An-Najah Staff

What is known and Objective: Drug–drug interactions (DDIs) cause considerable morbidity and mortality worldwide and may lead to hospital admission. Sophisticated computerized drug information and monitoring systems, more recently established in many of the emerging economies, including Malaysia, are capturing useful information on prescribing. Our aim is to report on an investigation of potentially serious DDIs, using a university primary care–based system capturing prescription records from its primary care services.  Methods: We retrospectively collected data from two academic years over 20 months from computerized databases at the Universiti Sains Malaysia (USM) from users of the USM primary care services.  Results and Discussion: Three hundred and eighty-six DDI events were observed in a cohort of 208 exposed patients from a total of 23 733 patients, representing a 2-year period prevalence of 876·4 per 100 000 patients. Of the 208 exposed patients, 138 (66·3%) were exposed to one DDI event, 29 (13·9%) to two DDI events, 15 (7·2%) to three DDI events, 6 (2·9%) to four DDI events and 20 (9·6%) to more than five DDI events. Overall, an increasing mean number of episodes of DDIs was noted among exposed patients within the age category ≥70 years (P = 0·01), an increasing trend in the number of medications prescribed (P < 0·001) and an increasing trend in the number of long-term therapeutic groups (P < 0·001).  What is new and Conclusion: We describe the prevalence of clinically important DDIs in an emerging economy setting and identify the more common potentially serious DDIs. In line with the observations in developed economies, a higher number of episodes of DDIs were seen in patients aged ≥70 years and with more medications prescribed. The easiest method to reduce the frequency of DDIs is to reduce the number of medications prescribed. Therapeutic alternatives should be selected cautiously.

Background: The prescription of contraindicated drugs is a preventable medication error, which can cause morbidity and mortality. Recent data on the factors associated with drug contraindications (DCIs) is limited world-wide, especially in Malaysia.
Aims: The objectives of this study are 1) to quantify the prevalence of DCIs in a primary care setting at a Malaysian University; 2) to identify patient characteristics associated with increased DCI episodes, and 3) to identify associated factors for these DCIs.
Methods: We retrospectively collected data from 1 academic year using computerized databases at the Universiti Sains Malaysia (USM) from patients of USM’s primary care. Descriptive and comparative statistics were used to characterize DCIs. Results: There were 1,317 DCIs during the study period. These were observed in a cohort of 923 patients, out of a total of 17,288 patients, representing 5,339 DCIs per 100,000 patients, or 5.3% of all patients over a 1-year period. Of the 923 exposed patients, 745 (80.7%) were exposed to 1 DCI event, 92 (10%) to 2 DCI events, 35 (3.8%) to 3 DCI events, 18 (2%) to 4 DCI events, and 33 patients (3.6%) were exposed to 5 or more DCI events. The average age of the exposed patients was 30.7 ± 15 y, and 51.5% were male. Multivariate logistic regression analysis revealed that being male (OR = 1.3; 95% CI = 1.1 – 1.5; p < 0.001), being a member of the staff (OR = 3; 95% CI = 2.5 – 3.7; p < 0.001), having 4 or more prescribers (OR = 2.8; 95% CI = 2.2 – 3.6; p < 0.001), and having 4 or more longterm therapeutic groups (OR = 2.3; 95%CI = 1.7 – 3.1; p < 0.001), were significantly associated with increased chance of exposure to DCIs. Discussion and
conclusions: This is the first study in Malaysia that presents data on the prevalence of DCIs. The prescription of contraindicated drugs was found to be frequent in this primary care setting. Exposure to DCI events was associated with specific socio-demographic and health status factors. Further research is needed to evaluate the relationship between health outcomes and the exposure to DCIs.

Patients with diabetes mellitus and hypertension are at high risk of vascular complications, particularly, renal deterioration. This study aimed to evaluate the prevalence and the risk factors of reduced renal function corresponding to chronic kidney disease (CKD) stages 3 – 5 among diabetic hypertensive patients. This is a retrospective cohort study of diabetic hypertensive patients attending A-Watani governmental medical center from August 2006 until August 2007. Creatinine clearance (CrCl) was estimated using the Cockcroft–Gault equation. Those with CrCl< 60 ml/ min, corresponding to CDK stages 3 – 5, were considered to have reduced renal function. The prevalence of reduced renal function was calculated, and the risk factors associated with it were evaluated using multiple logistic regression. The following were the results found in this study: (a) the prevalence of reduced renal function among the study patients was 35.5% distributed as follows: (63.5%) had stage 3 CKD, 21.7% had stage 4 and 13% had stage 5 CKD. (b) Patients with reduced renal function were elder, had higher number of chronic diseases and had longer duration of diabetes and hypertension than those with CrCl≥ 60ml/ min. (c) Men had a higher prevalence of reduced renal function than women. (d) Significant predictors of reduced renal function were older age, duration of diabetes and number of chronic diseases based on logistic regression analysis. Early and continuous screening of renal function among diabetic hypertensive patients is required to implement preventable strategies of end stage renal disease (ESRD). Better control of blood pressure and diabetes mellitus are important. (IJPPP811001).

