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The consistency in reporting the severity of drug interactions across the drug information resources is important in guiding the appropriate clinical use of drug-pairs, to minimize the associated adverse events. This necessitates the need of a standardized severity rating scale, that can accommodate the different severity ratings of the same interacting drug-pair into a reasonable severity category, that can ease the consistency assessment among different drug information resources.To develop and validate a standardized severity rating scale that can ease the consistency assessment among the various drug information resources.The definitions of various severity rating categories as documented in the eight drug information resources was consolidated to develop a standardized severity rating scale. Thus developed rating scale was validated using twenty commonly used drug-pairs. Fleiss' kappa score was used as an indicator for assessing overall consistency among various drug information resources, whereas, Cohen's kappa was used as an indicator of level of consistency between two drug information resources and between individual drug information resource and newly developed standardized severity rating scale.The newly developed standardized severity rating scale classifies the severity of drug-drug interactions into three categories namely mild, moderate and major. The Fleiss' kappa score was improved from 0.047 to 0.176, indicating improved strength of agreement [Average pairwise agreement: 16% Vs 36.7%] among various drug information resources. The average pairwise Cohen's kappa was 0.082 [Strength of agreement: poor] in original severity ratings whereas it was improved to 0.198 [Strength of agreement: almost equal to fair] in standardized severity rating scale.The newly developed standardized severity rating scale can be used as a tool to assess the consistency of severity rating categories among the various drug information resources.

Antidepressant medications are prescribed to treat depression and related psychiatric illnesses. In patients with depression, many categories of drugs are prescribed to treat clinical conditions and comorbidities. Hence, it is essential to screen such patients for potential drug interactions. The study aimed to assess the frequency of potential drug interactions (pDDIs) associated with antidepressant medications administered to the outpatients of the psychiatry department. This cross-sectional investigation was conducted in a psychiatry outpatient setting. Patients satisfying inclusion criteria were screened for pDDIs by reviewing the patients’ electronic case records. All the identified pDDIs were further evaluated using Micromedex database 2.0.A total of 131 eligible patients’ case records were reviewed. The frequency of pDDIs between antidepressants and other psychotropic medications, antidepressants and non-psychotropic medications, antidepressants,tobacco, antidepressants, and ethanol was 48.1%,9.2%, 7.6%, and 3.8%, respectively. Use of more than three medications [RR: 1.5; CI: 1.1-2.1], presence of total [RR: 7.9; CI: 1.1-52.5] as well as psychiatric polypharmacy [RR: 4.8; CI: 1.3-17.9] were identified as predisposing factors of pDDIs.The results of the multiple regression indicated that the model was a significant predictor of pDDIs (F[3, 127]= 6.368, p

Description: The COVID-19 pandemic compelled the traditional higher educational institutions to make a quick transition to the virtual instruction model. Considering the COVID-19 restrictions, the Department of Clinical Pharmacy and Pharmacology at Ras Al Khaimah College of Pharmaceutical Sciences, United Arab Emirates restructured their original onsite experiential training for final year Bachelor of Pharmacy students as a virtual online experience to ensure educational continuity. Evaluation: The virtual experiential training was conducted over two weeks and was imparted employing different virtual platforms like Google Classroom, Google Meet, Google Forms, Google Docs, etc. As a part of the community pharmacy training, the students were given different e-activities and tasks like e-case scenario analysis and interpretation, e-prescription screening, virtual patient education and were shown various 3-D animated videos related to community pharmacy. For the hospital training, the students were given different e-cases for developing pharmaceutical care plans, e-case scenario analysis, e-drug information query and were shown different animated videos related to rounds of different hospital departments. Conclusion: The virtual experiential training was successfully conducted achieving the desired learning outcomes and was well received by the students. Based on this experience, it is recommended that efforts should be made to develop an integrated model for experiential training in the future, which can be an amalgamation of online tools and traditional experiential methods.

