An-Najah Blogs :: SAMAH W. AL-JABI http://blogs.najah.edu/author/samahjabi An-Najah Blogs :: SAMAH W. AL-JABI en-us Fri, 22 Nov 2019 17:56:15 IST Fri, 22 Nov 2019 17:56:15 IST webmaster@najah.edu webmaster@najah.edu Knowledge and practices of pesticide use among farm workers in the West Bank, Palestine: safety implicationshttp://blogs.najah.edu/staff/samahjabi/article/Knowledge-and-practices-of-pesticide-use-among-farm-workers-in-the-West-Bank-Palestine-safety-implicationsPublished Articles Objectives The objectives of this study were to assess the knowledge and practices associated with pesticide use in an agricultural community in Palestine and to determine the prevalence of self-reported health symptoms related to pesticide exposure Methods In this cross-sectional questionnaire study agricultural farm workers in Nablus district Palestine were interviewed on their knowledge and practices of pesticide use Comparisons of knowledge and practices of pesticide use between various groups were performed using the MannWhitney U-test or the KruskalWallis rank test of variance The program of the Statistical Package for Social Sciences SPSS version 15 was used for data analysis Results The questionnaire was completed by 381 farm workers The mean age SD of the participants was 388 118 years The majority 979 of the participants were male The mean participant scores for knowledge and safety procedures were 28 32 out of 8 and 98 24 out of 15 respectively There was a significant positive correlation r = 0323; P 0001 between the knowledge and safety procedure scores Unsafe behaviors were identified as the storage of pesticide products at home the preparation of pesticides in the kitchen inadequate disposal of empty pesticide containers eating and drinking during pesticide application and using inadequate protective clothing The most frequent self-reported toxicity symptoms associated with pesticide use were skin rash 375 headache 37 excessive sweating 249 and diarrhea 213 There was a strong significant negative correlation r = 083; P 0001 between self-reported toxicity symptoms and scores for protective measures Conclusion The results of this study indicate that most farm workers in this district need more educational programs regarding the safety and use of pesticides Legislation promoting the use of safer pesticides is also needed Incidence of adverse drug reactions induced by N-acetylcysteine in patients with acetaminophen overdosehttp://blogs.najah.edu/staff/samahjabi/article/Incidence-of-adverse-drug-reactions-induced-by-N-acetylcysteine-in-patients-with-acetaminophen-overdosePublished ArticlesBackground: Intravenous N-acetylcysteine IV-NAC is widely recognized as the antidote of choice for acetaminophen overdose However its use is not without adverse drug reactions ADR that might affect therapeutic outcome or lead to treatment delay Objective: the aim of this study was to investigate the type and incidence of ADR induced by IV-NAC in patients treated for acetaminophen overdose Methods: This is a retrospective study of patients admitted to the hospital for acute acetaminophen overdose over a period of 4 years 1 January 2005 to 31 December 2008 The primary outcome of interest in this study was the occurrence of ADR during NAC administration Pearson chi-square test or Fishers exact test students t test and Mann-Whitney U test were used in univariate analysis SPSS 15 was used for data analysis Results: Two hundred and fifty five patients were studied Different types of ADR were observed in 119 467 cases Of those patients 83 697 had been treated with IV-NAC versus 36 303 who had not p 001 The following ADR were significantly associated with IV-NAC administration: vomiting p frac14; 001 flushing p 001 rash p 001 pruritus p 001 chest pain p frac14; 001 bronchospasm p frac14; 03 coughing p frac14; 01 headache p frac14; 001 dizziness p 001 convulsion p frac14; 03 and hypotension p frac14; 001 ADR were mild in 54 432 moderate in 17 136 and severe in 12 96 patients There were no ADR in 42 336 patients Comparative results of the characteristics of patients who reacted to IV-NAC and nonreactors showed that patients with ADR had no significant difference in age gender ethnicity amount ingested latency time and acetaminophen level than nonreactors Conclusion: ADR to IV-NAC were common among patients with acetaminophen overdose butmostlyminor and all reported adverse reactions were easilymanagedHigh prevalence of hypokalemia after acute acetaminophen overdose: Impact of psychiatric illnesshttp://blogs.najah.edu/staff/samahjabi/article/High-prevalence-of-hypokalemia-after-acute-acetaminophen-overdose-Impact-of-psychiatric-illnessPublished ArticlesBackground: Hypokalemia is not an isolated disease but an associated finding in a number of different diseases It is also a commonly neglected condition among patients with acute acetaminophen overdose Objectives: This study intended to determine the prevalence of hypokalemia and its clinical correlates in acute psychiatric illness among hypokalemic and normokalemic patients after acetaminophen overdose Methods: This is a retrospective cohort study of hospital admissions for acute acetaminophen overdose conducted over a period