THE EFFICACY OF DIFFERENT ORAL MAGNESIUM SUPPLEMENTS FOR MIGRAINE PREVENTION: A LITERATURE REVIEW

No study was conducted to evaluate the efficacy of particular oral magnesium supplement over another in preventing migraine. Different magnesium supplements have different oral absorption and bioavailability. The objective was to identify the efficacy of different oral magnesium supplements in migraine prophylaxis. A literature review using MEDLINE, Scopus, Cochrane library, and EMBASE was conducted during the period from November 1, 2015 until December 30, 2015. Keywords included migraine, prophylaxis, and magnesium. Magnesium citrate was used as single oral migraine prophylactic supplement in most of the published trials. Migraine attack frequency and intensity were significantly lower in magnesium citrate group compared to placebo with 41.6-64% and 43-59% reduction in migraine attack frequency and severity frequently. Magnesium oxide was used in combination with magnesium citrate in 2 randomized clinical trials (RCTs), and used alone in one RCT in adults and children. No different in migraine frequency or severity between Mg-oxide and placebo in RCT conducted in children while Only Mg-oxide containing groups showed significant reduction in migraine days when compared to control (p<0.006) in RCT conducted in adults.  Magnesium chloride had never introduced as migraine prophylactic agent in clinical trials. Magnesium citrate seems to be the preferred oral magnesium supplement for migraine prevention; however, further studies comparing the efficacy of different oral magnesium supplements are needed

A cross-sectional study on the flood emergency preparedness among healthcare providers in Saudi Arabia

This study used a descriptive cross-sectional methodology to measure healthcare workers’ knowledge, attitudes, perceptions, and willingness to respond to a flood scenario in Saudi Arabia. A validated survey was distributed to collect data using a convenience sampling technique through multiple social media platforms. A total of 227 participants were included in this study: 52% of them were aged between 26 to 34 years, 74% were residents from Riyadh, and 52.4% worked in nursing divisions. A significant number of respondents (73.2%) had positive perceptions towards their hospitals’ ability to provide an effective response to a flood, 89% were willing to report to work following a flood, and 90% of participants reported the need to develop both guidelines and training for flood disaster preparedness. Preparation and successful flood mitigation in the hospital setting requires staff that have both knowledge and training in emergency management. One way to obtain such readiness is through competency-based training, including both table-top and full-scale live exercises. Although the willingness to respond to such a flooding emergency was high among staff, the development of guidelines and educational programs is needed in order to develop the competencies and skills sets to improve disaster preparedness response and preparedness efforts

Assessment of Saudi Mother’s Knowledge and Attitudes towards Childhood Diarrhea and Its Management

This study evaluates the knowledge, attitude of Saudi mothers towards diarrhea in their children and its management at home. Online cross-sectional validated online surveys, targeting Saudi mothers who are living in Saudi Arabia, are used to collect data from the beginning of March to the end of April 2019. Our results show that a total of 1140 mothers (52.1% of them were housewives) participated in the study. Approximately 40.3% of participating mothers believed that childhood diarrhea is a major problem in the Saudi community; however, almost 23% of the participants were unable to identify any critical sign of severe diarrhea, and around 66% falsely stated that diarrhea is caused by teething. Although 62% of our participating mothers knew about oral rehydration therapy (ORS), only 23.5% of them used it for their children. Adequate knowledge about the critical signs, causes, transmission, prevention, and management of childhood diarrhea should be applied in simple language to communicate the health-related information clearly

EVALUATION OF THE EFFECTIVENESS OF FREE NICOTINE PATCH THERAPY IN A CHARITY CLINIC FOR SMOKING CESSATION

The purpose of this study was to evaluate the efficacy of a free nicotine- patch therapy for smoking cessation in Saudi smokers. A single centered prospective study was carried out in a charity clinic for smoking cessation in Riyadh, Saudi Arabia.  A total of 31 subjects who attended the smoking cessation clinic from June 2014 to August 2014 were studied. All participants were male and their mean age was 31.1±6.4 years. The duration of history of smoking was 12.9±6.8 years. The nicotine- patch therapy outcomes were measured at baseline and at 6 weeks after using nicotine- patch therapy. At base line the number of cigarettes per day was 27±10 and carbon monoxide (CO) level was 20.2±8.3. The analyzed statistics revealed that there were significant decreased in the number of cigarette per day (p=0.001) and Carbon Monoxide (CO) level (p=0.001) over 6 weeks of nicotine- patch therapy. After 6 weeks of therapy, abstinence rate was 58 % (verified by CO level) and no serious adverse reactions were documented. The most common side effects were nausea, headache and local irritation sings. In addition, our finding revealed that smokers were likely to suffer from withdrawal symptoms following trying to quit. These withdrawal symptoms include sleep disturbance, loss of concentration and weight gain as well as irritability. Results of this study show that free nicotine-patch therapy is an effective measure for smoking cessation in Saudi population.Keywords: nicotine patch therapy, smoking cessation clinic, side effect

