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The Covid-19 pandemic has changed almost all aspects of education. The anatomy and histology courses for pharmacy students focus heavily on the face-to-face communication of theory and practical knowledge, and due to the pandemic, only theory content was delivered in an online format. This brought up many concerns about pharmacy student preparedness. This work explores the effectiveness and student perspective of remote teaching of the theoretical anatomy and histology course in Jordanian universities from the perspective of pharmacy students. The objectives are to determine the strengths, challenges, and the effectiveness of remote delivery on student learning. An online-based validated questionnaire was distributed to students majoring in Pharmacy and enrolled in the course during the second semester of 2019-2020 at 11 universities in Jordan. A total of 442 students participated in the study. Results showed that there were significant differences in perceptions of the social media platforms used in distance learning and remote delivery of the course. Most participants had positive perceptions of the educational process and studying via distance learning. There were many strengths noted including time flexibility and several challenges such as the lack of face-to-face interaction with instructors, inadequate internet connectivity, and technical issues. In conclusion, online-taught anatomy and histology course during the Covid-19 lockdown in Jordan was a success as perceived by students, but the course still possessed challenges need to be overcome in the future. more...

Dysmenorrhea association with post-traumatic stress disorder (PTSD) has not been studied in refugees. We aimed to examine the associations between dysmenorrhea severity, dysmenorrhea analgesics self-medications, and PTSD in a cohort of Syrian war refugees residing in Jordan. This is a cross-sectional study based on predetermined inclusion criteria held at Caritas primary care centers in Jordanian districts between September and October 2022. The participants’ demographics and analgesic self-medication type were recorded through a structured questionnaire. The dysmenorrhea severity was measured by (working ability, location, intensity, days of pain, and dysmenorrhea) WaLiDD scale, PTSD was measured by Davidson trauma scale (DTS)-DSM-IV. Data from 347 Syrian female war refugees were analyzed. The multivariate analysis showed that dysmenorrhea severity demonstrated significantly higher estimates for PTSD (10.48 [6.72-14.23], p=0.001), however, the analgesic type was not associated with PTSD burden. In conclusion, dysmenorrhea severity, but not self-medication, was associated with a higher PTSD burden. more...

Digoxin is a cardiac glycoside that was introduced to cardiovascular medicine more than 200 years ago. Its use is associated with large variability, which complicates achieving the desired therapeutic outcomes. To present a synthesis of the available literature on the population pharmacokinetics of digoxin in adults and to identify the sources of variability in its pharmacokinetics. This is a PROSPERO registered systematic review (CRD42018105300). A literature search was conducted using the ISI Web of Science, Science Direct, PubMed, and SCOPUS databases to identify digoxin population pharmacokinetic studies of adults that utilized the nonlinear mixed-effect modeling approach. Sixteen articles were included in the present analysis. Only two studies were conducted in elderly subjects as a separate population. Both the pharmacokinetics and pharmacodynamics of digoxin were investigated in one study. Furthermore, the reviewed studies were mostly conducted in East Asian populations (68.8%). Digoxin's pharmacokinetics were usually described by a one-compartment model because of the nature of the collected data. Weight, age, kidney function, presence of heart failure, and co-administered medications such as calcium channel blockers were the most commonly identified predictors of digoxin clearance. The value of apparent clearance in a typical study individual ranged from 0.005 to 0.2 l/h/kg, while the value of the apparent volume of distribution ranged from 3.14 to 15.2 l/kg. The quality of model evaluation was deemed excellent only in 31.3% of the studies. This review provides information about variables that need to be considered when prescribing digoxin. The results highlight the need for prospective studies that allow two-compartment pharmacokinetic/pharmacodynamic models to be established, with a special focus on the elderly subpopulation. more...

Objectives:The novel 2019 coronavirus outbreak that first appeared in Wuhan has quickly gained global attention, due to its high transmissibility and devastating clinical and economic outcomes. The aim of this study was to assess the possible roles of Jordanian pharmacists in minimizing the stage of community transmission.Methods:A cross-sectional survey using Google forms targeting Jordanian pharmacists was conducted during March 2020 and distributed electronically by means of social media. Using the survey tool, we measured the pharmacists’ knowledge, the educative activities they perform, and their perceptions regarding undertaking traditional and untraditional roles during the COVID-19 outbreak, as specified by the International Pharmaceutical Federation (FIP). Collected data were analyzed using SPSS version-19.Results:Jordanian pharmacists (n = 449) reported performing various educative activities, and in general, they were knowledgeable about various aspects of the COVID-19 disease (median knowledge score: 20 [range, 13-25]), but certain gaps in knowledge were detected that must be addressed. Pharmacists had positive perceptions about both their traditional and untraditional roles specified by the FIP, the median perceptions score was 4 (range, 1-5).Conclusions:Jordanian pharmacists can be used to reduce community transmission of the outbreak. However, more actions are required to keep pharmacists knowledgeable with recent disease updates to enable them to perform their tasks effectively during times of crisis. more...

