Knowledge, attitude and practice towards tuberculosis among healthcare and non-healthcare students at a public university in Saudi Arabia

Background

Tuberculosis (TB) is a bacterial infection. It mostly affects the lungs (pulmonary TB), but it can also affect other organs. This cross-sectional study evaluated knowledge, attitudes, and practices (KAP) related to TB among King Khalid University (KKU) students between October and November 2023.

Objective

The objective of this study was to investigate current TB knowledge, attitudes, and practices of students at King Khalid University in Abha, Saudi Arabia.

Methods

A self-administered, cross-sectional, descriptive, web-based questionnaire was conducted from October to December 2023 among the students of King Khalid University. We used a 29-item questionnaire with five sections. Section 1 contained five questions about sociodemographic factors, there were 13 knowledge questions in Section 2, Section 3 contained 7 attitude questions, Section 4 contained 3 practice questions, and Section 5 contained 1 source of information question. A chi-squared test was used to assess differences in participants' knowledge, attitude, and practices in relation to their demographic variables (p < 0.05).

Results

A total of 518 students completed the questionnaire. 53.66% were healthcare students and 46.33% non-healthcare students. The mean scores for healthcare and non-healthcare students, respectively, were as follows: knowledge 11.80 ± 4.81, 7.35 ± 4.96; attitude 6.94 ± 1.33, 5.05 ± 2.09; and practice 2.26 ± 0.85, 1.14 ± 0.87. The results of this study showed good knowledge (24.82 and 5.83% for healthcare and non-healthcare students, respectively) good attitude (67.62 and 46.25%) and good practice (45.32 and 9.58%). A total of 24.32% healthcare students and 28.18% non-healthcare students reported that most effective sources for obtaining information about TB were social networks, the internet and the radio.

Conclusion

The current study concludes that the knowledge, attitude, and practice about TB among healthcare faculty students is better than their non-healthcare counterparts. However, there are still areas of poor knowledge, attitude and practice toward some aspects of TB among the two categories, which shows the necessity of educational intervention that aims at improving student understanding about the disease and its impact on public health.

Reproductive health services: attitudes and practices of Saudi community pharmacists

BACKGROUND

Sexual and reproductive health (SRH) services are a crucial provision of public health. The consequences of having suboptimal SRH services include unplanned pregnancies, unsafe abortions, reproductive cancers, and sexually transmitted and bloodborne infections. This study was conducted to assess the role community pharmacists play in providing SRH, their practices, and their attitudes toward fulfilling the exciting demand.

METHODS

A cross-sectional, self-administered questionnaire was used. The study was conducted among community pharmacies across the Asir region.

RESULTS

A total of 196 community pharmacists were included in this study. The majority of pharmacy chains reported selling pregnancy tests (93.9%) compared to independent pharmacies (72.9%), p value (0.0001). Similarly, community pharmacists working in pharmacy chains educated patients on pregnancy tests (78.2%) more often than those working in independent pharmacies (62.6%), p value (0.03). Ovulation tests were sold more frequently in pharmacy chains (74.3%) than in independent pharmacies (52.08%), p value (0.004). Providing education on these products followed the same pattern with (72.9%, 47.9%), respectively, p value (0.003).

CONCLUSION

The majority of pharmacists reported selling pregnancy tests and ovulation and educated patients regarding both these test kits. However, these services were more widely available in pharmacy chains than in independent pharmacies. Pharmacists exhibited a positive attitude toward SRH, exhibiting social accountability and an ethical responsibility to fulfill their role.

An evaluation of knee osteoarthritis pain in the general community-Asir region, Saudi Arabia

BACKGROUND

Knee osteoarthritis (KOA) is one of the most common conditions resulting in disability, particularly in the elderly population. Osteoarthritis (OA) is the most common articular disease and the leading cause of chronic disability in the developed world.

OBJECTIVE

This study was carried out to evaluate knee pain in the Asir region of Saudi Arabia. An analytical cross-sectional survey design was adopted in the Asir region from April 2023 to August 2023 to assess the knee pain of the adult population using an anonymous online questionnaire.

RESULTS

Of 1234, 332 were men (26.90) and 902 were women (73.09). WOMAC index score category 55.34% (n = 683) of the subjects had a low risk (score <60), 28.68% (n = 354) had a moderate risk (score 60-80), and 15.96% (n = 197) had a high risk (score ≥81) for KOA. According to clinical criteria, 79.33% (n = 979) of the study subjects had OA. Age group, gender 2.17 (1. 67-2.82) [OR 2.17; 95% CI 1.67-2.82), family history of OA [OR 0.47; 95% CI 0.37-0.62], diabetes [OR 2.78; 95% CI 2.17-3.56], hypertension [OR 0.35; 95% CI 0.26-0.45] were significantly associated with the percentage of the WOMAC index score using the Chi-square test analysis (P<0.05). Therefore, the WOMAC index showed higher diagnostic precision with a statistically significant association [OR 9.31 CI 6.90-12.81] with a P< 0.0001.

CONCLUSION

KOA is more common in older, obese people who have reached the age of 50 in the Asir region, and it is more prevalent in women. Alarms the need for appropriate awareness programs for better disease prevention and health outcomes for the benefit of the community through general public health programs.

Role of lisinopril in the therapeutic management of cardiovascular disease by targeting microtubule affinity regulating kinase 4: molecular docking and molecular dynamics simulation approaches

Cardiovascular diseases (CVDs) are a major cause of premature adult death. Various factors contribute to the development of CVDs, such as atherosclerosis leading to myocardial infarction (MI), and compromised cardiac function after MI leads to chronic heart failure with systemic health complications and a high mortality rate. Microtubule detyrosination has rapidly evolved as an essential mechanism to regulate cardiomyocyte contractility. Microtubule affinity regulating kinase 4 (MARK4) regulates cardiomyocyte contractility in a way that it promotes phosphorylation of microtubule-associated protein 4, thereby facilitating the access of vasohibin 2-a tubulin carboxypeptidase-to microtubules for the detyrosination of α-tubulin. Lisinopril, a drug belonging to the class of angiotensin-converting enzyme inhibitors, is used to treat high blood pressure. This is also used to treat heart failure, which plays a vital role in improving the survival rate post-heart attack. In this study, we will evaluate the MARK4 inhibitory potential of lisinopril employing molecular docking and molecular dynamics (MD) simulation approaches. Molecular docking analysis suggested that lisinopril binds to MARK4 with a significant binding affinity forming interactions with functionally essential residues of MARK4. Additionally, MD simulation deciphered the structural dynamics and stability of the MARK4-lisinopril complex. The findings of MD studies established that minimal structural deviations are observed during simulation, affirming the stability of the MARK4-lisinopril complex. Altogether, this study demonstrates lisinopril's crucial role in the therapeutic management of CVD by targeting MARK4.Communicated by Ramaswamy H. Sarma.

