Medicine articles list

Living with epilepsy, its unpredictable seizures, and its comorbid conditions present many challenges over the time. Continued educational efforts can play a key role in helping people learn to live with epilepsy and understand epileptic medications over the life span. The aim of this study is to assess the impact of pharmacist-initiated education on patients with epilepsy. Prospective and observational pilot study to evaluate the impact of educational interventions during February and March, 2019 was conducted. A total of seven patients with epilepsy was included in this study. They received ordinary consultation care in National Centre of Epilepsy at Ali Omar Askar Hospital in Tripoli, Libya. Knowledge assessment questionnaire was assessed initially and patients were subjected to pharmacist-initiated education and they have given follow up reporting card. A follow up for one month has continuously been done and final evaluation included: knowledge assessment questionnaire, adverse drug reactions and epileptic attacks reporting. All the patients completed the pre and post education questionnaire. There was no significant difference between the patients’ knowledge before and after interventional questionnaire except for only two patients which is statistically significant (P=0.03) and (P=0.02) whose knowledge was significantly enhanced by post education. Thus, there are a lot of opportunities and challenges for pharmacists to play a role in epileptic care and education as patients with epilepsy are not knowledgeable about their illness regardless of age, educational background or duration of epilepsy. This role must be highly enforced and implemented in patients with epilepsy.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Thrombocytopenia is a recurrent hematological disturbance in pregnancy. In pregnant women with thrombocytopenia, the risk of excessive bleeding during or after child-birth is high, particularly when they require a cesarean section, other surgery during pregnancy, labor or in the puerperium period. The objective of this study was to assess the prevalence of thrombocytopenia among pregnant women attending antenatal care service at Tripoli University Hospital, Libya. A cross-sectional analysis was used to determine the prevalence thrombocytopenia in pregnant women attending prenatal care services from July to December, 2020 at Tripoli University Hospital. A structured pretested questionnaire was used to obtain socio-demographic data, nutritional factors, obstetrics and gynecological factors, history and clinical conditions. Venous blood samples were collected for platelet count and other platelet parameters, which determined by using Sysmex automation. A total of 72 participated women; about 40%, 35% and 259% of the participants were in the third, second and first trimester, respectively. The mean number of children that women have was 2, with 2.7% having just one child and 47% having three or more children. This study concluded that the prevalence of thrombocytopenia and mostly with mild form is 8.3% and as being greater among pregnant women living in rural areas. Health care providers should do thrombocytopenia test regularly for every pregnant woman in order to prevent excessive bleeding during pregnancy, especially whom living in rural areas.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

The rate of aging is rapidly increasing and the term of geriatric refers to offer a medical care to elderly people. Drug consumption study on geriatric population is a vital issue since this group is totally neglected in Libya. The aim of this study was to assess drug utilization pattern among elderly patients in terms of world health organization core prescribing indicators and to evaluate the treatment cost. A total of 106 prescriptions were randomly collected from different community pharmacies located in Tripoli during the summer 2019, and were evaluated (total number of prescribed drugs is 359) for their clinical efficacy and safety. The findings revealed that 60 drugs acting on GIT (16.7%), 50 antimicrobial drugs (13.9%), 31 antihypertensive drugs (8.6%) and 30 drugs for respiratory diseases (8.4%) were prescribed to patients who are 65 years old or more. With regard to disease pattern in the elderly Libyan patients, 27 drugs were prescribed for diabetes mellitus (7.5%), 24 drugs for cardiovascular drugs (6.7%) and 14 drugs for anti-hyperlipidemia (3.9%). According to the WHO core drug use indicator pattern, the average number of drugs prescribed per encounter was 3.3. Prescription by generic name was low (41.5%). Antibiotics were 36.8% while injections were 26.6%. Thus, this study suggest that geriatric medicine and rational drug use should strongly be implanted in medical schools and teaching hospitals. Besides, a drug pattern use of the Libyan community is urgently required to avoid drug prescribing errors.