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OBJECTIVES To identify the self-reported vaccine-related side effects among healthcare professionals (HCPs) in the Jazan province, Saudi Arabia, and determine the associated socio-demographic factors. With the recent second and third waves of coronavirus disease -19 (COVID-19) infections worldwide, the race is not only to encourage but also to achieve mass vaccination. METHODS A total of 397 HCPs from across Jazan province participated in an anonymous online cross-sectional survey conducted for a period of 45 days (March 30, 2021 to May 13, 2021) in Jazan province, Saudi Arabia. Data was collected using a validated 22-items self-report survey. RESULTS For both COVID-19 vaccines, majority of reports were related to flu-like symptoms including fever, chills, headache, fatigue, tiredness, and myalgia. Statistically significant associations were observed between the severity of side effects and gender (χ2=73.32; p

The novel coronavirus, designated as “Severe Acute Respiratory Syndrome Coronavirus 2” (SARS-CoV-2), is a new coronavirus that has evolved as a global pandemic recently, and it has created a widespread interest in coronaviruses causing human infections. This article compares the pathogenesis, distribution, clinical characteristics, and treatment of the three highly pathogenic coronaviruses that caused epidemics, namely, “Severe Acute Respiratory Syndrome Coronavirus” (SARS), “Middle East Respiratory Syndrome” (MERS), and SARS-CoV-2. This narrative review is prepared using the data compiled from literature search using relevant MeSH terms. The clinical manifestation of SARS-CoV-2 infection (COVID-19) is mild with relatively low fatality rate than the other two coronaviruses; however, its overall capability to cause explosive spread of the disease and reach a pandemic level is greater. Unlike SARS and MERS, COVID-19 has no accepted treatment protocols at present. Extensive studies and analyses on COVID-19 are necessary before making strong recommendations for or against any particular treatment, although some recent medications have shown great potential. COVID-19 still needs further investigation, where all of the lessons gained from previous outbreaks of SARS and MERS and the experience from the countries that managed COVID-19 seem to be the best approaches to counteract this new global hazard at present until effective preventive vaccines are available in sufficient quantity for mass vaccination programs worldwide.

Background: Drug and poison information (DPI) elective rotation develops interns into drug information experts, educators, and policymakers. DPI is an important pharmaceutical service built on technical skills, knowledge and expertise. Aim: A pre- and post-rotation survey to assess the current knowledge, attitude and perceptions of student pharmacists about DPI rotation. Methods: Three cohorts of student pharmacists responded to the survey, which was composed of closed- and open-ended questions. Descriptive statistics, McNemar's test, and Chi-square test were utilised for data analysis. Results: Knowledge of primary resources increased from 37.2% to 85.6% at the end of the rotation. In the beginning, only 13.8% were aware of Pharmacy and Therapeutic committee related activities, and 15.9% considered identification adverse drug reactions as auxiliary responsibilities. However, the proportion increased to 82% and 83.5% by the end of the rotation. Both at the beginning and the end, student pharmacists felt the training was essential to appraise literature. Twice the number of respondents expressed that there were job opportunities in the DPI centre post-rotation compared with the pre-rotation response (p

Background: The rapid change in the socio-demographic pattern and changing beliefs toward fertility and birth spacing have resulted in a notable increase in the use of oral anticonceptives in the Saudi Arabian community. However, information on the current utilization of oral anticonceptives and attitudes toward their use remains sparse. Objective: The present study evaluated the utilization pattern of oral anticonceptives, attitude toward pill use, and incidence of side effects among Saudi women. Setting: The study was conducted in a community setting in Jazan, Kingdom of Saudi Arabia. Methods: Eligible Saudi women routinely using oral anticonceptive pills were invited to participate in this prospective, cross-sectional survey. Data were collected using a standardized, pretested, semi-structured questionnaire. Jazan was selected as it recorded the highest number of women using contraceptives in Saudi Arabia. Main outcome measure: The pattern of pill utilization, attitude toward pill use, and incidence of side effects. Results: A total of 496 women consented to participate in this study. Most of the respondents (87.5%) were using or had used oral anticonceptives for birth control. In nearly half (49.2%) of participants, oral pills were advised by a gynaecologist, and approximately two-thirds (69.0%) were using or had used combined oral anticonceptives. Nearly two-thirds (63.1%) of respondents preferred pills over other contraception methods due to their ease of use. More than one-third (39.3%) of participants agreed that oral pills are safe. Approximately half (53.2%) of participants were aware that a missed pill must be taken immediately after recalling that a dose was missed. A total of 69.6% of participants experienced at least one side effect, of which mood swings (61.1%), weight gain or increase appetite (42.2%), decreased libido (34.1%), and nausea (31.2%) were most common. Conclusion: Saudi women had a high acceptance rate for oral anticonceptives as a legitimate method to prevent unintended pregnancy. This was associated with a modest degree of understanding about their risks and benefits. Pharmacists should provide up-to-date information and counsel patients about the use and side effects of oral anticonceptives.