An analysis of pharmacy workforce capacity in Saudi Arabia

Background: Previous reports have highlighted the core issues with the intelligence of the national pharmacy workforce reliance on non-native pharmacists, despite the increasing supply of local pharmacy graduates; limited participation of female pharmacists in the workforce; and inadequate proportions of pharmacists in primary healthcare centres, resulting in pharmaceutical services being provided without a pharmacist's supervision. Methods: The current study used a retrospective cross-sectional design and data was collected from January to May 2023. Data was retrieved from the Health Statistics Yearbook, 2017, 2018, 2019, 2020 and 2021. The data included the total number of pharmacists, the number of Saudi pharmacists, the number of foreign pharmacists, the distribution of the proportions of male and female pharmacists, and the distribution of the workforce by region, sector and nationality. Data was also obtained relating to pharmacy education, including the number of pharmacy colleges, the number of pharmacy students and the number of pharmacy graduates. Results and conclusion: The capacity of the pharmacy workforce, meaning the number of pharmacists per 10,000 population, fluctuated between 2017 and 2021, with the lowest number being in 2020, a mere 7.9 pharmacists per 10,000 population. However, in 2021, the overall density of pharmacists increased to (9.04), which is above the global average (7.36 per 10,000 population). The proportion of women working in the pharmacy profession increased from 12% to 22%, and in community pharmacies from 0.3% to 7.2%, between 2016 and 2021. Another issue that still exists is a lack of proportionate and imbalance in the distribution of the pharmacy workforce across the regions. The renationalisation initiatives increased the overall proportion of Saudi pharmacists to 39% in 2021, compared to 22% in 2016. There is a need for a policy mechanism that will overcome the identified issues.

An Evaluation of Continuing Medical Education among Pharmacists in Various Pharmacy Sectors in the Asir Region of Saudi Arabia

BACKGROUND

Continuing medical training is an important component of modern medical practice because it maintains the ability of physicians to provide up-to-date patient care. This study explored pharmacists' involvement in CME activities and investigated the barriers to undertaking CME activities in Saudi Arabia. It also aimed to highlight the obstacles that prevent pharmacists from participating in CE activities.

METHODS

This study used a cross-sectional self-administered web-based questionnaire. It was conducted among practising pharmacists in various pharmacy fields in the Asir region of Saudi Arabia. The structured questionnaire consisted of four domains. A convenience sampling strategy was used to select and recruit study participants. The results were described in terms of frequencies and percentages. A Chi-square test was used to assess the differences for categorical data. p value of <0.05 was considered significant.

RESULTS AND CONCLUSIONS

A total of 173 pharmacists participated in the study. Attending the conference was the most popular activity (67%), followed by training courses (61.8%) and approved web-based activities (60.1%). Regarding barriers that prevented pharmacists from participating in CME activities, a lack of a scientific database or books was the top-rated barrier that hindered pharmacists from obtaining the required CME hours (79.8%). Another important barrier was the cost of the activities (74.6%). Regarding the area of practice for which pharmacists would be interested in attending CME activities, public health was the favourite (89.6%), followed by personal skills (82.7%). Gathering the required CME hours for re-registration was the main motive for attending CME activities in most of the pharmacy sectors. Policymakers should consider shifting the current CME system to the Continuing Professional Development (CPD) model, which promotes engagement in professional development activities that are relevant to the scope of practice.

Assessment of oral health literacy and oral health related quality of life in Saudi university students: A cross sectional study

BACKGROUND

Oral health literacy was recognized as important to encouraging oral health and avoiding oral health diseases. Therefore, this study was conducted to assess oral health literacy (OHL) and oral health-related quality of life (OHRQoL) among undergraduate students studying at university.

MATERIALS & METHODS

A prospective cross-sectional study was carried out from November to February 2023 among the students of King Khalid University. OHL and OHRQoL were assessed using a Rapid estimate of adult literacy in dentistry-30 (REALD-30) and oral health impact profile (OHIP-14). Further, Pearson's correlation tests were used to measure the correlation between REALD-30 and OHIP-14.

RESULTS

Among the 394 completed respondents, the majority were Aged>20 years (n=221; 56.09%), Aged <20 years (n=173 43.91%), female (n=324; 82.23%), male (n=70; 17.7%). Participants from health-related colleges were (n=343; 87.06%), and other colleges were (n=51; 12.94%) *P<0.04. Participants brushing frequency once daily were (n=165; 41.88%) twice or more per day (n=229; 58.12%) *P<0.018. The overall mean REALD-30 score of the participants was 11.76 ±0.17 indicating Low OHL. The higher mean score of OHIP-14 for the following domains physical pain 12.93±0.56, physical disability 12.05±0.72, and psychological disability 12.71±0.76. Oral health impact profile-14 and REALD showed a positive correlation for health-related colleges (r = 0.314; *P<0.002) and other colleges (r = 0.09; P<0.072). However, a significant correlation was observed between REALD-30 and OHIP-14 scores among health-related colleges (P < 0.05).

CONCLUSION

The current study concluded that self-rated poor oral health is significantly linked with OHIP-14 scores. Furthermore, systematic health education programs such as regular dental checkups for college students must be arranged to assist in changing the student's everyday life and oral health behaviors.

A cross-sectional study on Saudi pharmacists working as medical representatives: What attracted them and what is keeping them in this sector—Misconceptions and reality

Background

The government in Saudi Arabia issued a labor reform initiative to renationalize the pharmacy profession in pharmaceutical companies to generate more employment for Saudi pharmacists. Considering the nationalization of the pharmacy workforce employed in this sector, as well as the pharmacists' preferences toward working in this setting, the current study was conducted determine the reasons to choose this career pathway, to clarify the common misconceptions about this sector and to assess job satisfaction, work commitment, and intentions to leave.

Methods

An online self-administered questionnaire was used to collect data from pharmacists working as medical representatives across Saudi Arabia. A total of 133 medical representatives participated in the study.

Results

The main factors that motivated study participants to join this sector included performing a socially important job, receiving a high salary, and further career development. The common misconceptions about the sector, such as lacking honor and value and considering commercial values to be accepted, were found to be incorrect by the medical representatives. A high job satisfaction level, high work commitment, and low intentions to leave the sector were reported by participants.

Conclusion

Working as a medical representative in a pharmaceutical company is an appealing career choice that fulfills pharmacists' career ambitions and may help in creating more jobs for the increasing numbers of pharmacy graduates.

Detection and analysis of potential drug-drug interactions among patients admitted to the cardiac care unit in a tertiary care hospital

OBJECTIVE

This study aimed to estimate how prevalent potential drug-drug interactions (pDDIs) were in patients with cardiovascular diseases who were hospitalized for more than 24 hours, and to determine the risk factors associated with these pDDIs.

PATIENTS AND METHODS

A prospective observational study was conducted on patients admitted to the cardiac care unit in a tertiary care hospital. We included two hundred medical records of cardiovascular disease patients who were prescribed more than one drug. These medical records were analyzed for pDDIs using the Micromedex drug interaction checker database. Data were analyzed using Descriptive statistics. Chi-square test and the Pearson correlation coefficient were applied.

RESULTS

PDDIs were prevalent in 95% of the analyzed medical records, with at least one detected pDDI per record. Within the 200 medical records, 430 potentially interacting drug pairs were identified, with the majority resulting in moderate and major interactions. Aspirin/clopidogrel (111), furosemide/aspirin (89), enoxaparin/clopidogrel (89) and Lisinopril/aspirin (60) were the most common interacting pairs. Whereas, aspirin, heparin, clopidogrel, furosemide, ranitidine and Lisinopril were the most frequently implicated drugs in DDIs.

CONCLUSIONS

PDDIs were common among hospitalized cardiovascular patients. PDDIs were associated with age and number of drugs prescribed. The routine integration of an online drug interactions screening tool may improve the ability of pharmacists to identify cardiac patients at higher risk of potential drug interactions and conduct appropriate interventions thereafter.

