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Re: يا فخرنا سودانية اخرى....تعيّن أول خبيرة في برنامج بريطاني لمكافحة فيروس خطير (توجد صورة) (Re: Sawsan Ahmed)
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التحية للدكتورة عزة وهى فخر لكل السودانيين و"من شابه أباه فما ظلم" والتحايا كذلك لوالدها المسرحى المتميز د. جعفر النصيرى فهو ممن كانوا باكرا، ولا يزالون، منشغلين بأمر التوعية والتنوير فالمعروف عنه أنه ممن ساهم بدور مفصلى فى إخراج وتمثيل مسرحية "العجكو" الشهيرة والتى قد تكون أرخّت لبروز خاصية العنف المتأصلة عند تنظيم الأخوان المسلمين إذ بادر حاج نور فى تلك الليلة، وتبعه آخرون، بإثارة العنف إحتجاجا على الرقص المختلط حتى أدى ذلك لمقتل طالب، ولكن لسخرية القدر، دارات الأيام فلم يجد ذات "الأخوان" فنا سودانيا خالصا يقدمونه لضيوفهم من العرب وغيرهم فى خاتمة ليالى "الخرطوم عاصمة الثقافة العربية" غير رقصة العجكو!!! دكتور النصيرى أيضا ألف وأخرج فى لندن مسرحية عن الأستاذ محمود محمود طه - فى الذكرى السابعة عشر لإستشهاد الأستاذ محمود محمد طه، بعنوان "محمود" وقد عرضت بقاعة «فينشر سنتر» الكبرى الكائنة في وورنينغتون رود بمنطقة لادبروك غروف غربى لندن وقد شارك فيها بالأداء - حسب جريدة الشرق الأوسط اللندنية - كل من سلمى بابكر الريح وتؤدي دور المنادية، ومحمد المهدي عبدالوهاب الذى أدى دور قاضي محكمة الاستئناف وعز الدين طه وسيف الحلفاوي (الادعاء) وعاصم نورين في دور عبد اللطيف احد تلاميذ محمود المستتابين. ويشارك ايضا محمد عثمان عبد الحميد والقاضي السوداني السابق اسماعيل التاج وانشراح احمد ومواهب ميرغني وعادل مانديلا ومعتز سنجة. التحية مرة أخرى لدكتورة عزة ولوالدها ولكل الذين ذكرت اسمائهم
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Re: يا فخرنا سودانية اخرى....تعيّن أول خبيرة في برنامج بريطاني لمكافحة فيروس خطير (توجد صورة) (Re: بكرى ابوبكر)
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http://www.pjonline.com/editorial/20071020/news/news_htlv.html
HTLV specialist pharmacist appointed
A pharmacist in London may well be the first in the world to specialise in the management of a rare viral infection that can cause debilitating myelopathy. Dawn Connelly finds out about the virus and what the specialist role involves London pharmacist Azza Elnusairi is believed to be the world’s first pharmacist to specialise in a rare human retrovirus. Human t-lymphotropic virus type 1 (HTLV-1) is transmitted via blood, unprotected sexual intercourse and breast milk (see Panel). In a small proportion of those infected, it can lead to debilitating muscle weakness called HTLV-1 associated myelopathy (HAM) or adult t-cell leukaemia/lymphoma (ATLL).
What is HTLV-1? Human t-lymphotropic virus type 1 (HTLV-1) is a retrovirus that is transmitted via blood, unprotected sexual intercourse and breast milk. Worldwide, the virus affects 10 to 20 million people. It was only identified in 1985 but it is an old virus, thought to have migrated in ancient times from indigenous people in North and South America, Australia, Japan and Melanesia, and, more recently, into southern Africa, the Caribbean and East Asia.
It is estimated that around 22,000 people carry the virus in the UK, but most of these have no symptoms and fewer than 1,000 know they are carriers.
For 5 per cent of carriers, infection can lead to two conditions — a debilitating muscle weakness in the lower limbs called HTLV-1 associated myelopathy (HAM) or a blood cancer called adult t-cell leukaemia/lymphoma (ATLL).