This is a PROSPERO registered systematic review (CRD42018105207), conducted to summarize the available knowledge regarding the population pharmacokinetics of digoxin in paediatrics and to identify the sources of variability in its disposition. PubMed, ISI Web of Science, SCOPUS and Science Direct databases were searched from inception to January 2019. All paediatric population pharmacokinetic studies of digoxin that utilized the nonlinear mixed‐effect modelling approach were incorporated in this review, and data were synthesized descriptively. After application of the inclusion–exclusion criteria 8 studies were included. Most studies described digoxin pharmacokinetics as a 1‐compartment model with only 1 study describing its pharmacokinetics as 2‐compartments. Age was an important predictor of clearance in studies involving neonates or infants, other predictors of clearance were weight, height, serum creatinine, coadministration of spironolactone and presence of congestive heart failure. Congestive heart failure was also associated with an increased volume of distribution in 1 study. The estimated value of apparent clearance in a typical individual standardized by mean weight ranged between 0.24 and 0.56 L/h/kg, the interindividual variability in clearance ranged between 7.0 and 35.1%. Half of the studies evaluated the performance of their developed models via external evaluation. In conclusion, substantial predictors of digoxin pharmacokinetics in the paediatric population in addition to model characteristics and evaluation techniques are presented. For clinicians, clearance could be predicted using age especially in neonates or infants, weight, height, serum creatinine, coadministration of medications and disease status. For future researchers, designing pharmacokinetic studies that allow 2‐compartment modelling and linking pharmacokinetics with pharmacodynamics is recommended. more...

The use of the dried blood spot (DBS) sampling technique has extended the scope of clinical research, particularly in children. The effects of different hematocrit levels (25-55%) and different blood volumes (7.5-30 μL) on the surface area of the blood spots were investigated using ImageJ® software. Variation in hematocrit levels between patients and inaccuracies in blood volumes applied to Guthrie cards can have a marked effect on analyte concentrations measured in DBS samples. The current study presents a validated model that links blood volume and hematocrit to the surface area of the blood spot. The final model showed that both factors affect the blood spot surface area, however, the positive effect of blood volume is higher than the negative effect of hematocrit. The measurement of surface area could be added as an additional quality control step in clinical studies that have adopted fixed volume DBS sampling for the quantification of the analytes. This approach can be used in estimating the hematocrit if this is not known for a patient or estimating the volume in spots that are visually different in size from the norm, i.e. technical error. more...

Aims The aim of this study was, to use a multiple methods approach, including, for the first time, dried blood spot (DBS) sampling with population pharmacokinetic interpretation, to assess adherence to mycophenolate in children with kidney transplant. A second aim was to identify patient/parental factors that influenced adherence and to link adherence behaviour to clinical outcomes. Methods A convenience sample of 33 children with kidney transplant (age ≤ 18 years) who had been prescribed mycophenolate for at least 3 months were recruited from participating outpatient clinics in the UK and Jordan. Medication adherence was determined via self-report questionnaires, medication refill data from dispensing records, and via mycophenolic acid concentrations in plasma and DBS samples obtained from children during a clinic visit. Results Through triangulation of results from the different methodological approaches a total of 12 children (36.4%) were deemed to be nonadherent with their prescribed mycophenolate treatment. Logistic regression analysis indicated that nonadherence was significantly associated with the presence of mycophenolate side effects. Poor adherence was positively linked to measures of poor clinical outcomes (hospitalisation and the need for kidney biopsy). Conclusions Despite the imperative regarding medication adherence to help prevent organ rejection, a significant proportion of children are not fully adherent with their therapy. Side-effects appear to be an important factor leading to nonadherence. Measurement of mycophenolate in DBS samples, coupled with the use of population pharmacokinetics modelling, was a convenient direct approach to assessing adherence in children with kidney transplant and has the potential to be introduced into routine practice. more...

