Survey of COPD Knowledge, Skills, and Attitudes Among Saudi Arabian Respiratory Therapists

Abstract Chronic Obstructive Pulmonary Disease (COPD), a global health problem, is gradually increasing. It was predicted that by 2020, COPD would be the third cause of death, with 10% of the cases being in high-income countries. Worldwide, this disease affects 380 million people leading to 3 million deaths yearly. High mortality is attributed to late diagnosis, which decreases the chances of recovery and survival. COPD is highly prevalent in low-income countries than in developed countries. In Saudi Arabia, the prevalence rate is 14.5 % among current and ex-smokers. Smoking rates among Saudi population is 27.9%, and the dusty weather of Saudi Arabia are considered the major risk factors for COPD among the Saudi community. Respiratory therapists (RTs) would play a major role in managing COPD patients because of the shortage of pulmonologists. Therefore, the purpose of this descriptive research study was to examine knowledge, attitude, and awareness of COPD among Saudi Arabian RTs to increase their involvement of treating COPD patients. The study method was a convenient sample (n = 119) of Saudi RTs. Findings of descriptive analysis showed that 53.2% of RTs answered correctly on the scale of knowledgeability of COPD. Independent t-test analysis revealed no gender differences in RTs’ knowledgeability about COPD and its global guidelines. Similarly, One-way ANOVA revealed no significant differences (p\u3e0.05) in knowledge due to education level. Moreover, 52% of the RTs have the appropriate skills to treat COPD patients with no significant differences (p\u3e0.05) in skills based on education level. Lastly, the RTs were moderately confident in implementing diagnosis and assessment according to guidelines/recommendations. The males (̅=6.9) were more confident than females (̅=6.11). However, based on the ANOVA test, there was no significant difference (p=0.306 \u3e0.05) in confidence scores due to education level. Overalls, it can be concluded that gender and education level may impact the knowledge levels, skills, and attitudes of Saudi Arabian respiratory therapists differently, and the Saudi ministry of healthy can rely on them in terms of mange, examine, and treat COPD patients

Analysis of Gabapentinoids Abuse-Reports in the Middle East and North Africa Region Utilizing the Food and Drug Administration Adverse Event Reporting System

Objectives: The purpose of this study was to identify abuse-related post-marketing reports associated with gabapentinoids use in the Middle East and North Africa (MENA) region countries. Methods: A retrospective cross-sectional analysis of abuse-related adverse drug event (ADE) reports from the Middle East and North Africa (MENA) region. It was performed using the Food and Drug Administration Adverse Event Reporting System (FAERS) database from January 2008 through June 2020. Abuserelated ADE reports for gabapentin and pregabalin were extracted from the FAERS database. Descriptive statistics were performed, and the proportional reporting ratio (PRR) was calculated to detect disproportional attribution of abuse-related ADEs for gabapentin versus pregabalin. Results: We identified 559 all-cause ADE reports for gabapentinoids, including 205 (36.7%) abuse-related ADE reports reported to FAERS in the period of analysis. FAERS included 139 (67.8%) pregabalin and 66 (32.2%) gabapentin abuse-related ADE reports. Among MENA region countries, Turkey (55, 39.6%) and Saudi Arabia (34, 23.7%) had the highest number of abuse-related ADE reports for pregabalin. The most pregabalin abuse-related ADE reports involved adult male patients. The PRR of pregabalin versus gabapentin abuse-related ADE reports was 1.11, indicating that the number of abuse-related events was higher for pregabalin compared to gabapentin. Conclusion: Over 200 cases of abuserelated gabapentinoids events were reported to FEARS from the MENA region in the study period. Further studies should assess risk factors and potential programs to reduce gabapentinoids abuse

Knowledge, Attitude, and Practice of Complementary and Alternative Medicine among Program’s Residents in Tabuk, Saudi Arabia

