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Linda Tahaineh,1 Sahar M Edaily,1 Shadi F Gharaibeh2 1Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology (JUST), Irbid, Jordan; 2Department of Pharmaceutical Sciences, Faculty of Pharmacy, Jerash University, Jerash, Jordan Objectives: To evaluate the degree of anticoagulation achieved with different enoxaparin dosing regimens used in obese and morbidly obese patients in a hospital setting in Jordan.Methods: All obese adult patients who were prescribed enoxaparin for various indications were invited to participate in the study. The anti-factor Xa (anti-Xa) level was checked once after 4–6 hours of the third or fourth dose of enoxaparin (at steady state). Patients were followed daily to evaluate drug efficacy and safety through their hospital course.Results: Enoxaparin daily dose used for prophylaxis indications ranged from 0.3 to 0.85 mg/kg and from 0.31 to 2.25 mg/kg in case of certain treatment indications. Most participants who received enoxaparin for treatment indications (76.9%) were on capping dosing regimens, which was 0.05). No bleeding events or thrombocytopenia were noticed, and there was one case of recurrent thrombosis.Conclusion: Enoxaparin dosing regimens that were used for obese patients varied based on prescribing physicians. Regardless of the regimen used, the majority of participants had nontherapeutic anti-Xa. Individualized dosing regimens based on anti-Xa levels are warranted for obese patients on enoxaparin. Keywords: anti-factor Xa, anticoagulation, enoxaparin, obesity

Annually, over 350,000 persons require cardiopulmonary resuscitation (CPR), either in or outside of the hospital. With obesity a rising health issue in the United States, concerns exist regarding the efficacy of quality compressions for CPR in obese patients. The aims of this study were to determine if the compressions for three adult simulation manikins (normal, obese, and morbidly obese) met quality guidelines; to examine any differences in quality of chest compressions performed by health care providers between the three manikins; and to examine the effect of participant characteristics on the quality of chest compressions in obese and morbidly obese manikins. A randomized controlled design was used. Sixty-one health care providers performed chest compressions on the three simulation manikins. Results showed that performance on the normal-sized manikin was significantly better than that on both obese and morbidly obese manikins. Participant characteristics were significantly associated with quality of chest compressions. The effectiveness of compressions in obese and morbidly obese CPR recipients has yet to be determined.

There is increasing evidence that obesity in humans is associated with infection with human adenovirus-36 (Adv36). Infection of experimental animals with Adv36 demonstrates that this virus causes obesity. Human studies have shown a prevalence of Adv36 infection of 30% or greater in obese adult humans, but a correlation with obesity has not always been demonstrated. In contrast, three published studies and one presented study with a total of 559 children all show that there is an increase in prevalence of Adv36 infection in obese children (28%) compared to non-obese children (10%). The explanation for the apparently more robust correlation of Adv36 infection with obesity in children vs. adults is not clear. The data in animals and people suggests that Adv36 has contributed to the worldwide increase in childhood obesity. More research is needed to identify prevalences and consequences of Adv36 infection in people of all age groups and geographic locations.

Rotter's (1966) Internal–External (I–E) Scale was administered to 65 adult and adolescent females in two outpatient obesity treatment programs. The adults were significantly higher in internal locus of control (LOC) and the adolescents higher in external LOC. These differences suggest that although the adults felt limited control over their weight and eating behavior, this did not reflect a lack of perceived control over other factors in their lives. In contrast, the adolescents appeared to feel that they had limited control over an array of factors in their lives.

In most Instances, obesity in adults represents increased food intake and decreased energy expenditure. In the management of these patients, increased physical activity is just as important as dietary restriction. The preferred diet is one that produces a deficit of 500 to 1000 cal per day and contains 30 to 50 gm of carbohydrate. There is good evidence that eating five or six small meals a day is a better schedule than one or two larger meals.