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Background: Non-adherence to cardiovascular medications is a global problem with clinical, economic, and humanistic consequences. Investigation of this problem may open the road for proper management of cardiovascular diseases. Objective: Our objectives were to assess the level of adherence to, and to examine factors influencing adherence to, cardiovascular medications in subjects visiting a heart center in Sudan. Methods: We have conducted a cross-sectional study that assessed adherence to cardiovascular medications among subjects visiting outpatient cardiac clinics in a heart center-Khartoum State, Sudan. The validated Adherence to Refills and Medication Scale (ARMS) tool was used to assess the level of medication adherence. A score of >16 was used as a cut-off point to categorize surveyed patients into non-adherent (e.g., 17–48) and adherent (e.g., 12–16) in ARMS. Descriptive statistics (frequencies and percentages) and inferential tests such as One-Way ANOVA and Binary regression were used for data analysis. Results: A total of 255 subjects were enrolled in this study. Slightly more than half the respondents were males (54.5%) and their ages ranged between (51–60 years), and have no insurance coverage (58%). Most of the subjects were married (60.4%), were from Khartoum-State (67.8%), and were unemployed (77.6%). About 39.6% had primary education while 34.5% had secondary (34.5%) education. Diabetes (56.1%) and hypertension (45.5%) were common among the study population. The results showed a high non-adherence prevalence rate (97.6%). The cited reasons for non-adherence include forgetfulness and the costs of refilling medications. Education and age were associated with the level of adherence. Those with high non-adherence behaviors were the more educated, younger and old patients, those not employed, and those having comorbid diseases. Conclusion: The results generally showed a high level of non-adherence to cardiovascular medications, necessitating interventions to support patients' adherence. [ABSTRACT FROM AUTHOR]

Purpose: Epilepsy, a prevalent chronic neurological disorder, is associated with misconceptions, negative attitudes, and stigma because of poor public knowledge and awareness. Therefore, the purpose of the current study was to assess the knowledge, awareness, and attitudes toward epilepsy and its associated factors among the Lebanese general population. Methods: A cross-sectional study was conducted on Lebanese adults between October 2021 and June 2022 using an electronic structured self-administered questionnaire that was circulated online using the different social media platforms. Data related to participants' demographic characteristics, knowledge, awareness, and attitude about epilepsy were measured. Eight items were included in the knowledge score that ranged between "0 and 16", five items were included in the awareness score and ranged between 0 and 10. Likewise, the attitude score was calculated from 14 items and the score ranged between "0 and 28". Data was analyzed using descriptive statistics, and logistic regression was employed to identify factors associated with knowledge and awareness of epilepsy. Results: A total of 301 participants filled the questionnaire with a mean age of 28.68 and majority (66%) were females. The analyzed scores revealed that most of the participants (87.4%) had a good knowledge regarding epilepsy as a disease with mean of 10.2 (± 2.14), 70.1% had good awareness about epilepsy with mean of 6.3 (± 1.4), and 88% had good attitude toward patients with epilepsy with mean of 21.5 (± 6.2). Attending lecture about epilepsy was significantly associated with higher knowledge (OR 5.756, CI 95% 4.652–11.676, p < 0.001), better awareness (OR 4.936, CI 95% 3.062–10.566, p < 0.001) and attitude (OR 5.187, CI 95% 1.687–9.761, p < 0.014) toward the disease. Conclusion: The findings of this study reflected an adequate knowledge and awareness, as well a positive attitude toward patients with epilepsy in Lebanon. However, there is a need for raising societal awareness and understanding of epilepsy to minimize the public misconceptions and reduce the stigma and discriminatory attitudes toward epileptic patients. [ABSTRACT FROM AUTHOR]

Background: Drug-related problems (DRPs) significantly threaten the safety of the elderly. In order to improve pharmacists' ability to minimize these events, novel educational interventions that consider the current challenges in clinical practice are crucial. Objectives: The primary objective is to assess the impact of two unique educational interventions on pharmacists' ability to identify DRPs. Method: A total of 127 community pharmacies in the United Arab Emirates (UAE) were recruited and randomly allocated to one of three arms using a 1:1:1 allocation ratio. While a series of clinical case scenarios (N = 24) related to elderly care were established and validated and sent to pharmacists in Active Group A over a 3-month period, lengthy research articles focused on medication safety in elderly were emailed to pharmacists in Active Group B. The control group pharmacist received no intervention. Then, pharmacists self-reported the number, categories, and severity of DRPs and pharmacist recommendations. Results: The incidence of DRPs identified by pharmacists was 10.8% in Active Group A, 2.0% in the Control Group (p = 0.011), and 3.8% in Active Group B (p = 0.014). A significant difference was observed in the proportion of DRP types between Active Group A and the Control Group. The most common DRPs in Active Group A were avoidable medication (14.7%) and untreated disease (9.2%). Pharmacists in Active Group A (37.2%) and Active Group B (32.3%) most commonly intervened by recommending the cessation of medication, while the most common intervention in the Control Group was recommending a decrease in dose (29.8%). The mean cost reduction per patient was highest in Active Group A (31.3 ±11.8 $), followed by Active Group B (20.8 ±8.6 $) and the Control Group (19.6 ±9.5 $). The mean time needed to resolve a DRP was shortest in Active Group A (7.3 ±3.5 minutes), followed by Active Group B (9.8 ±4.2 minutes) and the Control Group (9.8 ±5.7 minutes). Conclusion: Using WhatsApp to deliver clinical scenarios was effective in improving pharmacists' ability to identify and address DRPs in elderly patients, resulting in faster resolution and higher cost savings. [ABSTRACT FROM AUTHOR]