Assessment of novel oral anticoagulant use within a community teaching hospital

AbstractBackground: Novel oral anticoagulants (NOACs) are considered to be at least as effective and safe as warfarin with several advantages such as predictable pharmacokinetics, allowing for standardized dosing without monitoring, a lack of food interactions and fewer drug interactions; however, their misuse could potentially result in patient harm. Objective: To evaluate the appropriate use of the NOACs within a community teaching hospital. Setting: A community teaching hospital in the United States. Method: A retrospective chart review of patients that were prescribed dabigatran, rivaroxaban, or apixaban at our institution from October 2012 through November 2014 was conducted. Main outcome measure: The primary objective was to determine the percentage of patients that were appropriately prescribed NOACs. Secondary objectives were to determine the number of patients who were inappropriately transitioned from warfarin or parenteral anticoagulants to a NOAC or vice versa, the number of incidents when a NOAC was held or discontinued inappropriately before a procedure and the number of bleeding or thrombotic events while taking a NOAC. Results: Of the 113 patients receiving therapy with an NOAC, appropriate prescribing was observed in 79.7%. Dabigatran, rivaroxaban, and apixaban were appropriately prescribed in 73.8%, 88.3%, and 85.8% of patients respectively. Lack of renal dose-adjustment in patients with reduced renal function was the most common reason for inappropriate use (8.8%). Ten out of 38 patients (26%) were inappropriately transitioned from/to other anticoagulants. Two out of six patients underwent a procedure without holding NOACs as recommended prior to surgery. Of all patients receiving NOACs, a total of 3 bleeding incidents were observed, one with each NOAC. Conclusion: The NOACs were appropriately prescribed for the majority of patients within our institution. Future efforts however should focus on ensuring appropriate dose adjustments for renal impairment, procedures for transitioning between NOACs and parenteral anticoagulants, and adequate withholding times for NOACs prior to surgery in order to optimize the management of NOACs usage within our institution

Community Pharmacists’ Practice, Awareness, and Beliefs about Drug Disposal in Saudi Arabia

The awareness among Saudi people regarding the good and safe practice of drug disposal is fairly low. Community pharmacists’ potential toward drugs disposal directions and practice are not emphasized enough. Therefore, a cross sectional study was conducted in Riyadh, Saudi Arabia, to evaluate the practice, awareness and beliefs of community pharmacists about disposal of unused drugs. Out of 360 subjects who participated in the study, more than 70% returned the unused drugs to the pharmaceutical distributors. Around 80% of the participants confirmed the risk of environmental damage due to the inappropriate disposal of drugs, and 87.5% of them held themselves responsible for preventing such risk. Approximately 85% of surveyed pharmacists believed community pharmacies to be an appropriate location for the collection of unused drugs. There was no significant association between the community pharmacists’ age group and years of practice as community pharmacists with either the awareness of unused medication disposal on environmental hazards, or the beliefs about the appropriate location for collecting unused drugs (p > 0.05). The awareness and proactive accountable responsibility, along with community pharmacists’ belief of appointing pharmacies to collect unused drugs, strongly support the institution of drug take-back programs

Community Pharmacists’ Practice, Awareness, and Beliefs about Drug Disposal in Saudi Arabia