Exercise addiction (EA) has been described as a condition of psychological dysfunction characterized by excessive and obsessive exercise patterns, show withdrawal symptoms when unable to exercise, and experience numerous conflicts and other negative consequences in their social and professional lives, due to the extremely high volumes of exercise. The main objective of the present study was to assess the risk of exercise addiction among a Saudi Arabian sample of regular exercisers and to investigate possible associations between their inability to exercise during the COVID-19 pandemic lockdown (due to the closure of public gyms, swimming pools, and health clubs) and depression, anxiety, and loneliness. A total of 388 regular-exercising Saudis participated in an online cross-sectional survey over three months (December to February 2021). The study sample comprised 89.9% (males) and 10.1% (females), with a mean age of 28.59 years (SD ± 6.69). A 36-item online self-report survey was used for data collection. The prevalence of being at risk of exercise addiction among participants of the present study was 13.1%. Positive significant associations were noted between risk of exercise addiction and depression (r = .41; p < .01), risk of exercise addiction and anxiety (r = .20; p < .01), and risk of exercise addiction and loneliness (r = .17; p < .01). The findings of the present study suggest that those individuals at risk of exercise addiction might also be at an elevated risk of developing negative psychological impact owing to the disruption of the amount of exercise engaged in due to COVID-19 pandemic-related restrictions and therefore these high-risk individuals should receive appropriate psychological support to help them overcome the negative impact of the ongoing pandemic.

Kannan O Ahmed,1 Imad Taj Eldin,2 Mirghani Yousif,1 Ahmed A Albarraq,3 Bashir A Yousef,4 Nasrein Ahmed,5 Anas Babiker6 1Department of Clinical Pharmacy, Faculty of Pharmacy, University of Gezira, Wad Medani, Sudan; 2Department of Pharmacology, Faculty of Pharmacy, University of Gezira, Wad Medani, Sudan; 3Pharmacy Practice Research Unit, Department of Clinical Pharmacy, College of Pharmacy, Jazan University, Jazan, Saudi Arabia; 4Department of Pharmacology, Faculty of Pharmacy, University of Khartoum, Khartoum, Sudan; 5Department of Cardiology, Ahmed Gasim Cardiac Surgery and Renal Transplantation Centre, Khartoum, Sudan; 6Department of Cardiology, Royal Care International Hospital, Khartoum, SudanCorrespondence: Kannan O AhmedDepartment of Clinical Pharmacy, Faculty of Pharmacy, University of Gezira, Hospital Street No. 1, Wad Medani, 21112, SudanTel +249 121860001Fax +249 511861180Email omerkannan@gmail.comBackground: Medications known to improve outcomes in heart failure (HF) are either not prescribed or prescribed at sub-therapeutic doses. The addition of clinical pharmacists to the HF team positively impacts optimizing prognostic medications for a patient with HF with reduced ejection fraction (HFrEF).Objective: To assess the intervention of the clinical pharmacist as part of the multidisciplinary (MD) team in up-titration to achieve target doses of key therapeutic agents for HFrEF.Methods: This was a prospective one group pretest-posttest interventional study; a comparison of the target dose achievement of key therapeutic agents for HFrEF was performed before and after clinical pharmacist interventions.Results: Out of 110 HFrEF patients, 57.3% were males, and the mean age of patients was 55.8 years (SD 12.6). Cardiomyopathy was the leading cause of HF. At baseline, 86% were on angiotensin-converting enzyme inhibitors/angiotensin receptor blockers/angiotensin receptor-neprilysin inhibitors (ACEIs/ARBs/ARNi) and 93.6% on beta blockers (BBs). At the end of study, the proportion of patients achieved the target dose was significantly increased (0 vs 77.4%, 6.8 vs 85.4%, and 0 vs 55.6%) for ACEIs, ARBs and ARNi, respectively, and (8.6% vs 66.1%; P = 0.001) for BBs. Moreover, the up-titration process was associated with significant improvement in most clinical as ejection fraction and New York Heart Association (NYHA) scale and laboratory characteristics.Conclusion: As a part of the MD team in the outpatient HF clinic, the clinical pharmacists increased the percentage of HFrEF patients achieving the target or maximal doses of key therapeutic agents and improving clinical and laboratory parameters.Keywords: clinical pharmacist, intervention, heart failure, medications titration, Sudan

