Leila Kouti became a board certified clinical pharmacist at the age of 29 years (2009) and completed her PhD three years later, from Tehran University of Medical Sciences. She is an assistant professor in clinical pharmacy department at Ahvaz Jundishapur University of Medical Sciences. She has published more than 20 papers in different journals.
The present study was designed to evaluate the use of unlicensed and off-labeled drugs in neonatal intensive care units (NICU) of two academic hospitals in Iran. To our knowledge it is the first study done in this area in Iran. In this cross sectional study, all neonates that had at least 24 hour NICU admission, during the first 3 months of 2016, in two different hospitals were included in this study after their parental consent. The drugs were categorized as licensed, unlicensed and off-labeled according to Pediatric and neonatal dosage handbook (Lexicomp® 22nd Edition). 193 patients (52.85% M, 47.15% F), 64.2% of them delivered via C-section, were included in this study. Mean gestational weight was 409±3317 g for term babies and 1732± 621 g for preterm neonates. A total of 1049 drug orders were made for these patients (including 59 agents and 72 drug formulations). The mean number of drug orders and pharmaceutical agents for each patient were 5.44±4.08 and 4.46±2.98 respectively. Preterm neonates had a higher number of drug orders and medications (p values 0.003 and <0.001). 38.04% of the drug orders were off-labeled (received by 85% of the neonates) and 1.91% unsilenced (used in 8% of the patients). 45% of the off-label use was regarding the dose and 36.86%, dose interval. 60.05% of the used drugs were licensed. It seems that due to the high rate of off-label and unlicensed drug use in NICUs, further studies regarding their safety and efficacy should be performed.
Badar Al Dhouyani has completed his MD at the age of 25 years from medical school at Sultan Qaboos university in Oman .Currently i am paediatric resident at Oman Medical Specialty Board (third years , R3)
Objectives: To identify the prevalence of certain viruses in asthmatic children during acute asthma exacerbation and identify any correlation between certain virus and severity of the episode. Methods: A retrospective cross-sectional study was carried out including all children aged between 2 to 12 years who were admitted in royal hospital between January 2015 to October 2017 with acute exacerbation of asthma and who had nasal swab. Nasal swab were collected, which can detect 18 viruses like Rhinovirus, Boca virus, RSV A/B, Adenovirus respiratory, Human metapneumovirus, Coronavirus OC43, Parainfluenza 1, Parainfluenza 4, Influenza, Coronavirus 229E, Coronavirus HKU1, Parainfluenza 2, Parainfluenza 3, Influenza A(H1N1), Influenza A, Coronavirus NL63, Influenza B and Para echovirus. Results: Among the 108 enrolled patients, viral infections were detected in 82 patients (75.9%). Rhinovirus is the most frequently detected virus (41%) followed by adenoviruses (13%), RSV (11%), Boca virus (7%) and human metapneumovirus (6%).According to severity of asthma, viruses were detected in 6.1%of mild cases, 61% of moderate and 32.9% of severe cases. No association between asthma severity and presence of virus (P=0.062). No significant difference in severe asthma exacerbation with or without viral infection. (32.9% vs 53.8%) (P=0.066). Among the viral positive patients, Adenovirus has significant association with asthma severity (P=0.021%). In our study, age, respiratory rate and Oxygen saturation were significantly different between viral positive and viral negative group. (P values respectively: 0.0001, 0.036 and 0.01). Conclusion: Respiratory viruses were identified in 75.9% of patients with acute asthma exacerbation. Rhinovirus is the most frequently detected virus(41%), but adenovirus has significant association with asthma severity (P=0.021%). Keywords: Acute exacerbation, Bronchial asthma, virus, viral infection, sputum.