Khawla Q. Nuseir

Sucrose-induced analgesia during early life modulates adulthood learning and memory formation.

This study is aimed at examining the long-term effects of chronic pain during early life (postnatal day 0 to 8weeks), and intervention using sucrose, on cognitive functions during adulthood in rats. Pain was induced in rat pups via needle pricks of the paws. Sucrose solution or paracetamol was administered for analgesia before the paw prick. Control groups include tactile stimulation to account for handling and touching the paws, and sucrose alone was used. All treatments were started on day one of birth and continued for 8weeks. At the end of the treatments, behavioral studies were conducted to test the spatial learning and memory using radial arm water maze (RAWM), as well as pain threshold via foot-withdrawal response to a hot plate apparatus. Additionally, the hippocampus was dissected, and blood was collected. Levels of neurotrophins (BDNF, IGF-1 and NT-3) and endorphins were assessed using ELISA. The results show that chronic noxious stimulation resulted in comparable foot-withdrawal latency between noxious and tactile groups. On the other hand, pretreatment with sucrose or paracetamol increased pain threshold significantly both in naive rats and noxiously stimulated rats (P<0.05). Chronic pain during early life impaired short-term memory, and sucrose treatment prevented such impairment (P<0.05). Sucrose significantly increased serum levels of endorphin and enkephalin. Chronic pain decreased levels of BDNF in the hippocampus and this decrease was prevented by sucrose and paracetamol treatments. Hippocampal levels of NT-3 and IGF-1 were not affected by any treatment. In conclusion, chronic pain induction during early life induced short memory impairment, and pretreatment with sucrose prevented this impairment via mechanisms that seem to involve BDNF. As evident in the results, sucrose, whether alone or in the presence of pre-noxious stimulation, increases pain threshold in such circumstances; most likely via a mechanism that involves an increase in endogenous opioids.

Knowledge, attitudes and barriers towards breast cancer health education among community pharmacists

The goal of this study was to evaluate knowledge, attitudes and perceived barriers among community pharmacists towards breast cancer health promotion.

Sources of information used when prescribing for children, a survey of hospital based pediatricians.

BACKGROUND Due to the lack of properly tested medicines for children, there is little available information with regards to indications and dosing of medications in children. AIM To collect data on sources where hospital based pediatricians obtain prescribing information when treating children and the extent of collaboration with the hospital pharmacist. METHOD Two hundred and fifty pediatricians in different hospitals within different cities in Jordan were asked to fill in a structured questionnaire regarding information sources used when prescribing for children. RESULTS Questionnaires were collected from 162 (64.8%) hospital based pediatricians, who have completed the questionnaire by the designated date. Most (75.5%) reported that the Lexi Comps Drug Information Handbook was the source that they most frequently used for drug information when prescribing for in children. The BNF and the BNFc (British National Formulary for children) were found to be the most sources that contain sufficient information that aids pediatricians when prescribing for children. A minority (22%) claimed to consult with the hospital pharmacist when they face difficulties when prescribing for children. CONCLUSIONS Pediatricians rely on different information sources when they prescribe for children. Those sources vary in their reliability in aiding pediatrician when prescribing. Further work should be done in the provision of useful information on pediatric drug therapy to pediatricians. More steps should be taking place to activate collaboration and interaction between pediatricians and pharmacists as well.

Behaviors and Attitudes towards Dysmenorrhea; a Cross-sectional Survey of 2,000 Jordanian University Students

Background and Aims: Dysmenorrhea is a very common gynecologic condition encountered by women. The majority of women suffering from dysmenorrhea self-medicate with over the counter medications, which might be inadequate or not very effective. The present study aims to determine the prevalence of dysmenorrhea, the factors significantly associated with the prevalence of dysmenorrhea, the attitudes and behaviors towards dysmenorrhea among Jordanian female students, and the pharmacists role in the management of dysmenorrhea. Materials and Methods: A total of 2,000 female university students in seven public universities were randomly approached and anonymously surveyed by our research team using a validated structured questionnaire technique. Responses were coded and entered into a customized database in SPSS, version 17, for statistical analysis. Results: Two thousand female university students took part in this survey. The prevalence of dysmenorrhea among the study group was 90.1% (50.5% had pain during each menstruation while 39.6% had pain during some menstruations). Participants were statistically more likely to have dysmenorrhea if they were underweight, having a low family income, living in a rural area, and reporting to have a family history of dysmenorrhea. The majority of respondents thought that the pharmacist had a major role in the treatment of dysmenorrhea. Conclusion: This study has reported a high prevalence of dysmenorrhea among female university students in Jordan. There are growing opportunities for pharmacists to act in the treatment and management of dysmenorrhea.

Sucrose and naltrexone prevent increased pain sensitivity and impaired long-term memory induced by repetitive neonatal noxious stimulation: Role of BDNF and β-endorphin

Pain in neonates is associated with short and long-term adverse outcomes. Data demonstrated that long-term consequences of untreated pain are linked to the plasticity of the neonates brain. Sucrose is effective and safe for reducing painful procedures from single events. However, the mechanism of sucrose-induced analgesia is not fully understood. The role of the opioid system in this analgesia using the opioid receptor antagonist Naltrexone was investigated, plus the long-term effects on learning and memory formation during adulthood. Pain was induced in rat pups via needle pricks of the paws. Sucrose solution and/or naltrexone were administered before the pricks. All treatments started on day one of birth and continued for two weeks. At the end of 8weeks, behavioral studies were conducted to test spatial learning and memory using radial arm water maze (RAWM), and pain threshold via foot-withdrawal response to a hot plate. The hippocampus was dissected; levels of brain derived neurotrophic factor (BDNF) and endorphins were assessed using ELISA. Acute repetitive neonatal pain increased pain sensitivity later in life, while naltrexone with sucrose decreased pain sensitivity. Naltrexone and/or sucrose prevented neonatal pain induced impairment of long-term memory, while neonatal pain decreased levels of BDNF in the hippocampus; this decrease was averted by sucrose and naltrexone. Sucrose with naltrexone significantly increased β-endorphin levels in noxiously stimulated rats. In conclusion, naltrexone and sucrose can reverse increased pain sensitivity and impaired long-term memory induced by acute repetitive neonatal pain probably by normalizing BDNF expression and increasing β-endorphin levels.