Amphotericin B is most widely used antifungal drug of choice. We report a case of a 56-year-old man developed pain and skin swelling over right forearm at the intravenous access site during amphotericin B administration treatment given for mucormycosis, the post-operative of sinuses. After 4 hours of affected period, amphotericin B was administration. A well revealed thrombophlebitis of the right forearm was noted. The systemic reaction was assessed based on the naranjo algorithm and was found to be probable. The safety profile of amphotericin B and its adverse effects must be monitored on long term treatment usage. Key words: Thrombophlebitis, Amphotericin B, Adverse drug reaction, Pharmacovigilance, Mucormycosis.

Increased prevalence of inherited genetic disorders is a significant public health problem that significantly affects the quality of life of the affected patients and their families in Arab countries. Knowledge about the disorders may empower the community by raising awareness about prevention methods and early detection to reduce the incidence of genetic disorders. This study was aimed to assess the knowledge and attitude related to inherited genetic disorders among health science university students in Ras Al Khaimah. A cross-sectional study was carried out for six months among health science university students in Ras Al Khaimah by using a validated self-administered questionnaire. A total of 359 students completed the study. The overall mean knowledge and attitude scores of the study respondents were 4.47 ± 1.81 and 5.37 ± 2.32, respectively. One hundred and six (29.5%) respondents had adequate knowledge, and a majority (74.65%) of the respondents showed a positive attitude towards genetic disorders. Lectures (25.5%) followed by the internet (20.7%) and healthcare professionals (15.7%) were the most cited sources of information. Comprehensive knowledge about genetic disorders was found to be low despite positive attitude and awareness among respondents. Strengthening knowledge about genetic education and mandatory premarital screening programs may help in early detection and prevention and thereby reducing the incidence of genetic disorders.

Objectives Antibiotic resistance is a major global public health concern today. We explored the usefulness of an educational intervention in increasing antibiotic-related awareness of the public. Methods This community-based interventional study was conducted among 100 people living in Ras Al Khaimah, UAE. Preintervention awareness regarding antibiotics and antibiotic resistance was assessed using the World Health Organization antibiotic resistance: multicountry public awareness survey. After the baseline assessment of the knowledge, educational intervention was given to the study participants. The same questionnaire was used to assess the impact of this intervention after 4 weeks. Key findings The study participants had low baseline knowledge of antibiotics and the phenomenon of antibiotic resistance. A high proportion of study participants (54%) took antibiotics in the past 6 months. Our intervention significantly improved antibiotic-related knowledge and behaviours. Postintervention majority of study participants realized that full course of antibiotics should be taken (% change: 50.0, P < 0.001), leftover antibiotics from family and friends should not be used (% change: 40.0%, P = 0.004), antibiotics are of no use in viral infections (% change: 72.0%, P < 0.001), infections are becoming increasingly resistant to antibiotics (% change: 37%, P < 0.001), bacteria resistant to antibiotics can be spread from person to person (% change: 73%, P < 0.001) and infections from resistant bacteria are difficult to treat (% change: 38%, P < 0.001). Conclusion Following the intervention, antibiotic-related awareness was significantly improved among study participants. Further efforts should be made to ensure that this improved awareness is converted to necessary health behaviour changes in the long term.

Background Drug interactions are a significant issue in mental illnesses and coronavirus disease 2019 (COVID-19) infections. Inconsistency in drug interaction resources makes prescribing challenging for healthcare professionals. To assess the scope, completeness, and consistency of drug-drug interactions (DDIs) between psychotropic and COVID-19 medications in six specific drug information (DI) databases. Methodology For the comparison, six DI resources were used: Portable Electronic Physician Information Database, Micromedex®, Medscape.com, UpToDate®, Drugs.com drug interaction checker, and WebMD.com drug interaction checker. Using the Statistical Package for the Social Sciences (SPSS) software version 27 (IBM Corp., Armonk, NY), the gathered data were examined for scope, completeness, and consistency. Results Scope scores were higher for PEPID© than all the other resources (p < 0.001) for each comparison. PEPID© had better overall completeness scores (median 5, Interquartile range [IQR] 5 to 5; p

