Guideline-directed medical therapy in heart failure patients with reduced ejection fraction in Palestine: Retrospective clinical audit study.

Objectives: To assess the characteristics of patients with heart failure with reduced ejection fraction (HFrEF) and heart failure with mid-range ejection fraction (HFmrEF), as well as the current application of guideline-directed medical therapy (GDMT) in Palestine. Methods: This retrospective cohort study involved a population of heart failure (HF) patients who visited cardiology clinics at An-Najah National University Hospital and the National Hospital, Palestine. The primary outcome measures of interest were the proportions of patients prescribed guideline-based cardiovascular medications (GBCMs), such as angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin II receptor blockers (ARBs), ß-blockers, and mineralocorticoid receptor antagonists (MRAs), and the corresponding optimized doses at ≥ 50 % of targets and the reasons underlying the non-prescription of GDMT. Results: A total of 70.5%, 56.6%, and 88.6% of patients were on ACEIs/ARBs, MRAs, and ß-blockers, respectively. Of all patients, 38.7% were on the triple GDMT regimen. Conclusion: Less than half the patients received the triple combination treatment. Age, diabetes mellitus, chronic renal disease, and admission to the hospital for HF all had significant independent relationships with the reduced utilization and inadequate dosage of GDMT.

Social media use is linked to poor sleep quality: The opportunities and challenges to support evidence-informed policymaking in the UAE.

BACKGROUND: This study was conducted among a convenience sample of Ajman University students in UAE between February 2018 and May 2019. METHODS: All undergraduate and master's degree students from the 1st to 5th year of medical and non-medical colleges. The survey was carried out by distributing a pre-designed, pre-structured questionnaire to the students during lectures. The questionnaires were primarily composed of three sections: demographic characteristics, educational characteristics and sleep quality characteristics. The data were analyzed using STATA version 14.2. Logistic regression analysis was used to investigate the association between sleep characteristics, social media use and other significant risk factors. The P-values < 0.05 were considered to be statistically significant. RESULTS: The vast majority of the study participants were social media users, and a considerable proportion suffered from poor sleep quality. A significantly increased risk of bad sleep quality and intermittent/anxious sleep patterns were observed among social media users. CONCLUSION: Health policymakers should fully consider these factors in improving the sleep quality of university students.

Airport-based pharmacies: Products, services and challenges essential for patients in a global travel landscape.

The role of airport pharmacies has grown in recent years to provide a range of services to travelers, including over-the-counter and prescription medicines, as well as advice on prevention of infectious and other diseases. Prevention, including protective equipment, is especially important during pandemics, as seen with the recent coronavirus disease-2019 (COVID-19) pandemic. In addition, offering vaccinations where appropriate. However, this is not universal, and there are currently no acknowledged guidelines for pharmacists operating within airports. In addition, research into their role as well as potential ways to improve this is lacking. This is a concern with community pharmacists playing a valuable role during the COVID-19 pandemic. Potential ways forward include greater research into their activities to enhance their role and address challenges. These include issues of brand names and language, as well as encouraging travel pharmacy in future university curricula. In addition, producing guidelines for their activities and monitoring their implementation. This can help build a greater role for their services, benefiting airport staff and travelers in the future.

Exploring the Gap Between Knowledge and Behavior Regarding Thalassemia Among University Students: A Cross-Sectional Study in the United Arab Emirates.

Thalassemia is humanity's most common genetic disorder and represents a serious healthcare challenge in the United Arab Emirates. Increasing awareness is a crucial part of any successful strategy to prevent thalassemia. This research examined knowledge levels and attitudes regarding thalassemia screening, counseling, and monitoring from medical and nonmedical students at Ajman University. This was a cross-sectional, descriptive study conducted among a convenience sample of Ajman university students in the UAE. A questionnaire was distributed which was composed of three main sections. The first section covered participants' demographic data. The second section covered general knowledge of thalassemia and its screening measures. The third section assessed risk factors, regulations, and preventive measures. The data were analyzed using the statistical package for social sciences (SPSS) version 24. A total of 523 participants completed the whole survey. Generally, there was a good level of awareness of thalassemia and thalassemia screening among participants. Approximately three-quarters of participants (76.5%) agreed that thalassemia screening should be compulsory for the individual and the majority of students and 92.7% recognized the importance of thalassemia screening for both partners. Approximately three-quarters (75.9%) of participants disagreed that fetuses with thalassemia should be aborted. More than half of the participants disagreed that thalassemia carriers and patients should be prevented from marrying each other. Generally, older respondents (final year students), respondents who had dealt with thalassemia patients, and respondents with relatives with thalassemia had more comprehensive knowledge of thalassemia. Campaigns focusing on college and university students should be regarded as an essential element of the thalassemia prevention strategy for contemporary UAE society.

