Knowledge and practice of community pharmacists regarding the safety of drugs during pregnancy: a cross-sectional study from a developing country.

BACKGROUND: Drug use during pregnancy can cause unfavorable fetal and maternal outcomes. Information sharing is essential for pharmacists' role within intricate, modern healthcare systems. Community pharmacists (CPs) have demonstrated unsatisfactory knowledge across various pharmacological domains in most developing countries. This study aimed to explore the knowledge and practices of CPs regarding medications and herb safety during pregnancy. METHODS: A cross-sectional study was conducted in a developing country using a self-administered questionnaire. A sample of CPs working in the northern governorates of the West Bank was selected by convenience sampling. The questionnaire included questions on sociodemographic characteristics, practices and knowledge. Descriptive and inferential statistics were calculated using the Statistical Package for the Social Sciences (SPSS) to analyze the data. RESULTS: A total of 207 questionnaires were completed. Most respondents had only a bachelor's degree (89.9%) but did not participate in continuous professional development (CPD) (71.0%). Almost one-third of the CP workload involved dispensing drugs to pregnant women. The majority of the participants reported that they inquire about pregnancy status (59.9%), refer to scientific sources (82.6%), and contact a prescribing physician (51.2%) in cases of uncertainty. A higher knowledge score was associated with receiving a master's degree and CPD programs. Most CPs identified folic acid, paracetamol and amoxicillin as safe, while tetracycline, isotretinoin, enalapril, pseudoephedrine and ibuprofen were among the drugs mostly reported as unsafe. Castor oil, Senna, St. John's wort and ginseng were the most frequently reported herbs as unsafe. CONCLUSIONS: Despite the gaps in knowledge about herb pharmacology, CPs demonstrated acceptable knowledge and practice regarding drug safety during pregnancy. CPD is recommended for addressing gaps in knowledge and practice. Future research evaluating knowledge and practice may benefit from developing a specific, accurate, validated instrument.

Gut microbiota and autism spectrum disorders: where do we stand?

BACKGROUND: Children with autism spectrum disorder (ASD) often have digestive problems and microbial imbalances in their guts, suggesting that these conditions may play a role in the development of the disorder. Scopus-based research on the gut microbiota and ASD was examined in this bibliometric analysis to shed light on the current state of research and identify potential hotspots for future work in this area. METHODS: We searched documents from the Scopus database and reference citation analysis to collect published data on the gut microbiota and ASD from 2003 to 2022. The downloaded document records were exported to VOSviewer v.1.6.19 to examine and visualize the collaboration between countries and determine the research hotspots. RESULTS: The search yielded 958 articles specifically dedicated to gut microbiota and ASD. The number of publications in this field increased rapidly after 2013, with a peak in 2022. The United States (n = 267; 27.87%) was the most active country, followed by China (n = 171; 17.85%) and Italy (n = 96; 10.02). International collaboration was observed, with the USA playing a central role. University College Cork, Ireland, was the most productive institution (n = 24; 2.51%). The National Natural Science Foundation of China was the most active funding agency (n = 76; 7.93%). Nutrients journal had the highest number of publications (n = 28; 2.92%). The articles related to gut microbiota and ASD were highly cited, with an h-index of 108. The research themes identified focused on the modulation of gut microbiota as a potential therapy for children with ASD and gut-brain axis dysfunction in ASD. CONCLUSIONS: In recent years, the study of gut microbiota and its association with ASD has garnered considerable interest as an emergent field of study. The results of this study substantially enhance our current understanding of the knowledge landscape in this field and illuminate potential avenues for future research. It is essential to emphasize the significance of devoting more resources to the newest and most promising research areas, such as investigating the potential therapeutic benefits of modulating the intestinal microbiota in children with ASD. This research has enormous potential and merits intensified focus and investigation.

Assessment of practices and awareness regarding the disposal of unwanted pharmaceutical products among community pharmacies: a cross-sectional study in Palestine.

