Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 11 4 2023 12 31 195 199 Simin Dashti-Khavidaki Tehran University of Medical Sciences 2023 09 24 2023 10 22 Clinical solid organ transplant (SOT) pharmacy services started half a century ago in United States (US). In 2004, United Network of Organ Sharing (UNOS) bylaws mandated all SOT programs to recognize pharmacist as a responsible for providing pharmaceutical care to SOT patients. Soon after that, SOT pharmacy services were implemented in Iran and nowadays SOT pharmacists are members of SOT multidisciplinary teams with various clinical, education, and research duties during pre-, peri-, and post-transplantation phases. Board Certification in Solid Organ Transplant Pharmacotherapy (BCTXP) was established in 2018 in the US. The aim of this postdoctoral program is providing SOT pharmacotherapy services for all patients from pre-transplantation era to decades after transplantation event in community and hospitals. Inspiring that, SOT pharmacotherapy fellowship has been programmed in Tehran University of Medical Sciences and is under consideration by National Board of Clinical Pharmacy and Ministry of Health and Medical Education of Iran. Hopefully, this program will be initiated with the first applicants among board certified clinical pharmacists from Fall 2024. https://jpc.tums.ac.ir/index.php/jpc/article/view/616

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 11 4 2023 12 31 200 206 EN Sandeep Kamlekar Department of Pharmacology, Geetanjali Medical College & Hospital, Udaipur, Rajasthan, India. Sakshi Singh Department of Pharmacology, Geetanjali Medical College & Hospital, Udaipur, Rajasthan, India. Arvind Yadav Geetanjali Medical College & Hospital, Udaipur Meenu Pichholiya Department of Pharmacology, Geetanjali Medical College & Hospital, Udaipur, Rajasthan, India. Sangita Gupta Department of Pharmacology, Geetanjali Medical College & Hospital, Udaipur, Rajasthan, India. 2023 08 18 2023 11 15 Background: Drug utilization studies are powerful exploratory tools for establishing the role of drugs in society and also effective methods for assessing the prescribing pattern of clinicians. Around 4-10% of children suffer at least one seizure episode at 16 years of age. Even after the availability of several Antiepileptic drugs (AEDs), choosing the correct drug with accurate dosing will produce seizure-free generation. Hence, this study aims to examine the prescription patterns of drugs in epileptic children.  Methods: This study was a cross sectional observational study. Children <16 years old visiting neurology department with a history of epileptic seizures and already on antiepileptic drug therapy were included in the study. The data comprised of demographic details, disease history, type of seizure, diagnosis, investigations done, along with prescribed medication noted in case record form. The total study duration was 13 months.  Results: In this study, the maximum epilepsy encountering age in male and female children was   below the 12-year age group, male predominance was higher than females (male 60.83% vs. female 39.16%). The majority of children were diagnosed with generalized tonic colonic seizures, 54.17%, followed by focal/or partial seizures, 39.17%. Sodium valproate 19.16%, carbamazepine 14.17%, oxcarbazepine 16.67%, and levetriacetam 13.33% were the most commonly prescribed single drug regimens for treating both types of seizures, followed by clobazam added as second and third adjuvant drug in resistant epilepsy to valproate 12.5%, oxcarbazepine 6.67%, and levetriacetam plus carbamazepine combination 5% respectively.  Conclusion: Monotherapy was majorly followed in 70% of pediatric patients for maintaining better patient compliance. Both old and new AEDs regimens are prescribed for maintaining the quality of life in patients. https://jpc.tums.ac.ir/index.php/jpc/article/view/610