Self‐medication can facilitate patients’ access to medicinal products, save time, and reduce financial and health‐care service use burden. On the other hand, irresponsible use of self‐medications can result in adverse consequences. Self‐medication is common among different demographic groups including pregnant women. In general, medicinal products might have harmful effects on mothers and baby. This study aimed to assess self‐medication practices among pregnant women in the northern region of Jordan. A cross‐sectional study was conducted on pregnant women attending outpatient clinics in the northern region of Jordan. Self‐medication practices among the target population were assessed using a survey questionnaire that was administered through interviewer‐assisted mode. Data were collected between December 2019 and September 2020, and descriptive statistics and inferential analysis were applied. A total of 1,313 pregnant women were surveyed (response rate = 95.50%). Self‐medication and the use of herbal remedies were practiced by 33.10% and 32.14% of the participant, respectively. Headaches and general pains were the most frequently reported conditions treated by self‐medication practice with either conventional medicinal products or herbal remedies. The gravidity (≥4) and the gestational stage (≥28 weeks) were the predictors of self‐medication practice. This study showed that self‐medication was not widely practiced by pregnant women in the northern region of Jordan. Disease simplicity and previous history were the main motives for self‐medicating. Efforts should be made by health‐care providers to address pregnant women and educate them to increase their awareness about the unsafe use of medicines and the harmful effects on fetus., A cross‐sectional study conducted at the Northern region of Jordan showed that 33.1% of pregnant women practiced self‐medication during their pregnancy. Health‐care providers need to be actively involved in educating pregnant women and raising their awareness about the safe utilization of medicines during pregnancy. more...

Cervical cancer (CC) is one of the most common types of cancer that affect females worldwide with hundreds of thousands of women dying annually due to this disease, mainly in developing countries. Infection with human papillomavirus (HPV) is the main risk factor for this cancer. There are no public awareness and national immunization programs in most Arab countries. This study aimed to investigate the knowledge and awareness about the HPV vaccine among females in four Arab countries and their acceptance to receive the vaccine. A cross-sectional study was conducted in several Arab countries: Jordan, Qatar, the United Arab Emirates (UAE), and Iraq. Respondents that fulfilled the desired criteria and were willing to participate in the study were asked to fill out the survey. Knowledge and awareness were assessed using 13 questions. Ethical approvals were given from the four countries. A total of 3658 individuals participated in the study; however, 2804 responses were included in the analysis and more than one third of participants (n = 1007) were aged between 18 and 25 years old. This study revealed poor awareness and knowledge of the participants about HPV and its vaccine among all four countries’ participants with relatively better knowledge among participants from the UAE. Participants who are younger (18–25 years old), have a postgraduate education, have an education or career related to the medical field, or had a Pap smear in the last three years tend to have higher knowledge about the HPV vaccine compared to others. Poor knowledge and awareness findings in this study were expected, considering the lack of public education campaigns regarding the HPV virus coupled with the absence of the HPV vaccination from the national immunization schedule in three participating countries (Jordan, Qatar, and Iraq). It is recommended that there is a need to provide national educational campaigns about the HPV vaccine to the public in all Arab populations. more...

BackgroundCervical cancer (CC) is the most common gynecologic malignancy worldwide and the fourth most common cancer in women. Most cases of cervical cancer are attributed to Human Papillomavirus (HPV). Assessment of knowledge about cervical cancer and HPV vaccination is needed.Results504 students took part in the study. 42.3% of males and 57.7% of females. The mean knowledge score of students in our survey 21.4 ± 4.4 out of 34, which was categorized as a moderate level of knowledge regarding cervical cancer and HPV. Only 40.5% knew about the availability of HPV vaccine in Jordan, and 65.9% accept the idea that it is necessary to introduce HPV vaccine in schoolgirls in Jordan.ConclusionsThis study highlights inadequate knowledge about cervical cancer and its screening among medical students in Jordan. Despite the limited awareness about HPV vaccine among the study’s participants, there is a favorable opinion towards the introduction of the vaccine in school girls in Jordan. The data provide a benchmark on the level of knowledge about cervical cancer and awareness about HPV, which can be used to formulate an effective awareness program. more...

Objectives:Outbreaks and containment measures implemented to control them can increase stress in affected populations. The impact of the coronavirus disease 2019 (COVID-19) outbreak on perceived stress levels in the Jordanian population is unknown. The aim of the study was to determine the perceived stress level and factors associated with it in the Jordanian population during the COVID-19 outbreak.Methods:Required data, such as those from the Perceived Stress Scale (PSS-10) and possible predictors of perceived stress, were collected through a Web-based survey. Statistical analysis was conducted through SPSS.Results:The mean (SD) of perceived stress score was 19.8 (6.7). Regression analysis revealed that stress was increased in females, young adults, usually being stressed more than others by a health problem, increased perceived severity of the disease, increased overall worry score, and student’s worry regarding their studies/graduation. Perceived stress was decreased if participants’ self-rated health status score increased.Conclusions:In the context of increasing public health preparedness, the results of this study can be used in designing interventions to alleviate stress in susceptible segments of the Jordanian community. more...

