KNOWLEDGE, ATTITUDE AND PRACTICE OF YEMENI PHYSICIANS TOWARD PHARMACOVIGILANCE: A MIXED METHOD STUDY

Objective: The objective of the current study was to investigate the physician's knowledge, attitude and practice towards pharmacovigilance.Methods: A mixed qualitative and quantitative method was conducted in this study using a face to face questionnaire among the physicians in the capital Sana'a, Yemen.Results: Of the 105 respondents (79 %) were male. Participants age mean was 35.55±4.45 y. Majority of physicians (73.3 %) had a moderate knowledge towards pharmacovigilance; (15.2 %) had a good knowledge and (11.4 %) had a poor knowledge. 35 (33.3 %) physicians were seen adverse drug reactions (ADRs) happened to their patients. Allergy was the most common ADRs. However, no ADR was reported. 66.7 % of physicians had a positive attitude towards pharmacovigilance. The most barriers reported by physicians were: lack of motivation and lack of knowledge about reporting system. Reported factors to encourage ADRs reporting were: attend courses or workshops; educational materials and simplification of reporting procedures.Conclusion: Majority of physicians in Sana'a, Yemen had moderate knowledge and postitive attitude towards pharmacovigilance. Educational and training programmes are the cornerstone of improving ADRs reporting in Yemen.Â

Pharmacy Practice and its challenges in Yemen

Background Pharmacy practice in Yemen was established in 1875 in Aden. Objectives To describe current pharmacy practice as it currently exists in Yemen, the challenges it faces, and to recommend changes that will improve pharmaceutical care services. Methods This study has two parts. Part 1 comprised a literature search performed between May and July 2011 to identify published studies on pharmacy practice in Yemen. Full text papers, abstracts, and reports in Arabic or English between 1970 and 2011 were reviewed. Part 2 entailed a qualitative study consisting of face-to-face interviews with a representative sample of pharmacists, staff from the Ministry of Public Health and Population (MoPHP), and patients. Results The analysis revealed several issues that plaque pharmacy practice in Yemen: 1) Fewer than 10 per cent of pharmacists working in pharmacies and drug stores are graduates of government-recognized colleges; 2) Most Yemeni pharmacists are dissatisfied with their work conditions and opportunities; 3) Medicines are expensive and hard to access in Yemen, and counterfeit medicines are a serious problem; 4) Few regulations and standards exist for pharmacists and pharmaceutical care; 5) Pharmaceutical marketing plays an important role in marketing and selling products in Yemen; and 6) A dearth of standards, regulations, and laws are hurting pharmacy practice in the country and potentially endangering peoples’ lives.Conclusion In order to improve pharmacy practice in Yemen, many changes are needed, including updating the pharmacy curriculum taught, implementing industry standards for pharmacy practice, implementing and reinforcing laws, and integrating pharmacists more fully in the healthcare industry. Additionally, the quality of the pharmacy workforce needs to be improved, and there needs to be increased awareness by the public, physicians, other healthcare professionals, and policy makers about the value of pharmacists.

Evaluation of community acquired pneumonia treatment outcomes and cost of illness and development of mortality model.

Pneumonia aruhan komuniti (CAP) adalah punca mortaliti dan kematian utama di seluruh dunia termasuk Malaysia. Pengenalan perbezaaan dalam keputusan perubatan dan kos di antara hospital universiti dengan hospital umum (GH) boleh membantu perkembangan dalam rawatan pneumonia dan membantu pasukan kesihatan melakukan perkhidmatan perubatan dengan tepat and berkesan. Community acquired pneumonia (CAP) is a major cause of morbidity and mortality worldwide including Malaysia. Identification of the differences in the outcome and cost between a university hospital and a general hospital (GH) could lead to the development of pneumonia interventions and guide the health team to accurately perform and administrate health care services effectively

Medication errors in a health care facility in southern Saudi Arabia

Purpose: To identify medication errors at Aseer Central Hospital (ACH, Abha) in the southern province of Saudi Arabia. Methods: A cross-sectional retrospective study was conducted by reviewing adult patients’ records (> 15 years old) at ACH’s inpatient and outpatients settings over an 8-week period in October and November 2015. Results: We identified 113 medication errors, including 112 prescribing errors and 1 dispensing error. Most medication errors (91.2 %) in this study were for inpatient prescriptions. The most common prescribing error was medication duplication (31.2 %) followed by missing patient identifying information (25 %). Conclusion: Medication errors, mainly in inpatient prescriptions, have been fully identified at ACH. Educational interventions such as workshops could help minimize and prevent medication errors

Pharmacovigilance and adverse drug reaction reporting: a perspective of community pharmacists and pharmacy technicians in Sana’a, Yemen

open access journalObjective: The aim of this study was to compare the knowledge, attitude and barriers of pharmacy technicians and pharmacists toward pharmacovigilance, adverse drug reactions (ADRs) and ADR reporting in community pharmacies in Yemen. Methods: This cross-sectional survey was conducted among community pharmacists and pharmacy technicians in the capital of Yemen, Sana’a. A total of 289 community pharmacies were randomly selected. The validated and pilot-tested questionnaire consisted of six sections: demographic data, knowledge about pharmacovigilance, experience with ADR reporting, attitudes toward ADR reporting, and the facilitators to improve ADR reporting. Results: A total of 428 pharmacy technicians and pharmacists were contacted and 179 went on to complete a questionnaire (response rate: 41.8%). Of the 179 respondents, 21 (11.7%) were pharmacists and 158 (88.3%) were pharmacy technicians, of which, 176 (98.3%) were male and 3 (1.7%) were female. The mean age of the respondents was 25.87±2.63 years. There was a significant difference between the pharmacists and pharmacy technicians in terms of knowledge scores (P,0.05). The mean knowledge scores for pharmacists was 3.33±2.852 compared to 0.15±0.666 for pharmacy technicians. With regard to attitudes toward ADR reporting, all pharmacists (100%) showed a positive attitude, while only 43% of pharmacy technicians showed a positive attitude. Conclusion: Pharmacists have a significantly better knowledge than pharmacy technicians with regard to pharmacovigilance. More than half of pharmacy technicians showed a negative attitude toward ADR reporting. Therefore, educational interventions and training is very important for community pharmacists and pharmacy technicians in Yemen to increase their awareness and participation in ADR reporting

