An-Najah Staff

Objective: The purpose of this study was to determine the availability and adequacy of antidote stocking at hospitals in north Palestine based on published guidelines for antidote stocking.
Methodology: This study is a cross sectional survey of all hospitals at north Palestine (n=11) using a questionnaire which was completed by the director of the pharmacy department at each hospital. The questionnaire was divided into 2 parts. The first part contained a list of 25 antidotes while the second part contained a list of 12 antidotes. This classification is based on the guideline proposed by the British Association for Emergency Medicine (BAEM). The net antidote stock results were compared with the American guidelines as well.
Result: The overall availability of each antidote in the first list varied widely from zero for glucagon to 100% for atropine. The number antidotes of the first list that were stocked in the 11 hospitals ranged from 5 to 12 antidotes but none of the hospitals stocked all the 25 antidotes. Additionally, availability of antidotes in the second list varied widely from zero for polyethylene glycol to 100% for dobutamine. The number of antidotes stocked ranged from 5 to 9 but none of the hospitals stocked all the 12 antidotes.
Discussion and Conclusion: hospitals in north Palestine do not have adequate stock of antidotes. Raising awareness of the importance of antidotes by education, regular review of antidote storage, distribution plans, and appropriate legislation might provide solutions. Coordination between Palestinian hospitals and the PCDIC at An-Najah National University is also important.

Background Acetaminophen poisoning is a common clinical problem, and early identification of patients with more severe poisoning is key to improving outcomes. Purposes This study intends to document prevalence, clinical characteristics, and predictors of gastrointestinal (GI) manifestations and to assess the impact of these manifestations on outcome in patients with acetaminophen poisoning.
Methods This is a retrospective cohort study of hospital admissions for acute acetaminophen poisoning conducted over a period of 5 years from 1 January 2004 to 31 December 2008. Parametric and non-parametric tests were used to test differences between groups depending on the normality of the data. Statistical Package for Social Sciences (SPSS) 15 was used for data analysis.
Results Two hundred and ninety-one patients were studied; their mean age was 23.017.4 years and 76.6% had GI manifestations. Multiple logistic regression showed that significant risk factors for GI manifestations were present among patients who reported acetaminophen dose ingested [1]10 g (p<0.001), and latency time more than 8 hours ( p¼0.030). GI manifestations at first admission predicted poorer outcomes in terms of estimated acetaminophen levels to be a possible toxic ( p<0.001), elevated bilirubin levels (p¼0.002), prolonged prothrombin time (PT; p¼0.002), elevated creatinine level ( p¼0.028), declination of potassium level ( p<0.001), and prolonged hospital stay ( p<0.001).
Conclusions GI manifestations were common among patients with acetaminophen poisoning. This study suggests that the presence of GI manifestations at first presentation appears to be an important risk marker of subsequent hepatotoxicity and nephrotoxicity.

Background And Aims: Cleaning products are used to achieve cleaner homes. However, they have been responsible for a considerable number of poisoning cases. The aims of this study were to investigate the storage and utilization patterns of cleaning products in the home, as well as the risk of adverse and toxic effects produced by them.
Methods: This study has been performed using a questionnaire that was developed by the Poison Control and Drug Information Center (PCDIC). The questionnaire was distributed randomly in northern Palestine. The questionnaire included questions regarding storage, utilization habits, and the adverse effects experienced by respondents upon handling the cleaning products.
Results: All respondents utilized and stored cleaning products in their homes. Chlorine bleach and acidic cleaning products were the most common. Respondents stored cleaning products at different places in their homes, but most of those storage places were suboptimal and were within the reach of children. The daily utilization rate of cleaning products was 1.6+/-0.8 with chlorine bleach being the most commonly used. Of the respondents, 27% reported experiencing a wide range of acute adverse and toxic effects resulting from cleaning product use and that exposure occurred mainly via inhalation. Caustic substances, bleach, and kerosene were the agents mainly involved in producing these adverse and toxic effects. About half of those who experienced adverse and toxic effects sought medical help, and 22% of them were children younger than 6 years of age. Finally, most respondents reported mixing and discarding cleaning product leftovers and their containers improperly.
Conclusion And Recommendations: Correct utilization and safer storage of cleaning products is encouraged. Several preventive strategies should be implemented in order to decrease the incidence of accidental harmful exposure that is due to cleaning agents. The role of the PCDIC is very important in the education, prevention, and management of cleaning product-induced adverse effects.

Objective: The purpose of this study was to determine the availability and adequacy of antidote stocking at hospitals in north Palestine based on published guidelines for antidote stocking.
Methodology: This study is a cross sectional survey of all hospitals at north Palestine (n=11) using a questionnaire which was completed by the director of the pharmacy department at each hospital. The questionnaire was divided into 2 parts. The first part contained a list of 25 antidotes while the second part contained a list of 12 antidotes. This classification is based on the guideline proposed by the British Association for Emergency Medicine (BAEM). The net antidote stock results were compared with the American guidelines as well.
Result: The overall availability of each antidote in the first list varied widely from zero for glucagon to 100% for atropine. The number antidotes of the first list that were stocked in the 11 hospitals ranged from 5 to 12 antidotes but none of the hospitals stocked all the 25 antidotes. Additionally, availability of antidotes in the second list varied widely from zero for polyethylene glycol to 100% for dobutamine. The number of antidotes stocked ranged from 5 to 9 but none of the hospitals stocked all the 12 antidotes.
Discussion and Conclusion: hospitals in north Palestine do not have adequate stock of antidotes. Raising awareness of the importance of antidotes by education, regular review of antidote storage, distribution plans, and appropriate legislation might provide solutions. Coordination between Palestinian hospitals and the PCDIC at An-Najah National University is also important.