Beyond pillbox: a national cross-sectional study on the attitudes, practices, and knowledge of community pharmacists regarding complementary and alternative medicine.

BACKGROUND: While community pharmacists are uniquely positioned to promote the safe and effective use of complementary and alternative medicine, their potential role remains largely untapped. The objective of this study was to assess the knowledge, attitudes, and practices related to complementary and alternative medicine products among community pharmacists in the United Arab Emirates and explore the correlates of knowledge in the study sample. METHODS: Using a stratified random sampling frame, a national survey of community pharmacists was conducted in the United Arab Emirates. In a face-to-face interaction, participants completed a multi-component questionnaire consisting of four sections: sociodemographic and general characteristics; knowledge of complementary and alternative medicine products and usage; attitudes towards complementary and alternative medicine and practices related to complementary and alternative medicine. Based on participants' answers, scores were calculated with higher scores indicating more positive knowledge, attitudes, and practices. RESULTS: 373 community pharmacists participated in the study (response rate: 83%). For the knowledge questions, more than 50% of community pharmacists correctly answered the functions of complementary and alternative medicine, however lower percentages were noted for the side effects and drug interactions questions. Most community pharmacists had positive attitudes towards complementary and alternative medicine, except for particular aspects such as efficacy, where 40% agreed that complementary and alternative medicine is only effective in treating minor complaints. As for practices, while more than 70% of participants counseled patients on complementary and alternative medicine use, only 47% reported the toxic effects when encountered. Multiple linear regressions showed that community pharmacists working in independent pharmacies, those with fewer years of experience, and those who did not receive complementary and alternative medicine education during their academic degree had lower knowledge scores (p < 0.05). CONCLUSIONS: The findings of this study showed that community pharmacists in the United Arab Emirates have good knowledge of complementary and alternative medicine functions and generally positive attitudes and practices, with few gaps identified in each. Together, these findings provide critical evidence for the development of targeted interventions to promote the role of community pharmacists towards safe and effective complementary and alternative medicine use in the country.

Modulatory role of dietary curcumin and resveratrol on growth performance, serum immunity responses, mucus enzymes activity, antioxidant capacity and serum and mucus biochemicals in the common carp, Cyprinus carpio exposed to abamectin.

In this study, we investigate the potentials of dietary curcumin and resveratrol on blood biochemistry, immune responses and resistance to the toxicity of the pesticide, abamectin. 540 common carps (30.78 ± 0.17 g) were randomly distributed into 18 tanks (30 fish per tank), as six experimental groups (T1: non-supplemented and on-exposed fish, T2: 300 mg/kg curcumin, T3: 300 mg/kg resveratrol, T4: 12.5% LC50 of abamectin, T5: 300 mg/kg curcumin +12.5% LC50 of abamectin, T6: 300 mg/kg resveratrol + 12.5% LC50 of abamectin). Use of 300 mg/kg resveratrol in the diet of non-abamectin exposed fish improved the growth performance (P < 0.05), while such effects were not observed for curcumin (P > 0.05). There were no differences in the final weight (FW), feed conversion ratio (FCR) and weight gain (WG) between control and fish of the treatments, resveratrol + abamectin and curcumin + abamectin (P < 0.05). The immune components in blood [lysozyme, complement activity, Total immunoglobulin (total Ig), protease, myeloperoxidase (MPO), nitro-blue-tetrazolium (NBT), peroxidase, albumin] and mucus [acid phosphatase (ACP), alkaline phosphatase (ALP), esterase, antiprotease)] and antioxidant enzymes [(superoxide dismutase (SOD), glutathione peroxidase (GPx)] exhibited various change patterns compared to the control group, however, these components were almost all higher in fish supplemented with curcumin and resveratrol in an abamectin-free medium than in control and other groups (P < 0.05). In most cases, the levels of immune and antioxidant components in the control did not show significant difference with the treatments, resveratrol + abamectin and curcumin + abamectin (P > 0.05). Abamectin induced oxidative stress in fish, as the malondialdehyde (MDA) levels significantly increased in the exposed fish compared to non-exposed groups (P < 0.05). It appears that neither curcumin nor resveratrol were as effective in preventing oxidative stress, because MDA levels were higher in exposed fish (abamectin, curcumin + abamectin, resveratrol + abamectin) than in control and non-exposed individuals (P < 0.05). Curcumin and resveratrol also showed protective effects on liver, since the levels of liver metabolic enzymes [aspartate transaminase (AST), ALP, lactate dehydrogenase (LDH)] were lower in the supplemented fish in a abamectin-free medium than in control (P < 0.05). Curcumin and resveratrol also mitigated the stress responses in the exposed fish, as cortisol and glucose levels showed significant decreases in the supplemented fish (P < 0.05). In conclusion, this study revealed that abamectin can depress the growth and immunity in the common carp. Although, both resveratrol and curcumin were mitigated the toxic effects of abamectin, it seems that resveratrol be more effective than curcumin.