The awareness among Saudi people regarding the good and safe practice of drug disposal is fairly low. Community pharmacists’ potential toward drugs disposal directions and practice are not emphasized enough. Therefore, a cross sectional study was conducted in Riyadh, Saudi Arabia, to evaluate the practice, awareness and beliefs of community pharmacists about disposal of unused drugs. Out of 360 subjects who participated in the study, more than 70% returned the unused drugs to the pharmaceutical distributors. Around 80% of the participants confirmed the risk of environmental damage due to the inappropriate disposal of drugs, and 87.5% of them held themselves responsible for preventing such risk. Approximately 85% of surveyed pharmacists believed community pharmacies to be an appropriate location for the collection of unused drugs. There was no significant association between the community pharmacists’ age group and years of practice as community pharmacists with either the awareness of unused medication disposal on environmental hazards, or the beliefs about the appropriate location for collecting unused drugs (p &gt; 0.05). The awareness and proactive accountable responsibility, along with community pharmacists’ belief of appointing pharmacies to collect unused drugs, strongly support the institution of drug take-back programs.</jats:p

Evaluation of the Efficacy and Safety of Quetiapine in the Treatment of Delirium in Adult ICU Patients: A Retrospective Comparative Study

Background: Quetiapine is commonly prescribed off-label to manage delirium in intensive care unit (ICU) patients. However, limited studies comparing its efficacy and safety to those of other antipsychotics exist in the literature. Method: A retrospective, single-center chart review study was conducted on adults admitted to the ICU between January 2017 and August 2022, who were diagnosed with delirium and treated with a single antipsychotic and had no neurological medical conditions, active alcohol withdrawal, or prior use of antipsychotics. Data were analyzed using SPSS software version 28, with p-values of &lt;0.05 indicating statistical significance. Results: In total, 47 patients were included, of whom 22 (46.8%), 19 (40.4%), 4 (8.5%), and 2 (4.3%) were on quetiapine, haloperidol, risperidone, and olanzapine, respectively. The median number of hours needed to resolve delirium were 12 (21.5), 23 (28), 13 (13.75), and 36 (10) (p = 0.115) for quetiapine, haloperidol, risperidone, and olanzapine, respectively, with haloperidol being used for a significantly shorter median number of days than quetiapine (3 (2.5) days vs. 7.5 (11.5) days; p = 0.007). Of the medication groups, only quetiapine-treated patients received a significantly higher median maintenance compared to the initiation dose (50 (50) mg vs. 50 (43.75) mg; p = 0.039). For the length of stay in the ICU and hospital, delirium-free days, % of ICU time spent in delirium, ventilator-free days, the difference between the highest and baseline QTc intervals, and ICU and hospital mortalities, no significant difference was observed between the groups. Conclusions: Overall, the use of quetiapine in our retrospective study seems to not be advantageous over the other drugs in terms of efficacy and safety outcomes

Community pharmacists’ knowledge, prospective and practice towards health related illness at Hajj and Umrah: A cross sectional study

Objectives: To assess the community pharmacists' (CPs) knowledge, attitude, and perception of health-related illness among pilgrims, and to investigate the common diseases and the pattern of medications dispensed by CPs during Hajj and Umrah seasons. Method: A cross-sectional study was carried out in Riyadh, Saudi Arabia over two months in 2022, through electronic platform using prevalidated questionnaires adopted from the literature. The questionnaires were divided into 4 sections assessing the CP's knowledge, attitude, and perception about health-related illness, common dispensed agents, and required vaccination during Hajj and Umrah. Results: A total of 544 CPs, mostly between the age of 31–40 (69.9%), participated in this research. About 87.9% of the CPs received a pilgrim after performing their rituals coming to the pharmacy complaining of infection or health problem. In this study, 99.8%(n = 544), 99.6%(n = 543), and 92.7% (n = 505) of the CPs identified influenza, food poisoning, and diarrhea/gastroenteritis as the most common issues during the Hajj &amp; Umrah season respectively. As results, anti-diarrheal agents (96.3%), painkillers (87.3%), inhalers (89.4%), and sunscreens (88.3%) were the most requested pharmaceutical agents. Additionally, 96.7%(n = 527) of the CPs agreed that vaccination is safe to be given to Hajj and Umrah pilgrims particularly for those aged ≥ 65 years, and 89.4%(n = 487) of them reported awareness of vaccines that are required by Saudi Ministry of Health. Both Influenza and meningococcal meningitis vaccines were identified by 99.8% of the CPs, but polio vaccine was identified by 33.9%. Conclusion: Community pharmacists provided pharmaceutical care services for Hajj and Umrah pilgrims. The majority of CPs had adequate knowledge about viral diseases during Hajj and Umrah and their requirement for vaccination