Ethnopharmacological Study of Medicinal Plants Used in the Treatment of Skin Burns in the Arab World.

Traditional healers are often practiced in rural areas owing to cultural beliefs and are known to provide various forms of healthcare and home remedies. Patients in the Mediterranean region rely on traditional medicine to cure a variety of health concerns, like skin burns. This study was conducted to identify the various practices used by traditional healers for treating skin burns. The survey was conducted in 18 Arab countries, including Syria, Iraq, Jordan, Saudi Arabia, Egypt, United Arab Emirates, Algeria, Bahrain, Palestine, Kuwait, Oman, Qatar, Lebanon, Yemen, Tunisia, Oman, Morocco, and Sudan. Between September 2020 and July 2021, an online questionnaire was administered to 7530 participants from 12 Asian and 5 African countries. The survey was designed to gather information from common medicinal plant users and herbalists on their practices as specialists in using various herbal and medicinal plant products for diagnosis and treatment. Among the participants, 2260 had a scientific background in plant application, and the study included one phytotherapeutic professional. The crude-extraction technique was favored, by Arabic folk, for plant preparation over the maceration and decoction method. Olive oil was the most commonly used product among participants as an anti-inflammation and for scar reduction. Aloe vera, olive oil, sesame, Ceretonia siliqua, lavender, potato, cucumber, shea butter, and wheat flour are used as crude drugs to reduce pain because of their analgesic and cooling effects. The present study is the first database of medicinal plants with burn-healing properties conducted in Arab countries. These plants can be employed in the search for new bioactive substances through pharmacochemical investigations, as well as in the development of new formulations containing a combination of these plants.

Semaglutide for the treatment of type 2 Diabetes Mellitus: A systematic review and network meta-analysis of safety and efficacy outcomes.

BACKGROUND AND AIMS: To assess the safety and efficacy of semaglutide compared with placebo and other anti-hyperglycaemic agents in type 2 diabetes (T2DM). METHODS: We searched PubMed, Scopus, Web of Science, and Cochrane library for relevant randomized controlled trials (RCTs). A network meta-analysis was conducted to compare different doses, durations, and interventions in T2DM. We presented results as mean difference (MD) or relative risk (RR) and 95% confidence interval (CI). RESULTS: Twenty-six included RCTs studied different doses of subcutaneous (SC) and oral semaglutide, tirzepatide, liraglutide, sitagliptin, canagliflozin, and empagliflozin compared with placebo. Tirzepatide showed the highest efficacy, however, it was comparable to semaglutide. SC semaglutide 1 mg once-weekly showed higher reduction in HbA1c (MD = -1.72, 95% CI [-2.32; -1.12]), and fasting blood glucose (MD = -1.93, 95% CI [-2.81; -1.04]) versus placebo at 30 weeks and other timepoints. Adverse events (ADs) were comparable to placebo with oral and SC semaglutide, oral sitagliptin, SC liraglutide, and oral empagliflozin at most timepoints. However, SC semaglutide 0.8 mg and tirzepatide 10 mg groups had the highest gastrointestinal adverse events. CONCLUSION: Tirzepatide, oral and SC semaglutide has a favourable efficacy in treating T2DM. The adverse events were comparable to placebo; however, gastrointestinal adverse events were highly recorded in tirzepatide, oral and SC semaglutide groups.

Restless Leg Syndrome in Hemodialysis Patients: A Narrative Review.