Screening and Determination of Synthetic PDE-5 Inhibitors in Adulterated Sexual Enhancement Supplements.

This paper reports an important investigation and quantification of adulteration of sexual enhancement supplements with prescription medicines available in United Arab Emirates (UAE): tadalafil, sildenafil and vardenafil. A total of 158 sexual enhancement supplements were collected and analyzed in the current study. The samples were screened using REVERSE-phase liquid chromatography tandem high-resolution mass spectrometry/mass spectrometry (RP-HPLC-MS/MS). Of all sexual enhancements, 12.7% (95% CI: 7.4-18) contained undeclared sildenafil, 3.8% (95% CI: 0.78-6.81) contained undeclared tadalafil and 1.9% (95% CI: 0.25-4.05) contained undeclared vardenafil. Of all sexual enhancement supplements, 13.9% (95% CI: 8.5-19.4) contained significant concentrations of sildenafil, tadalafil or vardenafil. While the study found relatively low levels of undeclared pharmaceutical ingredients in the sexual enhancement dietary supplements available on the UAE market, it is likely that patients with ED tend to consume multiple such supplements daily, thereby exposing themselves to highly elevated cumulative levels.

Scale validation for the identification of falsified hand sanitizer: public and regulatory authorities perspectives from United Arab Emirates.

BACKGROUND: Since the time of declaration of global pandemic of COVID-19 by World Health Organization (WHO), falsified hand sanitizers surfaced regularly in markets, posing possible harm to public due to unlisted inclusion of methanol. The current research is an attempt to develop and validate a tool to document falsified hand sanitizer in the UAE community. METHOD: A descriptive cross-sectional community-based study was conducted among 1280 randomly selected participants. Respondents were sent a web-based electronic link to the survey via email. Content validity, factor analyses and known group validity were used to develop and validate a new scale to identify falsified hand sanitizer. Test-retest reliability, internal consistency, item internal consistency (IIC), and intraclass correlation coefficients (ICCs) were used to assess the reliability of the scale. SPSS version 24 was used to conduct data analysis. RESULTS: A total of 1280 participants were enrolled in the study. The content validity index (CVI) was 0.83 with the final scale of 12 items. The Kaiser-Meyer-Olkin (KMO) value was 0.788, with the Bartlett test of sphericity achieving statistical significance (p < 0.001). Our factor analysis revealed a 3-component model. The 3-factor solution was confirmed by PCFA analysis and had associations with good fit values. The PCFA for NFI was 0.970, CFI 0.978, and TLI 0.967. All values were in excess of 0.95, with RMSEA values below 0.06 at 0.03; all of these values indicated a good model fit. The Cronbach's alpha was good overall (0.867). All factors had a Cronbach's alpha value in excess of 0.70. The instrument demonstrated that every item met the IIC correlation standard ≥0.40. The scale displayed good overall ICC statistics of 0.867 (95% CI 0.856-0.877) with statistical significance (p < 0.001). The scale's test-retest reliability was assessed through correlation of the falsified hand sanitizer identification score of respondents at the two time points. The test-retest correlation coefficient was 0.770 (p value < 0.01). Participants with post-graduate education were more likely to identify the falsified hand sanitizer compared to those with high school education. (p < 0.001). CONCLUSIONS: This study developed and validated a new scale for the measurement of falsified hand sanitizer. This is expected to improve and promote collaboration between the health regulators and the public and hereby encourage customer satisfaction and participation.

Predictors of chronic kidney disease survival in type 2 diabetes: a 12-year retrospective cohort study utilizing estimated glomerular filtration rate.