Objective: The general objective of this study was to identify and evaluate adverse drug reactions (ADRs) associated with antiepileptic drugs. Methodology: This was a cross-sectional study, conducted in the neurology department of a secondary care hospital. All the patients meeting the inclusion criteria were identified and evaluated. Data were collected from the electronic medical records and was entered into a data collection. All ADRs identified and reported were evaluated for causality, severity, preventability and predictability using different standard scales. Results: A total of 24 ADRs was detected, documented, evaluated and reported during the study period. The incidence was found to be 10%. Assessment of severity of the suspected ADRs revealed that 12% of suspected ADRs were mild level 1 (54.2%) and level 2 (41.7%). Causality assessment by WHO assessment scale reveals that majority of ADRs were considered as a probable 15 (62.5%). Higher incidence of ADRs was documented in females (58.8%). Central and peripheral nervous system was most commonly affected 09 (37.5%) organ system. Sodium valproate was the most common drug mostly associated with ADRs. All 24 (100%) of ADRs were definitely preventable. None of the demographic, disease or treatment-related factors were significant (p>0.05) predictors of ADRs. Conclusion: The findings of our study highlights the importance of regular monitoring and reporting of ADRs in the study setting. However, the study necessitates the importance of multicenter studies to further explore and evaluate the pattern of ADRs to different AEDs in the multiethnic population of U.A.E. Key words: Antiepileptic drugs, Adverse drug reactions, Pharmacovigilance, Sodium Valproate, Ovarian Cyst.

Objective: Hypoglycemia is the most common complication of the treatment for diabetes mellitus. Various factors predispose an individual for drug-induced hypoglycemia. The aim of this study was to explore the relative frequency and likely predisposing factors for drug-induced hypoglycemia among type-2 diabetic patients in the United Arab Emirates (UAE). Methods: In this cross-sectional survey-based study which was conducted from February to April 2018 in two local community pharmacies in the UAE, diabetic patients underwent a structured interview on their diabetes mellitus status and management and specific open-ended questions related to hypoglycemic symptoms that they might have experienced and the occurrence of symptoms. Collected data were used to estimate the relative frequency of drug-induced hypoglycemia and to identify the probable predisposing factors and their contribution in causing hypoglycemia using relative risk, Chi-square test, and Fisher's exact test. Findings: The relative frequency of drug-induced hypoglycemia in our study was 46.25%. Patients' age of ≥65 years, duration of diabetes mellitus for more than 1 year, patients with more than one comorbid condition, and patients using more than one antidiabetic medication were predisposing for developing drug-induced hypoglycemia. Conclusion: The relative frequency of drug-induced hypoglycemia in a nontrial environment which lacks the special cares routinely provided in drug development clinical trials is high. We suggest that more attention should be paid to identify, prevent, and manage drug-induced hypoglycemia in type-2 diabetic patients who have more than 1 year of diabetes, more than one comorbidity, using more than one antidiabetic medication, and elderly.

Background Information related to drug-drug interactions (DDIs) varies significantly from one drug information (DI) resource to another. These variations pose challenges for healthcare professionals in making the right decisions regarding using some of the drug combinations in needy patients. The objective of this study was to review eight different DI resources for scope, completeness, and consistency of information related to DDIs. Methodology A total of eight DI resources, namely, Micromedex®, Portable Electronic Physician Information Database©, UpToDate®, Medscape.com drug interaction checker, Drugs.com drug interaction checker, Stockley's Drug Interactions (ninth edition, 2010), Drug Interactions Analysis & Management: Facts and Comparisons 2014 (ninth edition, 2014), and the drug interaction appendix of the British National Formulary-76, were compared. Each DI resource was scored for scope by calculating the percentage of interactions that had an entry in each resource. A completeness score was calculated for each resource describing severity, clinical effects, mechanism, and DDI management. The consistency of the information was assessed using Fleiss Kappa (k) score estimated using ReCal3 0.1 (alpha) web service and Statistical Package for the Social Sciences version 24. Results The scope score was the highest (100%) for UpToDate® and Portable Electronic Physician Information Database©, whereas the completeness score was the highest (100%) for Drug Interaction Analysis & Management: Facts and comparisons 2014. The inter-source reliability scores among the eight different DI sources were poor (k < 0.20, p < 0.05) for documentation of information related to severity, clinical effects, mechanism, and management of DDIs. Conclusions Variations in the information cause uncertainty among healthcare professionals concerning interacting drug pairs in clinical practice. This may also increase the possibility of adverse drug outcomes when interacting drug pairs are used in at-risk patients. We recommend comprehensive preventive and management strategies for DDIs depending on a uniform scale of severity and clinical effects across various DI resources.

