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Sultan M Alshahrani,1 Sirajudeen Shaik Alavudeen,1 Khaled M Alakhali,1,2 Yaser Mohammed Al-Worafi,3 Ahmed K Bahamdan,1 Easwaran Vigneshwaran1 1Clinical Pharmacy Department, College of Pharmacy, King Khalid University, Abha, Saudi Arabia; 2Clinical Pharmacy Department, College of Pharmacy, USCI University, Kuala Lumpur, Malaysia; 3Clinical Pharmacy Department, College Of Pharmacy, University of Science and Technology of Fujairah, Fujairah, UAECorrespondence: Yaser Mohammed Al-WorafiCollege of Pharmacy, University of Science And Technology of Fujairah, Fujairah, UAETel +971543041178Email yworafi@yahoo.comPurpose: This study objective was to explore the pattern of self-medications among King Khalid University students, Saudi Arabia.Patients and methods: A cross-sectional study was conducted over five months among King Khalid University students, Abha, Saudi Arabia.Results: Among all the study participants, nearly 98.7% were practicing self-medication. Headache (75.9%), cough and cold (52.5%), and fever (35.6%) and body pain (24.6%) were the most reported symptoms. Use of painkillers (91.6%) was significantly predominant among the medical students, whereas non-medical students used antibiotics (35.4%).Time saving (64.2%), mild symptom (51.7%) and quick relief (36.9%) were the reasons behind seeking self-medication in this study.Conclusion: Self-medications was common in King Khalid University. Educational programs are highly recommended.Keywords: self-medication, students, medical, nonmedical, King Khalid University, Saudi Arabia

Abstract Background The COVID-19 pandemic has caused an unparalleled increase in psychological distress among everyone and everywhere. Perinatal depression, anxiety, and stress (DAS) are more prominent among HIV-positive pregnant women and are associated with poor maternal and neonatal outcomes. Therefore, this study aimed to assess the prevalence and explore the factors associated with DAS among HIV-positive pregnant women in India. Methods A multicentric, cross-sectional, analytical study was conducted among all HIV-positive pregnant women, aged more than 18 years, taking antiretroviral therapy, and attending antenatal care visits at two hospitals that are offering HIV care services in Anantapur District, Andhra Pradesh, India. Women who were unable to communicate were mentally ill, and refused to give consent were excluded. The study was conducted for a period of eighteen months from April 2020 to September 2021. A validated and interview-based data collection form was used to capture sociodemographic, obstetric profiles, clinical and support-related profiles, and COVID-19 stressors among study participants. The DASS-21 scale was used to assess depression, anxiety, and stress among study participants. Univariable and multivariable Poisson regression analyses were used to identify factors associated with DAS among study participants. Results The prevalence of depression, anxiety, and stress among HIV-positive pregnant women was found to be 50.3% (95% CI 23.6–76.4), 56.2% (95% CI 28.3–80.3), and 42.2% (95% CI 18.5–69.9), respectively. A multivariate Poisson regression analysis showed that participants living in a rural area (adj. PR 1.43,1.08–1.91), primigravidae (adj. PR 1.37, 1.09–1.72), less number of ANC visits (adj. PR 1.41, 1.12–1.76), identified HIV during pregnancy (adj. PR 1.42, 1.13–1.77), non-disclosure of HIV status with one’s partner (adj. PR 1.43, 1.11–1.83), no partner support (adj. PR 1.84, 1.31–2.59), and having a negative HIV status sexual partner (adj. PR 1.35, 1.02–1.79) were all significantly associated with depression. Factors such as lack of partner support (adj. PR 1.48, 1.09–1.99) and known HIV status during pregnancy (adj. PR 1.24, 1.01–1.52) were significantly associated with anxiety. Participants who had less ANC visits (adj. PR 1.50, 1.12–2.02), non-disclosure of HIV status with partner (adj. PR 1.47, 1.08–2.02), known HIV status during pregnancy (adj. PR 1.62, 1.23–2.15), negative HIV status of sexual partner (adj. PR 1.44, 1.02–2.02), and no partner’s support (adj. PR 1.85, 1.25–2.74) were significantly associated with stress. Conclusion The study concludes that about one-third of the HIV-positive pregnant women reported anxiety, and more than half of the women were feeling stressed and depressed during COVID-19. Factors such as residence and primigravidae were linked with antenatal depression. Whereas variables like ANC visits, knowing HIV status during pregnancy, non-disclosure of HIV status, no partner’s support, and sexual partner HIV negative status were associated with depression and stress. The anxiety symptoms are very high among women who are HIV positive during pregnancy, and not having a partner’s support. Demographic, clinical, and support-related determinants and COVID-19 stressors of DAS provide insights for interventions to reduce the burden of mental health problems among HIV-positive pregnant women.