AIM To assess the impact of educational workshops on the knowledge, attitudes, and intended practices (KAP) of the general public towards diabetes in Jordan in terms of symptoms, risk factors, complications, and prevention. METHODS A pharmacist led educational intervention and Propensity score matching was carried out for a convenience sample to assess Jordanians pre- and post-knowledge, attitudes, and practices towards diabetes mellitus (DM) using a validated questionnaire. RESULTS Among the 357 invited participants, 335 attended the educational workshops (response rate 93.8%). Prior to intervention, participants showed an overall knowledge score of 16.03 ± 4.88. About half of the participants knew that a sedentary lifestyle is a risk factor for getting DM (n = 172, 51.3%). Following educational intervention, knowledge scores significantly improved to be 21.36 ± 2.11 (P value more...

Introduction Viral infection is the main cause of Upper respiratory tract infections (URTIs). However, antibiotic resistance is promoted through inappropriate prescription of antibiotics for children with URTIs. This study aimed to assess the possible risk factors which may be associated with such antibiotic misuse. Methods This prospective study was designed to evaluate parents' knowledge and attitudes towards antibiotic use for their children. Study questionnaires were distributed to adult parents caring for children aged between 4 and 8 years at Jordan University Hospital. Detailed content analysis was conducted to obtain all relevant information. Results A total of 1301 parents agreed to participate in this study. Parents’ knowledge score was 7.02/14 (SD = 1.52). The knowledge score was positively associated with both the age of parents and the income level (p-value = .001 and Conclusions This study showed there was a relationship between the number of children, the age of parents and income on parent’s knowledge and attitude towards using antibiotics. Additional intervention programs may be required for such groups of parents. more...

Surgical site infections (SSIs) following caesarean surgeries are common. The present study aimed to evaluate the frequency of SSIs following caesareans at Jordan University Hospital during the 30 postoperative days and to identify factors associated with increased SSIs risk. Data regarding the occurrence of SSIs were collected both prospectively via follow-up phone calls and retrospectively via reviewing wound culture results and clinical notes. SSI cases were subsequently determined utilizing predefined criteria. Data relating to possible risk factors of SSIs were collected from patient interviews and hospital records. Risk factors for SSIs were identified via logistic regression. A high rate of SSIs (14.4%) was detected; implicated factors included body mass index ≥36 kg/m2 prior to pregnancy odds ratio (OR) 3.8, 95% confidence interval (95% CI) 1.6–9.4, hospital stay longer than 3.5 days OR 2.3, 95% CI 1.4-3.6, having the operation at a gestational age greater than 40 weeks OR 2.2, 95% CI 1.3-3.9. Receiving a higher weight-adjusted dose of the prophylactic antibiotic cefazolin was associated with lower SSIs risk OR 0.967, 95% CI 0.94-0.99. In conclusion , a high rate of SSIs following caesareans was detected, and modifiable risk factors of SSIs should be incorporated into targeted policies aiming to reduce the rate of SSIs. more...

Background. Measurement of the degree of adherence is a key element for the evaluation of treatment efficacy and safety; thus, adherence plays an important role in clinical research and practice. The aim of this study was to investigate medication adherence in children with inflammatory bowel disease (IBD) utilizing a multimethod assessment approach. A further aim was to examine factors that can influence adherence within this population. Methods. Medication adherence in 47 children (age range 3 to 17 years) with IBD in three centers in Northern Ireland and Jordan was assessed via subjective (parent and child versions of the Medication Adherence Report Scale (MARS) specific questionnaire) and objective methods, that is, high-performance liquid chromatography (HPLC) determination of the 6-mercaptopurine (6-MP) and azathioprine (AZA) metabolites in packed red blood cell samples taken during a clinic visit. Beliefs about prescribed medicines were also assessed in parents/guardians using the Beliefs about Medicines Questionnaire (BMQ). Results. An overall nonadherence to AZA/6-MP therapy in children with IBD was found to be 36.17% (17 out of 47 patients were classified as nonadherent using at least one of the assessment methods). A total of 41 patients (91.1%) were classified as adherent to AZA or 6-MP using the blood sampling, while adherence rates using the MARS questionnaire completed by children and parents/guardians were 60.6% and 72.7%, respectively. The latter provides a more longitudinal measure of adherence. Child self-reported nonadherence rates were significantly higher than parent/guardian reported rates (p=0.013). Binary logistic regression analysis identified age to be independently predictive of adherence, with adolescents (children aged ≥ 13 years old) more likely to be classified as nonadherent. Regarding the BMQ, when parental/guardian necessity beliefs outweighed concerns, that is, higher scores in the necessity-concern differential (NCD), adolescents were more likely to be classified as adherent. Conclusion. Results provide evidence for ongoing adherence challenges in the paediatric population with IBD. It is recommended that parents/guardians (particularly of older children) and older children themselves, should receive enhanced counselling and education about their prescribed medicines. more...