of 5 years from 1 January 2004 to 31 December 2008 Demographic data and different types of psychiatric illness were compared between hypokalemic and normokalemic patients Hypokalemia was predefined by a serum concentration 35 mmolL Statistical Package for Social Sciences SPSS 15 was used for data analysis Results: Two hundred and eighty patients out of 305 admissions were studied Hypokalemia was found in 636 of patients with a higher prevalence in the presence of psychiatric illness 677 Hypokalemic patients were significantly associated with the presence of major depression p frac14; 04 adjustment disorder p 001 anxiety p frac14; 01 and suicidal attempts p frac14; 04 Conclusion: Hypokalemia was common among patients with psychiatric illness and acute acetaminophen overdoseAnalysis of Prescription dispensed at Community Pharmacies in Palestinehttp://blogs.najah.edu/staff/samahjabi/article/Analysis-of-Prescription-dispensed-at-Community-Pharmacies-in-PalestinePublished ArticlesSawalha AF Sweileh WM Zyoud SH Al-Jabi SW Bni Shamseh FF Odah AA Analysis of Prescription dispensed at Community Pharmacies in Palestine Accepted at Eastern Mediterranean Health Journal 2009 [Publisher: Eastern Mediterranean Regional Office of the World Health Organization Country where published: Egypt] Accepted 18 January 2009 Abstract Background and Objective: Rational prescribing is a key element in clinical practice The present study investigated the prescription quality and prescribing trends of private clinicians in Nablus governate Palestine Method: Prescriptions were collected from a random sample of community pharmacies Data regarding a checklist of elements in the prescription as well as the types of drug classes prescribed were entered and analyzed using SPSS Result: A total of 363 prescriptions were collected from 36 community pharmacies during a study period of 288 working hours Physician related variables were mostly present However patients address and weight were absent in all prescriptions Less than half of the prescriptions included information regarding age and gender of the patient Information regarding strength of the medications prescribed was deficient in most prescriptions However other drug related variables like frequency and instruction of use were present in the majority of prescriptions Antimicrobial agents were the most commonly prescribed followed by NSAIDsanalgesics class Of the antimicrobial agents amoxicillin alone or in combination was the most commonly prescribed followed by cefuroxime Conclusion: In general prescription writing quality in Nablus Palestine is deficient in certain aspects and improvement is required Areas of further improvement include writing age and sex of patient as well as the importance of prescribing drugs by generic name Over-prescribing of antibiotics as well as other drug classes require close monitoring A pharmaco-epidemiology center is needed to monitor and enhance rational drug use Key words: Prescriptions Community Pharmacy Palestine Running title: Analysis of PrescriptionsPharmacy education and practices in West-Bank (Palestine).http://blogs.najah.edu/staff/samahjabi/article/Pharmacy-education-and-practices-in-West-Bank-Published ArticlesSweileh WM Sawalha AF Zyoud SH Al-Jabi SW Pharmacy education and practices in West-Bank Palestine Accepted for publication American Journal of Pharmaceutical Education2008 [Publisher: American Association of Colleges of Pharmacy Country where published: United state] In pressPatterns of Antihypertensive Therapy in Diabetic Patients with and without Reduced Renal Functionhttp://blogs.najah.edu/staff/samahjabi/article/Patterns-of-Antihypertensive-Therapy-in-Diabetic-Patients-with-and-without-Reduced-Renal-FunctionPublished ArticlesSweileh WM Sawalha AF Zyoud SH Al-Jabi SW Tameem EJ Patterns of Antihypertensive Therapy in Diabetic Patients with and without Reduced Renal Function Accepted for publish at Saudi Journal of Kidney Diseases and Transplantation SJKDT2010 [Publisher: Saudi Center for Organ Transplantation Country where published: Saudi Arabia] In press AbstractBackground: Renal deterioration is a common complication in patients with diabetes mellitus and hypertension Appropriate use of antihypertensive agents and tight control of blood pressure BP can minimize and delay such complications Objective: To investigate the utilization patterns of antihypertensive agents and to evaluate blood pressure control among diabetic hypertensive patients with and without reduced renal function Methodology: Retrospective cohort study All diabetic hypertensive patients attending Al-Watani medical governmental center from August 01 2006 until August 01 2007 were considered in the study Patients with a history of congestive heart failure andor end stage renal disease were excluded Proportions of use of 5 different antihypertensive drug classes were compared for all patients receiving 1 2 3 or 4 drugs and separately among patients with and without reduced renal function Results: Over 60 of patients were receiving angiotensin-converting enzyme inhibitors ACEI angiotensin receptor blocker ARB followed by diuretics 408 calcium channel blockers 251 and -blockers 125 The majority 55 of