Evaluation of risk factors in acute myocardial infarction patients admitted to the coronary care unit, Tripoli Medical Centre, Libya

The aim of this study was to provide an overview of the risk factors for acute myocardial infarction in patients attending Tripoli Medical Centre, Libya. Records were reviewed for 622 patients with a mean age of 58.3 [SD 12.9] years. Diabetes mellitus [48.2%], hypertension [35,7%] and smoking [50.6%] were among the risk factors reported. There were 110 patients [17.7%] who died during hospitaiization, mainly suffering cardiogenic shock [48.0%]. The rate of use of thrombolytic therapy was low in patients who were female [40.4% versus 58.4% for males], older age [31.6% for those > 85 years versus 63.3% for patients < 55 years], diabetics [45.3% versus 62.0% for non-diabetic patients] and hypertensives [47.3% versus 57.8% for non-hypertensive patients]. Prevention strategies should be implemented in order to improve the long-term prognosis and decrease overall morbidity and mortality from coronary artery disease in Libyan patients

Cutaneous leishmaniasis in Bam: a comparative evaluation of pre- and post- earthquake years [1999-2008]

The recent devastating earthquake of December 26 in Bam, 2003 created various risk factors; caused a sharp increase in incidence of anthroponotic cutaneous leishmaniasis [ACL] cases and reached to an epidemic proportion. The objective of this study was to evaluate the status of ACL cases five years before the earthquake compared to the cases occurred five years after the earthquake [1999-2008]. Status of disease was assessed retrospectively for the five years before the earthquake and prospectively for the five years after the earthquake. Identification was confirmed by smear and polymerase chain reaction [PCR]. The mean annual incidence of ACL for the period from 1999 to 2003 was 1.9 per 1000 comparing to post earthquake period, which was 7.6 per 1000. Most of the infection was in individuals of <20 years, more frequently in females before the earthquake, whilst in contrast, there was a progressive rise in the number of cases, significantly in male individuals of >20 years [P< 0.0001] in post earthquake era. The anatomical distribution of lesions considerably changed during the two periods. Most of the cases were limited to three zones within the city prior to the earthquake, whereas it was spread throughout different zones after the earthquake. PCR indicated that the CL was due to Leishmania tropica in the city. The results strongly suggest that in natural disasters such as earthquakes various precipitating factors in favor of disease will be created, which in turn provide a suitable condition for propagation of the vector and the transmission of the parasite

Trends of home drug storage and use in different regions across the northern United Arab Emirates

To investigate the habits of use and home storage of over-the-counter [OTC] and prescription drugs. A pretested questionnaire was distributed to university students who represented 300 household units in different regions of the northern United Arab Emirates. Household chairs [parents] answered questions on various aspects of home use and storage of OTC and prescription medicines. The number of drugs stored at home was collapsed into 5 unequal groups [1-3, 4-6, 7-10, 11-15 and 16-20]. The response rate was 300 [100%]. The average number of drugs per household unit was 6 items. Almost 40% of the participants stored between 16 and 20 drugs. More than half [56%] of the household units stored medicines in a home pharmacy kept either in the bedroom [n=66; 39%] or in the kitchen [n=71; 42%]. No correlation was found between the level of education and the number of family members [r=0.29] or drugs stored at home [r=-0.35]. Only 2 [0.7%] of the participants did not keep drugs at home. There was a clear discrepancy in either OTC or prescription drugs stored, and the variation in the utilization and preference of drugs was obvious among the pooled sample. Various problems related to the use and storage at home of OTC and prescription drugs were revealed. Discussing the results of this survey with students who participated as members of the household units that took part in the study may prove to be a helpful intervention. The need for public educational efforts on the rational use of medicines at home is urgent to foster awareness of the proper use of drugs

Patterns of drug prescribing in a hospital in Dubai, United Arab Emirates

To determine the pattern of drug prescription by consultants in a private hospital in Dubai, United Arab Emirates, 1190 prescriptions were collected from the hospital's pharmacy over 30 days. In total, 2659 drugs were prescribed. The mean number of drugs per encounter was 2.2. Only 4.4% of all drugs prescribed were generic. Polypharmacy was observed in only 7.5% of all encounters. Information about the prescribing physician and the patient was invariably deficient. Name of patient, age, and gender were absent in 2.9%, 9.7%, and 12% of prescriptions, respectively. In addition, none of the prescriptions mentioned address, diagnosis, or allergy of the patient. Name of physician, signature, speciality and license or registration number were omitted in 12.2%, 10.3%, 20.3%, and 54.9% of prescriptions. The most commonly prescribed therapeutic classes of drugs [and principal drug in each class] were as follows: 23.4% non-steroidal anti-inflammatory drugs [NSAIDs, Diclofenac sodium being 51.6%], 21.4% antibiotics [amoxicillin-clavulanate 13.5%], and 11.5% gastrointestinal drugs [GI, Hyoscine-N-butylbromide 28.1%]. Other therapeutic classes included endocrine drugs [6.1%], vitamin supplements [5.9%], nasal decongestants [4%], antihistaminics [3.8%] and cardiovascular drugs [2.6%]. Antibiotic injections accounted for 7.4% of all antibiotics prescribed, which was equivalent to 1.6% of all prescriptions. Other agents prescribed in small proportions of encounters collectively amounted to 21.3%. This study reveals the prescription trends, and indicates possible areas of improvement in prescription practice

Cortical cholinergic mechanisms

In recent years there has been a growing interest in the role of cholinergic mechanisms in the regulation of nervous activity, action of drugs on the central nervous system and in several neurological and psychiatric disorders. Development of sophisticated techniques and usage of drugs as investigating tools have further enabled a detailed systematic study of the dynamic role of cholinergic mechanism in the brain. The review provides an overview of our current knowledge of the anatomy, physiology and pharmacology of the cholinergic mechanisms in the cerebral cortex