In Vitro, Molecular Docking and In Silico ADME/Tox Studies of Emodin and Chrysophanol against Human Colorectal and Cervical Carcinoma

Anthraquinones (AQs) are present in foods, dietary supplements, pharmaceuticals, and traditional treatments and have a wide spectrum of pharmacological activities. In the search for anti-cancer drugs, AQ derivatives are an important class. In this study, anthraquinone aglycons chrysophanol (Chr), emodin (EM) and FDA-approved anticancer drug fluorouracil were analyzed by molecular docking studies against receptor molecules caspase-3, apoptosis regulator Bcl-2, TRAF2 and NCK-interacting protein kinase (TNIK) and cyclin-dependent protein kinase 2 (CDK2) as novel candidates for future anticancer therapeutic development. The ADMET SAR database was used to predict the toxicity profile and pharmacokinetics of the Chr and EM. Furthermore, in silico results were validated by the in vitro anticancer activity against HCT-116 and HeLa cell lines to determine the anticancer effect. According to the docking studies simulated by the docking program AutoDock Vina 4.0, Chr and EM had good binding energies against the target proteins. It has been observed that Chr and EM show stronger molecular interaction than that of the FDA-approved anticancer drug fluorouracil. In the in vitro results, Chr and EM demonstrated promising anticancer activity in HCT-116 and HeLa cells. These findings lay the groundwork for the potential use of Chr and EM in the treatment of human colorectal and cervical carcinomas.

The Structural, Biological, and In-Silico Profiling of Novel Capryloyl Tetra-Glucoside and Aliphatic Ester Constituents from the Abutilon indicum Offers New Perspectives on the Treatment of Pain and Inflammation

Abutilon indicum L. (Malvaceae), more often referred to as Peeli booti, Kanghi, and Kakhi, is a perennial shrub found in many countries of Asia. Traditionally, this plant is used as a diuretic to treat inflammation, discomfort, urethral infections, and gout. Inflammation and pain are key topics of interest for researchers throughout the globe, since they are linked to almost every illness that could affect humans or animals. The present study was conducted to isolate the phytoconstituents from the methanolic extract of Abutilon indicum collected from the Bihar state Koshi river belt in India, and to evaluate the isolated phytoconstituents' ability to reduce nociception and inflammation. Furthermore, molecular docking was performed to investigate the molecular interaction profile, with possible therapeutic targets for anti-inflammatory medicines. A. indicum methanolic extract yielded two novel phytocompounds identified as 5'-hydroxyhexyl n-hexadecanoate (AB-01) and n-octanoyl-β-D-glucopyranosyl-(2'-1'')-β-D-glucopyranosyl-(2''-1''')-β-D-glucopyranosyl-(2'''-1'''')-β-D-glucopyranoside (AB-05), together with three previously recognized phytocompounds such as ester glucoside. All isolated molecules were tested for the efficacy of analgesic and anti-inflammatory characteristics at doses of 5 and 10 mg/kg body weight. The isolated compound's molecular interaction profile with anti-inflammatory drug targets cyclooxygenase-2 and tumor necrosis factor-alpha possessed high potential energy in molecular docking. These findings may aid in developing anti-inflammatory and analgesic drugs from A. indicum.

Pharmacological Efficacy of Probiotics in Respiratory Viral Infections: A Comprehensive Review

Mortality and morbidity from influenza and other respiratory viruses are significant causes of concern worldwide. Infections in the respiratory tract are often underappreciated because they tend to be mild and incapacitated. On the other hand, these infections are regarded as a common concern in clinical practice. Antibiotics are used to treat bacterial infections, albeit this is becoming more challenging since many of the more prevalent infection causes have acquired a wide range of antimicrobial resistance. Resistance to frontline treatment medications is constantly rising, necessitating the development of new antiviral agents. Probiotics are one of several medications explored to treat respiratory viral infection (RVI). As a result, certain probiotics effectively prevent gastrointestinal dysbiosis and decrease the likelihood of secondary infections. Various probiotic bacterias and their metabolites have shown immunomodulating and antiviral properties. Unfortunately, the mechanisms by which probiotics are effective in the fight against viral infections are sometimes unclear. This comprehensive review has addressed probiotic strains, dosage regimens, production procedures, delivery systems, and pre-clinical and clinical research. In particular, novel probiotics’ fight against RVIs is the impetus for this study. Finally, this review may explore the potential of probiotic bacterias and their metabolites to treat RVIs. It is expected that probiotic-based antiviral research would be benefitted from this review’s findings.

A modified Delphi study to establish consensus on continuing education requirements for pharmacists' relicensing in Saudi Arabia

OBJECTIVE

Continuing education is a key priority for pharmacy workforce development and the achievement of the nation's health goals. The current study was conducted to evaluate continuing medical education requirements for pharmacists' re-registration in Saudi Arabia. It also aimed at establishing a continuous professional development (CPD) system that fills the gaps in the current continuing medical education (CME) system.

MATERIALS AND METHODS

A modified Delphi method was utilized. Data extraction and statement development (review of key documents) was initially conducted by benchmarking the current CME requirements for pharmacists' re-registration in Saudi Arabia to continuing professional development models from 3 countries: the UK, Ireland, and Australia. This stage identified the gaps in the current model and was used in developing the data collection tool (11 statements). A 3-round Delphi, with 15 expert panel members, was used to reach consensus and to establish a suggested guideline document for a national CPD model for pharmacists' re-registration in Saudi Arabia.

RESULTS

A CPD model for pharmacists' re-registration was developed. Panel members reached consensus on the need to shift the current CME system to a CPD model and individualize CPD plans according to the pharmacists' identified knowledge gaps and areas of practice. They agreed on the incorporation of unplanned activities and non-accredited CPD activities into the new model if they improve pharmacists' practice. They also noted that the current biennial re-registration is appropriate, considering pharmacists' busy work schedules.

CONCLUSIONS

This study used the modified Delphi technique to develop a suggested CPD model for pharmacists' re-registration in Saudi Arabia. Expert panel members reached consensus on shifting from a CME model to a CPD model, increasing CPD credits to 40 per annum and incorporating unplanned CPD activities, while keeping re-registration to every two years.

Intravenous Nanocarrier for Improved Efficacy of Quercetin and Curcumin against Breast Cancer Cells: Development and Comparison of Single and Dual Drug-Loaded Formulations Using Hemolysis, Cytotoxicity and Cellular Uptake Studies

The present work highlights the suitability of an oil-based nanocarrier to deliver quercetin (Q) and curcumin (C) through the intravenous route for treatment of breast cancer. The nanoemulsion prepared by the modified emulsification-solvent evaporation method resulted in particle size (<30 nm), polydispersity index (<0.2), zeta potential (<10 mV), optimum viscosity, high encapsulation efficiency and drug loading for both drugs. The pH and osmolarity of the nanoemulsion were about 7.0 and 280 mOsm, respectively, demonstrated its suitability for intravenous administration. In-vitro release of drugs from all the formulations demonstrated initial fast release followed by sustained release for a period of 48 h. The fabricated single and dual drug−loaded nanoemulsion (QNE, CNE, QC-NE) exhibited moderate hemolysis at a concentration of 50 μg/mL. The % hemolysis caused by all the formulations was similar to their individual components (p ˃ 0.05) and demonstrated the biocompatibility of the nanoemulsion with human blood. In vitro cytotoxic potential of single and dual drug−loaded nanoemulsions were determined against breast cancer cells (MF-7). The IC50 value for QNE and CNE were found to be 40.2 ± 2.34 µM and 28.12 ± 2.07 µM, respectively. The IC50 value for QC-NE was 21.23 ± 2.16 µM and demonstrated the synergistic effect of both the drugs. The internalization of the drug inside MF-7 cells was detected by cellular uptake study. The cellular uptake of QNE and CNE was approximately 3.9-fold higher than free quercetin and curcumin (p < 0.0001). This strategically designed nanoemulsion appears to be a promising drug delivery system for the proficient primary preclinical development of quercetin and curcumin as therapeutic modalities for the treatment of breast cancer.

