RESUMO
Introduction: Doctor of Pharmacy (PharmD) programs offer students' academic coursework and Advanced Pharmacy Practice Experiences (APPEs). APPEs are crucial for students, providing hands-on training in practice settings and enhancing clinical skills and decision-making abilities. Nevertheless, successful APPEs relies mainly on preceptorship. Hence, this study aims to evaluate preceptorship during APPEs in one of the non-major cities in Saudi Arabia. Method: A Cross-Sectional survey study was conducted among 40 PharmD students at Taibah University's College of Pharmacy which involved two telephone interviews conducted seven months apart. The survey instrument consisted of 46 questions divided into eight sections which covered various aspects such as demographics, clarity of rotation objectives, clinical and communication skills, assessment of the training and learning opportunities, preceptors' feedback and evaluation, interaction with patients, healthcare providers, and preceptors. Descriptive statistics and Cronbach's alpha coefficient were utilized to analyze the collected data and to assess the internal consistency of the multi-item Likert questions. Results: Preceptors were predominantly male, aged 26-35, with extensive experience in pharmacy practice and mentorship, yet they lacked specialized post-graduate training or education certification. Almost 50% of the preceptors exhibited competence in pharmacotherapy-related science, demonstrated a willingness to teach students and acknowledged the students' knowledge and skills. Furthermore, most of the students reported understanding of the APPEs objectives as the internship progressed. However, only 15% of late rotation participants strongly agreed on the safety of the learning environment, adequate time and regular contact with their preceptors. Starkly, only 3.0% of early rotation students and 6.1% of late rotation students strongly agreed with the improvement of their written and verbal communications. Conclusion: This study reported a noted decline in perceived learning support and environment safety as the APPEs' year progressed. Feedback and communication skills development were areas of concern, with limited satisfaction reported. The study highlights regional disparities in training quality, emphasizing the need for structured learning experiences and re-evaluation of preceptorship. Future research should aim to better understand the challenges associated with APPEs in non-major cities and rural areas, thereby making significant contributions to the enhancement of the pharmacy profession.
RESUMO
Background: Migraine is often associated with depression and anxiety, leading to a diminished quality of life. Calcitonin gene-related peptide (CGRP) antagonists have shown promise in treating migraines, but their effects on concurrent depression and anxiety have not been clarified. Methods: A literature review was conducted on ClinicalTrials.gov, PubMed, Ovid Medline, and EMBASE focusing on phase 3 clinical trials, post-hoc analysis studies, and real-world evidence (RWE) published in the past 5 years. The review primarily utilized patient-reported outcome tools, such as the Patient Health Questionnaire-9, Hamilton Depression Rating Scale, Beck Depression Inventory-II, generalized anxiety disorder (GAD)-7, and Hamilton Anxiety Rating Scale (HARS), to assess anxiety and depression in relation to CGRP-targeted monoclonal antibodies. Results: Out of 260 studies, 17 met the inclusion criteria. Eptinezumab lacked sufficient evidence regarding its impact on depression and anxiety. While sufficient evidence on its effect on comorbid anxiety was not available, fremanezumab was shown to significantly improve comorbid depression in one study while not achieving statistical significance in another. Erenumab and galcanezumab showed significant improvement in comorbid depression, implying possible benefits in patients with migraine. Galcanezumab showed faster relief from depressive symptoms than other injectable CGRP antagonists. Galcanezumab also exhibited improvements in GAD-7 scores for anxiety, although not statistically significant, whereas RWE showed promising HARS scores for both galcanezumab and erenumab. Conclusions: Galcanezumab and erenumab appear to be more effective in improving concurrent depressive and anxiety symptoms in migraine patients than fremanezumab. Notably, these psychometric questionnaires were not the primary outcome measures of the trials and were not specifically designed to investigate the effects of these medications on depression or anxiety. Further research is needed to fully understand the impact of CGRP antagonists on mental health disorders associated with migraines. These findings have implications for enhancing the overall well-being and quality of life in individuals with migraines and comorbid psychiatric conditions.
RESUMO
Background: Methicillin-resistant Staphylococcus aureus (MRSA) pathogens are considered a serious global health threat, leading to increased mortality and antimicrobial resistance. Rates in Saudi Arabia remain high, necessitating continuous surveillance. This study investigates MRSA prevalence and susceptibility at a Saudi maternity and children's hospital. Method: A cross-sectional study was conducted on pediatric (<18 years) and maternal patients with S. aureus infection from Jan. 2020 to March. 2022. Bacterial strains were obtained from patient's clinical specimens and was identified by standard method. The BD Phoenix™ M50 was used for antibiotic susceptibility tests and MRSA detection. Data were analysed using descriptive and inferential statistics (Chi-square test) with SPSS software. Results: Out of 152 S. aureus cases, 114/152 (75 %) were pediatric and 38/152 (25 %) were maternal patients. The overall MRSA infection was 69/152 (45.4 %). Among pediatrics, 31/54 (57.4 %) MRSA cases were female; over 30/54 (56 %) were under 1 year old; and most MRSA infections were obtained from skin 29/54 (53.7 %) compared to other sites of infections (p = 0.024). Among maternal cases, 15/38 (39.5 %) were MRSA, primarily from wound infections 14/15 (93.3 %) compared to other sites of infections (p = 0.39). All MRSA isolates were sensitive to vancomycin and linezolid. While 51/60(85 %) were sensitive to Trimethoprim/ sulfamethoxazole. Conclusion: This investigation found a high prevalence of MRSA among pediatrics and maternal inpatients, indicating a significant burden. All MRSA isolates were susceptible to vancomycin but demonstrated variable sensitivity to other antibiotics. These findings highlight the need for ongoing surveillance, infection control strategies, and research into alternative treatment options to combat this major public health threat.