Abdulkareem M Albekairy,1 Aiman A Obaidat,1 Mansour S Alsharidah,2 Abdulmajeed A Alqasomi,3 Abdulrhman S Alsayari,4 Ahmad A Albarraq,5 Ahmad M Aljabri,6 Alian A Alrasheedy,7 Bader H Alsuwayt,8 Bandar E Aldhubiab,9 Faisal A Almaliki,10 Majed M Alrobaian,11 Mohammad A Aref,12 Najla A Altwaijry,13 Nasser H Alotaibi,14 Saad A Alkahtani,15 Saleh A Bahashwan,16 Yaser A Alahmadi16 1College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 2College of Medicine, Qassim University, Buraydah, Saudi Arabia; 3College of Pharmacy, Qassim University, Buraydah, Saudi Arabia; 4College of Pharmacy, King Khalid University, Abha, Saudi Arabia; 5College of Pharmacy, Jazan University, Jazan, Saudi Arabia; 6College of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia; 7College of Pharmacy, Qassim University, Unaizah, Saudi Arabia; 8College of Pharmacy, Northern Border University, Rafha, Saudi Arabia; 9College of Clinical Pharmacy, King Faisal University, Al Hofuf, Saudi Arabia; 10College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia; 11College of Pharmacy, Taif University, Taif, Saudi Arabia; 12College of Pharmacy, Albaha University, Albaha, Saudi Arabia; 13College of Pharmacy, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia; 14College of Pharmacy, Jouf University, Aljouf, Saudi Arabia; 15College of Pharmacy, Najran University, Najran, Saudi Arabia; 16College of Pharmacy, Taibah University, Madina, Saudi ArabiaCorrespondence: Aiman A ObaidatCollege of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 3660, Riyadh, 11481, Saudi ArabiaEmail obaidata@ksau-hs.edu.saBackground: With the expansion in pharmacy education in Saudi Arabia, there is a pressing need to maintain quality assurance in pharmacy programs using several tools. The progress test is a formative assessment tool that can serve to provide information to all stakeholders. This study evaluated the results of a unified progress test that was shared among 15 colleges of pharmacy.Methods: The progress test was composed of 100 MCQs where 30% of which cover basic pharmaceutical sciences and 70% cover pharmacy practice. The questions were collected from all the 15 colleges of pharmacy participated in the test. The test was administered online to all undergraduate students in the professional programs of these colleges.Results: The overall attendance rate was 80% from the total number of students enrolled in the participating colleges. Mean scores of students in basic pharmaceutical sciences were relatively higher than in pharmacy practice. The assessment results of the students in the unified program learning outcomes among colleges were higher in the domains of knowledge and skills compared to competence domain. There was a significant increment in the mean scores of the students as they progress through the years of the professional program. No correlation was found between the mean scores in the test and the cumulative grade point average (cGPA) of all students regardless of their level.Conclusion: The results indicated growth and maintenance of the gained knowledge and skills by the students as they progress through the years of the professional program with consistency in the results among the participating colleges. Sharing a unified test was effective as a valuable tool for the colleges of pharmacy for the purposes of benchmarking and improving the curricula. In addition, it could serve to evaluate learning of students and harmonize knowledge and skills gained by students at different institutions.Keywords: progress test, formative test, assessment, learning outcomes, pharmacy education, Saudi Arabia

