Community pharmacists’ perspectives on cardiovascular disease pharmaceutical care in the United Arab Emirates: a questionnaire survey-based analysis

Background: Community pharmacists play an intermediary role between prescribing physicians and patients in the United Arab Emirates (UAE) and thus are responsible for ensuring that patients receive optimal cardiovascular disease (CVD) pharmaceutical care.Methods: we used a cross-sectional design to assess the perceptions and practices of community pharmacists concerning pharmaceutical care for patients with CVD. A trained researcher visited randomly selected community pharmacies and used a structured questionnaire to conduct in-person interviews with pharmacists. The questionnaire collected demographic data and information on perceptions and practices regarding CVD pharmaceutical care.Results: Five hundred and fifty-one participants were recruited. The average participant age (mean ± SD) was 35 ± 2.7 years. The average perception score regarding CVD prevention and management was 75.6% (95% confidence interval [CI] 77.1%–74.2%), and the average practice score for CVD prevention and management was 87.1% (95% CI 76.5%–79.6%). Bivariate analysis revealed that gender (p = 0.001), education level (p < 0.001), pharmacy position (p = 0.004), work experience (p < 0.001), number of patients served per day (p < 0.001) and being trained on CVD prevention and management (p < 0.001) were significantly associated with perceptions about the prevention and management of CVD. Better practice scores were seen among older participants (OR 1.01; 95% CI 1–1.019), postgraduates (OR 1.77; 95% CI 1.66–1.89), workers at chain pharmacies (OR 1.24; 95% CI 1.11–1.39), pharmacists in charge (OR 1.22; 95% CI 1.01–1.47), pharmacists with >10 years of experience (OR 11.3; 95% CI 6.01–15.62), pharmacists with 6–10 years of experience (OR 4.42; 95% CI 3.90–5) and pharmacists trained on CVD prevention and management (OR 1.29; 95% CI 1.15–1.46).Conclusion: Pharmacy practitioners working in community pharmacies in the UAE actively engage in delivering pharmaceutical care to patients, playing a role in CVD management and prevention. However, they showed low levels of involvement in other healthcare services, specifically in screening and measuring patients’ weight, glucose levels, and blood pressure, monitoring treatment responses, maintaining medical records, and reviewing medication refill histories. Activities such as educating patients, providing medication counseling, offering support for treatment adherence, and fostering collaborative relationships with other healthcare providers should be encouraged among UAE community pharmacists to ensure the provision of high-quality patient care

Evaluating Soft Tissue Healing after Implant Placement Using Two Different Mouthwashes (Myrrh and Chlorhexidine Gluconate): A Randomized Control Trial

The use of mouthwash is often recommended by dental experts for dental healing. A double-blind, randomized clinical study was conducted to evaluate the efficacy of two mouthwashes (myrrh and chlorhexidine gluconate) on postoperative pain and their effects on tissues after dental implant placement in 35 patients (18 in the myrrh group and 17 in the chlorhexidine gluconate group). Soft tissue healing was evaluated in terms of wound closure, soft tissue swelling, and the color of the gingiva at 1 week postoperative. To decrease the chances for error, only the participants who did not show preoperative symptoms of infection and those who committed to practicing better oral hygiene were included in the study. The samples were evaluated for the infiltration of inflammatory cells (using inflammatory extent and inflammatory cellularity grades), maturation of collagen (osteoblast activity), and arrangement of cells (for detecting the remodeling phase). A questionnaire pertaining to mouthwash satisfaction, the duration of postoperative pain after the procedure, the time of stoppage of bleeding at the surgical site, and any sensitivity at the surgical site was given to the patients. The Chi-square test and Mann–Whitney U-test were used to analyze the data. The difference in postoperative surgical swelling, pain, bleeding, and redness in the patients was not statistically significant between the myrrh and chlorhexidine gluconate mouthwash groups. However, in the acute phase, the myrrh mouthwash showed a positive impact on the process of wound healing after implant placement. The small sample size and inability to compare wound healing in different anatomical areas of the oral cavity were the study limitations

Prevalence and Associated Factors of Depression among Patients with Diabetes at Jazan Province, Saudi Arabia: A Cross-Sectional Study