BACKGROUND: The improper disposal of pharmaceutical preparations substantially threatens human health and environmental safety. Pharmacists are responsible for properly disposing of unwanted medications and educating patients about how to do so themselves. This study aimed to assess community pharmacists' knowledge, determine their views on how to dispose of unwanted pharmaceuticals, and assess the extent to which they realize that it is their responsibility to guide patients toward the safe disposal of expired medications. METHODS: A descriptive cross-sectional study was conducted between December 2021 and April 2022 among 400 practicing pharmacists who were chosen to participate by random cluster sampling. Community pharmacists' practices, awareness, and beliefs about disposing of unused drugs were evaluated. The Statistical Package for Social Sciences (IBM-SPSS) version 21 was used for data entry and analysis. RESULTS: Of 400 pharmacists, 348 stated that they did not participate in courses on the safe disposal of unwanted medications. Disposal of drugs in the garbage, an unsafe method, was very frequently recommended by pharmacists to patients, especially regarding inhalers, antibiotics, hormonal drugs, and solid and semisolid drugs. However, many pharmacists advised patients to return their hormonal, category B, and category C drugs to the pharmacy. A total of 61.3% of pharmacists agreed and 26% strongly agreed that unsafe disposal of drugs negatively affects the environment. A total of 54.3% of the participants agreed that improper disposal of antibiotics might be a reason for increased antimicrobial resistance, and 54.5% of them agreed that improper disposal of hormonal drugs might contribute to the development of certain cancers. A total of 80.3% of the participants perceived that most unwanted drugs in pharmacies were those returned from patients. A total of 97.3% of the participants supported establishing a drug disposal system, with 77.5% choosing to have the district health board responsible for funding this system. A total of 48.5% of the participants indicated that a lack of education and awareness on the issue of getting rid of unused drugs constitutes a challenge to the safe disposal of medicines, and 66% of them said that a lack of law enforcement constitutes another challenge. A total of 95.5% of the participants agreed or strongly agreed that good training for health sector workers and organizing workshops to develop knowledge on this subject would improve practices. A total of 93.3% supported distributing educational brochures, and 92.8% supported placing special containers in every pharmacy to collect unwanted drugs. CONCLUSIONS: Most pharmacists in our study returned drugs to manufacturing companies and stores, and few followed the correct methods of incineration and return of drugs to the Ministry of Health. Current data emphasize the issue of improper disposal of medicine in Palestine and the need for improved education among healthcare workers.

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.

Global trends in research related to the links between microbiota and antibiotics: a visualization study.

The scientific community widely acknowledges that the gut microbiota plays a critical role in maintaining host health and can be altered by a range of factors, such as antibiotic use, diet, stress, and infections. Therefore, this study utilized bibliometric analysis to thoroughly investigate research trends in the microbiota and antibiotics. Scopus was used to extract papers linked to microbiota and antibiotics published between 2002 and 2021, and both Microsoft Excel and VOSviewer were used to conduct the analysis of the data. A total of 2,816 publications discussed the connection between the microbiota and antibiotics. Growth occurred in two stages: the first (2002-2015) was characterized by fairly slow publication production, while the second (2016-2021) saw a rapid increase in publishing progress. The United States has the most publications, 654, representing 23.22% of the total. China came second with 372 publications (13.21%), followed by the United Kingdom with 161 publications (5.72%) and India with 157 publications (5.58%). In addition, publications on 'altered intestinal microbiota composition with antibiotic treatment' were introduced after 2017, while 'gut microbiota and antimicrobial resistance' and 'probiotics as an alternative antimicrobial therapy' were introduced before 2017. Based on these results, this study provides an in-depth look at key moments in the history of microbiota and antibiotic research, as well as possible directions for future research in different areas of microbiota and antibiotic research. Therefore, it is suggested that more attention should be given to the latest promising hotspots, such as how antibiotic treatment changes the composition of the gut microbiota.

Bibliometric mapping of the landscape and structure of nutrition and depression research: visualization analysis.

