Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 8 2 2020 06 26 48 49 Kourosh Sadeghi Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. 2020 05 11 2020 05 11  No Abstract .This is an editorial without any abstract. https://jpc.tums.ac.ir/index.php/jpc/article/view/346

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 8 2 2020 06 26 83 87 Saeed Mehralinejadian Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Mandana Izadpanah Department of Clinical Pharmacy, School of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Farhad Soltani Department of Anesthesiology and Critical Care, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Sepideh Sayadi Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Maryam Aghakouchakzadeh Department of Clinical Pharmacy, School of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. 2019 11 10 2020 04 13 Background: Increasing microbial resistance is a severe threat to global public health. One of the most common diseases in the intensive care unit is ventilator-associated pneumonia. Methods: The method of this research was non-interactive and descriptive. This study was carried out from January to March 2018, at the Golestan Hospital of Ahvaz. Patients with ventilator-associated pneumonia (VAP) were included in the study. The prevalence of resistant gram-negative microorganisms was studied through reported laboratory antibiogram results of cultures. Results: From 373 hospitalized patients, 38 (10.2%) were diagnosed with VAP. From the 57 respiratory cultures performed, overall 90 microorganisms were isolated, from which Enterobacter with 36 cases (39.5%) and E.Coli with 28 cases (30.7%) were most frequently compared to other organisms. From the 90 organisms responsible for the infection, 43 cases (47.2%) were Multiple drug-resistant (MDR)  microorganisms and 47 (51.6%) were Extensively drug-resistant (XDR) microorganisms. Enterobacter and E.Coli were the most prevalent MDR microorganisms with 17 cases (39.5%) and 13 (30.2%), respectively. Also, these two microorganisms were the most abundant XDR microorganisms with 19 cases (40.4%) and 15 (31.9%), respectively. Conclusion:The results show the requirement of robust antibiotic monitoring and the optimization of antibiotic use in order to prevent the progression of antibiotic resistance in these units. https://jpc.tums.ac.ir/index.php/jpc/article/view/295

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 8 2 2020 06 26 50 52 EN Betul Ozdemir Department of Cardiology, Faculty of Medicine, Nigde Omer Halisdemir University, Campus, 51240, Nigde, Turkey. 2020 02 12 2020 03 09 Background: Congestive heart failure (CHF) is a chronic disease that incidence is growing in the population. Vitamin D effects on directly myocardial cells. The aim of this study was to investigate the association between vitamin D levels with ejection fraction of left ventricle. Methods: The study population consisted of 101 patients admitted with heart failure. Age, gender, and demographic characteristics (diabetes mellitus, hypertension, smoking-nonsmoking, coronary artery disease) of all patients were recorded. In all patients for blood analyses vitamin D, creatine, crp and lipid profile were studied. And all patients were studied echocardiography. Results: CHF patients, in our population 35 (34.7%) patient is female and 66 (65.3%) patient is male. The mean age of our patients was calculated as 67.4±12.9 years. Our patients laboratory parameters mean were measured for vitamin D 24.3±17.3 ng/ml. Left Ventricular Ejection Fraction (LVEF) mean was measured 31.8±9.5. In our study group LVEF and vitamin D was correlated with each other Conclusion: Vitamin D and LVEF had a positive correlation in heart failure patients. It may be occured with the protective effect of vitamin D or consequence of hipovitaminosis. https://jpc.tums.ac.ir/index.php/jpc/article/view/323