Due to the shortage of literature related to the safe use of over‐the‐counter (OTC) products by patients worldwide, the aim of this study was to evaluate people's knowledge and attitudes regarding the use of OTC products in Jordan. Using an internet‐based questionnaire mainly spread through social media platforms, a descriptive cross‐sectional study was conducted with Jordanian candidates who consume OTC products. A total of 274 OTC product users answered the survey questions. The results showed that analgesics were the most commonly used OTC products among the participants (50.4%). The majority used the OTC products only as needed rather than on a regular basis. Only 42.4% of the participants sought a pharmacist's help in determining the dose of the OTC medicine. Most of the participants were very interested in reading a patient information leaflet (80.3%) and the side effects and contraindications (89.5%). The majority of participants agreed that antibiotics have to be prescribed (68.5%), and anti‐allergy medications should not be used as sleep aid medications (75.0%). About 53.4% thought that OTCs are sometimes enough to treat their health conditions without the need to follow‐up with a physician. A chi‐square analysis showed an association between gender, age, educational level and having a family member in the medical field and OTC products knowledge among Jordanians. Females, for example, were more interested in reading leaflet, checking production and expiry dates, knowing adverse effects, and appropriate storage conditions (P more...

The use of complementary and alternative medicine in infants to maintain health and treat illnesses is popular in Jordan. No guidelines or regulations govern their use.This study explored mothers' knowledge and use of complementary and alternative therapies for infants younger than 3 months in Jordan and their reasons for using these remedies.This was a cross-sectional study of a convenience sample of mothers of babies born in 2015 in Jordan. Data were collected using a questionnaire posted on six Facebook groups that target mothers in Jordan. Mothers were asked about their use of several complementary and alternative therapies for different conditions.Of 1028 questionnaires received, 520 were included in the analysis. Most mothers (81.3%) were 18-29 years old and had a university degree (78.3%). Most knew about the use of the complementary and alternative medicines for bloating/ colic but had never used them. Of the medicines used for bloating/colic, aniseed was most often used (by 70.2% of mothers). Aniseed was also used by 60.8% of mothers to help their baby sleep and by 48.1% for constipation. The main reasons for using these remedies were availability at home (60.4%) and social acceptability of their use (55.4%). The main sources of information about these medicines were older female relatives (78.1%) and social media (56.0%).The use of complementary and alternative medicines for babies is common in Jordan. Efforts are needed to increase awareness among mothers of the risks, side-effects and efficacy of complementary and alternative therapies in infants.استخدام العلاجات التكميلية والبديلة للرضع الأقل من 3 أشهر في الأردن.زينة العلمي، إسراء طيبة، ميرفت الصوص، مي أبو حاكمة.يحظى استخدام الطب التكميلي والبديل مع الرُّضَّع بغرض الحفاظ على الصحة وعلاج الأمراض بشعبية في الأردن، غير أنه لا توجد مبادئ توجيهية أو لوائح تحكم استخدامه.هدفت هذه الدراسة إلى استكشاف معرفة الأمهات بالعلاجات التكميلية والبديلة واستخدامهن لها مع الرضع الذين تقل أعمارهم عن 3 أشهر في الأردن وأسباب استخدام تلك العلاجات.هذه دراسة مقطعية لعينة عشوائية من أمهات الأطفال الذين وُلدوا في عام 2015 في الأردن. وجُعت البيانات باستخدام استبيان نُشر على ست مجموعات على الفيسبوك تستهدف الأمهات في الأردن. وسُئلت الأمهات عن استخدامهن لعدة علاجات تكميلية وبديلة لحالات مختلفة.من بين 1028 استبياناً مُسْتَكملاً، أُدرِجَ 520 استبياناً في التحليل. وتراوحت أعمار معظم الأمهات (81.3 ٪) بين 18 و 29 عاماً، كما كُنَّ حاصلات على درجة جامعية (78.3 ٪). وكانت لدى أغلبيتهن معرفة باستخدام الأدوية التكميلية والبديلة المعالجة لانتفاخ البطن/ المغص، لكنهن لم يستخدمنها قط. ومن بين الأدوية المستخدمة لعلاج انتفاخ البطن/ المغص، كان الينسون هو الأكثر استخداماً (من قبل 70.2 ٪ من الأمهات). كما استخدمت 60.8 ٪ من الأمهات الينسون لمساعدة أطفالهن على النوم، و 48.1 ٪ لعلاج لإمساك. وكانت الأسباب الرئيسية لاستخدام تلك العلاجات هي توافرها في المنزل (60.4 ٪) ومقبولية استخدامها من الناحية الاجتماعية (55.4 ٪). وكانت المصادر الرئيسية للحصول على معلومات حول تلك الأدوية هن القريبات الأكبر سناً (78.1 ٪)، ووسائل التواصل الاجتماعي (56.0 ٪).يشيع استخدام الأدوية التكميلية والبديلة للرضع في الأردن. ويلزم بذل جهود لإذكاء وعي الأمهات بمخاطر العلاجات التكميلية والبديلة وآثارها الجانبية وفعاليتها بالنسبة الرضع.Utilisation de traitements complémentaires et alternatifs chez les nourrissons de moins de trois mois en Jordanie.L'utilisation de médicaments complémentaires et alternatifs chez les nourrissons pour maintenir leur santé et traiter les maladies est populaire en Jordanie. Aucune directive ou réglementation ne régit leur utilisation.La présente étude a analysé les connaissances des mères et leur recours aux traitements complémentaires et alternatifs chez les nourrissons de moins de trois mois en Jordanie, ainsi que les raisons pour lesquelles elles utilisent ces remèdes.Il s’agissait d’une étude transversale portant sur un échantillon de commodité de mères de bébés nés en 2015 en Jordanie. Les données ont été recueillies à l'aide d'un questionnaire publié sur six groupes Facebook ciblant les mères en Jordanie. Les mères ont été interrogées sur leur utilisation de plusieurs traitements complémentaires et alternatifs pour différentes affections.Sur les 1028 questionnaires reçus, 520 ont été inclus dans l'analyse. La plupart des mères (81,3 %) étaient âgées de 18 à 29 ans et détenaient un diplôme universitaire (78,3 %). Beaucoup d'entre elles connaissaient l'utilisation des médicaments complémentaires et alternatifs pour le traitement des ballonnements/coliques mais ne les avaient jamais utilisés. Parmi les médicaments utilisés pour le traitement des ballonnements/coliques, l’anis était le plus souvent utilisé (par 70,2 % des mères). L'anis était également utilisé par 60,8 % des mères pour aider leur bébé à dormir et par 48,1 % pour la constipation. Les principales raisons de l'utilisation de ces remèdes sont la disponibilité à domicile (60,4 %) et l'acceptabilité sociale de leur utilisation (55,4 %). Les principales sources d’information sur ces médicaments étaient les femmes plus âgées membres de la famille (78,1 %) et les médias sociaux (56,0 %).L’utilisation de médicaments complémentaires et alternatifs chez les nourrissons est courante en Jordanie. Des efforts doivent être déployés pour sensibiliser les mères aux risques, aux effets secondaires et à l’efficacité des traitements complémentaires et alternatifs chez les nourrissons. more...

