Research Article
Volume 4 Issue 1 - 2016
National Survey of Total Parentral Nutrition Practice in Saudi Arabia: Drug Monitoring and Patient Education at MOH Hospitals
Yousef Ahmed Alomi1* and Sumaiah Mohammed Aljudaibi2
1Department of National Clinical pharmacy and pharmacy parcticeHead, Pharmacy R & D Adminstration, Riyadh, Saudi Arabia
2Department of Oncology Prepration Progarms, General Adminstration of Pharmaceutical Care, Riyadh, Saudi Arabia
*Corresponding Author: Yousef Ahmed Alomi, Past General Manager of General Administration of Pharmaceutical CareHead, National Clinical pharmacy and pharmacy parcticeHead, Pharmacy R & D Adminstration Ministry of Health, Riyadh, Saudi Arabia.
Received: April 29, 2016; Published: May 11, 2016
Citation: Yousef Ahmed Alomi and Sumaiah Mohammed Aljudaibi. “National Survey of Total Parentral Nutrition Practice in Saudi Arabia:Drug Monitoring and Patient Education at MOH Hospitals”. EC Nutrition 4.1 (2016): 784-792.
Abstract
The National Survey of Total Parenteral Nutrition practices with emphasis on TPN drug monitoring and patient education at MOH hospital conducted in Saudi Arabia. To explore the TPN current practice with focusing on TPN monitoring and patient education Twenty-four hospitals received the survey with twenty hospitals responded 80.33% response rate. Of that 45% of the hospitals not documented TPN medications errors, 55% of the hospital not reported TPN adverse reaction. More than 50% of hospitals the drug quality reporting system not existed and more 95% of the hospital does not do ISMP self-assessment of medication safety. The TPN staff competency is done in 80% of the hospital while pharmacy staff job satisfaction not done at 40% of the hospitals. TPN education program for patients not existed in 75% of the hospitals, 95% of the hospital does not apply patient satisfaction, and only 20% of the hospitals participated at world nutrition days. TPN utilization evaluation not presented in 90% of hospitals, 90% of the hospitals does not apply for TPN Pharmacogenomics programs and 100% of the hospitals do not do any researches. The survey explored the real TPN practice of monitoring and patient education Targeting of implementing international standard TPN Practice on Monitoring and patient education lead to preventing TPN-related problems, improve TPN training and education, raise patient satisfaction of TPN services to reach TPN patient outcome, and prevent burden cost on health care system.
Keywords: Parenteral Nutrition; Drug monitoring; Patient counseling; Ministry of Health; Saudi Arabia
Abbreviations: TPNS: Total parenteral nutrition services; ASPEN: American Society of Parentral and Enteral Nutrition; ISMP: Institution of Safe Medication Practice; GAPC: General Administration of Pharmaceutical care; MOH: Ministry of Health; ASHP: American society of heath system pharmacist; SPS: Saudi Pharmaceutical Society
Introduction
The total parenteral nutrition (TPN) distribution procedures system consisted of procurement, prescribing, transcribing, preparation and dispensing. Thus, ending with very two important steps TPN monitor and patient education and counseling. That a final step affects all previous works; if not done properly. A joint commission of hospital accreditation standard and Saudi center of health care accreditation made the separate chapter on medication management and used (MMU) [1-2]. They stated the final step of medication processes was medication monitoring, follow-up and patient education. That is including drug-related problems after reach to the patient with another name her TPN-related challenges and complications. It consisted of TPN medication errors, TPN adverse reaction, TPN quality manufacturing products and patient education with counseling related issues [1-2].
In the world, the idea behind founded Intravenous (IV) admixture and TPN preparation is exposure to fatal errors. Several reports from medication safety organization; American Society of Parentral and Enteral Nutrition (ASPEN) and Institution of Safe Medication Practice (ISMP) issued TPN-related errors cases and led potential to death, especially in pediatrics population [3-7]. Some international literature said that stage of transcribing (39%), preparation (24%) and administration (35%) with a high percentage of errors among stages of TPN distribution [8]. Moreover, with a high rate of TPN errors ISMP considered it as one of the high-risk medication, all health care organizations should set up preventive measures and avoid all factors contributing to TPN-related mistakes. ISMP recommended making self-assessment of medication safety at hospitals [9]. ASPEN and ASHP advised to follow up safety guidelines in all stages of TPN distribution system [5-10]. General Administration of Pharmaceutical Care (GAPC) established national medication safety program to prevent drug misadventures. It required to follow up and documentation of medication errors, adverse drug reaction, drug quality problems. That’s including all medications and TPN among them [11-13].
