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Copyright of Jordan Journal of Applied Sciences - Natural Sciences is the property of Applied Science University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Jordan Journal of Applied Sciences - Natural Sciences is the property of Applied Science University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To investigate the effectiveness of a standard educational module on pharmacy students' inhaler technique demonstration skills. Methods: This investigational study was conducted during the Clinical Pharmacy and Therapeutics tutorial classes in 2011. All fifth-year students were given placebo inhaler devices and information leaflets explaining the use of these devices. Students were then shown, by demonstration, the correct technique for each of the inhalers. All the students were assessed on the use of each of the inhalers two weeks following the tutorial. A validated questionnaire regarding the students' barriers to demonstrate the correct inhaler technique was completed by all the students. The inhaler techniques demonstrated were Accuhaler (ACC), Turbuhaler (TH) and metered-dose inhaler (MDI). Results: Students scored significantly better with ACC with a score of 4.38 ± 1.81 (out of 9.00) than with TH (3.96 ± 1.75 out of 9.00); p = 0.004, and MDI (2.69 ± 1.76 out of 8.00); p < 0.001, based on Friedman test 2 weeks following training. The majority of students (78%) believed that lack of practice with the devices was the primary barrier to correct inhaler use. Conclusion: Standard educational training may not be the most appropriate method of teaching students the correct use of inhalers. Clearly, there is a practice element missing which needs to be addressed in a feasible way. [ABSTRACT FROM AUTHOR]

In this work, variation in microbiota in the lower respiratory tract (LRT) among asthmatic and non-asthmatic subjects is identified. All participants (27 asthmatic patients and 27 non-asthmatic subjects) were asked to expectorate a sputum sample in special sterile tubes after rinsing the mouth with a sterilizing solution. The expectorated sputum specimen was immediately homogenized and stored in the deep freezer for DNA extraction for microbial gene sequencing and sequence analyses. For sequencing the V4 region of the 16S rRNA gene was sequenced using Illumina MiSeq, followed by an analysis of alpha and beta diversity. It was found that asthmatic patients had greater bacterial diversity than non-asthmatic subjects. Bacteria associated to the phyla (Bacteroidetes, Proteobacteria, and Firmicutes) accounted for 90 % of all sequences. The relative abundance of Proteobacteria in the asthmatic patients was higher than that of non-asthmatic (30 % vs 17 %; P-value = 0.044), along with a high abundance of the pathogen Haemophilus influenza. In contrast, Firmicutes (41 %) and Bacteroidetes (31 %) showed higher relative abundances in the non-asthmatic subjects. No significant link was found between the type of asthma drug or the method of drug usage (orally or via inhalation) and the respiratory microbiota. Therefore, the variations in LRS microbiota are not caused by the drugs taken by the asthmatic patients, rather they might be connected to the etiology of asthma. Since the asthmatic patients had higher proportions of Haemophilus influenzae , these organisms could be a causative factor in the pathophysiology of asthma. [ABSTRACT FROM AUTHOR]

Copyright of Jordan Journal of Pharmaceutical Sciences is the property of University of Jordan and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To explore the use of the blood pressure monitors by hypertensive patients in Jordanian homes and investigate their effect on emotional status and disease management, and the role of the pharmacist in this regard. Methods: This cross-sectional study was conducted over two months in 2012, in Amman, Jordan. Participants visiting cardiovascular clinics were approached and asked to answer a validated questionnaire. One hundred patients with doctor-diagnosed hypertension were recruited into the study. The questionnaire investigated the role of the pharmacist regarding the use of the blood pressure home measuring devices, patients' emotional response to their blood pressure readings and actions taken in response. Completed questionnaires were encoded and the data were analyzed using SPSS (version 17). Results: A majority of the patients (82%) use home measuring monitors to monitor their blood pressure at home. The pharmacist was reported as the health care professional mostly responsible for counseling patients on the proper use of blood pressure monitors (50%) and delivering needed relevant education (56%). A majority of participants suffer from anxiety (68%) in response to high blood pressure readings. The main follow-up management performed by participants in response to elevated blood pressure was physical activity (40%). Conclusion: Most hypertensive patients in Jordan use home blood pressure monitors; however, home self-measurement showing high blood pressure readings cause many patients to feel anxious. Pharmacists take the lead in educating patients in this regard. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The aims of this study were (1) to assess the ability of a range of health-care professionals (HCPs: specialists [physicians specializing in management of airways disease], general practitioners, pharmacists, pharmacist assistants, nurses, and respiratory therapists) in Jordan to demonstrate the correct use of some commonly used inhalers using standardized checklists, with highest scores indicating optimal use, and (2) to evaluate the short-term and long-term effectiveness of a single educational intervention on the HCPs’ skills in using inhalers. METHODS: HCPs’ inhaler technique was assessed at baseline. All HCPs were then invited to attend a workshop on asthma management with particular reference to inhaler use. At the workshop, HCP skills in inhaler technique were optimized. Inhaler technique was assessed before and after training. All participants were assessed on their inhaler technique at follow-up (after 4 months). RESULTS: Two hundred HCPs (10 specialists, 46 general practitioners, 79 pharmacists, 15 pharmacist assistants, 40 nurses, and 10 respiratory therapists) participated in the study. Specialists scored highest on baseline inhaler technique demonstration skills. All HCPs scored poorly in demonstrating the correct use of the dry powder inhalers when compared with pressurized metered-dose inhalers (MDIs) (range of mean scores ± SD: MDI, 7.24 ± 0.97 to 8.70 ± 0.67; Diskus, 4.83 ± 0.51 to 6.30 ± 1.7; Turbuhaler, 4.90 ± 0.32 to 6.40 ± 1.7). Participants attending the workshop showed improved inhaler skills (mean scores before and after training: MDI, 4.77 ± 1.60 vs 8.77 ± 0.52; Diskus, 4.40 ± 2.60 vs 8.85 ± 0.41; Turbuhaler, 4.96 ± 2.05 vs 8.63 ± 0.67). Four months after the workshop, the inhaler technique of 129 participants was again assessed. Those who had attended the workshop (n = 48) scored significantly higher mean scores for all devices (score = 7.64) than nonattendees (n = 81, score = 5.99, P < .001), by one-way analysis of covariance. CONCLUSIONS: With the exception of specialists, HCPs in Jordan need to be updated on their inhaler technique skills, specifically the newer dry powder inhalers. A single effective educational workshop on inhaler technique can significantly improve HCPs’ long-term ability to demonstrate these skills. [ABSTRACT FROM AUTHOR]