Aims: The study aimed to evaluate the potential benefits of luteolin treatment in Huntington's disease (HD), an inherited progressive neurodegenerative disorder. Methods: HD N171‐82Q transgenic and WT mice received luteolin or vehicle for treatment at 6 weeks of age. The mice's body weight changes and survival rates were monitored throughout the study, and a series of motor functional tests were conducted. Serum level of the marker NfL was also determined. Immunohistochemical staining and western blotting were utilized to assess the expression of huntingtin aggregates. Results: Luteolin treatment enhanced survival and prevented weight loss in HD mice compared to the vehicle‐treated HD group. Furthermore, the luteolin‐treated HD mice exhibited enhanced motor coordination and balance and significantly reduced motor dysfunction. Also, luteolin decreased serum NfL levels in HD mice. Notably, the accumulation of huntingtin aggregates was significantly reduced in the brain's cortex, hippocampus, and striatum of luteolin‐treated HD mice compared to the vehicle‐treated HD group. Conclusion: Luteolin holds promise as a therapeutic agent for improving survival outcomes, managing motor dysfunction, and reducing huntingtin aggregates in HD. The findings are of significance as currently, there are no approved therapeutic interventions that reverse HD pathology or slow down its progression. [ABSTRACT FROM AUTHOR]

Congestive heart failure (CHF) frequently coexists with anemia, which is associated with negative results. To the best of our knowledge, this was the first study to evaluate the characteristics of iron metabolism markers in patients with CHF and anemia in Jordan. The current investigation included 150 CHF patients divided into 3 subgroups: 50 patients with absolute iron deficiency (AID) where (serum ferritin (SF) <100 µg/L), 50 patients with functional iron deficiency (FID) where (SF=100-300 µg/L and iron transferrin saturation coefficient (ITSC) <20%), and 50 other patients having anemia without ID. Among the total studied patients, hemoglobin values corresponded to a mild degree of anemia. Serum iron (SI), serum ferritin (SF), and soluble transferrin receptors (STR) matched reference levels, transferrin (TR) was below normal, and the median iron transferrin saturation coefficient (ITSC) <20% is an indication of ID. SI, SF, and TR conformed to reference values. TR, STR, ITSC, total iron-binding capacity (TIBC), endogenous erythropoietin (EPO), and Creactive protein (CRP) all showed statistically significant variations among the studied subgroups, indicating important variations in iron metabolism of these subgroups. In the AID subgroup, CRP and hepcidin values were minimal, indicating a minor role in inflammation. Anemia in individuals with CHF was normocytic and normochromic, with low erythropoietin release and significant amounts of CRP and hepcidin. At later phases, iron supplements should be recommended for these two subgroups. [ABSTRACT FROM AUTHOR]

Background: Since outbreak of COVID-19 pandemic, almost whole world asked to wear the facemask especially in the public areas as a precaution to avoid the transmission of the disease, and curbs the pandemic. Looking from another perspective, we need to consider the effect of the facemask in reducing allergic rhinitis symptoms. Objective: The current study objective was to assess the impact of facemasks on the symptoms of allergic rhinitis in subjects who were obligatory using facemask due to the COVID-19 pandemic. Methods: The current study was ethically approved self-administered validated survey (Cronbach Alfa 0.81) comprised of 28-items to assess the impact of wearing the facemask, and whether there was an improvement in symptoms of allergic rhinitis. The outcome measure was the responses to the four domains (knowledge, attitude, symptoms, and help/advice) measured on Likert scale to assess the responses of subjects with allergic rhinitis during the COVID -19 pandemic. Results: 82 respondents (mean age was 22.59 ±2.77 years) have completed the survey, of which 73 females (89%) and (52/82, 63.4%) university students. 29 (35.4%), stated that the fabric facemask is useful in reduction of symptoms. 44 (53.7%) believe that the surgical mask N95 is very beneficial in the reduction of symptoms. There was a significant difference in knowledge levels for both eye and nasal symptoms' reduction responses (P <0.001). Tukey's HSD (honestly significant difference) used to determine the specifics of the variances (differences in multiple means) in symptom reduction. For eye symptoms, the analysis revealed that respondents who reported that they had reduced symptoms had higher knowledge scores (6.74±2.7) than those who reported no reduction in allergic symptoms (mean ±SD: 4.96±3.2). The lowest score was associated with respondents that were uncertain regarding their symptom alleviation (mean ±SD: 4.53±3.1). For nasal symptoms, the analysis revealed that respondents who reported that they had reduced symptoms had higher knowledge scores (7.03±2.7) than those who reported no reduction in allergic symptoms (3.94±2.5). Conclusion: Our results reveal that facemask usage may reduce allergic rhinitis symptom severity in chronically affected individuals with intermittent disease. The study supports the hypothesis that facemask may reduce atopic allergic responses. [ABSTRACT FROM AUTHOR]

