Salim A. Hamadi, Kal, " Pharmacy Training Student Guide: A practical approach for community pharmacy training " , "Pharmacy Training Student Guide: A practical approach for community pharmacy training to pharmacy students",Vol.,No., , Amman, Jordan, 10/10/2012
Salim A. Hamadi1, Mo, " The Role of Topical and Oral Melatonin in Management of Melasma Patients " , "The Journal of the Association of Arab Universities for basic Sciences (JAAUBAS) ",Vol.8,No.1, college of science, university of Bahrain, Bahrain, Bahrain, 12/03/2009
This novel study was designed to evaluate the possible effects of topically formulated melatonin cream alone or in combination with sunscreen and oral melatonin for the management of melasma patients in comparison with hydroquinone as a standard therapy. This study carried out in the dermatology department at the AL-Karama teaching hospital, Baghdad, Iraq. In a double blind manner, this preliminary clinical study was performed on 36 patients with epidermal melasma and 10 healthy subjects as control. They were diagnosed as having melasma and they were under dermatologist supervision during the entire period of treatment. The patients were allocated into four groups (A, B, C, and D), and treated with topical melatonin only, topical melatonin and sunscreen, topical and oral melatonin, and 4% hydroquinone cream, respectively for a period of 90 days followed by 30 days treatment with placebo. The severity of melasma was evaluated using the Melasma Area & Severity Index (MASI) before starting treatment and after each 15 days for 120 days. To evaluate the oxidative stress status, malondialdehyde (MDA) and glutathione (GSH) levels in plasma were measured before starting treatment and after 45, 90, and 120 days of treatment.
At the end of treatment period (90 days); all melasma patients demonstrated significant reduction in MASI score in different levels. In addition, the plasma MDA levels were decreased and plasma GSH levels were increased in different scales after 90 days of treatment. The overall results of this preliminary study suggested that topical melatonin could be used as a hypopigmenting agent in treatment of melasma, and this effect is augmented by the oral administration of the drug and the use of sunscreen, possibly by its antioxidant activity or by other mechanisms unrelated to antioxidant effect.
Mohammed Mahmood, Sa, " Formulation of metatonin as a cream and studying the release, diffusion, and stability of the cream " , "Almustansiryah Journal of Pharmaceutical Sciences (AJPS)",Vol.6,No.1, college of pharmacy/ Almustansiriyah University, Baghdad, Iraq, 03/07/2009
The topical preparations are used to give localized effects at the site of their application by penetration of the drug into the underlying layers of the skin, mucous membranes, the cornea of the eye, nasal, rectal, vaginal or urethral mucosa. While some topical preparations are designed for the systemic absorption of drug substances in therapeutic quantities, like the transdermal drug delivery system.
Melatonin is a hormone with multiple functions in human, synthesized and secreted by the pineal gland in response to changes in the darkness and light environment of the human. It is a powerful antioxidant and the most potent free radical scavenger known.
Formulation of melatonin as a cream and studying the release and diffusion of the drug from this formula. Also evaluation the effect of temperature & storage time on the stability of melatonin in the prepared cream.
Preparation of the cream base using the general method employed for the preparation of the various ointments, cream and gel bases, the fusion method. Then determination the in vitro release and diffusion of melatonin from the cream, also determination the stability of melatonin in the cream formula including the expiration date, Physical Properties, and pH of the cream.
The release was increased with time, and after 6 hours, the amount of melatonin released was approximately 16.4% of the original amount of the drug, the. After 6 hours, the amount of melatonin diffused through mouse skin was 4.1% of the original amount of the drug. Arrhenius plot was utilized to predict the degradation rate constant and then the expiration date was 1.997 years. No change in the color and odor of the cream which stored at 50 oC, 60 oC and 70 oC in a well-closed container and protected from light. Cream pH of the final product was 8.4 and after the storage period (45 days), the pH was around 8.2 .
The overall results of this study suggested that the prepared melatonin cream exerts its effects locally more than in a systemic way, which may increases its effectiveness in treatment of different skin pathological conditions locally, in the future work. In the future; it is possible to use different bases and chose the suitable one according to the study results, also enhancers, preservatives, and co-solvents could be used.
Khalifa E Sharquie* , " The Oxidative Stress and the Anti-Oxidant Mechanisms in Patients with Vitiligo in Relation to the Duration and Severity of the Disease " , "Iraqi Medical Journal ",Vol.52,No.1, Iraqi Medical Association, Baghdad, Iraq, 06/10/2006
Background: Vitiligo is an autoimmune disease. Previous studies showed that the progress of auto-immune diseases may be related to oxidative modification of cellular structures by free radicals, and at least partly depends on the concentration of antioxidants at critical cellular sites.
Objectives: The present work was arranged to evaluate the alterations in oxidative stress as measured by plasma and red blood cells Malondialdehyde (MDA) and the changes in antioxidant mechanism as measured by plasma and red blood cells Glutathione (GSH) in patients with vitiligo, in comparison to a healthy control group. These changes were studied according to the severity and duration of the disease. Methods: Fifty patients with vitiligo were included in this study. The severity of the disease was graded according to the rule of nine into three grades (mild, moderate, and severe). Duration of the diseases was graded into 2 grades (less than 6 months and equal or more than 6 months). Plasma and red blood cells Malondialdehyde (MDA), and plasma and red blood cells Glutathione (GSH) were assessed in all patients.