The adherence to those guidelines varies from 15-80% depending on each safety steps and procedure [14]. ASHP did hospital pharmacy practice general in the USA including little information of TPN practice [15-17]. Also, ASHP collaborated with Saudi Pharmaceutical Society (SPS) did the same hospital pharmacy survey in Riyadh City, Saudi Arabia only [18-20]. Their publication had very few information about TPN practices in Saudi and did not include TPN monitoring and patient education per say in the study. In Saudi, the authors not familiar with any studies to investigate what’s the real situation and exploring of TPN practice with emphasis to TPN monitoring and patient counseling? It is even not available at Gulf or Middle East countries it very hard to find them. The authors do a survey of TPN practice at MOH hospitals with emphasis to TPN monitoring and patient education as part of TPN distribution system stages. The goal of this study to examine TPN practices with emphasis of TPN monitoring and patient counseling.
Methods
The survey is the third segment of the national survey of Total Parenteral Nutrition at MOH hospitals; Drug monitoring and patient education. It consisted of part of 50 questions designed by the authors. The survey based on American Parenteral and Enteral Nutrition standard and guidelines (ASPEN), American Society of Health-System Pharmacists (ASHP) and current literature. It included the following but not limited to; TPN Practice Management, Managing the TPN-Use Process, Total Parenteral Nutrition Patient Care, TPN Material Procurement and Inventory Management, Total Parenteral Nutrition (TPN) Delivery, Evaluating the Effectiveness the TPN-use System, Total Parenteral Nutrition (TPN) Research.
The survey distributed to twenty-four hospitals had a Total parenteral nutrition services (TPNS) of MOH Hospital located in several regions. In 2014; The study conducted in 2014. The survey distributed to TPNS supervisors. The authors followed up by telephone and emails after two weeks. By the end of four weeks, the final surveys collected. The survey data information entered into Microsoft Excell version 10 for analysis. In this study, the second segment; Drug monitoring and patient education explored and analyzed.
Results
The survey distributed to twenty-four hospitals, twenty hospitals responded, the response rate was 20 (80%). As showed in Table 1; 65% large hospitals, 20% medium size hospitals and 15% medical cities. In TPN medication safety; 45% of the hospitals not documented TPN medications errors, 55% of the hospital not reported TPN adverse reaction. More than 50% of hospitals the drug quality reporting system not existed and more 95% of the hospital does not do ISMP self-assessment of medication safety in TPN services as showed in Table 2. The TPN staff competency is done in 80 % of the hospital while pharmacy staff job satisfaction not done at 40% of the hospitals in TPN services as showed in Table 3. In TPN education program for patients, 75% of the hospitals not existed, 95% of the hospital does not apply patient satisfaction about TPN services and only 20 % of the hospitals participated at world nutrition days as explored in Table 4. In TPN utilization and researchers, the authors found that is TPN utilization evaluation in 90% of hospitals not existed, 90% of the hospitals does not apply for TPN Pharmacogenomics programs and 100% of the hospitals do not do any researches as showed in Table 5. In the TPN services reporting and evaluation the authors found that is only 40% of hospital done TPN monthly reporting system while 60% of the hospital evaluate the TPN services annually as showed in Table 6.
Discussions
In Saudi Arabia, this is the first study about TPN services at MOH hospitals with the third stage of TPN monitoring and patient educations. It discussed crucial elements in TPN distribution process. Starting from TPN monitoring related issues; besides to patient TPN education. In TPN medication safety; the authors found the number of hospitals reported TPN adverse drug reaction less than what found in Alsutan et al. study. The other issues related to medication safety not mentioned in the same study [20]. Most of the pharmacists excepted should report a regular medication, not TPN, also, medication safety new started at MOH hospitals in 2013, its need more awareness to improve reporting system. The remaining of TPN safety things for current medication errors, drug quality