Predicting the course of kidney disease in individuals with both type 1 and type 2 diabetes mellitus (DM) is a significant clinical and policy challenge. In several regions, DM is now the leading cause of end-stage renal disease. The aim of this study to identify both modifiable and non-modifiable risk factors, along with clinical markers and coexisting conditions, that increase the likelihood of stage 3-5 chronic kidney disease (CKD) development in individuals with type 2 DM in the United Arab Emirates (UAE). This was a single-center retrospective cohort study based on data derived from electronic medical records of UAE patients with DM who were registered at outpatient clinics at Tawam Hospital in Al Ain, UAE, between January 2011 and December 2021. Type 2 DM patients aged ≥ 18 years who had serum HbA1c levels ≥ 6.5% were included in the study. Patients with type 1 DM, who had undergone permanent renal replacement therapy, who had under 1 year of follow-up, or who had missing or incomplete data were excluded from the study. Factors associated with diabetic patients developing stage 3-5 CKD were identified through Cox regression analysis and a fine and gray competing risk model to account for competing events that could potentially hinder the development of CKD. A total of 1003 patients were recruited for the study. The mean age of the study cohort at baseline was 70.6 ± 28.2 years. Several factors were found to increase the risk of developing stage 3-5 CKD: advancing age (HR 1.005, 95% CI 1.002-1.009, p = 0.026), a history of hypertension (HR 1.69, 95% CI 1.032-2.8, p = 0.037), a history of heart disease (HR 1.49, 95% CI 1.16-1.92, p = 0.002), elevated levels of serum creatinine (HR 1.006, 95% CI 1.002-1.010, p = 0.003), decreased levels of estimated glomerular filtration rate (eGFR) (HR 0.943, 95% CI, 0.938-0.947; p < 0.001), and the use of beta-blockers (HR 139, 95% CI 112-173, p = 0.003). Implementing preventative measures, initiating early interventions, and developing personalized care plans tailored to address specific risk factors are imperative for reducing the impact of CKD. Additionally, the unforeseen findings related to eGFR highlight the ongoing need for research to deepen our understanding of the complexities of kidney disease.

Prevalence of Anemia in Type 2 Diabetic Patients and correlation with Body Mass Index and Kidney function in Palestine.

Background: The objective of this study was to determine the prevalence of anemia in patients with type 2 diabetes mellitus and to identify the set of anthropometric and biochemical factors that jointly influence the diabetic and anemic patients including body mass index and kidney function. . Methods: A retrospective cross-sectional design study that was carried out in a private medical center in Palestine. The study included a total of 453 patients with type 2 diabetes. Inclusion criteria included all patients (18 years or older) suffering from type 2 Diabetes mellitus attended the diabetic clinic from the 1st of January 2018, till 30th of December 2018. . Results: A total number of 453 diabetic patients were recruited in the study. Male constituted 48.5% (n=220) of the study sample and 51.4% (n=233) were female. Of total 453 diabetic patients, 38.4% (95% CI, 34%-43%) had anemia. The results of statistical modeling showed that female gender (AOR 18.5; 95% CI 9.35-21.97), presence of hypertension (AOR 2.11; 95% CI 1.98- 4.25), high BMI (AOR 1.101; 95% CI 1.045-1.159), high Serum Creatinine (AOR 1.72; 95% CI 1.22-2.13), high BUN level (AOR 1.22; 95% CI 1.145-1.301) and low e-GFR (AOR 0.571; 95% CI 0.271-0.872) are strong determents of anemia in type 2 diabetic patients. . Conclusion: The results of the current study revealed a high prevalence of Anemia among type 2 diabetes Mellitus patients. A significant association was reported between Anemia, kidney functions and body mass index. .

Quantification of p-Phenylenediamine in Hair Dyes and Health Risk Implications in the UAE: Describing Discordances Between Regulations and Real-Life Practices.