Background and aims Our study sought to investigate the prevalence of moderately increased albuminuria in United Arab Emirates (UAE) nationals with type 2 diabetes, and to identify the associated factors. Methods This prospective cross-sectional study was conducted in two hundred and seven UAE nationals with type 2 diabetes mellitus attending the internal medicine department of a secondary care hospital. Moderately increased albuminuria was estimated in random spot urine samples and was defined as urinary albumin-to-creatinine ratio (UACR) of 3–30 mg/mmoL. Prevalence and associations of moderately increased albuminuria were evaluated. Results The study population had a mean UACR of 7.2 ± 10.2 mg/mmoL with mean eGFR of 94.5 ± 11.7 mL/min/1.73 m2. Prevalence of moderately increased albuminuria in our study population was found to be 44.0%. Multivariate logistic regression analysis showed that duration of diabetes (OR:1.72, 95% CI:1.34–2.19; p Conclusion We report a high prevalence of moderately increased albuminuria in UAE nationals with type 2 diabetes in a secondary care setting. Routine screening and timely management of moderately increased albuminuria in type 2 diabetes mellitus can lead to better patient outcomes.

Background: Antidepressant medications are primarily used in the management of depression and various anxiety disorders. Antidepressant medications are known to cause adverse drug reactions (ADRs). Reporting ADRs can help in the rational use of medication and better patient drug management. Objective: The aim of this study was to monitor the incidence and nature of ADRs to antidepressant medications in a psychiatric outpatient setting of a secondary care hospital of the UAE. Materials and Methods: It was a cross-sectional study conducted in the psychiatric outpatient setting of a secondary care hospital. Patients attending psychiatry outpatient department and prescribed with antidepressant medications were included. All clinical side effects or ADRs noted by physician and reported by patients were documented and assessed according to causality, severity, and preventability scales. Results: A total of 131 patients were screened for the presence or occurrence of ADRs. During the study duration, an aggregate of 29 patients reported at least one ADR. Incidence of suspected ADR to antidepressant medications was found to be 22.1%. Most commonly documented suspected ADR was found to be weight gain in eight (18.1%) patients followed by somnolence in four (9.1%) patients. Escitalopram was the most common drug implicated with ADR in 13 (29.6%) patients followed by fluoxetine in 6 (13.6%) patients. According to World Health Organization-The Uppsala Monitoring Centre causality assessment, the predominance of the suspected ADRs was of “possible” type in 27 (61%) patients, and “mild” in severity in 40 (91%) patients, and “not preventable” in 37 (84%) patients. A statistically significant association (P = 0.019) was observed only between the presence of drug-interaction and the occurrence of ADR (relative risk: 0.429, confidence interval: 0.211–0.872). Conclusion: Most of the suspected ADRs related to antidepressants were “mild,” “predictable,” and “not preventable” in nature. Continuous monitoring may help in identifying, reducing, and preventing the risk of ADRs.