Copyright of Jordan Journal of Pharmaceutical Sciences is the property of University of Jordan and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Turbuhaler and Diskus are commonly used powder inhaler devices for patients with respiratory disease. Their effectiveness is limited in part by a patient’s ability to use them correctly. This has led to numerous studies being conducted over the last decade to assess the correct use of these devices by patients and health care professionals. These studies have generally used device-specific checklists to assess technique, this being the most feasible and accessible method for assessment. However, divergence between the checklists and scoring systems for the same device in different studies makes direct comparison of results difficult and at times inappropriate. Little evidence is available to assess the relative importance of different criteria; however, brief patient training based on specific inhaler technique checklists leads to significant improvement in asthma outcomes. This paper reviews common checklists and scoring systems used for Turbuhaler and Diskus, discusses the problem of heterogeneity between different checklists, and finally recommends suitable checklists and scoring systems for these devices based on the literature and previous findings. Only when similar checklists are used across different research studies will accurate comparisons and meta-analysis be possible. [ABSTRACT FROM AUTHOR]

Purpose: To examine the effect of divergence in patients' socioeconomic background on their perspective of the roles of the pharmacist in Amman, Jordan. Methods: This was a single-phase observational study conducted in two different socioeconomic areas: Western (WA) and Eastern Amman (EA, which is of a lower socioeconomic status than WA) in March to May of both 2009 and 2010. A validated questionnaire was completed by patients walking into community pharmacies. The source of advice (clinical specialist, general practitioner, pharmacist, nurse or herbalist) regarding patient's disease management and medication use, as well as patients' expectation of the pharmacist were investigated. Results: 2000 patients (mean age: 35.1 ± 13.7 years, 57.2 % males) visiting community pharmacies in Amman (1000 each from WA and EA) took part in the study. The majority of patients chose the pharmacist as the source of advice on medication use (WA, 50.8 %; EA, 53.6 %), followed by the clinical specialist (WA, 35.7 % vs EA, 26.9 %, p = 0.001). Other aspects of patient perspective and expectation of the pharmacist were also assessed; in several instances, more reliance on the pharmacist was observed in EA (lower socioeconomic status) than in WA. Conclusion: The findings of this study is important for future social pharmacy studies in the area, as it shows that socioeconomic status influences patient's perception of the role of the community pharmacist in Amman, Jordan. [ABSTRACT FROM AUTHOR]

Background Research conducted in Jordan has shown that suboptimal use of medications by outpatients along with the suboptimal role played by community pharmacists is currently a big dilemma highlighting the need for the Home Medication Review (HMR) service in the country. Objectives To evaluate the prevalence and types of treatment related problems (TRPs) for outpatients with chronic diseases. Setting Patient interview was conducted at the patients' community pharmacy initially, then at their home to collect required data. Methods 167 patients with chronic conditions (mean age 58.9 ± 13.54, 53 % males) were recruited. Data collected by the graduate pharmacists to conduct a HMR included patient's demographics, income, laboratory data, medical history, medication record, and adherence. A HMR was conducted for each patient by the researchers (experienced clinical pharmacists) to identify the patients' TRPs based on published literature. A focus group interview was conducted to elicit information regarding the feasibility of the HMR process and acceptability of the patient to the service. Main outcome measure Prevalence and nature of identified TRPs, associated diseases and drugs, and patients' acceptability to the HMR service. Results The mean number of disease conditions per patient was 4.1 ± 1.7, and the mean number of medications taken by each patient was 8.1 ± 2.7. HMR results showed a mean number of TRPs per patient of 7.4 ± 2.8. TRPs prevalence: 34.7 % of patients were found to have unnecessary drug therapy; 68.3 % had untreated conditions, and 74.9 % had ineffective/incomplete drug therapy; 50.3 % had inappropriate dosage regimen; 10.2 % were found to have actual adverse drug effects. A significant correlation between the number of TRPs and the number of disease states the patient had (r = 0.311, p = 0.003; Pearson correlation) and the number of drugs the patient was taking (r = 0.443, p < 0.001) was found. Patients accepted the HMR service well including the home visiting part. Conclusion TRPs in Jordanian outpatients with chronic diseases visiting community pharmacies are of concern and this signifies the integral role of pharmacists to identify these TRPs and hence provide the HMR service in the country. [ABSTRACT FROM AUTHOR]

Purpose: This study was designed to assess inhaler technique skills, asthma control level, adherence, and quality of life scores amongst asthmatic patients living in Amman, Jordan, investigating the role of pharmacist's educational intervention. Patients and Methods: This single-blinded randomized parallel-group active-controlled study was conducted at the Jordan University Hospital (JUH) clinic in 2019. Patients were assessed at baseline and follow-up (after three months) on their inhaler technique (based on validated published checklists), asthma control based on the asthma control test (ACT) questionnaire, adherence to treatment, and quality of life (QoL). Patients in the active group were counseled on correct inhaler technique and administration skills, orally and using inhaler adhesive labels delivered by the clinical pharmacist. Results: Asthma patients (n = 157; active, n = 79, and control, n = 78) were recruited into the study and grouped based on the controller inhaler they were using (Turbohaler (TH) and Accuhaler (ACC). There was no statistically significant difference between both groups at baseline for inhaler technique, adherence, ACT, and QoL. At follow-up, 93.7% of the active group patients used their inhalers correctly, while only 16.7% of the control group used them correctly (P-value < 0.001). Also, the ACT mean score was significantly higher for the active group (21.21± 5.27) versus the control group (15.92± 7.31; P-value < 0.001). The QoL mean score was significantly improved for the active group compared with the control group (active = 63.85± 24.78, Control = 38.746± 3.23, P-value < 0.001). Improvement in adherence for the active group was noticed compared with the control group but did not reach a significant level (P-value=0.691). Conclusion: Through a practical educational intervention, pharmacists were found to significantly improve patients' asthma inhaler technique, ACT scores, and QoL scores for patients with asthma. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "User error with Diskus and Turbohaler by asthma patients and pharmacists in Jordan and Australia," by I. A. Basheti and colleagues in the 2011 issue.

