management of non-invasive bladder tumours with doxorubicin intravesical instillation after transurethral resection

Evaluation of the intravesical instillation of doxorubicin for its effect on disease recurrence for patients with non-invasive bladder tumour. The trial was performed at Al Assad University Hospital in Lattakia, Syria and included patients with non-invasive bladder tumours who were managed with transurethral resection and induction and maintenance therapy with intravesical doxorubicin. They were followed up by cystoscopy every 3 months for 2 years and every 6 months thereafter with special emphasis on recurrence rates. The trial included 85 patients with non-invasive bladder tumours: 23 with non-invasive papillary carcinoma [Stage Ta], 62 with tumour invading subepithelial connective tissue [Stage T1]. Twelve patients had well differentiated tumours [Grade 1], 48 were moderately differentiated [Grade 2], 25 were poorly differentiated [Grade 3]. The total recurrence rate was 23%. The rates of recurrence were 56% in Grade 3 and 0% in Grade 1. The recurrence rate was 41% in patients with large tumours versus 17% in those with small tumours; 44% in those with multiple tumours compared to 18% in those with solitary tumours; 30% of Stage Ta tumours recurred and 21% of Stage T1 tumours. In short term follow-up, our rate of recurrence was 23% compared to 54% in multicentre international studies without the intravesical adjuvant; thus adjuvant intravesical doxorubicin was shown to reduce the recurrence of superficial bladder cancer. Tumour grade, size and number were shown to be prognostic factors for recurrence

management of health promotion by Jordanian pharmacists

Pharmacists are increasingly being held accountable for their patients' health outcomes. This accountability is not limited to clinical outcomes, but also includes responsibility for the effects of disease and treatment on patients' quality of life [QoL]. Indeed, QoL is a centerpiece of the philosophy of pharmaceutical care. Health Promotion and Disease Prevention is one of the major domains of pharmaceutical activities. Specific activities include developing health programming and assisting patients in making lifestyle changes to improve health outcomes. A major core activity in pharmaceutical educational goals is addressed by our College of Pharmacy in order to incorporate education in health promotion and disease prevention. Any pharmacist may participate in health promotion and those working in community and hospital practice are well placed to do so. The purpose of this work was to identify the preperedness of pharmacists to counsel their patients and how the Jordanian pharmacists' see and manage health promotion as part of their responsibility. A survey instrument was constructed in order to extend the benefit of this study to patients, health care providers, or to a third party. Health promotion beliefs, the pharmacists' confidence in their ability to help patients change their behavior and the perceived barriers to integrating prevention into daily practice were measured. The collected data were analyzed using SPSS version-10 program. Results of the study indicate that pharmacists most frequently participate in health education/disease-preventing activities directly related to the dispensing or selling of medications. Pharmacists, uniquely positioned as the most accessible health care providers in the community, can dedicate their considerable strengths to organize their own efforts and motivate their patients. The majority of pharmacists claimed the need for Continuous Education CE programs that should be directed toward sharpening pharmacists' skills in health promotion

Lifestyle of hypertensive patients and their drug compliance

Hypertension is increasing at an alarming rate in Jordan. The present study was done with the help of 100 hypertensive Jordanian patients. A questionnaire designed specifically for this new study in Jordan was used. The independent variables were: patient background and lifestyle, clinical findings, medications used, alternative therapies and drug compliance. The results were analyzed thoroughly and the findings showed that family history, smoking, stress, obesity, age, diabetes, hyperlipidemia and sedentary lifestyle were the major concomitant risk factors among hypertensive patients. The proportion of each antihypertensive drug prescribed by physicians was mentioned. Such result serve as a reference for physicians, pharmacists, drug manufacturers, and drug distributors, in order to find the place of any studied drug either in the therapy or in the drug marketing in Jordan

Conclusions: the increase in prevalence of hypertension in Jordan was associated with aging, stress factors, obesity and a more sedentary lifestyle. Recommendations on basis of the results were made and the Jordanian health care providers, particularly pharmacists, were asked to improve their roles in the health care team, by counseling patients and providing optimal information in order to reduce the development of hypertension and its complications