OBJECTIVE: Many countries, including the USA, are currently confronting a triple epidemic in children as COVID-19 cases increase and new strains emerge which urge COVID-19 vaccination for children. The Advisory Committee on Immunization Practices (ACIP) for the CDC unanimously approved the inclusion of the COVID-19 vaccine (C19V) in the recommended immunizations. As healthcare professionals (HCPs) and parents are significant players in changing the trend of the triple epidemic by giving the C19V, the present study was done to determine awareness and perception of HCPs and parents on the tripledemic and the need for inclusion of C19V in vaccination schedules for children. PATIENTS AND METHODS: A cross-sectional study was conducted among 400 HCPs and 200 parents to assess their knowledge and perception of tripledemic and the need for the inclusion of C19V. RESULTS: Noticeably, half of the participants had either recent personal (36.2%) or family (21.8%) exposure to some of the tripledemic like RSV, Flu, or COVID-19. On perceived awareness, 42% were concerned about tripledemic, and 35% thought that regular C19V may prevent or reduce tripledemic. Ironically, 11% were not willing to give C19V to their children. The logistic regression model for positive perception of tripledemic and regular C19V identified significant relationships with education (OR 2.19, CI 1.48-3.81), gender (OR 0.9, CI 01.02-2.63), recent personal or family exposure to any of the tripledemic (OR 0.239, CI 0.87-1.63) and presence of children in the family (OR 0.71, CI 1.4-1.96). The reason for favorable perception was preventing self and family from tripledemic. CONCLUSIONS: The findings may give insight to the policymakers for a strategic plan to include C19V in the routine schedule to combat the pandemic and tripledemic by improving herd immunity. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The study aim is to determine the drug-induced incidence of basophobia, falls, its’ related variables and the consequences among older adults. PATIENTS AND METHODS: A descriptive, cross-sectional study was adopted with 210 older adult samples. The tool consisted of 6 sections: a standardized, semi-structured questionnaire and physical examination. Descriptive and inferential statistics were used to analyze the data. RESULTS: Among the study participants, 49% had falls or near falls and 51% had basophobia in the past 6 months. As per final simultaneous regression analysis model of the study, the covariates to activity avoidance were age (ß=-0.129, CI=- 0.087 to -0.019), having >5 chronic diseases (ß=- 0.086, CI=-1.41 to -1.182), depressive symptoms (ß=-0.09, CI=-0.089 to -0.189), vision impairment (ß=-0.075, CI=-1.28 to -1.56), basophobia (ß=-0.26, CI=-0.059 to -0.415), taking regular antihypertensives (ß=-0.096, CI= -1.21 to -1.56), oral hypoglycemics and insulin (ß=-0.17, CI=-0.442 to -0.971) and sedatives and tranquilizers (ß=-0.37, CI=-1.32 to -1.73). Use of antihypertensives (p<0.001), oral hypoglycemics and insulin (p<0.01), sedatives and tranquilizers (p<0.001) were strongly associated with fall related to activity avoidance. CONCLUSIONS: The result of this current study suggests that the falls, basophobia and its related activity avoidance among elderly may set in a “vicious cycle” of falls, basophobia, and the numerous negative outcomes such as functional impairment, a decrease in quality of life, and hospitalization. Preventive strategies such as tittering dosage, home- and community -based exercises, cognitive behavioral therapy, yoga, meditation and sleep hygiene may be the choice to break this vicious cycle. [ABSTRACT FROM AUTHOR]