patients were either on mono or no drug therapy Patients on monotherapy were mostly receiving ACEIARB 60 In patients with reduced renal function use of diuretics but not ACEIARB or CCB was higher and 418 of the patients were on monotherapy compared to 466 in patients with normal renal function The proportions of patients achieving BP control were 20 and 28 for patients on monotherapy versus those on combination therapy respectively Conclusions: Patterns of antihypertensive therapy were generally but not adequately consistent with international guidelines Areas of improvement include increasing ACEIARB and diuretic use decreasing the number of untreated patients and increasing the proportion of patients with controlled BP in this population Running Title: Antihypertensive Therapy in Diabetic Patients Kew Words: Antihypertensive Therapy Diabetes Mellitus Renal FunctionDischarge Medications among Stroke Survivors: A Study in Palestinehttp://blogs.najah.edu/staff/samahjabi/article/Discharge-Medications-among-Stroke-SurvivorsPublished ArticlesSweileh WM Sawalha AF Zyoud SH Al-Jabi SW Abaas MA Discharge Medications among Stroke Survivors: A Study in Palestine Accepted for publish at Journal of stroke and cerebrovascular disease 2008; 181: [Publisher: Elsevier Saunders Country where published: United States] In pressBackground: The aim of this study was to analyze the types and cost of medications prescribed at discharge for ischemic stroke survivors Methods: This is a descriptive study of medications prescribed for ischemic stroke survivors admitted to Al-watani hospital during a 6-month period Results: A total of 95 consecutive stroke patients were included in the study period; 78 821 survivors were having ischemic stroke subtype and were designated the study group The average age of the survivors was 669 6 127 years Survivors had prevalent risk factors such as diabetes mellitus 70 hypertension 68 and ischemic heart disease 346 On average survivors experienced a minimum of 073 complications range 0-3 with the most common being infections n 5 35 448 Forty-two per cent of the ischemic stroke survivors were taking antiplatelet drugs prior to the current attack At discharge ischemic stroke survivors were prescribed an average of 49 medications from 43 different drug classes All ischemic stroke survivors were prescribed antiplatelet therapy at discharge Aspirin monotherapy was prescribed for 61 survivors while the combination of aspirinclopidogrel antiplatelet therapy was prescribed for 17 survivors The average monthly cost for prophylactic therapy and for medications used to treat post-stroke complication was approximately 52 USD per survivor Conclusion: Most of the patients in the study group were having the traditional risk factors for ischemic stroke and were suffering form typical post-stroke complications Lack of medical insurance will impose a heavy financial burden on stroke survivors in Palestine Key Words: MedicationsischemicstrokePalestine link: http:linkinghubelseviercomretrievepiiS1052305708002139Evaluation of Antihypertensive Therapy in Diabetic Hypertensive Patients: Impact of Ischemic Heart Diseasehttp://blogs.najah.edu/staff/samahjabi/article/Evaluation-of-Antihypertensive-Therapy-in-Diabetic-Hypertensive-PatientsPublished ArticlesSweileh WM Sawalha AF Zyoud SH Al-Jabi SW Tameem EJ Shraim NY Evaluation of Antihypertensive Therapy in Diabetic Hypertensive Patients: Impact of Ischemic Heart Disease Journal of pharmacy practice; 2009 [Publisher: Directory of Open Access Journals Country where published: Spain] Accepted for publication Abstract Background and Objective: Macrovascular complications are common in diabetic hypertensive patients Appropriate antihypertensive therapy and tight blood pressure control are believed to prevent or delay such complication The objective of this study was to evaluate utilization patterns of antihypertensive agents and blood pressure BP control among diabetic hypertensive patients with and without ischemic heart disease IHD Methodology: Retrospective cohort study of all diabetic hypertensive patients attending Al-watani medical center from August 2006 until August 2007 Proportions of use of different antihypertensive drug classes were compared for all patients receiving 1 2 3 or 4 or more drugs and separately among patients with and without IHD Blood pressure control 130 80 mmHg was compared for patients receiving no therapy monotherapy or combination therapy and separately among patients with and without IHD Results: 255 patients were included in the study; their mean age was 644 114 years Sixty on e 239 of the included patients was on target BP Over 60 of the total patients were receiving angiotensin-converting enzyme inhibitors ACEI angiotensin receptor blocker ARB followed by diuretics 408 calcium channel blockers 251 and -blockers 125 The majority 55 of patients were either on mono or no drug therapy More than 55 of patients with controlled BP were using ACE-I More than half 508 of the patients with controlled BP were on combination therapy while 423 of patients with uncontrolled BP were on combination therapy; P = 024 More patient in the IHD achieved target BP than those in non-IHD group P = 0019 