Prescribing generic drugs: constraints ?

In Morocco, development of generic drugs, which are copies of original drugs, is not as fast as expected since accession to prescribers, which is essential to the development of these drugs, is still not well established. This report is intended to describe constraints that are behind this reluctance to prescribe these innovative products in public hospitals on the Rabat / Salé Wilaya. The study is based on administrated questionnaires to 91 medical specialists. Collated data were supported by results from interviews with officials at the National Laboratory of Drug Control and the Department of Pharmacy, responsible of hospital pharmacies and medical representatives. Quantitative analysis has been carried out by SPSS [version: 17.0] and Excel software, Among the salient findings, the fact that 83% of physicians suspect the quality of generic drugs and 75% of them believe that the requirement for bioequivalence study is essential to prove their quality. 75% of participants felt that the generic present a higher potential risk following their administration and 82% attest of their therapeutic failure after use. Only 21% of the participants to the study are opting for generic drugs in their prescriptions with 80% of them not adhering to the strategy of the Ministry of Health by considering it as an infringement to their professional freedom. This study highlights the key elements to allow building the National drug policy in order to ensure rational use of medicines and increase the prevalence of generic drugs prescribing. The generic policy, beside the consumer role, is an integration of many parameters as well as the action of the various actors of the health sector. Achieving an equilibrated policy is to combine all these elements and actions responding to patient's needs without overlooking the interests of different parties

Adherence to hand hygiene

Preventing associated with said nosocomial infections care, topic in health facilities. Despite the promotion of preventive measures, we find that they are not fully implemented. This study aims to describe the factors that impede the observance of hand hygiene with the paramedics, because of the rate attributable to nosocomial infections manu brought an estimated 1.4 million worldwide, from 4.9% in Europe and an average of 15% at the continental level. This is a quantitative descriptive study; through a questionnaire and an observation grid with paramedic services in medical and surgical intensive care, a comprehensive sampling arrested 35 participants. This study found a rate of 40% of participants who did not receive any further education on hand hygiene, resulting in an average knowledge observed in these participants on washing techniques 35% of hands. About intolerance, 20% say the drying and irritating detergents hand rub; statements of intolerance to hand hygiene products have never been subject to notification of pharmacovigilance. Factors influencing adherence to hand hygiene, 24% of participants reported inadequate hand hygiene products. 45% mentioned the workload.: The study revealed a satisfactory level of compliance with hand hygiene services resuscitation of this institution, comparable to that described in other studies and for continuous improvement of these practices, the recommendations of this study were offered as corrective and preventive measures adapted to the deficiencies observed

Bacterial resistance state of play in Morocco

In Morocco, despite the importance of the subject, no studies concerning the magnitude of the problem of bacterial resistance to antibiotics have been conducted nationally. In hospitals, the results of some studies have shown that the use of amoxicillin alone or in combination with clavulanic acid for the treatment of urinary tract infections showed a resistance rate of E. Coli that goes from 50 to 70%. In the city, the growth of antibiotic resistance of this organism in community infections is also considered a disturbing phenomenon since resistance rates remain very high. There are many reasons for this resistance but the major determinant one is the excessive and / or inappropriate use of antibiotics. Surveys have shown that antibiotics engulf more than 25% of the total drug consumption in Moroccan hospitals. In addition, in our cities, there is also an abuse in the prescription of antibiotics. Their counter in pharmacies without prescriptions or diagnosis may explain the misuse of these drugs and the increase of self-medication. From these bad habits in prescribing and increasing antibiotic consumption result the change of the resistance patterns of bacterial species and the emergence of multidrug-resistant bacteria. It is high time that all concerned are aware of the seriousness of this problem. Policy monitoring and management of this bacterial resistance should be adopted

Urinary tract infections related to urinary polls

They are the most common and yet occupy 65% to 80% of nosocomial infections worldwide, despite efforts to control provided by the health authorities. In Africa, on a 46.7% infection rate of these infections, 43% are due to the survey. In Morocco, there is an incidence rate of 13.4% with a rate of 7.5% nosocomial bacteriuria among patients surveyed and a rate of nosocomial colonization of 6.5%. Hence the importance of this work to describe the risk factors for these infections aims. This is a descriptive study, prospective, qualitative and quantitative data collection tools as means of a questionnaire to 35 people involved in such acts; interviews with four medical specialists and the study of 30 cases of patients with urological services and resuscitation. This study showed that the risk factors associated with these infections are advanced patient age, poor health and disease history such as urinary tract infection, prostate cancer, gallstones and diabetes. Added to this are the organization of care such as lack of supervisory, non-notification of the surveyed patients and the workload of staff. As can be seen from this study, 33% of staff did not receive training in this technique, while there are twice as many bacteriuria when the probe is asked by a staff that is not specifically trained. The combination of the results allowed us to predict the risk factors of urinary tract infection-related survey and propose corrective and preventive actions; [a] set up units to IEC for patient education; [b] strengthen the health care team to reduce the workload attributed to it; [c] ensure compliance with protocols