Background The COVID-19 pandemic had an enormous impact on people’s quality of life worldwide. Appropriate use of facemasks is an important checkpoint in containing the spread of infection, which was believed to provide the desired level of protection and preserve the community. Given the relative novelty of facemask use in the general population, it is imperative to prioritize the promotion of appropriate facemask utilization and identify factors that may contribute to poor adherence. Aim This study assessed the factors that determined facemask use among the public. Methods A cross-sectional questionnaire-based study was conducted among the residents of the Kingdom of Saudi Arabia between November 2020 and January 2021. The current study explored the factors such as demographic characteristics influencing the knowledge and practice of proper use of facemasks. The study included a total of 198 participants. The results were derived through binomial logistic regression analysis to determine the relationship between the demographic characteristics and responses. Results The key findings of the study which are crucial in developing targeted intervention strategies to enhance the responsible use and disposal of facemasks are gender, income and employment. A significant difference was found between male and female participants regarding a positive approach to using facemasks, such as washing their hands (P = 0.042). In addition, homemakers differed significantly from students, regarding the correct usage of facemasks (P = 0.026). The study participants were aware that hand hygiene is essential when putting on and removing facemasks. Despite wearing facemasks properly, adult participants possessed less knowledge about the hazards of reusing facemasks and appropriate disposal (OR = 0.202, 95% CI [0.032–1.298]). Conclusion The present research identified gender, income, and employment as the primary attributes that play a pivotal role in the formulation of focused intervention tactics aimed at improving the cautious use and appropriate disposal of facemasks. It is essential to implement nationwide awareness activities, such as information campaigns, to enhance knowledge. Health authorities should establish a functional infrastructure for the collection and disposal of used facemasks by the general public, starting with the dissemination of knowledge. Moreover, the results of the present study have significant implications for health preventive programs aimed at preparing for future pandemics, since they highlight the specific demographic groups that should be prioritized in the development of such policies. Furthermore, it is advisable to integrate these interventional initiatives with national health polices to promote preparedness for handling future pandemics.

Aims and Objectives. Admission in the intensive care unit is highly stressful, for both the child and family. This study aimed to identify the factors influencing the nurse-parent partnership in the pediatric intensive care units. Methods. The data were collected from 71 ICU nurses through a web-based survey by the Pediatric Nurse-Parent Partnership (NPP) Scale, Wong and Law Emotional Intelligence (EI) Scale, and patient-centered communication (PCC) proficiency by Park and Oh’s. Descriptive and inferential statistics were used to analyze the data. Results. The mean scores for NPP, EI, and PCC skills were 67.91 ± 9.62, 55.16 ± 5.77, and 33.38 ± 4.81, respectively. There was a positive correlation between NPP, EI (r = 0.71, p

Background Worldwide, millions of people die of sudden cardiac arrest every year. A well-timed cardiopulmonary resuscitation (CPR) increases the possibility of survival by two- to fourfolds. This study aimed to assess the knowledge, attitude, and preparedness of health care students toward basic life support (BLS) at King Khalid University. Methods A cross-sectional study was conducted among the health care students of King Khalid University from August to October 2020. Data were collected using a pretested, semi-structured questionnaire and the data were analyzed using Statistical Package for the Social Sciences. Resulrs The total number of participants was 346. Overall, the participant’s knowledge regarding the BLS was inadequate. Majority of the participants were not aware of the acronyms used in BLS. The level of education has a significant impact on the knowledge, whereas gender has no significant impact on the knowledge. The answers to the attitude and the preparedness items were also not satisfying. Lack of knowledge is one of the common reasons for not performing BLS. Periodical training program and refresher courses were the most recommended methods to increase the knowledge toward the BLS. Conclusion It is evident from the current study that there is a lack of knowledge and preparedness toward BLS among most health care students. It is recommended to incorporate more BLS training and refresher courses in the health care college curricula.

