Trace element deficiency is common among patients with end-stage renal disease (ESRD); the reason is that since these patients undergo dialysis, they lose these elements more than healthy people, and also the use of trace elements is restricted due to loss of appetite. Selenium (Se) is a trace element that is essential for the oxidative stress defense system. Se deficiency leads to some complications similar to those often seen in ESRD patients, such as all-cause mortality due to cardiovascular diseases, bone loss, uric acid elevation, and anemia. This article aims to review the evidence on consequences of Se deficiency in ESRD patients, as well as effects of Se supplementation in hemodialysis patients. Multiple databases were searched to summarize the available evidence on selenium's role in kidney diseases. Since the complications of ESRD and those of Se deficiency are mostly similar, this triggers the idea that Se deficiency may be considered as a cause of these problems, but it needs to be more assessed that Se deficiency is a single factor or there are other factors participated in. Also the role of Se supplementation on resolving the mentioned complications, needs to be more studied through well-designed clinical studies.

Objective: The present study aimed to evaluate the effectiveness of N-Acetylcysteine (NAC), as an antioxidant, in preventing nephrotoxicity in patients receiving colistin. Methods: In a randomized controlled clinical trial, eligible participants receiving colistin were divided into two groups including drug (n = 43) and control (n = 39). In the drug group, 1200 mg of NAC was administered daily for 10 days concurrently with colistin. Patients in the control group received only colistin. The serum creatinine level (SCr), blood urea nitrogen (BUN), and creatinine clearance (CrCl) at baseline and every other day, and the number of cases with acute kidney injury (AKI) during the study were recorded. Before starting treatment and on day 5, the level of urinary neutrophil gelatinase-associated lipocalin (NGAL) was determined. Finally, the values were compared between the groups. Findings: There was a significant increase in SCr and BUN and a significant reduction in CrCl in both groups, but there was not any significant difference between the two groups at any time. Changes in the urine NGAL levels were not significantly different between the two groups. Even though the number of cases with AKI in the drug group (8 cases, 18.6%) was less than the control group (11 cases, 28.2%), the difference was not statistically significant (P = 0.303). Conclusion: Simultaneous administration of NAC with a dose of 1200 mg daily does not have any effect in the prevention of colistin-induced nephrotoxicity.

Objective: Aluminum phosphide (ALP) (rice-tablet) is a common cause of adult poisoning in Iran, including Isfahan. So far, no effective treatment has been identified for this poisoning. We aimed to investigate the outcome of ALP poisoned patients admitted to the clinical toxicology ward of Khorshid Hospital in Isfahan from 2017 to 2019. Methods: This chart-review study was performed on the population of ALP poisoned patients admitted to the clinical toxicology ward of Khorshid University Hospital from 2017 to 2019 treated with the hospital's new treatment protocol, using the complete enumeration approach. The outcomes were determined by reviewing and abstracting medical charts of ALP poisoned patients from the hospital archive. Findings: The most common complaints at admission were depressed consciousness (41.9%) and vomiting (32.2%). There was no significant change in blood sugar, pH, base excess (BE), and venous blood bicarbonate throughout their hospitalization (P > 0.05). Treatment outcomes had a significant relationship with blood pH 2 h and 6 h after admission and the BE 6 h after admission (P < 0.05). There was also a significant relationship between the outcome and the length of stay, initial ejection fraction (EF), and EF in predischarge echocardiography (P < 0.05). Out of 31 patients, 24 (77.4%) died within 72 h, 5 (16.1%) recovered without any complication, and 2 (6.5%) recovered with some complications. Conclusion: The mortality rate of ALP poisoned patients was reasonably high and can be attributed to the poor efficacy of the new treatment protocol or the long time it takes for patients to reach the hospital and start receiving treatments.

Objective: Patient satisfaction is considered an essential indicator of the treatment outcomes of pharmaceutical services. This study aimed to assess patient satisfaction with the pharmaceutical services at the Ministry of Health (MOH) hospitals in Makkah city in Saudi Arabia. Methods: A cross-sectional study was conducted via an interview-based questionnaire that involved patients who visited the outpatient pharmacy in five MOH hospitals from August 2018 to September 2018. The data were collected using a previously published, validated, and reliable questionnaire. The questionnaire was translated and piloted for the local context. Findings: Data of 295 respondents were analyzed. The overall mean score of satisfaction level with the pharmaceutical services was found to be 2.50 out of a maximum score of 3. The item that the patients were most satisfied with was, “The extent of cleanliness in the waiting area for the provision of pharmaceutical services” (mean = 2.80) whereas the item the patients were least satisfied with was, “The information the pharmacist gives you about the proper storage of your medication” (mean = 2.00). “Illiterate” patients and those who visited the pharmacy first time had significantly higher satisfaction levels compared to those with other educational categories and those who had visited the pharmacy before, respectively. Conclusion: Our study showed that the overall level of satisfaction of patients with pharmaceutical services was high.

Objective: This study aimed to compare the LaxaPlus Barij^® and polyethylene glycol (4000) in pediatric (children 2–15 years old) functional constipation. Methods: The present study is a randomized clinical trial. The study population included patients with functional constipation aged 2–15 years who were referred to the gastrointestinal clinic of Imam Hossein hospital in Isfahan in 2019. Patients were randomly assigned into two treatment groups. Data analysis was performed using SPSS software. The significance level in the present study is considered <0.05. Findings: Sixty children with functional constipation were selected based on the inclusion and exclusion criteria in this study. The present study results showed no significant difference between demographic characteristics, including age, weight, and gender of children with constipation in the two groups (P > 0.05). The present study results showed that both groups' mean stool consistency and the number of bowel movements increased significantly after the intervention (P < 0.05). However, the number of bowel movements in the first group was significantly higher than in the second group (P < 0.05). Conclusion: The present study results showed that both drugs effectively treat children with functional constipation. However, after 8 weeks of intervention, the frequency of bowel movements, pain intensity, and abdominal pain in the group LaxaPlus Barij^® was more effective. However, the level of satisfaction did not differ significantly between the two groups.

Objective: Professional nurses, pharmacists, and medical practitioners are responsible for disposing of medicines within health-care facilities. South African regulations stipulate that medicines should not be disposed of through sewage systems because of the potential impact on patients and the environment. Consequently, our objective was to determine knowledge and practices among health-care professionals (HCPs) in South Africa and the information they provide to patients regarding the safe disposal of unused/expired/damaged medicines to provide future guidance with identified concerns. Methods: A descriptive study was conducted among 165 HCPs at 16 primary health-care clinics in two subdistricts of the city of Tshwane in Gauteng Province through self-administered questionnaires. Findings: Only 23.5% of HCPs stated that they participated in destroying medicines within their facilities. More than half (65.1%) also reported that they always counsel patients regarding the safe storage of their medicines in their homes, with 27.9% indicating they counsel patients on the safe disposal of their medicines during consultations. More than half (65.1%) also reported that patients never asked about the disposal of medicines. Of concern is that incineration (31.9%), flushing down the toilet (20.6%), and flushing down the sink (9.9%) were regarded by HCPs as correct disposal methods, while 9.6% stated that they did not know the correct methods. In addition, 71.1% reported never receiving training regarding the safe disposal of medicine. Conclusion: There is an urgent need to educate HCPs regarding appropriate medicine waste disposal in South Africa. This can start with including this topic in the curriculum of HCPs, including pharmacists, and continuing post qualification.