Studies on the antimicrobial activity of juglans regia.

Juglans regia L. bark is used in some countries as a toothbrush and as a dye for coloring the lips for cosmetic purposes. Its extract showed a broad spectrum antimicrobial activity in a dose dependent manner. It inhibited the growth of several species of pathogenic micro-organisms representing Gram-positive bacteria (Staphylococcus aureus and Streptococcus mutans), Gram-negative bacteria (Esherichia coli and Pseudomonas aeruginosa) and a pathogenic yeast (Candida albicans). The extract has either synergistic or additive action when tested with a wide range of antibacterial drugs. It also increased the pH of saliva. Thus, brushing the teeth with this bark may improve oral hygiene, prevent plaque and caries formation, and reduce the incidence of gingival and periodontal infections.

Treatment of cutaneous leishmaniasis with antimony: intramuscular versus intralesional administration.

The various methods used to treat cutaneous leishmaniasis (CL) have not given consistent results. The aim of the present study was to compare the efficacy of a solution of meglumine antimoniate (MA; 85 mg Sb/ml) given intralesionally (i.l.) with that of the same solution given intramuscularly (i.m.). Eighty CL patients, with a total of 147 lesions, were randomly allocated into the two treatment groups. Forty were injected i.m. with MA (15 mg Sb/kg.day) on 6 days/week until 12 injections had been given to each. The lesions of the other 40 patients were infiltrated with MA (0.2-0.8 ml/lesion) every other day for 30 days. After 15 days' therapy, none of the lesions on those treated i.m. had fully healed (although five lesions showed some improvement) whereas two lesions on those treated i.l. had fully healed and 10 showed good improvement. After 30 days, 46 (68%) of the 68 lesions on those treated i.m. had healed completely, 11 (16%) had improved, and five (8%) worsened. The corresponding values for the 66 lesions on those treated i.l. were 48 (73%), 10 (15%) and three (5%). There was no statistically significant difference between the two treatment groups, either in terms of satisfactory response (lesions fully healed or improved) or unsatisfactory response (lesions unchanged or advanced), when assessed on day 30 (P > 0.5). Intralesional antimony is a rapidly effective, safe and economical method of treating simple CL, particularly in patients with cardiac, liver or renal disease, for whom antimonials are contra-indicated.

Fatal anaphylactic reaction to diclofenac.

A case of apparent anaphylactic reaction to diclofenac sodium (Voltaren) is reported. A 45-year-old man collapsed 15 min after intramuscular injection of diclofenac for treatment of low back pain. Twenty minutes following successful resuscitation, he went into coma from which he never recovered and was pronounced dead on the following day. To our knowledge, this is the first reported case of anaphylactic reaction to diclofenac.

Alkohl use in Saudi Arabia. Extent of use and possible lead toxicity.

The extent of alkohl use, its lead content and blood lead levels after use were investigated. A total of 500 individuals were interviewed. It was observed that 233 (47%) had used alkohl. The main purposes for its use were: eye cosmetic (66%) and eye and umbilical stump remedy (26%). Of those who used it as an eye cosmetic, 45% applied it daily and 18% occasionally. Sixty-five (28%) of the users experienced some type of adverse reactions. Their mean blood lead levels was 0.99 uMol/L as compared to 0.26 uMol/L in non-users. The majority of alkohl samples analyzed had high lead content. Mean blood lead levels of rabbits treated with alkohl was 3.31 uMol/L. It is recommended that the public should be educated on the possible dangers of continued alkohl use.

The role of pharmacists in patients' education on medication.

The pharmacist, as the last health professional to come into contact with the patient, plays a vital role in patient education on drug use. The objective of this study was to assess the extent of pharmacists' involvement in the education of patients on drug use. Five hundred patients were interviewed. The findings indicated that both physicians and pharmacists explained the use of medication; however, pharmacists (20%) were much clearer in their instructions than physicians (11%). Ninety percent of patients who needed more information on their medicines, besides its frequency of use, did not receive it. Patients were not told about drug adverse reactions (100%), storage conditions (93%), important precautions (91%), drug-food interaction (90%) and preparation of suspensions (64%). Fifty-one respondents had in the past made mistakes in the use of their medications, and in 16% this resulted in serious consequences. Ninety-three prescriptions contained drug-drug interactions, and 97% of these were dispensed unnoticed. Of the patients interviewed, 72% were satisfied with the role of pharmacists in disseminating drug information, 67% would get a refill from them without going to their physicians, and 52% had consulted them for OTC medications. It is concluded that, although there are some deficiencies, pharmacists are providing information on drug usage and patients have confidence in them. They should, therefore, acquire the proper training and communication skills to enable them to provide this service more effectively.