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Objectives: Zinc is considered an essential multipurpose trace element because of its ability to act as a cofactor and signaling molecule. As reported in earlier studies of pediatric respiratory infection management, zinc exhibits potent immunoregulatory and antiviral properties, but its effects on pediatric patients with COVID-19 remain unknown. The aim of this study was to determine the extent to which zinc supplementation improves COVID-19 symptoms, length of hospitalization and, to determine how zinc supplementation impacts ICU admission, in-hospital mortality, need for ventilation, duration of ventilation, need for vasopressors, development of liver injury, or respiratory failure. Methods: Pediatric patients younger than 18 years with confirmed COVID-19 infection during the study period (March 1, 2020, to December 31, 2021) were recruited for this retrospective cohort study. The study population was divided into two arms (zinc/no zinc supplementation as an adjunct to standard therapy). Results: Of 169 hospitalized patients who were screened, 101 met the inclusion criteria. No statistically significant association was found between the administration of zinc as adjunctive therapy and symptom reduction, intensive care unit (ICU) admission, or mortality (p = 0.105; p = 0.941, and p = 0.073, respectively). However, zinc supplementation was associated with a statistically significant reduction in respiratory failure and length of hospitalization (p = 0.004 and p = 0.017, respectively), also, zinc administration was associated with elevated serum creatinine (p = 0.01*). Conclusions: Among pediatric patients with COVID-19, zinc supplementation was associated with shorter hospital stay. However, there was no significant difference between the two groups in terms of symptom improvement, in-hospital mortality, or ICU admission. In addition, the study raises question about the possibility of kidney injury as indicated by high levels of serum creatinine.
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Introduction: There are limited studies that address the use of newer antidiabetics by prescribers in Saudi Arabia and their adoption of the newer diabetes guidelines. The primary aim of our study was to explore the prescribing patterns of first- and second-line agents for the management of type 2 diabetes and the factors affecting them. Methods: A cross-sectional self-administered survey was designed to collect responses from the prescribers in the Makkah Region of Saudi Arabia from 16 February through 16 June 2021. The questionnaire was developed in the English language, piloted, and tested for validity. Participants were recruited on a convenience sampling basis, and the data were collected by visiting them in-person. Results: A total of 103 prescribers responded to the survey. The majority of the respondents were male (69%), Saudi nationals (54%), practicing in Makkah city (62%), working in the government sector (62%), and had the prescribing experience of 1-5 years (37%). Metformin (95%) was the respondents' most preferred first-line drug of choice, followed by sulfonylureas (5%). When the first-line was contraindicated, sulfonylureas (30%) were considered the most preferred drug of choice, followed by DPP4 inhibitors (25%) and SGLT2 inhibitors (16%), respectively. When the first-line was not sufficient to control diabetes, sulfonylureas (32%) and DPP4 inhibitors (31%) were considered the most preferred drugs of choice as an add-on therapy. SGLT2 inhibitors (31%) and metformin (24%) were considered the preferred first-line choices if the patient had an established cardiovascular disease. Conclusion: Sulfonylureas were found to be the most considered choice as second-line therapy. There is a need to provide targeted education to the prescribers related to the newer diabetes guidelines in order to promote the use of more evidence-based and safer antidiabetics.
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Objective: Medical representatives (MRs) frequently interact with physicians who may have different perceptions about and expectations from product promotional activities by pharmaceutical companies, especially through MRs. This can affect their prescribing practice. We explored the views and perceptions of MRs and physicians about the role of MRs and pharmaceutical advertisements in Saudi Arabia. Methods: Semi-structured interviews were conducted virtually through the ZOOM application with five MRs and five physicians from July to October 2022. The participants were recruited from the Makkah region in Saudi Arabia on a convenience sampling basis and through the snowballing method. The interviews were recorded with the consent of the participants, transcribed verbatim, and thematically analyzed. Findings: Data saturation was found to be achieved with four interviews from each group of participants. Thematic analysis generated 338 codes which were categorized into 31 subthemes. These subthemes were further categorized into 11 overarching themes: "MR daily work," "Role of MRs in healthcare and their future," "Value of MRs in healthcare," "Pros and cons of the MR career," "MRs in the COVID-19 pandemic," "Differences between the pharmaceutical companies," "Goods and not-so-goods about the MRs," "Suggestions provided by physicians for MRs and pharmaceutical companies," "Marketing strategies of different pharmaceutical companies," "Experience of MRs" and "Support provided by pharmaceutical companies." Conclusion: Our pilot study sheds light on the role of MRs and pharmaceutical advertisement from MRs' and physicians perspectives. Several recommendations can be drawn from our findings to make the interactions between MRs and physicians more effective and improve pharmaceutical advertisement, prescribing practices, and patient care.
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INTRODUCTION: COVID-19 pandemic induced lockdown, suspending all on-campus educational activities in the Kingdom of Saudi Arabia (KSA), compelling to continue the education online. We explored pharmacy students' perspective on its impact on their learning. METHODS: A Twitter chat was organized on three consecutive days, after final examinations, inviting all pharmacy students in KSA to participate. Day 1 chat included 11 questions regarding learning and assessment, Day 2 chat included six questions about online examinations and six questions about technology use, Day 3 chat included six questions related to lessons learnt from the learning experiences during the lockdown. The questions were validated and piloted before the chat. The responses were copied, reviewed to remove any confidential information, and thematically analyzed by two teams of research students independently. RESULTS: During the three-day chat, 790 responses were received in total. Thematic analysis generated 944 codes which were categorized into 43 subthemes. These subthemes were further categorized into six main themes: 'facilitators for online education', 'barriers for online education', 'online versus onsite education', 'role of technology in online education', 'suggestions for improving online education' and 'long-term impact of online education during lockdown'. Participants highlighted several facilitators and barriers which affected their education during the lockdown, compared online education with onsite education, and provided suggestions for improving online education based on their learning experiences during the lockdown. CONCLUSION: As COVID-19 pandemic and its repercussions are expected to last longer, pharmacy colleges and academic staff will find these findings useful to prepare for the coming years, ensuring pedagogical and accreditation standards.
