Effect of interactive group discussion among physicians to promote rational prescribing

This study assessed the effect of an educational intervention [interactive group discussion] on the prescribing behaviour of 51 general physicians from the north-west of Tabriz. Prescriptions were analysed pre-intervention and post-intervention [control and intervention groups] using a proforma with 8 indicators of correct prescribing. The mean number of drugs per prescription pre-intervention was 3.82. The percentage of prescriptions with antibiotics, corticosteroids and injections were 40.8%, 25.9% and 58.0%, respectively. Following the intervention there were slight but not significant changes in the indicators in both intervention and control groups compared with pre-intervention results

Relationship of pharmacist interaction with patient knowledge of dispensed drugs and patient satisfaction

A prospective survey of pharmacists' tasks and patients' knowledge and satisfaction was conducted in 35 randomly selected community pharmacies in Tabriz, Islamic Republic of Iran. The total pharmacist interaction received a mean score of 3.05 out of 5. Providing written directions for use attained the highest score of 0.98 out of 1. Patients scored 3.18 out of 5 for knowledge about their medicines. There was a close correlation between patients' knowledge of dispensed drugs and pharmacist interaction [r = 0.95]. Mean total prescription filling time was 7.6 min, but only 1.4 min was spent on pharmacist-patient counselling. The interaction between pharmacist and patient increases patients' knowledge about dispensed medicines and their satisfaction with the pharmacist's activities

effect of interactive group discussion among physicians to promote rational use of drugs

Rational use of drugs remains a problem in Iran. Polypharmacy, overuse of antibiotic, misuse and overuse of injections, short consulting time and poor patient compliance are common patterns of irrational use of drugs in Eastern Azarbydjan - Iran. Concerning the promotion of rational use of drugs, this study aimed the effect of educational intervention as interactive group discussion on prescribing behavior of Tabriz Northwest physicians. Fifty one general physicians from private and public sectors in Northwest of Tabriz were selected randomly and their prescriptions were analyzed. A questionnaire with 8 close questions was completed for each prescription to investigate all aspects of prescribing patterns. By a professional software the information of the prescriptions was analyzed and drug prescribing indicators such as percentage of patients receiving antibiotics, glucocorticoids and other drug groups were determined. The method of intervention included focus group and interactive group discussions. Focus group was built in group of health professionals to collect training material using pre-intervention results for interactive group discussion. The physicians were divided into two groups of control and intervention groups. Following pre-intervention study the physicians of intervention group were discussed and trained in one-day interactive group discussion course using pre-intervention data and educational materials obtained from the focus group discussion. The results of pre-intervention study showed that the average number of drugs in each prescription was 3.82. The percentage of patients receiving antibiotics, corticosteroids and injections were 40.81, 25.94 and 58.04%, respectively. The results of this survey show great differences from WHO and international standards. Following the intervention the indicators were similar in both intervened and non-intervened groups and also were same as the pre-intervention results. The results of this study show that a very close and effective method of training program as an interactive group discussion has no beneficial effects on improving rational prescription behavior of general physicians involved in this study. To promote rational prescription the underlying factors must be considered more

[ effect of L-Carnitine on ischemia - reperfusion induced arrhythmias in rat heart]