Rational: In March 2020, the World Health Organization (WHO) declared the coronavirus infectious disease as a pandemic referred to as COVID-19. As an essential service, community pharmacists have been enacting a key role in patient counseling and supply of essential medicines and protective equipment. Objectives: To investigate pharmacists' perspectives of the role of educational institutes and professional pharmacy organizations in supporting them to take on roles during COVID-19 pandemic and to identify barriers to be able to support themselves and their patients. Methods: This descriptive mixed-method study was conducted via a cross-sectional online survey distributed to pharmacists/pharmacy students in Jordan during the COVID-19 outbreak (15–30 March 2020) using an online questionnaire, followed by an online focus group. Questionnaire items related to participants' perspectives in being prepared for and supported in their roles during the COVID-19 pandemic, and items were tested for face validity. Data were descriptively analyzed using the Statistical Package for the Social Sciences and triangulated with focus group findings. Results: Considering that fear and anxiety are a consequence of mass social distancing/quarantine, study participants (n = 726, age = 26.9 (SD = 8.0) years, 71.9% females), reported needing training on mental healthcare to be able to support themselves and people during pandemics (90.2%). Most respondents agreed/strongly agreed (59.7%) with the statement around pharmacy educators/educational institutes having a key role in preparing pharmacists for practice during epidemics/pandemics and agreed that their faculties should add a course regarding pandemic preparedness in their curriculum (89.9%). Results were similar regarding roles for the pharmaceutical associations. Focus group findings (n = 7) mirrored the survey findings to a large extent. Conclusions: Most participants believed that pharmacy educators and pharmaceutical associations have a role in preparing them to deal with the COVID-19 pandemic through online educational workshops/webinars. Online education on mental healthcare is specifically needed. [ABSTRACT FROM AUTHOR]

Purpose To assess levels and predictive factors of health-related quality of life (HRQOL) among stroke patients. Methods The study employed a cross-sectional predictive correlational design. Levels of HRQOL were assessed using the Stroke-Specific Quality of Life (SS-QOL) scale, and the Hospital Anxiety and Depression Scale was employed to assess psychological aspects among 209 Saudi stroke patients. The analysis included demographic and medical variables to comprehensively explore influencing factors. Results A two-step hierarchical multiple regression analysis was performed. The overall SS-QOL summary score (49 items) showed a mean score of 94.4 (SD  = 8.1), indicating poor functioning. Nine predictor variables were found to significantly predict HRQOL levels, including age (β = −0.212, p  ≤ .001), female (β = −5.33, p  ≤ .001), unmarried (β = 2.48, p  ≤ .001), low gross monthly income (GMI) (β = −9.02, p  ≤ .001), medium GMI (β = −8.36, p  ≤ .001), having a medical history of hypertension (β = 2.7, p  ≤ .01), time since stroke (β = 3.26 p  ≤ .001), and being a probable case of anxiety (β = −4.29, p  ≤ .001) and/or depression (β = −2.75, p  ≤ .001). These variables collectively explained ~76% of the variance in HRQOL scores (adjusted R 2 = .762, F (16,192) = 42.6, p  ≤ .001). Conclusions Stroke patients exhibited poor HRQOL levels influenced by various factors. Clinicians should consider these predictors and intervene early to enhance HRQOL among patients at risk, emphasizing the importance of optimizing patient outcomes. [ABSTRACT FROM AUTHOR]

Consumer electronics (CE) and the Internet of Things (IoTs) are transforming daily routines by integrating smart technology into household gadgets. IoT allows devices to link and communicate from the Internet with better functions, remote control, and automation of various complex systems simulation platforms. The quick progress in IoT technology has continuously driven the progress of further connected and intelligent CEs, shaping more smart cities and homes. Blockchain (BC) technology is emerging as a promising technology offering immutable distributed ledgers that improve the security and integrity of data. However, even with BC resilience, the IoT ecosystem remains vulnerable to Distributed Denial of Service (DDoS) attacks. In contrast, the malicious actor overwhelms the network with traffic, disrupting services and compromising device functionality. Incorporating BC with IoT infrastructure presents groundbreaking techniques to alleviate these threats. IoT networks can better detect and respond to DDoS attacks in real time by leveraging BC cryptographic techniques and decentralized consensus mechanisms, which safeguard against disruptions and enhance resilience. There must be a reliable mechanism of recognition based on adequate techniques to detect and identify whether these attacks have happened or not in the system. Artificial intelligence (A) is the most common technique that uses machine learning (ML) and deep learning (DL) to recognize cyber threats. This research presents a new Blockchain with Ensemble Deep Learning-based Distributed DoS Attack Detection (BCEDL-DDoSD) approach in the IoT platform. The primary intention of the BCEDL-DDoSD approach is to leverage BC with a DL-based attack recognition process in the IoT platform. BC technology is utilized to enable a secure data transmission process. In the BCEDL-DDoSD approach, Z-score normalization is initially employed to measure the input data. Besides, the selection of features takes place using the Fractal Wombat optimization algorithm (WOA). For attack recognition, the BCDL-DDoSD technique applies an ensemble of three models, namely denoising autoencoder (DAE), gated recurrent unit (GRU), and long short-term memory (LSTM). Lastly, an orca predator algorithm (OPA)-based hyperparameter tuning procedure has been implemented to select the parameter value of DL models. A sequence of simulations is made on the benchmark database to authorize the performance of the BCDL-DDoSD approach. The simulation results showed that the BCDL-DDoSD approach performs better than other DL techniques. [ABSTRACT FROM AUTHOR]

The immediate aim of this study was to comparatively examine the bacterial respiratory microbiome of patients in a stable state and during an exacerbation of asthma–COPD (chronic obstructive pulmonary disease) overlap (ACO). This prospective observational study took place in Jordan between 1 September 2021 and 30 April 2022. Sputum samples from patients with recognized ACO were acquired within 48 h of the exacerbation onset and again at 3 weeks following the exacerbation. The next-generation sequencing Illumina MiSeq was employed and uncovered significantly high bacterial diversity in the sputa. The results showed a significant decrease in the taxonomic richness in the sputum samples collected during the exacerbation episodes compared with those collected from patients in a stable state (p = 0.008), with an increase in the taxonomic evenness (p < 0.005). This change in the composition of the airway bacterial community suggests that the replacement of a significant portion of the airway microbiome with certain microorganisms may play a role in the decrease in microbial diversity observed during an ACO exacerbation. Greater knowledge of this link could allow for a more focused administration of antibiotics, especially during exacerbations, improving clinical efficacy and patient outcomes. [ABSTRACT FROM AUTHOR]

Post‐COVID‐19 condition affects patients on various aspects. This 41‐year‐old female presented to the outpatient clinic complaining of severe insomnia characterized by inconsistent 2 h of sleep per day despite taking sleep aid pills after being infected with COVID‐19 and persisting for 6 months after recovery. [ABSTRACT FROM AUTHOR]

Worldwide, the incidence of cancer is on the rise. Current cancer treatments include chemotherapy, radiation therapy, and surgery. Chemotherapy and radiation treatment are typically associated with severe adverse effects and a decline in patients' quality of life. Anti-cancer substances derived from plants and animals need to be evaluated therapeutically as it is cost-effective, have fewer side effects, and can improve cancer patients' quality of life. Recently, bovine colostrum (BC) has attracted the interest of numerous researchers investigating its anti-cancer potential in humans. Dressings loaded with BC are beneficial in treating chronic wounds and diabetic foot ulcers. Lactoferrin, a glycoprotein with potent anti-oxidant, anti-inflammatory, anti-cancer, and anti-microbial effects, is abundant in BC. The BC pills successfully promote the regression of low-grade cervical intraepithelial neoplasia when administered intravaginally. The biological, genetic, and molecular mechanisms driving BC remain to be determined. Oral BC supplements are generally well-tolerated, but some flatulence and nausea may happen. To evaluate the therapeutic effects, long-term safety, and appropriate dosages of BC drugs, well-designed clinical trials are necessary. The purpose of this article is to emphasize the anti-cancer potential of BC and its constituents. [ABSTRACT FROM AUTHOR]

Background: Syrian refugees living in Jordan have many chronic conditions and use many medications. Pharmacists delivering the Medication Management Review (MMR) service can have a role in improving this growing global refugees' problem. Objectives: To assess the effect of the MMR service on adherence to treatment therapy and knowledge of chronic medications for Syrian refugees residing in Jordan. Methods: This randomized intervention control single-blinded study was conducted in Jordan. Syrian refugees were recruited and randomized into intervention and control groups. Two home visits were delivered to each participant, at baseline and three months later. All participants completed questionnaires regarding adherence and knowledge. As a part of the MMR service, treatment-related problems (TRPs) were recognized for all patients; recommendations to resolve these TRPs were only delivered to intervention group refugees' physicians; TRPs were corrected. At follow-up, TRPs assessment, adherence and medication knowledge were assessed for all refugee participants. Results: Participants (n = 106; intervention n = 53, control n = 53) had a number of medications and diagnosed chronic diseases of 5.8 ± 2.1 and 2.97 ± 1.16 per participant respectively. A significant improvement in the adherence and knowledge scores were noted in the intervention (P < 0.001 for both) but not the control group (P = 0.229, P = 0.07 respectively). Conclusion: The MMR service can significantly improve refugees' TRPs, adherence to therapy and knowledge of chronic medications. If this approach was extended to the large scale, many refugees in need would be able to access a quality essential health-care service; a step towards achieving universal health coverage. Trial registration: Registry: ClinicalTrials.gov Identifier: NCT04554810. [ABSTRACT FROM AUTHOR]