Background: The novel coronavirus disease (COVID-19) has affected hundreds of thousands of people across more than 200 countries. As the pandemic continues, the health agencies, worldwide, are recommending strict preventive practices to avert its transmission at community scale. We sought to predict the behavior of the Saudi population for adopting community preventive practices during the COVID-19 pandemic. Methods: An online questionnaire consisting of 22 items pertaining to the Health Belief Model constructs was used to measure the perceived susceptibility and perceived severity of contracting COVID-19, along with the perceived benefits and perceived barriers to follow the Ministry of Health's recommendations. The outcome was assessed by their readiness to be compliant with the community protective measures. Data were analyzed using STATA at significance level of 0.05. Results: A total of 900 individuals received the online survey link, of which 688 (response rate: 76.4%) respondents consented to participate in the study. The mean age of the respondents was 31.39 (SD = 8.94). Positive associations were observed between perceived susceptibility (Beta: 0.24; p value

Background: The fight against malaria has been effective globally and Saudi Arabia is in the stage of malaria pre-elimination to nearly complete elimination.Aim: The current study assesses ...

First aid is the most basic and life-saving service provided before emergency care is received. This study aimed to assess students’ knowledge and attitudes about performing first aid for snakebite emergencies and their perception of snakes. A cross-sectional study was conducted between January and March 2019 among upper-level students (3rd year and above) of health-related courses at Jazan University, Saudi Arabia. Three hundred and nine students from four programs responded to the self-administered questionnaire. The collected data were analyzed using SPSS 23.0. The highest percentage of the study sample comprised pharmacy students (44%), followed by nursing (25.2%), medical (16.8%), and emergency medicine students (13.9%). Overall, the emergency medicine students exhibited greater knowledge of snakebite first aid. However, over three-fourths of the students were unaware of dry bites. Around two-thirds were sure that they should not massage the bite site, while nearly one-fourth were not sure about the use of a tourniquet. The fifth- and sixth-year students had extremely diverse perspectives on snakes. The majority of the participants (92.8%) did not feel good about snakes. However, most of the students (95.2%) wanted to learn about snakebite first aid and overcome their fear of snakes. Overall, the students had a positive attitude towards first aid but lacked knowledge of snakebite emergencies. Public health awareness is required to dispel first-aid myths about snakebites and misconceptions regarding snakes.

Breast cancer is the most widespread malignancy in women from corner to corner of the world. Nanostructured lipid carrier (NLC) proved its efficacy in the treatment of cancer. NLC loaded with Imatinib (IMA) (NANIMA) was prepared and evaluated for in vitro efficacy in MCF-7 breast cancer cells. Hot homogenization method was used for the preparation of NANIMAs. Aqueous solution of surfactants (hot) was mixed with molten mixture of stearic acid and sesame oil (hot) under homogenization. The prepared NANIMAs were characterized and evaluated for size, polydispersity index, zeta potential, encapsulation efficiency, release studies, stability studies and MTT assay (cytotoxicity studies). The optimized NANIMA revealed particle size of 104.63 ± 9.55 d.nm, PdI of 0.227 ± 0.06 and EE of 99.79 ± 0.03. All NANIMAs revealed slow and sustained release behaviour. The surfactants used in the preparation of NANIMAs exhibited their effects on particle size, zeta potential, encapsulation efficiency, stability studies and release studies. The cytotoxicity studies unveiled 8.75 times increase in cytotoxicity for optimized NANIMA (IC50 = 6 µM) when compared with IMA alone (IC50 = 52.5 µM) on MCF-7 breast cancer cells. After this, NLC containing IMA possibly will be employed for the cure of breast cancer. A lesser amount of IMA loaded NLC will be sufficient than IMA alone for the treatment of breast cancer. Moreover, the patient will exhibit not as much of adverse effects as in case of IMA alone. Consequently, NANIMA could prove to be useful for effective therapeutic outcome in breast cancer treatment.

Objective: To assess the preparedness for handling injuries by female primary school teachers based on their knowledge, attitude, practice and their willingness to learn first aid. Methods: A cross-sectional questionnaire on first aid was provided to female primary school teachers, and the knowledge, attitude, practice and their willingness to learn first aid were investigated. Data were analyzed using SPSS version 23. Quantitative data were analyzed by one-way ANOVA, categorical variables were analyzed by the Chi-square test. The level of significance was set at P

Background: Osteoporosis is a major health problem in most nations, including Saudi Arabia. Awareness among the Saudi population is essential for early detection, timely treatment and subsequent fracture prevention.Aim: The current study was intended to evaluate the level of knowledge, attitudes and practices towards osteoporosis among the general population residing in Jazan region, south-western Saudi Arabia.Study design: A community-based cross-sectional survey was developed, and a structured questionnaire was distributed among residents of Jazan. Data were collected from 400 male and female participants and analysed using STATA 15.0 software.Results: The data revealed that most of the participants were aware about osteoporosis risks, causes and symptoms. However, knowledge and attitude levels were significantly higher among females and individuals who were

