ساره كاظم عبود الشمري

The post-operative fluid therapies are considered a key part of surgical care and have attracted more attention and importance over the last period because of their remarkable impact on post-surgical outcomes. Several studies showed inappropriate and suboptimal therapy of intravenous fluid and associated with many compactions such as Weight gain due to fluid overload and electrolyte abnormalities. Therefore in 2013, a new guideline had been initiated by the National Institute of Health and Care Excellence dealing with fluid therapy in adults. This study aims to assess the current practice of fluid therapy versus the guideline. Methods: The study was a prospective observational with 105 patients match the eligibility criteria and only 84 are included. The patient’s body weight, amount of fluid given to patients were calculated and compared to guideline also, serum sodium and serum potassium measured before and after fluid therapy. Results: The main results of this observational study demonstrated that the amount of fluid is significantly higher than the recommended amount by a guideline and lack of correlation with the body weight. Also, the body weight increased and serum potassium decreased significantly after two days of fluid therapy. Increased incidence of electrolytes abnormalities and trend of use of more saline containing fluids with less ringer was also observed. Conclusions: The data of current practice collectively indicated that extra amounts of fluid were prescribed resulted in increasing body weight of patients and appearance of electrolytes disturbances.

Abstract The objective of this study was to measure organization factors that can influence the ability of nursing staff to prevent and detect ADEs in public hospitals using Systems Engineering Initiative for Patient Safety (SEIPS) model. Methods: This was a multi-center cross-sectional study. The study included a self-administered paper-based survey which was distributed and collected between October through December 2019. The study participants were nurses from 11 public hospitals located in two Iraqi provinces. Binary logistic regression was used to measure the relationship between the independent SEIPS factors (persons, organizations, tools, tasks, and environments) and the incidence of ADEs (outcome variable). Results: The study recruited 603 nurses (68.3% men) from 11 public hospitals across two provinces. Less than half (48.8%) of the nurses received enough training to detect ADEs, 43.1% had adequate experience to detect ADEs, and 69.8% had to report ADEs in a special record. More than three-quarters (78.4%) believed that their jobs need fast work. Two of the five SEIPS model domains had significant negative association with the incidence of ADEs including organization (nurse-physician collaboration) and nurse experience in ADE detection. Conclusions: Nursing staff face several challenges to prevent and minimize ADEs including shortages in nurses, inadequate nurse experience in ADE detection, no training for ADE detection was received, fear of reporting ADEs, and a lack in monitoring equipment. Increasing nurse/patient ratio and providing more monitoring equipment and training courses can minimize ADEs and enhance their detection. Keywords: Adverse Drug Events; Hospitals; Nurse; Organization Factors; Patient safety model; SEIPS model.

Abstract Objective: The objectives of this study were to evaluate the current practice of postoperative fluid prescribing and assess the effectiveness of pharmacist-led intervention in the implementation of the National Institute of Health and Care Excellence (NICE) fluid therapy guideline in an Iraqi hospital. Methods: The prospective interventional study was conducted at AL-Hilla Teaching Hospital, Babylon, Iraq between November 2017 and July 2018. The study included two phases: The pre-intervention phase with 84 patients and the post-intervention phase with 112 patients. A pharmacist provided training and educational sessions for the hospital physicians and pharmacists about the NICE guideline of fluid therapy. The researcher calculated the amount of given post-operative fluids and compared to the NICE guideline and also measured the patients’ body weight, serum Na, K and creatinine pre-and post-operatively. Results: The pre-intervention phase showed no correlation between the amounts of prescribed fluids and body weight which caused increases in patients’ body weight. In pre-intervention phase, 6% of patients experienced hyponatremia, 19% had hypernatremia and 7.1% had hypokalemia. In the post-intervention phase, abnormal level of electrolytes and patient weight gain decreased significantly. Additionally, the intervention led to a strong correlation between body weight and amount of prescribed fluids in addition to lowering the incidence of electrolyte disturbances. Conclusions: A high proportion of patients in the pre-intervention phase experienced fluid overload, weight gain and electrolyte disturbances when fluid therapy was not prescribed in accordance with the NICE guidelines. The pharmacist-led intervention increased the surgeon awareness of the proper use of the NICE guideline which decreased the incidence of fluid-related complications and the inconsistency of fluid prescribing. Pharmacists can play a critical role to enhance post-operative fluid prescribing and minimize fluid-induced complications.