Objectives To assess the knowledge about cervical cancer and HPV infection and the awareness towards and perceived barriers of HPV vaccination amid medical students in Jordan. Methods The present study is a cross-sectional survey that was conducted for a period of three months in the College of Medicine at six different universities in Jordan. Third-year to sixth-year students from these medical colleges in Jordan were invited to participate in the study. Results There were 504 students that took part in the study with 42.3% being males and 57.7% females. The mean knowledge score of students in our survey was 21.4 ± 4.4 out of 34, which was categorized as a moderate level of knowledge regarding cervical cancer and HPV. Only 40.5% knew about the availability of the HPV vaccine in Jordan, and 65.9% accepted the idea that it is necessary to introduce the HPV vaccine for school girls in Jordan. Conclusions This study highlights that there is inadequate knowledge about cervical cancer and its screening among medical students in Jordan. Despite the limited awareness about the HPV vaccine among the study’s participants, there is a favorable opinion towards the introduction of the vaccine for school girls in Jordan. The data provide a benchmark on the level of knowledge about cervical cancer and awareness about HPV, which can be used to formulate an effective awareness program. more...

AimsTo assess the knowledge and practices toward diabetes in the Jordanian community.MethodsThis study was conducted as a public based cross-sectional study in different cities in Jordan. A previously published validated questionnaire about knowledge, attitudes, and practices (KAP) toward diabetes mellitus (DM) was translated from the Arabic version and used in this study with very minor modification to be suitable for this study of the Jordanian population.ResultsA total of 1,702 participants were recruited in the present study. About half of the participants (53.3%) had good knowledge scores. The respondents' knowledge scores were significantly correlated with attitudes (p < 0.001). The education level (university or higher) and education related to a field were predictors for good knowledge and positive attitudes. About 46.3% of participants had positive attitudes toward the disease. As for practices, 37.7% of participants did not engage in regular exercise while more than half of the study subjects had never checked their blood glucose level on an annual basis. The factors influencing the practice of checking blood glucose level have been investigated.ConclusionThis study has highlighted the need for more educational interventions to address negative attitudes and promote healthy lifestyle practices and regular health checks especially in certain subgroups of patients, such as those not having a degree related to the medical field and not having a first-degree relative with DM. more...