Academic Help-Seeking Behaviours of Undergraduate Pharmacy Students in Saudi Arabia: Usage and Helpfulness of Resources

Background: University students usually find it difficult to handle academic challenges by themselves and tend to seek help. Academic help seeking is defined as “a behavioral strategy that involves controlling one’s behavior and interacting socially to obtain help from other people.” Methods: A cross-sectional design was planned. An online self-administered questionnaire was used to collect data on academic help-seeking behaviours among year 5 undergraduate pharmacy students. Demographic and background information was described in terms of frequency. Their reasons for seeking academic help (five items) and factors considered for choosing academic resources (six items) used a Likert scale ranging from one (strongly disagree) to five (strongly agree). Usefulness (ten items) was rated on a five-point scale ranging from ‘very useful’ to ‘not useful at all.’ Frequency (ten items) was rated on a five-point scale ranging from ‘never’ to ‘every day.’ Results: A total of 116 pharmacy students completed the survey. The study indicated that the key reasons for seeking help were positive factors—a further improvement of one’s learning and the desire to complete a course. The resources that were most frequently used were peers, the course online portal, and online educational resources. The resources that students found most helpful were peers, the course instructor, textbooks, and online resources. Discussion and conclusion: The frequency of using a certain support resource was not mirrored by its helpfulness. Resources, including professors, teaching assistants, and textbooks, were found helpful but not frequently consulted for help. On the other hand, summaries and notes, for example, were frequently used but not particularly helpful. However, peers currently taking the course and the course management system were found to be very useful and frequently used.

Adopting global tools for the advancement of pharmacy practice and workforce in Saudi Arabia

Background

Methods

Results

Conclusion

Knowledge, Attitude and Practice of Community Pharmacists Toward Non-pharmaceutical Products in Saudi Arabia

Introduction

Community pharmacy is a rapidly changing sector in Saudi Arabia. Customers visit local community pharmacies for a variety of reasons including disease-related advice, buying OTC medication, cosmetic products and re-filling a prescription for a chronic illness. The current study was conducted to fill the gap in the literature regarding community pharmacists' knowledge, attitude and practice toward non-pharmaceutical products.

Methods

The study used a cross-sectional design. A total of 211 community pharmacists working in the Asir region, Saudi Arabia were included. The questionnaire was adopted from a previous study with the same purpose.

Results

Products sold in community pharmacies were mainly pharmaceutical products (69.7%) compared to 30.3% non-pharmaceutical products. The most commonly sold non-pharmaceutical products were mother and baby products (26%) and skin care products (19%). Pharmacists showed good mean knowledge (3.96 out of 5), mean positive attitude (3.79 out of 5) and mean positive practice (3.32 out of 5).

Conclusion

Community pharmacists showed considerable knowledge pertaining to non-pharmaceutical products. Respondents demonstrated positive attitudes toward the non-pharmaceutical products and were interested in expanding their knowledge on the topic through continuing education. Additionally, they showed social accountability by assuming responsibility for providing patient counseling on non-pharmaceutical products.

Patients’ Satisfaction with E-Prescribing (Wasfaty) in Saudi Arabia: A Survey of Country-Level Implementation

Aim: This study was conducted to assess patient satisfaction with the e-prescription service implemented by the Ministry of Health hospitals and primary healthcare centres in Saudi Arabia. Methods: The study used a cross-sectional approach. Data were collected using a random sampling technique, and an online questionnaire was distributed among the study population. A five-point Likert scale, ranging from 1 (not at all satisfied) to 5 (very satisfied), was used to assess patient satisfaction. Results and Conclusions: A total of 400 patients participated in the study. More than half (57.5%) of them were males, and approximately one-third were between the ages of 30 and 39. Aspects related to the pharmacy, i.e., accessibility of pharmacies in terms of numbers, location, and opening hours, as well as pharmacy facilities, including waiting area, counselling area, dispensing area and parking lots, were skewed towards 5 (very satisfied). Aspects related to pharmacy personnel, i.e., knowledge, skills, and competencies, as well as friendliness and approachability, were also skewed towards 5 (very satisfied). Factors related to patient experience with Wasfaty, the new service, as compared with old primary healthcare centres’ pharmaceutical services, such as the availability of pharmacists, procedures for refills, waiting time, privacy, and confidentiality, were also skewed towards 5 (very satisfied).

Involvement of community pharmacists in public health services in Asir Region, Saudi Arabia: A cross-sectional study

BACKGROUND

Community pharmacists are one of the most accessible healthcare practitioners worldwide and their services are used by a large proportion of the population. Expanding the roles of community pharmacists could contribute to reducing pressure on general health practice and other areas of the health services. This research aimed to evaluate the contribution of community pharmacists in the provision of public health services and to investigate the perceived barriers for the provision of these services in Saudi Arabia.

MATERIALS AND METHODS

This study followed a cross-sectional design using an online anonymous self-administered questionnaire. The study took place in Asir region, Saudi Arabia, between September 2019 and February 2020. A convenience sampling strategy was used to select and recruit the study participants. The questionnaire was adapted from previous research and involved three sections: demographics, involvement in public health services and barriers for practising public health roles.

RESULTS

The total number of respondents was 193. The proportion of respondents who reported that they were "very involved" or "involved" in each service was 61.7% for weight management, 60.6% for sexual health, 57.5% for healthy eating, 53.4% for physical activity promotion, 51.3% for dental health, 46.1% for smoking cessation, 39.4% for screening for diabetes, 35.7% for screening for hypertension, 31.1% for alcohol dependence and drug misuse counselling, 30.6% for screening for dyslipidaemia, and 21.8% for vaccination and immunisation. Most of the barriers in the current research were rated as having low relevance to the provision of public health services.

CONCLUSION

Findings in the current research suggest that community pharmacists in Asir region have varying levels of involvement in public health roles. Further research needs to be undertaken to understand the barriers to the provision of public health services and what strategies would be beneficial for enhancing the public health role of community pharmacists in Saudi Arabia.

Pharmacists' Perceptions of Handling Antimicrobial Resistance (AMR): A Case Study in Saudi Arabia

Introduction

Saudi Arabia is one of the countries facing the emergence of antimicrobial resistance (AMR). The pharmacist is an important stakeholder in the healthcare system who plays a crucial role in avoiding AMR and implementing antimicrobial stewardship (AMS).

Methods

A cross-sectional design was used in this study. The online questionnaire collected data regarding the enablers that have helped in preparing pharmacists to handle AMR and the barriers faced by pharmacy personnel in handling AMR, as well as the strategies used to overcome the identified barriers.

Results

A total of 109 participants were included in the study. Just under two thirds (62.4%) of participants were female and the majority (70.6%) worked as pharmacists. Just under half (41.7%) had between 6 and 10 years of work experience. Three quarters (74.3%) had antimicrobial stewardship in place and around the same number (73.4%) were involved in handling infectious disease management during the COVID-19 pandemic. Pharmacists have found that preparatory items/tasks, pharmacy college curriculum, pharmacy rotation, years of experience and self-education related to AMR handling to be natural, with a mean of 3.2. The participants found all the barriers - insufficient background, in site education and training, limited time, limited CPD activities, limited educational tools and no free access to relevant clinical journals - to be relevant, with a mean of 4.05. The participants found all the enablers - CPD activities, funded educational programs, allowing time for self-education, accessible educational resources and tools, annual evolution of competencies - to be relevant, with a mean of 4.12.