Results: The results showed that plasma and red blood cells Malondialdehyde (MDA) were high in mild cases and in the early course of the disease, while they were low in severe and chronic cases. Plasma Glutathione (GSH) was low in mild and acute cases while it reached near to normal levels in chronic and extensive cases. Conclusion: Free radicals are high in mild, and in the early course of the disease in patients with vitiligo, and near to normal in chronic, generalized vitiligo. Similarly, the antioxidants are low in mild, and in the early course of the disease in patients with vitiligo, and near to normal in chronic, generalized disease.
Keywords: Vitiligo, Glutathione, Malondialdehyde, Antioxidants, Oxidative stress,
Iraqi Medical Journal Vol. 52, No. 1, June 2006; p. 41-49
AL- Gaff AN, Hamadi , " Effect of melatonin on oxidative stress markers in patients with alopecia areata " , "Iraqi Journal of Pharmacy",Vol.5,No.1, College of pharmacy/University of Mousel, Mousel, Iraq, 05/10/2005
Alopecia areata is an autoimmune, nonscarring, multifocal disorder of hair growth characterized by circular bald areas, which occur on any hair bearing site of the body. The exact cause of alopecia areata is unknown. Recent study reported a potential role of oxygen free radicals (OFR) in pathogenesis of alopecia areata.
This clinical study was designed to evaluate the antioxidant effect of melatonin (3 mg every other day ) in patients with alopecia areata. This study revealed that two month treatment with melatonin antioxidant led to a decrease in the basal level of malondialdehyde (MDA) an index of lipid peroxidation, an increase in basal glutathione (GSH) content a major endogenous antioxidant in both plasma and erythrocytes and an increase in plasma total antioxidant status( TAS ) .
The most important point is the clinical significance of antioxidants in improving the hair growth response of patients with alopecia areata. This may be due to direct and/or indirect effect of melatonin on immune system. The direct effect may be through its immunoenhancing/ immunostimulatory properties of melatonin. The indirect effect is the scavenging activity of this antioxidant, which in turn decrease damaging effect of oxygen free radicals (OFR) and utilization of GSH in neutralizing phagocytes-induced free radicals. So replenishment of GSH within natural killer (immune) cells strengthens the immune system and increases the rate of hair growth.
Muqdam . Mohamed, Sa, " Clinical Evaluation of Melatonin alone & in combination with Pizotifen in the prophylaxis of Migrain " , "Iraqi Journal of Pharmaceutical Sciences",Vol.16,No.1, College of pharmacy, university of Bagdhad, Baghdad, Iraq, 10/05/2007
Anwar Hussain, Salim, " Does increasing the lipophilicity of peptides enhance their nasal absorption? " , "Journal of Pharmaceutical Sciences",Vol.80,No.12, American Pharmaceutical association, USA, 12/10/1991
Nasrin Sh. Mohammed,, " Angiotensin-1 and plasma renin activity in pre-eclampsia " , "PAN Arab Medical Journal",Vol.1,No.4, , Amman, Jordan, 05/10/2005
Angiotensin-I and Plasma Renin Activity In Pre-eclampsia
Nasrin Sh. Mohammed*, Salim A. Hamadi * (Ph.D.) & Wafa R. Al – Omari** (FRCOG).
The etiology of pre-eclampsia has not been fully established, it is characterized by the development of hypertension and proteinuria after 20 weeks gestation. This study was designed to measure the plasma Angiotensin-1(Ang-I) and plasma renin activity (PRA) to evaluate the role of renin-angiotensin aldosterone system in pre-eclampsia.
A total of 60 women aged ((19 - 40)) year were included in this study. They were divided into three groups; normal non - pregnant (( n = 20 )) , normal pregnant (( n = 20 )) , and pre-eclamptic women (( n = 20 )) . Angiotensin-1 was measured by the radio immune assay technique and the plasma renin activity (PRA) is calculated as an amount of angiotensin I generated in [(ng/ml)/hr].The mean ± SD of Ang-I in normal non pregnant, normal pregnant and pre-eclamptic women was [(0.5±0.15),(1.5±0.2) and (3.1±0.4) ng/ml] respectively. Statistical analysis (ANOVA) showed that Ang-I was significantly higher in preeclampsia ((P < 0.05)).
A significant positive correlation between albuminuria and plasma Ang-I concentration was found in pre-eclampsia. And a positive correlation between albuminuria and PRA concentration was also found in pre-eclampsia.
The results showed there is clear increase in renin activity in preeclamptic women which might be expected to result in higher level of Angiotensin in the plasma, Since angiotensin-II is the most potent of the circulating vasoconstrictors in the human placental so that renin angiotensin (RA) systems plays the key role in blood pressure.
