impact of oxidative stress on glucose-6-phosphate dehydrogenase level and prevalence of anemia among diabetic patients

The present study was conducted to assess the impact of oxidative stress on glucose 6 phosphate dehydrogenase [G6PD] and prevalence of anemia among diabetic patients. The study involved 100 adult patients attending Buraidah Central Hospital and 30 healthy controls. Blood samples were collected and analyzed for [G6PD] activity, total antioxidant status [TAS], fasting blood sugar [FBS], hemoglobin [HGB],red cell[RBCs] count, hematocrit [HCT], mean cell volume [MCV], mean cell hemoglobin [MCH], and mean cell hemoglobin concentration [MCHC], hemoglobin A1c [Hb A1c], blood urea, serum creatinine, and microalbuminuria. It showed significant correlation between G6PD deficiency and low TAS among diabetics and significant correlation between low hemoglobin concentration [females < 120 g/L, males <130 g/L], G6PD deficiency and low concentration of TAS. The prevalence of anemia was 22% in diabetics. It can be concluded that there is significant impact of oxidative stress [reduced TAS] on reduced G6PD level and the low HGB concentration in diabetic patients, that means oxidative stress of diabetes mellitus is possible cause of G6PD anemia

Physicians' medication prescribing in primary care in Riyadh city, Saudi Arabia. Literature review, part1: variations in drug prescribing

Rational prescribing is associated with improved safety in drug use, better quality of life for patients and cost-effective care. Medication prescribing is a relatively unexplored area of research in Saudi Arabia and until now most studies have been in the secondary and tertiary health care system. This paper is the first of 3 review articles that form the background for a series of 5 interconnected studies of prescribing patterns and medication errors in the public and private primary health care sectors of Saudi Arabia. A MEDLINE search was conducted to identify papers published in peer-reviewed journals over the previous 3 decades. The paper reviews variations in prescribing patterns and influences on physicians' prescribing behaviour worldwide and in Saudi Arabia

Physicians' medication prescribing in primary care in Riyadh city, Saudi Arabia. Literature review, part 2: rational prescribing

Unlike suB-optimal prescribing rational prescribing, coupled with certain indicators, is associated with improved safety in drug use in drug for prescribing, better quality of life for patients and cost-effective care. Medication prescribing is relatively unexplored area of research in Saudi Arabia and until now most studies have been health care system. This paper is the second of 3 review articles that form the interconnected studies of prescribing patterns and medication errors in the public care sectors of Saudi Arabia. A MEDLINE search was conducted to identify papers published in peer- reviewed journals over the previous 3 decades. The paper reviews rational prescribing with its indicators suboptimal prescribing, classification of medication errors, and how to achieve quality in health care prescribing worldwide and in Saudi Arabia

Physicians' medication prescribing in primary care in Riyadh city, Saudi Arabia. Literature review, part 3: prescribing errors

Medication errors are globally huge in magnitude and associated with high morbidity and mortality together with high costs and legal problems. Medication errors are caused by multiple factors related to health providers, consumers and health system, but most prescribing errors are preventable. This paper is the third of 3 review articles that form the background for a series of 5 interconnected studies of prescribing patterns and medication errors in the public and private primary health care sectors of Saudi Arabia. A MEDLINE search was conducted to identify papers published in peer-reviewed journals over the previous 3 decades. The paper reviews the etiology, prevention strategies, reporting mechanisms and the myriad consequences of medication errors

Medication prescribing pattern in primary care in Riyadh city, Saudi Arabia

Physicians' prescribing behaviour is closely linked with patient safety and this area is poorly researched in Saudi Arabia. The objective of this stulf was to analyse physicians' prescribing patterns and the adequacy of noted information in the primary health care sector in Riyadh city. All medication prescriptions from 5 public [n = 1182] and 5 private [n - 1200] health centres were collected by simple random sampling during 1 working day. Antibiotics were the most commonly prescribed drugs in both sectors. The mean number of drugs per prescription was 2.08 and 2.36 in the public and private sectors respectively. Information and instructions noted on prescriptions varied considerably between private and public health centres. Similarly the medication prescribing pattern differed across the 2 health settings. Primary care physicians in Saudi Arabia need continuing training to improve their prescribing practices

Determinants of physicians' medication prescribing behaviour in primary care in Riyadh city, Saudi Arabia