Objectives: To collect all studies related to COVID-19 infected pregnant women and summarize the symptoms, laboratory findings, treatments, and perinatal outcomes. Methods: The systematic review was conducted according to the PRISMA consensus statement. A systematic search was performed in PubMed, Scopus, Web of Science, and Cochrane databases on April 3, 2020. All studies relevant to COVID-19 infection among pregnant women are considered for inclusion. A total of 12 studies are considered for inclusion in this systematic review. Two authors extracted the data by using pre-designed, piloted, and customized data extraction form. Results : Fever (60.2%), cough (36.6%), and postpartum fever (23.5%) are the most common symptoms observed in pregnant women infected with COVID 19. The most common abnormal laboratory finding observed in COVID 19 infected pregnant women include; raised AST or ALT (21.0%), lymphopenia (55.8%), elevated C-reactive protein (62.2%), and abnormal chest CT scan (90.2%). Oxygen administration, antibiotic, and antiviral therapy is the mainstay of management strategy in the majority of the studies. Chloroquine and hydroxychloroquine are not advised in pregnancy due to secondary complications. The most common adverse obstetric and neonatal outcomes are preterm delivery, C-section, fetal distress, and low birth weight. There was no vertical transmission of COVID 19 from mother to fetus. Conclusion: Fever, cough, postpartum fever, elevated C-reactive protein, lymphopenia, and abnormal chest CT are the most common clinical and laboratory examinations in pregnant women infected with COVID-19. All healthcare professionals need to consider possible outcomes in this review and make a decision to reduce the risk of complications in both mother and fetus.

Background: E-learning is a modern and flexible mode of education and is being used as an alternative to conventional mode of education during the ongoing COVID-19 pandemic. However evidence suggests that effectiveness of e-learning is influenced by many prevailing factors. Methods: A cross sectional study aimed to evaluate health care students’ perception towards implementation of e-learning was conducted for a period of 4 months, from April 2020 to July 2020. Research instrument consisted of a self-designed, qualitative questionnaire with three domains was validated using field pretest method and administered among health care students of King Khalid University using social media platforms. Chi square test was used to estimate the effect of e-learning on various domains whereas linear regression analysis was used to find the association between subjects’ characteristics to overall domain scores. P value

Background: In India, there is a scarcity of epidemiological data related to risk factors and prevalence of depression, anxiety, and stress (DAS) among diabetics. Therefore, their estimation may provide data for an effective management of these disorders in diabetic patients. Aim: The current study was undertaken to analyze the effect of sociodemographic characteristics toward DAS symptoms and to estimate the prevalence of DAS among diabetics. Materials and Methods: It was a cross-sectional study conducted among diabetics at the resource-limited settings of South India. Non probabilistic convenient sampling was used for recruitment fo study subjects. DAS scale 21 questionnaire is a validated self-report questionnaire designed to measure the severity of a range of symptoms for DAS. The patients with established psychiatric disorders were excluded from the study. Results: Overall, the prevalence of DAS symptoms was 57.5%, 55.9%, and 44.9%, respectively, and which ranges from mild to extremely severe. Gender plays a major role in increasing the prevalence of depressive and stress symptoms. The elderly age group was found to have more prevalence of all these three symptoms than younger age. Conclusions: The study showed that the prevalence of DAS symptoms was high. However, in our study, these symptoms are poorly associated to demographic characteristics. We recommend to screen all the diabetic patients for DAS symptoms.

