Background: Medication errors have potential to cause harm and death; especially children who are three times more vulnerable than adults. Risk of medication errors is higher in out- patient settings due to a stressful work environment with less familiarity of individual patients. This problem in sub-Saharan Africa is however largely undetermined. A Voice Recognition System that converts verbal messages into text and stores it in a database in a retrievable format could impact on reduction of medication errors. Objectives: The primary objective was to compare medication prescription and dispensing errors in written prescriptions with those from a Voice Recognition System. Secondary objectives were to determine the types and frequency of medication errors, determinants of medication errors and acceptability of routine use of a Voice Recognition System to make medication prescriptions. Study design: A before -after Intervention study to determine the impact of introduction of a Voice Recognition System on the occurrence of medication errors. Methods: Prescriptions issued from the Paediatric Accident and Emergency Department at Aga Khan University Hospital Nairobi over a six month period were randomly selected and analyzed for errors. Patient‟s bio-data, diagnosis, prescriber‟s specialization and time of prescription were retrieved from outpatient medical records and documented in a standard study tool. A Voice Recognition System was installed and doctors and pharmacists consenting to use Voice Recognition were trained to enhance proficiency in its use. During consultations, doctors enrolled patients who provided written informed consent to have their prescriptions made using Voice Recognition. Prescription and dispensing records were analysed to determine the occurrence of medication errors. Questionnaires were issued to pharmacists and doctors to rate the use of Voice Recognition in the medication process. Results: During the VRS phase the proportion of female patients reviewed were 56.9% compared to 40% in the pre VRS phase. (OR= 0.5 (95% CI 0.37-0.69), P<0.001). The top five conditions diagnosed at the pediatric A&E department were upper respiratory tract infections, urinary tract infections, tonsillitis, pharyngitis and gastroenteritis. Incidence was similar in both pre VRS and VRS phases. (51.5% and 58.3% OR=0.74 (95% CI 0.53-1.01), P=0.063.) Overall, there was a 19.5% reduction in prescription errors from 86.1% in the pre Voice Recognition phase to 69.3% in the Voice Recognition phase (P<0.001). Among prescription errors analysed, there was a 31.9% reduction in omitted drug route (P <0.001) and a 64.8 % reduction in incorrect drug dose (P<0.001). Analysis of dispensing errors revealed the greatest
ماہ گذشتہ میں ایک شخص مسمٰی ٹامس میرس نے امریکہ میں وفات پائی، جس کی بابت خیال ہے کہ وہ دنیا کا معمر ترین شخص تھا، وفات کے وقت اس کی عمر ۱۲۶ سال کی تھی، اس کے گھر میں انجیل کا ایک نسخہ تھا، جس پر اس کی تاریخ ولادت ۱۵؍ جنوری ۱۷۹۴ء درج تھی، اس کا مولد نارتھ ویلز (انگلستان) تھا، اس کو نپولین کے زمانہ کی لڑائیاں خصوصاً جنگ واٹرلو بطور چشم دید واقعات کے اچھی طرح یاد تھیں، پچاس برس سے اس کی سکونت امریکہ میں تھی، اس کی عمر ۲۶ سال کی تھی جب اس کی معشوقہ کا انتقال ہوگیا، اس وقت سے وہ برابر عورت کی صحبت سے محترز رہا۔
Congenital Heart Defect (CHD) is a multifactorial disorder based on both genetic and environmental factors involved in development. The basic problem lies in the structure of heart leading to CHD that occurs in walls, valves, arteries and veins of heart. During cell cycle, the gene that controls this process may mutate, causing disturbance in any portion of heart leading to disturbed blood flow, blood flow in wrong direction or complete blockage. Defect may range from simple with no manifestations to complex with severe symptoms. Simple defects need no treatment while some babies with complex birth defects during birth require special care, vaccination, medication or otherwise treated with surgery. The incidence of CHD has declined from 80 to 20% due to progress in heart surgery techniques, medical treatment and interventional cardiology. Various genetic and non-genetic increase the susceptibility for CHD. The diagnosis and treatment of CHD has greatly improved in recent years. Almost all the children with CHD survive to adulthood and spend healthy and active lives after being treated.
In last two decades vanadium coordination chemistry has grasp the interest of chemists due to its importance from catalysis and medicinal point of view. Vanadium plays significant role in different biological systems, actively serving in vanadium dependent haloperoxidase and nitrogenase enzymes. It also exhibits insulin-mimetic (anti-diabetic) activity. The present study is carried out in order to synthesize new vanadium (V) complexes with N and O donor hydrazide ligands and reveal their biological importance in terms of antioxidant activities and different enzyme inhibition activities. On the basis of spectral, elemental and physical data, synthesized vanadium (V) complexes are tentatively assigned to have an octahedral geometry with two hydrazide ligands and two oxo groups forming a negatively charged sphere complex with ammonium as counter ion. This is further verified by the conductivity studies of the complexes. In synthesized vanadium (V) complexes hydrazides act as bidentate ligands and are found to be attached with O of C=O and N of NH2, and these attachments are evident from IR and NMR spectra of these complexes. The inhibitory potential of vanadium (V) complexes of hydrazides against oxidative enzymes including xanthine oxidase and lipoxygenase is determined. In addition, non-enzymatic radical scavenging activities of these complexes were also determined. Results show that hydrazide ligands (1-12) and their respective vanadium (V) complexes (1c-12c) posses scavenging and inhibition potential against DPPH and lipoxygenase, respectively. However, contrary to that uncoordinated ligands showed no activity against nitric oxide, superoxide and xanthine oxidase whereas their complexes showed varying degree of activity. It is interesting that V(V) complexes are more active for all enzymatic and radical scavenging studies reported here except for lipoxygenase enzyme which demonstrates the difference in the interaction of metal complexes with metalloenzymes. Furthermore enzyme inhibition potential of all the synthesized ligands, metal salt and vanadium (V) hydrazide complexes has also evaluated against tyrosinase, urease and carbonic anhydrase enzymes. Results obtained during the course of this study reveal that hydrazide ligands show moderate inhibition against tyrosinase, but found to be inactive against urease and carbonic anhydrase enzymes. Vanadium (V) hydrazide complexes show variable degree i.e. excellent, moderate to weak activity against all of these studied enzymes. These studies indicate that geometry of complex, nature and position of substituent groups play a vital role in scavenging and inhibition potential of these compounds and demonstrate the difference in the interaction of metal complexes with metalloenzymes. Further pharmacological and toxicological studies are required to evaluate the bioactive vanadium complexes to find out their potential for use as drugs.