Background: p-Phenylenediamine (PPD) has been used over the past five decades as a primary precursor in the production of oxidative hair dyes. Numerous health dangers are associated with the short- and long-term use of PPD, raising concerns about its safety. For instance, mounting data suggests that PPD is linked to dermatitis and allergy cases. Objective: To quantify the PPD content in hair dyes by measuring the PPD concentration after mixing the ingredients of commercial hair dyes. Methods: A total of 290 permanent hair dyes were tested. RP-HPLC-DAD analysis was performed to determine and quantify the PPD content. Results: The estimated mean of the PPD limit was 0.89 (95% CI [0.81-0.96]). Of the 290 tested hair dyes, 7.2% (n = 21) exceeded the recommended PPD concentration after mixing. Significantly more hair dyes manufactured in India and China had a PPD content exceeding 2% after mixing compared to dyes from other regions (P = 0.001). Moreover, hair dyes manufactured in India and the UAE were more likely to have incomplete descriptions of the conditions of use and warnings on the label (P = 0.002). Conclusion: The effectiveness of the current regulations relevant to these products should be reevaluated. Moreover, through the use of good manufacturing procedures (GMPs), research, and the reporting of adverse reactions, hair dyes should be subjected to better control and monitoring in terms of their safety and quality.

Community pharmacist-led point-of-care eGFR screening: early detection of chronic kidney disease in high-risk patients.

Adherence to scheduled physician screenings for renal function monitoring in patients with chronic kidney disease (CKD) or those at high risk remains suboptimal despite the endorsement of regular screenings by several clinical practice guidelines. Our study aims to assess the effectiveness of a point-of-care CKD screening program led by these pharmacists using the PICCOLO device while recognizing the unique position of community pharmacists in primary care. We conducted an 11-month prospective point-of-care interventional research study in the United Arab Emirates to evaluate the performance of a community pharmacist-led CKD screening program for high-risk patients. Six diverse community pharmacies were selected based on staff availability, patient volume, and their offered range of services. Eligible individuals with risk factors for CKD were identified during medication evaluations. The PICCOLO Comprehensive Metabolic Panel facilitated on-site blood analysis, delivering estimated Glomerular Filtration Rate (eGFR) results within 10 to 15 min. Data also included eGFR categories, demographic information, and insights into lifestyle and health habits collected through a questionnaire. Pharmacists conducted comprehensive medication reviews and offered referrals and lifestyle guidance as part of the program. The study encompassed a total of 400 patients, with an average age of 69 ± 13.4 years within the study cohort. Notably, 38.8% (155 individuals) of the 400 patients were found to have undiagnosed CKD stages 3-5. Univariate logistic regression analysis revealed a significant association between a higher incidence of CKD stages 3-5 and factors such as older age, a history of hypertension, vascular disease, and diabetes mellitus. In the multivariate regression model, age and a history of diabetes mellitus emerged as significant predictors of an elevated risk of CKD. This study sheds light on the viability and impact of CKD screening programs conducted by community pharmacists, particularly in detecting CKD stages 3-5. The findings have implications for healthcare policies, as they can influence the enhancement of early detection and management of CKD. Moreover, these insights may catalyze focused screening initiatives and strengthen collaboration between community pharmacies and healthcare systems to benefit patients at high risk of CKD.

Benefit-Risk Assessment of ChatGPT Applications in the Field of Diabetes and Metabolic Illnesses: A Qualitative Study.

Background: The use of ChatGPT and artificial intelligence (AI) in the management of metabolic and endocrine disorders presents both significant opportunities and notable risks. Objectives: To investigate the benefits and risks associated with the application of ChatGPT in managing diabetes and metabolic illnesses by exploring the perspectives of endocrinologists and diabetologists. Methods and materials: The study employed a qualitative research approach. A semi-structured in-depth interview guide was developed. A convenience sample of 25 endocrinologists and diabetologists was enrolled and interviewed. All interviews were audiotaped and verbatim transcribed; then, thematic analysis was used to determine the themes in the data. Results: The findings of the thematic analysis resulted in 19 codes and 9 major themes regarding the benefits of implementing AI and ChatGPT in managing diabetes and metabolic illnesses. Moreover, the extracted risks of implementing AI and ChatGPT in managing diabetes and metabolic illnesses were categorized into 7 themes and 14 codes. The benefits of heightened diagnostic precision, tailored treatment, and efficient resource utilization have potential to improve patient results. Concurrently, the identification of potential challenges, such as data security concerns and the need for AI that can be explained, enables stakeholders to proactively tackle these issues. Conclusions: Regulatory frameworks must evolve to keep pace with the rapid adoption of AI in healthcare. Sustained attention to ethical considerations, including obtaining patient consent, safeguarding data privacy, ensuring accountability, and promoting fairness, remains critical. Despite its potential impact on the human aspect of healthcare, AI will remain an integral component of patient-centered care. Striking a balance between AI-assisted decision-making and human expertise is essential to uphold trust and provide comprehensive patient care.