Conclusion

The study concluded that the barriers preventing the handling of AMR could be overcome through allowing pharmacists more time for self-directed continuous education, providing access to tools and online educational resources, and offering pharmacists funded courses to equip them with the knowledge, skills and competencies needed to handle AMR.

An evaluation of the psychological impact of COVID-19 and the precautionary measure of social isolation on adults in the Asir region, Saudi Arabia

BACKGROUND

The COVID-19 outbreak is worrying for people and society. The aim of this study is to evaluate the psychological impact of the COVID-19 pandemic and the precautionary measure of social isolation on adults in the Asir region of Saudi Arabia.

METHODS

A descriptive cross-sectional survey design was carried out in the Asir region for a period of 5 months from May 2020 to September 2020 to assess the psychological response of the adult population during the COVID-19 pandemic using an anonymous online questionnaire. The questionnaire was adapted from previous research and involved three sections, namely sociodemographic data, Patient Health Questionnaire-9 (PHQ-9) and the Generalised Anxiety Disorder Scale (GAD-7 Scale). A total score of ≥10 indicates depression and anxiety. Data were analysed using SPSS V.25.

RESULTS

Females had higher rates of COVID-19 depression than males. There was a significant correlation between age and home setting and anxiety, and a significant association between marital status and the level of education and depression. There was a significant association between gender and depression and anxiety, while there was no significant association between occupation and income, and depression and anxiety.

CONCLUSION

The findings of the study clearly show that depression and anxiety are highly prevalent among adults. Females had higher rates of COVID-19 depression and anxiety than males. The findings from this study show that implementing a strategy for the prevention and management of depression and anxiety is highly recommended to minimise the impact of these disorders.

Community pharmacists' knowledge, attitude and practice of oral health care in Asir region, Kingdom of Saudi Arabia

OBJECTIVES

To assess community pharmacists' knowledge, attitude and practice towards oral health care in Asir region, Saudi Arabia.

METHODS

A prospective cross-sectional study was carried out using a self-administered structured questionnaire, targeting 254 community pharmacies across the Asir region. The questionnaire consisted of four domains: demographics, knowledge, attitudes and practice related to oral health care. Statistical analysis was performed using Social Sciences (SPSS) version 23.0.

RESULTS

Of the 254 pharmacists, 202 respondents completed the survey, yielding a response rate of 79.5%. Almost two-thirds (66%) of the community pharmacists exhibited good knowledge, 65% possessed a positive attitude, and 55% perceived a good practice towards oral health care. Pharmacists have shown a good understanding on dental care (p < 0.001) and oral conditions. Fifty-five per cent (n = 119) of pharmacists preferred to have dental-based subjects in Pharmacy curriculum.

CONCLUSION

Community Pharmacists possess overall good knowledge and attitude required for the provision of dental care counselling patients. They may participate in oral health development programmes to make a better practice.

Professionalism among Family Medicine Residents in Al Madinah Region, Saudi Arabia

Abstract This was an observational, descriptive, and cross-sectional study conducted among the medical students at UB. Background: Professionalism is the core to sustaining trust between a healthcare provider and the community. Family medicine has an important role in health promotion, prevention and is the first line care which provides service to all age groups; this cross-sectional study was conducted to assess knowledge and attitude among family medicine residents in Al Madinah region. Methods: A structured self-administered web-based questionnaire was adapted from CanMEDs use to assess professionalism. The questionnaire contained five domains: demographics, commitment to patients, commitment to society, commitment to the profession, and commitment to self. 119 out of 161 residents at family medicine training centres in Al Madinah responded by completing the questionnaire, giving 74% response rate. There was 49% male and 51% female participants; most (47%) graduated from Taibah University, followed by 18% from Umm Al-Qura University. Results: findings of commitment towards patients indicated that 75% of participants often or always exhibited appropriate professional behaviour and relationships in all aspects of practice. More than 80% of participants often or always demonstrated a commitment to excellence in all aspects of practice. More than half (58%) of participants often or always recognised and managed conflicts of interest. Findings of commitment toward society showed that more than half (59%) of participants often or always demonstrated accountability to patients, society and the profession by responding to societal expectations of physicians always or often. Findings of commitment revealed that 68% of participants often or always fulfilled and adhered to the professional and ethical codes, standards of practice, and laws governing practice. Findings of commitment to oneself showed that 60% of residents often or always exhibited self-awareness and managed influences on personal well-being and professional performance. About two-thirds (65%) often or always managed personal and professional demands for a sustainable practice.

Use of Complementary and Alternative Medicine Among Hemodialysis Patients in the Southern Region of Saudi Arabia: A Cross-Sectional Study

Due to its perceived safety and ease of access, complementary and alternative medicine has gained great popularity around the world for the self-management of a disease, including end-stage renal disease. The current study was conducted to determine the prevalence and types of complementary and alternative medicine used among the end-stage renal disease patients receiving hemodialysis in the southern region of Saudi Arabia. The study employed face-to-face interviews of patients with end-stage renal disease undergoing hemodialysis at three outpatient renal centers in the southern region of Saudi Arabia from November 2019 to January 2020. Of the 331 participants interviewed, 166 (50.1%) reported the use of complementary and alternative modalities. Of the complementary and alternative approaches used, herbal remedies were the most common (80%), followed by Quran recitation (40.8%), Zamzam water (29.9%), and honey (24.5%). Most patients used botanical-based therapies, such as herbal medicine that necessitates need for better understanding of the possible mechanism for better communication between the patients and healthcare providers. Patient education on the potential risks/benefits of different complementary and alternative modalities and herbal drug/disease interactions should be offered by healthcare professionals.

A cross-sectional study on prescribing and dispensing errors at a corporate hospital in South India

BACKGROUND

The substantial and increasing use of medications escalating the risk of harm globally. The serious medication errors in hospital and community settings resulting from patient injury and death. Hence, a cross-sectional study was aimed to analyse the prescribing and dispensing errors in the outpatient departments of a south Indian hospital.

MATERIALS AND METHODS

A prospective cross-sectional study was carried out to evaluate the prescribing, and dispensing errors in outpatients who seek patient counseling at the tertiary care multispecialty hospital. The data were collected from various sources such as patient's prescriptions and dispensing records from the pharmacy.

RESULTS

A total of 500 prescriptions were screened and identified 65.60% of prescriptions with at least any one type of medication errors. Out of 328 prescriptions, 96.04% were handwritten and 3.96% were computerised prescriptions. Among the 328 prescriptions with medication errors, 32.62% noticed prescribing errors, 37.80% with dispensing errors, and 29.58% with both prescribing and dispensing errors. Out of these 328 prescriptions, 74.09% prescriptions were found to have polypharmacy.

DISCUSSION

Medication errors are serious problems in healthcare and can be a source of significant morbidity and mortality in healthcare settings. The present study showed that dispensing errors were the most common among the types of medication errors, in these particularly wrong directions were the most common types of errors.

CONCLUSION

This study concludes that the overall prevalence of medication errors was around 80%, but there were no life-threatening events observed. A clinical pharmacist can play a major role in this situation appears to be a strong intervention and early detection and prevention of medication errors and thus can improve the quality of care to the patients.