Context. Patients with diabetes mellitus (DM) have a poorer quality of life when compared with patients without DM. In fact, one in every five diabetic patients suffers from comorbid depression, which can lead to poor management, poor compliance with treatment, and low quality of life. Therefore, we assessed the prevalence of depression and identified its associated factors among diabetic patients at Jazan Province, KSA. Methods and Materials. A cross-sectional study was conducted among 500 diabetic patients attending a diabetic center in addition to four primary healthcare centers. We used a simple Arabic translation of the Beck Depression Inventory (BDI II) tool to evaluate the depression level among the subjects. We also evaluated the frequencies of certain sociodemographic characteristics and clinical information. Moreover, we performed univariate and multivariate analyses to identify the potential risk factors using adjusted odds ratios (AORs). Results. The prevalence of depression among DM patients was 20.6%. The majority of patients showed no depression (N = 285, 59.4%), one-fifth had mild depression (N = 96, 20.0%), some (N = 55, 11.4%) had moderate depression, and some had severe depression (N = 44, 9.2%). Depression was significantly more prevalent among uneducated patients (N = 27, 31.8%) (X2 = 17.627, P = 0.001) and patients with low monthly income (< 2500 SR/month) (N = 33, 22.8%) (X2 = 9.920, P = 0.019). Hypertension (AOR = 2.531, 95% CI [1.454, 4.406]) and ischemic heart diseases (AOR = 3.892, 95% CI [1.995, 7.593]) were considered as risk factors for depression among diabetic patients. Conclusions. Almost one in every five patients with DM is affected by depression coexisting with cardiovascular diseases. Therefore, screening for psychological problems, proper treatment, and educating patients with diabetes about DM self-management should be routine components of DM care

Prevalence and Awareness of Hypertension among a Rural Jazan Population

Background: Hypertension (HTN) is a major global public health problem. Knowledge of the risk factors and repercussions of HTN is crucial to preventing the disease. Rural populations have lower levels of knowledge of the disease than urban populations. However, no studies have assessed the levels of awareness of HTN and their determinants in rural regions of Saudi Arabia. Objectives: This study aimed to assess the awareness of HTN and its determinants among a rural population of Jazan region, Saudi Arabia. Methodology: We conducted a cross-sectional analytical study among six primary healthcare centers selected randomly from the rural areas of Jazan region. We targeted all Saudi adults visiting these centers. Information was gathered using interview questionnaires completed by 607 people. SPSS was utilized to analyze the collected data. Results: In all population groups, the prevalence of diagnosed HTN increased with age, particularly gradually increasing in those aged younger than 40 years and then rapidly and sharply increasing in those aged 40 years and over. The women (43.3%) had a higher prevalence of HTN than the men (34.6%), which is comparable with findings in other areas in Saudi Arabia and the Middle East. Approximately 65.6% of the participants without HTN and 34.4% of the participants with HTN did not know their normal blood pressure. Approximately 61.7% of the participants without HTN and 59.0% of the participants with HTN felt that pharmaceuticals are insufficient in curing HTN, while 60.7% and 64.7% believed that HTN can be cured. Conclusions: The global prevalence of HTN is increasing annually owing to rapid changes in lifestyle and dietary habits. Furthermore, because adherence to antihypertensives is poor in rural Jazan, the Ministry of Health and researchers advocate implementing a program to increase awareness and assess patient adherence to prescribed medication for the control of HTN

Betulin prevents high fat diet-induced non-alcoholic fatty liver disease by mitigating oxidative stress and upregulating Nrf2 and SIRT1 in rats

Non-alcoholic fatty liver disease (NAFLD) is a common chronic hepatic disorder characterized by hepatic lipid accumulation. This study explored the effect of betulin (BE), a terpenoid with promising antioxidant, anti-inflammatory and insulin sensitizing effects, on NAFLD induced by high fat diet (HFD). Rats received HFD and BE (15 and 30 mg/kg) for 12 weeks and blood and liver samples were collected for analyses. HFD caused hyperlipidemia, cholesterol and triglycerides accumulation in the liver, hepatocellular ballooning, fibrosis, insulin resistance (IR), lipid peroxidation (LPO), and NF-kB p65 upregulation. BE ameliorated serum and liver lipids, blood glucose and insulin, liver LPO, prevented steatosis and fibrosis, suppressed NF-kB p65 and enhanced antioxidants in HFD-fed rats. BE downregulated acetyl-CoA carboxylase (ACC1) and fatty acid synthase (FAS), and upregulated Nrf2, HO-1 and SIRT1 in the liver of HFD-fed rats. In silico investigations revealed the binding affinity of BE towards FAS, NF-kB, Keap1, HO-1 and SIRT1. In conclusion, BE attenuated HFD-induced NAFLD by ameliorating hyperlipidemia, IR, lipogenesis, liver lipid accumulation, and oxidative stress. The protective effect of BE was associated with enhanced Nrf2/HO-1 signaling and SIRT1