Regulatory frameworks must evolve to keep pace with the rapid adoption of AI in healthcare. Sustained attention to ethical considerations, including obtaining patient consent, safeguarding data privacy, ensuring accountability, and promoting fairness, remains critical. Despite its potential impact on the human aspect of healthcare, AI will remain an integral component of patient-centered care. The use of ChatGPT in the management of metabolic and endocrine disorders presents both significant opportunities and notable risks. The benefits of heightened diagnostic precision, tailored treatment, and efficient resource utilization have potential to improve patient results. Concurrently, the identification of potential challenges, such as data security concerns and the need for AI that can be explained, enables stakeholders to proactively tackle these issues. Regulatory frameworks must evolve to keep pace with the rapid adoption of AI in healthcare. Sustained attention to ethical considerations, including obtaining patient consent, safeguarding data privacy, ensuring accountability, and promoting fairness, remains critical. Despite its potential impact on the human aspect of healthcare, AI will remain an integral component of patient-centered care. Striking a balance between AI-assisted decision-making and human expertise is essential to uphold trust and provide comprehensive patient care.

Detecting manuscripts written by generative AI and AI-assisted technologies in the field of pharmacy practice.

Generative AI can be a powerful research tool, but researchers must employ it ethically and transparently. This commentary addresses how the editors of pharmacy practice journals can identify manuscripts generated by generative AI and AI-assisted technologies. Editors and reviewers must stay well-informed about developments in AI technologies to effectively recognise AI-written papers. Editors should safeguard the reliability of journal publishing and sustain industry standards for pharmacy practice by implementing the crucial strategies outlined in this editorial. Although obstacles, including ignorance, time constraints, and protean AI strategies, might hinder detection efforts, several facilitators can help overcome those obstacles. Pharmacy practice journal editors and reviewers would benefit from educational programmes, collaborations with AI experts, and sophisticated plagiarism-detection techniques geared toward accurately identifying AI-generated text. Academics and practitioners can further uphold the integrity of published research through transparent reporting and ethical standards. Pharmacy practice journal staffs can sustain academic rigour and guarantee the validity of scholarly work by recognising and addressing the relevant barriers and utilising the proper enablers. Navigating the changing world of AI-generated content and preserving standards of excellence in pharmaceutical research and practice requires a proactive strategy of constant learning and community participation.

Empowering precision medicine: Insights from a national survey on pharmacogenomics knowledge, attitudes, and perceptions among community pharmacists in the UAE.

Background: Community pharmacists are essential to pharmacogenomics implementation because they can help trainers, clinical advisors, and other medical professionals understand the importance of pharmacogenomics and encourage them to use it in their practice. This study is to evaluate the community pharmacists' understanding, attitudes, and perceptions of pharmacogenomics in the United Arab Emirates (UAE). Methods: Professionals employed at community pharmacies in Abu Dhabi, Dubai, and the Northern Emirates participated in a cross-sectional study design. From July 2023 to February 2024, five pharmacy students in their last year conducted the survey. The study team employed a structured questionnaire to collect data in addition to conducting in-person interviews. The study questionnaire comprised three distinct sections namely, demographic information, knowledge of pharmacogenomics concepts, and perceptions regarding pharmacogenomics. Results: A total of 586 pharmacists enrolled in the study. The average knowledge score regarding pharmacogenomics was 75.1 % with a 95 % confidence interval (CI) of [72.4 %, 77.7 %]. The average attitude score toward pharmacogenomics was 67.5 % with a 95 % CI of [66.3 %, 68.7 %]. Better pharmacogenomics knowledge among several groups: independent pharmacies (OR 1.7; 95 % CI 1.2-2.4), Pharmacists in Charge (OR 1.4; 95 % CI 1.3-2.02), pharmacists with 11-15 years of experience (OR 2.1; 95 % CI 1.4-4.2), graduates from international universities (OR 4.6; 95 % CI 1.6-12.9), and those who received training on pharmacogenomics (OR 11.9; 95 % CI 3.3-14.5). Similarly, better attitude scores were observed among independent pharmacies (OR 1.5; 95 % CI 1.1-2.1), Pharmacists in Charge (OR 1.5; 95 % CI 1.07-2.1), pharmacists with 16-20 years of experience (OR 2.1; 95 % CI 1.16-3.7), graduates regional universities (OR 1.47; 95 % CI 1.05-2.1), and those who received training on pharmacogenomics (OR 4.8; 95 % CI 3.2-7.3). Conclusion: The positive attitudes toward pharmacogenomics that we found in our research indicate that community pharmacists in the United Arab Emirates are beginning to realize the potential advantages of pharmacogenomics in terms of improving patient care. Policies ensuring the privacy and confidentiality of genetic information are also necessary in considering concerns about the availability of genetic test results to insurance companies and potential employers.

