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Pharmacists are trusted and easily accessible healthcare providers. We assessed awareness and knowledge of symptoms, etiology, and treatment of autism spectrum disorders (ASDs) among pharmacists practicing in Palestine. The pharmacists reported low familiarity with ASDs. The median score on the 12-item knowledge section was 50.0% with an interquartile range of 16.7%. Having course(s) or lecture(s) on ASDs during pharmacy degree program was significantly associated with familiarity ("p" value <0.001), knowledge ("p" value <0.001), and confidence ("p" value <0.05) scores. Nearly 62% of the pharmacists reported as not feeling confident enough in their ability to counsel parents about medications used for their children with ASDs and their side effects. This study revealed gaps in awareness and knowledge of ASDs among pharmacists.

Aims The current study was carried out to examine prevalence of complications related to diabetes mellitus (DM) and to investigate association between clinical variables and biochemical factors with complications of DM in patients treated in primary healthcare settings in the West Bank of Palestine. Materials and methods Sociodemographic, clinical, and biochemical variables were collected from 385 patients visiting 17 primary healthcare settings in the West Bank. Patients provided blood and urine samples, responded to a questionnaire interview, and were subjected to ophthalmic examination. Results HbA 1c levels were predicted by duration of DM (p < 0.001), HDL (p = 0.011), alkaline phosphatase (p = 0.001), blood urea (p = 0.006), and LDL (p = 0.008). Triglycerides levels were predicted by blood urea (p = 0.002), HDL (p < 0.001), and total cholesterol (p < 0.001). GOT levels were predicted by LDL (p = 0.002) and GPT (p < 0.001). GPT levels were predicted by HDL (p = 0.003) and blood urea (p = 0.025). Urine albumin were predicted by total cholesterol (p = 0.001), LDL (p = 0.005), and blood urea (p = 0.036). CD ratio was predicted by the IOP and the IOP was predicted by the CD ratio (p = 0.001). Conclusions Prevalence of complications related to DM was high among patients with DM treated in primary healthcare practice. These complications and risk factors were predicted by certain clinical characteristics and biochemical factors. Policies and programs are needed to manage these modifiable risk factors. [ABSTRACT FROM AUTHOR]

Pregnant and nursing women are at higher risk of zinc deficiency which can have detrimental consequences on health. We assessed blood zinc levels in 72 nursing women from the West Bank of Palestine and investigated the association between sociodemographic variables and blood zinc levels. Blood samples were analyzed for their zinc contents using graphite furnace atomic absorption spectrophotometry. Blood and data collection were performed between July and December 2016. The median blood zinc level was 4.53 mg/L (interquartile range of 0.38 mg/L). In unadjusted analyses, blood zinc levels were higher in nursing women who lived in cities (p-value <.001), had higher household income (p-value <.001), whose husbands had a white collar job (p-value <.05), were nonsmokers (p-value <.05), did not use hair dyes (p-value <.05), and consumed energy beverages (p-value <.001). Multiple linear analysis showed that living in cities and consuming energy beverages remained significantly associated with higher blood zinc levels (p-value <.05). Blood zinc levels were in the range previously reported for similar non-malnourished populations. Nursing women living in cities and those consuming energy beverages tended to have higher blood zinc levels. Urbanized lifestyle might have enhanced blood zinc levels in nursing women. [ABSTRACT FROM AUTHOR]

Background: Complementary and alternative medicine (CAM) utilization is dramatically increasing among patients. As community pharmacies are a major provider of CAM products, community pharmacists need to have the sufficient knowledge and information to advice their patients, answer their inquiries and to be proactive in the healthcare process to ensure optimal therapy outputs and minimize both drug-drug and drug-herb interactions. Therefore, the main objective of this study was to assess the knowledge, beliefs, and practices of community pharmacists in Palestine about CAM. Methods: The study was conducted in a cross-sectional design in which a questionnaire was administered on a sample of licensed community pharmacists from Palestine. The questionnaire was of 5 sections: demographic and practice details of the participants, practice, beliefs, and knowledge about CAM. Mann-Whitney-U or Kruskal-Wallis tests were used to comparison of different issues as appropriate. P-values of <0.05 were considered significant. Results: A total of 284 community pharmacists were surveyed, however, 281 were included in the analysis as they met inclusion criteria. Out of the 281, 149 (53.0%) of the participants were males and the rest were females. About 40% of the participants were between 20 to 29 years old. Pharmacists frequently recommended CAM modalities. Exercises (84.0%) and food supplements (82.6%) were the most commonly recommended modalities. In the last year, vitamin B12 was the most frequently prescribed supplement. The median knowledge score was 5 out of 8 and the median beliefs about CAM score was 4.0 out of 7.0. Conclusions: CAM recommendations by pharmacists appear to be commonplace. Although their knowledge scores were fair to average, pharmacists still need more education and training about CAM in order to be more qualified to provide better pharmaceutical care and improve their patient’s outcome. [ABSTRACT FROM AUTHOR]