United Arab Emirates (UAE) has a high prevalence of hypovitaminosis D. Not much data are available regarding the prevalence of Vitamin D deficiency among multiethnic UAE adult population. (1) To determine the prevalence of hypovitaminosis D in multiethnic UAE population (2) To compare the Vitamin D status in Arab and non-Arab population (3) To identify the demographic variables associated with hypovitaminosis D. It was a retrospective study conducted at a secondary care hospital. Electronic case records of all the subjects who had checked their Vitamin D levels during the time period of May 2010–October 2012 were considered for the study. Vitamin D severe deficiency, deficiency, insufficiency, and sufficiency were defined as serum 25-hydroxy Vitamin D (25(OH)D) levels < 10 ng/mL, 10–20 ng/mL, 21–30 ng/mL, and > 30 ng/mL, respectively. A total 425 subjects were included for the data analysis. Vitamin D deficiency was diagnosed in 208 (48.9%) subjects followed by severe Vitamin D deficiency and insufficiency in 141 (33.2%) and 63 (14.8%) subjects, respectively. The overall prevalence of hypovitaminosis D was 96.9%. Negative association (r = −0.196, P < 0.01) was observed between body mass index (BMI) and 25(OH)D levels. Ethnicity was not (P = 0.103) a predictor of 25(OH)D levels. Majority of our study subjects had Vitamin D deficiency. There was no substantial difference in 25(OH)D levels of different ethnic groups. Female gender, age, and BMI were the predictors 25(OH)D levels.

Aim: The aim of this study is to assess the nature, reasons, and consequences of self-medication practice among the general population of Ras Al-Khaimah, UAE. Materials and Methods: This was a prospective, cross-sectional, survey-based study. Data with respect to knowledge, awareness, and practices regarding self-medication were collected through an interviewer-assisted questionnaire answered by the study participants. Thus, collected data from 413 survey respondents were analyzed using SPSS version 24.0. Results: The prevalence of self-medication practices among our study respondents was 52.1%. A headache (155 [37.5%]) was the most common clinical condition treated through self-medication practice. Familiarity with the treatment/medication (198 [48%]) was the most common cited reasons, whereas the advertisement and friend's advice were the most (182 [44%]) cited sources of information for self-medication usage. The majority (265 [64.1%]) of the respondents were considered self-medication practice as safe. However, 19 respondents reported side-effects or complications during the due course of self-medication. It was observed that there is a statistically significant association (P < 0.05) between age and employment status of this study participants with self-medication practices. Conclusion: The data from this study show that the self-medication practice is very common among the study population. Variables such as younger age group and occupation status were significantly associated with self-medication practice. We emphasize the role of pharmacist in educating the community regarding safe medication practices such as harmful effects of self-medicating and inappropriate practices such as sharing the medications among family members and friends.

Background: Clinical pharmacy services in various ambulatory care settings are well-defined and documented. Nevertheless, data addressing clinical pharmacist-provided drug information services to the nephrology department are very limited. The aims of our study were to evaluate the type and quality of clinical pharmacist provided drug information services to the nephrology department. Methodology: The research clinical pharmacist participated in nephrology ward rounds for six days in a week along with an academic renal clinical pharmacist. Any medication related queries requested by the nephrologists or by other healthcare nephrology members were received and attended as per the modified systematic approach for the provision of drug information. Subsequently, the feedback information was provided to the concerned enquirer. The quality of all drug information services provided was evaluated by using drug information quality assurance assessment questionnaire. Results: Overall, 97 drug information requests were received and answered during the study period. Majority of the requests (n=72, 74.22%) were related to the management of the patient under nephrology care and good number of the requests were related to medication dosage (n=42, 43.29%) followed adverse drug reactions (n=22, 22.68%). The preponderance of the requests (n=54, 55.67%) required up to 15 minutes of search from various drug information resources and most of these requests (n=61, 62.88%) were answered verbally with the aid of single reference (n=48, 49.48%). Majority (n=62) of the drug information requests were graded as excellent. Conclusion: Our study confirms the promising role of a renal pharmacist in drug therapy management of really impaired patients and participation of renal clinical pharmacist in the regular ward rounds could be the main reason for both good number and quality of drug information provided.