Purpose: Saudi Arabia is one of the leading nations in the world in terms of the high frequency of chronic diseases and their associated risk factors. Knowledge and awareness are crucial for pharmacists to play an active role in the prevention of cardiovascular diseases (CVD). The current study assessed the pharmacists' knowledge, attitude, and practice to determine the potential differences with respect to their respective practice settings toward CVD prevention and related health promotions., Methods: It is a cross-sectional study targeted the registered pharmacists in the Kingdom of Saudi Arabia. An online questionnaire was prepared, and the link was circulated through various social media platforms. Descriptive statistics, multivariate linear regression analysis and chi square test were used to analyze the data accordingly., Results: A total of 324 pharmacists were included in the study. Among these, 157 (48.4 %) were community pharmacists, and the remaining were hospital pharmacists (51.6 %). No significant differences in knowledge scores were observed between community and hospital pharmacists. The mean attitude score among community and hospital pharmacists was found to be 26.40 ± 5.125 and 25.09 ± 5.393 respectively, which was statistically significant ( p  = 0.026). Similarly, the total practice scores across the settings were statistically significant ( p  = 0.02). Gender plays a significant role in terms of knowledge scores among both community and hospital pharmacists ( p  = 0.016 & 0.029). Gender, professional practice experience, and number of prescriptions handled and prescriptions with CVD medications showed significant differences in the distribution of positive attitudes and good practice frequency between community and hospital pharmacists., Conclusion: It is evident that there is a deficiency in knowledge among hospital pharmacists compared to community pharmacists. Which indicates that there is a need for a rigorous continuous pharmacy education covering the fundamental aspects of CVD primary prevention and health promotion among pharmacists, given more focus on hospital pharmacists., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

Background: Women living with HIV are at increased risk of developing cervical cancer (CC). Screening for cancer is an important preventive strategy for the early detection of precancerous lesions and its management. There has been inadequate evidence on cervical cancer screening (CCS) practices among HIV-positive women in rural western Uganda. This study aimed to assess the prevalence and predictors of CCS among HIV-positive women, as well as knowledge and practices regarding cervical cancer screening., Methods: A cross-sectional, analytical study was conducted among HIV-positive women attending HIV care facilities located in rural settings of western Uganda. A validated and interview-based data collection form was used to capture statistics regarding demographics, HIV care, obstetric profile, health belief constructs, and knowledge and history of CCS from the participants. Bivariate and multivariate logistic regression analyses were used to correlate women's characteristics and health beliefs toward CCS practices., Results: The prevalence of CCS among HIV-positive women was found to be 39.1% (95%CI: 14.0-71.7). A multivariate logistic regression analysis showed that post-secondary education attainment (AOR = 3.21; 95%CI = 2.12-7.28), four years or more lapsing after being diagnosed as HIV-positive (AOR = 2.87; 95%CI = 1.34-6.13), having more than one child (AOR = 1.87; 95%CI = 1.04-3.35), antenatal care attendance (AOR = 1.74; 95%CI = 1.02-3.43), post-natal care attendance (AOR = 3.75; 95%CI = 1.68-5.89), and having good knowledge regarding CC (AOR = 1.26; 95%CI = 1.98-3.02) were positively associated with adherence to CCS among HIV-positive women in western Uganda. Health Belief Model (HBM) constructs like the perceived risk of developing CC (AOR = 1.82; 95%CI = 1.16-2.01), worries about developing CC (AOR = 5.01; 95%CI = 4.26-8.32), believing that CC leads to death (AOR = 2.56; 95%CI = 1.64-3.56), that screening assists in early identification (AOR = 2.12; 95%CI = 1.84-3.74) and treatment (AOR = 4.63; 95%CI = 2.78-6.43) of precancerous lesions, reducing the risk of mortality (AOR = 1.84; 95%CI = 1.12-2.75), and the reassurance provided by negative test results (AOR = 2.08; 95%CI = 1.33-4.22) were positively associated with adhering to CCS. A female doctor performing the screening (AOR = 2.02; 95%CI = 1.57-3.98) as well as offering a free screening service (AOR = 3.23; 95%CI = 1.99-4.38) were significantly associated with CCS. Meanwhile, screening being painful (AOR = 0.28; 95%CI = 0.12-0.45), expensive (AOR = 0.36; 95%CI = 0.24-0.53), time-consuming (AOR = 0.30; 95%CI = 0.19-0.41), embarrassing (AOR = 0.02; 95%CI = 0.01-0.06), and the fear of positive results (AOR = 0.04; 95%CI = 0.02-0.10) were found to have a significant negative association with adhering to CCS., Conclusions: Only one-third of HIV-positive women had undergone CCS. Variables including secondary education attainment, four years or more lapsing after being diagnosed as HIV-positive, having more than one child, antenatal care attendance, post-natal care attendance, and knowledge about CC were positively associated with CCS adherence. Educational programs should be geared towards the risk of CC, severity of cases, benefits of screening, and reducing barriers associated with screening, which can significantly improve cervical CCS among HIV-positive women. The study proposes the incorporation of free screening services and the inclusion of trained female staff in CC prevention policies to improve CCS., (© 2023. The Author(s).)