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 8 2 2020 06 26 53 56 EN Mostafa Alavi-Moghadam Department of Emergency Medicine, Imam Hossein Educational Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Farhad Shahim Imam Hossein Educational Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Mohammad Sistanizad Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Elham Pourheidar Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Rezvan Hassanpour Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2020 01 16 2020 03 01 Background: Irrational use of antibiotics is a healthcare problem which can lead to antibiotic resistance. Vancomycin resistance is developing worldwide and is a huge financial burden to healthcare systems. Antimicrobial control programs are an essential component of educational programs in ensuring the optimal use of antibiotics. This study aimed to evaluate the effects of an educational program implemented at an Educational Medical Center on vancomycin prescription patterns. Methods: This was a cross-sectional, pre-post interventional study carried out at Imam Hussein Hospital affiliated with Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran, between 2014 to 2016. Vancomycin protocol was prepared, then all physicians and assistants were trained through workshops and instructed to order vancomycin based on the approved protocol. The primary objective of this study was to determine the change in vancomycin usage – calculated based on the Defined Daily Dose (DDD) per 100 patient-days in each ward – collected in three phases: at baseline, during the educational program and post-intervention phase. Results: The data revealed that total vancomycin consumption significantly decreased at the baseline and post-intervention phases in comparison with during the educational program (p=0.007, p= 0.105, respectively). Conclusion: The educational programs in this study were effective at optimizing antibiotics usage and the study results showed that antimicrobial training programs can be successfully implemented for the management of vancomycin usage at our university-affiliated hospital. https://jpc.tums.ac.ir/index.php/jpc/article/view/312

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 8 2 2020 06 26 57 64 EN Hananeh Baradaran Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Nasirpur School of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran. Hadi Hamishehkar Department of Clinical Pharmacy, School of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran. 2019 12 23 2020 04 20 Background: Pharmacotherapy in elderly patients has become a major concern due to their physiological changes, pharmacokinetic and pharmacodynamics variations and poly-pharmacy. In considering the global trend in population aging, we aim to evaluate the effect of “Beers Criteria” education on prescribing medications for elderly patients by General Practitioners (GPs). Methods: Thirty GPs with the highest number of prescriptions were included in this pilot study. All prescriptions written over a three-month period were considered, then prescriptions for geriatric patients were selected and evaluated. The GPs were trained using pamphlets and booklets which were prepared based on Beers 2015 explicit criteria. In order to evaluate the effect of education, appropriateness of prescriptions was analyzed before and 1 month following training. Results: Of 15,447 prescriptions selected during the first step, 1,281 prescriptions were related to geriatric patients in which the prevalence of inappropriate drug prescriptions was 37.3%. The most inappropriate medications identified were Bisacodyl, Alprazolam, and Hyoscyamine. While in the second step 1,055 of 15,154 prescriptions concerned the elderly and inappropriate drug prescription rate was noted as 23.6%. The most common inappropriate medications included Alprazolam, Amitriptyline, and Hyoscyamine. Based on our results, the prevalence of prescribing potentially inappropriate medications (PIMs) for elderly patients is high among GPs and educational interventions that raise awareness about “Beers Criteria” significantly reduce the prescribing PIMs. Conclusion: Given the importance of GP training programs in reducing inappropriate prescription rates among geriatric patients, it will be necessary for the National Committee of Rational Use of Drugs (NCRUD) to consider undertaking comprehensive educational strategies for reducing the prevalence of inappropriate medication use in elderly people. https://jpc.tums.ac.ir/index.php/jpc/article/view/304

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 8 2 2020 06 26 65 69 EN Afsaneh Vazin 1Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran. Seyed Ruhollah Mousavinasab Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran. Golnar Sabetian Department of Anesthesiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. AND Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran 2019 12 23 2020 03 29 Background: One of the complications of critical ill patients admitted to intensive care unit (ICU) are stress-related mucosal damage. Stress ulcer prophylaxis (SUP) should be administered to all critically ill patients with at least one major risk factor and two or more minor criteria. Methods: This study was performed during 6 months from October 2013 to December 2013 in Namazi Hospital intensive care units to assess the appropriate administration of SUP, according to American Society of Health-System Pharmacists (ASHP) protocol. Candidate for SUP according the ASHP guideline is considered if there is a at least one major risk factor or two or more minor risk factors. Results: Ninety-four patients were enrolled (46 men and 48 women). The mean age of study subjects was 51.5 years. The most major risk factor to stress ulcer found to be mechanical ventilation more than 48 hours (53%). The most minor risk factor for stress ulcer was ICU admission for less than one week (23.5%). Most prescribed medication for stress ulcer prophylaxis was intravenous Pantoprazole (44.7%). Our results have shown that about 74% patients were candidate for SUP according the ASHP guideline. 13(13.8%) of patients had only major risk factors. 5 (5.3%) of patients received SUP while they did not have at least one major risk factor or two or more minor risk factors. Conclusion: Our results have shown that 76.2% of the total SUP administrations were compliant with the ASHP guideline. Among the prescribed medication for SUP, intravenous pantoprazole had the highest percentage of administration (44.7%) and oral omeprazole had the lowest percentage of administration (7.4%). According to the results of our study, 72% of the route administrations are compliant with the ASHP guideline. https://jpc.tums.ac.ir/index.php/jpc/article/view/303