PAN Arab Medical Journal. Issue 4, 2005
pamj.com-e. P.O. BOX 11121 Amman, Jordan
Haitham I. Baqie, Ma, " Evaluation of Seriological Tests for the diagnosis of Helicobactor Pylori infection " , "Iraqi Journal of gastroenterology, IJGE",Vol.1,No.4, Iraqi society of gastroeneterology & hepatology, Baghdad, Iraq, 05/10/2003
Abstract Original article
A total of 58 outpatients referred for endoscopic evaluation of gastroduodenal symptoms were included in this study.
Biopsy specimens were taken from the gastric antrum of each patient. Samples were tested for the presence of H. pylori by standard biopsy related tests (urease, histology, and culture) which are considered as gold standard methods for H. pylori detection. Sera from these patients were
tested for anti - H. pylori antibodies by enzyme-linked-immunoassay, immuno-chromatogrphy, and latex agglutination test for the evaluation of performance indices of these techniques. Sensitivity, specificity, positive and negative predictive values and accuracy of each test were calculated relative to one or more of the “gold standard”.
A total of 45 patients gave positive results for the presence of H. pylori by two or more of these tests used. The other 13 samples showed negative results by all three tests used. Serological tests show sensitivities ranging
from 95.5% for ELISA technique to 80% for latex agglutination test. Specificity ranges from 76.9% in ELISA technique to 69.2% by latex agglutination method.
Serological tests can provide a reliable non invasive method for detection
of H. pylori infection.
Iraqi Journal of gastroenterology, IJGE, Vol 1, issue 4 2003
Mohammed A. Taher, S, " The changes in sex hormones in females working in batteries manufacturing plant " , "Iraqi Journal of pharmaceutical sciences",Vol.15,No.2, college of pharmacy/University of Baghdad, Baghdad, Iraq, 08/10/2006
Ibder F.H., Salim A., " Mechanistic Approach to the diuretic effect of Iraqi Fenugreek seeds on rabbits " , "Kufa Medical Journal",Vol.9,No.2, College of Medicine/University og Kufa, , 12/10/2006
AL-Jaff A. N., Salim, " Evaluation of oxidative stress indicators in lymphocytes of patients with alopacia areata " , "AL-Mustansiria Journal of Pharmaceutical Sciences (AJPS)",Vol.2,No.1, College of Pharmacy, AL-Mustansiriya University, , 04/06/2005
Salim A. Hamadi, " Effect of trigonelline and ethanol extract of Iraqi Fenugreek seeds on oxidative stress in alloxan diabetic rabbits " , "Journal of the Association of Arab Universities for Basic and Applied Sciences ",Vol.12,No.2, ELSEVER, Bahrain, Bahrain, 04/04/2012
This study was designed to evaluate effect of trigonelline and ethanol extract of Iraqi
Fenugreek seeds on oxidative stress in alloxan diabetic rabbits.
Oral dose of (10 mg/12 h) isolated trigonelline or (7.7 ml/12 h) of ethanol extract of Iraqi
Fenugreek seeds was administered to the rabbits for four weeks. Plasma malondialdehyde
(MDA) and glutathione (GSH), as oxidative stress markers were measured in all rabbits before
treatment and once weekly for four weeks after the treatment. The results showed a significant
improvement in the stress induced oxidation parameters by alloxan-induced diabetes in rabbits.
The ethanol extract of Fenugreek seeds significantly decreases the plasma malondialdehyde
(MDA) from 2.51 ± 0.34 lmol/l in diabetic control rabbits to 1.57 ±0.12 lmol/l after four weeks
(P <0.05). The plasma glutathione (GSH) level increases significantly from 0.11 ±0.02 lmol/l to
0.26 ± 0.02 lmol/l after four weeks of treatment of the ethanol extract (P <0.05). The percent
reduction in plasma MDA level was 37.45%, while the percent elevation in plasma GSH was
136% after four weeks of treatment. The data showed that isolated trigonelline was less effective
than the ethanol extract of Fenugreek seeds in lowering plasma MDA or increasing the plasma
GSH markers. The results of this study clearly indicate that both ethanol extract of Fenugreek
and its major alkaloid, trigonelline are promising natural antioxidants and may be used in the treatment
of many diseases, especially diabetes mellitus.
Salim Hamadi, S.L. C, " Quantitation of verapamil and norverapamil in small blood samples from the rat by high perfromance liquid chromatography " , "Analytical Letters",Vol.19,No.11 & 12, Taylor & Francis, Germany, 06/04/1986
A simple, sensitive HPLC assay using fluorescence detection was developed for quatitation of verapamil and its active metabolite, norverapamil in 100-200 ul blood samples from the rat. Baseline separation of verapamil, norverapamil and internal standard, propranolol, was attained within 14 minutes. Standard curves for verapamil and norverapamil were linear from 7 ng/ml to 1000 ng/ml with a limit of detection of 4 ng/ml for both compounds. The intraday and interday coefficients of variation in verapamil and norverapamil concentrations, determined from spiked whole blood samples, were less than 10%.