Assessing Students' Knowledge and Attitudes Regarding the Risks and Prevention of Consanguineous Marriage: A Cross-Sectional Online Survey.

Background: Several studies indicate a correlation between consanguinity and genetic disorders, congenital malformations, harm to reproductive health, and increased child mortality. Objective: To assess students' knowledge and attitudes about risks and prevention of consanguineous marriage. Methods: Demographic details of the participants and data on knowledge and attitudes concerning the risks and prevention of consanguineous marriage were obtained using an online self-administered questionnaire. The factors associated with good knowledge and attitude toward consanguineous marriage were investigated by logistic regression analysis. Results: A total of 667 participants enrolled in the study. The average knowledge score about consanguineous marriage risk and prevention was 78.6% with a 95% confidence interval (CI) [77.3, 79.8], and the average attitude was 79.7% with a 95% confidence interval (CI) [79, 80.6]. A better knowledge score was observed in older participants (OR 1.01; 95% CI 1.004-1.024), females (OR 1.69; 95% CI 1.48-1.94), participants with parental history of consanguinity (OR 1.33; 95% CI 1.17-1.52), participants with family history of consanguineous marriage (OR 5.18; 95% CI 2.19-7.10), and participants with family history of inherited disease (OR 1.52; 95% CI 1.25-1.86). Conclusion: In general, the overall level of knowledge and attitudes toward consanguineous marriage risk and prevention was good among university students. To efficiently control and manage the adverse health impacts associated with consanguineous marriage, there is an urgent need to develop and implement evidence-based counseling and screening programs for consanguineous marriage that would significantly reduce the number of at-risk marriages.

Advancements and recent explorations of anti-cancer activity of chrysin: from molecular targets to therapeutic perspective.

In recent times, there have been notable advancements in comprehending the potential anti-cancer effects of chrysin (CH), a naturally occurring flavonoid compound found abundantly in various plant sources like honey, propolis, and certain fruits and vegetables. This active compound has garnered significant attention due to its promising therapeutic qualities and minimal toxicity. CH's ability to combat cancer arises from its multifaceted mechanisms of action, including the initiation of apoptosis and the inhibition of proliferation, angiogenesis, metastasis, and cell cycle progression. CH also displays potent antioxidant and anti-inflammatory properties, effectively counteracting the harmful molecules that contribute to DNA damage and the development of cancer. Furthermore, CH has exhibited the potential to sensitize cancer cells to traditional chemotherapy and radiotherapy, amplifying the effectiveness of these treatments while reducing their negative impact on healthy cells. Hence, in this current review, the composition, chemistry, mechanisms of action, safety concerns of CH, along with the feasibility of its nanoformulations. To conclude, the recent investigations into CH's anti-cancer effects present a compelling glimpse into the potential of this natural compound as a complementary therapeutic element in the array of anti-cancer approaches, providing a safer and more comprehensive method of combating this devastating ailment.

Current Perspectives, Practices, and Barriers Faced by Community Pharmacists Regarding Pharmaceutical Care Services for Diabetes Mellitus in the United Arab Emirates.