notification system and ISMP self-assessment of hospitals medication safety did not report in any previous study as part of TPN services practice. The TPN staff competency did at an acceptable level. It is hard to find the local study to investigate the extent of general pharmacy competencies or even in TPN competencies. There are few studies examined the competencies related to using metered dose inhaler in Saudi while another study investigated competency of pharmacy research in Qatar [21-22]. In TPN staff job satisfaction; the authors found little results less than what should require from Joint Commission organization [1]. There is no international, or local study examined the extent application of pharmacist job satisfaction and TPN utilization evaluation, although both used as a pharmacy indicator of pharmacy strategic plan. However; there are few studies in Saudi Arabia conducted to measure the level of pharmacy job stratification with the different section of pharmacy practice workforce including job satisfaction in community pharmacy, job satisfaction in the hospital and primary care centers [23-24]. Both TPN staff job satisfaction and TPN competency required for pharmacy strategic plan in Saudi Arabia [11].
In TPN education program for patients, the author found TPN education program application at MOH hospital less than Saudi study by Alsultan et al. [20]. This result is normal finding due to a new concept of patient education program at MOH hospitals. Just last year in 2015, GAPC started patient medication education program including nutrition support pharmacy. Inpatient satisfaction on TPN services; there is no study discussed this matter related TPN, most of the studies conducted community pharmacy worldwide with few studies as the hospital. Also, only four studies done in Saudi and Gulf counties, all of them carried out with community pharmacy or ambulatory care visitors at an outpatient pharmacy, there is not yet published for inpatient [25-28]. The number hospitals participated at world nutrition days tiny. This typical finding because the GAPC based on strategic planning, they started pharmacy public health since 2013 with focusing on the chronic diseases world diabetic day, world Asthma day, world psychiatric day, and world pharmacist day. Maybe in the future, we see more participation on global nutrition days.
In TPN utilization and researchers, the authors found that is TPN utilization evaluation program at hospitals much less than found in the study by Alsultan et al. [18], Medication usage evaluation is not activated at MOH hospitals including TPN services. Also, TPN Pharmacoeconomics program did not exist; this finding is normal because it not applied on a grand scale at all MOH hospitals and even for each pharmacy practice or clinical pharmacy specialties. It may be the most application in the process of addition new medication to MOH formulary (drug evaluation processes); it is a part of the national drug information program. Moreover, it used as a part of the drug utilization evaluation program [29-31]. The TPN researchers did not exist yet; maybe this reports the first study done in the TPN field. However, both of these elements included as a part of pharmacy strategic planning [11]. In the TPN services reporting and evaluation; the authors found small percentages. It is okay to find this result; however the general pharmacy planning is required to follow up based on pharmacy indication, just recently apply them, the author hope next report may be the percentage increases [11].
Limitations
Despite the survey is the unique in Saudi Arabia and Gulf countries and it maybe around the world, as a national study of TPN practice with emphasis on TPN monitoring and patient counseling, it reflected the real TPN practice contained strengths points and weakness elements and this the best available resources currently. However, it had some limitations including but not limited to the following, the study with a small number of hospitals; it did not include non-MOH hospitals or privates sectors. In addition to there is no full or complete information about TPN monitoring and patient counseling.
Conclusion
This survey explored the gap analysis between the real practice and our strategic goals and objectives in TPN safety preventive measures, TPN staff competency, TPN utilization evaluation and TPN pharmaco economics related issues and TPN research field. Targeting to resolve those changeless and the discrepancies with regular survey follow up every year; it improve TPN services with emphasis on monitoring patients on TPN, prevent TPN-related problems and complications and raise TPN patient satisfaction.
Region Number of hospitals Percentages %
Hospital size (Number of staffed beds)
   
Small
   
< 50
0 0%
50-99
0 0%
Medium
   
100-199
0 0%
200-299
4 20%
Large
   
300-399
4 20%
400-599
9 45%
More that or equal 600
0 0%
Very Large
   
Medical Cities
3 15%
Missing No-Response
4 20 %
Ownership
   
MOH-Hospitals
20 100%
Non-MOH Hospitals
0 0%
Privates
0 0%
Accreditation
   
CIBAHI
20 100%
JCI
5 25%
Canada
0 0%

Table 1: Size, Ownership and Accreditation of Respondents.

Region Small
< 100
n (%)
Medium
100-299
n (%)
Large
300-399
n (%)
Large
400- > or =
600 n (%)
Medical
Cities
n (%)
Total
n (%)
TPN Medication errors report
(hospitals n = 20)
           
Less than 3 months
0 (0) 1 (5) 1 (5) 4 (20) 2 (10) 8 (40)
Every 3 months
0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
Every 6 months
0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
Every 12 months
0 (0) 0 (0) 0 (0) 3 (15) 0 (0) 3 (15)
Not reporting
0 (0) 3 (15) 3 (15) 2 (10) 1 (5) 9 (45)
TPN ADR report present (hospitals
n = 20)
           
Less than 3 months
0 (0) 1 (5) 0 (0) 2 (10) 2 (10) 5 (25)
Every 3 months
0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
Every 6 months
0 (0) 0 (0) 0 (0) 1 (5) 0 (0) 1 (5)
Every 12 months
0 (0) 0 (0) 0 (0) 3 (15) 0 (0) 3 (15)
Not reporting
0 (0) 3 (15) 4 (20) 3 (15) 1 (5) 11 (55)
TPN Drug quality report system
present (hospitals n = 20)
           
Less than 3 months
0 (0) 1 (5) 1 (5) 2 (10) 2 (10) 6 (30)
Every 3 months
0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
Every 6 months
0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
Every 12 months
0 (0) 0 (0) 0 (0) 2 (10) 0 (0) 2 (10)
Not reporting
0 (0) 3 (15) 3 (15) 5 (25) 1 (5) 12 (60)
Annual scores ISMP assesment
in TPN ((hospitals n = 19)
           
100%
0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
75%
0 (0) 0 (0) 0 (0) 2 (10) 0 (0) 0 (0)
50%
0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
25%
0 (0) 1 (5.26) 0 (0) 0 (0) 0 (0) 1 (5.26)
Not done
0 (0) 3 (15.78) 4 (21.04) 6 (31.56) 3 (15.78) 18 (97.74)

Table 2: TPN Medication Safety.

Region Small
100
n (%)
Medium
100-299
n (%)
Large
300-399
n (%)
Large
400- > or = 600
n (%)
Medical
Cities
n (%)
Total
n (%)
Pharmacist and Pharmacy Technition TPN
Competancy (hospitals n = 20)
           
100% Pharmacist and Pharmacy Technition
0 (0) 3 (15) 1 (5) 5 (25) 3 (15) 12 (60)
75% Pharmacist and Pharmacy Technition
0 (0) 1 (5) 1 (5) 2 (10) 0 (0) 4 (20)
50% Pharmacist and Pharmacy Technition
0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
25% Pharmacist and Pharmacy Technition
0 (0) 0 (0) 0 (0) 1 (5) 0 (0) 1 (5)
0% Pharmacist and Pharmacy Technition
0 (0) 0 (0) 2 (10) 1 (5) 0 (0) 3 (15)
TPN Pharmacist and Pharmacy Technition job
satisfaction (hospitals n = 20)
           
100% Pharmacist and Pharmacy Technition
0 (0) 1 (5) 0 (0) 5 (25) 2 (10) 8 (40)
75% Pharmacist and Pharmacy Technition
0 (0) 1 (5) 0 (0) 0 (0) 0 (0) 1 (5)
50% Pharmacist and Pharmacy Technition
0 (0) 0 (0) 0 (0) 1 (5) 0 (0) 1 (5)
25% Pharmacist and Pharmacy Technition
0 (0) 0 (0) 2 (10) 0 (0) 0 (0) 2 (10)
100% Pharmacist and Pharmacy Technition
0 (0) 2 (10) 2 (10) 3 (15) 1 (5) 8 (40)

Table 3: TPN Staff Competancy and Satisfaction.

Region Small
< 100
n (%)
Medium
100-299
n (%)
Large
300-399
n (%)
Large
400- > or = 600
n (%)
Medical
Cities
n (%)
Total
n (%)
TPN services Patient Counselling (hospitals n = 20)
           
100% of TPN patients
0 (0) 0 (0) 0 (0) 2 (10) 1 (5) 3 (15)
75% of TPN patients
0 (0) 0 (0) 0 (0) 0 (0) 1 (5) 1 (5)
50% of TPN patients
0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
25% of TPN patients
0 (0) 0 (0) 0 (0) 1 (5) 0 (0) 1 (5)
TPN services Patient satifaction every six moths
(hospitals n = 20)
           