BACKGROUND: Restless legs syndrome (RLS) is a clinical entity characterized by sensory-motor manifestations commonly observed in end-stage renal illness. Evidence suggests that RLS is a multifactorial phenomenon that can be influenced by many critical factors, including genetic predisposition, dietary patterns, and deficiency in some vitamins. Iron metabolism disorders and metabolic derangements have been generally accepted as predisposing elements in RLS. Furthermore, both pharmacological and neuroimaging studies demonstrated dopamine deficiency and dopamine receptors decrease in basal ganglia during RLS. REVIEW SUMMARY: A literature search was done in three databases (PubMed, Google Scholar, and Cochrane) to identify the pertinent articles discussing the epidemiology, pathogenesis, and management of RLS in hemodialysis patients. RLS can affect the morbidity and mortality of patients treated with dialysis. It also has significant impacts on the quality of life since it can lead to insomnia, increased fatigue, mental health troubles, and other movement problems. Appropriate measures should be considered in this particular population so to prevent and treat RLS. Many drugs and other nonpharmacological methods have been investigated to attenuate the disease's severity. No treatment, however, could offer long-term effects. CONCLUSION: Further efforts are still required to improve the understanding of RLS pathogenic trends to find more specific and efficient therapies. A wide range of treatment options is available. However, it can be individualized according to the patients' several factors.

Attitudes of midwives and obstetricians towards midwives practiced roles in hospitals: A national study in Jordan.

AIMS: The aims of this study were to identify midwives' and obstetricians' attitudes towards midwives practised roles in hospitals and to identify the differences in their attitudes towards midwives practiced roles. MATERIALS AND METHODS: A descriptive, cross-sectional, study design was used. A convenience sample of 303 midwives and 143 obstetricians were recruited. Participants were from 12 Ministry of Health (MOH) and Royal Medical Services (RMS) hospitals distributed across seven governorates. Two reliable and valid self-administered questionnaires were used to collect data including socio-demographic data-related characteristics of participants and obstetricians' and midwives' attitudes towards midwives' practiced role in hospitals. RESULTS: There were significant differences between obstetricians in the three subscales of attitudes: midwives women relationship attitude subscale, midwives trust and mutual respect subscale and work environment attitudes subscale. A significant difference by the institution was reported: obstetricians and midwives who worked in MOH reported more positive attitudes than those who worked in RMS. CONCLUSION: The results show that obstetricians recognise that midwives are qualified and competent professionals but still lack the competencies/skills to make them independent practitioners. The findings also confirm the need to improve midwives' practices by moving from being able to perform a specific task to possess all three attributes of "competencies," where they can intervene, manage and make decisions with confidence in each situation. IMPLICATION FOR PRACTICE: Based on the current study findings, parallel cooperation between educational/academic policymakers from both midwives and obstetricians may re-evaluate and upgrade the midwifery curriculum to meet the ICM competencies and health sector needs as a step to graduate competent midwives where their responsibility is recognised and organised.

Knowledge, attitudes, and practices regarding antibiotic use and resistance among community pharmacists: a cross sectional study in Jordan.

Background Antibiotic resistance is a global threat and burden on healthcare systems. One major factor contributing to this problem is inappropriate use of antibiotics, which comprises suboptimal use, misuse, abuse, and dispensing errors. Another important factor is dispensing antibiotics without medical prescription. Many studies considered pharmacists as healthcare providers accountable for this malpractice. Objectives To investigate community pharmacists' knowledge, attitudes, and practices in relation to antibiotic dispensing, antibiotic resistance and antibiotic stewardship. Setting Community pharmacists selected from different areas in Amman/Jordan. Subjects were selected based on their availability and accessibility. Methods A descriptive cross-sectional survey of community pharmacists was conducted between May to October 2019, using a structured, validated, and pilot-tested questionnaire. A four-part systematic survey consisting of biography, knowledge, practice and attitude domains was used. Main outcome measure community pharmacist knowledge, practices and attitudes regarding antibiotic use and resistance. Results Of 150 community pharmacists approached, 114 completed and returned the questionnaire (response rate 76%). More than 83.3% perceived antimicrobial resistance as a global problem. A substantial percentage (59.7%) educate patients about issues of inappropriate antibiotics use. Almost half the participants (44.7%) agreed that implementing antimicrobial stewardship would result in better outcomes. Conclusion It is crucial to improve the curriculum in schools of pharmacy, emphasizing on interprofessional education and developing customized interventions. Regulations on dispensing antibiotics without prescription should be enforced. Policy makers need to implement antimicrobial stewardship and encourage the use of public educational interventions in community pharmacy.