BACKGROUND: Numerous epidemiological studies have examined the relationship between dietary intake of specific foods or nutrients and the incidence of depression and have noted that nutrition has a significant impact on mental health. Therefore, the purpose of this study is to assess the state of research, the frontiers of research, and development trends in the field of nutrition and depression using bibliometric and visual analysis. METHODS: We collected publications on the topic of nutrition and depression from Scopus between 2002 and 2021. Subsequently, we utilized VOSviewer 1.6.18 and Microsoft Excel 2013 to perform bibliometric analysis and visualization. Bibliometric analysis involves retrieving documents from a singular database, such as SciVerse Scopus or Web of Knowledge, and subjecting them to quantitative and qualitative analysis. Notably, gray literature is not considered in bibliometric analysis. RESULTS: A total of 2171 publications on nutrition and depression were found between 2002 and 2021, namely 1855 (85.44%) original articles, 190 (8.75%) reviews, 38 (1.75%) letters, and 88 (4.05%) other types of publications. The most productive country was found to be the USA (n = 726; 33.44%), followed by Australia (n = 172; 7.92%), the United Kingdom (n = 158; 7.28%), China (n = 132; 6.08%), and Canada (n = 131; 6.03%). The remaining publications were from other countries (n = 852; 39.25%). According to the citation analysis, the retrieved papers were cited on an average of 26.6 times and had an h-index of 105 with 57,781 citations. The most frequent terms on the map include those related to (a) fatty acid links to depression and brain inflammation, (b) depression and eating disorders, and finally, (c) adherence to the Mediterranean diet and risk of depression. CONCLUSIONS: The current study was the first novel bibliometric analysis of nutrition and depression research that used data extracted from Scopus for visualization network mapping. In recent years, the theme "Mediterranean diet adherence and risk of depression" has been identified more frequently, indicating that studies in this field have garnered considerable attention and reflect the most recent scientific advances. Researchers should continue to investigate nutrition and depression, and we believe this study provides significant information for researchers, nutritionists, and clinicians.

Mapping the global research landscape on nutritional support for patients with gastrointestinal malignancy: visualization analysis.

BACKGROUND: Early nutritional treatment is crucial for the care of patients with operable and advanced gastrointestinal malignancies. Therefore, much research has focused on nutritional support for patients with gastrointestinal malignancies. Therefore, this study aimed to evaluate the global scientific output and activity with respect to nutritional support and gastrointestinal malignancy. METHODS: We searched in Scopus for publications on gastrointestinal cancer and nutritional assistance published between January 2002 and December 2021. Then, using VOSviewer 1.6.18 and Microsoft Excel 2013, we conducted bibliometric analysis and visualization. RESULTS: A total of 906 documents were published between 2002 and 2021, including 740 original articles (81.68%) and 107 reviews (11.81%). China ranked first (298 publications, 32.89%), Japan ranked second (86 publications, 9.49%) and the USA ranked third (84 publications, 9.27%). The organisation with the highest number of publications was the Chinese Academy of Medical Sciences & Peking Union Medical College from China, with 14 articles, followed by the Peking Union Medical College Hospital from China and the Hospital Universitari Vall d'Hebron from Spain (13 publications for each). Before 2016, most studies focused on 'nutrition support for patients undergoing gastrointestinal surgery'. However, the latest trends showed that 'nutrition support and clinical outcomes in gastrointestinal malignancies' and 'malnutrition in patients with gastrointestinal cancer' would be more widespread in the future. CONCLUSIONS: This review is the first bibliometric study to provide a thorough and scientific analysis of gastrointestinal cancer and nutritional support trends worldwide over the last 20 years. This study can aid researchers in decision-making by helping them understand the frontiers and hotspots in nutrition support and gastrointestinal cancer research. Future institutional and international collaboration is expected to accelerate the advancement of gastrointestinal cancer and nutritional support research and investigate more efficient treatment methods.