This study in Saudi Arabia explored the determinants of physicians' prescribing behaviour in primary care in Riyadh city. A self-administered questionnaire designed to explore factors influencing prescribing [sociodemographic factors; practice access to educational materials; pharmaceutical company representatives, and patients factors] was completed by 87 PHC physicians. A factor analysis of 56 variables extracted 7 factors that explained 46% of the variance. Of these, 4 components positively related to perceived good prescribing behaviour could be summarized as: clinical experience of physicians; use of educational materials for continuous updating of medical knowledge; enhanced levels of continuing medical education and willingness to involve patients in decision-making; and working as a team using pharmacists for consultation and emphasizing the role of medical education.The other 3 factors derived from the analysis were less easy to interpret and may have been statistical anomalies [or measurement errors]

Predictors of quality of medication prescribing in primary care in Riyadh city, Saudi Arabia

Identifying the indicators of good quality medication prescribing assists physicians in preventing medication errors. This study in Riyadh city aimed to examine the relationship between physicians' self-reported influences on prescribing and the quality of their prescribing, defined as the completeness and accuracy of their prescription documentation. A sample of 600 randomly selected prescriptions written by 87 physicians were rated as high or low quality. The same physicians completed a questionnaire to determine the indicators of quality prescribing. The 7 components identified with factor loadings +0.5 or -0.5 were subjected to binary logistic regression modelling. While a range of potential quality indicators of drug prescribing were identified, none of the variables underpinning the 7 components/factors survived the binary logistic regression mode. More studies are needed that take into account other quality indicators of medication prescribing in Saudi Arabia

Effectiveness of three interventions on primary care physicians' medication prescribing in Riyadh city, Saudi Arabia

A number of strategies have been shown to improve the quality of drug prescriptions. The objective of this study was to implement and assess the effectiveness of 3 interventions on physicians' prescribing and cost containment: training physicians about quality prescribing, regulatory and administrative measures to improve rational drug prescribing; and a multi-faceted approach using 2 these strategies plus additional elements. Three public health centres, 1 for each intervention, were randomly selected, 61 physicians were trained in drug prescribing and completed a pre- and post-training questionnaire, and 100 post-intervention prescriptions from each centre were compared. All 3 interventions effectively improved the quality of drug prescriptions and the notation of drug-related information and trainees returned positive evaluations of the training course. Whether or not physicians' improvement in prescribing will be sustained is unclear and therefore subsequent follow-up evaluations are needed

Psychiatric co-morbidity in primary care and hospital referrals, Saudi Arabia

Psychiatric and physical morbidities among patients referred from primary health care [PHC] centres and general hospitals [GH] in Al-Qassim region were compared. Thus, 540 psychiatric referrals [GH = 138; PHC = 402] were selected randomly. Fifteen GH patients but no PHC patients were referred for admission. Psychiatrists made more diagnoses of dementia, affective and anxiety disorders, mixed anxiety-depression and somatoform disorders than clinicians and general practitioners [GPs]. Clinicians made significantly more diagnoses of acute psychoses and somatoform disorders than GPs. Physical morbidity was noted in 38.4% and 17.2% of GH and PHC referrals respectively

community-based survey on the incidence and etiology of maternal mortality in Gezira province, Sudan

Maternal mortality in Gezira Province, Sudan, was studied through an epidemiological survey namely a household interview to determine the incidence and causes of maternal mortality and to identify the important risk factors in maternal mortality. It was a retrospective cross-sectional epidemiological survey, the first of its kind in Gezira Province, conducted during the period 28 November 1987 to 26 December 1987 when 3826 families were visited. This study included 52 maternal deaths. The maternal mortality rate [MMR] was estimated as 348 per 100 000 live births. The main causes of death were haemorrhage, hypertensive diseases with pregnancy, sepsis and infectious hepatitis. Maternity services were adequate in Gezira Province; 78.8% of deaths were in localities where a primary health care unit was available and 80.8% of deaths were in localities where a trained village midwife was available. The utilization of those services was satisfactory; 71.2% of all deaths had antenatal care and 50% of the deaths were attended by consultant obstetricians. The level of education of the mother and husband, the husband's income and the council area where the pregnant woman resided were found to be the most significant factors affecting maternal survival during pregnancy and childbirth