Objective: To investigate the characteristics and medical expenditures of patients with Asthma- chronic obstructive pulmonary disease (COPD) overlap (ACO) compared to asthma and COPD patients. Methods: This was a retrospective cohort study involving patients diagnosed with ACO, asthma or COPD as of January 2016. Medical records for patients attending King Abdullah University Hospital (KAUH), in northern Jordan, during the years 2015–2016 were used to identify eligible patients and all relevant clinical characteristics. Both respiratory and all-cause charges were extracted from KAUH billing system during the year 2016. Total, inpatient, outpatient, and pharmacy charges were described and compared across the three disease categories. Charges were measured in Jordanian Dinar (JOD, equal to 1.41 US Dollar). Results: Of a total of 761, 87 ACO patients, 494 asthmatic patients and 180 COPD patients were identified and included in this study. The average total respiratory-related charges were significantly higher in patients with ACO compared to patients with asthma (601.4 versus 354.3 JODs; P value < 0.001). Average all-cause charges were higher in case of ACO and COPD compared to patients with asthma (1830.8 and 1705.4 versus 1251.7 JODs; P value < 0.001). ACO was a significant predictor of higher respiratory and all-cause related charges. Respiratory charges were also higher in older patients and those with higher disease severity. Conclusions: ACO is a risk factor for incurring higher health expenditures in Jordan. Higher respiratory expenditures are also associated with older ages and higher disease severity. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the relationship between controlled release behaviour, swelling and initial water sorption of zein powder filled into hard gelatin capsules. Release, release rate and dissolution efficiency of various physical mixtures of zein and propranolol HCl filled into capsules were measured by dissolution testing. As the gelatin shell dissolved, zein rapidly formed a matrix, providing prolonged drug release, after an initial drug burst. Drug loading and ionic strength of the medium significantly influenced drug release. Imaging and gravimetric analysis were used to investigate matrix swelling and erosion. Zein matrices swelled like hydrophilic matrices, yet were practically non-erodible. Moreover, a strong significant positive correlation was found between matrix swelling and drug release (Pearson's correlation coefficient, r ≥ 0.9657, p -value ≤ 0.0017), suggesting that the degree of swelling governed drug release. The tensiometry test revealed that the initial ingress of media through the pores of zein powder was significantly limited by a reduction of the capillary radii of these pores, as a result of rapid polymer hydration. In conclusion, the rapid hydration of zein powder could explain the matrix formation and the controlled release observed with the capsules in the dissolution studies. Initial hydration, swelling and release behaviour were dependent on the ionic strength of the medium. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effect of home monitoring of blood pressure (HMBP) on adherence to antihypertensive medications and control of the disease among patients attending a tertiary health facility in Amman, Jordan. Methods: This cross-sectional correlation study was conducted in 2012 at the cardiovascular clinics of Jordan University Hospital. A questionnaire investigating participants' disease level of control, disease duration, frequency of HMBP use, type of measuring devices used, and effect of HMBP on adherence to antihypertensive medications and life style changes was used for the study. To minimize any bias that may have resulted from the involvement of pharmacists in data collection, we designed a clear stringent protocol that was strictly followed by the researcher with all patients. In addition to that, the researcher clearly introduced herself as an independent figure that cannot make any decisions or changes. Results: Two hundred and five hypertensive patients who practice HMBP were recruited into this study. Sixty percent of the patients were aged 50 - 69 years. About 45% of the patients were diagnosed with hypertension for > 10 years. Almost half of the patients have been using digital devices for blood pressure monitoring. The mean rate of HMBP was 15 times per month but almost 80% of the patients did not document their blood pressure readings. Around 55% of the patients referred high readings to a healthcare professional. Patients with higher levels of education as well as patients with lower BP readings showed significantly higher rates of adherence to their antihypertensive medications. Patients with high BP readings reported that they exercise more and reduced their daily salt intake. Conclusion: Overall, the patients showed high adherence rates to antihypertensive medications and adoption of better life style. However, increasing patient's awareness in respect to documenting and communicating BP readings to their physicians is needed. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the perceptions, expectations, and experiences of physicians regarding hospital-based pharmacists in some Iraqi government hospitals. Methods: A cross-sectional study was conducted at four government hospitals in Baghdad and Erbil, Iraq from March to July 2012. A validated, self-administered questionnaire was hand-delivered to a random sample of 200 physicians. The questionnaire comprised four sections that probed the physicians' demographic characteristics as well as their perceptions of, expectations of, and experiences with hospital pharmacists. Results: Most participants (69.4%) reported rarely interacting with pharmacists and that enquiring about the availability of medications was the main purpose (74.9%) of any interactions. Physicians reported being comfortable with pharmacists preventing prescription error, treating minor illness, and suggesting prescription medication to physicians of 74, 75 and 67%, respectively, but only 47% were comfortable with pharmacists providing patient education. The perspective of physicians in Erbil differed from that of physicians in Baghdad (p < 0.05). Conclusion: Interactions between Iraqi physicians and pharmacists are still not optimal. Physicians are much more comfortable with traditional pharmacist functions than with the extended, patient-oriented pharmacy services currently being promoted. Great efforts are needed to enhance the Iraqi physician's attitude regarding the clinical services provided by pharmacists which in turn would result in more collaboration among healthcare professionals. [ABSTRACT FROM AUTHOR]

Purpose: To assess osteoporosis knowledge among Jordanian people and to evaluate the effect of a pharmacist-directed brochure on the knowledge. Methods: This study was an interventional study conducted in two major cities of Jordan. The baseline knowledge of participants about osteoporosis (KOS) was evaluated by a validated, back-translated questionnaire. Thereafter, participants received a pharmacist-directed brochure education about osteoporosis, and then their knowledge was assessed using the same questionnaire. Results: Of the 395 people visiting community pharmacies in Jordan that were enrolled into the study, their age ranged from 18 to > 60 years old and 70.4% were female. More than 60% of the participants had good baseline knowledge about osteoporosis (median KOS > 50%). Gender, education and smoking status significantly affected baseline knowledge. The pharmacist-directed brochure significantly improved KOS score (78% vs. 56%, p < 0.001). Conclusion: Current knowledge of Jordanians about osteoporosis is moderate, especially females. However, majority of Jordanians believe that they need more education about osteoporosis. The educational brochure significantly improved knowledge in various important aspects. Comprehensive educational programs, which cover more areas of osteoporosis knowledge, and that should not necessarily depend only on written material, is therefore recommended. [ABSTRACT FROM AUTHOR]

Purpose: To explore healthcare providers' (HCPs) and medical students' attitudes to, and perceptions of the pharmaceutical services that clinical pharmacists can provide in United Arab Emirates. Methods: A total of 535 participants (265 HCPs and 270 medical students) were asked to complete a questionnaire over a period of three months (January through March 2009). Results: Almost three quarters of the students perceived that the clinical pharmacist is an important part of the healthcare team while 82% believed that clinical pharmacists can help improve the quality of medical care in hospitals. Eighty one percent of medical students expressed confidence in the ability of clinical pharmacists to minimize medication errors. Although slightly more than half of the respondents (53%) reported that they did not have clinical pharmacy services in their institutions, there was substantial willingness among physicians and nurses to cooperate with clinical pharmacists. The majority of physicians (92%) and nurses (87%) expressed the view that the clinical pharmacist is an important integral part of the healthcare team. Conclusion: The HCPs and medical students in the study setting valued the role of clinical pharmacists in healthcare delivery. However, new developments in pharmacy services in the UAE hospital setting is recommended for adoption in hospitals. [ABSTRACT FROM AUTHOR]

Background: The WHO classified the mpox outbreak as a worldwide health emergency. Increasing the contribution of healthcare providers, such as pharmacists, can enhance preventive efforts. Assessing the knowledge and confidence levels of pharmacists in diagnosing and managing mpox cases can shape the response strategies necessary for the management of such outbreaks., Methods: This research employed a cross-sectional survey designed to assess the knowledge and preparedness of pharmacy students and pharmacists in the United Arab Emirates (UAE) regarding the mpox virus outbreak. Independent researchers evaluated the survey items to confirm the face and content validity of the developed survey. The final study's survey was structured into three distinct sections, each addressing a specific area of interest. Data were analyzed using the IBM SPSS Statistics., Results: The 388 participants had a median age of 22.00 years (IQR = 5.00). The survey revealed that participants primarily relied on the WHO reports for mpox information (79.8%). The total knowledge scores (TK score) varied, ranging from -6 to 23 (median = 6.00), and symptom knowledge scores (SK score) ranged from -3 to 9 (median = 2.00). Older participants ( p -value = 0.008) and females ( p -value = 0.014) exhibited significantly higher TK scores. Only about 31.0% of participants expressed confidence in diagnosing mpox cases, and 34.6% expressed confidence in managing mpox cases. Nearly a quarter of the participants (24.5%) thought that getting vaccinated against COVID-19 led to contracting mpox more likely, whereas 45.7% believed that a previous infection with COVID-19 increases the risk of having mpox and its associated symptoms. Many respondents (38.7%) expressed their concern that mpox could emerge as the next major epidemic following COVID-19., Conclusion: Although pharmacists and pharmacy students in the UAE are aware of mpox, their knowledge and confidence levels in diagnosing and managing vary significantly. These findings suggest the need for targeted educational programs to enhance the understanding and preparedness of pharmacists to manage and prevent mpox cases.