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 8 2 2020 06 26 70 74 EN Sajad Khiali Department of Clinical Pharmacy, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran. Samira Eskandari Department of Clinical Pharmacy, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran. Hadi Hamishehkar Department of Clinical Pharmacy, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran. AND Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Parham Maroufi Department of Orthopedic Surgery, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. Haleh Rezaee Department of Clinical Pharmacy, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran. AND Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. 2020 02 23 2020 03 14 Background: Vancomycin is a potent antibiotic and has central role in the managing of infections with known resistance to other antibiotics or in patients with allergy to beta-lactams. Irrational use of vancomycin is associated with increased morbidity and mortality as well as the antibiotic resistant. Methods: The DUE was done in Imam Reza Hospital, Tabriz, Iran. A total of 100 patients were included during a 6‐month period. We aimed to evaluate vancomycin administration pattern and assess its compliance with Centers for Disease Control and Prevention (CDC) and the American Society of Health-System Pharmacists (ASHP) protocols as the primary outcome and its adverse effects as the secondary outcome. Results: The mean duration of hospitalization and antibiotic therapy were 22.11 ± 1.76 and 19.08 ± 1.51 respectively (mean ± SD).  The most causes of vancomycin administration (51%) were for surgery prophylaxis. In 38% of patients, vancomycin administration was not in accordance to standard guidelines. Dose and duration of vancomycin therapy was according to ASHP and CDC guidelines in 74% and 59% of patients. Dose readjustments of antibiotics were necessary in 28 patients which were done in 12 of them. A total of 140 samples were collected from 60 patients. In 30% of patients, vancomycin use was continued without considering the culture results. Conclusion: It is important to set practical pharmaceutical and therapeutic infection control committees in hospitals under the clinical pharmacists’ observation. Furthermore, educational programs for health care professionals regarding rational use of antibiotics can be helpful in improving antimicrobial medications utilization and monitoring. https://jpc.tums.ac.ir/index.php/jpc/article/view/327

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 8 2 2020 06 26 75 82 Arash Abdolmaleki https://jpc.tums.ac.ir/index.php/jpc/article/view/620

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 12 2 2024 06 29 113 118 Nasibeh Ghalandari Shahid Beheshti University of Medical Sciences Shahaboddin Emami Department of Clinical Pharmacy, School of Pharmacy, Hamadan University of Medical Sciences, Hamedan, Iran. 2024 02 13 2024 04 07 Background: Drug and Poison Information Centers (DPIC) play a pivotal role in pharmacovigilance, public education, and preventing adverse drug reactions, medication errors, and poisoning incidents. Methods: This study presents an epidemiologic analysis of inquiries received by the DPIC at Hamadan University of Medical Sciences in Iran over four years (2019-2023). A descriptive cross-sectional analysis of recorded phone calls to the DPIC at Hamadan University of Medical Sciences from October 2019 to November 2023. The demographic distribution of inquirers, types of inquiries, and sources used to answer questions were considered in the analysis. Results: The study reports a total of 3904 recorded calls over the four-year period, with an average of 78.08 calls per month. The majority of callers were female (61%). The top three questions focused on coronavirus, side effects, and drug-drug reactions. Psychiatric agents, gastrointestinal agents, and antibiotics were the top three drug families inquired about. The data were collected from various references, with UptoDate® being the most frequently used (43.3%). Conclusion: This study provides a comprehensive epidemiologic analysis of inquiries received by the DPIC at Hamadan University of Medical Sciences. The findings underscore the importance of DPICs in providing evidence-based information, contributing to pharmacovigilance, and enhancing patient safety. https://jpc.tums.ac.ir/index.php/jpc/article/view/652