Assessment of Psychological Distress among the General Public in Saudi Arabia during the Coronavirus Disease-19 Pandemic

Background: COVID 19 and its preventative measures have disrupted people's day-to-day lives and jobs and consequently had an impact on their health and wellbeing. Studies have revealed high levels of depression, anxiety and sleep disorders. The main aim of this study was to determine the prevalence of psychological distress among the general public during the COVID-19 pandemic. In addition, it aimed to determine the characteristics of highly susceptible population.   Methods: A prospective cross-sectional study using an online self-administered questionnaire gathering sociodemographic information and using the Kessler scale, which measures psychological distress. A total of 1,058 people agreed to participate in the study and completed the questionnaire.   Results: The study findings showed that 48.6% (n=514) of the study’s respondents were psychologically distressed, i.e. either in the high or very high distress category. Significantly higher ratings of psychological distress were observed among female participants, younger adults, those who self-reported poor health status, single persons, students, individuals with caring responsibilities and those who have no access to a private outdoor space. This distress was also found among those who have been in close or indirect contact with an individual with confirmed COVID-19 infection, P< 0.05. Conclusion: Psychological distress has been widely prevalent among the general public in Saudi Arabia during the COVID-19 pandemic. The Saudi government and the health authorities should pay special attention to the highly susceptible population and implement effective strategies to preserve and improve the mental health and wellbeing of these individuals.  

Using a Global Systematic Framework Tool to Identify Pharmacy Workforce Development Needs: A National Case Study on Saudi Arabia

Background

Healthcare is one of the key focuses of the Saudi Vision 2030. Identifying and acknowledging the strengths and weakness of the healthcare manpower, including pharmacy, are crucial for workforce development and for achievement of the vision.

Methods

This paper used a global systematic framework tool, the International Pharmaceutical Federation the International 21 Development Goals (FIP DGs), as a roadmap to identify pharmacy workforce development needs.

Results

An increase in the number of qualified Saudi pharmacy employees was successfully achieved by increasing the number of pharmacy education institutions. Several postgraduate pharmacy programs (Master’s and Ph.D.) were also established. Some pharmacy colleges around the country obtained national and international accreditation/certification from reputable quality assurance organizations, such as the NAAA, ACPE and CCAPP. Clinical pharmacy residency programs were expanded to cover various specialties. No comprehensive competency framework exists for pharmacists in Saudi Arabia. A wide range of CDP programs, including electronic courses, have been offered for healthcare practitioners and accredited by SCFHS. While a certain number of CME hours are required for re-registration as a pharmacist, these CME hours are currently not linked to a needs-based health initiative. Several initiatives and strategies have been developed and implemented to address pharmaceutical workforce gender and diversity balances. The pharmacy profession is regulated by the MOH, the SCFHS, and the HRSD.

Discussion and Conclusion

Among the three clusters of the DGs – Academia, Professional Development, and Systems – Cluster 2, Professional Development, was identified as a priority area for improvement. Within this cluster, these particular DGs were selected as top priority: competency development (DG 5), leadership development (DG 6), and working with others (DG 8). Two DGs in Cluster 3, Systems, were also highlighted as priorities: continuing professional development strategies (DG 9) and impact and outcome (DG 11).

Using Design Thinking Principles to Improve Outpatients' Experiences in Hospital Pharmacies: A Case Study of Two Hospitals in Asir Region, Saudi Arabia

Introduction: Design thinking, an innovative problem-solving approach, has gained wide popularity in healthcare disciplines. The aim of this work is to improve outpatients' experiences in hospital pharmacies in two hospitals in Asir region, Saudi Arabia. Methods: The design thinking approach, adopted from Stanford University's D-School, was used in this study. Results: Several problems were identified: lack of comfortable environment in the pharmacies' waiting area, lack of a queue management system, and workflow inefficiencies related to ordering and supplies of medicines. A prototype was proposed to overcome these challenges. Discussion and Conclusion: The design thinking approach helped in identifying end-user (patients visiting outpatient pharmacies) values and desires and provided an understanding of their struggles. It also proposed tailored solutions that could improve patients' experiences while using the services of the outpatient pharmacies.

Pharmacological Efficacy of Ginseng against Respiratory Tract Infections

Respiratory tract infections are underestimated, as they are mild and generally not incapacitating. In clinical medicine, however, these infections are considered a prevalent problem. By 2030, the third most comprehensive reason for death worldwide will be chronic obstructive pulmonary disease (COPD), according to the World Health Organization. The current arsenal of anti-inflammatory drugs shows little or no benefits against COPD. For thousands of years, herbal drugs have been used to cure numerous illnesses; they exhibit promising results and enhance physical performance. Ginseng is one such herbal medicine, known to alleviate pro-inflammatory chemokines and cytokines (IL-2, IL-4, IFN-γ, TNF-α, IL-5, IL-6, IL-8) formed by macrophages and epithelial cells. Furthermore, the mechanisms of action of ginsenoside are still not fully understood. Various clinical trials of ginseng have exhibited a reduction of repeated colds and the flu. In this review, ginseng’s structural features, the pathogenicity of microbial infections, and the immunomodulatory, antiviral, and anti-bacterial effects of ginseng were discussed. The focus was on the latest animal studies and human clinical trials that corroborate ginseng’s role as a therapy for treating respiratory tract infections. The article concluded with future directions and significant challenges. This review would be a valuable addition to the knowledge base for researchers in understanding the promising role of ginseng in treating respiratory tract infections. Further analysis needs to be re-focused on clinical trials to study ginseng’s efficacy and safety in treating pathogenic infections and in determining ginseng-drug interactions.

Patients’ adherence to topical antiglaucoma medications in a tertiary care hospital

Objectives

Adherence to glaucoma medications is a central factor to control intraocular pressure and manage glaucoma effectively. This study aims to assess the level of adherence of glaucoma patients to ocular hypotensive agents and determine factors contributing to non-adherence in the Aseer region.

Methods

This was a single-centre, prospective cross-sectional study carried out in Aseer Hospital, Saudi Arabia. Data were collected through a customized questionnaire adapted from the Morisky, Green and Levine Medication Adherence Questionnaire (MGLS).

Key findings

Of the 102 glaucoma patients, 63 (61.8%) were non-adherent to their glaucoma medications. About 48 (76.2%) of them reported that they have no background information about glaucoma. Older participants (37, 58.7%; &gt;50 years) showed a low adherence level compared with the younger individuals. Contributing factors to non-adherence include forgetting the dose time (32, 50.8%), illiteracy (31, 49.2%; P = 0.313), economic problems (26, 41.3%; P = 0.286) and lack of information about prescribed medications (15, 23.8%; P = 0.188).

Conclusions

No significant relationship was found between medication adherence and patient’s demographic data or their background knowledge about glaucoma. Despite the need for improving the glaucoma patient’s knowledge of their disease and the importance of medication adherence, an additional strategy as alerts by smartwatches should be encouraged to improve the adherence level.

Sickle cell disease patients' health-related quality of life in the southern region of Saudi Arabia

BACKGROUND

Research that focuses on the health-related quality of life of patients with sickle cell disease remains challenging in Saudi Arabia.

AIMS

This study aims to assess the health-related quality of life of sickle cell disease patients and determine the factors that contribute to a poorer quality of life in the Asir Region or southern region, compared with other regions in Saudi Arabia.