Aims and Objectives: This study was conducted to identify the different types of complementary and alternative medicine (CAM) used, reasons for the use of CAM, and the perceptions, experience, and information seeking-behavior toward usage and safety of CAM by the general public of Ras Al-Khaimah, UAE. Materials and Methods: This was a prospective cross-sectional study. A validated, self-administered, or interviewer-assisted survey questionnaire was used to collect the data. Data from 403 respondents satisfying inclusion criteria were collected and were analyzed using the Statistical Package for the Social Sciences version 24.0. Results: A majority of the respondents (218 [54.1%]) were females. The most commonly (210 [52.1%]) used CAM among the study respondents was herbal medicine. A total of 91 (22.6%) of the survey respondents mentioned that they receive conventional medications along with their CAM. Majority (213 [52.9%]) of the survey respondents opted for CAM to prevent illness. Good number (208 [51.6%]) of the survey respondents mentioned that CAM usage was beneficial in improving their health condition, and they (216 [53.6%]) do believe it as safe and effective. However, a small group (26 [6%]) of respondents reported side effects or complications with the use of CAM. Conclusion: Widespread use of CAM for different medical problems was evident in our study. Although majority of the CAM users believe it as safe and effective, CAM usage should be discussed with the health-care providers to understand the safety issues involved in the use of majority of CAM.

Background and aim: Health promotion is one of the vital and key element for a healthy living. The health care professional spent their initial developing years in learning about health and thereafter training and imparting knowledge to their students and people to whom they serve. The faculty of health sciences are the educators who not only teach health promotion to their students but also educate and prepare the students for the health promotion of the society. Aim: The purpose of the study was to assess the perception of health promotion and health promotion practices existing among the faculty of Medical and Health Sciences University, Ras Al Khaimah, UAE.Study design: The study was descriptive and cross sectional. Data was collected using convenience sampling technique. Self-administered questionnaire was used for data collection. The sample size of the study was 52.Results: Of the total 52 respondents, majority were females, 31-50 years old (63%), married (87%) from nursing and medical faculty ( 63%), non arabic (77%), with 20 or less years of total professional experience(62%). About 52% of the faculty reported that their daily routine comprises sitting at one place for 6-10 hours. Majority (98%) of the participant felt that health promotion is most important for healthy living and is the best resource for everyday life (100%). However majority (60%) of the faculty reported that they do not find time to perform health promotion activities especially daily physical exercises and only 39% were actually able to perform their daily exercises.CONCLUSION: Though health promotion activities are most important for healthy living, the physical exercises as essential health promotion activities are not practiced by the health sciences university faculty.

Background: Adverse reactions (ARs) are one of the most important causes of morbidity, hospitalization and increased healthcare cost. ARs to cosmetics are often underreported. The aim of our study was to assess the incidence, nature, causality and the outcome of ARs to cosmetics.Methods: This was a prospective observational study conducted in a dermatology outpatient clinic of a secondary care hospital of UAE. All the patients with suspected AR to cosmetics and reporting to dermatology clinic were included. The required data were collected from patient case files, patients and their caretakers. The Colipa causality scale was used to assess the causality of reported ARs.Results: The incidence of cutaneous ARs to cosmetics was 1.58%. Shampoo was the most common [7 (16.6%)] type of cosmetic suspected to cause AR, followed by face cream [6 (14.2%)]. The most common cutaneous AR to cosmetics observed in our study was rash and pruritus [13 (30.9%)] followed by itching [10 (23.8%)]. The majority of the cutaneous ARs in our study were on scalp, face and lower limbs each contributing about 21.4%. Causality assessment reveals that 16 (38%) of the cutaneous ARs were very likely type, while 25 (60%) of ARs were of not clearly attributable to use of cosmetic/s.Conclusions: Good number of the adverse reactions documented were mild in nature. Majority of the adverse reactions were not clearly attributable type. The results of this study can form a basis for creating awareness regarding the most common cosmetics associated with ARs. The study fosters the role of initiating cosmetovigilance activities.

Background: Poisoning is an important public health problem, causing significant morbidity and mortality throughout the world. Currently limited data available in UAE regarding the incidence, type of poison, management and outcome of poisoning cases both in adults and children are very limited. The present study focused to assess the type, clinical characteristics, nature and outcome of poisoning cases in two secondary and Tertiary Care Hospitals of U.A.E.Methods: This was a prospective observational study conducted in two hospitals of northern emirates of U.A.E. Patient case notes related to hospital admissions due to poisoning were identified and reviewed by the study investigator. Various details such as patient demographic characteristics, type, clinical characteristics, management and outcome of poisoning were entered into a suitably designed data collection form. The collected data were analyzed using poison severity and snakebite severity assessment scales.Results: A total of 97 poisoning cases was identified during the study period. The prevalence of poisoning among male (50.5%) and female (49.5%) was found to be almost similar. The majority of poisoning cases 55 (56.7%) was of accidental type. The most common type of agent responsible for poisoning was drugs 61 (62.9%). Paracetamol was the most common drug involved in poisoning 16 (26.2%). The outcome of the poisoning was a recovery in majority 96 (98.9%) of the cases. Demographic factors such as gender, age, nationality and occupation were found to be significantly (p