Mapping the output of the global literature on the links between gut microbiota and COVID-19.

BACKGROUND: The term "human microbiota" refers to populations of microorganisms that live harmoniously in co-existence with humans. They contribute significantly to the host's immunological response when confronted with a respiratory viral infection. However, little is known about the relationship between the human microbiome and COVID-19. Therefore, our objective is to perform a bibliometric analysis to explore the overall structure and hotspots of research activity on the links between microbiota and COVID-19 at the global level. METHODS: The research literature on the microbiota and COVID-19 published between 2020 and 2022 was obtained from the Scopus database. Bibliometric analysis and network visualization were performed with VOSviewer. RESULTS: Of the 701 publications selected, the USA contributed the most (n = 157, 22.40%), followed by China (n = 118, 16.83%) and Italy (n = 82, 11.70%). Hotspots in this field were "COVID-19 is associated with an altered upper respiratory tract microbiome," "the effect of antibiotics on the gut microbiome," as well as "patient nutrition and probiotic therapy in COVID-19." CONCLUSIONS: The links between microbiota and COVID-19 remain an urgent concern at present, and the use of probiotics or/and antibiotics during the pandemic needs to be further improved. This landscape analysis of the links between the microbiota and COVID-19 will provide a basis for future research.

Mapping the global research landscape on insulin resistance: Visualization and bibliometric analysis.

BACKGROUND: Insulin resistance is a risk factor for metabolic syndromes and is associated with a wide variety of metabolic illnesses, including obesity, type 2 diabetes, and cardiovascular disease. AIM: To investigate and map global insulin resistance studies. METHODS: A bibliometric methodology was applied to the literature retrieved from the Scopus database and Reference Citation Analysis (https://www.referencecitationanalysis.com) by using a validated search strategy. The study period was limited from 2002 to 2021. Bibliometric indicators and mapping were presented. RESULTS: A total of 26808 articles on the topic of insulin resistance were included in the Scopus database. The articles included research articles (n = 21918; 81.76%), review articles (n = 2641; 9.85%), and letters (n = 653; 2.44%). During the study period, 136 countries contributed to the research on insulin resistance. The highest number of articles was from the United States (n = 7360; 27.45%), followed by China (n = 3713; 13.85%), Japan (n = 1730, 6.45%), Italy (n = 1545; 5.54%), and the United Kingdom (n = 1484; 5.54%). The retrieved articles identified two main research themes: "inflammatory mechanisms in the regulation of insulin resistance" and "mechanisms linking obesity to insulin resistance". CONCLUSION: Our data show that insulin resistance has steadily gained interest from researchers, as evidenced by the number of citations and yearly publications. Publications have grown significantly in the last decade, while low-income countries with greater burdens continue to produce fewer publications in this field. This approach might assist researchers in choosing new research areas and recognizing research hotspots and frontiers. In the future, perhaps high-quality clinical evidence will be acquired.

Mapping the landscape and structure of global research on binge eating disorder: Visualization and bibliometric analysis.

BACKGROUND: Binge-eating disorder (BED) is a clinical syndrome and is considered the most common type of eating disorder. However, our understanding of the global performance and progress of BED research is limited. AIM: To describe and perform a bibliometric analysis of the state of BED research. METHODS: The term 'Binge eating' was searched in the title throughout the previous year's up to December 31, 2020. We searched the Scopus and Reference Citation Analysis for publications on Binge eating. The VOSviewer software version 1.6.17 was used to produce the network visualization map of the most frequent author, collaborative relationships between countries/regions, and to determine the hotspots related to binge eating research. In addition, conventional bibliometric indicators were generated. RESULTS: The search strategy found 2713 total articles and an average of 62 articles per year. Among them, 'Article' represented 82.49% of the publications (n = 2238 articles) and was the most frequent type, followed by reviews (n = 243; 8.96%). The number of publications increased steadily during the last decade of the study period. One hundred and thirty-two countries contributed to binge eating research, with 1495 (55.11%) articles published in the United States, followed by Italy with 256 (9.44%), the United Kingdom with 183 (6.75%), and Germany with 182 (6.71%). Currently, the main hot topics related to BED are 'type of treatment and management and treatment provided to BED"; "processes and pathways to binge eating"; and 'diagnosis, signs and symptoms, comorbidities and prevalence and associated factors with BED'. CONCLUSION: The number of publications has increased noticeably during the previous decade. There are indeed relatively few publications on BED from low-and middle-income nations, so much is to be learned from the experience of all countries. Studies on this topic are critical in all countries to discover risk factors and effective intervention measures. Although our findings are preliminary, they imply that the future prospects for interventions aimed at BED management are bright, focusing on complex models of care and long-term maintenance of therapeutic gains.