Background: Recently, direct oral anticoagulant (DOAC) has been projected for secondary prevention of recurrent ischemic events post-acute coronary syndrome (ACS). The addition of a DOAC to the antiplatelet regimen of subjects with the ACS is clinically practiced in candidates where compelling anticoagulation is indicated by high thromboembolic risk. The current evidence provides approved compelling indication for the DOAC, particularly for rivaroxaban which bears the strongest existing evidence. Objective: We intend to assess the role of DOAC in addition to single or dual antiplatelet therapy in subjects with ACS. We will compare the clinical characteristics and explore the efficacy and safety of the DOAC class members (apixaban, betrixaban, dabigatran, edoxaban and rivaroxaban) in terms of reduction in ischemic events in subjects with ACS (ST-segment elevation myocardial infarction [STEMI] or non--ST-segment elevation [NSTEMI]) or subjects who underwent percutaneous coronary intervention (PCI) and or ACS and coexisting atrial fibrillation (AF). Methods: Relevant data will be searched on known data-bases such as Embase, Google Scholar, the Cochrane Central, and PubMed. The trials included will be randomized controlled trials from 2009 to 2022. Subjects will be receiving DOAC for ACS were evaluated for inclusion. The extraction, synthesis, quality, and validity of data will follow the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The risk of bias tool, version 2.0 (Cochrane) will be used for risk of bias assessment. Data will be pooled using random-effects models. The primary outcome measure will be efficacy end point (composite of cardiovascular death, myocardial infarction, and stroke), while the safety outcome will be minor/major bleeding. Results: We will report the primary efficacy end point risk in the various regimens (DOAC plus SAPT or DAPT) with odds ratio (confidence interval) and both statistical and clinical significance. Further results of risk of bleeding will be compared between the regimens in the subsets of subjects with ACS (e.g. STEMI or NSTEMI) or with comorbid AF or heart failure (HF). Conclusion: We will critically appraise the evidence to support the effects of DOAC plus SAPT or DAPT based on the clinical presentation of subjects. The risk-benefit profile of DOAC will be presented in the two regimens of dual antithrombotic or triple antithrombotic therapy. [ABSTRACT FROM AUTHOR]

Introduction: Remote pharmacist interventions have achieved much more attention during the coronavirus disease 2019 (COVID-19) outbreak, since they reduce the risk of transmission and can potentially increase the access of vulnerable populations, such as patients with COVID-19, to pharmaceutical care. This study aimed to examine differences in rates and types of pharmacist interventions related to COVID-19 and medication dispensing errors (MDEs) across community pharmacies with and without telepharmacy services.Methods: This was a prospective, disguised, observational study conducted over four months (from March 2020 to July 2020) in 52 community pharmacies (26 with and 26 without telepharmacy) across all seven states of the United Arab Emirates using proportionate random sampling. A standardised data-collection form was developed to include information about patient status, pharmacist interventions and MDEs.Results: The test (telepharmacy) group pharmacies provided pharmaceutical care to 19,974 patients, of whom 6371 (31.90%) and 1213 (6.07%) were probable and confirmed cases of COVID-19, respectively. The control group pharmacies provided care to 9151 patients, of whom 1074 (11.74%) and 33 (0.36%) were probable and confirmed cases of COVID-19, respectively. Rates of MDEs and their subcategories, prescription-related errors and pharmacist counselling errors across pharmacies with telepharmacy versus those without remote services were 15.81% versus 19.43% (p < 0.05), 5.38% versus 10.08% (p < 0.05) and 10.42% versus 9.35% (p > 0.05), respectively.Discussion: This is one of the first studies to provide high-quality evidence of the impact of telepharmacy on COVID-19 patients' access to pharmaceutical care and on medication dispensing safety. [ABSTRACT FROM AUTHOR]