People with HAM experience inflammation of the spinal cord that can cause a number of symptoms, including severe neuropathic pain, urinary incontinence, constipation, erectile dysfunction, and stiff and unsteady lower limbs, that often result in disability. Treatment is symptomatic but research into antiviral therapy is ongoing. Those who develop ATLL are often treated with chemotherapy although some specific treatment with antiviral drugs has been shown to improve outcomes.
Although only around 12 people a year in the UK are diagnosed with HAM and about 20 with ATLL, cases are rising, in part because the National Blood Service started screening all donated blood for the virus in 2002. Greater movement of people between the UK and countries in East Asia, Western Africa, South America and the Caribbean, where the virus is more prevalent, is also contributing to increasing patient numbers.
It is against this background that Mrs Elnusairi was appointed earlier this year as HTLV-1 specialist pharmacist at the National Centre for Human Retrovirology, based at Imperial College Healthcare NHS Trust in London. The centre opened in 2004 and is funded by the Department of Health’s national commissioning group — it is the national referral centre for HTLV-1.
The centre is set to expand and there are plans to recruit a consultant and a research fellow registrar to join the current team, which includes a consultant physician, a clinical nurse specialist and a neurophysiotherapist in addition to Mrs Elnusairi.
Graham Taylor, the centre’s lead consultant for HTLV-1, says that he was keen to recruit a specialist pharmacist to the team since polypharmacy is a real problem in this group of patients. He adds that the centre’s focus on clinical trials requires dedicated pharmacist input.
It was the challenge of developing a new post and working as an integral member of a health care team that attracted Mrs Elnusairi to the post. “When I saw the job advertised I thought it sounded fascinating. I had experience of developing new posts before and always found that really challenging and enjoyable,” she says.
Although Mrs Elnusairi had no previous knowledge of HTLV-1, she had some experience of neurology from her role as principal pharmacist for medical specialties at St Mary’s Hospital in London, and has always been interested in immunology and infectious diseases. “I was also excited to be working in a clinic and to be integral to a clinical team,” she adds.
Clinics are held at the centre three times a week, with one clinic being dedicated to people participating in clinical trials. Mrs Elnusairi’s role mainly involves helping patients to manage the symptoms of HAM. “The complex range of symptoms, combined with the fact that many sufferers are older people and are often taking over-the-counter or alternative medicines in addition to their prescription, creates a cocktail of triggers for poor compliance and unpleasant side effects,” she explains.
Patients can be referred to Mrs Elnusairi by any member of the team and she can also arrange her own appointments. Many HTLV-1 patients are taking lots of medicines and Mrs Elnusairi carries out medication reviews both face-to-face and via notes review. “Most of the patients who come to us have tried many treatments before so I spend a lot of time trying to gain an accurate drug history. Often I will find that they have tried medicines for spasticity and pain relief at suboptimal doses in the past.”
Mrs Elnusairi also conducts telephone consultations to monitor compliance with pain relief medicines. “I contact several patients once or twice a week, carry out pain scores and adjust their medicines according to response and side effects,” she explains.
Improving access to medicines is another part of Mrs Elnusairi’s role. “Because we are the national referral centre, patients often travel long distances, with many relying on hospital transport because of their disabilities. So I have tried to speed up the dispensing process so they do not have to wait for their medicines.” She also liaises with patients’ GPs and community pharmacists to pass on any recommendations from her medication reviews and to ensure continuity of supply.
The centre has an expanding research programme, which focuses on evaluating existing therapies to see if they bring down patients’ viral loads or reduce the symptoms of HAM by decreasing spinal cord inflammation. Most of the trials involve using licensed drugs, such as immunosuppressants and antiepileptics, off label. Antiretrovirals have been studied in the past without much success. Ciclosporin is currently being investigated and there are plans to study infliximab and sodium valproate in the future, says Mrs Elnusairi. She currently helps to write clinical trial applications, develops patient information leaflets, reviews trial protocols, and monitors adherence.
Looking to the future, Mrs Elnusairi believes that there is great potential to develop pharmacist prescribing within the clinic. She also hopes to carry out medication reviews in patients’ homes, especially for those with severe mobility problems. Providing more pharmacy input into the research programme is also on her agenda.