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 11 4 2023 12 31 207 213 Majid Hajimaghsoudi Department of Emergency Medicine, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Fatemeh Saghafi Department of Clinical Pharmacy, Faculty of Pharmacy and Pharmaceutical Sciences, Yazd Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Mahya Shorabi Student Research Committee, Faculty of Paramedicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran. Samaneh Mirzaei Department of Health in Emergencies and Disasters, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran. Mehrnaz Moharami Student Research Committee, Faculty of Paramedicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran. Negin Daryaei Student Research Committee, Faculty of Paramedicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran. Farahnaz Hoseinzade Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran. Farzad Jalili Student Research Committee, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran. Hamid Reza Rezaei Student Research Committee, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran. Yekta Rameshi Pharmaceutical Sciences Research Center, Student Research Committee, School of Pharmacy, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran. Mohsen Gholinataj Jelodar Department of Internal Medicine, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. 2023 07 21 2023 12 03 Background During COVID-19, healthcare systems in underdeveloped nations had significant challenges and were unlikely to offer the necessary care. It appears that a new, reliable healthcare model that prevents hospitalization is necessary to reduce the pressure that COVID-19 is putting on healthcare systems and patients. More particularly, as Remdesivir's use as an outpatient treatment for mild to severe SARS-CoV-2 infection has rarely been examined; we aimed to investigate in-depth comprehension of the effects of Remdesivir in these cases. Methods In our two-month cross-sectional study, non-hospitalized patients with mild to moderate COVID-19 who were referred to the hospital for up to 5 days of Remdesivir treatment received 200 mg of Remdesivir intravenously on day 1, followed by 100 mg of Remdesivir once daily for the subsequent 4 days. Patients were divided into groups based on the time of starting Remdesivir treatment after the appearance of symptoms: group 1 less than and equal to 7 days, and group 2 more than 7 days. Two groups were evaluated for a correlation between Remdesivir administration time and clinical symptoms on days 1 and 14 (follow-up visits). Results The study enrolled 273 eligible patients with a mean age of 47.5 years, of whom 112 were males and 125 were females. Results showed that patients who received Remdesivir in the first 7 days had less dyspnea (P-value<0.0001) and lung involvement (P-value<0.0001) than those who received it after 7 days at the end of the study. Patients who came later to receive Remdesivir also showed higher fatigue, AST, and ALT levels on the first day. Conclusions Among patients with moderate COVID-19, those who received a 5-day course of Remdesivir within 7 days of the onset of symptoms had a statistically significant difference in clinical status compared with those who received their treatments later. However, the size of this finding has uncertain clinical importance. https://jpc.tums.ac.ir/index.php/jpc/article/view/602

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 11 4 2023 12 31 214 218 Niloufar Sadat Mirasi Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran. Mehrnoush Dianatkhah Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran. Alireza Hosseiny Department of Cardiac Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Rasool Soltani Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran. Azadeh Keshavarz Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran. Sepehr Boroumandpour Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran. 2023 08 15 2023 11 04 Background: Surgical site infection (SSI) is the most common reason for patient readmission after surgery. Because most cases of surgical site infection are preventable with antimicrobial prophylaxis, adherence to appropriate guidelines is critical. The aim of this study was to evaluate adherence to guideline recommendations for antimicrobial prophylaxis of surgical site infections at Shahid Chamran Heart Hospital, Isfahan, Iran. Methods: This cross-sectional observational study was conducted using prospective data collected from December 2021 to June 2022 in the cardiac surgery ward of Chamran Hospital. Adherence to "Clinical practice guidelines for antimicrobial prophylaxis in surgery (2013)" was assessed using data from patient records regarding the type, dosage, timing, and duration of antimicrobial prophylaxis. Results: A total of 363 patients were included in this study. The compliance rate with the guideline in terms of the type, dosing, initiation time, redosing and duration of the antimicrobial agent was 99.72%, 1.6%, 98.8%, 29.28%, and 0% respectively.Conclusion: The present study revealed relatively low adherence to the guidelines in terms of dosing, re-dosing and duration of antimicrobial prophylaxis at Chamran Heart Hospital. Based on the results, developing a local guideline is highly recommended. https://jpc.tums.ac.ir/index.php/jpc/article/view/607