METHODS

Sickle cell disease patients attending Asir General Hospital and Abu Aresh General Hospital were consecutively invited to enrol in the study from November 2019 to April 2020. The Medical Outcomes Study (SF-36) questionnaire was used to assess the health-related quality of life of patients with sickle cell disease.

RESULTS

This study included 107 individuals (22 males and 85 females) with sickle cell disease, with a mean age of 25 ± 7.851. The mean physical health summary and mental health summary were 60.6 ± 23.4 and 52.12 ± 22.37, respectively. Exercise and family support affected the physical health, mental health and vitality scores positively, while swelling and fever had a negative effect on physical and mental health. Furthermore, more educated patients demonstrated significantly better mental health than uneducated or less educated patients (P = .031).

CONCLUSION

Patients with sickle cell disease exhibited a poor health-related quality of life. Interventions such as a comprehensive center for sickle cell disease should consider improvements in health-related quality of life important outcomes.

COVID-19 Vaccine Hesitancy among Young Adults in Saudi Arabia: A Cross-Sectional Web-Based Study

Ending the COVID-19 pandemic requires achieving herd immunity, either by previous infection or by vaccination. However, concerns about the COVID-19 vaccine are growing around the globe. The current study was conducted to investigate young the adult population's hesitancy towards the vaccine. The study used a prospective cross-sectional design. Data was collected using an online self-administered questionnaire. A total of 862 Saudi adults participated. Information was gathered on the participants' perspectives towards the severity and susceptibility of the COVID-19 infection, reasons for their hesitancy to receive the vaccine, perceived benefits, and reasons for action. Just under a quarter (19.6%) of respondents had previously tested positive for COVID-19. A small minority of the participants had already received the vaccine (2.1%), while 20.3% had registered in the Sehaty app (application) to receive the vaccine. Just under half of them (48%) will take the vaccine when mass vaccination is achieved and approximately the same number (46.7%) will only take it if it is made mandatory. Vaccine reluctance is highly prevalent among the general public in Saudi Arabia during the COVID-19 pandemic. While many are aware of a high likelihood of getting the infection, the efficacy and safety of the COVID-19 vaccine were reported as barriers to vaccination.

Attitudes and Awareness of Complementary and Alternative Medicine Use Among Adults in the Asir Region, Saudi Arabia: A Web-Based Cross-Sectional Study

The use of complementary and alternative medicine has earned great popularity in Saudi Arabia. However, its use in the adult population of the Asir region of Saudi Arabia remains to be examined. The present study aimed to explore adults' use, attitudes, and awareness of complementary and alternative medicine in this region of Saudi Arabia. A cross-sectional online survey using a structured questionnaire was conducted on a convenience sample of adult residents in the Asir region. The results showed that the most commonly used type of complementary and alternative medicine included natural products such as honey and olive oil followed by herbs and religious/spiritual healing. Residents of this region showed a high level of awareness regarding complementary and alternative medicine in general, but awareness could be raised, particularly among those using complementary and alternative medicine for progressive medical conditions.

Aetiology and antimicrobial susceptibility pattern of bacterial isolates in community acquired pneumonia patients at Asir region, Saudi Arabia

BACKGROUND

Community acquired pneumonia is a commonly presenting respiratory tract infection around the world. Its treatment is problematic at times because of diversity of infecting organisms and change in susceptibility pattern to commonly prescribed antimicrobials.

METHODS

This was a single centred prospective cross sectional study. About 165 patients diagnosed with community acquired pneumonia were included and blood samples, sputum samples were taken for culture sensitivity and antimicrobial susceptibility.

RESULTS

Of the 165 patients (43% males and 57% females), 77 (46.6%) patients tested positive for bacterial pathogens out of a total of 165. The most common pathogen was Streptococcus pneumonia (34%) followed on by Hemophilus influenza (16%), Staphylococcus aureus (13%) Klebsiella (12%), Pseudomonas aeruginosa (10%), Legionella (6%), Eschericha coli (5%) and Proteus mirabilis (2%). The sensitivity pattern of all 77 bacterial isolates was high for cephalosporins (ceftriaxone, 81%; ceftazidime, 80%), penicillins (amoxicillin/sulbactam, 70%), quinolones (levofloxacin, 74%) and aminoglycosides (amikacin, 80.5%). The sensitivity to macrolides (azithromycin, 59.7%; clarithromycin, 53.2%) and tetracycline's (55.8%) is somewhat intermediate and low for ampicillin (42.8%) and cotrimoxazole (51.9%).

CONCLUSION

The decreased susceptibility to macrolides and tetracyclines is a matter of concern and judicious use of antimicrobials should be done to prevent further rates of resistance.

Flavonol Glycosides: In Vitro Inhibition of DPPIV, Aldose Reductase and Combating Oxidative Stress are Potential Mechanisms for Mediating the Antidiabetic Activity of Cleome droserifolia

Diabetes is a major health problem that is associated with high risk of various complications. Medicinal plants hold great promise against diabetes. The traditional use of Cleome droserifolia as an antidiabetic agent was correlated to its flavonol glycosides content. In the current study, five major flavonol glycosides appeared on the RP-HPLC chromatogram of the aqueous extract namely; quercetin-3-O-β-d-glucosyl-7-O-α-rhamnoside (1), isorhamnetin-7-O-β-neohesperidoside (2), isorhamnetin-3-O-β-d-glucoside (3) kaempferol-4'-methoxy-3,7-O-α-dirhamnoside (4), and isorhamnetin-3-O-α-(4″-acetylrhamnoside)-7-O-α-rhamnoside (5). The inhibitory activities of these compounds were tested in vitro against several enzymes involved in diabetes management. Only the relatively less polar methoxylated flavonol glycosides (4, 5) showed mild to moderate α-amylase and α-glucosidase inhibitory activities. Compounds 1-4 displayed remarkable inhibition of dipeptidyl peptidase IV (DPPIV) enzyme (IC50 0.194 ± 0.06, 0.573 ± 0.03, 0.345 ± 0.02 and 0.281 ± 0.05 µg/mL, respectively) comparable to vildagliptin (IC50 0.154 ± 0.02 µg/mL). Moreover, these compounds showed high potential in preventing diabetes complications through inhibiting aldose reductase enzyme and combating oxidative stress. Both isorhamnetin glycoside derivatives (2, 3) exhibited the highest activities in aldose reductase inhibition and compound 2 (IC50 5.45 ± 0.26 µg/mL) was even more potent than standard quercetin (IC50 7.77 ± 0.43 µg/mL). Additionally, these flavonols exerted excellent antioxidant capacities through 2, 2-diphenyl-1-picrylhydrazil (DPPH) and ferric reducing antioxidant (FRAP) assays.

Knowledge, attitude, perception and practice of antibiotics usage among the pharmacy students

BACKGROUND

Resistance to antibiotics causes negative impact on health of the patients. Antibiotic resistance is the major global concern that has to be nullified for the better health outcome. The knowledge on antibiotics is very essential for the students who undertake pharmacy and health science courses. Hence a study was aimed to assess the level of knowledge, attitude, perception and practice on antibiotics usage among the pharmacy students of King Khalid University, KSA.

MATERIALS AND METHODS

A prospective online questionnaire based survey was carried out among the pharmacy students about knowledge, attitude perception and practice of antibiotics using 5-point "Likert scale" and true/false responses. The responses range from strongly agree to strongly disagree, and always to never were recorded. The data were analysed by using simple descriptive statistics.