Background:There is a lack of a standardized tool for adherence measurement in patients with epilepsy. Studies in children with epilepsy have reported adherence in 50–96.5%. The primary objective of this study was to identify predictors of nonadherence to antiepileptic drugs (AEDs) using two different methods in Jordanian children and adolescents with epilepsy.Methods:Participants included 63 children and adolescents with epilepsy and their primary caregivers. Adherence measures included a subjective approach (using parent and child self-reports via Medication Adherence Report Scale (MARS)) and an objective method (measuring plasma levels of AEDs coupled with the application of population pharmacokinetic models to predict AED concentrations in the children). The Beliefs about Medicines Questionnaire (BMQ) was used to examine the association beliefs about medicines with nonadherence in the participating patients.Results:Measuring AEDs in plasma samples captured the highest percentage of nonadherence (36.2%). No significant agreement was found between the AED plasma level method and both the MARS (parent) and MARS (child). The overall nonadherence (combined methods) to AED therapy in children with epilepsy was 44.4%. Logistic regression analysis indicated that children with longer duration of disease were more likely (odds ratio [OR]: 1.54, 95% confidence interval [CI]: 1.16–2.04) to be classified as nonadherent as were children whose parents have lower AED Necessity scores (OR: 0.68, 95% CI: 0.53–0.87) and higher AED Concerns (OR: 1.6, 95% CI: 1.26–2.04) as measured by the BMQ.Conclusion:The use of a multimethod approach for assessing adherence increases sensitivity for detection of nonadherence to AEDs. Disease duration and parental necessity beliefs and concerns assessed by the BMQ-specific questionnaire were significant predictors of nonadherence to the AED therapy. The need for the development and implementation of interventions that can be employed to improve adherence within this pediatric population has been highlighted by the high levels of nonadherence identified. more...

Background Pharmaceutical companies provide a broad range of different mandatory trainings to their medical representatives to keep the business running; however research related training has often been neglected by these companies. Thus, this study was developed to assess the amount of scientific research knowledge and interest among pharmacy medical representatives in Jordan. Method A cross sectional study was conducted in Jordan in 2016. During the study period, a questionnaire was administered to 250 medical representatives working in pharmaceutical companies to evaluate their scientific research knowledge and attitudes. Results The majority of medical representatives had positive attitudes towards clinical trials and research communication and believe that it will increase the value of their work, but a considerable number of medical representatives did not detail clinical trials on every visit and found difficulty in answering clinical trials and research related questions asked by health care professionals. Most of the medical representatives did not have a complete understanding of some basic research terminologies. Medical representatives working in multinational companies seemed to have a significantly better understanding of research and terminologies compared to local companies (P-value= 0.000). Also Medical representatives with higher educational degrees seemed to have significantly better understanding of basic research terminologies (P-value= 0.023). Conclusion The majority of medical representatives had positive attitudes towards clinical trials and research communication and found that it will increase the value of their work, but still there is a gap in their frequency of detailing. Thus, local pharmaceutical companies need to invest more in research and clinical trials knowledge kind of training. Also, universities need to include research related courses and subject in their bachelors' program curriculum in order to make pharmacists equipped in terms of research knowledge, regardless of the career path they choose. more...

Background Surgical site infections are common, especially in developing countries. Nevertheless, up to 60% of surgical site infections can be prevented with appropriate perioperative care, which includes among other measures using suitable surgical antimicrobial prophylaxis (SAP). Methods After a short interview with patients and retrospective review of medical charts, compliance with 6 SAP parameters was assessed for appropriateness; those parameters are indication, choice, dose, time of administration, intraoperative redosing interval, and duration of prophylaxis in 1,173 operations. Results Overall compliance was poor; nevertheless, certain components showed high compliance rates, such as indication and choice of antibiotics. The most frequent error noted was extended administration of prophylactic antibiotics, which was observed in 88.2% of the study population. Emergency operations were associated with a lower risk of noncompliance in administering the correct dose at the correct time (odds ratio, 0.63; 95% confidence interval, 0.47-0.83 and odds ratio, 0.21; 95% confidence interval, 0.14-0.3, respectively). On the other hand, women who underwent an emergency operation were associated with a 6-fold higher risk of receiving prophylactic therapy following surgery. Conclusions The present study demonstrated the existence of a surprisingly low level of overall compliance with the hospital-adapted SAP guidelines. Factors implicated in noncompliance were investigated, and the present results create a starting point to improve the current practice. more...