Purpose: Stroke poses significant challenges to affected individuals, their families, and healthcare systems, with adherence to medications being a pivotal determinant of health outcomes. In this study, we aim to evaluate the medication adherence of stroke patients living in Iraq, and explore how patients' demographic and clinical details relate to their adherence levels. Furthermore, we seek to assess the self-care practices used by stroke patients and their adherence to them., Patients and Methods: We carried out a cross-sectional correlational study conducted from November 2022 to April 2023, stroke patients diagnosed in seven hospitals across Baghdad and Al-Mothanna governorate were recruited, with diagnoses confirmed by physicians and senior neurologists using MRI and/or CT scans. Patients' adherence to medications, demographic data, clinical characteristics, and self-care activities were analyzed using descriptive statistics and regression analyses., Results: Of the 200 participants, mean age was 58.27 years, with males constituting 53.5%. About 40.5% had a hemorrhagic stroke, and 59.5% an ischemic stroke. The mean adherence score was 13.36 (SD= 4.658) out of a possible 28. Factors significantly correlated with medication adherence included age, monthly income, time since having a stroke, and education level. Adherence was also significantly linked to having diabetes mellitus or high blood pressure. The assessment of participants' self-care activities and medication adherence revealed that responses to questions about healthcare habits varied, with "None" being the most common response for most items. Notably, we found no significant association between adherence and factors such as gender, marital status, living place, and smoking status., Conclusion: Medication adherence remains suboptimal among stroke patients in Iraq. Various demographic and clinical factors play a role in influencing adherence. The conformity to medication regimens and factors associated with it among individuals who have suffered a stroke in Iraq is vital., Competing Interests: The authors report no conflicts of interest in this work., (© 2024 Basheti et al.)

Background: The COVID-19 pandemic has had a large impact on global mental health including anxiety and depression rates, many factors affected the vulnerability to these psychological conditions amongst university students., Aim: To explore the level of anxiety and depression of university students living in Jordan., Methods: A cross-sectional study design was conducted in which an electronic survey was created and distributed, university students residing in Jordan participated in the study., Results: A total of 1241 students were enrolled in the study. The mean anxiety score among males and females was (9.68 (SD = 4.10)) and (10.46 (SD = 4.14)), respectively. 42.1% of males had "abnormal" anxiety score compared to 48.4% females. The mean depression score among males (7.77 (SD = 4.31)) was similar to that for the females (7.64 (SD = 4.14)), and 26.0% of the males had "abnormal" depression score compared to 22.6% of the females. Factors affecting anxiety scores included younger age, being a female, taking medication/s, or drinking two cups of coffee or more a day., Conclusion: With 46% and 24% of students suffering from abnormal anxiety and depression respectively, it is important for education policy makers to take immediate measures to allocate students in need of psychological assessment and help to deliver suitable interventions., Competing Interests: Authors declare no conflict of interest., (© 2023 Basheti et al.)

Aim: The purpose of this study was to investigate the prevalence of poststroke depression (PSD) in Saudi Arabia and its association with socio-demographic and clinical factors., Design: A predictive correlational cross-sectional study., Methods: The study adopted a non-probability convenience sampling method to recruit 211 stroke survivors between April and October 2021 from the neurology outpatient departments of two main governmental hospitals in Saudi Arabia. PSD was measured using a self-assessment reliable and valid scale (The Hospital Anxiety and Depression Scale [HADS])., Results: More than two-thirds (70.6%) of the study sample (Mean age = 53 years, SD = 8.5, 51.2% were males) experienced some degree of depression (Score ≥8); of these, approximately half (48.8%) were in severe depression. The final prediction model was statistically significant (χ 2 [15] = 31.39, p ˂ .01). PSD is a statistically significant health issue and requires immediate attention by healthcare providers to improve the health outcomes of stroke survivors., (© 2022 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Patients infected with coronavirus have new experiences and hence new needs from the healthcare sector. Acknowledging patients' experiences can exhibit promising outcomes in coronavirus management. Pharmacists are considered a vital pillar in managing patients' experiences during their infection. A cross-sectional study was conducted to assess the experiences of COVID-19-infected individuals and the roles of pharmacists in the United Arab Emirates. The survey was face- and content-validated after being developed. Three sections were included in the survey (demographics, experiences of infected individuals, and the roles of pharmacists). Data were analyzed using the Statistical Package for the Social Sciences. The study participants ( n = 509) had a mean age of 34.50 (SD = 11.93). The most reported symptoms among participants were fatigue (81.5%), fever (76.8%), headache (76.6%), dry cough (74.1%), muscle or joint pain (70.7%), and sore throat (68.6%). Vitamin C was the most used supplement (88.6%), followed by pain relievers (78.2%). Female gender was the only factor associated with symptom severity. About 79.0% agreed that the pharmacist played an important and effective role during their infection. The most reported symptom was fatigue, with females reporting more severe symptoms. The role of the pharmacist proved to be vital during this pandemic.