Mapping the global research landscape on nutrition and the gut microbiota: Visualization and bibliometric analysis.

BACKGROUND: Nutrition is a significant modifiable element that influences the composition of the gastrointestinal microbiota, implying the possibility of therapeutic diet methods that manipulate the composition and diversity of the microbial. AIM: To overview research papers on nutrition and gut microbiota and determines the hotspots in this field at the global level. METHODS: Scopus and Reference Citation Analysis were used to construct a bibliometric technique. It was decided to create bibliometric indicators and mapping as in most previous studies. 2012 through 2021 served as the study's timeframe. RESULTS: A total of 5378 documents from the Scopus database were selected for analysis. Of all retrieved studies, 78.52% were research papers (n = 4223), followed by reviews (n = 820; 15.25%). China ranked first with a total number of articles of 1634 (30.38%), followed by the United States in second place with a total number of articles of 1307 (24.3%). In the last decade, emerging hotspots for gut microbiota and nutrition research included "gut microbiota metabolism and interaction with dietary components", "connection between the gut microbiota and weight gain", and "the influence of high-fat diet and gut microbiota on metabolic disorders". CONCLUSION: This is the first thorough bibliometric analysis of nutrition and gut microbiota publications conducted on a global level. Investigation of the association between nutrition/diet and the gut microbiota is still in its infancy and will be expanded in the future. However, according to recent trends, the "effect of gut microbiota and high-fat diet on metabolic disorders" will be an increasing concern in the future.

Storage and wastage of drug products in Jordanian households: a cross-sectional survey.

OBJECTIVE: Appropriate household storage and use of drug products can reduce drug wastage and unnecessary hazards. We aimed to quantify the amounts and types of medications that were stored in Jordanian households and the extent of drug wastage in terms of the amount and cost of these medications. METHODS: The setting was households in Amman, Jordan. This was a cross-sectional survey study using a pre-piloted questionnaire. Family members were interviewed in person about use of drug products, and where drug products were stored. The main outcomes were types, storage methods, cost and quantities of drug products in every household. KEY FINDINGS: Two hundred and forty-three households were approached, out of which 219 agreed to participate. A total of 2393 (mean 10.9, SD 5.2) drug products were recorded from the 219 households surveyed. A significant positive correlation was noted between the number of drug products in a household and family size (r = 0.19, P < 0.01), the level of the mother's education (r = 0.24, P < 0.01), the level of the father's education (r = 0.28, P < 0.01) and income (r = 0.14, P = 0.034). Eighty nine (40.6%) households had at least one child younger than 6 years of age, and 1122 (46.9%) drug products were stored in unsafe places in the houses, within the reach of children. More than a quarter of drug products (1509, 27.2%) were not in their original containers, 360 (15%) were unused since dispensing, 261 (10.9%) had expired and 44 (1.8%) had no clear expiry date. We estimated that the cost of drug wastage in the 219 households was US$5414. Paracetamol (202, 8.4%), diclofenac (98, 4.1%) and amoxicillin (79, 3.3%) were the most commonly reportedly stored individual drugs. CONCLUSION: Drug products are stored in large quantities in Jordanian households. Unsafe storage practices have the potential to pose safety hazards, especially to children.