Shalla, A. Ali, Sali, " Effect of ergotamine and its combination with vitamin E or melaotonon on total antioxidant status in migrain patients " , "Iraqi Journal of Pharmaceutical Sciences",Vol.16,No.2, Coolge of pharmacy. University of Baghdad, Baghdad Iraq, 04/10/2007
Free radicals and oxidative damage caused by them have being suggested to be involved in the pathogenesis of migraine. These may result from distorted equilibrium of pro-oxidant/anti-oxidant system that continuously generates and detoxifies oxidants during normal aerobic metabolism. Escape of such system from equilibrium leads to damage of cellular elements with the depletion of cellular stores of anti- oxidants material such as glutathione and vitamin E. Therefore, free radical scavengers (vitamin E or melatonin) seems to be of potential benefit as prophylactic anti-migraine therapy by neutralizing free radicals overproduction and possibly preventing formation of highly toxic intermediates (such as nitric oxide). In addition of being powerful antioxidant, melatonin was shown to possess promising effects in modulating severity, frequency and duration of migraine attacks. For this reason the present study was conducted to investigate the involvement of changed anti-oxidant defense (measured as total antioxidant status “TAS”) during migraine attack and the possible modulation of such status by classical anti-migraine therapy (ergotamine), antioxidants (vitamin E and melatonin) and their combination. 23 normal subjects and 21 migraine patients with age range of (17-45) years were enrolled in the study. Patients were diagnosed according to neurologist decision to have migraine with and without aura. Migraine patients were divided into three treatment groups; first group treated with ergotamine alone, second group with ergotamine /vitamin E and third group with ergotamine /melatonin. All groups were advised to take their treatments during attacks. Blood samples were drawn from migraine patients and normal subjects before initiation of therapy and after pain has been relived (from migraine patients only) for the investigation of TAS . The results of the study showed that TAS was significantly lower in migraine patients in comparison to control healthy subjects (P<0.05) with a percent reduction ranged from 35.46% to 43.97%. However, there is no significant difference in the level of TAS among migraine patients (P>0.05). Treatment with ergotamine raised significantly the level of TAS by 157%. The addition of vitamin E or melatonin greatly raised TAS by 179% and 176% respectively. The addition of vitamin E to ergotamine showed superior effect to that when melatonin was added. The greater reduction in TAS seen in this study among migraine patients in comparison to control healthy subjects suggests the presence of generalized decrease in antioxidant defense elements. Elevation of TAS by all treatments was very clear. In conclusion the decrease in TAS can be implicated in the pathophysiology of migraine and enhancement of antioxidant system can add a beneficial effect for the management of migraine headache with the use of antioxidants (vitamin E or melatonin) with classical anti-migraine drug.
Ashwaq Al-Jaff, Sali, " The ability of nutrient antooxidants to influence oxidative stree and lower the dose of prednisolone in patients with alopacia areata " , "Iraqi Journal of pharmaceutical sciences",Vol.15,No.1, College of Pharmacy-University of Baghdad, Baghdad- Iraq, 05/10/2006
Alopecia areata is a common disorder, hypothesized to be autoimmune in etiology. Cortisone taken orally may stimulate new hair growth.Prednisone (orally administered steroid)has proved effective for patients with alopecia areata ,but its potential side effects include weight gain,metabolic abnormalities, acne and menstrual problems.
This clinical study was designed to assess the clinical significance of the nutrient antioxidants(vitamin A,vitamin E and vitamin C)in reducing the dose of corticosteroids(prednisolone),and as a consequence,their side effects in patient with alopecia.The res ults of this study reveal the potential clinical significance of the therapy for two months with these antioxidants in reducing the dose of prednisolone from 100mg to 10 mg administered each other day and improving the rate of hair growth by attenuating free radicals damaging effect on immune system, thereby decrea sing the immunecomplex deposition. According to the results of this s tudy, the use of nutrient antioxidants may have an important role in protecting the immune system, and decreasing the dose and sid e effects that result from the use of high dose of corticosteroids .
Ekbal Al-Khateeb,Sal, " Hypoglycemic effect of trigonelline isolated from Iraqi Fenugreek seeds in normal and alloxan-diabetic rabbits " , "European Scientific Journal",Vol.8,No.30, , , 12/10/2012
Fenugreek (trigonella foenum graecum) is one of the most widely used medicinal plants in folk medicine. It is known to have a diuretic, cardio tonic, hypotensive, hypoglycemic and hypolipidemic effect. This study was designed to evaluate the hypoglycemic effect of Trigonelline isolated from Iraqi fenugreek seeds in normal and alloxan –diabetic rabbits.
Sixty male adult albino rabbits were used in this study. They were divided randomly into two main groups, a non-diabetic group (group A) and a diabetic group (group B). The two groups were further subdivided into subgroups, A1 - A4 and B1 – B5. Group A1 & B1 were control. Group A2 & B2, A3 , B3 and A4 & B4 were received orally 10mg/12hrs isolated pure trigonelline, 10mg/12 hrs standard Trigonelline and 7.7ml/12hrs ethanol extract of the fenugreek seeds respectively, while group B5 received insulin.