Carnitine is a vital biologic substance transporting fatty acids into myocytes and facilitates fatty acids -oxidation for energy production.There is little findings about its cardio protective effects on cardiac arrhythmias during ischemia / reperfusion. So in this study, effects of L-Carnitine on cardiac arrhythmias in the ischemic reperfused isolated rat hearts were investigated. Male Sprague-Dawley rats [270-330g] divided into 4 groups randomly and were anesthetized by Sodium Pentobarbital [50-60 mg/kg-ip]. The hearts were removed and quickly mounted on a Langendorff apparatus and were perfused by a modified Krebs-Henseleit solution under constant pressure at 37 C. In control group [n=6], the hearts were perfused only by normal Krebs -Henseleit solution at stabilization, 30 min regional ischemia and 30 min reperfusion time, while in the treated groups [n=6 in each group], the hearts during ischemia / reperfusion were perfused with 0.5,2.5 and 5mM/L of L-Carnitine - enriched Krebs-Henseleit solution. ECG was recorded during the experiment. During ischemia and reperfusion, cardiac arrhythmias were analyzed based on Lambeth Convention. At the ischemic phase, number, duration and incidence of Ventricular Tachycardia [VT] were decreased with doses of 2.5 and 5mM/L L-Carnitine [p<0.05].L-Carnitine in doses of 2.5 and 5mM/L reduced the number of VT considerably [p<0.05] at the reperfusion phase. But duration of VT was not decreased significantly. Total Ventricular Ectopic Beats [VEBs: Single + Salvos + VT] also were reduced in treated groups by 0.5-5mM/L of L-Carnitine [p<0.05]. However, single VEBs and duration of Reversible Ventricular Fibrilation [Rev VF] were decreased only by 5mM/L L-Carnitine. There were no significant differences between control and treated groups in the time to onset of Rev VF and incidences of VF and VT at the reperfusion phase. Considering these results, we conclude that L-carnitine has a protective effect against ischemia reperfusion injuries as a reduction of cardiac arrhythmias

[Perscription pattern of drugs acting on the central nervous system in Tabriz in 1999]

Drug acting on the central nevrous system [CNS] are widely used in the world as well as Iran due to social, economic and cultural factors. Thus because of the importance and wide prescription of drugs , prescription patterns of five groups of drugs including sedatives , hypnotics, antidepressants , antiepileptics, antipsychotics and antiparkinsonism were evaluated in Tabriz. 1461 prescriptions were collected from 24 randomized - selected pharmacies and analyzed. The results indicated that: 1]-On an average 3.65+/-0.3 types of drugs were included in each prescription which was 1.8 times more compared to International standards. 2-Out of 1461 prescriptions, 288[19.71] contained at least one drug affecting the CNS. 3- 41.41% of the total prescriptions were prescribed by general physicians, out of which 18.34% contained at least one drug affecting the CNS. 4- Drugs acting on the CNS were prescribed in 94.87%, 58.18% and 36.66% of cases by Psychiatrists, Neurologists and Rehabilitists, respectively. 5- Women received these druge more compared to men so that 62.5% and 35.77% of these prescriptions were advised for women and men respectively [p<0.01]. Average mean ages of women and men receving these drugs were 41.76+- 4.2, 26.29+/-4.7 respectively and for children under 12 years 4.66+/-0.5. 6- Sedatives, hypnotic agents were the most common prescribed drugs both for women and men. However, these agents were prescribed for women more than men [p<0.05]. In contrast, Antiepileptic drugs were prescribed for men more than women [p<0.01]. 7- 58.68% and 26.04% of the prescriptions contained one or two of these agents, respectively and the rest contained 3-6 of them. Considering of these results, we conclude that the correct prescription of these agents, therapeutic monitoring of them, prescription by specialists and limitation of poly pharmacy may increase efficacy and safety of them

Sphingomyelin metabolites as second messengers in airway smooth muscle cell proliferation

Sphingolipid metabolism was examined in guinea-pig airway smooth muscle cells stimulated by platelet-derived growth factor [PDGF] and 4[BETA]-phorbol 12-myristate 13-acetate [PMA], as mitogens and bradykinin [BK] as non-mitogen. Stimulation of the cells by PMA and PDGF for 60 min. at 37°C induced the following changes in sphingolipid metabolites: in cells prelabeled with [3] H palmitate, a 1.2 fold increase in radio-labeled sphingosine, a concomitant 20% decrease in radio-labeled ceramide and no significant change in sphingomyelin level. Stimulation of the cells by BK induced no changes in sphingolipid levels at any time tested. This study demonstrates the existence of a "sphingomyelin cycle" in airway smooth muscle cells. Such sphingolipid cycles may function in a signal transduction pathway and in cellular proliferation