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Hypertension is a public health issue that significantly increases the risk of health problems and decreases health quality of life of the patients. Angiotensin converting enzyme inhibitors are used to control hypertension by preventing production of angiotensin II in turn decrease blood pressure, thus it may enhance the quality of life. This study aims to assess the effect of angiotensin converting enzyme inhibitors on the quality of life of patients with hypertensive aging 40 years or older in Benghazi city in comparison with other classes of hypertension medications. A case control observational study was conducted, adopting the structured face-to-face interviewing survey technique. Over 150 patients who visited Benghazi medical center during the study period (November, 2019 to March, 2020), to follow up their chronic disease. The investigators used a pre-validated, pre-piloted questionnaire that has been adopted from SF 36 and modified according to the updated literature review; responses to each question were coded and analyzed. The results display that antihypertensive medications were found to be significantly related to the limitation on the physical activity domain and found that medications decrease the limitation on the activity with about 20% of the patients who taking angiotensin receptor blockers (20%) and 30% of the patients taking angiotensin converting enzyme inhibitors, 40% of the patients had no limitations on bending kneeling and stooping. Moreover, on the limitations on walking more than one kilometre, the results were about 15% of the patients taking angiotensin receptor blockers and 30% of the patients taking angiotensin converting enzyme inhibitors had a slightly or no limitation on walking more than a kilometre. Thus, the findings indicate that antihypertensive medications have a positive effect on quality of life of the patient in limitation on activity domain but no conclusive difference was found between angiotensin converting enzyme inhibitors and angiotensin receptor blockers medications.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Colon is part of the digestive system in the human body responsible for absorbing water and nutrients from food residues. There are many problems affecting the colon including irritable bowel syndrome, constipation, hemorrhoids, anal fissures, abscess, colitis and colon cancer which considered one of the most common diseases among the Libyan community. The aim of this study was to search the presence of colonic disease and the tendency of those diseases to transform into colonic cancer at Benghazi medical center in Benghazi-Libya. A survey was comprised of 15 questions concerning colon diseases, proper diagnosis and treatment type. The survey was distributed to the physician specialized in medicine at Benghazi medical center and they fill it voluntary. The initial part of the questionnaire designed to obtain demographic data concerning the physicians who diagnose the colon illness. The rest part of the questionnaire was concerning special questions to define frequency of the diagnosed disease. There were 20 participants at this study. The response to all questionnaires were collected and analyzed for drug use, patients and disease distribution. In conclusion, this study demonstrates that the correct diagnosis, prescribing the appropriate treatment for the colon disease and using the medicine properly is one of the most important things that help in treating the disease and reducing its exacerbation. In some cases, eradication procedures may be required if the medicine is not sufficient to treat the disease without the need for operations

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Inflammation is a natural aspect of the immune system's response. Pain, redness, heat or warmth, and swelling are the four major symptoms of inflammation. Plants can generate a vast range of phytochemical substances as secondary metabolites, all of which have anti-inflammatory properties. Herbal medicines are significant cures for the treatment of a variety of disorders around the world. Medicinal plants are made up of roughly 7500 species, with representatives from about 17,000 higher flowering plant species. Even when synthetic chemistry has advanced beyond expectations, the utilization of natural products in the production of medications utilized in modern medicine is unrivalled. Anti-inflammatory medicines can help to reduce tissue damage and improve patient comfort by interfering with the pathophysiology of inflammation. As a result of the huge number of species available for investigation, the effective creation of new naturally occurring anti-inflammatory medications relies mostly on a multidisciplinary approach to finding new compounds. Despite the fact that many review articles have been written in this area, the vast majority of them only looked at the subject from a regional perspective. Various non-steroidal anti-inflammatory medicines have been proven to alleviate pain and inflammation by inhibiting the isoform of cyclooxygenase enzyme's digestion of arachidonic acid, hence lowering prostaglandin synthesis. Non-steroidal anti-inflammatory medicines come with a slew of negative side effects. Thus, there are, however, medicinal herbs that have anti-inflammatory therapeutic properties with a little or no negative side effects.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Hypothyroidism is a common endocrine disorder resulting from deficiency of thyroid hormone or its effects on peripheral tissues. Previous hospital based study have revealed high prevalence of hypothyroidism in pregnant women. Also, studies with small sample size indicated a rising trend of prevalence of hypothyroidism during pregnancy. Moreover, pregnancy is seen as a risk factor in the occurrence of thyroid dysfunctions. Thus, the aim of was to assess and analyze prevalence of hypothyroidism among Libyan pregnant women in Benghazi city in to study its relation and risk in pregnancy. The study was conducted on a sample size of 177 Libyan pregnant women in Benghazi city in Libya during 2018. A cross-sectional observational study was conducted in clinics located in Benghazi city. Responses to the question was coded and analyzed. The prevalence of hypothyroidism among the pregnant women was found to be 10.2% (n = 18) and no significant relation between age and hypothyroidism among women. Only nine percent of the pregnant women had medical conditions (as diabetes mellitus and high blood pressure). 28% of the hypothyroidism pregnant women are of the first gestation and 72% are of the second or more. 83% of the hypothyroidism pregnant women had no thyroidectomy. Thus, this study concludes that there is a high prevalence of hypothyroidism during pregnancy period in Benghazi and a national screening is necessary for hypothyroidism in Libya.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Objectives: Viral gastroenteritis is a major health problem that is common worldwide, especially in developing countries, and is responsible for the majority of childhood diarrhea disease. The aim of this study was to determine prevalence of rotavirus and enteric adenovirus frequency and the age and seasonal distribution of viral agents in children with acute gastroenteritis attending to our hospital. Materials and Methods: In this study, 6999 stool specimens were investigated for the presence of rotavirus and adenovirus. The samples were obtained between January 2013 and August 2019 from children age 0-17 suffering from acute gastroenteritis attending to our hospital. Frequency of rotavirus and adenovirus were retrospectively evaluated with regard to seasonal distribution, gender and age of patients. Results: Viral antigens were detected in 1341 (19.1 %) of the specimens examined in the study. Among the positive results, rotaviruses and adenoviruses frequency were detected in 14.7 %, 4.4 %respectively. Rota-adenovirus co-infection was 8.4 %(n=113). Whereas rotavirus antigen was determined in all age groups, the highest was found in children age 0-2 with a rate of 57.9 %. Moreover, considering the seasonal distribution of the cases, it can be said that rotavirus infections are mostly observed in winter and spring, while adenovirus infections are frequently detected in summer and autumn. Conclusion: Rotavirus and enteric adenovirus infections are important public health problems that caused hospitalization, morbidity and mortality among children <5 years children in our country. As well as an approach to prevention of acute gastroenteritis, it is very important to detect the agent correctly and quickly for the treatment approach.

Sağlık Bilimleri Enstitüsü Dergisi YYÜ

Vitamin C is associated with history of the cause of the ancient hemorrhagic disease scurvy. Vitamin C is an essential nutrient with important antioxidant properties. It is required by the body for normal physiological function. The body cannot synthesize vitamin C, it is present in nature through foods and other natural sources and it exists as a nutritional food supplement. The antioxidant activity of vitamin C protects the body from free radical damage. Vitamin C is essential for the development and maintenance of connective tissues. It is used as therapeutic agent in many diseases and disorders. Vitamin C plays an important role in several metabolic functions, as the conversion of the amino acid, tryptophan, to the neurotransmitter, serotonin, and the conversion of cholesterol to bile acids. Vitamin C supplementation resulted in a significant increase in vitamin C levels in populations; its high intake is associated with positive effects on cardiovascular risk factors. Vitamin C protects the immune system, reduces the severity of allergic reactions and helps to fight infections. It has an important role in bone formation, wound healing and the maintenance of healthy gums. There is profound beneficial effect of vitamin C in respect to human diseases as cancer, atherosclerosis, diabetes, neurodegenerative disease and many metal toxicities. Several vitamin C analogs have been produced as anticancer and antioxidant activity. Vitamin C is useful if it is used as adjuvant therapy for several chronic diseases. Thus, this review summarizes the importance of vitamin C in the body’s physiology and biochemistry, in addition, the different mechanisms that vitamin C is implicated to treat different acute and chronic diseases. Future exploration should pay attention to chronic disease management by vitamin C.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Vitamin C is associated with history of the cause of the ancient hemorrhagic disease scurvy. Vitamin C is an essential nutrient with important antioxidant properties. It is required by the body for normal physiological function. The body cannot synthesize vitamin C, it is present in nature through foods and other natural sources and it exists as a nutritional food supplement. The antioxidant activity of vitamin C protects the body from free radical damage. Vitamin C is essential for the development and maintenance of connective tissues. It is used as therapeutic agent in many diseases and disorders. Vitamin C plays an important role in several metabolic functions, as the conversion of the amino acid, tryptophan, to the neurotransmitter, serotonin, and the conversion of cholesterol to bile acids. Vitamin C supplementation resulted in a significant increase in vitamin C levels in populations; its high intake is associated with positive effects on cardiovascular risk factors. Vitamin C protects the immune system, reduces the severity of allergic reactions and helps to fight infections. It has an important role in bone formation, wound healing and the maintenance of healthy gums. There is profound beneficial effect of vitamin C in respect to human diseases as cancer, atherosclerosis, diabetes, neurodegenerative disease and many metal toxicities. Several vitamin C analogs have been produced as anticancer and antioxidant activity. Vitamin C is useful if it is used as adjuvant therapy for several chronic diseases. Thus, this review summarizes the importance of vitamin C in the body’s physiology and biochemistry, in addition, the different mechanisms that vitamin C is implicated to treat different acute and chronic diseases. Future exploration should pay attention to chronic disease management by vitamin C.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Vitamin D deficiency and its effect have attracted a considerable research interest due to its relation to glucose homeostasis, insulin secretion, sensitivity and synthesis. The aim of this study was to evaluate vitamin D levels in patients with type II diabetes mellitus aged between 35 - 65 years and investigating their relations with glycemic control and obesity. The study included 74 Libyan patients with known history of type II diabetes mellitus (33 males and 41 females). Serum glucose, glycosylated hemoglobin (HbA1c) and vitamin D levels were biochemically estimated in these patients. Further, body mass index (BMI) was calculated for all the diabetic patients (weight in kilogram per height in meter square). The mean level of plasma glucose level was 150.58 ± 63.82 mg/dl (mean ± SD). The mean of HbA1c level was 7.90 ± 8.48% (mean ± SD). The mean level of vitamin D was 22.7 5 ± 14.97 ng/ml. The mean of BMI was 26.55 ± 4.10 Kg per m2. The findings showed that 58.10% of the cases had vitamin D deficiency (Out of which 24.24% were males and 85.36% were females). This study showed statistical significance differences in glucose, HbA1c, vitamin D and BMI between male and female patients. Moreover, elderly ages for both sexes had adverse effects on vitamin D status. Vitamin D levels have negatively been correlated with levels of glucose, HbA1c and BMI. It is concluded that vitamin D deficiency has an adverse effect on glucose homeostasis in patients with type II diabetes mellitus and this can be a contributor risk factor in complications of type II diabetes mellitus development in Libyan patients.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection caused more than five million deaths throughout the world and more than five thousand deaths in Libya, a little is known about the mortality rate and the risk factors for death from this serious infectious disease in Libya. Thus, it is aimed in this study to identify the potential risk factors for mortality from SARS-CoV-2 infections among 176 Libyan COVID-19 patients in Zawia city. This research is a retrospective cohort study that was conducted on 176 randomly selected volunteers who had been infected with SARS-CoV-2 during a period of December 2020 to February 2021 in Zawia city, Libya. Following filling the prepared validated questionnaire by COVID-19 patients, the data was analyzed to determine the previously mentioned risk factors. The mean age (SD) of the total 176 participated COVID-19 patients was 45.06 (± 17.7) and the mortality rate among these total involved cases (mild to severe cases) was 10.8%. It is found that the mortality among the severe COVID-19 cases was 41.3% and the mean age (SD) of COVID-19 deaths was 69.1 years (13.8) and 73.7% of them were 60 years old or older. In addition, it is found that 63.2% of the SARS-CoV-2 deaths were females and 78.9% of them had a positive history of chronic diseases. Moreover, it was found that the most common chronic diseases among COVID-19 deaths are diabetes mellitus and hypertension (73.3% and 53.3%, respectively). Collectively, it is concluded that COVID-19 elderly female patients aging 60 years or older with a positive history of chronic disease are more likely at high risk for death from SARS-CoV-2 infection among the participated COVID cases.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

The prevalence of vitamin D deficiency has recently been recognized in different parts of the world, even affecting healthy populations. The deficiency of vitamin D can lead to rickets in children and osteomalacia in adults. Few studies have been done to evaluate the status of vitamin D in the medical community around the world. No studies have been done in Libya to evaluate the status of vitamin D in medical students. The aim of this study was to evaluate the prevalence of low level of vitamin D in among healthy Libyan medical students of first year in University of Tripoli, Tripoli. Prospective study was conducted on 100 medical students of first year in Faculty of Medicine with a mean age of 19.5 years, 38 males and 62 females. Blood samples were taken and investigated for different biochemical parameters including serum calcium, serum vitamin D and serum parathyroid hormone levels. Questionnaire containing different data was completed for each student including personal data (age, address, nationality, and other data related to vitamin D deficiency. The prevalence of vitamin D deficiency in all the participated students was 74% (58.7% in males and 83.8% in females), while 21% had vitamin D insufficiency (28% in males and 16.12% in females). Only 5% of the students that had normal vitamin D was males. The mean 25-hydroxy vitamin D level was 19.49 ± 8.56 ng/ml in males and 12.08 ± 6.70 ng/ml in female students. Statistical analysis revealed that there is a highly significant difference among the student in vitamin D deficiency. In conclusion, low concentration of vitamin D is highly prevalent among the medical students included. An urgent action has to be taken in order to prevent adverse consequences of low vitamin D in young population.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Diabetes is a global issue, the diabetes epidemic is expected to continue, and the burden of diabetes causes catastrophic expenditure for healthcare system. The current study aimed to determine the presentation, the clinical feature and cardio-vascular risk factors in patients with diabetes. A retrospective observational study had been conducted in out-patients department at Almustaqpal Almosherq Centre during September, 2013 till September, 2020, the total number of attended out-patients department were 1 024, 820 patients who were selected for this study. A special perform was completed for every patient, which included details about patient’s demographics, points in clinical history, relevant investigations and clinical examinations were recorded. The study reported that out of 820 patients, 66% (n = 538) was female and their age range was between 14 - 87 years with a mean age of 56.53 ± 13.49 years, 96% (n = 791) were clinically diagnosed as type II diabetes, 07% of the patients were diagnosed as pre-diabetes, the duration of diabetes ranged from newly diagnosed to more than 10 years, with 46% (n = 379) of the studied population were more than 10 years diabetes duration, 70% (581) were presented with classical symptoms of diabetes. Initial treatment for diabetes also different in the studied sample, were absent of anti-diabetic medications in 30% (n = 248) of the patients, they refused to start glucose lowering drugs, 34.6% (n = 284) of them have morbid obesity (body mass index is more than 40), 80% (n = 662) have high HBA1c (more than 8 g%), 40.3% (n = 240/596) were uncontrolled hypertension on anti-hypertension drugs, 95.6% (n = 682/713) were controlled on treatment of lipid lowering drugs. This study showing the presentation of diabetes were the common, type II diabetes, at age group between 41 - 66 years about 65%, female sex, with high body mass index, high glycated hemglobulin and uncontrolled hypertension. There is concern that diabetic patients were occurring at a high frequency in younger adults, where longer duration of illness could increase the risk of developing more complications in later life. The rate of coexist cardiovascular risk factors (hypertension, dyslipidaemia and obesity) in Libyan patients with diabetes is highlighted.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Petroleum refineries are largest chemical industries that are responsible for emission of several pollutants into the atmosphere. Benzene and its metabolites are regarded as the most hazardous compounds that are emitted by petroleum refineries. These contribute to toxic oxidants, which cause many serious health risks to petroleum refineries workers. This study was aimed to analyze the effects of chemical exposure on hematological and biochemical parameters among workers at Zawia oil refinery and Mellituh oil and gas refinery companies. A total of 200 workers participated in this study which consisting of two equal groups (each group: n = 100). The first group consists of petroleum refineries workers and the second group consists of non-oil work civil servants serving were recruited as exposed and control subjects, respectively. The results of blood picture, liver enzymes and kidney functions were compared between the groups. Mean white blood cells counts, platelet counts, and hematocrit count were significantly higher, while the mean red blood cells count was insignificantly changed in petroleum refineries workers. While the mean hemoglobin and corpuscular hemoglobin concentration levels were significantly lower, whereas the mean corpuscular volume and mean corpuscular hemoglobin levels were insignificantly changed in petrol refineries workers. Liver enzymes and renal functions were significantly higher in petrol refineries workers. The present findings indicate that occupational exposure to benzene causes significant alterations in hematological and biochemical parameters and workers are at high risk of developing blood, hepatic or renal related disorders. Protection and frequent medical attention should be given to petroleum refineries workers.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Background: Exposure to cigarette smoke has been associated with pulmonary and reproductive dysfunctions; inflammatory response, oxidative stress and oxidative DNA damage induced by polycyclic aromatic hydrocarbons (PAHs) present in cigarette smoke have been implicated in the pathogenesis of these disorders. The peak expiratory flow rate (PEFR), a biomarker of inflammation and oxidative DNA damage (8-hydroxy-2-deoxyguanosine (8-OHdG), tumor necrosis factor alpha (TNF-α)), reproductive hormones (testosterone (TST), luteinizing hormone (LH), follicle stimulating hormone (FSH)) cotinine and urinary PAH metabolite (1- hydroxypyrene (1-HOP)) were estimated in male active smokers. Methods: One hundred men aged 20-47 years, comprising 50 active male smokers and 50 non-smokers, were randomly recruited into this comparative cross-sectional study. The PEFR was measured using a peak flow meter, serum levels of cotinine, FSH, LH, TST, TNF-α, and urine 8-OHdG by enzyme-linked immunosorbent assay and 1-HOP by high-performance liquid chromatography. Data analysis was done using a t-test and correlation analysis at p≤0.05. Results: Smokers had significantly higher cotinine (49.73±31.76 versus 0.51±0.69 ng/ml, p≤0.001), 8-OHdG (16.34±12.10 versus 5.79±2.14 ng/ml, p≤0.001) and lower PEFR (309.20±56.05 versus 452.80±45.76 L/min, p≤0.001) and LH (5.75±2.06 versus 6.97±2.79 mIU/ml, p=0.015) compared to non-smokers. Duration of exposure to cigarette smoke correlated positively with cotinine (r=0.937, p≤0.001) and 1-HOP (r=0.813, p≤0.001) while cotinine correlated positively with 1-HOP (r=0.863, p≤0.001) only in smokers. Conclusion: Reduced lung function and luteinizing hormone and concurrent increase in oxidative DNA damage associated with exposure to cigarette smoke may suggest the involvement of PAH-induced DNA damage in the development of pulmonary and reproductive impairment in smokers.

Eworo Raymond

Anemia, iron deficiency and iron deficiency anemia are common blood disorders. The role of vitamin D was agreed to be regulating in calcium and phosphate absorption and bone metabolism and its deficiency is observed as a crucial nutritional problem. Vitamin D is created under the skin by ultraviolet light. It is usually get vitamins from the food; however, in the case of vitamin D, there simply are not enough rich food sources for people to get adequate amounts in their diet. Its effects on the prevention of diseases such as cardiovascular disease and anemia has received much attention recently. To get sufficient vitamin D, need to be exposed to sunshine or use supplements. Vitamin D3 was found in the largest population as a deficiency. With regard to hemoglobin was the subject whom has less normal range of hemoglobin (19.05%) than international normal range, and in ferritin the low population number was the subject whom has less normal range of ferritin than WHO normal range. The population who has low ferritin also has low vitamin D3 and variable hemoglobin. According international guidelines, optimizing nutrition with daily or intermittent (1 to 3 times per week) iron supplementation, should be considered a first-line intervention in high-risk or high-prevalence groups. Although it is probably less effective than daily iron supplementation, intermittent iron appears to be a useful and cost effective way of controlling anemia and iron deficiency anemia. This may indicate that a positive relation between the low concentration parameter of vitamin D3 and ferritin level but no significant correlation with hemoglobin.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Community acquired pneumonia is a prevalent disease in the Emergency Department (ED). The literature reveals that clinical practice could not be related with guidelines recommendations. The aim of this study is to determine the impact of the implementation of the recommendations of the Spanish society of Emergency Medicine in the Hospital Clínico Universitario Lozano Blesa (Zaragoza) ED in the management of community acquired pneumonia. Use of Pneumonia Severity Index (PSI) estimation was used to assess the adherence. This study was carried out from December, 2014 to February, 2015. Data was compared with the previous two months. The indicators management (discharge or admission decision, adequacy and anti-biotherapy) as well as the incidence of PSI estimation before and after the intervention in these parameters were evaluated. 209 patients were included, 97 before the intervention and 112 after the intervention. No significant differences were observed in the calculation of PSI. A significant decrease of admissions was observed after the intervention in the patients in whom the PSI was calculated (68.8% vs. 45.0%, p < 0.05). A greater use of the Observation Room was aimed at those patients in whom the PSI was calculated (06.3% vs. 17.5%, p < 0.05). PSI calculation significantly increased antibiotic prescription adherence (88.9% vs. 75.2%, p < 0.05). There were no modifications in the prescription after the intervention. In conclusion, PSI is a useful and effective measure to achieve a greater adherence to the recommendations. However, despite the positive trend in the use of the PSI and its interpretation, a low-intensity intervention is not sufficient to generalize its use.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

ABSTRACT Background: One of the many functions of the liver is the synthesis of carrier proteins and hormone metabolism, and liver diseases have been linked to a variety of endocrine disorders. Aim:The study's goal was to look at the spectrum of chronic liver disease and the relationship between thyroid profile and severity of liver damage in a tertiary hospital. Methods and materials: The current study was a single-center, tertiary care hospital-based,case-control study that included 50 cases of liver cirrhosis/chronic liver disease and 50 age/sex matched healthy controls (chosen at random from relatives attending OPD with patients). Thyroid function tests were performed and results were compared between cases and controls.Result : This study included 50 cases of liver cirrhosis/chronic liver disease and 50 healthy controls.The mean age and gender of cases and controls were comparable, and the difference was not statistically significant. The majority of cases (76%) had alcoholic liver cirrhosis, with the remainder having non-alcoholic liver cirrhosis (16%) and chronic viral hepatitis (8%). As per Child-Pugh Score, the majority of cases (40%), followed by Child-Pugh C (32%) and Child-Pugh A (28%). In the current study, free T3, free T4, and TSH levels were compared between cases and controls, and abnormal values were found in cases, indicating a statistically significant difference. Serum thyroid profile abnormalities were observed as Child-Pugh Score Classes advanced, and the difference was statistically significant for free T3 and free T4. Conclusion: As compared to healthy subjects, patients with liver cirrhosis had abnormally high levels of circulating thyroid hormone, and severe abnormalitieswere linked to an advanced Child Pugh score. Derangement in thyroid profile is common in patients with cirrhosis of liver. Low free T3 and T4 levels are associated with more severe liver injury and may be used for prognostication in patients with cirrhosis of liver. Keywords: chronic liver disease; NAFLD, cirrhosis, Liver function tests; Free T3 and T4; TSH;

Tapas Tripathi

Background Covid-19 pandemic has hit many countries and put the majority of the public health system to test globally. Mandatory use of face mask was among policies set by the government to contain the spread of the novel disease. But citizens’ attitudes and compliance with these policies are important in controlling the pandemic. We assessed gender-based compliance to Covid-19 protocol (use of face mask) in Jos South, Plateau State, Nigeria. Methods Perception regarding Covid-19 and the use of face masks were assessed among participants using a questionnaire-based survey. In a cross-sectional study, ninety (n=90) questionnaires were administered to willing participants directly. A Chi-square test was used to determine the descriptive analysis of all responses, P-values <0.05 were considered statistically significant. Result Out of 90 participants, 55.6% (50/90) were male and 44.4%(40/90) were female. Forty-two (84%) males deny the existence of the pandemic while in females, 14 (35%) deny that Covid-19 exist. Thirty-seven (74%) of the male respondents do not comply with to use of the face mask and use a single face mask multiple times without decontamination. In females, 28 (70%) comply with the use of the face mask. Unlike the men, 20 (50%) of the females always decontaminate the face mask. The middle-aged adult (26-45 years) uses the face mask more than the young (18-25 years). There was a significant association of gender in relation to the perception of Covid-19 and the use of facemask (p< 0.05). Conclusion Male respondents showed an irresponsible attitude complying to Covid-19 protocol than the females, therefore, enlisting them as a risk factor for the continued spread of the virus. We recommend that public health awareness and campaigns should focus and employ greater influence on men and young adults in their compliance with the preventive protocols.

Bitrus Inuwa