The data revealed that the isolated pure trigonelline exhibited a significant (P < 0.05) hypoglycemic effect in normal and diabetic rabbits, but its effect is more profound in diabetic groups. Isolated pure trigonelline reduces blood glucose level by 21.3% in the non-diabetic group and 27.53% in the diabetic group. The result of this study also indicated that the hypoglycemic effect of ethanol extract of fenugreek seeds and that of isolated pure trigonelline was not significant (P >0.05 ).
In conclusion, based on the result of this study, trigonelline at a dose of 10mg/12hrs has a significant hypoglycemic effect in both normal and diabetic rabbits. It is preferred to use trigonelline to avoid the possible adverse reactions which may appear due to the multi-components of the ethanol extract of the fenugreek seeds.
Yasir E. N. Al-Khash, " Formulation and evaluation of ciprofloxacin as a topical gel " , "AJPS",Vol.8,No.2, , Baghdad, Iraq, 10/01/2010
Ciprofloxacin is an antibacterial agent belong to fluoroquinolones group, it
has broad spectrum activity against Gram positive and Gram negative bacteria. Ciprofloxacin – HCl was formulated as a gel dosage form using two different bases, a 5% methylcellulose and 5% sodium carboxyl-methyl-cellulose gel base. The concentration of (1% w/w) of the drug in each base was prepared. In vitro availability of ciprofloxacin – HCl from these bases was studied, in addition the diffusion of the drug using excised mouse skin technique were also evaluated.
The results indicated that the extent of ciprofloxacin – HCl release was
higher from methylcellulose gel base than that from sodium caroboxy-methylcellulose gel base. While the data revealed that the diffusion of the ciprofloxacin through the excised mouse skin was higher from sodium carboxyl-methyl-cellulose gel base than that from methylcellulose. According to these results, 5% methylcellulose gel base was selected for further studies. The influence of storage time and temperature on the stability of the drug, as well as physical properties and pH, for the selected formula over a period of 45 days was studied.
The concentration of ciprofloxacin was found to decrease with time and temperature and no changes in the physical properties were noticed. The shelf life of the drug in the selected gel base was determined using exaggerated temperature technique and it was equal to 2.5 years.
The overall results of this study suggest that the selected formula could be
used in the preparation of ciprofloxacin gel as a topical dosage form to be used in the treatment of some dermatological infections.
Ehab Shaker, Salim H, " Therapeutic Drug Monitoring and Population Pharmacokinetics of Digoxin in Jordanian Patients " , "American Journal of Pharmacological Sciences",Vol.1,No.2, Science and Education Publishing, USA, 04/23/2013
Therapeutic monitoring of digoxin and the population pharmacokinetic parameters in Jordanian patients were done. Fifty three patients visited cardiac department of Jordan University hospital participated in this study, thirty two patients had congestive heart failure (CHF), while twenty one patients had atrial fibrillation (AF). Ninety three blood samples were collected from those patients for the measurement of digoxin level using AxSYM digoxin II assay method. Serum creatinine and potassium levels were also measured, in addition to blood pressure and heart rate. Microsoft Excel and Statistica programs were used for kinetic and statistical analysis. NONMEM computer program ADVAN 4 and 2 compartment model was used for population analysis of digoxin parameters. The serum digoxin level ranged from 0.11- 4 ng/ml. The percentage of all patients enrolled in this study that were out of therapeutic range was 49.05%. Serum digoxin levels were out of therapeutic range in 53.12% of patients with CHF and 42.85% in those with AF. The pharmacokinetic parameters for digoxin obtained in this study using traditional methods were: creatinine clearance CLcr (89.78 ± 45.61 ml/min), digoxin actual clearance CL (200.57 ± 154.52 L/day), volume of distribution V (541.57 ± 149.87L), t1/2(2.98 ± 2.05 day), elimination rate constant (0.41± 0.396 day-1). A strong correlation was also found between actual digoxin clearance with log dose normalized (R2=0.999), and t1/2 (R2= 0.875). No correlations were found between the log of the normalized dose and other pharmacokinetic parameters or potassium levels. The population pharmacokinetic parameter for digoxin obtained in this study were: CL (3.34L/h), Vc (3.27L), Vt (123L), inter-compartment clearance Q (72L/h), absorption rate constant KA (1.25h-1). In Jordanian patients with either AF or CHF digoxin dose adjustment based on therapeutic drug monitoring principles is recommended. Digoxin pharmacokinetics were similar to those reported in non-Jordanian patients; estimated population pharmacokinetic parameters were in agreement with literature values.
Eyad Qunaibi, Iman A, " Effect of Divergence in Patients’ Socioeconomic Background on their Perspective of the Role of the Community Pharmacist in Amman, Jordan " , "Tropical Journal of Pharmaceutical Research",Vol.12,No.2, Pharmacotherapy Group, University of Benin, Benin City, Nigeria, 04/26/2013
Purpose: To examine the effect of divergence in patients’ socioeconomic background on their
perspective of the roles of the pharmacist in Amman, Jordan.