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 11 4 2023 12 31 219 225 EN Mohammad-Reza Alizadeh Department of Clinical Pharmacy, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran. Sana Hamedani Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Hadi Saghaleini Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. Elnaz Shaseb Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. 2023 08 25 2023 12 11 Background: This study evaluated the current practices of opioid and non-opioid analgesic administration for postoperative pain management in gynecological surgeries, aiming to optimize pain relief while minimizing side effects. Methods: A cross-sectional, prospective Drug Utilization Evaluation (DUE) study was conducted at Al-Zahra Hospital, Tabriz, Iran. Medical records of 100 patients undergoing gynecological surgery were reviewed over five months. Data on prescribed analgesics, pain scores, and adherence to APS2016 and ERAS2016 guidelines were collected and analyzed statistically. Results: Meperidine (pethidine) and diclofenac were the most frequently prescribed analgesics. The average patient pain score was 2.48 units. A combination of meperidine, diclofenac, and acetaminophen was identified as the most effective regimen for pain control. Prescribed regimens demonstrated 41.4±27.3% theoretical and 60.60 ± 28.77% practical compliance with APS2016 and ERAS2016 guidelines. While achieving the primary objective of pain relief with minimal side effects, compliance with established guidelines could be further improved through educational interventions. Conclusion: Optimizing analgesic regimens for postoperative pain management requires careful consideration of individual patient needs, including the benefits of opioid analgesics in achieving greater pain reduction. Adherence to evidence-based guidelines and ongoing educational programs for healthcare professionals are crucial for ensuring optimal pain relief with minimal side effects. https://jpc.tums.ac.ir/index.php/jpc/article/view/592

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 11 4 2023 12 31 226 232 EN Yasaman Soroush Shahid Beheshti University of Medical Sciences Hadi Esmaily Shahid Beheshti University of Medical Sciences Nasibeh Ghalandari Shahid Beheshti University of Medical Sciences 2023 06 24 2023 12 27 Background: In 2019 COVID became the cause of a pandemic, with approximately 500,000 deaths in six months worldwide. Remdesivir, the first drug approved by the U.S. Food and Drug Administration (FDA) for COVID-19 treatment, gained attention from numerous medical centers worldwide. Objective:The consecutive waves of COVID-19 peaks in Iran, coupled with the lack of widespread vaccination, and high consumption leading to a shortage of Remdesivir in the country, prompted an investigation into the usage patterns of Remdesivir and its correlation with clinical indicators in hospitalized patients. Method: A retrospective cross-sectional study was conducted using 390 patients' electronic records in seven different hospitals. Electronic records were reviewed and information was extracted under four categories: demographic data, lab test results at admission, medication information, and lab test results after completing treatment. Patients were classified into three time periods based on the date of their first Remdesivir injection. Outcomes were defined as final clinical status and length of stay in hospital. Results: A total of 390 patients were enrolled, with 198 females and 192 males. The longest hospital stay was 88 days, with an average of 7.5 days. A total of 1,979 doses of Remdesivir were prescribed, with 224 doses being in accordance with the national protocol, 22 doses exceeding the protocol, and 144 doses below the protocol. The overall average dose consumption was 5.07 for each patient. Conclusion: Overall pattern of Remdesivir utilization in the hospitals evaluated in this study (affiliated with Shahid Beheshti University of Medical Sciences) has been reasonable and in accordance with national protocols for COVID-19 infection. https://jpc.tums.ac.ir/index.php/jpc/article/view/596

Tehran University of sh the adverse effects of free radicals and treatment of the many diseases such as cancer. In this article, we discussed the correlation between acute myeloid leukemia incidence and the oxidant biomarkers (oxidative stress), and more focusing on the great role of antioxidant biomarkers, whether the non-enzymatic or the enzymatic in the protection of the cells against harmful effects of free radicals in the acute myeloid leukemia patients. https://jpc.tums.ac.ir/index.php/jpc/article/view/573

Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 11 3 2023 09 30 173 187 EN Priyanka Hotha Department of Pharmacology, University College of Medical Sciences, Delhi, India. Rachna Gupta Department of Pharmacology, University College of Medical Sciences, Delhi, India. 2023 05 17 2023 07 01 Corona virus disease 2019 (COVID-19) is primarily an infectious disease of the respiratory system. COVID-19 might have unusual extra pulmonary clinical manifestations as initial symptoms. This systematic review included case reports published from January 2020 to June 2022 in English language that met the following criteria: unusual clinical manifestations as a sole or first initial manifestation of COVID-19, Confirmed positive Reverse Transcription Polymerase Chain Reaction&