Applications, Benefits, and Risks of ChatGPT in Medical and Health Sciences Research: An Experimental Study

This article explored the potential applications, benefits, and risks of using ChatGPT in medical and health sciences research. The experimental study was performed with content analysis of the potential applications, benefits and risks of using ChatGPT in medical and health sciences research. This study shows many potential applications, benefits, and risks of using ChatGPT in medical and health sciences research. The average experts’ ChatGPT appropriateness and accuracy rates in the eight research themes were between 60% and 95%. This concludes that ChatGPT could help medical and health sciences researchers, especially new researchers, with caution in many aspects of research. The ChatGPT is still in the early phase of use by researchers worldwide, and its ability to help in research will be better soon. Attending training workshops about ChatGPT and AI is very important and highly recommended. The practice of ChatGPT in medical and health sciences research is important and recommended to explore the potential uses, benefits, risks and suggest recommendations for the best practice

A Review of Herbal Treatment for Functional Gastrointestinal Disorders and Infection

Functional dyspepsia (FD), a common gastrointestinal condition, poses significant burdens on both individuals and society. In this article, we conducted PubMed searches using specific keywords to review clinical trials focusing on conventional and herbal treatments for dyspepsia as well as the adverse effects of non-herbal treatments. Dyspepsia can be managed using proton pump inhibitors, H2 blockers, and antacids. Additionally, we explore Tegaserod, a partial agonist of the 5-HT4 receptor, in the context of prokinetic medications. We summarise the research supporting the effectiveness of non-herbal dyspepsia treatment, considering factors beyond acid reduction, such as the placebo effect and the variability of dyspepsia symptoms, as discussed in the section on proton pump inhibitor (PPI) medication. Unlike most pharmacotherapies targeting a single mechanism, herbal medications often contain multiple active ingredients that can address several signalling pathways simultaneously. Notable herbs like fennel, cumin, aloe vera, ginger, and licorice have documented uses in the literature. Whether derived from a single plant or a combination, herbal treatments hold promises for addressing multiple conditions simultaneously. Therefore, evaluating herbal therapy at all stages of development should adhere to the same scientific rigour applied to chemically specifi

Toxicological Review of Anticancer Plants Used in Traditional Medicine in Morocco

In Morocco, traditional medicine utilizes many toxic plants for cancer treatment, despite a lack of scientific evidence supporting their effectiveness. Further research may be able to explore and discover the potential therapeutic effects of these plants' bioactive molecules with antioxidant and anticancer properties. Based on our review, we have determined that the 13 plants under examination possess various pharmacological and biological activities due to their diverse phytochemical composition. Despite their toxicity, these plants have a history of traditional use in Morocco for treating multiple diseases. Further research, including preclinical and clinical trials, should be conducted to investigate the potential therapeutic benefits of these plants. Moroccan cuisine commonly incorporates gruels, herbal drinks, and spicy beverages, which possess significant health benefits, including chemo-preventive properties and natural inhibitors against certain infections. These properties may aid in reducing the incidence of cancer and potentially have therapeutic effects in various human pathologies when consumed in appropriate amounts and in combination with a healthy lifestyle

Xylophagia : a meta-synthesis of the literature

Purpose – The purpose of this paper is to provide an insight into xylophagia, its treatment, intervention options, etiological causes and possible relationship with other diseases. Design/methodology/approach – A systematic search was performed across four scientific databases (i.e. Ovid Medline, Embase via Ovid, PubMed and ProQuest). All of the qualitative studies reporting on xylophagia from the inception of databases until August 2019 have been included. The quality of included studies was assessed through a ten-item checklist given by Kmet et al. (2004). Findings – A total of 18 studies were included, and five primary themes emerged after analysis: precipitation/onset of xylophagia, co-morbid psychiatric or medical illnesses, assessment and investigation modes to confirm diagnosis, outcomes of xylophagia and treatment options comprising medical care, psychological care, counseling and duration of recovery. There were 16 females and 9 males in included studies. The mean ages and standard deviations of males and females were 29.25(12.17) years and 32.81(11.92), respectively. The mean duration and standard deviation of paper pica were 4.80(4.27) years. Research limitations/implications – Despite the limitation that this meta-synthesis is based upon findings from case studies, results show that standardized medication regimens for treating xylophagia are still not available or are unknown. There is a dire need for further research in order to better understand the disorder. The healthcare professionals need to use reciprocal, mutually constituent influence of biological and sociocultural factors in order to screen, diagnose and manage complex psychological problems like xylophagia. Originality/value – The findings advance our understanding of the positive effects of patients and family members undergoing counseling or cognitive behavior therapy in reducing stress and enhancing coping skills thus, avoiding self-damaging behaviors

Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021

Background: Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. Methods: Using forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8–63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0–45·0] in 2050) and south Asia (31·7% [29·2–34·1] to 15·5% [13·7–17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4–40·3) to 41·1% (33·9–48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6–25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5–43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5–17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7–11·3) in the high-income super-region to 23·9% (20·7–27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5–6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2–26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [–0·6 to 3·6]). Interpretation: Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions