Eman Elayeh

Evidence-based medicine use in pharmacy practice: a cross-sectional survey

RATIONALE, AIMS AND OBJECTIVES This study aimed to evaluate the awareness, attitude, knowledge and use of evidence-based medicine (EBM) among pharmacists in Jordan. METHODS A cross-sectional self-reported survey was conducted on 122 pharmacists (both hospital and community) who were asked to fill a validated structured questionnaire. RESULTS The participants showed a positive attitude towards EBM; more than 80% thought that EBM improves patient care, improves quick knowledge update, helps to unify the quality of care provided, is a good educational tool and a convenient source of advice. But despite this positive attitude, pharmacists showed partial understanding of the technical terms used in EBM; also they relied on their own judgment, medical representatives and standard textbooks in making their decision, resources that can no longer be considered sufficiently updated and/or evidence based. Patient overload, lack of personal time and limited access to EBM sources were the most commonly identified barrier to practicing EBM. Also this study suggest that pharmacists experience is negatively associated with EBM knowledge score (Spearmans rho value -0.187, P-value 0.04). CONCLUSIONS In spite of the positive attitude towards EBM, this study showed numerous personal and institutional barriers towards implementing EBM in Jordan, which necessitate immediate action by all health care decision makers to formulate a national plan to overcome such barriers, and to further investigate the evidence that teaching, learning and daily application of EBM in practice can improve the quality of care and reduce the cost.

A Cross-Sectional Study On Knowledge and Perceptions of Pharmacovigilance Among Pharmacy Students of Selected Tertiary Institutions In Jordan

