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Background: Potentially inappropriate prescriptions (PIPs) have significant clinical, humanistic, and economic impacts. Identifying PIPs may reduce their burden of adverse drug events. “Screening Tool of Older Person's potentially inappropriate Prescriptions (STOPP) and Screening Tool of Alert doctors to the Right Treatment (START) criteria” are promising tools that formulated to identify potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) in geriatrics. To determine the PIMs and PPOs using STOPP/START criteria and to determine the most frequent PIPs. Methods: The study was a descriptive cross-sectional hospital-based retrospective study. Medical files of elderly (≥65 years) patients admitted to the internal medicine unit at Soba university hospital from January to July 2020 were used. Data were collected using a checklist of STOPP/START criteria (version 2) to determine PIPs. Statistical package for social sciences was used for data analysis. Results: A total of 100 patients were included, around 59% were aged between 65-70 years, and 58% were males. The mean number of medications was 5.3 ± 1.9 drugs/patient. The results showed that the prevalence of PIPs was 68%. The STOPP criteria detected 209 PIMs in 42 patients, whereas the START criteria detected 155 PPOs in 45 patients. Furthermore, the drugs that used beyond the indication period was the most common PIMs, whereas the most detected PPOs were observed in the cardiovascular system medications. Conclusion: The study revealed a high prevalence of PIPs among elderly patients. This necessitates a further evaluation of its impact on clinical outcomes and implements interventions to improve prescribing practice.

Background: Based upon WHO (World Health Organization) Coronavirus Dashboard more than 5 million deaths worldwide have been attributed to the COVID-19 (Coronavirus Disease 2019) caused by the SARS-Cov-2 virus (Severe Acute Respiratory Syndrome Coronavirus) till November 2021. The annual flu vaccination has raised many questions about the vaccine's effects on Covid-19 outcomes. Several possible mechanisms including cross-reactivity and cross-protection have been reported to be responsible for the potential protective effect of the flu vaccine on the COVID-19 infection. This study was performed to evaluate the possible effect of the influenza vaccine on the disease severity, the mortality rate, and the length of hospitalization in COVID-19 patients. Methods: The data of 1300 patients were recorded from May 2020 to October 2020. Patients with a previous history of COVID-19, patients under 18 years old, and patients who did not have accurate information about their influenza vaccination history were excluded. 498 hospitalized unvaccinated COVID-19 patients with typical clinical manifestations and a positive PCR (Polymerase Chain Reaction) test for COVID-19 were included in this observational, cross-sectional study. The participants were divided into two groups (vaccinated and unvaccinated) based on the history of influenza vaccination at the time of admission.Results: The length of hospital stay was lower in the vaccinated compared to the unvaccinated group (p < 0.05). However, there was no significant difference between the mortality rate, the need for ICU (Intensive Care Unit) admission, and the severity of the disease between the two groups (p> 0.05).Conclusion: Since the patients studied in this article did not receive any of the Covid-19 vaccines; Therefore, the effect of influenza vaccination on the clinical course of Covid-19 can be evaluated using the results of this study. A longer length of hospital stay was observed in the unvaccinated patients in our study, which may suggest the possible protective effect of the influenza vaccine against COVID-19. 

Background: Mistakes occur inevitably, but medication errors can cause catastrophic consequences such as death, which accentuates investigation through presumptive sources and possible solutions for the prevention of errors that took place before. Methods: Twelve different medical wards of an educational hospital were analyzed using the direct disguised observation (DDO) method for administration step and chart review for prescription step. Each ward was randomly chosen, and the time at which the researcher presented oneself to each ward was contingent. The researcher observed the medicine continuously from the time prescribed by the physician until the drug finally entered the patient's body.mResults: Of 1350 dose of drugs, which were evaluated; 65% of data was collected in the morning shift (n=867), 28.6% in the afternoon shift, 6.4% of the night shift. About one-third of the physician orders were defective and did not contain all six parameters (drug name, dosage form, dose, measuring unit, administration route, and intervals of administration). Interpretation of the administration phase revealed 69% of drugs were erroneously administered due to errors detected as wrong route, omission, wrong dose, wrong time, and unauthorized dose. Conclusion: Our findings exhibit errors in the pivotal stages of the therapy process. Clear instructions and protocols should be implemented for hospital technicians, nurses, and physicians to avoid irreparable detriments caused by medication errors.