Sweet Solution Analgesia

Mammals’ first tasting experience is usually sweet solution. Whether it is milk (breast or formula), sugar water as in some cultures or even dates as advocated by Prophet Mohammed to his followers. Thus, it is no wonder the soothing, calming and even pain relieving effects of oral sweet solutions. Nevertheless, using sweet solution purposely for its pain-relieving effects for infants in the clinical setting is relatively recent; however, the discussion concerning sweet solution effectiveness, mechanism of actions and adverse long-term effects are still ongoing. In this chapter, we present an account of studies on both humans and animals that explored and examined the use of several sweet solutions for analgesia.

Healthcare Providers’ Knowledge and Current Practice of Pain Assessment and Management: How Much Progress Have We Made?

Context. Despite improvement in pain management and availability of clinical treatment guidelines, patients in Jordan are still suffering from pain. Negative consequences of undertreated pain are being recognized as a reason for further illnesses and poor quality of life. Healthcare providers (HCPs) are responsible for relieving pain of their patients. Objective. To evaluate the knowledge and attitudes of HCPs toward pain management in Jordan. Methods. A 16-item questionnaire with agree or disagree options was given to 662 HCPs in seven hospitals in Jordan who volunteered to participate in the study. Following data collection, the responses were coded and entered into SPSS. Results. There was a statistically significant difference (p < 0.004) in percentage scores between physicians (36%) and pharmacists (36%) versus nurses (24%). The level of knowledge was the best among physicians, followed by pharmacists specifically in the area of cancer pain management. Nurses scored the lowest for knowledge of pain assessment and management among HCPs. However, HCPs overall scores indicated insufficient knowledge specifically in relation to pain assessment and management among children.

Prevention of memory impairment induced by post-traumatic stress disorder by cerebrolysin

Post-traumatic stress disorder (PTSD) may occur after exposure to stressful, fearful or troubling events. Until now, there is no curable medication for this disorder. Cerebrolysin is a neuropeptide, which has an important role in the treatment of vascular dementia. In this study, the probable protective effect of cerebrolysin on PTSD-induced memory impairment was investigated. To induce PTSD, the single prolonged stress (SPS) model was used. Rats were allocated into four groups: control (vehicle-treated), CBL (administrated cerebrolysin 2.5 ml/kg by intraperitoneal route for 4 weeks), SPS (as a model of PTSD and administered vehicle), and CBL-SPS (exposed to SPS and administered cerebrolysin for 4 weeks). Learning and memory were assessed using the radial arm water maze (RAWM). Results showed that SPS impaired both short- and long- term memories; and chronic cerebrolysin administration prevented such effect. Cerebrolysin also prevented decreases in hippocampal GSH levels and GSH/GSSG ratios, and increased GSSG and TBARs, levels induced by PTSD. In conclusion, a protective effect of cerebrolysin administration against SPS model of PTSD induced short- and long- term memory impairment was characterized. This protection could be accomplished, at least partly, by prevention of PTSD induced increase in oxidative stress in the hippocampus via the use of cerebrolysin.

Students' Perceptions of Pharmacy as a Specialization and Their Future Career : A Cross Sectional Study of Final Year Pharmacy Students in Jordan = انطباعات الطلبة عن الصيدلة كتخصص و مهنة مستقبلية : دراسة مقطعية لطلبة السنة الأخيرة لتخصص الصيدلة في الأردن

This study aimed to establish a baseline understanding of the career aspirations, motivations and expectations of students within undergraduate pharmacy education in Jordan and to examine students’ incentives to select pharmacy and how they feel about their choice as they are approaching graduation. A draft survey instrument was designed to collect the required information. The questionnaire was administered to final year pharmacy students (B.Sc. Pharmacy and PharmD) at the University of Jordan and the Jordan University of science and Technology. The questionnaire was administered at the end of all lectures at both universities. Following data collection, responses were coded and entered into a customized database in SPSS, version 17, for statistical analyses. Chi-square and Fisher exact tests were used to test for significant differences between groups A total of 240 final-year pharmacy students took part in the present study. The majority of respondents (n=147, 61.3%) indicated that pharmacy was not their first choice of study at the time of application to universities. More than half (n=138, 57.5%) the respondents claimed that they were optimistic regarding the future of pharmacy as a profession. When asked to rank pharmacy among different suggested professions, the majority of respondents (n=95, 39.58%) ranked pharmacy second after medicine and before dentistry. The majority of respondents (n=202, 84.17%) thought they had a positive self image. Students studying pharmacy seem to have optimistic aspirations of their future career and a positive image. Further qualitative research is needed to gain more in-depth understanding of this issue and to create a realistic connection between market needs and pharmacy education outputs.