The Light Dependent Resistor (LDR) is made from a Cadmium-Sulfide compound (CdS). CdS is a semiconductor material. The resistance of the LDR changes as the light level changes. More light produces more electron — hole pairs in the material, making the material a better conductor in light. Resistance decreases (conductivity increases) as light levels increase because there are more charge carriers in the material. Note that R = 1/G (G is conductance). The LDR controls the voltage on the transistor’s base. As it gets darker in the room, the voltage on the base will increase until the transistor is forward biased. This results in high current flowing from the transistor’s collector to the base. This collector current flows to the LED and is responsible for turning the LED on.

The objectives of this study were to measure the incidence and types of medication prescribing errors (MPEs) in Iraqi hospitals, to calculate for the first time the percentage of physician agreement with pharmacist medication regimen review (MRR) recommendations regarding MPEs, and to identify the factors influencing the physician agreement rate with these recommendations. Methods: Fourteen pharmacists (10 females and 4 males) reviewed each hand-written physician order for 1506 patients who were admitted to two public hospitals in Al-Najaf, Iraq during August 2015. The pharmacists identified medication prescribing errors using the Medscape WebMD, LCC phone application as a reference. The pharmacists contacted the physicians (2 females and 34 males) in-person to address MPEs that were identified. Results: The pharmacists identified 78 physician orders containing 99 MPEs with an incidence of 6.57 percent of all the physician orders reviewed. The patients with MPEs were taking 4.8 medications on average. The MPEs included drug-drug interactions (65.7%), incorrect doses (16.2%), unnecessary medications (8.1%), contra-indications (7.1%), incorrect drug duration (2%), and untreated conditions (1%). The physicians implemented 37 (37.4%) pharmacist recommendations. Three factors were significantly related to physician acceptance of pharmacist recommendations. These were physician specialty, pharmacist gender, and patient gender. Pediatricians were less likely (OR= 0.1) to accept pharmacist recommendations compared to internal medicine physicians. Male pharmacists received more positive responses from physicians (OR=7.11) than female pharmacists. Lastly, the recommendations were significantly more likely to be accepted (OR= 3.72) when the patients were females. Conclusions: The incidence of MPEs is higher in Iraqi hospitalized patients than in the U.S. and U.K, but lower than in Brazil, Ethiopia, India, and Croatia. Drug-drug interactions were the most common type of MPEs in hospitals. Physician specialty and pharmacist gender and patient gender significantly influenced physician agreement with the pharmacist comments. Only one-third of the pharmacist recommendations were implemented. Phone drug applications would be helpful for daily hospital pharmacy practice. More pharmacist-physician collaboration is needed to address MPEs. Pharmacist-led MRR can identify and address MPEs to improve patient safety.

أقيمت حلقة دراسية في كلية الصيدلة /فرع الصيدلة السريرية ألقاها م. م. ساره كاظم عبود تناولت التطبيقات الطبية للروبوتات الدقيقة /النانوية وأهم البحوث الحديثة التي استخدمت الروبوتات النانوية لتوصيل الأدوية بصورة دقيقة للنسيج المحدد وهذه التجارب تهدف مستقبلا لتقليل الأضرار الجانبية المرافقة للأدوية كأدوية السرطان. تتضمن هذه الحلقة الدراسية خلفية بسيطة حول تكنولوجيا الروبوتات النانوية ومكوناتها واستخداماتها في المجال الطبي مثل التشخيص والجراحة وتوصيل الأدوية إلى جانب شرح مفصل لاثنين من التطبيقات البحثية في الجسم الحي لتكنولوجيا النانو وسيتم استخدامها في علاج السرطان والأمراض الوراثية. إلى جانب ذلك ، تقدم الندوة فكرة عن أحدث روبوت نانو حي تم تصنيعه في الأشهر القليلة الماضية في أمريكا