Background: Providing accurate and sufficient information is a crucial requirement for delivering effective diabetes care, making it essential for community pharmacists to possess adequate knowledge of diabetes mellitus (DM) and its management. Objective: To investigate community pharmacists' level of expertise and engagement in providing counseling and health promotion services for individuals with DM in the United Arab Emirates (UAE). Methods: A cross-sectional study design was used. The community Pharmacies were chosen via random sampling and researchers then conducted face-to-face interviews with them using the structured questionnaire. The questionnaire included demographic data, 14 questions on the knowledge and 9 questions about the practice concerning pharmaceutical care for Diabetes Mellitus. Results: The average age ± SD was 31 ± 6.3. Of the total 516 community pharmacists recruited in the study, 37.2% (n=192) were male and 62.8% (n=324) were female. The average knowledge score about DM prevention and management was 9.7 with a 95% confidence interval (CI) [9.5, 9.9] and the average practice score about DM prevention and management was 7.1 with a 95% confidence interval (CI) [6.9, 7.2]. Better knowledge scores were observed in chief pharmacists (OR 1.29; 95% CI 1.08-1.56), pharmacists with 6-10 Years of experience (OR 6.92; 95% CI 3.43-8.86), pharmacist with > 10 years of experience (OR 1.99; 95% CI 1.67-2.36), when the number of patients the pharmacist serve is 5-10 (OR 1.27; 95% CI 1.06-1.53) and being trained on DM prevention and management (OR 2.18; 95% CI 1.92-2.47). Similarly, better practice scores were observed in older participants (OR1.02; 95% CI 1.001-1.03), chain pharmacies (OR 1.42; 95% CI 1.20-1.68), chief pharmacists (OR 1.56; 95% CI 1.18-2.06), when the number of patients the pharmacists serve was 5-10 (OR 12.26; 95% CI 7.26-16.19), when the number of patients the pharmacists serve was 11-20 (OR 4.23; 95% CI 3.54-5.06) and being trained on DM prevention and management (OR 1.33; 95% CI 1.11-1.59). The most commonly reported barriers to providing counseling and health promotion services for diabetes mellitus (DM) in community pharmacies include a lack of coordination with other healthcare professionals (77%) and insufficient knowledge or clinical skills (68.7%). Conclusion: Our study revealed that community pharmacy staff members displayed a noteworthy level of involvement in providing pharmaceutical care services for patients with diabetes mellitus. Based on these findings, it is recommended to enhance pharmacy education by incorporating more advanced, evidence-based training and curricula focusing on disease management and appropriate therapies, particularly for diabetes.

Exploring Promising Therapies for Non-Alcoholic Fatty Liver Disease: A ClinicalTrials.gov Analysis.

Background: Non-alcoholic fatty liver disease (NAFLD) is a common disease and has been increasing in recent years. To date, no FDA-approved drug specifically targets NAFLD. Methods: The terms "Non-alcoholic Fatty Liver Disease" and "NAFLD" were used in a search of ClinicalTrials.gov on August 24, 2023. Two evaluators independently examined the trials using predetermined eligibility criteria. Studies had to be interventional, NAFLD focused, in Phase IV, and completed to be eligible for this review. Results: The ClinicalTrials.gov database was searched for trials examining pharmacotherapeutics in NAFLD. The search revealed 1364 trials, with 31 meeting the inclusion criteria. Out of these, 19 were finalized for evaluation. The dominant intervention model was Parallel. The most prevalent studies were in Korea (26.3%) and China (21.1%). The most common intervention was metformin (12.1%), with others like Exenatide and Pioglitazone accounting for 9.1%. Conclusion: Therapeutics used to manage NAFLD are limited. However, various medications offer potential benefits. Further investigations are definitely warranted.

Perspectives on Preparedness for Chemical, Biological, Radiological, and Nuclear Threats in the Middle East and North Africa Region: Application of Artificial Intelligence Techniques.

Over the past 3 decades, the diversity of ethnic, religious, and political backgrounds worldwide, particularly in countries of the Middle East and North Africa (MENA), has led to an increase in the number of intercountry conflicts and terrorist attacks, sometimes involving chemical and biological agents. This warrants moving toward a collaborative approach to strengthening preparedness in the region. In disaster medicine, artificial intelligence techniques have been increasingly utilized to allow a thorough analysis by revealing unseen patterns. In this study, the authors used text mining and machine learning techniques to analyze open-ended feedback from multidisciplinary experts in disaster medicine regarding the MENA region's preparedness for chemical, biological, radiological, and nuclear (CBRN) risks. Open-ended feedback from 29 international experts in disaster medicine, selected based on their organizational roles and contributions to the academic field, was collected using a modified interview method between October and December 2022. Machine learning clustering algorithms, natural language processing, and sentiment analysis were used to analyze the data gathered using R language accessed through the RStudio environment. Findings revealed negative and fearful sentiments about a lack of accessibility to preparedness information, as well as positive sentiments toward CBRN preparedness concepts raised by the modified interview method. The artificial intelligence analysis techniques revealed a common consensus among experts about the importance of having accessible and effective plans and improved health sector preparedness in MENA, especially for potential chemical and biological incidents. Findings from this study can inform policymakers in the region to converge their efforts to build collaborative initiatives to strengthen CBRN preparedness capabilities in the healthcare sector.