BACKGROUND: Complementary and alternative medicine (CAM) focuses on stimulating the body’s ability to heal itself through energy alignment, herbal supplementation, and other balancing techniques. AIM: The objective of the study was to investigate and compare the Knowledge Attitude Practice (KAP) of CAM among program’s residents in Tabuk region. METHODS: A cross-sectional CAP study was conducted among program’s residents in Tabuk region. All program’s residents of all specialties in Tabuk region were included in the study. Data were collected by predesigned electronic questionnaire covering the needed items. Collected data were coded and analyzed using SPSS Inc., Chicago, Illinois, USA. The Chi-square test was used as a test of significance and p = 0.05 or less was considered statistically significant. RESULTS: Most (95.8%) of the participants have heard about CAM, 25% have used CAM in treatment before, and 72.3% of them reported beneficial outcome, 25.7% strongly agree and 48.6% agree that CAM is a useful complement to pharmacological medicine, 38.2% believed that the results of CAM are usually due to the placebo effect, and 52.1% recommended using CAM. On the other hand, 79.9% have knowledge about acupuncture, 54.9% spiritual healing and herbal medicine, 43.1% massage, 41% yoga, 70.8% bloodletting cupping, and 56.3% about cauterization. More than third (38.2%) of the participants agreed that the use of herbal products is a valid form of drugs which can be used for the treatment of variety of diseases, 48.6% agreed that CAM is a useful complement to pharmacological medicine, while 36.1% strongly agreed that CAM treatments are not tested in a scientifically recognized manner. CONCLUSION: In our study, the majority of program’s residents in Tabuk region agree that CAM is a useful complement to pharmacological medicine and recommended using CAM while reasonable percentage of them believed that the results of CAM are usually due to the placebo effect

Clinical Management in Diagnosis and Treatment of the Iron Deficiency Anemia in Adults: Systemic Review

This study aimed at exploring with a systematic review the clinical management in diagnosis and treatment of the iron deficiency anemia in adults, as the iron deficiency is the most frequent cause of anemia worldwide. And it impairs quality of life, increases asthenia and can lead to clinical worsening of patients. In addition, iron deficiency has a complex mechanism whose pathologic pathway is recently becoming better understood. This review summarizes the current knowledge regarding diagnostic algorithms for iron deficiency anemia. The majority of aetiologies occur in the digestive tract, and justify morphological examination of the gut. First line investigations are upper gastrointestinal endoscopy and colonoscopy, and when negative, the small bowel should be explored; newer tools such as video capsule endoscopy have also been developed. The treatment of iron deficiency is aetiological if possible and iron supplementation whether in oral or in parenteral form.

Saudi Vigilance Program: Challenges and lessons learned

Pharmacovigilance is vital to public health. Adopting a robust spontaneous reporting system for adverse drug events can counteract most hazards that arise from utilizing medicinal products. Prior to the establishment of the Saudi Food and Drug Authority (SFDA), the number of pharmacovigilance-related activities in Saudi Arabia was limited. In 2009, the SFDA established the National Pharmacovigilance and Drug Safety Center (Saudi Vigilance). The pharmacovigilance system has remarkably improved during the past few years. Several initiatives have been taken to improve the program’s performance. These initiatives include initiation of pharmacovigilance guidelines, enhancement of communication and reporting tools, training sessions for concerned staff and healthcare providers, and compliance from stakeholders. This review article provides an overview of what the Saudi Vigilance program is, focusing on the scope, mission and vision, hierarchy, operational themes, and overall work processes. Additionally, we will shed light on the challenges we encountered during the early phase and on our future plans

Current trends and future prospects of chemical management of oral biofilms

Oral biofilm, a tribulation encountered on a general basis is known to associate and contribute to many oral and systemic diseases. Eradication of these biofilms is a primary step in treatment of the underlying malady. Management of a biofilm is governed by various factors: the microenvironment within a biofilm, bond between the adhered surface and the biofilm, location of the biofilm, access to the biofilm for removal. Though annihilation is the priority, the mode of approach to achieve the same is equally important, because biofilm's heterogenic nature and location govern the strategical treatment required. Literature supports that the consequences of oral biofilms is not restricted to its home ground, but disseminated to other systems of the body. This contemplates us to procure knowledge on its development, structure and progression to aim its eradication. Therefore, this review attempts to recognize the type of biofilm based on location and enumerate all the possible chemical modes of management for the specific type of oral biofilms encountered. In addition, to the traditional strategies prescribed or administered, newer approaches which are gaining popularity due to their ease and efficiency are also addressed. Frontiers in the above field, under investigation and promising in near future are also compiled. Thus, the present review aims to provide a comprehensive elucidation of chemical management of oral biofilms, both the conventional and novel approaches under investigation

Ethnopharmacological evaluation of Poppy seed oil in combination with Tramadol on behavioral paradigm and on dopamine, and cytokines levels

