مجموعة من الابحاث الصحية المنشورة لباحثينا في المجلات العالمية

اقدم لكم بعضا من اسهامات باحثينا العرب في المجال الطبي العالمي

حيث نشر موقع اكاديمي يعنى بالسموم والمعلومات الدوائية سلسلة من الابحاث المنشورة عالميا فاحببت اضافتها لكم من باب نشر العلم والمعرفة

الموقع لا يحوي اعلانات وهو اكاديمي بحت:


هنا المصدر:

http://www.najah.edu/ar/pcdic

بحث بعنوان: النّتائج الطبيّة و السمية للتطبيب الذاتي بين الطلبة الجامعيين في فلسطين



الملخص: الأهداف:
إن التطبيب الذاتي شائع في العالم كله .لا يوجد معلومات عن الوضع الحالي لممارسة التطبيب الذاتي في فلسطين.إن هدف هذه الدراسة هو تقييم درجة ممارسة التطبيب الذاتي بين عينة عشوائية من طلبة جامعة النجاح الوطنية. الطريقة:هذه دراسة وصفية تعتمد على الاستبانة ، وشملت1581 طالباً من مختلف السنوات الدراسية ومن مختلف كليات الجامعة . تم تجربة الاستبانة و التّأكد من وضوحها قبل استخدامها . تحوي الاستبانة أسئلة متنوعة و تم توزيعها بشكل عشوائي على الطلبة . تم إدخال البيانات و تحليلها بواسطة برنامج إحصائي. النتائج: ثلاثٌ وستون بالمئة من المشاركين كانوا من الإناث اللواتي يدرُسنَ في كليّات غير طبيّة ، متوسط عمر المشاركين كان 19.9 سنة. تسعٌ وثمانون بالمئة من المشاركين أشاروا إلى استخدامهم للتطبيب الذاتي .
لم تكن هناك فروق إحصائية بين المشاركين اللذين مارسوا التطبيب الذاتي بناءاً على جنسهم أو نوع الكلية التي يدرسوا فيها ( طبية أو غير طبية ). متوسط عدد الأدوية التي تم استخدامها في التطبيب الذاتي كان 2.63 ± 1.38 لكل مشترك. المسكنات، مضادّات الاحتقان، الأعشاب الطبية، و المضادّات الحيويّة، كانت أكثر المجموعات الدوائية المستخدمة في التطبيب الذاتي. الصداع، ألم الحلق، الرشح، و آلام الدورة الشهرية كانت أكثر الأسباب الطبية التي استخدم لتطبيب الذاتي لعلاجها.
أغلبية المشاركين مارسوا التطبيب الذاتي لأن المرض كان بسيطاً أو لأن لديهم خبرة سابقة به. أغلبية المشاركين يتمتعون بمعرفة جيّدة بالأدوية و لكنهم لا يتمتعون باهتمام عالي بالذات.
لم تكن المعرفة بالأدوية أو مستوى الاهتمام بالذات ذا أهميّة لتوقع ممارسة التطبيب الذاتي. لكن في اختيار نوع الدواء كانت العوامل المؤثرة هي الجنس، نوع الكلية، و درجة الاهتمام بالذات.

الاستنتاج:

التطبيب الذاتي شائع جدّاً بين طلبة جامعة النجاح. هذا النوع من الممارسة شائع لمعالجة الأمراض البسيطة أو ما يمتلك الطلبة خبرة سابقة به. رغم عدم وجود عامل لتوقع ممارسة التطبيب الذاتي إلا أن مستوى المعرفة بالأدوية و كذلك مدى الاهتمام بالذات لهما دور في تحليل نوعيةالأدوية المستخدمة

بحث: تدقيق ممارسات وصف الكورتيكوستيرويدات الموضعية في العيادات الخارجية للأمراض الجلدية في شمال فلسطين

في إطار هذه الدراسة التي استهدفت تحليل أنماط وصف الكورتيكوستيرويدات الموضعية، تم جمع 802 من الوصفات العلاجية في العيادات الخارجية للأمراض الجلدية خلال المدة من حزيران/يونيو 2003 إلى أيلول/سبتمبر 2003، وذلك من جميع العيادات الجلدية الخاصة الاثنتي عشرة الموجودة في شمال فلسطين. وبلغ عدد مرات وصف الكورتيكوستيرويدات الموضعية 616 مرة من جملة الأدوية الموصوفة التي بلغ عددها 2458 دواءً. وبالنسبة لجميع الوصفات، كانت المعلومات المتعلقة بقوة الدواء، ومدة المعالجة، والكمية الموصي باستهلاكها، غير كافية؛

أما المعلومات المتعلقة بتكرار أخذ الدواء، وطريقة أخذه، وموضعه، فكانت كافية.

ولوحظ أن الكورتيكوستيرويدات ذات النجاعة العالية وذات النجاعة العُلْيَا، قد تم وصفها لنحو 18% من المرضى؛ في حين تمَّ وصف الكورتيكوستيرويدات المتوسطة النجاعة لنحو 50% من المرضى. وتوصي الدراسة بمواصلة تقديم التثقيف الطبي للممارسين، بُغْيَة تحسين استخدام الكورتيكوستيرويدات الموضعية في علاج الأمراض الجلدية.

البحث باللغة لانجليزية
ملاحظة: اذا واجهت صعوبة في الترجمة فاستعن بجوجل للترجمة

استعمال دواء ( الأسيتامينوفين) في فلسطين: الدلالات الدوائية والسمية


Sweileh WM. UTILIZATION OF ACETAMINOPHEN IN PALESTINE: TOXICITY AND THERAPEUTIC IMPLICATIONS. Journal of the Islamic University of Gaza, (Natural Sciences Series) Vol.12, No.1, PP. 25-36 2004.

Abstract

Although its therapeutic mechanism of action is uncertain, acetaminophen (APAP) is one of the most commonly used analgesic antipyretic drug among children and adults. No studies were conducted on the pattern and extent of utilization of analgesics and APAP in particular in Palestine. The objective of this study is to analyze patterns of prescription and nonprescription of (APAP) use among the general Palestinian population. The prescribing patterns in Palestine for (APAP) were studied by analyzing the 2002 prescription database.

The non-prescription sale was obtained by a survey of 118 out of approximately 620 community pharmacies in West-Bank. Analysis showed that 3925 (14.7%) prescriptions contain an APAP products suggesting that at the national level, every seventh patient to a doctor’s clinic receives an APAP or APAP containing product. More than 50% of these APAP prescriptions were dispensed for children or infants. Analysis of APAP non-prescription sale showed the annual sale of APAP in community pharmacies in West-Bank regardless of dosage form is approximately 6,026,400 box suggesting that annual consumption rate of APAP per capita in Palestine is 20.4 gram/inhabitant/year.



The national expenditure on APAP bought as an over-the-counter (OTC) from community pharmacies is estimated to be 10,668,350 million USD per year. Legislative actions and health awareness are needed to reduce consumption of APAP and risk of its toxicity among the general population.

مدى الأعراض الجانبية عند المرضى الذين يتناولون الأدوية المضادة لأرتفاع ضغط الدم





Abstract

OBJECTIVE: To investigate the frequency of potential antihypertensive drug interactions among patients with cardiovascular diseases receiving antihypertensive medications.


METHODS: The study took place in Nablus, Palestine starting April through October 2003. Patients with cardiovascular diseases (n=876) or who were receiving one or more antihypertensive medications were evaluated. All drugs prescribed for the patients were obtained from their medical files. A drug interaction database was developed based on updated Drug Interaction Facts to examine potential and level of drug interactions in each patient's regimen. Data were entered and analyzed using SPSS software. RESULTS: The number of "unique" pairs of potential drug interactions among the antihypertensive agents present in the data was 433.
These included 16 cases (3.7%) level one; 34 cases (7.8%) level 2; 116 cases (26.8%) level 3; 136 cases (31.4%) level 4, and 131 (30.3%) level 5 interactions. Both increasing age and number of drugs were significantly associated with the potential for significant interactions at all levels with a p value less than 0.025.



CONCLUSIONS: This study found a high frequency of potential drug interactions with agents typically used for hypertension. Similar investigations need to be carried out among patients with other types of chronic diseases. Drug interaction software might be necessary in governmental pharmacy departments.

معدل الأصابة بالصرع المصاحب بالأعاقة العقلية وطرق علاجه


Waleed Sweileh, Asaad Al-Shakshair, Nidal Jaradat, Karam Abu-Rabie & Wafa Sabah. Prevalence & treatment of patients with epilepsy associated with intellectual disability: A pilot study in Palestine. The Islamic University Journal (Series of Natural Studies and Engineering) Vol.14, No.1, P.183-189, 2006.


Abstract:

We carried out a pilot study to investigate the prevalence and treatment pattern of epilepsy associated with intellectual disability in governmental neurological/psychiatric clinics in Nablus / Palestine. Medical files of all patients diagnosed with epilepsy in Al-Makhfeh neurology/psychiatry clinic were investigated. Focus was made on treatment practices among patients whose files indicated intellectual disability. All data were entered and analyzed using Statistical Package for Social Sciences (SPSS) software.
Out of one hundred and thirty four patients, twenty patients (15%) were diagnosed with intellectual disability. Both combo and mono therapy were practiced among those patients.


Barbiturates were commonly used both in mono or in combotherapy. Newer agents like vigabatrin, lamotrigene and felbamte were not used. This pilot study should stimulate health authority in Palestine to implement rational treatment policies of epilepsy among patients with intellectual disability given the fact that this group of people does not receive adequate medical and health attention.


تحميل الملف

عامل الجنس والاختلافات المرضية المؤثرة على اختيار العلاج الأحادي لمرضى فرط ضغط الدم



Sweileh WM, Jaradat N. Sex differences and disease factors affecting monotherapy choice for hypertension. The Islamic University Journal (Series of Natural Studies and Engineering) 2006; 14(1):51-61.

Clinical Pharmacy Graduate Program, AN-Najah University, Nablus, Palestine.
Corresponding Author: waleedsweileh@mail.najah.edu

Objective: To investigate the impact of sex differences and disease factors on drug monotherapy choice for hypertension. Design and Methods: The data for this study were collected from patient’s medical files. The sample studied included 876 patients with cardiovascular diseases. Focus was made on the 228 patients with uncomplicated and complicated hypertension who were receiving monotherapy. SPSS was used for data entering and statistical analysis. Results: 43% (98) of the treated men and 57% (130) of the treated women were on monotherapy for hypertension. Women tend to be treated with diuretics more often than men while men were more often treated with beta blockers.



Prevalence of the four major anti-hypertensive drug classes among men and women were as follows: diuretics (men 12%, women 32%), [beta]-blocker (men 45%, women 42%), calcium antagonist (men 15%, women 11%) or an angiotensin converting enzyme inhibitor (men 27%, women 15%). Disease factors that produce significant impact on drug choice include age category, diabetes mellitus, and bronchodilators co-medication. Presence of ischemic heart disease does not have statistically significant impact on BB or CCB antihypertensive drug choice.



Conclusions: The pattern of antihypertensive drug use is influenced by sex and presence of other co-morbid conditions. The influence of sex needs further long term investigation. In general, physicians in Palestine take most known indications and contra-indications into account when they prescribe an antihypertensive drug motherapy.

Running Title: Factors Affecting Hypertension Monotherapy Treatment
Key words: Sex differences, Disease Factors, Hypertension Treatment, Monotherapy.

تحميل الملف:

http://www.iugaza.edu/ara/Research/articles/volume%2014-%20Issue%201%20-studies%20-4.pdf

الأثار الضارة لمثبطات الأنزيم المحول لمادة أنجيوتنسين ومدرات البول عند أعطائهما معا على مستوى كرياتنين المصل



Sweileh WM. EFFECT OF COMBINED TREATMENT OF ANGIOTENSIN CONVERTING ENZYME INHIBITORS AND DIURETICS ON SERUM CREATININE LEVELS AMONG ELDERLY PATIENTS. Saudi Pharmaceutical Journal, 2006; 14(3-4):196-200.


Clinical Pharmacology, College of Pharmacy, An-Najah National University, Nablus, Palestine. E-mail: waleedsweileh@najah.edu

Abstract:





Background: The adverse effects of angiotensin converting enzyme inhibitors (ACE-I) and diuretics when given together need extensive research and attention. Methods: We performed a cross-sectional study of patients admitted to the internal department of a general medical hospital to investigate the effect of drug combinations on serum creatinine level and creatinine clearance upon admission. Results: age, sex, disease status and prior consumption of the 'target' drugs: diuretics and ACE-I were correlated with creatinine and creatinine clearance on admission.
The levels of serum creatinine for groups receiving the target combination in both sexes were significantly higher than groups who were not receiving the target combination. Computing an estimate of creatinine clearance based on Cockroft equation yields similar results to that for serum level creatinine.

The levels of creatinine clearance in both sexes were significantly higher in the control group compared to those receiving the target combinations.
Low dose aspirin seems to have a synergistic negative effect on renal function when given in combination with the target medications.


Conclusion:
taking ACE-I/diuretic combination was associated with significant changes in creatinine levels and creatinine clearance.

Attention should be made to balance positive effects of these medications against their negative effect on renal function.



Key words: ACE-I, diuretics, serum creatinine, renal impairment.



Links: http://wwww.ksu.edu.sa/colleges/pharm/SPJ/1434/143408.pdf

دراسة عن رأي الجمهور الفلسطيني في الأدوية



Sweileh WM, Arafat RT. ATTITUDES TOWARD MEDICATIONS: A PILOT STUDY IN PALESTINE. The Islamic University Journal (Series of Natural Studies and Engineering) 2006; 14(2): 21-30.











Chairman, Clinical Pharmacy Graduate Program. College of Pharmacy, An-Najah University, Nablus, Palestine. waleedsweileh@mail.najah.edu

Abstract:

Aims: The effectiveness of drug therapy is largely influenced by noncompliance, which is believed to be affected by attitude toward drugs. The aim of this study was to evaluate the attitudes toward drugs from an epidemiological perspective in Palestine. Methodology: A cross-sectional study, based on questionnaire survey randomly distributed to individuals in Palestine in the period starting November 2004 to January 2005. Data collected were entered and analyzed using Statistical Package for Social Sciences Program (SPSS) version 11 for windows. Results: Out of 573 respondents, 79.9% considered drugs as positive, a help; 15.4% viewed medication as necessary, evil; 4.7% considered medication as negative danger. “Self-Care” oriented people viewed medications more positive than others. Differences in attitude were observed among users of different types of drugs; those using antihypertensive or asthmatic, psychotropic drugs viewed medication more negatively than others. Patient’s medication knowledge greatly affects attitude toward drugs and thus patient’s compliance and drug effectiveness. Discussion and Conclusion: The majority of the study sample viewed medication as something positive, a help. Both written and oral information given to patients about illness and drug use greatly influence the attitude toward drugs and patient compliance. Certain population such as the elderly, patients using antihypertensive, psychotropic and asthmatic drugs needs special concern. Clinical pharmacists are the appropriate specialists to provide drug education to patients.

التحليل الدوائي والعلاجي لأدوية السكري والضغط عند المرضى الذين يعانون من مرض السكري والضغط معا في فلسطين.



Waleed M. Sweileh, Ola A. Aker & Nidal A.Jradat. Pharmacological and Therapeutic Analysis of Anti-Diabetic and Anti-hypertensive Drugs Among Diabetic Hypertensive Patients in Palestine. Journal of the Islamic University of Gaza (Natural Sciences Series), Vol 12, No. 2, PP. 35-57, 2004.



Abstract

The objective of this study was to determine the utilization pattern of antidiabetic and antihypertensive medication among diabetic hypertensive patients. The medical profile of three hundred and forty two patients diagnosed with type 2 diabetes mellitus and hypertension were reviewed and analyzed. Among the tested sample, antidiabetic monotherapy was prevalent (74.3%). Antihypertensive monotherapy was found among 47.3% of the tested sample. Analysis of the antidiabetic medications shows underutilization of insulin combination therapy and inappropriate use of metformin among the elderly.

Analysis of the antihypertensive therapy shows that there is underutilization of combination therapy, low dose thiazides and angiotensin II receptor antagonists (ATIIRA). Some of the 2-drug antihypertensive combinations were irrational like beta blockers (BB) plus diuretics, angiotensin converting enzyme inhibitors (ACE-I) plus BB or ACE-I plus dihydropyridine calcium channel blockers (CCB). In conclusion, the study shows that some prescribing practices for diabetic hypertensive patients were appropriate while others were inappropriate and do not adhere to current recommendations in the literature. Continuing medical education is needed to improve the prescribing practices in Palestine

[URL="http://www.najah.edu/ar/page/2482"] التداوي بالأسبرين عند المرضى المصابين بالسكري والضغط معا.[/URL]


Waleed M. Sweileh, Ola A. Aker & Nidal A. Jaradat. Aspirin Therapy Among Diabetic Hypertensive Patients. Journal of the Islamic University of Gaza, (Series of Natural Studies & Engineering) Vol.13, No.1, P.1-9, 2005.



Abstract The objective of this study was to determine the percentage of diabetics with hypertension who are using aspirin, and to report on any differences between males and females and age groups. Medical records of the 342 diabetic hypertensive patients were analyzed. The mean age of the patients in the sample was 64.4 years and male: female ratio was 1.03: 1. Among the sample population studied, only 108/342 (31.5%) were using aspirin. Gender differences in aspirin therapy were noticed. Aspirin was used in 42/168 (25%) females versus 66/174 (38%) males. No significant age differences were seen in aspirin therapy. As a conclusion, aspirin use is low in diabetics with hypertension. Physicians in Palestine should be encouraged to use aspirin more in diabetics for both primary and secondary prevention of cardiovascular disease.

Key Words: Aspirin, Clinical Pharmacology, Diabetic Hypertensive Patients, Palestine.

تقييم المعالجة بالأدوية الخافضة لضغط الدم عند المرضى المصابين بالسكري والضغط معا وتاثير عامل الأصابة بالذبحة الصدرية عليها


Sweileh WM, Sawalha AF, Zyoud SH, Al-Jabi SW, Tameem EJ, Shraim NY. Evaluation of Antihypertensive Therapy in Diabetic Hypertensive Patients: Impact of Ischemic Heart Disease. Journal of pharmacy practice; (2009), [Publisher: Directory of Open Access Journals, Country where published: Spain]. Accepted for publication



Abstract

Background and Objective: Macrovascular complications are common in diabetic hypertensive patients. Appropriate antihypertensive therapy and tight blood pressure control are believed to prevent or delay such complication. The objective of this study was to evaluate utilization patterns of antihypertensive agents and blood pressure (BP) control among diabetic hypertensive patients with and without ischemic heart disease (IHD). Methodology: Retrospective cohort study of all diabetic hypertensive patients attending Al-watani medical center from August 2006 until August 2007. Proportions of use of different antihypertensive drug classes were compared for all patients receiving 1, 2, 3, or 4 or more drugs, and separately among patients with and without IHD. Blood pressure control (≤130/ ≤80 mmHg) was compared for patients receiving no therapy, monotherapy, or combination therapy and separately among patients with and without IHD.


Results: 255 patients were included in the study; their mean age was 64.4 ± 11.4 years. Sixty one (23.9%) of the included patients was on target BP. Over 60% of the total patients were receiving angiotensin-converting enzyme inhibitors (ACEI)/ angiotensin receptor blocker (ARB), followed by diuretics (40.8%), calcium channel blockers (25.1%) and β-blockers (12.5%). The majority (> 55%) of patients were either on mono or no drug therapy. More than 55% of patients with controlled BP were using ACE-I. More than half (50.8%) of the patients with controlled BP were on combination therapy while 42.3% of patients with uncontrolled BP were on combination therapy; P = 0.24. More patient in the IHD achieved target BP than those in non-IHD group, P = 0.019. Comparison between IHD and non-IHD groups indicated no significant difference in the utilization of any drug class with ACE-I being the most commonly utilized in both groups.



Conclusions: Patterns of antihypertensive therapy were generally but not adequately consistent with international guidelines. Areas of improvement include increasing ACE-I drug combinations, decreasing the number of untreated patients, and increasing the proportion of patients with controlled BP in this population. Clinical pharmacist can play a role in achieving this.





Key Words: Hypertension control; Diabetes mellitus; Drug regimens; Prescribing patterns; JNC 7th report.

استهلاك الحوامل للأدوية: دراسة في فلسطين


Sawalha A. Consumption of Prescription and non-Prescription Medications by Pregnant Women: A Cross Sectional Study in Palestine. The Islamic University Journal (Series of Natural Studies and Engineering) Vol.15, No. 2, 41-57,







Abstract


Background and aims: Maternal intake of medications and supplements has changed over time, and it may be related to adverse reproductive outcomes. The purpose of this study was to evaluate the extent of utilization of supplements, medications, and herbs by pregnant women in Palestine and the expected effects.


Methods: Pregnant women attending the prenatal clinic at Rafedia Governmental Hospital at Nablus/Palestine were interviewed using a questionnaire containing questions regarding medications intake and disease status. Data obtained from pregnant women were entered and analyzed using Statistical Package for Social Sciences (SPSS) version 10. Results: Of the pregnant women attending Rafedia prenatal clinic, 70.2% were village residents, 89.9% of them had no chronic diseases at the time of pregnancy except for anemia which was a common condition. More than half of the pregnant women did take vitamins, iron, and calcium (56.4%, 63.3%, 57.8%, respectively) during pregnancy. Less than fifty percent of the pregnant women took folic acid. Nausea and vomiting were common but most women did not take any medications to treat it. Less than one third of the pregnant women took over the counter (OTC) medications, mainly analgesics, and more than two thirds took prescription only medications (POM), mainly antibiotics. Mean medication intake per pregnant woman was 1.6±0.9. Most of the women who took medications did take only one (44.5%), a lesser percentage took two (30.8%) or more (9.3%) medications. The medications taken belonged to categories B and C, and few belonged to category D. About 45% of pregnant women used herbal medications to treat mainly GIT problems such as upset stomach, diarrhea, and constipation. The majority of pregnant women in this study did not visit a dentist during their pregnancy. Discussion and


Conclusion:

In this study, utilization of OTC, POM, and herbal medications was common among pregnant women. Not all women received supplements, particularly folic acid. The majority of pregnant women were anemic yet they did not take iron as they should. Women and health care providers need to be educated about the importance of supplement intake during pregnancy. Self-medicating or doctors prescriptions of POM, OTC, and herbal medications during pregnancy support the importance of expanding the knowledge about the potential risks and benefits of such treatments.

مدى استهلاك المضادات الحيوية في فلسطين بمقياس الجرعة الدوائية اليومية


Waleed M. Sweileh, Ansam F. Sawalha, Rami M. AL-HajAbed, Abdullah Kh. Rabba. Utilization of Anti-infective Agents Measured in “Defined Daily Dose” (DDD): A Study in Palestine. The Islamic University Journal (Series of Natural Studies and Engineering) Vol.15, No. 2, 59-66, 2007


Abstract

Over utilization of anti-infective agents is a worldwide problem. The Anatomical Therapeutic Chemical (ATC) classification/DDD system is adopted by the world health organization (WHO) for drug utilization research to compare the pattern of drug usage at international level. This is the first study in Palestine that uses this methodology. The study was carried out for 30 consecutive days (23/10/2005-23/11/2005) in the internal wards at Al-Watani governmental hospital in Nablus-Palestine. Data collected included, age sex, diagnosis, anti-infective agents prescribed, dosage regimen and number of doses of antibiotic administered. Data were analyzed using SPSS version 12.
DDD/100 bed-days were calculated for the anti-infective agents using the international formula.During the study period, 442 patients were admitted to the internal wards. The patients were 193 females (43.7%) and 249 males (56.3%). Among these patients, 191 (43.2%) were prescribed anti-infective agents. Cefuroxime, ceftriaxone, and metronidazole were the most frequently prescribed with the percentages of 27.8%, 6.1% and 5.7% respectively. The total amount of anti-infective agents prescribed was 38.99 DDD/100 bed days.

The DDD/patient/day was 0.4 compared to 1 DDD/patient/day as the optimum. The results of this study reflect a deviation from the optimum use of anti-infective agents. Optimizing anti-infective therapy is necessary.

نمط استخدام مثبطات الأنجيوتنسين ومستقبل بيتا بعد الأصابة بالذبحة الصدرية الحادة



Sweileh WM, Shkokani FM, Sawalha AF, Al-Ramahi RJ, Jaradat NA, Zaid AA, Barakat AS.Prescribing pattern of angiotensin- converting enzyme inhibitors and beta blockers after acute myocardial infarction. Saudi Med J. 2005 Nov;26(11):1837-9.


Absrtact: No abstract available.

بارك الله فيك أخي زادها الله لك في ميزان حسناتك