Background: Although a large body of evidence exists on the effect of long-term exercise training program on pulmonary function, much less attention has been dedicated to investigating the acute effect of short-term exercise program on improving the ventilatory function. Objective: The present study was carried out to investigate the effect of short term high intensity aerobic exercise on lung function in adults to start first step in establishing an evidence based exercise program designed for chest patients who can only be supervised in short term hospitalization phase. Methods: A pre-post test study design was carried out on thirty healthy men students with their mean age 21.7 ± 1.26 who were enrolled in this study. Every student performed a 20-minute high-intensity monitored stationary arm Ergometer exercise and ventilatory function tests was performed in order to measure forced vital capacity (FVC), forced expiratory volume at the end of the first second (FEV1), FEV1/FVC ratio and peak expiratory flow rate PEFR before and after the exercise. Results: The result showed significant increase in the mean value of FEV1, and a non-significant difference in the mean values of (FVC), FEV1/FVC and PEFR. Conclusion: A single high intensity arm Ergometer exercise sitting has a significant effect on improving forced expiratory volume in the normal adult.3 Abstract: Immunological techniques have been developed over years using different Fasciola antigens for diagnosis of fascioliasis and as to replace the parasitological techniques which are time consuming and usually lack sensitivity and reproducibility. In this study, Fasciola gigantica purified metacercarial antigen was early detected in sera of infected sheep using both sandwich and Dot-ELISA in order to evaluate the efficacy of purified metacercarial antigen performance in diagnosing early fascioliasis. This work was conducted on 150 sheep blood samples which were classified according to their parasitological manifestation into 110 sera infected with fascioliasis, 20 infected with other different parasites and 20 healthy control sera. The sensitivity and specificity of sandwich ELISA compared to those of the Dot-ELISA were 92.7% and 93.7% versus 95.5% and 97.5%, respectively. On the other hand, the parasitological examination recorded 68.6% sensitivity and 100% specificity. The purified F. gigantica metaceraial antigens have shown a powerful antigencity for early immune-diagnosis of fascioliasis in both ELISA techniques, however, Dot- ELISA was trouble-free, more sensitive, greater specific and affordable as well as feasible test; the features recommended for any technique to be used in detecting the light infection, particularly, at the early stages that precede the onset of parasite eggs.Several factors may contribute to the rising of water-pipe smoking. Objectives: Several factors may contribute to the rising of water pipe smoking. The objectives of our study were to determine the prevalence, individual and social factors of water pipe smoking among undergraduate medical students of King Saud University in Riyadh, Saudi Arabia. Methods: A cross-sectional descriptive/analytical study was done among a representative sample of 408 male and female undergraduate medical students. A simple random sampling method was used to select the participants. Aself-administered questionnaire was constructed based on the National Youth Tobacco Survey in the United States. Multiple logistic regression analysis was performed to analyze the data. Results: The prevalence of water-pipe smoking among medical students was 11.8% for males and 2% for females. Factors associated with water pipe smoking were water pipe smoking among siblings (OR=6.6; 95% CI = 2.3 – 18.2),parents (OR=4.6; 95% CI = 1.7 – 12.0), and closefriend (OR=65.7; 95% CI = 8.8 – 490.0). The odds of water pipe smoking among the 5th year students were five times higher (OR = 5.5; 95% CI = 1.4 – 24.6) compared to other years. Students whose parents were widowed had 4.2-fold (95% CI = 1.213.7) odds of water pipe smoking compared to students with full families. Conclusion: Social determinants, such as water pipe smoking among siblings, parents and close friends, as well as individual factors such as years of a study and parental marital status were associated with water pipe smoking among undergraduate medical students. Our finding can potentially improve tobacco control programs in Saudi Arabia and decrease the prevalence of water pipe smoking among students.M tourism has transformed from a cottage industry to a sector experiencing tremendous growth and becoming a focus area for governments regionally.As the coming rise in domestic demand brings strong growth and stability to the health care industry, further expansion into the world market through medical tourism represents an untapped resource that could take the sector to a new level. However, medical tourism is a highly competitive market and the emirate is working to establish itself within a crowded field – namely from South East Asia cities, who are accelerating their push into solidify their position as hubs for medical tourism.The key to entering and establishing a foothold will be from promoting existing strengths and reaching patients across different mediums, on both a continuous basis and during the time of decision making.”Objectives: to assess the Prevalence of anxiety and depression among secondary school students and to compare male and female group Methods: This is an observational cross section study using The sampling technique followed stratified convenient sampling and data was collected using self-administered questionnaires (Arabic version of the symptom revised SCL 90- R). Data was collected from 331 secondary school students between 15 and 18 years old from both genders after raking an informed consent Results: Results show 25.7% of the students had anxiety, On comparing boys and girls,23 boys (10.1%) had anxiety, while 62 (59.6%) of the girls had anxiety. In depression 28.4% is the Prevalence of depression in both genders, on comparing boys and girls, 34 male students (14.9%), while 60 female students (57.7%) had depressive symptoms with strong significance when comparing boys to girls Conclusion: This study analyzed the importance of mental health assessment and follow-up in secondary school students, especially girls. However, further assessment for other co – factors such as socioeconomic differences should be considered.Methods: Using a previously validated questionnaire that comprises 38 questions to assess the level of knowledge, attitude and practices towards blood donation, 469 Saudi adults who attended different shopping malls in Riyadh, Saudi Arabia were interviewed. Based on calculated scores, level of knowledge and attitude of our study cohort were categorized into different groups. Multiple regression analyses were used to identify significant predictors of blood donation.Procedure: A sample of 250 postmenopausal women ranging in age between 45 to 80 years was selected by purposive sampling from various parts of north India (Haryana, Punjab, and Chandigarh). Anthropometric parameters (height, weight), physiological variables (systolic and diastolic blood pressure, pulse rate), hypertension (as per JNC VII criteria) and bone mineral density (using dual Energy X-ray Absorptiometry at lumbar spine L1-L4) of all the participants were recorded. Findings indicated that 40.4% women were identified with hypertension, out of which 12.8% had normal bone mineral density, 16.4% and 11.2% were osteopenic and osteoporotic respectively.