Objectives: To measure the prevalence and severity of post-traumatic stress disorders (PTSD) among Syrian refugees and explore its association with various factors., Methods: A cross-sectional study was carried out among a convenience snowball sample of Syrian refugees residing in non-camp settings in Jordan in 2019. A 4-part self-administered structured questionnaire was used to collect data. Part one included socio-demographic data, part 2 included an Arabic version of Harvard Trauma Questionnaire (HTQ) (part I: trauma event and part IV: trauma symptoms), part 3 was related to participants' physical symptoms, and part 4 to participants' satisfaction with the healthcare they received., Results: Study participants (n=279; mean age 32 years (SD=10.45), 52% were males) reported high prevalence of traumatic symptoms (86.2%); of these, 68.5% were considered symptomatic for PTSD (HTQ-16 sub-scale or the entire symptom scale HTQ-45 mean item score of >2.5), regardless of the type of trauma. Those who were middle-aged, a female, unemployed, sexually abused or raped, had a family member who died in the conflict, witnessed catastrophic events like burning, or razing of residential areas, and have received the body of a family member while being prohibited from expressing grief and doing funeral rites, were more likely to be considered as a case of PTSD., Conclusion: Majority of the refugees residing in non-camp settings in Jordan suffer from PTSD. Refugees have low satisfaction with the healthcare services provided., (Copyright: © Saudi Medical Journal.)

Background: Patients infected with coronavirus have new experiences and hence needs from the healthcare sector. Pharmacists can play vital roles in adopting innovative strategies to meet such needs., Objectives: To assess the experience of people who have been infected with coronavirus, and to assess the roles played by pharmacists to meet their new needs., Methods: This descriptive cross-sectional online survey was developed based on previous literature, validated, and conducted in Jordan (3-13 May 2021)., Results: The mean age of the study participants (n=470) was 34.31 years (SD=11.75). About three-quarters were females. Out of the study participants, 24.0% reported to having been infected with the coronavirus previously, and 48.9% of them were infected after contacting an infected family member/friend. Only 36.0% ranked their commitment to the preventative measures as "very committed" before getting infected. The most reported symptom was fatigue (77.1%). The most used medicine/supplement was vitamin C (85.3%), followed by pain relievers (77.7%), and zinc tablets (75.3%). More than half of the participants (66.4%) documented that their anxiety and stress levels increased during their infection. More than half of the participants (53.7%) strongly agreed/agreed that pharmacists had an important and effective role during their infection., Conclusion: The experience of individuals who contracted the coronavirus indicated that few were very committed to preventative measures before getting infected. Fatigue was the main experienced symptom, while vitamin C was the supplement used the most. About half of the participants believed that pharmacists have an important role in managing their needs during their COVID-19 infection., (Copyright: © Pharmacy Practice.)

Background: There have been varying reports on the potential occurrence and severity of changes to menstruation including the median cycle length, days of bleeding, bleeding heaviness, and menstrual pain, following receipt of COVID-19 vaccinations. We aimed to assess potential postvaccination menstrual changes in women residing in the Middle East., Methods: We implemented a cross-sectional online survey-based study. Data about the participants' demographic characteristics, menstruation experience, and vaccination status were collected and analyzed among six Arab countries., Results: Among 4942 menstruating females included in this study, females who had received one or more doses of COVID-19 vaccination reported a higher frequency of back pain, nausea, tiredness, pelvic pain with periods, unprescribed analgesics use, and passage of loose stools. They also reported higher scores describing average and worst menstrual pain. Fully vaccinated females reported heavier flow and more days of bleeding., Conclusion: Our findings indicate that COVID-19 vaccine may have an effect on menstruation in terms of menstrual pain and bleeding heaviness. The evidence needs to be further investigated in longitudinal studies., (© 2022 The Authors. Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd.)

Background: The perception of COVID-19 vaccines as being unsafe is a major barrier to receiving the vaccine. Providing the public with accurate data regarding the vaccines would reduce vaccine hesitancy., Methods: A cross-sectional study was conducted to collect data on the side effects experienced by the vaccinated population to assess the safety of the inactivated COVID-19 vaccine., Results: The majority of the study participants (n = 386) were female (71.9%), and 38.6% of them were under 30 years old. Around half of the participants (52.8%) reported side effects after receiving the inactivated COVID-19 vaccine. Fatigue (85.1%), a sore arm at the site of the injection (82.1%), and discomfort (67.2%) were the most commonly reported side effects after the first dose. Reporting side effects was significantly associated with the female sex ( p -value = 0.027). Significant associations between being female and experiencing chills, muscle or joint pain, anorexia, drowsiness, and hair loss were also found, as well as being above the age of 30 and experiencing a cough. Being a smoker was significantly associated with experiencing a cough, and a headache. Furthermore, chills, and a sore throat were significantly associated with individuals who had not been infected before., Conclusion: Mild side effects were reported after receiving the inactivated COVID-19 vaccine. Fatigue was the most commonly reported side effect. Females, older adults, smokers, and those who had never been infected with COVID-19 had a greater susceptibility to certain side effects.

Objective: Given the major shift to patient-directed education, novel coronavirus (nCoV) provides a live example on how medicinal chemistry could be a key science to teach pharmacy students. In this paper, students and clinical pharmacy practitioners will find a stepwise primer on identifying new potential nCoV treatments mechanistically modulated through angiotensin-converting enzyme 2 (ACE2)., Methods: First, we identified the maximum common pharmacophore between carnosine and melatonin as background ACE2 inhibitors. Second, we performed a similarity search to spot out structures containing the pharmacophore. Third, molinspiration bioactivity scoring enabled us to promote one of the newly identified molecules as the best next candidate for nCoV. Preliminary docking in SwissDock and visualization through University of California San Francisco (UCSF) chimera made it possible to qualify one of them for further detailed docking and experimental validation., Results: Ingavirin had the best docking results with full fitness of -3347.15 kcal/mol and estimated ΔG of -8.53 kcal/mol compared with melatonin (-6.57 kcal/mol) and carnosine (-6.29 kcal/mol). UCSF chimera showed viral spike protein elements binding to ACE2 retained in the best ingavirin pose in SwissDock at 1.75 Angstroms., Conclusion: Ingavirin has a promising inhibitory potential to host (ACE2 and nCoV spike protein) recognition, and hence could offer the next best mitigating effect against the current coronavirus disease (COVID-19) pandemic., (Copyright: © Pharmacy Practice.)