Comparison between IHD and non-IHD groups indicated no significant difference in the utilization of any drug class with ACE-I being the most commonly utilized in both groups Conclusions: Patterns of antihypertensive therapy were generally but not adequately consistent with international guidelines Areas of improvement include increasing ACE-I drug combinations decreasing the number of untreated patients and increasing the proportion of patients with controlled BP in this population Clinical pharmacist can play a role in achieving this Key Words: Hypertension control; Diabetes mellitus; Drug regimens; Prescribing patterns; JNC 7th report Predictors of in-Hospital Mortality after Acute Stroke: Impact of Genderhttp://blogs.najah.edu/staff/samahjabi/article/Predictors-of-in-Hospital-Mortality-after-Acute-StrokePublished ArticlesSweileh WM Sawalha AF Al-Aqad M Sana Zyoud SH Al-Jabi SW Predictors of in-Hospital Mortality after Acute Stroke: Impact of Gender Accepted for publish at International journal of clinical and experimental medicine 2x:xxx-xxx2009 [Publisher: e-Century Pub Corp Country where published: United States] PublishedAbstractAbstract: The purpose of this study was to identify predictors of in-hospital mortality after acute stroke and investigate the impact of gender on stroke mortality All patients admitted to Al-watani governmental hospital in Palestine from September 2006 to August 2007 and diagnosed with acute stroke were included in the study Diagnosis of stroke was confirmed by computerized tomography scan Demographics and clinical data pertaining to the patients were obtained from their medical files The main outcome measure in this study was vital status at hospital discharge Multiple logistic regression analysis was used to identify the independent predictors of in-hospital mortality Statistical analysis was carried out using SPSS 15A total of 186 acute stroke cases 95 females and 91 males were included in the study Hypertension 699 and diabetes mellitus 452 were the most common risk factors among the patients Thirty nine 21 of the stroke patients died in hospital Multiple logistic regression analysis indicated that chronic kidney disease P = 0004 number of post-stroke complications P= 0037 and stroke subtype P = 0015 were independent predictors of in-hospital mortality among the total stroke patients Conclusion: Knowledge of in-hospital mortality predictors is required to improve survival rate after acute stroke The study showed that gender was not an independent predictor of mortality after acute stroke More research is required to understand gender differences in stroke mortalityIJCEM811001 Key Words: Predictors hospital mortality acute stroke gender Links: http:wwwijcemcom811001AhtmlOptimal dosing of angiotensin-converting enzyme inhibitors in patients with chronic heart failure: a cross-sectional study in Palestinehttp://blogs.najah.edu/staff/samahjabi/article/Optimal-dosing-of-angiotensin-converting-enzyme-inhibitors-in-patients-with-chronic-heart-failurePublished ArticlesSweileh WM Sawalha AF Reno Tamara M Zyoud SH Al-Jabi SW Optimal dosing of angiotensin-converting enzyme inhibitors in patients with chronic heart failure: a cross-sectional study in Palestine Submitted to journal of Annals of Saudi Medicine 2008 [Publisher: King Faisal Specialist Hospital and Research Centre Country where published: Saudi Arabia] In pressAbstractBACKGROUND AND OBJECTIVE: Because high-dose angiotensin-converting enzyme ACE inhibitor therapy is desirable in patients with chronic heart failure CHF we sought to determine the usage and dosing patterns of ACE inhibitors in CHF patients at a governmental hospital in Palestine METHODS: This cross-sectional study was conducted between September 2006 and August 2007 All patients admitted with a confirmed diagnosis of CHF and an ejection fraction 40 were evaluated After excluding patients with a cautioncontraindication to ACE inhibitor use or not taking an ACE inhibitor we determined the number of patients receiving optimal captopril = 150 300 mgday; enalpril = 20 40 mgday; ramipril = 5 10 mgday and suboptimal doses We then conducted statistical analyses to evaluate associations between ACE inhibitor use and dosing and various demographic and clinical factors RESULTS: Of the 165 patients initially evaluated 69 418 had cautioncontraindication 28 406 or were not using an ACE inhibitor 41 594 Of the remaining 96 patients 701 4996 51 were given an optimal dose while 4796 49 were given a suboptimal dose Of all patients with CHF and no contraindication 88 642 were either receiving no ACE inhibitor or a suboptimal dose Only the presence of hypertension was significantly associated with the use of an ACE inhibitor P=009 odds ratio=27 The use of an optimal dose was not significantly associated with any of the tested factors age gender presence of hypertension diabetes mellitus renal dysfunction ischemic heart disease or number of diagnosis CONCLUSION: Underutilization and suboptimal dosing of ACE inhibitors was common Since there is an abundance of evidence in favor of using high-dose ACE inhibitor therapy in patients with CHF physicians need to be educated about proper dosing of these