Purpose: Pharmacists are key players in providing healthcare for patients with chronic diseases including women with epilepsy. The purpose of this study was to assess pharmacist's knowledge of women's issues in epilepsy in the Palestinian pharmacy practice.Method: The study was conducted in a cross-sectional observational design using a 12-item test on women's health in epilepsy. Demographic details were collected. Scores were calculated as percentage of correct answers for each pharmacist.Results: The sample consisted of 408 pharmacists. The median correct score was only 53.8% with an IQR of 30.8. Pharmacists who interacted with ≥10 patients with epilepsy per month were 1.61 (95% C.I of 1.04-2.49) more likely to score ≥60% in the test than those who interacted with <10 patients with epilepsy per month. The difficulty index ranged from very easy to difficult. Nearly 91% of the pharmacists answered correctly the question on the role of folic acid in reducing teratogenesis and only 46% answered correctly the question on exposure to valproic acid and the risk of giving birth to a child with autism.Conclusion: Although pharmacists could be knowledgeable and in key position to provide essential information to patients with chronic diseases, there are many knowledge gaps in women's health issues in epilepsy that need bridging. Greater exposure to and interaction with people with epilepsy might be helpful in enhancing knowledge of pharmacists of specific issues pertaining to women's health in epilepsy. [ABSTRACT FROM AUTHOR]

Objective Antiepileptic drugs (AEDs) are mainstay in controlling epileptic seizures. As experts in medications, pharmacists should be able to ensure accuracy of dosing regimens, explain adverse effects, and screen for and alert people with epilepsy (PWE) and their physicians to possible drug–drug interactions (DDIs). The aim of this study was to evaluate pharmacists' knowledge of issues in pharmacotherapy of epilepsy using AEDs. Methods This was a cross-sectional observational study conducted in the Palestinian pharmacy practice. A 10-item case-based questionnaire was used to determine actions taken by pharmacists in theoretical situations in pharmacotherapy of epilepsy. Demographic and practice details of the study participants were also collected. Scores were calculated as percentage of correct answers for each participant. Results The number of participants was 394. The majority (approximately 75%) identified themselves as community pharmacists. The median score was 33.4% with an IQR of 33.3. Pharmacists who received training on epilepsy and AEDs during their pharmacy degree program were 4.78-fold (95% C.I. of 1.82–12.60) more likely to score ≥ 50% in the test than those who did not receive training on epilepsy and AEDs. Despite gaps in knowledge, pharmacists tended to perform the necessary action in cases of adverse effects and aggravated seizures associated with AEDs. Conclusion Pharmacists can play a crucial role in providing essential information on AEDs to patients and prescribers. There are many knowledge gaps that need to be filled. Specifically designed pedagogic and/or training interventions might be helpful in filling these gaps. [ABSTRACT FROM AUTHOR]

Background: Psoriasis is a frequent skin inflammatory disorder that inflicts millions of patients around the globe. To meet their healthcare needs, patients with psoriasis often seek treatment outside the allopathic paradigm. Use of medicinal plants has emerged as one of the most common and preferred modalities of complementary and alternative medicine (CAM). The aim of this study was to investigate the use of medicinal plants by patients with psoriasis in the West Bank of Palestine. Methods: The current study was a questionnaire based cross-sectional descriptive study on the use of medicinal plants by psoriasis patients in the West Bank of Palestine. A sample of 149 patients with psoriasis who were visiting outpatient clinics responded to the questionnaire in face to face interviews. Results: Medicinal plants were used by 81 (54.4%) patients with psoriasis. Patients used 33 medicinal plants belonging to 26 families. Plants belonging to Lamiaceae and Leguminosae were the most commonly used by the study patients. Aloe vera, Trigonella arabica, Catharanthus roseus and Anthemis cotula were the most frequently used medicinal plants to treat psoriasis. Leaves and fruits were the most commonly used parts by the study patients. Paste was the most commonly used form of preparation. The use of medicinal plants was significantly associated with age and monthly household income of the patients. Enhancement of immunity, improving conventional therapy and reduction of side effects were the most commonly self-reported reasons for using medicinal plants. Conclusions: Patients with psoriasis in Palestine seem to use medicinal plants as a CAM modality to manage their psoriasis. Many medicinal plants were commonly used by patients with psoriasis. More randomized clinical trials are needed to demonstrate safety and efficacy for the majority of these medicinal plants reported to be used by patients with psoriasis in Palestine. [ABSTRACT FROM AUTHOR]