100% of TPN Services
0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
75% of TPN Services
0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
50% of TPN Services
0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
25% of TPN Services
0 (0) 0 (0) 0 (0) 1 (5) 0 (0) 1 (5)
0% of TPN Services
0 (0) 4 (20) 4 (20) 8 (40) 3 (15) 19 (95)
The pharmacist participate International World
TPN Day (hospitals n = 20)
           
100 % participatation
0 (0) 1 (5) 0 (0) 1 (5) 3 (15) 5 (15)
75 % participatation
0 (0) 1 (5) 0 (0) 0 (0) 0 (0) 1 (5)
50 % participatation
0 (0) 0 (0) 1 (5) 2 (10) 0 (0) 3 (15)
25 % participatation
0 (0) 0 (0) 1 (5) 2 (10) 0 (0) 3 (15)
0 % participatation
0 (0) 2 (10) 2 (10) 4 (20) 0 (0) 8 (40)

Table 4: TPN Patient Education and Consultation.

Region Small
< 100
n (%)
Medium
100-299
n (%)
Large
300-399
n (%)
Large
400- > or = 600
n (%)
Medical
Cities
n (%)
Total
n (%)
Total Parentral Nutrition Utlization Evlauation
(hospitals n = 20)
           
100% of TPN Prescriptions
0 (0) 0 (0) 0 (0) 1 (5) 0 (0) 1 (5)
75% of TPN Prescriptions
0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
50% of TPN Prescriptions
0 (0) 0 (0) 0 (0) 0 (0) 1 (5) 1 (5)
25% of TPN Prescriptions
0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
0% of TPN Prescriptions
0 (0) 4 (20) 4 (20) 8 (40) 2 (10) 18 (90)
TPN services Pharmacoeconomics program
(hospitals n = 20)
           
100% of TPN patients
0 (0) 0 (0) 0 (0) 0 (0) 1 (5) 1 (5)
75% of TPN patients
0 (0) 0 (0) 0 (0) 0 (0) 1 (5) 1 (5)
50% of TPN patients
0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
25% of TPN patients
0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
0% of TPN patients
0 (0) 4 (20) 4 (20) 9 (45) 1 (5) 18 (90)
TPN services Researches (hospitals n = 20)
           
100% of TPN Services
0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
75% of TPN Services
0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
50% of TPN Services
0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
25% of TPN Services
0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
0% of TPN Services
0 (0) 4 (20) 4 (20) 9 (45) 3 (15) 20 (100)

Table 5: TPN Utilization Evaluation and Research.

Region Small
< 100
n (%)
Medium
100-299
n (%)
Large
300-399
n (%)
Large
400- > or = 600
n (%)
Medical
Cities
n (%)
Total
n (%)
Theres TPN Services Monthly Stastical reports (hospitals
n = 20)
           
100% of TPN reports done
0 (0) 1 (5) 1 (5) 4 (20) 2 (10) 8 (40)
75% of TPN reports done
0 (0) 0 (0) 0 (0) 1 (5) 0 (0) 1 (5)
50% of TPN reports done
0 (0) 0 (0) 0 (0) 1 (5) 0 (0) 1 (5)
25% of TPN reports done
0 (0) 2 (10) 1 (5) 1 (5) 0 (0) 4 (20)
0% of TPN reports done
0 (0) 1 (5) 2 (10) 2 (10) 1 (5) 6 (30)
TPN services Annual Evaluation (hospitals n = 20)
           
100% of TPN Services
0 (0) 3 (15) 1 (5) 5 (25) 3 (15) 12 (60)
75% of TPN Services
0 (0) 0 (0) 0 (0) 1 (5) 0 (0) 1 (5)
50% of TPN Services
0 (0) 0 (0) 1 (5) 1 (5) 0 (0) 2 (10)
25% of TPN Services
0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
0% of TPN Services
0 (0) 1 (5) 2 (10) 2 (10) 0 (0) 5 (25)

Table 6: TPN Follow up Evaulation.

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Copyright: © 2016 Yousef Ahmed Alomi and Sumaiah Mohammed Aljudaibi. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992


EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505


EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793


EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211


EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047


EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560


EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318


EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819


EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840


EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344


EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476


EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658


EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489


EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278


EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108


EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571


EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333


EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883


EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001


EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937


EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723


EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726


EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603


EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646


EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616


EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290


EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226


EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812


EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268


News and Events


August Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the August issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before August 18, 2022.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.