The role of clinical pharmacy services in achieving treatment targets in Iranian haemodialysis patients

<p><b>INTRODUCTION</b>The number of patients suffering from chronic kidney disease (CKD) is increasing worldwide. Hyperphosphataemia and high serum calcium (Ca) and phosphorus (P) product contribute to the substantial increase in cardiovascular events in CKD patients. Although reports of CKD complications in Iranian haemodialysis (HD) patients are comparable to data from other developed countries, management of these complications has failed to meet generally accepted targets. This study evaluated the impact of clinical pharmacy services in the management of complications in HD patients.</p><p><b>METHODS</b>During a six-month prospective study, clinical pharmacists conducted medical visits in the HD ward and adjusted the patients' medications according to their laboratory findings.</p><p><b>RESULTS</b>Serum Ca concentration was increased in hypocalcaemia patients and decreased in hypercalcaemia patients until it reached the optimal range in both groups. A decline in serum P level was noted in hyperphosphataemia patients, although it did not reach the target range. The Ca × P product decreased in patients with Ca × P > 55 mg2/dL2. Although it did not reach the goal, there was an increase and decrease in serum intact parathyroid hormone (iPTH) concentration in suboptimal and supraoptimal range patients, respectively. Serum Ca, P and iPTH levels did not change in patients with optimal values at the initiation of the study. Haemoglobin concentration increased in anaemic patients and serum ferritin reached target values in all patients. Total cholesterol, low-density lipoprotein cholesterol and triglycerides decreased to near-optimal values in dyslipidaemia patients.</p><p><b>CONCLUSION</b>This study showed that clinical pharmacy services at the HD centre can improve the management of complications in CKD patients.</p>

[Ecological characters of leishmaniasis vectors in Kalaleh district, Golestan province, Iran, [2006-07]]

Leishmaniasis is a Zoonotic disease that is transmited by sandfly to human. This study were carried out in order to demonstrate some ecological characters of leishmaniasis vectors in Kalaleh district, Golestan province Iran, during 2006-07. In present study 6 villages were selected. Sandfly were collected by sticky traps. 3 places were sampled in each village and in each places 20 traps were installed. After sampling collection, we used diagnostic criteria to identify the Sandflies, also confirmed human cases were recorded according to the months of identification. 4900 sandflies were detected in 6 villages and 12 species of sandflies were identified, which including P.papatasi, P.mongolensis, P.caucasieus, P.caucasicus group, P.sergenti, P.alexandri, P.kazeroni, P.brevis, P.[adlerhis] sp, S.sintoni, S.clydei, S.sogdiana. P.papatasi was predominant species in indoor places [46.1%] and S.sintoni was in outdoor places [36.7%]. Sandflies activities extended from early May through mid October with two peaks in mid June and September. Human infection had a important peak in January. During the collection of sandflies, the species of P.alexandri, P.kazeroni, P.brevis, P.[Adlerius sp.] S.clydei and S.sogdiana were collected for the first time from this area. In this study, P.papatasi was the predominant species in this area. Sandflies second activity peak occured in September that is crucial for transmission of disease. The incubation period for this disease was four months