agentsEpidemiological, Clinical, and Pharmacological Aspects of Headache in a University Undergraduate Population in Palestinehttp://blogs.najah.edu/staff/samahjabi/article/Epidemiological-Clinical-and-Pharmacological-Aspects-of-Headache-in-a-University-Undergraduate-Population-in-PalestinePublished ArticlesBackground and Objectives: Headache is one of the most common complaints in clinical practice Few studies regarding headache in university students have been investigated in the in the Middle East The objective of this study was to explore the prevalence clinical characteristics triggering factors and treatment options of headaches in university undergraduate students in Palestine Middle East Methodology: Data were collected by interviewing a sample of 1900 students The Headache Assessment Quiz was used to measure quality and severity of headache and to collect data on triggering factors and symptom management Results: A total of 1808 952 reported having at least one headache episode in the previous year A positive family history of headache was found in 40 of students The prevalence rate of frequent headache 2 episodes month was found in 1096 609 students; 613 females 559 Of those having frequent headaches 228 208 experience moderate to severe episodes 341 312 have pulsating throbbing and pounding pain and 274 25 have unilateral pain The most common triggering factors among students with frequent headaches were: tension stress 782 and sleep deprivation 754 Less than 5 of students sought medical assistance during headache episodes Most of the students 791 reported self- therapy with single analgesic 534 herbs 102 or combination 155 while 209 reported using no medication of any type to decrease pain Acetaminophen 485 followed by ibuprofen 49 were the most commonly used non-prescription analgesic drugs Conclusion: Headache is a prevalent symptom in the college age population Further research is needed to determine the prevalence of specific types of headaches Health care providers are required to educate this population as well as to assist students in properly diagnosing and treating headache typesThe Epidemiology of Stroke in Northern Palestine: A One-Year, Hospital-Based Studyhttp://blogs.najah.edu/staff/samahjabi/article/The-Epidemiology-of-Stroke-in-Northern-PalestinePublished ArticlesSweileh WM Sawalha AF Al-Aqad M Sana Zyoud SH Al-Jabi SW The Epidemiology of Stroke in Northern Palestine: A One-Year Hospital-Based Study Journal of stroke and cerebrovascular disease 2008; 176: 406-411 [Publisher: Elsevier Saunders Country where published: United States] PublishedAbstract BACKGROUND: Although stroke is one of the leading causes of morbidity and mortality worldwide no studies on stroke were reported from Palestine The objective of this study was to identify the risk factors and incidence rates of stroke in a well-defined area in north Palestine ie the district of Nablus with 362159 native Palestinian inhabitants METHODS: All patients admitted to Al-Watani governmental hospital from September 2006 to August 2007 and given the diagnosis of acute stroke were included in the study Diagnosis of stroke was confirmed by computerized tomography scan Demographic characteristics and clinical data pertaining to the patients were obtained from their medical files RESULTS: A total of 186 patients with stroke 95 female and 91 male were identified during the study The average age of the patients was 6909 - 109 years Among the total patients 112 had a first-ever stroke FES and 74 had recurrent stroke RS Hypertension diabetes mellitus and renal dysfunction were the most common risk factors with comparable prevalence in both FES and RS The majority of patients 153; 823 had ischemic stroke subtype whereas 33 177 had hemorrhagic stroke subtype The overall FES RS annual crude incidence rate of stroke was 514 per 100000 persons whereas the annual crude incidence rate of FES was 31 per 100000 persons The age-adjusted incidence rates were 545 FES and 898 FES and RS The overall inhospital mortality was 21 and was higher in patients with RS than in those with FES CONCLUSION: Modifiable risk factors were common among patients with stroke Better control of these risk factors might decrease incidence of stroke and all consequences thereafter Incidence rate and inhospital mortality of stroke reported in this study were within the range reported from other Arab countriesLink: http:linkinghubelseviercomretrievepiiS1052-30570800148-1Self-Therapy Practices among University Students in Palestine: Focus on Herbal Remedieshttp://blogs.najah.edu/staff/samahjabi/article/Self-Therapy-Practices-among-University-Students-in-PalestinePublished ArticlesSawalha AF Sweileh WM Zyoud SH Al-Jabi SW Self-Therapy Practices among University Students in Palestine: Focus on Herbal Remedies Complementary therapies in medicine 2008;166:343-349[Publisher: Elsevier Churchill Livingstone Country where published: England Scotland] PublishedAbstract BACKGROUND: Herbal self-therapy is a common practice among Palestinians However no published data are available on herbal self-therapy in the Middle East in general and in Palestine in particular OBJECTIVE: This study was conducted to 1 determine the extent of herbal self-therapy among university students 2 investigate the different types of herbal remedies used and 3 investigate the correlates and reasons associated with such practices METHODOLOGY: This cross-sectional descriptive study was carried out using a structured questionnaire that contained five sections: 1 demographics; 2 medication knowledge and self-care orientation; 3 types of herbal remedies used; 4 clinical conditions treated; and finally 5 the reasons reported by students for herbal self-therapy practice Pearson chi2 multiple logistic regression and one-way ANOVA were performed using SPSS 13 program RESULTS: 339 of the respondents reported using herbal remedies in self-therapy Female gender students at medical colleges and those with high self-care orientation were significant predictive model for herbal use Sage Salvia fruticosa L chamomile Chamaemelum nobile L anise Pimpinella anisum L and thyme Thymus vulgaris L were the most commonly utilized herbal remedies The types of herbal remedies selected were significantly influenced by gender but not by the level of medication knowledge or self-care orientation Herbal remedies were used primarily for the treatment of headache flu menstrual pain and sore throat The main motivating factor for using herbal remedies reported for using herbal remedies was simplicity of symptoms CONCLUSIONS: Herbal self-therapy was a common practice among university students Health care providers need to be aware of the students self-therapy practices and need to have sufficient knowledge regarding herbs not simply because of the widespread use but also because of significant reported side effects Academics need to consider offering courses about herbal remedies to students in both the medical and non-medical faculties to broaden their treatment capabilities during this time of increased unregulated medical interventions such as herbal therapylink: http:linkinghubelseviercomretrievepiiS0965-22990700118-5Comparative Analysis of Patient Package Inserts of Local and Imported Anti-Infective Agents in Palestinehttp://blogs.najah.edu/staff/samahjabi/article/Comparative-Analysis-of-Patient-Package-Inserts-of-Local-and-Imported-Anti-Infective-Agents-in-PalestinePublished ArticlesSawalha AF Sweileh WM Zyoud SH Al-Jabi SW Comparative Analysis of Patient Package Inserts of Local and Imported Anti-Infective Agents in Palestine Accepted for publish at Libyan Journal of Medicine2008; 34 [Publisher: Directory of Open Access Journals Country where published: Libya] PublishedAbstract Background and Objective: The patient package insert is an important source of drug information The aim of this study was to evaluate and compare the PPI of the anti-infective agents manufactured in Palestine with the imported equivalents Method: The selection criteria generated 15 different anti-infective agents available as 36 locally manufactured products and 15 imported equivalents The design of the patient package insert was evaluated in terms of the number of words used in eight main headings and the presence or absence of certain information regarding nine statements Results: Inserts of locally manufactured products have significantly fewer words than those of imported products with respect to warnings dosage and administration and side effects The most significant difference was found in the warnings Moreover differences were found between inserts of local and imported products in terms of the presence of the nine informative statements Locally manufactured products did not mention inactive ingredients clinical pharmacology or date of last revision but all of them provided information on the use of the drug during pregnancy and lactation and on the duration of therapy However in general they provided less information than the imported equivalents Conclusion: Palestinian authorities and local manufacturers should implement appropriate measures to regulate the quality and quantity of information in the patient package insert of locally produced anti-infective agents PPI improvement will better direct health practices to the benefit of the patientsLink: http:wwwljmorglymodulesphp?name=Newsfile=articlesid=1354 Chewable Tablets: Is this Dosage Form Well Evaluated by Palestinian Health Professionals?http://blogs.najah.edu/staff/samahjabi/article/Chewable-TabletsPublished Articles Zaid AN Abu Ghosh AO Sweileh WM Al-Jabi SW Jaradat NA Chewable Tablets: Is this Dosage Form Well Evaluated by Palestinian Health Professionals? The Islamic University Journal Series of Natural Studies and Engineering Vol15 No 2 pp 83-94 2007 Abstract:To evaluate the scientific knowledge and attitudes of health professionals in Palestine regarding the advantages of chewable tablets in comparison with other related dosage forms Methods: Data was gathered from a questionnaire that was handed out to community pharmacists Physicians Pharmaceutical industry decision makers were also enrolled in this study Data was analyzed using SPSS statistical software program version 110 Results: Both the 149 pharmacists and 111 physicians who participated in this study had very close opinions with regard to the superiority of chewable tablets over the corresponding liquid dosage forms especially