Salah Kheder | University of Khartoum (original) (raw)
Papers by Salah Kheder
Value in Health Regional Issues
Global Drugs and Therapeutics
Background: Effective drug supply management ensures uninterrupted availability of quality approv... more Background: Effective drug supply management ensures uninterrupted availability of quality approved, safe and effective pharmaceuticals. This could be achieved through proper selection, quantification, procurement, distribution and use of drugs based on consumption and morbidity pattern of the catchment area by using a system like ABC-VEN analysis. ABC/VEN analysis used for the investigation represents the simple and effective method of analysis of medicine expenditures, identifying priority groups of medicines, the use of which, when improved, may provide the greatest clinical and economic impact. Methods: Descriptive, retrospective cross sectional study was conducted using document reviewed from the main central national and state medical supply organizations NMSF and RDF respectively, in addition to hospital based study. All data was analyzed with excel spread sheet to obtain ABC, VEN, and ABC-VEN matrix analysis results of the annual medicine expenditures and to explore the pharmaceutical inventory control management. Awareness about inventory system among pharmacists working in drug supply centers was measured using pretested questionnaires. Results: The analysis of drugs procured by the NMSF for years (2015-2017) shows that total number of items imported was 584 items, with total value of 1495510147.2 Euro. About 79 (14%) of items consumed 75% of the budget (class A), 100 (17%) items cost 15% (class B), while majority 405 (69%) items only consumed 10% of total medicine expenditure (class C). Among the class A medicines purchased items (Sodium chloride solution 0.9% w/v) 500 ml solution for intravenous infusion ranked first by contributing 5% of total expenditures. The results obtained from RDF for year (2017) shows that the total number of items imported was1134 items, with total value of 242,148,789.5 SDG. About 166 (15%) items consumed 75% of the budget (class A), and 277(24%) items consumed 15% (class B), where majority of items 691 (61%) only consumed 10% of total medicine expenditures (class C). Among the class A items ceftriaxone injection (1 gram) ranked first by contributing 4% of total expenditures and 95% of class A items total expenditure. Hospital based study from ALZYTONA private hospital for 2017 shows that the total number of items purchased was 175 items. With value of (135,695 SDG). The ABC analysis shows that about 66% of the medicines belonged to class A, and 19% (32 items) categorized as class B, The rest of items that is about 15% (27 items) categorized as class C. Among the class A purchased items Innohep 4500mg (Tenzaparin) contributing 4% of total expenditures (5500 SDG) as the highest purchased medication. Conclusion: The inventory management tools knowledge was found to be poor in fresh graduates and university pharmacists but it was better in some postgraduate pharmacists which leads to the problems in the decision making in purchasing drugs and optimizing cost.
In nt te er rn na at ti io on na al l J Jo ou ur rn na al l o of f B Bi io oa as ss sa ay ys s
Background: Continuous surveillance of local antimicrobial susceptibility patterns is a must for ... more Background: Continuous surveillance of local antimicrobial susceptibility patterns is a must for combating antimicrobial resistance. WHONET5 software was recognized as analysis and surveillance tool for investigators. Objective: To analyze Ibn Sina hospital laboratory microbiological data by using WHONET5 software, and to acquire information about antimicrobial resistance of G +ve and G-ve strains among GIT and urology surgical wards. Method: The surveillance database from May 2008-May 2010 had been analyzed using WHONET5 software. We investigated the resistance for the hospital antimicrobial panel available. We evaluated the cross-resistance for the widely prescribed antibiotics pre & postoperatively (Ceftrixone, Co-amoxiclave, and Ciprofloxacin). Also the quarter time transition of resistance ratio and resistance profile had been carried for the hospital antibiotic panel used. Results: the data of 1681 samples were accumulated and analyzed. High resistance rates for antibiotic panel used in GIT and urology wards for G +ve and G-ve organisms were detected. The ratio of ceftrixone cross-resistance for G +ve organisms were 70.9% with amoxiclave and 70% for ciprofloxacin and for G-ve organisms were 78.3% &73.5% for amoxiclave and ciprofloxacin respectively. The rates of resistance was kept high and persistent over the quarter time periods and the phenotypes did not changed obviously for the sequential quarters. Conclusion: Resistant degree among hospital wards studied were very obvious and high. WHONET is an effective computerized microbiology laboratory data management and analysis program that can provide guidance for drug-policy decisions and preventive measures and can be used to investigate the impact of interventions.