Ebola virus disease

The Ebola virus disease [formerly called Ebola hemorrhagic fever] is a serious and often fatal disease in humans. Since March, 2014, Ebola virus diseases are reported in Guinea. The outbreak spread then to Liberia, Sierra Leone, and neighboring countries. The continuation of the spread of the virus, the intensity of transmission at the community level and at the level of healthcare as well as the weakness of health systems in the countries currently affected and those most exposed to the risk make this disease a threat justifying a mobilization of the international community. In this development the authors recall the epidemiological context that has characterized the Ebola epidemic, the mode of transmission of the virus, the main events clinical and biological, the principles of support for suspected or confirmed cases and emphasize individual and collective protection measures adapted to this highly contagious disease

Medicines and breastfeeding: assessing the risk of medicines to infants

Milk, in addition to its undeniable nutritional and immunological benefits, is an important element for the development of the infant. Warnings, sometimes exaggerated, may prevent the mother and child from enjoying the benefits of both breastfeeding and appropriate medication. This approach is justified by the total absence of investigations on the excretion of drugs in breast milk during clinical trials. The actual risk was evaluated by several classifications; an estimate of the passage of drugs into milk and estimation of infant exposure to the drug are possible and can provide a reliable indicator to better judge the risk to the infant generally we are faced with two different situations: a new treatment during lactation or maintenance treatment already prescribed during pregnancy. If treatment needs to be prescribed for a long period of breastfeeding, a strategic approach is required

Pharmacoepidemiology: regulatory basis, methodological approaches and scope

Pharmacoepidemiology is a discipline that studies the use of drugs and evaluation of their beneficial or adverse effects on large populations. It requires compliance with laws and maintaining a regulatory approach in order to ensure confidentiality and protection of personal data. It also requires good knowledge of drugs and diseases and the use of the different available data sources. Pharmacoepidemiology incorporates epidemiological methods [cohort, case-control and cross-sectional studies] where the exposure is drug intake. These methods must be applied at the conception of the pharmacoepidemiological study in order to minimize the effect of bias hich can lead to false conclusions. This paper reviews the regulatory basis, methodological approaches and scope of pharmacoepidemiology

[Iodinated contrast induced acute renal and meningo-encephalitis]

The aim of this work is to report the cases of iatrogenic acute renal failure which has occurred after emergency realization of a cerebral scanner, with injection of iodinated contrast product at patients contracted by the meningoencephalitis. This prospective work was realized in a medical intensive care unit between January 2002 and December 2008. The criterion of principal judgment was the creatinin rate variations [>25% of its basic value] in the three weeks after a cerebral scanner with injection of iodinated contrast product at patients contracted by the meningoencephalitis. Eight patients were included among 360 meningoencephalitis cases corresponding to an incidence of 2.2%. The middle age was 43 +/- 17 years. The average time of appearance of the acute renal failure was 43 +/- 17 hours, with an average creatininemia of 66,8 +/- 37 mg/l. Three patients died. The incidence of this undesirable event remains weak but deserves a special attention. An adequate rehydration, before all using of the cerebral scanner with injection, should be realized for any patient presenting a meningoencephalitis

Prevalence of antitiuberculous drug-induced cytolytic hepatitis of tuberculous meningitises

The aim of this work was to specify the prevalence and the description of scondary cytolytic hepatitis of the antituberculous drugs used in treatment of tuberculous meningitis in the intensive care units. Method: We have been included retro-spectively [January 1998 - December 2002] patients having a tuberculous meningitis treated with antituberculous drugs who developed a cytolytic hepatitis defined by an increase of the alanin-aminotransferase [ALAT] level more than two times of its normal upper limit. Six cases have been included among 74 patients [prevalence of 8,1%], three women and three men aged 17 to 45 years. The delay of apparition of cytolytic hepatitis varied from four days to five weeks. ALAT rates varied from two and half to 26 times the normal level. No other potentialy hepatotoxic medication has been prescribed. Three patients normalized their ALAT after reducing the rifam picin dose to half measure, in another case a definitive stoppage of isoniazid was required. Ytolytic hepatitis regressed spotaneously in one patient whereas another died as a result of a nosocomial infection. The prevalence of secondary cytolytic hepatitis of antituberculous drugs during treatment of tuberculous meningitis in the intensive care unit raised to 8,1%, the evolution is most often favourable after adaptation of doses

Alcohol et accidents de la circulation au Maroc

The alcohol abuse or alcoholism not only the individual but society as a whole. Indeed, the road security is more and more threatened. A great number of road accidents results from drink driving. This work was undertaken in order to appreciate the significant role alcohol in road accidents in Morocco. It is based on a prospective study carried out in the service of emergencies and consisting of the study of alcoholemia in the injured who have been admitted to the service of Emergencies. This role is important and adequate arrangements must be made and taken into account