when issues of palatability stability dose precision ease of administration portability and safety were mentioned Pharmacists and physicians were uncertain about the higher effectiveness of chewable tablets in comparison with other related dosage forms ie syrups and suspensions which contain the same active ingredients All industrial decision makers thought that the number of chewable tablet formulations present in Palestine is relatively low One third of them believed that this dosage form is not fully evaluated nor well appreciated by pharmacists and doctors About half of them thought that the lack of technology or specialized personnel is the reason behind the poor development of this dosage form Conclusion: The importance of chewable tablets is not completely understood and appreciated by the Palestinian health personnel Pharmaceutical manufacturers should pay more attention to the development and production of chewable tablets due to the obvious advantages of this dosage form Clear and complete information about this dosage form must be provided to pharmacists and physicians by medical representatives Key words: chewable tablets portability palatability safetyMedication dosing errors in hospitalized patients with renal impairment: a study in Palestinehttp://blogs.najah.edu/staff/samahjabi/article/Medication-dosing-errors-in-hospitalized-patients-with-renal-impairmentPublished ArticlesSweileh WM Sawalha AF Janem SA Abu-Taha AS Zyoud SH Sabri IA Al-Jabi SW Jaradat NA Zaid AA Medication dosing errors in hospitalized patients with renal impairment: a study in Palestine Pharmacoepidemiology and drug safety 2007 Aug;168:908-12 [Publisher: Wiley Country where published: England] PublishedAbstract BACKGROUND AND AIM: Reduced renal function requires dose adjustment for certain drugs to avoid toxicity The aim of this study was to determine whether appropriate dosage adjustments were made for drugs that are nephrotoxic excreted or metabolized TEM medications by the kidney in patients with renal impairment METHODOLOGY: A cross-sectional study of a group of hospitalized patients was carried out at Al-Watni governmental hospital Nablus Palestine All patients with creatinine clearance =59 mlmin were included in the analysis Data regarding patients clinical laboratory findings and medications whether they were prescribed at hospital or at discharge were collected from patients medical files Evaluation of appropriate dosing was based on Physician Disk Reference PDR All data were collected for further research and subsequent statistical analysis using statistical package for social sciences SPSS for windows version 10 RESULTS: A total of 78 patients had calculated creatinine clearance =59 mlmin Those patients were prescribed a total of 1001 lines of prescription medication Dosage adjustment was necessary for 193 TEM medications Analysis of TEM medications with guidelines for adjustment indicated that 7358142 were found to be inappropriate and 2642 51 were found to be appropriate The most common inappropriate medications were ranitidine antibiotics and digoxin Approximately 775 of the unadjusted medications were prescribed during hospitalization CONCLUSION: In our study a wide range of dosing errors was common among patients with renal impairment that was common during hospitalization Continued medical education in the field of clinical pharmacokinetics is important for physicians Links: http:www3intersciencewileycomjournal114224304abstract?CRETRY=1SRETRY=0 Antidote Stocking at Hospitals in North Palestinehttp://blogs.najah.edu/staff/samahjabi/article/Antidote-Stocking-at-Hospitals-in-North-PalestinePublished ArticlesSawalha AF Sweileh WM Zyoud SH Al-Jabi SW Antidote Stocking at Hospitals in North Palestine Online Journal of Health Allied Science2006;54 [Publisher: Directory of Open Access Journals Country where published: India] PublishedAbstractObjective: The purpose of this study was to determine the availability and adequacy of antidote stocking at hospitals in north Palestine based on published guidelines for antidote stocking Methodology: This study is a cross sectional survey of all hospitals at north Palestine n=11 using a questionnaire which was completed by the director of the pharmacy department at each hospital The questionnaire was divided into 2 parts The first part contained a list of 25 antidotes while the second part contained a list of 12 antidotes This classification is based on the guideline proposed by the British Association for Emergency Medicine BAEM The net antidote stock results were compared with the American guidelines as well Result: The overall availability of each antidote in the first list varied widely from zero for glucagon to 100 for atropine The number antidotes of the first list that were stocked in the 11 hospitals ranged from 5 to 12 antidotes but none of the hospitals stocked all the 25 antidotes Additionally availability of antidotes in the second list varied widely from zero for polyethylene glycol to 100 for dobutamine The number of antidotes stocked ranged from 5 to 9 but none of the hospitals stocked all the 12 antidotes Discussion and Conclusion: hospitals in north Palestine do not have adequate stock of