Grewia tenax (Goddaim) fruits at 2%, 10% of basic diet ethanolic extract were administered in dri... more Grewia tenax (Goddaim) fruits at 2%, 10% of basic diet ethanolic extract were administered in drinking water (500 mg/Kg/day), via intraperitoneal route (50 mg /kg/day), and via intramuscular route (10/mg/kg/day) for varying periods were fed to 7-day old Bovans-type chicks. After feeding period of 4 weeks and recovering period of 3 weeks, 4 chicks were slaughtered at weeks 2, 4 and 7. Blood samples were collected for hematological and serum analysis. Chicks were examined for gross lesions and specimens of liver, kidneys, heart, spleen and intestines were processed for histopathology. Mean body weights, weight gains, feed conversion ratios were drastically affected throughout the 7-weeks study period in chicks receiving Grewia ethanolic extract via oral, intraperitoneal, and intramuscular routes comparing those fed on 2% Grewia with those fed on 10% Grewia, which exhibited an intense yellow discoloration at the combs and shanks. Enterohepatonephropathy is a characteristic feature of p...
Sudan Journal of Medical Sciences, 2008
Background: Prescription writing is a skill that almost every doctor will use several times a day... more Background: Prescription writing is a skill that almost every doctor will use several times a day. But are medical students effectively taught how to write a complete and accurate prescription? Most commonly the answer is no. There is increasing need for the rational of medicines and the clearly appropriate prescribing is a key to achieve this. Objectives: To find out whether a short training course of problem teaching, improves the competence of rational prescribing among medical students. Methods: All 6 th year medical students (Batch 13), Omdurman Islamic university were randomly separated into intervention and control group. Students of intervention group were taught to choose P how to apply this choice to specific patient problem, using the WHO Results: The competence of intervention group is significantly better than the control group p =0.011. The mean results of post test for intervention group was [3.4 ± 4.5] and fo Conclusion: Teaching medical students all basic knowledge about drugs does not guarantee rational prescribing. Additional short course of problem-based pharmacotherapy could be effective in improving prescribing skills Sudanese medical students.
Value in Health Regional Issues
Global Drugs and Therapeutics
Background: Effective drug supply management ensures uninterrupted availability of quality approv... more Background: Effective drug supply management ensures uninterrupted availability of quality approved, safe and effective pharmaceuticals. This could be achieved through proper selection, quantification, procurement, distribution and use of drugs based on consumption and morbidity pattern of the catchment area by using a system like ABC-VEN analysis. ABC/VEN analysis used for the investigation represents the simple and effective method of analysis of medicine expenditures, identifying priority groups of medicines, the use of which, when improved, may provide the greatest clinical and economic impact. Methods: Descriptive, retrospective cross sectional study was conducted using document reviewed from the main central national and state medical supply organizations NMSF and RDF respectively, in addition to hospital based study. All data was analyzed with excel spread sheet to obtain ABC, VEN, and ABC-VEN matrix analysis results of the annual medicine expenditures and to explore the pharmaceutical inventory control management. Awareness about inventory system among pharmacists working in drug supply centers was measured using pretested questionnaires. Results: The analysis of drugs procured by the NMSF for years (2015-2017) shows that total number of items imported was 584 items, with total value of 1495510147.2 Euro. About 79 (14%) of items consumed 75% of the budget (class A), 100 (17%) items cost 15% (class B), while majority 405 (69%) items only consumed 10% of total medicine expenditure (class C). Among the class A medicines purchased items (Sodium chloride solution 0.9% w/v) 500 ml solution for intravenous infusion ranked first by contributing 5% of total expenditures. The results obtained from RDF for year (2017) shows that the total number of items imported was1134 items, with total value of 242,148,789.5 SDG. About 166 (15%) items consumed 75% of the budget (class A), and 277(24%) items consumed 15% (class B), where majority of items 691 (61%) only consumed 10% of total medicine expenditures (class C). Among the class A items ceftriaxone injection (1 gram) ranked first by contributing 4% of total expenditures and 95% of class A items total expenditure. Hospital based study from ALZYTONA private hospital for 2017 shows that the total number of items purchased was 175 items. With value of (135,695 SDG). The ABC analysis shows that about 66% of the medicines belonged to class A, and 19% (32 items) categorized as class B, The rest of items that is about 15% (27 items) categorized as class C. Among the class A purchased items Innohep 4500mg (Tenzaparin) contributing 4% of total expenditures (5500 SDG) as the highest purchased medication. Conclusion: The inventory management tools knowledge was found to be poor in fresh graduates and university pharmacists but it was better in some postgraduate pharmacists which leads to the problems in the decision making in purchasing drugs and optimizing cost.