OBJECTIVE: The present study was taken up to evaluate the combination of two drugs in the management of behavioral disorders such as locomotor activity, muscle relaxation, analgesic, and anxiolytic activity. MATERIALS AND METHODS: In the methodology, Wistar rats weighing (150-180 g) were divided into six groups of 6 each (n=6). All the animals (groups II to VI) were subjected to stress and analyzed for anxiolytic activity using an elevated plus maze. The animals were treated for 28 days with poppy seed oil in lower and higher doses (1,000 and 2,000 mg/kg), tramadol in lower and higher doses (1.5 and 3 mg/kg) as individual groups, and one group with a combination of both drugs in lower doses. RESULTS: The results depicted showed that the combined treatment had significantly (**p <0.001) improvised behavior deficits, extemporized, and diminished anxiety-like attitude in rats, and showed the analgesic property in a significant manner. The pro-inflammatory cytokines TNF-α and IL-1β were evaluated in the serum and were observed to be lessened the values of both in a significant manner with the co-administration of both the test drugs. The dopamine concentrations were also determined in the serum, which disclosed a decline (**p <0.001) significantly. CONCLUSIONS: It was concluded from the results that a combined effect of drugs might be beneficial in the management of behavioral disorders and pain management

Examining Saudi Physicians’ Approaches to Communicate Bad News and Bridging Generational Gaps

Breaking bad news is an intrinsic aspect of physicians’ clinical practices. This study aims to investigate how Saudi physicians manage the process of communicating bad news and explore potential differences in breaking bad news practices between young physicians (interns) and their older colleagues. From 1 March to 15 April 2023, ok an anonymous online cross-sectional survey was conducted to explore the communication practices of Saudi physicians concerning breaking bad news using the Communicating Bad News Questionnaire. The physicians were recruited through convenience and snowball sampling methods, and the survey questionnaire was distributed on various social media platforms, including Facebook, Twitter, LinkedIn, and WhatsApp. Data were analyzed using R version 4.2.1. A total of 782 physicians were included in this study. Male physicians represented 50.9% of the participants. Three-quarters (74.7%) were aged 25–30 years. The largest proportion of physicians (45.3%) were interns, followed by junior residents (22.9%), senior residents (11.0%), and specialists (6.5%). The median years of experience was 1.0, ranging from 0 to 45 years. Regarding the place of work, most physicians (86.6%) worked in hospitals, while 13.4% worked in primary healthcare centers. A total of 14.8% said they were not comfortable with discussing patients’/relatives’ issues (20.60 among interns vs. 10.50% among non-interns, χ2 = 27.50, p = 0.0001), 66.6% reported being trained to break bad news (59.60% among interns vs. 72.40% among non-interns, χ2 = 14.34, p = 0.001), 59.1% reported breaking bad news to the patient, 37.9% reported to the family, and 3.1% reported to both, with no significant difference between interns and non-interns. A substantial proportion of physicians reported feeling uncomfortable discussing sensitive issues with patients and their relatives despite having received training to deliver bad news and being willing to communicate bad news directly to patients. Notably, our analysis identified a significant disparity between intern and non-intern physicians, particularly in terms of their comfort level in addressing patient-related concerns and access to breaking bad news training

Targeting mTOR as a Cancer Therapy: Recent Advances in Natural Bioactive Compounds and Immunotherapy

The mammalian target of rapamycin (mTOR) is a highly conserved serine/threonine-protein kinase, which regulates many biological processes related to metabolism, cancer, immune function, and aging. It is an essential protein kinase that belongs to the phosphoinositide-3-kinase (PI3K) family and has two known signaling complexes, mTOR complex 1 (mTORC1) and mTOR complex 2 (mTORC2). Even though mTOR signaling plays a critical role in promoting mitochondria-related protein synthesis, suppressing the catabolic process of autophagy, contributing to lipid metabolism, engaging in ribosome formation, and acting as a critical regulator of mRNA translation, it remains one of the significant signaling systems involved in the tumor process, particularly in apoptosis, cell cycle, and cancer cell proliferation. Therefore, the mTOR signaling system could be suggested as a cancer biomarker, and its targeting is important in anti-tumor therapy research. Indeed, its dysregulation is involved in different types of cancers such as colon, neck, cervical, head, lung, breast, reproductive, and bone cancers, as well as nasopharyngeal carcinoma. Moreover, recent investigations showed that targeting mTOR could be considered as cancer therapy. Accordingly, this review presents an overview of recent developments associated with the mTOR signaling pathway and its molecular involvement in various human cancer types. It also summarizes the research progress of different mTOR inhibitors, including natural and synthetised compounds and their main mechanisms, as well as the rational combinations with immunotherapies