The analysis of 6-thioguanine (6-TG) and 6-methylmercaptopurine (6-mMP) in biological samples is not straight forward and requires pre-treatment of samples. There are no validated published methods for the analysis of azathioprine/6-mercaptopurine (AZA/6-MP) metabolites in dried blood spot (DBS) samples that study the correlation with red blood cells (RBC) concentrations. DBS was prepared by applying fifteen microliters of blood [spiked with analytes or samples obtained from patients] to a Guthrie card which was then dried at room temperature overnight. The sample treatment procedure used protein precipitation followed by a hydrolysis step in which, 6-mMP was converted into 4-amino-5-(methylthio)carbonyl imidazole (AMTCI) then analytes were transferred to a solid phase extraction cartridge. The extracted sample was chromatographed using a reversed phase system (C18) column preceded by a guard column of matching chemistry. The method gave a linear calibration over the range 0.5–15 μmol/L and 3.75–175 μmol/L for 6-TG and 6-mMP, respectively. The method has been applied successfully to the determination of 6-TG and 6-mMP concentrations in DBS finger-prick samples from 27 paediatric patients with IBD who were receiving (AZA/6-MP). Patient 6-TG and 6-mMP RBC concentrations, calculated from whole blood finger prick DBS samples and those measured in RBCs derived from matched venous samples (analyzed using conventional HPLC-UV technique) showed good agreement using the Bland-Altman test. This is the first published method for determining 6-TG and 6-mMP in DBS that studies their correlation with RBCs concentrations. It is applicable to a range of clinical studies such as adherence and pharmacokinetic studies involving AZA/6-MP. more...

Purpose: To assess the knowledge, attitudes and practices of parents towards antibiotics use for upper respiratory tract infections (URTIs) in Jordan. Methods: A cross-sectional study was carried out at 10 private outpatients’ pediatric clinics across Amman-Jordan from September to December 2013. During the study period, 1329 parents of young children who fulfilled the inclusion criteria and agreed to participate were interviewed, and completed a validated structured questionnaire. Results: A large proportion of parents (903, 68 %) believed that weather change was the main cause of acute URTIs in their children. Although 1098 (82.8 %) of parents were aware that the recurrent use of antibiotics leads to a decrease in effectiveness due to bacterial resistance, 859 (64.6 %) of the respondents reported that they would give antibiotics without prescription. Fathers (135, 40.2 %), were significantly more aware that URTIs follow its natural course without antibiotic administration compared to mothers ( N = 327, 32.9 %), respectively ( p = 0.005). Conclusion: There is a lack of adequate parental knowledge concerning the use and misuse of antibiotics in children in Jordan. National publicity campaign should be mounted to improve awareness. Furthermore, existing laws should be enforced to prevent parents from purchasing antibiotics over-thecounter (OTC). Keywords: Antibiotics, Attitude, Knowledge, Parents, Upper respiratory tract infections, Publicity campaign more...

Purpose : To assess the perceptions and knowledge of pharmacovigilance and adverse drug reactions (ADRs) reporting among Bachelor of Pharmacy (BPharm) and Doctor of Pharmacy (PharmD) students of selected tertiary institutions in Jordan. Methods : A cross-sectional study involving 434 pharmacy students from three different Jordanian universities was conducted from March - April 2014. During the study period, a validated structured questionnaire was administered to the participants to assess their knowledge and perceptions regarding pharmacovigilance and ADRs reporting process. Results : Majority of the students had insufficient awareness and lack of knowledge of pharmacovigilance and ADRs reporting with a mean knowledge score of 4/10. PharmD students had better knowledge about pharmacovigilance and ADRs reporting system than the BPharm students (knowledge score of 5.4 versus 3.2, respectively; p < 0.001). Also, higher knowledge scores were recorded for public university and fifth-year students (p < 0.001). About two-thirds of the students expressed a positive attitude toward pharmacovigilance and ADRs issues and agreed that they would be willing to report ADRs during their clerkship programme. Conclusion : BPharm and PharmD students have insufficient knowledge of the concept of pharmacovigilance and ADRs reporting. There is a need to incorporate pharmacovigilance into pharmacy curriculum in order to increase its awareness among pharmacy students as this will positively impact on their practice and enhance public health. Keywords : Pharmacovigilance, Adverse drug reactions reporting, Pharmacy students, Knowledge, Perception, Awareness, Attitude more...