Adverse drug reactions (ADRs) are one of the common causes of morbidity and mortality. Renal insufficiency is considered as one of the risk factors for the development of ADR. The study determined the occurrence of ADRs in patients with renal failure and their incidence of hospital admission. The study also evaluated the nature and severity of ADRs. This was a prospective study conducted in the nephrology unit at a tertiary care teaching hospital for a period of nine months. Patients receiving regular hemodialysis and those either referred or admitted to the nephrology ward were included. ADRs were intensively monitored throughout the study. The causality of suspected ADRs was assessed with the WHO probability scale, Naranjo algorithm, and Karch and Lasagna’s scale. The predictability and preventability of ADRs were also determined. A total of 45 ADRs were identified in 369 patients; incidence was 12.19%. Nine ADRs (20%) needed hospitalization. A total of 27 (60%) and 17 (37.8%) ADRs were found to be probable and possible, respectively when assessed by the WHO probability scale. On the contrary, 33 (73.3%) and 26 (57.8%) ADRs were possible in causality when assessed by Karch and Lasagna’s scale and Naranjo scale, respectively. Most of the ADRs [26 (57.8%)] were predictable in nature. A wide range of ADRs was noticed in patients with renal impairment, and our study has systematically assessed the nature and severity of ADRs.

Objective: Hyperphosphatemia in end-stage renal disease (ESRD) is associated with many serious patient-level consequences including cardiovascular events and mortality. The purpose of this study was to investigate the use of phosphate binders in ESRD patients on maintenance hemodialysis. Materials and Methods: The study was a prospective observational cohort study including adult ESRD patients undergoing hemodialysis at a secondary hospital in United Arab Emirates. Patient characteristics were compared as per type of phosphate binder used. Bivariate and multivariate multinomial logistic regression analyses were carried out to determine variables that were independently associated with use of different phosphate binders. Results: Phosphate binders used at our study site were sevelamer, calcium carbonate, and a combination of sevelamer and calcium carbonate. Bivariate multinomial logistic regression analysis revealed that serum phosphorous (odds ratio [OR]: 0.14, 95% confidence interval [CI]: 0.04–1.09, P = 0.047; OR: 0.10, 95% CI: 0.03–0.89, P = 0.042), calcium (OR: 0.11, 95% CI: 0.02–0.86, P = 0.041; OR: 0.22, 95% CI: 0.01–0.96, P = 0.012), and calcium–phosphorous product (OR: 0.20, 95% CI: 0.06–0.64, P = 0.008; OR: 0.16, 95% CI: 0.05–0.54, P = 0.003) levels were significantly lower in patients on sevelamer per se as well as in patients on combination therapy, respectively when compared to calcium carbonate per se. Multivariate multinomial logistic regression analysis revealed that in sevelamer and combination groups, cardiovascular diseases (OR: 0.12, 95% CI: 0.02–0.65, P = 0.022; OR: 0.10, 95% CI: 0.01–0.88, P = 0.038) were significantly lesser compared to calcium carbonate group after being adjusted for other variables in the model. Conclusion: We observed that hyperphosphatemia and related events in our study population were better controlled by sevelamer per se and combination therapy than calcium carbonate per se. Further large scale, multicenter studies are required to confirm and establish these findings.

