMH was less compared with what was published in the literature in other countries. It was unclear whether these results reflect the level of elderly healthcare services provided to RMH patients or because of underreporting. Drug utilization review programs, medical education, recruiting physicians and clinical pharmacists who are specialized in geriatrics, finding safer medications or integration of computer software to detect such medications during prescriptions entry can improve the medical services provided to the elderly.

Evaluation of drug and poison information center in Saudi Arabia during the period 2000-2002.

OBJECTIVE: To evaluate the profile of the requestors, the number and content of questions which were received during the period of May 2000 - December 2002. METHODS: A total of 1967 requests were evaluated. The questions were sorted according to source of callers, caller identification, the content of the questions, search data and time required to answer the questions. All data analysis were performed using the Statistical Package for Social Sciences Version 9.0. RESULTS: The questions were received from different places, including Riyadh (90.1%), overall the Kingdom (8.9%) and gulf countries (1%). The Drug and Poison Information Center (DPIC) provides information to pharmacists, community, employee of King Saud University, physicians, nurses, dentists and others. The type of requests most frequently inquired about were drug related, health related, article/information, and poisoning. Requested data include information about therapeutics uses, drug identification, articles, adverse effects, dosage/administration, drug interactions, poisoning, with very few questions about availability, pregnancy and lactation, and IV incompatibilities. The most common resources used were Drugdex and internet, reference books, Iowa Drug Information Services (IDIS), PubMed and Poisondex. The time devoted to the service is varied ranging from 5 minutes to weeks. CONCLUSION: This study emphasizes on how important to document type of the activities of the DPIC to be used as a vital quality assurance tool. It also revealed the need to stimulate more requestors particularly physicians by advertising the drug information activities or possibly by establishing a website for the DPIC.