Objective: To assess the prevalence of intestinal parasites among Jenin Governorate (Northern Palestine) population.
Methods: A retrospective laboratory analysis of stool specimens was carried out for intestinal parasite examination in Jenin Governmental Hospital, Jenin Governorate, Northern Palestine. The records were collected from the clinical microbiology laboratory of the Jenin Governmental Hospital between January 2000 and December 2009.
Results: Our retrospective study showed that the prevalence of intestinal parasite infection during 10 years ranged from 32.0-41.5%. There are at least 7 different parasites encountered. The most common pathogenic parasites identified were: Entamoeba histolytica (8.2-18.2%), Enterobius vermicularis (15.6-28.9%). The other parasites present were Giardia lamblia, Ascaris lumbricoides, Strongyloides stercoralis, Taenia species and Ancylostoma duodenale (Hookworms (
Conclusions  Intestinal parasitic infection is an important public health problem in Jenin governorate, Palestine. It is necessary to develop effective prevention and control strategies including health education and environmental sanitation improvement.

Objective: To assess the prevalence of intestinal parasites among Jenin Governorate (Northern Palestine) population.
Methods: A retrospective laboratory analysis of stool specimens was carried out for intestinal parasite examination in Jenin Governmental Hospital, Jenin Governorate, Northern Palestine. The records were collected from the clinical microbiology laboratory of the Jenin Governmental Hospital between January 2000 and December 2009.
Results: Our retrospective study showed that the prevalence of intestinal parasite infection during 10 years ranged from 32.0-41.5%. There are at least 7 different parasites encountered. The most common pathogenic parasites identified were: Entamoeba histolytica (8.2-18.2%), Enterobius vermicularis (15.6-28.9%). The other parasites present were Giardia lamblia, Ascaris lumbricoides, Strongyloides stercoralis, Taenia species and Ancylostoma duodenale (Hookworms (
Conclusions  Intestinal parasitic infection is an important public health problem in Jenin governorate, Palestine. It is necessary to develop effective prevention and control strategies including health education and environmental sanitation improvement

Patients with diabetes mellitus and hypertension are at high risk of vascular complications, particularly, renal deterioration. This study aimed to evaluate the prevalence and the risk factors of reduced renal function corresponding to chronic kidney disease (CKD) stages 3 – 5 among diabetic hypertensive patients. This is a retrospective cohort study of diabetic hypertensive patients attending A-Watani governmental medical center from August 2006 until August 2007. Creatinine clearance (CrCl) was estimated using the Cockcroft–Gault equation. Those with CrCl< 60 ml/ min, corresponding to CDK stages 3 – 5, were considered to have reduced renal function. The prevalence of reduced renal function was calculated, and the risk factors associated with it were evaluated using multiple logistic regression. The following were the results found in this study: (a) the prevalence of reduced renal function among the study patients was 35.5% distributed as follows: (63.5%) had stage 3 CKD, 21.7% had stage 4 and 13% had stage 5 CKD. (b) Patients with reduced renal function were elder, had higher number of chronic diseases and had longer duration of diabetes and hypertension than those with CrCl≥ 60ml/ min. (c) Men had a higher prevalence of reduced renal function than women. (d) Significant predictors of reduced renal function were older age, duration of diabetes and number of chronic diseases based on logistic regression analysis. Early and continuous screening of renal function among diabetic hypertensive patients is required to implement preventable strategies of end stage renal disease (ESRD). Better control of blood pressure and diabetes mellitus are important. (IJPPP811001).

Patients with diabetes mellitus and hypertension are at high risk of vascular complications, particularly, renal deterioration. This study aimed to evaluate the prevalence and the risk factors of reduced renal function corresponding to chronic kidney disease (CKD) stages 3 – 5 among diabetic hypertensive patients. This is a retrospective cohort study of diabetic hypertensive patients attending A-Watani governmental medical center from August 2006 until August 2007. Creatinine clearance (CrCl) was estimated using the Cockcroft–Gault equation. Those with CrCl< 60 ml/ min, corresponding to CDK stages 3 – 5, were considered to have reduced renal function. The prevalence of reduced renal function was calculated, and the risk factors associated with it were evaluated using multiple logistic regression. The following were the results found in this study: (a) the prevalence of reduced renal function among the study patients was 35.5% distributed as follows: (63.5%) had stage 3 CKD, 21.7% had stage 4 and 13% had stage 5 CKD. (b) Patients with reduced renal function were elderly, had a higher number of chronic diseases and had a longer duration of diabetes and hypertension than those with CrCl≥ 60ml/ min. (c) Men had a higher prevalence of reduced renal function than women. (d) Significant predictors of reduced renal function were older age, duration of diabetes and the number of chronic diseases based on logistic regression analysis. Early and continuous screening of renal function among diabetic hypertensive patients is required to implement preventable strategies of end stage renal disease (ESRD). Better control of blood pressure and diabetes mellitus are important.