RESULTS

Out of 300 students approached 212 responded and the response rate was found to be 71%. In this study, most (95%) of the students were aware of the emerging problem of antibiotic resistance due to inappropriate use of antibiotics. Majority (89%) of the students agreed the inappropriate use of antibiotics can increase the overall cost of treatment. However, over half of the (54%) students were not aware of the antibiotic resistance that may be a nation-wide problem of Kingdom of Saudi Arabia. The net positive response (NPR) and net other response (NOR) of all items in perception on antibiotics received more or less equal responses.

CONCLUSION

The knowledge of antibiotics usage among the students are considerably good compared with previous studies. However, the attitude, perception and practice on antibiotics usage among the pharmacy students are very poor. It alarms the need of appropriate education to enlighten antibiotic awareness for the better disease prevention and health outcomes for the benefit of patient community.

Review on the coronavirus disease (COVID-19) pandemic: Its outbreak and current status

BACKGROUND

In late December 2019 and on 1st January 2020, the coronavirus (COVID-19) infecting humans was first identified in Wuhan, Hubei Province, China. Later cases have also been confirmed worldwide. Coronaviruses are RNA viruses that are phenotypically and genotypically diverse. Globally, as of 6th April 2020, laboratory confirmed cases of COVID-19 reported to the World Health Organisation (WHO) amounted to 1 211 214, including 67 666 deaths.

AIM

In the current study, we performed a literature review on coronavirus outbreak to summarise details about the pathogenesis, epidemiology, diagnosis and the management strategies for the disease control.

PATHOGENESIS

Coronaviruses are tremendously precise and mature only in differentiated respiratory epithelial cells, as seen in both organ cultures as well as human volunteers. This virus will cause the antiviral T-cell response to be erratic, owing to the T-cell apoptosis activation, triggering the immune system to collapse.

TRANSMISSION

The understanding of the transmission of COVID-19 risk is incomplete. The transmission mainly occurs through the respiratory droplets once an infected person sneezes, like the spread of flu and other respiratory infectious agents.

CLINICAL PRESENTATION

Presentations of COVID-19 includes fever, cough, shortness of breath, malaise and respiratory distress.

TREATMENT

There have been no approved vaccines available for COVID-19 until today. The Ministry of Science and Technology in the People's Republic of China declared three potential antiviral medicines suitable for treating COVID-19. Those three medicines are, namely, favilavir, chloroquine phosphate and remdesivir. Hydroxychloroquine combined with azithromycin enhances the reduction of the viral load in COVID-19 patients.

CONCLUSION

The corona virus transmits quicker than its two predecessors the MERS-CoV and SARS-CoV, but has reduced casualty. The global effects of this latest pandemic are still unclear. Nevertheless, considering that so far no vaccine has been available; preventive approaches are the best way to fight against the virus.

The Effects of the 2019 Novel Coronavirus Disease (COVID-19) Outbreak on Academic Staff Members: A Case Study of a Pharmacy School in Saudi Arabia

BACKGROUND

The 2019 coronavirus disease (COVID-19) pandemic has required governments to implement preventive policies to control the spread of the virus. Temporarily closing schools and other educational institutions has been adopted in many countries, including Saudi Arabia. This study aimed to assess academic staff satisfaction with suspending face-to-face teaching and turning to web-based education. Additionally, this study assessed how the suspension of face-to-face classes has affected the administrative work, research, and community at the College of Pharmacy, King Khalid University.

METHODS

This study used a cross-sectional, self-administered, anonymous online questionnaire. A total of 59 academic staff were included.

RESULTS

More than half the participants (55.9%) agreed or strongly agreed that the sudden shift to online education was done smoothly, more than half (57.6%) agreed or strongly agreed that virtual lectures were more flexible than face-to-face lectures, and a majority (79.7%) agreed or strongly agreed that the technology used for online education was reliable. A minority of participants agreed or strongly agreed that research (20.4%), community service (11.4%), and participation in scientific meetings (15.2%) had not been affected by the suspension.

CONCLUSION

Suspending classes without stopping education has been implemented effectively, and administrative work has continued to run smoothly. However, research, community service, and attending scientific meetings have been negatively impacted by the suspension.

Flipping pharmacoepidemiology classes in a Saudi Doctor of Pharmacy program

Purpose: To examine student perceptions towards the flipped classroom approach and its impact on their learning and their course evaluation  when compared to the traditional classroom method.Methods: Five classes of the pharmacoepidemiology course were delivered using the flipped classroom approach. Student perception towards the flipped teaching method was measured using a satisfaction survey. Measuring the impact of the flipped classroom on student learning and the  student course evaluation was achieved by comparing the midterm grades and the results of the standard endof- course evaluations with the previous semester's cohort.Results: Students’ perceptions of the flipped classroom were mostly favourable. The course and its various components were viewed more favourably in the second semester than in the first semester. Statistically significant improvements were observed in the perception of the topics covered in the course (p = 0.045), fairness of the grade assessment (p = 0.004), and perception of course feedback (p = 0.021). No statistical  difference was noted between the midterm examination scores of the first semester cohort (24.53 ± 3.80) and the second semester cohort (25.15 ± 3.00); [t (22.54) = 0.53, p =0.3].Conclusion: This study demonstrates that using the flipped classroom approach for teaching pharmacoepidemiology can improve student satisfaction, as well as maintain their academic performance. Keywords: Flipped classroom, Pharmacy education, Blended learning

Effectiveness of nasal continuous airway pressure therapy in patients with obstructive sleep apnea

OBJECTIVES

A prospective observational study was carried out with the aim of evaluating the effectiveness of nasal continuous positive airway pressure (nCPAP) therapy on the health-related quality of life (QoL) of patients with obstructive sleep apnea (OSA).

METHODS

The patients included in this study were those recently diagnosed with OSA (AHI > 5) and given nCPAP therapy, as well as being referred to a sleep laboratory for an assessment of their sleep disordered breathing. Prior to the start of nCPAP therapy and polysomnography evaluation, patients were asked to complete the validated Quebec sleep questionnaire (QSQ), and their baseline measurements were recorded.

RESULTS

Among the study population, 14.41% (n = 31) had mild OSA with an apnea and hypopnea index of 5 to 14.9 events/h, while 26.97% (n = 58) had moderate OSA and 40% (n = 86) had severe OSA. The overall average apnea and hypopnea index of the study population was 30.24 ± 9.73 events/h; mild OSA patients had an average apnea and hypopnea index of 10.09 ± 2.65 events/h, moderate OSA patients had 21.48 ± 4.40 events/h, and severe OSA patients had 59.16 ± 22.14 events/h. A significant difference was observed between the scores before treatment and after 6 months of therapy in all domains of the QSQ QoL scores (P < 0.0001).

CONCLUSION

Nasal continuous positive airway pressure treatment improved the QoL for patients with mild, moderate, and severe sleep apnea.

Pharmacy students' perceptions towards online learning in a Saudi Pharmacy School

Objectives

The aim of the study was to evaluate previous exposure to online learning and preference for learning through pre-recorded online lectures with or without live active learning among pharmacy students in their fifth year.

Methods

An anonymous online survey was self-administered to fifth-year students enrolled on the Graduation Research Project Course.

Results

The response rate was 100%. Ninety-seven percent of students had previous experience with at least one online course during their pharmacy undergraduate curriculum; 76% of the courses were science courses. The majority of respondents preferred face-to-face, in-class lectures to online lectures, but 17% expressed no preference.

Conclusion

Pharmacy students expressed some interest in online learning methods within the pharmacy curriculum.