Objectives: Although depression symptoms are common among patients with Parkinson's disease (PD), the medical literature still reports underrecognition of depression in patients with PD. Our main objective is to examine the trend of depression recognition during the first year of PD diagnosis using large population data., Methods: We conducted a population-based study of residents in Wales, using the Secure Anonymized Information Linkage (SAIL) Databank. We included newly diagnosed patients with PD aged 40 years or older with a first PD diagnosis between 2000 and 2015. Depression and antidepressants related data were extracted from SAIL. A series of multilevel logistic regressions were run to determine the factors affecting depression recognition. The results were presented using odds ratios (ORs) with 95% confidence intervals (CI)., Results: The study included 6596 patients with PD. About 38% of patients had a recorded code of antidepressants, depression diagnosis, or both within the first year of PD diagnosis. There was a significant association of depression diagnosis, antidepressant use, or both with the year of PD diagnosis (OR 0.972, 95% CI 0.962-0.983). We also found that patients who used monoamine oxidase inhibitors (MAO-B inhibitors) were associated with a lower depression diagnosis, use antidepressants, or both, compared to those who did not use MAO-B inhibitors (OR 0.769, 95% CI 0.627-0.943)., Conclusion: There is a slight decrease in depression recognition in PD patients between 2000 and 2015, which could be due to an increase in depression recognition during the prodromal phase of PD., (© 2021 The Authors. Brain and Behavior published by Wiley Periodicals LLC.)

Objectives: The safety and efficacy of treatment approaches in patients with type 2 diabetes mellitus (T2DM) after the failure of two oral hypoglycemic agents (OHAs) was studied., Methods: A combination of the ambispective study was conducted between June 2013 to June 2014 at the Asir Diabetes Center, Abha, Kingdom of Saudi Arabia (KSA). Patients with poorly controlled T2DM who were administered two OHAs for at least 6 months and had HbA1c levels greater than 7.0% were included. Subjects were treated with three OHAs (Group I), biphasic insulin and metformin (Group II), two existing OHAs and basal insulin (Group III), and insulin monotherapy (Group IV). Relevant data were collected at baseline at the interval of 3 months for one year., Results: Amongst 255 patients enrolled, 20.8, 29.8, 32.5, and 16.8% were in Groups I, II, III, and IV, respectively. The mean (Glycated hemoglobin) HbA1c levels were decreased significantly in the groups where insulin was an add-on therapy with the OHAs. Acceptable level of HbA1C (7 %) was significantly higher amongst patients in groups II and III, whereas hypoglycemic events were higher in Group IV., Conclusion: Insulin as add-on therapy with OHAs is an option for the management of T2DM where glycemic control is insufficient with two OHAs., (© 2020 John Wiley & Sons Ltd.)

Background: Data about the health-related quality of life (HR-QOL) of people living with HIV/AIDS (PLHA) after the implementation of free antiretroviral treatment in India are scarce., Aim: The study was to describe the HR-QOL and gender differences of PLHA in rural India., Materials and Methods: Cross sectional study of 120 PLHA who came to the outpatient department in a rural district hospital. Assessment of the HR-QOL was performed through interviews using a validated structured questionnaire from the Medical Outcome Study HIV Health Survey. Linear regression with robust standard errors was used for multivariable analysis., Results: Domains related to social and daily activities such as cognitive, role and social functioning had lower HR-QOL scores than domains related to physical health. Men had higher scores of HR-QOL in health transition, perceived HR-QOL, health distress, social functioning and role functioning. In multivariable analysis, factors associated with poorer HR-QOL were female sex, lower levels of education and being widowed or separated in women., Conclusions: HR-QOL of PLHA in rural India is poor, especially in widowed or separated women and people with lower levels of education. There is an urgent need of implementing programmes for improving the HR-QOL of HIV infected women in rural India.