BackgroundAutomated dispensing cabinets (ADCs) were introduced in 2010 and 2012 at the Heart Hospital (HH) and National Center for Cancer Care and Research (NCCCR), both run by Hamad Medical Corporation in Qatar. These medication distribution systems provide computer-controlled storage, dispensing, and tracking of drugs at the point of care in patient care units. The purpose of this study was to assess nurses’ perceptions of and satisfaction with the use of ADCs at HH and NCCCR.MethodsA cross-sectional study was conducted in the two institutions in May and November 2012 using a piloted, validated, online, and anonymous questionnaire. The questionnaire consisted of four parts: nurses’ sociodemographic and practice characteristics, 21 questions about their perceptions, one question about their overall satisfaction, and one about the system’s ease of use. The self-administered survey was distributed to 503 nurses working at HH and NCCCR over three weeks using Survey Monkey®.ResultsThe survey response rate was 80 % (n = 403). No significant difference was found in perception scores between the two institutions (p = 0.06). Ninety-four percent (n = 378) of nurses agreed that the medication delivery system allowed them to do their job more safely, and 90 % (n = 363) nurses agreed that they now spent less time waiting for medication from the pharmacy than they did before the ADC system was introduced. Eighty seven percent (n = 349) nurses agreed that they were able to administer medication more efficiently with the ADC system. The overall satisfaction rate (either “very satisfied” or “satisfied”) for the two hospitals was 91 %.ConclusionsThe nurses’ perceptions of and levels of satisfaction with the ADC system were very good over the 6 months after complete implementation and integration at HH and NCCCR. ADCs appear to increase efficiency in the medication process and should therefore improve the quality of care.Electronic supplementary materialThe online version of this article (doi:10.1186/s12912-015-0121-7) contains supplementary material, which is available to authorized users.

Therapeutic drug monitoring data collected during routine clinical practice can provide a useful tool for understanding factors affecting methotrexate pharmacokinetics. Patient weight and hematocrit levels may play a clinically important role in determining methotrexate serum exposure and dosing requirements. Future prospective studies are needed to validate results of the developed model and evaluate its usefulness to predict methotrexate exposure and optimize dosing regimens.

The overall survival of patients with Chronic Myeloid Leukemia (CML) treated by using tyrosine kinase inhibitors (TKIs) is very close to that of the healthy population. However, little is known about the effect of specific measures such as intermittent fasting, especially during Ramadan period. A 3-year retrospective study was conducted to evaluate the effect of fasting on patients with CML receiving TKIs by evaluating certain clinical, hematological, and molecular parameters. A total of 49 patients were eligible, with a median age of 46 years (range: 22-86), of these 36 (73.5%) were males and 13 (26.5%) were females. Twenty-seven (55%) patients are Middle Eastern, while 16 (32.7%) from the Indian subcontinent, and 6 (12.3%) Africans. Imatinib was the most common TKI; used in 25 patients (51%). The mean White blood cells (WBCs), neutrophils, and BCR-ABL were found to be reduced after fasting compared to before and during with statistical difference. The use of TKIs while fasting did not result in significant changes in hematological nor BCR-ABL levels in our study. Patients who wish to practice intermittent fasting may be reassured in this regard, yet physicians can adopt the safe trial approach, where they allow the patients to fast, but with instructions such as when to break fasting.

Obesity is a chronic disease that is increasing in prevalence in adults, adolescents, and children and it is now considered to be a global epidemic. Current recommendation for treatment of Chronic Myeloid Leukemia (CML) does not take in consideration the weight of the patient with regard to doses of different Tyrosine Kinase Inhibitors. Obesity and obesity related surgeries are emerging and unmet needs. To shed the light into this special category of patients and we provide a strategy to treat morbid obesity with CML as well as obesity related surgeries like gastric band, sleeve gastrectomy in patients with CML. Five case scenarios were used to illustrate what is seen in real life: CML (CP) with class III obesity, CML (CP) with sleeve Gastrectomy, CML (CP) post gastric band CML with blast crisis each scenario were followed by proposal for treatment. Obesity and obesity related surgeries are emerging and unmet needs, the treatment of each should be individualized, and the TKI dose may needs to be adjusted in certain categories. The morbidity and mortality associated with being overweight (body mass index [BMI] of 25-29.9 kg/m 2) or obese (BMI of ≥ 30 kg/m 2) have been known to the medical profession for more than 2000 years. Obesity is a chronic disease that is increasing in prevalence in adults, adolescents, and children and it is now considered to be a global epidemic. 1 Body mass index (BMI) based classifications were originally based upon the associated risks of cardiovascular disease (CVD). The recommended classifications for BMI, adopted by the National Institutes of Health (NIH) and World Health Organization (WHO), 2,3 for Caucasian, Hispanic, and black individuals are: Underweight-<18.5 kg/m 2 Normal weight-≥18.5 to 24.9 kg/m 2 Overweight-≥25.0 to 29.9 kg/m 2 Obesity-≥30 kg/m 2 Class I-30.0-34.9 kg/m 2 Class II-35.0-39.9 kg/m 2 Class III-≥40 kg/m 2 (also referred to as severe, extreme, or massive obesity)