Background: Stroke is one of the most significant neurological problems around the world, and is considered a leading cause of death. Due to polypharmacy and multimorbidity, stroke patients are susceptible to have lower levels of adherence to their medications and self-care activities., Methods: Patients who have suffered a stroke and had recently been admitted to public hospital were approached for recruitment. Patients' adherence to their medications was examined using a validated questionnaire during an interview between the principal investigator and the patients, where patients' adherence to their self-care activities was assessed using a developed, validated and previously published questionnaire as well. Reasons for lack of adherence was explored from the patients. Verification of patient's details and medications was done via the patient's hospital file., Results: The mean age of the participants (n=173) was 53.21 (SD= 8.61) years. Assessing patients' adherence to medications showed that more than half of them stated that they sometimes/often forgot to take their medication/s, while 41.0% sometimes/often stopped their medication/s from time to time. The mean adherence to medications score (out of 28) was 18.39 (SD=2.1), with 83.8% having a low adherence level. It is found that patients who did not take their medications were due to forgetfulness (46.8%) and complications from taking the medications (20.2%). Better adherence was associated with higher educational level, higher number of medical conditions, and higher frequency of glucose monitoring. Adherence to self-care activities showed that majority of patients performed correct self-care activities three times a week., Conclusion: Post-stroke patients in Saudi Arabia have indicated low levels of medication adherence, while reporting good adherence to their self-care activities. Better adherence was associated with certain patient characteristics such as higher educational level. These findings can help in focusing the efforts to improve adherence and health outcomes for stroke patients in the future., (Copyright: © Pharmacy Practice.)

Worldwide, during the COVID-19 pandemic in 2019, there was an increase in the tendency of misusing prescription drugs as well as self-medicating with over-the-counters. Additionally, an increase in the use of herbs and natural products was reported. A descriptive cross-sectional survey was conducted in Jordan from May 19th to July 29th, 2021, to assess the medications and natural products used in Jordan during the second wave of the pandemic. The survey was developed and validated, then distributed using Google Forms via social media platforms. Data was analyzed using Statistical Package for Social Sciences-24. The study participants (n = 386) had a mean age of 29.35 (SD = 11.90) years. Most of participants were females (72.8%), not married (64.5%), non-smoker (69.2%), have a Jordanian nationality (80.6%), hold a bachelor's degree (73.1%), and living in the middle of Jordan (74.1%). More than 70% of the participants used vitamin C, D and pain relievers. The most used natural products were citrus fruits (78.8%), honey (63.0%) and ginger (53.1%). The participants reported that family and friends (55.4%) played a major role in advising them to use medications and dietary supplements. Pharmacists ranked second (54.1%), followed by social media platforms (43.3%). Multiple logistic regression analysis highlighted that only the age significantly affected the participants' use of medications and natural products (P < 0.001). The results of this study warrant the need of conducting awareness campaigns guided by trained healthcare providers to educate people and minimize the risk of side effects that may arise from unsupervised use of medications and natural products., 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., (© 2022 The Author(s).)

Background: Adherence to medication is the cornerstone to achieve the best treatment outcome. Pharmacists are healthcare professionals found in a pivotal position to assess asthmatic patients' adherence to medication. A brief, reliable, and valid measure of patients adherence to mediations is useful to enable the pharmacists to deliver that vital service., Objective: To develop a reliable and valid adherence assessment tool for asthmatic patients., Methods: The Adherence to Asthma Medication Questionnaire (AAMQ-13) was developed based on an extensive literature review, followed by applying the Delphi technique, and then it was pilot-tested by 55 patients. The final AAMQ-13 was completed by 213 patients. Psychometric evaluation was assessed including reliability, criterion validity, and construct validity., Results: The AAMQ-13 is a feasible 13-item questionnaire, as it can be completed within an average of two minutes. It has high reliability (Cronbach's alpha= 0.87). Criterion-concurrent validity was established by comparing the AAMQ-13 to the Test of the Adherence to Inhaler (TAI) and the pharmacy refill records. Criterion-convergent validity was established by comparing the AAMQ-13 to the Asthma Control Test (ACT) questionnaire and the Positive Health Behaviors Scale (PHBS). Construct validity was established through AAMQ-13 factor analysis which revealed two factors explaining 51.76% of the total variance., Conclusion: The AAMQ-13 is a reliable and valid questionnaire with several desirable characteristics as it has high reliability, good criterion validity, and strong construct validity. The AAMQ-13 is a suitable questionnaire that can identify non-adherent patients and reveal the reasons behind their non-adherence : Asthma; Adherence to medication; Compliance; Questionnaire; Self-report; Scale; Survey., (Copyright: © Pharmacy Practice.)

Background: Patients infected with coronavirus have new experiences and hence new needs from the healthcare sector. Acknowledging patients' experiences can exhibit promising outcomes in coronavirus management. Pharmacists are considered a vital pillar in managing patients' experiences during their infection., Objective: To assess the experience of individuals who have been infected with coronavirus and the roles played by pharmacists to meet their new needs., Methods: This descriptive cross-sectional survey was developed based on previous literature, validated, and conducted in Syria. The survey included items related to participants' COVID-19 experiences, and items concerning the roles played by pharmacists when participants were infected. Items were tested for face validity. Data collection was conducted in May and June 2021. Data was analyzed using the Statistical Package for the Social Sciences (SPSS)., Results: The study participants (n=576) had a mean age of 37.99 years. Fatigue was the most reported symptom by the participants. Vitamin C was the most used supplement (76.4%), and 66.5% of the participants used herbs during their infection. More than 60.0% of the participants stated that their anxiety and stress levels increased during their infection. Around 40.0% of the participants needed to visit a specialist doctor. Only 5.4% needed to use an artificial respiration apparatus. The mean of the participants' infection severity was 4.97 (SD=2.30) out of 10. The severity of the infection was significantly affected by being older, female, smoking, and having a chronic condition. Doctors followed by pharmacists were the healthcare providers who advised participants to take certain medications/herbs. More than one-third of the participants strongly agreed/agreed that the pharmacist played important and effective roles during their infection., Conclusion: Patients' experiences indicated that fatigue was the most reported symptom by the participants diagnosed with coronavirus infection, while vitamin C was the most used supplement. Pharmacists have a major role in helping participants manage their infection and are considered a vital pillar in patients' experiences since they provided patients with the needed medications., (Copyright: © Pharmacy Practice.)