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 12 2 2024 06 29 119 130 Jignesh Kansagra Department of Scientific and Medical Affairs, Sundyota Numandis Probioceuticals Pvt. Ltd., Gujarat, India Vishal Dubey Department of Scientific and Medical Affairs, Sundyota Numandis Probioceuticals Pvt. Ltd., Gujarat, India Dharmeshkumar Kheni Department of Scientific and Medical Affairs, Sundyota Numandis Probioceuticals Pvt. Ltd., Gujarat, India Varun Sureja Department of Scientific and Medical Affairs, Sundyota Numandis Probioceuticals Pvt. Ltd., Gujarat, India 2024 02 13 2024 04 02 Bone fracture is a common orthopedic condition that represents a significant health concern. Bone fracture repair process is a complex process that involves the harmonic and synchronized activity of bone cells. 5-lipoxygenase (5-LOX) is an enzyme responsible for the conversion of arachidonic acid to form leukotrienes. While leukotrienes have an empirical inflammatory role, various evidence suggests that these 5-LOX mediators, by switching the inflammatory environment and altering the activity of bone cells, have a detrimental effect on the bone fracture healing process. Additionally, various evidence suggests that 5-LOX inhibition shows improvement in the overall bone healing process and improves overall bone health. Despite this evidence, the clinical use of 5-LOX inhibitors in bone fracture healing is largely unexplored. The current review aimed to summarize the available evidence and pave the way for future large scale pre-clinical and clinical studies to evaluate the effectiveness of selective 5-LOX inhibitors in bone fracture healing. https://jpc.tums.ac.ir/index.php/jpc/article/view/653

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 12 2 2024 06 29 131 136 Babak Sabet Department of Surgery, Shahid Beheshti University, Tehran, Iran. Shahriar Eslamitabar Health Law Department, Smart University of Medical Sciences, Tehran, Iran. Ehsan Lame Department of International Law, Najafabad Branch of Islamic Azad University, Isfahan, Iran. Fatemeh Anvar Department of Law, Science and research Branch of Islamic Azad University, Tehran, Iran. 2024 01 17 2024 04 15 The patent system has long been criticized for limiting access to medicines. Dramatic advances in artificial intelligence and machine learning technology present a revolutionary opportunity in drug discovery, formulation and testing of dosage forms. The pharmaceutical industry claims that patenting is necessary to encourage innovation in the risky, lengthy, and costly research and development (R&D) process. But it still does not provide logical evidence about the actual effects of patents on innovation. The increasing use of artificial intelligence in research is intensifying the debate about pharmaceutical patents. Inventions created or enabled by artificial intelligence raise questions about patentability and patent policy in general. Faster and more efficient research and development weakens the justification for pharmaceutical patents. Research findings suggest that despite the necessity of continuing incentives for drug research and development, lawmakers should consider alternative systems that prioritize access alongside incentives to advance healthcare as a human right. https://jpc.tums.ac.ir/index.php/jpc/article/view/638

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 12 2 2024 06 29 137 143 Fehmi Mukadam Department of Pharmacology, Dr. Vaishampayan Memorial Government Medical College, Solapur, Maharashtra, India. Ujwala Gawali Department of Pharmacology, Dr. Vaishampayan Memorial Government Medical College, Solapur, Maharashtra, India. 2024 03 14 2024 05 18