Objective: The purpose of this paper is to analyze the prescribing patterns for both conventional and non-conventional non-steroidal anti-inflammatory drugs (NSAIDs) with concomitant gastro-protective agents , at the outpatient clinic at Royal Rehabilitation Center (RRC) in King Hussein Medical Center (KHMC) in Jordan. Methods: A retrospective study was conducted at the outpatient clinic pharmacy in RRC. A total of 25,692 prescriptions were reviewed. Collected data includes: percentage of each type of NSAIDs, dosage form, percentage share for each selective and non-selective NSAID, and concomitant therapy with gastroprotective agent. Results: 52% of the collected prescriptions contain NSAIDs. 76% of the prescriptions are for women and 24% are for men. Age of patients included in the prescription ranges between 16 and 80 years, with a mean of 59.3± 15.8 years. Indications for NSAIDs are 58.3% for osteoarthritis, 12.1% for rheumatoid arthritis, and 20.1% for orthopedics pain. Additionally, 96.4% of prescriptions are for conventional NSAIDs, while only 3.6% prescriptions are for the selective COX-2 inhibitors. Furthermore, diclofenac topped the list with 83.74% of prescriptions of NSAIDs. Concomitant therapy with gastroprotective agents was reported in 71.2% of prescriptions. Famotidine is the most prescribed gastroprotective agents followed by antacid and omprazole. Conclusions: In summary, Diclofenac was the most prescribed NSAIDs as a result of its low price and availability in different dosage forms. Conventional NSAIDs combined with a gastroprotective agent is the most appropriate first-line NSAIDs therapy for many patients. To minimize the occurrence of gastrointestinal toxicity, the study suggests adopting the National Institute of Clinical Excellence (NICE) guidance or the American College of Gastroenterology recommendations.

Controlling blood glucose level in ICU is one of the main priorities in ICU to decrease mortality rates and morbidity rates and to decrease the healthcare cost. The main objective of the present study is design and implement an intervention protocol in ICU. The method involved a suggested intervention protocol which was applied for 25 ICU patients and their findings were compared with 25 ICU patients in control group. Study findings showed that the intervention protocol was able to reduce mortality rates, positive blood cultures, decreased morning glucose level in the intervention group compared with control group. As a conclusion, controlling blood glucose level in ICU is considered an appropriate approach and leads to better outcome of the patients.

Objectives: Decreasing in albumin levels are widely used to predict mortality. We evaluate the overall 28-day mortality prognostic value of percentage changes in albumin levels during first week of admission (%∆ ALB 1wk) in comparison to either albumin level at admission (ALB 1) or albumin level after 1 week of admission (ALB 2) taking into consideration the instability of critically ill patients. Methods: We retrospectively obtained serial measurements of albumin levels of patients admitted to our adult Intensive Care Unit (ICU) between April 2017 and Sep 2018. Patients will be excluded if they discharged or died before 1 week of ICU admission. A receiver operating characteristic (ROC) analysis was conducted to compare the prognostic efficacy of the three tested prognosticators. Results: A total of 163 critically ill patients were finally included in this study. The mean age was 58.37±9.96 years, and 112 (68.71%) were male. The overall 28-day ICU mortality rate was 39.26% (64 patients). The %∆ ALB 1wk was significantly higher in nonsurvivors than in survivors (-11.47%±8.23% vs 0.69%±4.61%; P<0.05). The prognostic value of the % ΔALB 1wk (0.929) was significantly greater than that of ALB 1 and ALB 2 (0.266and 0.655, respectively; P<0.001). Conclusion In comparison to Alb 1 , the %ΔALB 1wk and Alb 2 have a significantly prognostication which is significantly higher in % ΔALB 1wk than ALB 2 with a sensitivity and performance of (93.94% and 75.19% vs 59.59% and 29.91%, respectively; P<0.001). The % Δ ALB 1wk may serve a novel independent prognosticating indicator for critically ill patient's mortality who are taking intravenous human albumin.