“It is a steep learning curve, but it’s very interesting working in one of a handful of clinics worldwide that specialise in HTLV-1 conditions and there is great scope for a pharmacist to play a key role in furthering the treatment and care of patients with this very disabling form of myelopathy,” she says. http://www.pjonline.com/editorial/20071020/news/news_htlv.html
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Re: يا فخرنا سودانية اخرى....تعيّن أول خبيرة في برنامج بريطاني لمكافحة فيروس خطير (توجد صورة) (Re: abubakr)
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Pharmacist's world first in care of patients with rare virus
The National Centre for Human Retrovirology, based at St Mary’s Hospital in Paddington, has appointed a pharmacist with the specialist role of improving care for patients with conditions caused by a very rare virus.
Azza Elnusairi is believed to be the world’s first HTLV-1 Specialist Pharmacist. HTLV-1 (Human T-Lymphotropic Virus Type 1) is a retrovirus transmitted via blood, unprotected sex or breast milk and which can cause a form of blood cancer or debilitating, often disabling, muscle weakness in the lower limbs.
Both conditions are extremely rare in the UK – only around 12 people a year are diagnosed with the muscle weakness condition (HTLV-1-Associated Myelopathy, or HAM) and fewer than 20 with the blood cancer (Adult T-cell Leukaemia/Lymphoma, or ATLL).
But identified cases are on the increase, partly as a result of greater mobility to and from countries in East Asia, Western Africa, South America and the Caribbean where the virus is more prevalent, and partly due to greater awareness. In addition, a larger number of asymptomatic HTLV-1 carriers have been identified since the National Blood Service began screening all donated blood for the virus in August 2002.
People with HTLV-1-Associated Myelopathy (HAM) experience spinal cord inflammation that can cause a wide range of problems including severe pain, stiff or unsteady lower limbs (often resulting in disability), awkward changes in bladder function (such as urinary incontinence), bowel constipation and/or erectile dysfunction.
But, although there is no cure, the symptoms of HAM can be managed with appropriate medication – and that’s where Azza’s role comes in.
“This is the only post of its kind in the UK and, as far as I know, it’s the only specialist HTLV-1 pharmacy role in the world,” says Azza, “so it’s a really exciting opportunity.
“The complex range of symptoms, combined with the fact that many sufferers are older people and that they are often taking over-the-counter or alternative medicines in addition to their prescription, create a cocktail of triggers for poor compliance and unpleasant side-effects.”
Azza joins a multidisciplinary team of clinicians, researchers, nurses and physiotherapists at the St Mary’s centre, which is the UK’s national referral point for HTLV-1. She is working with HAM patients referred to the centre to ensure they are on the best combination of drugs, compliant with their medication and not experiencing unnecessary side-effects. As well as seeing patients face-to-face, she is conducting telephone consultations and medication reviews and adjustments, and counselling patients on how best to manage their medication.
She will also be providing pharmacy input into the centre’s research activities which mainly focus on conducting clinical trials of the off-label* use of existing drugs – for instance, investigating whether certain immunosuppressants can alter the course of the disease.
Azza says: “It is a steep learning curve, but it’s very interesting working in one of a handful of clinics worldwide that specialise in HTLV-1 conditions and there is great scope for a pharmacist to play a key role in furthering the treatment and care of patients with this very disabling form of myelopathy.
“It’s extremely fulfilling to have extensive contact with these patients and to be able to hold full consultations with them, go through all their medication and offer them the support and help they need to manage it. I am also very excited about the research the team here is carrying out and am looking forward to being able to get involved with it from a pharmacy perspective.”
Azza qualified in 1993 at the London School of Pharmacy and has spent most of her career in the acute sector working in general medicine and medical specialties. In addition to her clinical work three days a week at St Mary’s Hospital, she is a clinical pharmacist at Cromwell Hospital in London and also works with a Pharmacy Education Consultancy to produce educational modules for junior pharmacists.
* 'Off-label use’ means using drugs to treat or manage conditions other than that for which they were originally marketed.
http://www.st-marys.nhs.uk/NewsPage.html?NewsId=183
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