RESUMO
Objective: To assess the efficacy and safety of the induction chemotherapy's combination of docetaxel, cisplatin, and 5-fluorouracil (TPF) in Oral Squamous Cell Carcinoma (OSCC) patients and its positive outcomes on tumor size and surgical resection. Method: A retrospective chart review of patient's medical records was conducted from 2018 to 2023. All patients diagnosed with OSCC and who received induction chemotherapy combination of TPF were included in the study. Patients with other conditions that affect chemotherapy tolerability, other primary malignancy, or incomplete medical records were excluded. Descriptive analysis was undertaken to summarize the data pertaining to tumors before and after administration of the TPF chemotherapy. Result: Five patients met the inclusion criteria. All five patients experienced a reduction in tumor size after receiving the TPF induction chemotherapy. Three patients showed a downstaging to [stage 0] after surgical resection. Specifically, one patient demonstrated a reduction in overall stage from [IVb] to [IVa] after receiving TPF induction chemotherapy, and two patients demonstrated a noteworthy improvement in N staging, reducing from [N2c] to [N2b]. In contrast, the fourth patient slightly improved after the induction chemotherapy and surgical resection procedures. However, the stage of the fifth patient remained unchanged before and after the treatment approach. Conclusion: The study shows that implementing TPF induction chemotherapy to surgical resection improves clinical outcomes in a subset of patients with advanced OSCC without any harmful consequences.
RESUMO
In the Kingdom of Saudi Arabia, there is an increasing demand for community pharmacists to provide the highest level of clinical knowledge and services. However, evidence regarding Saudi public awareness of the clinical services offered by community pharmacies (CPs) and the barriers to using them is limited. In this cross-sectional study, we used an online questionnaire developed by adapting the Consolidated Framework for Implementation Research. A total of 273 participants completed the survey. Half the participants were generally aware of the availability of some CP services but were not informed about the full range on offer, eg, medication reviews (84%) and online counseling (89%). Most of the participants (69.6%) did not identify differences in the care provided by community pharmacists versus hospital pharmacists (P = 0.02). A commonly reported barrier to using CP services was a general preference for other healthcare professionals to seek pharmaceutical help (85.7%). Many other barriers were also reported, impacting the participants' use of these services. The decision-making authorities should consider improvements to increase patients' awareness and utilization of clinical services and enhance community pharmacists' performance in clinical-oriented pharmaceutical care.
RESUMO
Introduction: Entrepreneurship has recently become a focus in community development, innovation, and economic growth, including within pharmaceutical organizations. However, it remains a relatively new aspect of pharmacy education. For the effective incorporation of entrepreneurship in this field, a robust educational foundation is critical, one that emphasizes risk-taking, strategic planning, competitive spirit, and a sense of social responsibility. This study aims to evaluate Saudi pharmacists' attitudes towards entrepreneurship in their practice. Methods: A cross-sectional survey design to assess the attitudes of pharmacists and pharmacy students in Saudi Arabia towards entrepreneurship. The study sample consisted of 302 individuals, selected through convenience sampling, all of whom were either licensed pharmacists or pharmacy students in Saudi Arabia. The survey was conducted electronically and disseminated online throughout the duration of January 2023, spanning a one-month period. The research sought to provide a deeper understanding of how entrepreneurship is perceived within the pharmacy field. Results: The study involved 302 pharmacists in Saudi Arabia, with the majority being pharmacy students and Doctor of Pharmacy holders. Over 60% of the participants worked for the government sector. Results showed a strong interest in entrepreneurship, with nearly 80% expressing interest and believing in the entrepreneurial potential of pharmacists. However, there was a knowledge gap, as only 52% were familiar with entrepreneurship concepts, and most had not taken entrepreneurship courses. More than half of the participants reported insufficient institutional support for entrepreneurship. Remarkably, only 1% had started a pharmaceutical business. Conclusion: In conclusion, this study emphasizes the interest in entrepreneurship among pharmacists, highlighting the need for raising familiarity and formal education in the field. Factors such as working in the government sector were associated with higher willingness to become entrepreneurs, while the lack of awareness and institutional support hindered the entrepreneurial mindset.