The use and safety of medications known to affect driving in Jordan: a cross-sectional study

ABSTRACT Objectives: The aim of this study was to estimate the main driving-impairing medications used by drivers in Jordan, the reported frequency of medication side effects, the frequency of motor vehicle crashes (MVCs) while using driving-impairing medicines, as well as factors associated with MVCs. Methods: A cross-sectional study involving 1,049 individuals (age 18–75 years) who are actively driving vehicles and taking at least one medication known to affect driving (anxiolytics, antidepressants, hypnotics, antiepileptics, opioids, sedating antihistamines, hypoglycemic agents, antihypertensives, central nervous system [CNS] stimulants, and herbals with CNS-related effects) was conducted in Amman, Jordan, over a period of 8 months (September 2013–May 2014) using a structured validated questionnaire. Results: Sixty-three percent of participants noticed a link between a medicine taken and feeling sleepy and 57% stated that they experience at least one adverse effect other than sleepiness from their medication. About 22% of the participants reported having a MVC while on medication. Multiple logistic regression analysis showed that among the participants who reported having a crash while taking a driving-impairing medication, the odds ratios were significantly higher for the use of inhalant substance (odds ratio [OR] = 2.787, P = .014), having chronic conditions (OR = 1.869, P = .001), and use of antiepileptic medications (OR = 2.348, P = .008) and significantly lower for the use of antihypertensives (OR = 0.533, P = .008). Conclusion: The study results show high prevalence of adverse effects of medications with potential for driving impairment, including involvement in MVCs. Our findings highlight the types of patient-related and medication-related factors associated with MVCs in Jordan, such as inhalant use, presence of chronic conditions, and use of antiepileptics.

The Impact of Lack of Pharmacist Contribution on the Prescription Patterns and the Appropriateness of Indications of NSAIDs, A Cross-Sectional Study

Purpose: Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used medications worldwide. However, recent literature strongly points to gastrointestinal (GI) and cardiovascular (CV) risks associated with NSAIDs use. The current study was carried out in Jordan University Hospital. The main objective was to evaluate the role of pharmacists in directing the current prescription patterns and appropriateness of NSAID therapiesto establish strategies for medication reconciliation in the healthcare systems in the region. Methods: This is a prospective cross-sectional qualitative study that enrolled a total of 400 patients over a period of 10 months. The NSAID use was evaluated in patients with and without established CVD and various GI risk stratifications. In addition, 30 physicians were recruited into the study to determine the current prescription patterns. A structured questionnaire was validated and handed to physicians to determine strengths and weaknesses in the current system. NSAID-related drug interactions were evaluated in 200 of the patients. Results: Sixty five percent of the patients without CVD were at moderate GI risk and 12% were at high risk. Sixty nine percentof patients with CVD were at high GI risk and 28% were at moderate risk. Pharmacists were not involved in decision therapies pertaining to NSAIDs, which led to serious drug-related problems in the therapeutic regimens for patients using the NSAIDs.In 64% of the patients without CVD, NSAID therapy did not meetthe recommendations of current guidelines. There was no drug therapy monitoring or patient counseling by a proficient clinical pharmacist, whichled to virtually no identification of potential drug interactions or optimization of medication therapy. Conclusions: The study unraveleda great opportunity to improve the clinical outcomes in patients on NSAID therapy. The lack of pharmacist involvement puts patients at major health risks. Updating physicians on practice guidelines, including a clinical pharmacist in therapy decisions, and modifying hospital formularies are the most urgent recommendations.

Assessment of appropriate medication- use by 2015 Beers criteria among elderly critically ill patients in Jordan.

Case report A 45-year-old African woman presented to the infectious disease unit of a private hospital in Kampala, Uganda with a 7-month history of headache, bilateral lower limb weakness and a 2-month history of visual blurring in the left eye. Her headaches were generalized, throbbing, non-radiant, with no associated or aggravating factors though were mildly relieved with non-steroidal antiinflammatory drugs. She had no history of dizziness, vomiting, loss of consciousness, loss of balance, numbness or seizures. She had no history of ever being a pet-owner-in particular owning a cat. She owned a food business in a local area of the city that was directly adjacent to a chicken raring coup for more than 10 years. She had visited several physicians who had purportedly made a diagnosis of brucellosis.