Background: Antipsychotics are a class of medications used primarily for the treatment of psychotic disorders. However, these medications are associated with potential adverse drug reactions (ADRs). Aim: To monitor the incidence and nature of ADRs in the psychiatric inpatient department of a secondary care hospital of Ras Al Khaimah, UAE. Materials and Methods: This was an observational, prospective, noninterventional study, conducted in the psychiatric inpatient setting of a secondary care hospital. Psychiatric inpatients of all age groups and both the gender, diagnosed with any psychotic disorder, and hospitalized in the psychiatry ward and managed with at least one antipsychotic medication were included in the study. The causality, severity, and preventability of ADRs were assessed using different assessment scales. Results: Out of 170 patients, 38 patients reported at least one ADR with an incidence rate of 22.3%. The most common ADRs were weight gain 15 (29.4%) due to olanzapine, followed by pseudo‑parkinsonism 11 (21.6%) due to parenteral haloperidol. Schizophrenia (18, 35.3%), followed by bipolar I disorder (10, 19.6%) was the most common condition associated with ADRs. Female gender and duration of hospital stay were found to be significant (P < 0.05) predictors of occurrence of ADRs. Conclusion: A high incidence of ADRs was observed in the inpatients of psychiatry department, especially of mild nature and probably preventable types. The study highlights the importance of intensive monitoring by pharmacists to identify high ADR risk psychiatric inpatients. To reduce the ADR risk, specific and frequent monitoring for antipsychotics is recommended such as weight and extrapyramidal symptoms.

Background: Adverse drug reactions (ADRs) are a significant cause of morbidity and mortality, resulting in increased healthcare cost. Association of psychotropic medications with ADRs is common. Pharmacovigilance can play a vital role in alerting the healthcare providers from the possible ADRs and thus protecting the patients receiving psychotropic medications. Aim: To monitor and report the incidence and nature of ADRs in psychiatry outpatient department (OPD). Materials and Methods: A prospective observational study was carried out in the psychiatry OPD. All the patients attending psychiatry outpatient and satisfying the inclusion criteria were monitored for ADRs. The causality, severity and preventability assessment of documented ADRs was done. Chi-square test was done to identify the association between ADRs and sociodemographic, disease and treatment-related variables. Paired Student's t -test was carried out to compare the significance difference in the weight of the patients who reported weight gain to psychotropic medications. Results: The incidence rate of ADR was found to be 10.2%. A total of 112 ADRs were documented. Weight gain 18 (16.07%) followed by somnolence 8 (7.14%) was the most commonly reported ADR. Atypical antipsychotics 37 (33.0%) were the most common class of psychotropic drugs implicated in ADRs. Escitalopram 16 (14.28%) followed by quetiapine 14 (12.5%) were associated with a maximum number of ADRs. No significant association ( P > 0.05) documented between demographic and treatment-related variables with number of ADRs. Conclusion: Study revealed a moderate incidence of ADRs in patients attending the psychiatry OPD. Majority of the ADRs reported during the study were mild in nature and not preventable type.

Objectives. To identify and evaluate factors affecting the career preferences of fourth-year bachelor of pharmacy (BPharm) students in Malaysia in the presence of a 4-year period of mandatory government service. Methods. A validated self-administered questionnaire was used in this cross-sectional study to collect data from final-year BPharm students enrolled at 3 government-funded universities and 1 private university in Malaysia. Both descriptive and inferential statistics were used for data analysis. Results. Three hundred fourteen students responded (213 from public universities and 101 from the private university). Approximately 32% of public university students and 37% of private university students ranked their own interest in pharmacy as the reason for undertaking pharmacy degree studies; 40.4% of public and 19.8% of private university respondents stated that they would enter a nonpharmacy-related career upon graduation if given the choice. Public university students ranked hospital pharmacy as their choice of first career setting (4.39, p 5 0.001), while private students ranked community pharmacy first (4.1, p 5 0.002). On a scale of 1 to 5, salary received the highest mean score (3.9 and 4.0, p 5 0.854) as the extrinsic factor most influencing their career choice. Conclusions. Final-year students at Malaysian public universities were most interested in hospital pharmacy practice as their first career step upon graduation, while private university students were most interested in community pharmacy. The top 3 extrinsic factors rated as significant in selecting a career destination were salary, benefits, and geographical location.