Insights Into Metformin XR Pharmacotherapy Knowledge Among Community Pharmacists: A Cross-Sectional Study.

Background: There is a little knowledge on the extent to which healthcare providers understand and accept the professional recommendations and appropriate dosing strategy regarding metformin XR. Objectives: To evaluate UAE community pharmacists' knowledge, attitude, and practices (KAP) concerning metformin XR. Methods: This is a cross-sectional research study conducted amongst licensed community pharmacists. The survey took place via a questionnaire and physical interviews were held. The survey used in this study included questions on demographics and questions on the participants' attitudes, knowledge and practices concerning metformin XR. The factors influencing KAP regarding metformin XR were examined via simple logistic regression analysis. Results: Threehundred fifty-three (n = 353) participants were recruited in the study. Independent pharmacies constituted 57.5% of this study sample and 42.5% were chain pharmacies. The average knowledge score about metformin XR tablets was 42.5% with a confidence interval (CI) of 95% [37.3%, 47.4]. Better knowledge scores on metformin XR tablets was observed in respondents aged ⩾40 years (OR 2.97, 95% CI 1.63-5.4), having greater than 10 years in terms of experience (OR 2.28; 95% CI 1.25-4.16) and pharmacist graduated from Regional or international universities (OR 2.08; 95% CI 1.34-3.24). About 78% (n = 275) of the participants believed that metformin XR tablets have better efficacy and 63.2% (n = 233) indicated that metformin IR was associated with greater adverse effects. Conclusion: This study demonstrated a distinct gap in knowledge, attitude and practice pertaining to metformin XR among community pharmacists in the UAE. The community pharmacists need to enhance their practice by receiving accurate and reliable data to support their decision-making on the prescribing of metformin XR. The implementation of novel guidelines and evidence dissemination strategies may help bridge this gap.

Unveiling the hidden world of gut health: Exploring cutting-edge research through visualizing randomized controlled trials on the gut microbiota.

BACKGROUND: The gut microbiota plays a crucial role in gastrointestinal and overall health. Randomized clinical trials (RCTs) play a crucial role in advancing our knowledge and evaluating the efficacy of therapeutic interventions targeting the gut microbiota. AIM: To conduct a comprehensive bibliometric analysis of the literature on RCTs involving the gut microbiota. METHODS: Using bibliometric tools, a descriptive cross-sectional investigation was conducted on scholarly publications concentrated on RCTs related to gut microbiota, spanning the years 2003 to 2022. The study used VOSviewer version 1.6.9 to examine collaboration networks between different countries and evaluate the frequently employed terms in the titles and abstracts of the retrieved publications. The primary objective of this analysis was to identify key research areas and focal points associated with RCTs involving the gut microbiota. RESULTS: A total of 1061 relevant articles were identified from the 24758 research articles published between 2003 and 2022. The number of publications showed a notable increase over time, with a positive correlation (R2 = 0.978, P < 0.001). China (n = 276, 26.01%), the United States (n = 254, 23.94%), and the United Kingdom (n = 97, 9.14%) were the leading contributing countries. Københavns Universitet (n = 38, 3.58%) and Dankook University (n = 35, 3.30%) were the top active institutions. The co-occurrence analysis shows current gut microbiota research trends and important topics, such as obesity interventions targeting the gut microbiota, the efficacy and safety of fecal microbiota transplantation, and the effects of dietary interventions on humans. CONCLUSION: The study highlights the rapid growth and importance of research on RCTs that involve the gut microbiota. This study provides valuable insight into research trends, identifies key players, and outlines potential future directions in this field. Additionally, the co-occurrence analysis identified important topics that play a critical role in the advancement of science and provided insights into future research directions in this field.