Background: Although corticosteroids are commonly used for COVID-19 disease during the inflammatory phase, the effective doses and the best choice of corticosteroids are not yet known. Methods: In the present study, the effects of non-pulse (30-250 mg/day of prednisolone equivalent) versus pulse equivalent (>250 mg/day of prednisolone equivalent) doses of corticosteroids are compared in terms of the patients’ oxygen saturation, hospital mortality, and side effects. In addition, the patients were followed for 2 months for readmission and mortality. Results: 270 severe or critically ill patients with COVID-19 disease were included in the study. Diabetes and hypertension were the most common comorbidities. More than 80% of the patients received corticosteroids. Pulse equivalent doses of corticosteroids were used in 36.9 % of the patients. Treatment with pulse doses of corticosteroid significantly increased the oxygen saturation in the critically ill patients. However, the pulse doses significantly increased the in-hospital mortality rate [29 (20.3%) vs. 12 (10.6%), p=0.036] and the side effects. In addition, a trend toward higher 60-day mortality was observed in the pulse-based-treated patients [31 (21.7%) vs. 14 (12.4%), p=0.053]. The multivariate analysis showed that having comorbidities increased the mortality risk independently [OR 3.33, CI 1.148-9.647]. Conclusion: The results showed that the pulse doses of corticosteroids increase the oxygen saturation, but they also can increase mortality. Further randomized controlled trials with larger sample sizes are needed to confirm our findings.

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Backgrounds: The pharmacists have a crucial role in providing pharmaceutical care to patients who receive anticoagulants. This study was conducted to evaluate the pharmacists’ confidence in pharmaceutical consultation in the field of anticoagulant therapy, identify their educational needs, and find their commonly used sources of medical information. In addition, their preferred method for future educations and specific areas of interest were assessed. Methods: This cross-sectional study was conducted between June 2018 and April 2019 among pharmacists involved in different areas of professional activity. They filled out an online questionnaire specifically developed to evaluate the aims of the study. The questionnaire was prepared in three parts including 6 questions about demographic information, 13 questions about confidence level, and 9 questions about the commonly used sources of medical information and educational needs of participants. Results: At the end of the study, 229 pharmacists completed the questionnaire. The pharmacists’ confidence was significantly higher when advising patients on warfarin versus non-vitamin K antagonists oral anticoagulants (NOACs) (P=0.0001). More than 98% of participants acknowledged that additional education is required in the field of anticoagulation. Among the different educational methods, electronic learning (e-learning) was more attractive than others (P=0.0001). Conclusion: Pharmacists’ confidence was lower in providing pharmaceutical support on NOACs compared with other anticoagulants. Our findings suggest that additional educational courses are needed to enable pharmacists on the provision of anticoagulation care, preferably via e-learning methods.

Several evidence have shown the beneficial effects of pentoxifylline in the improvement of oral aphthous ulcers. However, the data in this regard are sparse. So, the efficacy and safety of pentoxifylline in oral route was systematically reviewed to elucidate its effects on the size and number of ulcers, as well as the healing time and recurrence frequency in RAS patients. PubMed (Medline), Web of Science, Scopus, ScienceDirect, Cochrane Library, ProQuest, and Clinicaltrial.gov were searched for related articles. The investigated outcomes were pain level, the size and number of ulcers, the frequency of recurrence, the healing time, and finally the pentoxifylline related side effects. Only 6 related study that investigate the efficiency of Pentoxifylline on RAS (n =107) were identified. Decreasing in the pain level, improving the ulcer size and number were establishe in approximately all studies. Pentoxifylline established its ability to shorten the healing time of this type of mouth ulcers. However, its potential to prevent the recurrence of the disease could not established based the data presented here. In conclusion, this systematic review suggests pentoxifylline in RAS patients because it confirmed that RAS patients who received this agent as oral administration reported suitable response. However, conducting more clinical trials with larger sample size and long follow-up time especially to efficiently judge about its ability to the recurrence prevention still is necessary to develop clinical practice guidelines for management of RAS.

In China Hubei province, Wuhan was recognized as the focus of an epidemic of pneumonia of unidentified origin in December 2019. Ultimately, intense focus on the disease was raised worldwide and in China. as a result, on January 7, 2020, Chinese research scientists identified the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in an affected patient in Wuhan.

Beta thalassemia is a congenital hereditary disorder of inefficient erythropoiesis that leads to peripheral red cell breakdown due to defective β-globin series. The severity of the disease depends on multiple genetic and environmental factors. Individuals with beta-thalassemia are classified based on their transfusion demands as having transfusion-dependent thalassemia (TDT) or non-transfusion-dependent thalassemia (NTDT). Routine transfusion remains the recommended standard management for beta-thalassemia, as it efficiently controls the thalassemia symptoms. If left untreated, Beta thalassemia major (BTM) can eventually induce spleen enlargement, deformation of bone because of bone marrow growth, and heart failure as a result of severe anemia.3, 4, 5, 6