Search results for: Naser Hamdami

Authors: Ola A. Nassr, Ali M. Abd Alridha, Rua A. Naser, Rasha S. Abbas

Abstract:

Background: Excessive and inappropriate use of antimicrobial agents among hospitalized patients remains an important patient safety and public health issue worldwide. Not only does this behavior incur unnecessary cost but it is also associated with increased morbidity and mortality. The objective of this study is to obtain an insight into the prescribing patterns of antibiotics in surgical and medical wards, to help identify a scope for improvement in service delivery. Method: A simple point prevalence survey included a convenience sample of 200 patients admitted to medical and surgical wards in a government teaching hospital in Baghdad between October 2017 and April 2018. Data were collected by a trained pharmacy intern using a standardized form. Patient’s demographics and details of the prescribed antibiotics, including dose, frequency of dosing and route of administration, were reported. Patients were included if they had been admitted at least 24 hours before the survey. Patients under 18 years of age, having a diagnosis of cancer or shock, or being admitted to the intensive care unit, were excluded. Data were checked and entered by the authors into Excel and were subjected to frequency analysis, which was carried out on anonymized data to protect patient confidentiality. Results: Overall, 88.5% of patients (n=177) received 293 antibiotics during their hospital admission, with a small variation between wards (80%-97%). The average number of antibiotics prescribed per patient was 1.65, ranging from 1.3 for medical patients to 1.95 for surgical patients. Parenteral third-generation cephalosporins were the most commonly prescribed at a rate of 54.3% (n=159) followed by nitroimidazole 29.4% (n=86), quinolones 7.5% (n=22) and macrolides 4.4% (n=13), while carbapenems and aminoglycosides were the least prescribed together accounting for only 4.4% (n=13). The intravenous route was the most common route of administration, used for 96.6% of patients (n=171). Indications were reported in only 63.8% of cases. Culture to identify pathogenic organisms was employed in only 0.5% of cases. Conclusion: Broad-spectrum antibiotics are prescribed at an alarming rate. This practice may provoke antibiotic resistance and adversely affect the patient outcome. Implementation of an antibiotic stewardship program is warranted to enhance the efficacy, safety and cost-effectiveness of antimicrobial agents.

Keywords: Acute care, antibiotic misuse, Iraq, prescribing.

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Authors: Ali Reza Vaezi, Naser Fakori Ivand, Fereshteh Azarifam

Abstract:

Inter-rill erosion is the detachment and transfer of soil particles between the rills which occurs due to the impact of raindrops and the shear stress of shallow surface runoff. This erosion can be affected by some soil properties such as texture, amount of organic matter and stability of soil aggregates. Information on the temporal variation of inter-rill erosion during a rainfall event and the effect of soil properties on it can help develop better methods to soil conservation in the hillslopes. The importance of this study is especially grate in semi-arid regions, where the soil is weakly aggregated and vegetation cover is mostly poor. Therefore, this research was conducted to investigate the temporal variation of surface flow and inter-rill erosion and the effect of soil properties on it in some semi-arid soils. A field experiment was done in eight different soil textures under simulated rainfalls with uniform intensity. A total of twenty four plots were installed for eight study soils with three replicates in the form of a random complete block design along the land. The plots were 1.2 m (length) × 1 m (width) in dimensions which designed with a distance of 3 m from each other across the slope. Then, soil samples were purred into the plots. Rainfall simulation experiments were done using a designed portable simulator with an intensity of 60 mm per hour for 60 minutes. Runoff production and soil loss were measured during 1 hour time with 5-min intervals. Soil properties including particle size distribution, aggregate stability, bulk density, exchangeable sodium percentages (ESP) and hydraulic conductivity (Ks) were determined in the soil samples. Correlation and regression analysis was done to determine the effect of soil properties on runoff and inter-rill erosion. Results indicated that the study soils have lower both organic matter content and aggregate stability. The soils, except for coarse textured textures, are calcareous and with relatively higher ESP. Runoff production and soil loss did not occur in sand texture, which was associated with higher infiltration and drainage rates. A strong relationship was found between inter-rill erosion and surface runoff (R2 = 0.75, p < 0.01). The correlation analysis showed that surface runoff was significantly affected by some soil properties consisting of sand, silt, clay, bulk density, gravel, Ks, lime (calcium carbonate), and ESP. The soils with lower Ks such as fine-textured soils, produced higher surface runoff and more inter-rill erosion. In the soils, surface runoff production temporally increased during rainfall and finally reached a peak after about 25-35 min. Time to peak was very short (30 min) in fine-textured soils, especially clay, which was related to their lower infiltration rate.

Keywords: Erosion plot, rainfall simulator, soil properties, surface flow.

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