In nt te er rn na at ti io on na al l J Jo ou ur rn na al l o of f B Bi io oa as ss sa ay ys s
Background: Continuous surveillance of local antimicrobial susceptibility patterns is a must for ... more Background: Continuous surveillance of local antimicrobial susceptibility patterns is a must for combating antimicrobial resistance. WHONET5 software was recognized as analysis and surveillance tool for investigators. Objective: To analyze Ibn Sina hospital laboratory microbiological data by using WHONET5 software, and to acquire information about antimicrobial resistance of G +ve and G-ve strains among GIT and urology surgical wards. Method: The surveillance database from May 2008-May 2010 had been analyzed using WHONET5 software. We investigated the resistance for the hospital antimicrobial panel available. We evaluated the cross-resistance for the widely prescribed antibiotics pre & postoperatively (Ceftrixone, Co-amoxiclave, and Ciprofloxacin). Also the quarter time transition of resistance ratio and resistance profile had been carried for the hospital antibiotic panel used. Results: the data of 1681 samples were accumulated and analyzed. High resistance rates for antibiotic panel used in GIT and urology wards for G +ve and G-ve organisms were detected. The ratio of ceftrixone cross-resistance for G +ve organisms were 70.9% with amoxiclave and 70% for ciprofloxacin and for G-ve organisms were 78.3% &73.5% for amoxiclave and ciprofloxacin respectively. The rates of resistance was kept high and persistent over the quarter time periods and the phenotypes did not changed obviously for the sequential quarters. Conclusion: Resistant degree among hospital wards studied were very obvious and high. WHONET is an effective computerized microbiology laboratory data management and analysis program that can provide guidance for drug-policy decisions and preventive measures and can be used to investigate the impact of interventions.
Grewia tenax (Goddaim) fruits at 2%, 10% of basic diet ethanolic extract were administered in dri... more Grewia tenax (Goddaim) fruits at 2%, 10% of basic diet ethanolic extract were administered in drinking water (500 mg/Kg/day), via intraperitoneal route (50 mg /kg/day), and via intramuscular route (10/mg/kg/day) for varying periods were fed to 7-day old Bovans-type chicks. After feeding period of 4 weeks and recovering period of 3 weeks, 4 chicks were slaughtered at weeks 2, 4 and 7. Blood samples were collected for hematological and serum analysis. Chicks were examined for gross lesions and specimens of liver, kidneys, heart, spleen and intestines were processed for histopathology. Mean body weights, weight gains, feed conversion ratios were drastically affected throughout the 7-weeks study period in chicks receiving Grewia ethanolic extract via oral, intraperitoneal, and intramuscular routes comparing those fed on 2% Grewia with those fed on 10% Grewia, which exhibited an intense yellow discoloration at the combs and shanks. Enterohepatonephropathy is a characteristic feature of p...
Sudan Journal of Medical Sciences, 2008
Background: Prescription writing is a skill that almost every doctor will use several times a day... more Background: Prescription writing is a skill that almost every doctor will use several times a day. But are medical students effectively taught how to write a complete and accurate prescription? Most commonly the answer is no. There is increasing need for the rational of medicines and the clearly appropriate prescribing is a key to achieve this. Objectives: To find out whether a short training course of problem teaching, improves the competence of rational prescribing among medical students. Methods: All 6 th year medical students (Batch 13), Omdurman Islamic university were randomly separated into intervention and control group. Students of intervention group were taught to choose P how to apply this choice to specific patient problem, using the WHO Results: The competence of intervention group is significantly better than the control group p =0.011. The mean results of post test for intervention group was [3.4 ± 4.5] and fo Conclusion: Teaching medical students all basic knowledge about drugs does not guarantee rational prescribing. Additional short course of problem-based pharmacotherapy could be effective in improving prescribing skills Sudanese medical students.