Relationship between consultation length and rational prescribing of drugs in Gorgan city, Islamic Republic of Iran

Doctors with longer consultation times tend to diagnose illnesses more precisely, prescribe fewer drugs and present better health advice to their patients. The aim of this study was to measure the average consultation time of general practitioners in Gorgan, Islamic Republic of Iran and to investigate the factors affecting consultation length, especially in relation to rational prescribing of drugs. Data were collected on 620 patient consultations with 62 randomly selected general practitioners. Mean consultation length was 6.9 [SD 2.6] minutes. Patient factors that were significantly associated with a longer mean duration of consultation time were; higher number of health problems, older age and fewer items of previously used drugs. Physician factors that were significantly associated with a longer mean consultation time were: younger age, higher numbers of items prescribed and injectable drugs prescribed, frequency of interruptions and higher workload

[Rate - dependent electrophysiological effects of Crocus sativus on extracellular field potential of isolated rabbit heart in-vitro]

Herbal remedies are suitable alternatives for synthetic drugs due to their availability, minimal side effects and lower price. Biologically active substances of plant origin represent an essential branch of modern cardiovascular pharmacotherapy. The aim of the present study is to investigate rate-dependent electrophysiological effects of Crocus sativus on extra-cellular field potential of isolated rabbit heart in-vitro. Male Newsland rabbits [1.5-2 kg] were used in all of experiments; various experimental stimulating protocols [WBCL, recovery, rate-dependent protocols] were applied to study electrophysiological properties of Node [N=25]. All of the stimulated protocols repeated in the presence and absence different concentration of saffron [54,108 mg]. Results were shown as mean +/- SE. Saffron inhibited basic and rate-dependent electrophysiological properties of AV-Node. Significant prolongation of WBCL from 141 +/- 4.7 to 165.9 +/- 6.7 msec [in control and saffron group] was recorded [p<0.05]. Rate-dependent protective role of plant to increases difference between atrial and nodal effective refractory period and was observed [from 10 +/- 5.5 to 23.6 +/- 7.4 msec in control and saffron] [p<0.05]. Rate-dependent minor inhibitory role of Crocus sativus in AV-Node can modify protective role of AV-Node during arrhythmia

Ouabaine like effects of ethanolic extract of aerial parts of urtica dioica l. on isolated rabbit atrioventricular node: potential role as an anti - arrhythmic plant

The ideal drug for treatment of wide range of supraventricular arrhythmia has yet to be developed. For cardiovascular disease, herbal treatments are suitable alternatives for synthetic drugs due to their availability, minimal side effects and lower price. Previous studies showed antihypertensive, negative inotropic activities of Urtica dioica [Nettle]. The aims of the present study were: 1] to determine concentration-dependent effects of ethanolic extract of nettle on the nodal basic and functional properties. 2] to campare mechanism of action nettel with ouabaine. Male Newsland rabbits [1-1.3 kg] were used in all of experiments; various experimental stimulating protocols [WBCL; Recovery, Facilitation, Fatigue] were applied to assessing electrophysiological properties of Node. We used isolated perfused AV-nodal preparation [n=24]. All protocols were repeated in the presence and absence [control] of different concentration [0.25 - 0.5-1 g/1] of Nettle and ouabaine [0.l microM]. Results were shown as Mean +/- SE and a probability of 5% was taken to indicate statistical significance. We had considerable depression in basic and functional properties of node after adding Nettle, as WBCL, Effective refractory period, Functional refractory period and nodal conduction Time significantly increased [p<0.05]. In addition magnitude of fatigue [deltaAH] and deltaFRP [Amount of facilitation] significantly increased [p<0.05]. The above results showed potential antiarrhythmic properties of [Urtica dioica] by increasing fatigue and nodal refractoriness. Therefore, it may be considered for treatment of supraventicular arrhythmias

[Effects of an active multifaceted educational intervention on dispensing time in the pharmacies of Gorgan]

Introduction: The pharmaceutical care framework requires an active client-pharmacist partnership, particulary with respect to consultation about medication [dispensing process]. The educational intervention can imply to improve rational use of drugs

Objectives: In this study the effect of active group discussion and dispenser feedback in increasing the patient care indicator [dispensing time] in the pharmacies of Gorgan were examined

Materials and Methods: An interventional, semi-experimental study was designed. The study was conducted in Gorgan, thirty pharmacies and 750 pharmacy client, were randomly selected in each step [before and after intervention]. A structural questionnaire was used to interview clients. Data were collected from patients and by interviewing immediately after patient-dispenser encounter. Focused group discussion, audit feedback and distribution of educational bucklet were designed and conducted, after two months. All data were collected and analyzed with SPSS-11.5 software and were shown as mean +/- SE

Results: Data from 750 prescriptions before intervention showed that the average drug dispensing time was 19.43 +/- 5.83 seconds and the average waiting time was 4.91 +/- 1.2 minutes. In the post-intervention period, we had significant increase in the aformention indicators. Patients' satisfaction and knowledge of adverse effects and dosage information significantly increased after intervention

Conclusion: The study shows the impact of active educational intervention in improving WHO patient care indicator [dispensing time]

[ effect of essence of Citrus aurantium on the electrophysiological properties of isolated perfused rabbit AV-node]

Pharmacological studies and traditional medical literature point to the cardiovascular effects of the Citrus aurantium L. [Rutaceae] in many instances. In the present study, we used isolated perfused AV-node of rabbit as an experimental model to determine the effect of various concentrations of essence of Citrus aurantium [0.1-0.3 v/v] on electrophysiological properties of isolated heart. The second goal of the present study was to assess the protective role of essence of Citrus aurantium on arrhythmogenic effects of ouabain. This was a semi-experimental study. We used isolated perfused rabbit AV-nodal preparation, in three groups. In the first group, the effect of various concentration of the Citrus aurantium [0.1, 0.2, 0.3 ml/l] was assesed on the AV-node. In the second and third groups, the effect of Citrus aurantium was tested in the presence of ouabain [0.1 micro molar] and verapamil [0.1 micro molar]. We used 6 rabbit in each group. Statistical analysis was preformed by SPSS Mean +/- SE was used in the all results. Our results showed depressant effects of extract of Citrus aurantium on Wenchebach Cycle Length [WBCL], AV Conduction Time [AVCT], Effective and Functional Refractory Periods [ERP and FRP]. Rate-dependent properties such as Facilitation and fatigue significantly increased by Citrus.a [0.3ml/l]. We had significant increase in the AVCT [32.6 +/- 3.6 to 40 /- 6.08 msec] and FRP [147 +/- 5.1 to 166.6 +/- 3.6 msec] by Citrus.a. We had a protective role of Citrus aurantium on ouabain induced AV-nodal depression. The magnitude of facilitation and fatigue in the concentration of 0.3 C.aurantium was 7.5 +/- 0.3 and 6.5 +/- 0.5, respectively. The above results indicated potential inhibitory and antiarrhythmic effect of Citrus aurantium in treating supraventricular tachyarrhythmia