antidotes Raising awareness of the importance of antidotes by education regular review of antidote storage distribution plans and appropriate legislation might provide solutions Coordination between Palestinian hospitals and the PCDIC at An-Najah National University is also importantLink: http:wwwojhasorgissue202006-4-4htmAdmission Blood Glucose Levels a Potential Indicator for short term Mortality and Morbidity after Myocardial Infarctionhttp://blogs.najah.edu/staff/samahjabi/article/Admission-Blood-Glucose-Levels-a-Potential-Indicator-for-short-term-Mortality-and-Morbidity-after-Myocardial-InfarctionPublished ArticlesSweileh WM Sawalha AF Salfeete S Zyoud SH Abu-Taha AS Al-jabi SW Jaradat NA and Zaid AA Admission Blood Glucose Levels a Potential Indicator for short term Mortality and Morbidity after Myocardial Infarction International Journal of Diabetes in Developing Countries 2006 26 3: 116-121 [Publisher: Directory of Open Access Journals Country where published: India] PublishedAbstract Aims : Hyperglycemia is common among patients with acute myocardial infarction AMI and is associated with high risk of mortality and morbidity However the relationship between admission plasma glucose APG levels and mortality in diabetic and nondiabetic patients with AMI needs further investigation The aim of this study was to investigate the relationship between APG level and short-term mortality and morbidity after AMI Materials And Methods : This is a prospective study of 79 consecutive patients with AMI followed up for 90 days Medical history as well as demographic and clinical baseline characteristics of the patients was obtained from Al-Watni Governmental Hospital medical records The patients were divided into four groups based on APG levels Patients\ health status was followed up by phone call interviews with the patients and their families Follow-up data were further confirmed using patients\ medical records at the hospital The phone interviews investigated all causes of death or congestive heart failure CHF or re-infarction Results : The mean age of patients was 619 123 years At the time of hospital admission the median PG level was 162 mgdl During the 3-month follow-up overall mortality was 203 and was increased to 563 in patients with glucose levels 200 mgdl Mortality was comparable 219 vs 191; P 005 between diabetic and nondiabetic patients Nonfatal adverse outcomes in the form of combined CHF and re-infarction were highest in group IV and lowest in group I Conclusion :Our study demonstrates that high APG level is common in patients with AMI and is associated with high risk of mortality and morbidity among patients with or without diabetes mellitus In fact our study showed that nondiabetic patients with high APG have higher risk of mortality than patients with a known history of diabetes mellitus Keywords:Diabetes myocardial infarction plasma glucose risk factorslink: http:wwwijddccomarticleasp?issn=0973-3930;year=2006;volume=26;issue=3;spage=116;epage=121;aulast=SweilehPrevalence of Reduced Renal Function among Diabetic Hypertensive Patientshttp://blogs.najah.edu/staff/samahjabi/article/Prevalence-of-Reduced-Renal-Function-among-Diabetic-Hypertensive-PatientsOn Going ResearchesSweileh WM Sawalha AF Zyoud SH Al-Jabi SW Nasr Y Shraim Prevalence of Reduced Renal Function among Diabetic Hypertensive Patients Accepted for publish at International Journal of Physiology Pathophysiology and Pharmacology2009; 11: 23-29 [Publisher: e-Century Pub Corp Country where published: United States] PublishedAbstract:Patients with diabetes mellitus and hypertension are at high risk of vascular complications particularly renal deterioration This study aimed to evaluate the prevalence and the risk factors of reduced renal function corresponding to chronic kidney disease CKD stages 3 5 among diabetic hypertensive patients This is a retrospective cohort study of diabetic hypertensive patients attending A-Watani governmental medical center from August 2006 until August 2007 Creatinine clearance CrCl was estimated using the CockcroftGault equation Those with CrCl 60 ml min corresponding to CDK stages 3 5 were considered to have reduced renal function The prevalence of reduced renal function was calculated and the risk factors associated with it were evaluated using multiple logistic regression The following were the results found in this study: a the prevalence of reduced renal function among the study patients was 355 distributed as follows: 635 had stage 3 CKD 217 had stage 4 and 13 had stage 5 CKD b Patients with reduced renal function were elder had higher number of chronic diseases and had longer duration of diabetes and hypertension than those with CrCl 60ml min c Men had a higher prevalence of reduced renal function than women d Significant predictors of reduced renal function were older age duration of diabetes and number of chronic diseases based on logistic regression analysis Early and continuous screening of renal function among diabetic hypertensive patients is required to implement preventable strategies of end stage renal disease ESRD Better control of blood pressure and diabetes mellitus are important IJCEM811001Links: http:wwwijppporgfilesIJPPP811001pdf