Background: Lead is a neurotoxic pollutant that is ubiquitously spread in our environment. Breast milk contaminated with lead poses a potential risk of exposing a recipient infant to lead. Objectives: The primary aims of this study were to evaluate the breast milk lead levels (BMLLs) in breastfeeding mothers in 3 major regions of the West Bank of Palestine and to investigate the effects of some sociodemographic variables on the BMLLs. Methods: Breast milk samples were collected from 89 breastfeeding mothers from the Nablus, Ramallah, and Jerusalem regions and analyzed for their BMLLs using graphite furnace atomic absorption spectrophotometry. Breastfeeding mothers were interviewed and responded to a sociodemographic questionnaire. Results: The median BMLL was 4.0 µg/L, ranging from 2.0 to 12.0 µg/L. Breast milk lead levels in 19.1% of the samples analyzed were higher than the World Health Organization’s safety limits of 2.0 to 5.0 µg/L for an occupationally unexposed population. Breast milk lead levels were significantly higher in breast milk of mothers who lived in cities and refugee camps (P < .01), had lower monthly household income levels (P < .05), lived close to paint shops (P < .05), lived in houses with peeling or chipping paint (P < .05), used eye kohl (P < .01), and worked in agriculture for a duration longer than 3 years (P < .01). Conclusion: Breast milk lead levels were higher than the safety limits for occupationally unexposed populations. Authorities need to implement measures to eliminate or reduce lead exposure, especially in refugee camps and cities. Marketed eye kohl preparations should be tested for their lead contents. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate community pharmacists’ knowledge and certainty of adverse effects and contraindications of pharmaceutical products to estimate the risk of error. Factors influencing their knowledge and certainty were also investigated. Methods: The knowledge of community pharmacists was assessed in a cross-sectional design using a multiple-choice questions test on the adverse effects and contraindications of active pharmaceutical ingredients and excipients from May 2014 to March 2015. Self-rated certainty scores were also recorded for each question. Knowledge and certainty scores were combined to estimate the risk of error. Results: Out of 315 subjects, 129 community pharmacists (41.0%) completed the 30 multiple-choice questions test on active ingredients and excipients. Knowledge on active ingredients was associated with the year of graduation and obtaining a licence to practice pharmacy. Knowledge on excipients was associated with the degree obtained. There was higher risk of error in items on excipients than those on ingredients (P< 0.01). Conclusion: The knowledge of community pharmacists in Palestine was insufficient with high risk of errors. Knowledge of community pharmacists on the safety issues of active ingredients and excipients need to be improved. [ABSTRACT FROM AUTHOR]

• Students with epilepsy reported less engagement in physical exercise compared to their healthy peers. • Knowledge gaps and negative attitudes toward students with epilepsy were identified among physical educators. • Interventions are needed to improve knowledge and correct attitudes of physical educators about students with epilepsy. The study aimed to test knowledge and attitudes of physical educators in Palestine toward epilepsy and students with epilepsy. The study also aimed to identify the variables that were associated with adequate knowledge and positive attitudes toward epilepsy and students with epilepsy. This study was done in a cross-sectional design among physical educators in Palestinian schools. The questionnaire tested knowledge and attitudes of physical educators using 18-item and 12-statement tests, respectively. Complete questionnaires were returned by 226 physical educators (response rate = 75.3%). The median knowledge score of the physical educators on the 18-item knowledge test was 50% [33.0%, 61.0] and the median attitudes score of the physical educators on the 12-statemtns was 50.0% [42.0, 58.0]. Higher knowledge scores were associated with age, teaching experience, educational level, having known/interacted with people with epilepsy, and receiving education about epilepsy. Higher attitude scores were associated with gender, age, educational level, place of residence, type of school, having known/interacted with people with epilepsy, and receiving education about epilepsy. Knowledge gaps and negative attitudes toward epilepsy and students with epilepsy were identified among physical educators in Palestine. Appropriately designed interventions are still needed to improve knowledge and correct attitudes of physical educators about epilepsy and students with epilepsy. [ABSTRACT FROM AUTHOR]