Methods: This was a single-phase observational study conducted in two different socioeconomic areas:
Western (WA) and Eastern Amman (EA, which is of a lower socioeconomic status than WA) in March to
May of both 2009 and 2010. A validated questionnaire was completed by patients walking into
community pharmacies. The source of advice (clinical specialist, general practitioner, pharmacist, nurse
or herbalist) regarding patient's disease management and medication use, as well as patients’
expectation of the pharmacist were investigated.
Results: 2000 patients (mean age: 35.1 ± 13.7 years, 57.2 % males) visiting community pharmacies in
Amman (1000 each from WA and EA) took part in the study. The majority of patients chose the
pharmacist as the source of advice on medication use (WA, 50.8 %; EA, 53.6 %), followed by the
clinical specialist (WA, 35.7 % vs EA, 26.9 %, p = 0.001). Other aspects of patient perspective and
expectation of the pharmacist were also assessed; in several instances, more reliance on the
pharmacist was observed in EA (lower socioeconomic status) than in WA.
Conclusion: The findings of this study is important for future social pharmacy studies in the area, as it
shows that socioeconomic status influences patient’s perception of the role of the community
pharmacist in Amman, Jordan.
Salim Hamadi, " Interactions between grapefruit juice and medication " , "Journal of Arab Medicine",Vol.1,No.54, Acdima, Amman, Joradn, 06/05/2008
Dana A Darwish, Suza, " Awareness of antibiotic use and antimicrobial resistance in the Iraqi community in Jordan " , "Journal of Infection in Developing Countries (JIDC) ",Vol.8,No.5, , , 04/14/2014
Introduction: Antimicrobial resistance is a serious global health concern. It has considerable implications on societies' health and resources.
In Jordan, there is a large Iraqi community due to the ongoing turmoil in Iraq. Unfortunately, health awareness and practices of this community are under-investigated due to scarcity of research. This paper assesses the awareness of antibiotic use and antimicrobial resistance in the Iraqi community residing in Amman, Jordan. Their level of interaction with health care professionals regarding antibiotics and differences in their antibiotic use between Iraq and Jordan are also discussed.
Methodology: A cross-sectional questionnaire-based survey involving randomly selected Iraqis residing in Amman, Jordan was conducted.
Results: The study involved 508 participants. Sixty-two percent of participants agreed with buying antibiotics without a prescription, 29% agreed with obtaining antibiotics from friends or relatives, and 46% agreed with keeping leftover antibiotics for future use. Furthermore, 60% disagreed with not completing an antibiotic course and almost 90% of the sample listed viral diseases as an indication for antibiotics. Forty-four percent of participants abided by physicians’ instructions on antibiotic use. Half of the participants believed that pharmacists provided instructions on antibiotics all the time, whereas physicians were perceived to do so by 29% of participants.
Conclusions: Gaps exist in knowledge of antibiotic use and reasons for antimicrobial resistance among Iraqis residing in Jordan. These gaps should serve in planning educational campaigns to raise the community’s awareness of responsible antibiotic use. Law enforcement to restrict access to antibiotics is also pivotal to tackle their misuse.
Iman A. Basheti1, Ey, " Patient Perspectives of the Role of the Community Pharmacist in the Middle East: Jordan, United Arab Emirates and Iraq " , "Pharmacology and Pharmacy",Vol.5,No., Scientific Research Publication Inc, , 06/19/2014
Objectives: To explore patient’s perspectives of the role of the community pharmacist in view of
other health care professionals (specialist physician, general practitioner, nurse and others (e.g.
herbalist) in Jordan, UAE and Iraq. The study also investigated patient’s willingness to pay for
specialized pharmaceutical care services. Methods: This study followed a single phase cross sectional survey methodology, conducted in three Middle Eastern countries. Data were collected over a period of 6 months on two consecutive years (March to May 2009 and 2010). A questionnaire was designed and validated, then completed by patients walking into community pharmacies. The source of advice (specialist physician, general practitioner, pharmacist, nurse, or herbalist) regarding patient’s medication use and medical management were investigated. Key findings: Patients visiting community pharmacies in Jordan (n = 1000), UAE (n = 1000) and Iraq (n = 968) were recruited into the study (mean age 35.9 ± 13.1, 50.6% males). Significant difference between the three countries was shown, as more patients chose the pharmacist as their primary source of advice on medication use vs. the specialist physician in Jordan (50.8% vs. 37.3%) and Iraq (41.9%vs. 36.7%) compared to UAE (38.0% vs. 40.1%), P < 0.001, Chi-square test. Few agreed to receive paid pharmaceutical care services (Jordan 19.5%; UAE 24.7%; Iraq 2.3%). Conclusion: Current situation resulting in the lower socioeconomic status in Jordan and Iraq seems to lead to patients’ higher reliance on the pharmacist, as compared to the UAE. Majority of patients, regardless of the country of origin, are not willing to pay for specialized pharmaceutical care services. These findings are important for future social pharmacy research in the area.
Iman A Basheti, Eyad, " Inhaler Technique Training and Health-Care Professionals: Effective Long-Term Solution for a Current Problem. " , "Respir Care",Vol.,No., , American Association of Respiratory care, 06/24/2014
INTRODUCTION: The aims of this study were (1) to assess the ability of a range of health-care professionals (HCPs: specialists [physicians specializing in management of airways disease], general practitioners, pharmacists, pharmacist assistants, nurses, and respiratory therapists) in Jordan to demonstrate the correct use of some commonly used inhalers using standardized checklists, with highest scores indicating optimal use, and (2) to evaluate the short-term and long-term effectiveness of a single educational intervention on the HCPs’ skills in using inhalers.
METHODS: HCPs’ inhaler technique was assessed at baseline. All HCPs were then invited to attend a workshop on asthma management with particular reference to inhaler use. At the workshop, HCP skills in inhaler technique were optimized. Inhaler technique was assessed before and after training. All participants were assessed on their inhaler technique at follow-up (after 4 months).
RESULTS: Two hundred HCPs (10 specialists, 46 general practitioners, 79 pharmacists, 15 pharmacist assistants, 40 nurses, and 10 respiratory therapists) participated in the study. Specialists scored highest on baseline inhaler technique demonstration skills. All HCPs scored poorly in demonstrating the correct use of the dry powder inhalers when compared with pressurized metered-dose inhalers (MDIs) (range of mean scores ± SD: MDI, 7.24 ± 0.97 to 8.70 ± 0.67; Diskus, 4.83 ± 0.51 to 6.30 ± 1.7; Turbuhaler, 4.90 ± 0.32 to 6.40 ± 1.7). Participants attending the workshop showed improved inhaler skills (mean scores before and after training: MDI, 4.77 ± 1.60 vs 8.77 ± 0.52; Diskus, 4.40 ± 2.60 vs 8.85 ± 0.41; Turbuhaler, 4.96 ± 2.05 vs 8.63 ± 0.67). Four months after the workshop, the inhaler technique of 129 participants was again assessed. Those who had attended the workshop (n = 48) scored significantly higher mean scores for all devices (score = 7.64) than nonattendees (n = 81, score = 5.99, P < .001), by one-way analysis of covariance.
CONCLUSIONS: With the exception of specialists, HCPs in Jordan need to be updated on their inhaler technique skills, specifically the newer dry powder inhalers. A single effective educational workshop on inhaler technique can significantly improve HCPs’ long-term ability to demonstrate these skills.
Salim A. Hamadi, Kh, " Antioxidants Use of Vitamin C and vitamin E in Patients with Vitiligo " , "Iraqi J. Comm. Med",Vol.19,No.2, Al-Mustansyriah University , Baghdad, Iraq, 04/01/2006
Background: The etiology of vitiligo is still unknown, but the autocytotoxic theory suggests that increased melanocytes activity leads to its own destruction. One of the proposed mechanisms by which autocytotoxicity may occur is that the destruction take place through reactive oxygen species.
Objectives: The present work was arranged to evaluate the effect of antioxidants in the form of vitamin C and vitamin E in patients with vitiligo in the view of their effects on the alterations in oxidative stress as measured by plasma and red blood cells Malondialdehyde (MDA) and the changes in antioxidant mechanism as measured by plasma and red blood cells Glutathione (GSH)..
Patients & Methods: Twenty-three patients with vitiligo were included in this study. The severity of the disease was graded according to the rule of nine into three grades (mild, moderate, and severe). The oxidative stress (plasma and red blood cells Malondialdehyde) and the antioxidants (plasma and red blood cells Glutathione) were measured in all patients. All patients included in this study received a combination of vitamin C and E (vitamin C 500 mg, vitamin E 100 mg twice a day) for 2 weeks and then the oxidative stress (plasma and red blood cells Malondialdehyde) and the antioxidants (plasma and red blood cells Glutathione) were measured again.
Results: The results showed that only the mild group showed a statistically significant reduction in mean plasma MDA of 0.86 micro mole/L after two weeks of treatment P<0.02. The changes observed in mean plasma MDA in the remaining 2 groups and in the total cases were small and not statistically significant, while in erythrocytes MDA, the changes observed in mean erythrocytes MDA in the 3 severity groups of vitiligo and in the total cases were small in magnitude and not significant statistically. Also, the changes observed in mean Plasma GSH in the 3 severity groups of vitiligo and in the total cases were small in magnitude and not statistically significant.
Conclusion: The results showed that the oxidative stress decreased significantly after treatment with antioxidant drugs in the mild group (i.e. early in the course of the disease when the disease is still active) and this may have a therapeutic applications suggesting that antioxidants may help to decrease the oxidative stress if it was given early in the course of the disease.
AL- Gaff A. N, Hamad, " Evaluation of oxidative stress indicators in lymphocytes of patients with alopecia areata " , "Al-Mustansiriyah Journal for Pharmaceutical Sciences, AJPS",Vol.2,No.1, Al-Mustansyriah University , Baghdad, Iraq, 06/06/2005
Alopecia areata is a nonscarring hair-loss condition that often has a patchy distribution and can be quite unpredictable. It's believed to be an autoimmune disease involving T lymphocytic infiltrate around the hair follicle. Recent study reported a potential role of oxygen free radicals (OFR) in pathogenesis of alopecia. This clinical study was designed for further evaluation of oxidative stress in lymphocytes and evaluate the antioxidant effect of nutrient antioxidants (vitamin A,E&C).This study revealed a significant increase in basal malondialdehyde (MDA) level and increase of lymphocyte susceptibility to invitro challege using hydrogen peroxide. Also there is significant decrease in lymphocyte glutathione content (GSH) and total antioxidant status (TAS) in patients with alopecia areata.Two month treatment with nutrient antioxidant combination [vitamin A (5000I.U./day);vitamin E (400mg/day) and vitamin C (500mg/day)] normalized MDA levels ,decreased susceptibility to in vitro challenge with hydrogen peroxide , increased GSH content and TAS level in lymphocytes of patients with alopecia areata. The present study suggests that supplementation with nutrient antioxidant have direct and indirect positive effect on immune system. The direct effect may be through the antioxidant immunoenhancing / immunostimulant effect of vitamins on immune system and the indirect effect by counteracting damaging effects of oxygen free radicals (OFR) and utilization of GSH in neutralizing phagocytes–induced free radicals. So replenishment of GSH within natural killer (immune) cells strengthens the immune system and increases the rate of hair growth.
Salim A Hamadi1*, Mo, " Perceptions, Experiences and Expectations of Physicians Regarding the Role of the Pharmacist in an Iraqi Hospital Setting " , "Tropical Journal of Pharmaceutical Research,TJPR",Vol.14,No.2, Pharmacotherapy Group, faculty of pharmacy, University of Benin, Benin, Nigeria, 02/05/2015
Purpose: To investigate the perceptions, expectations, and experiences of physicians regarding
hospital-based pharmacists in some Iraqi government hospitals.
Methods: A cross-sectional study was conducted at four government hospitals in Baghdad and Erbil,
Iraq from March to July 2012. A validated, self-administered questionnaire was hand-delivered to a
random sample of 200 physicians. The questionnaire comprised four sections that probed the
physicians' demographic characteristics as well as their perceptions of, expectations of, and
experiences with hospital pharmacists.
Results: Most participants (69.4 %) reported rarely interacting with pharmacists and that enquiring
about the availability of medications was the main purpose (74.9 %) of any interactions. Physicians
reported being comfortable with pharmacists preventing prescription error, treating minor illness, and
suggesting prescription medication to physicians of 74, 75 and 67 %, respectively, but only 47 % were
comfortable with pharmacists providing patient education. The perspective of physicians in Erbil differed
from that of physicians in Baghdad (p < 0.05).
Conclusion: Interactions between Iraqi physicians and pharmacists are still not optimal. Physicians are
much more comfortable with traditional pharmacist functions than with the extended, patient-oriented
pharmacy services currently being promoted. Great efforts are needed to enhance the Iraqi physician's
attitude regarding the clinical services provided by pharmacists which in turn would result in more
collaboration among healthcare professionals.
Iman Basheti, Eyad Q, " Patients' Perspective of the Role of Community Pharmacists in Amman, Jordan " , "Research in Social and Administrative Pharmacy (RSAP)",Vol.8,No.6, Elsevier, , 12/31/2012
Objectives This is the first study conducted in Jordan aiming to examine patient's perspective of the role of the community pharmacist among different socioeconomic regions in the country (Western Amman (WA) and Eastern Amman (EA).
Methods This single phased observational study was conducted in 2009/2010. Ethics approval was obtained from the Jordanian Ministry of Health. A two-part questionnaire was designed and validated, then completed by patients walking into community pharmacies. The first part investigated the source of advice regarding patient's medical management (Specialist, General Practitioner (GP), pharmacist, other). The second part investigated the general public's anticipation from a pharmacist. Data were entered and analysed using SPSS version 17.
Results 3351 patients visiting community pharmacies in Amman took part (mean age 35.0 ± 13.4, 56.5% males). Patients stated that for the management of their chronic conditions, the specialist is the main contributor (WA:63.9% vs. EA:56.8%, p<0.001); the pharmacist came next in both regions (WA:21.6% vs. EA:23.4%, p<0.001). A significantly lower proportion of patients from WA compared to EA chose the GP (9.7% vs. 16.5%, p<0.001). As for advice provision on medication use, pharmacists provided the most advice (WA:52.8% vs. EA:53.0%, p=0.224), followed by the specialist (WA:32.0% vs. EA:27.4%, p<0.001). The second part of the questionnaire revealed that patients expect brief counselling (2 minutes) on medication use from their pharmacist (WA:81.3% vs. EA:83.1%, p=0.216). A small proportion of patients (WA:18.2% vs. EA:20.0%, p=1.07) perceived the need for a paid Medication Management Review (MMR) service.
Conclusions Patients have high perception of the role of the pharmacist in Jordan, being the most accessible health care professional in the country. The role of the GP seems to be diminished. The low proportion of patients who perceived the need for a paid MMR service shows that this concept is not yet established in the Jordanian community.
Objectives: To explore whether an association exists between health care professionals’ (HCPs) asthma knowledge and inhaler technique demonstration skills.
Methods: HCPs’ asthma knowledge and inhaler technique demonstration skills were assessed at baseline at an interprofessional educational worksh