Background: It was considered that the resistance of drugs such as carbapenems and cephalosporins against severe or high risk gram-negative bacteria became a tremendous confront. This might be attributed to the little amount of these drugs to be used against the multi-resistant bacteria (MRB). Therefore, Colistin, Fosfomycin, Temocillin, and Rifampicin are antibiotics that have been used as multidrug-resistant bacterial infections in the treatment of some species of bacteria such as Acinetobacter, Pseudomonas species, and Enterobacteriaceae. Aim: the present study is aimed to assess the integrity and efficiency of colistin for treating of the multidrug-resistant bacteria (MDR) especially gram-negative one among critical and non-critical patients in tertiary hospital in Jazan city. Ninety four patients who met the selection criteria and received colistimethate sodium (colistin) in the period between Februarys 2017 and March 2018 were recruited and their charts were reviewed retrospectively. Patients' information, medical conditions, and laboratory data were extracted. All patients received IV colistin, and the majority of the patients showed in their culture reports multidrug-resistant bacteria such as Pseudomonas aeruginosa and Acinetobacter baumannii. Patients who had normal renal function received from 2.5 to 5.0 mg of colistin/kg, which was divided in two or three doses intravenously, for duration ranging between 10 and 14 days. Results and conclusion: Approximately half of patients (48.93%) were fully recovered, while 19% of them were partially responded to colistin treatment. In the current study it was showed that IV colistin treatment against the multidrug-resistant bacteria (gram-negative bacteria) was strongly related to mild nephrotoxicity in addition to with a proper response as shown only in three of our patients

Background : Mothers’ attitudes are strong predicators of choice of infant feeding method. This study was conducted to measure attitudes towards breastfeeding among Saudi mothers. Methods : A cross-sectional survey was conducted during April 2013 among Saudi nursing mothers in Taif Region; Kingdom of Saudi Arabia (KSA). Data was collected by trained pharmacy female students through face-to-face interview method using structured questionnaire. Mothers’ attitudes towards breastfeeding were assessed by The Iowa Infant Feeding Attitude Scale (IIFAS). Results : A total of 387 mothers were included of them 204 (52.7%) aged 32 years) 63 (34.4%), ( P < 0.001). Cross tabulation of the method of infant feeding and mothers’ total attitudes towards breastfeeding showed that mothers used formula feeding or mixed feeding method 120 (49.0%) had significantly positive attitudes towards breastfeeding more than breastfeeding ones 61(43.0%), ( P =0.025). Conclusion : The rate of exclusive breastfeeding was low. Positive attitudes towards breastfeeding was found to be more among mothers used formula or mixed feeding method. Educational interventions are needed to raise awareness and upgrade mothers’ knowledge on infant breastfeeding.

Injection is said to be safe when causing no harm to the recipient, and it does not expose provider to avoidable risk and does not result in any waste that is dangerous for other people. Purpose: The study was carried out to determine the perspectives of the Saudi health care providers on the safe use and disposal of injection. Methods: Prospective cross sectional survey was used, structured interviews were carried out by the use of pretested questionnaire to elicit general opinions on injection practices skills, and disposal processes in different health settings in Taif Area. Results: Females were dominant injection providers 82.3%. About 80% of providers tend to discard single use injection at once after administration and 84% tend to safely dispose them. Hygienic measures were well maintained. Increased used pattern of injection was observed 46%. Providers were well satisfied by the measures adopted to curb after using hazards. High rate of injection sticks 74.3% was observed. Conclusion: Although some measures of safe disposal were maintained by Saudi injections’ providers, still some regulation efforts should be done to curb spreading out of infection due to mal use and disposal of injection.

Objectives: The knowledge and behavior of caregivers are playing a significant role in preventing and managing the emergency conditions of disease or disorder suffered by their children. Pediatric asthma is one such severe health disorder, which cripples the child from regular activities and exerts enormous stress on parents if not appropriately managed with adequate knowledge and skills in the initial stage of onset. This research paper, thus, is aimed to appraise the caregivers' knowledge and behavior (n = 250) of asthmatic children admitted to general hospitals in Jazan province, Kingdom of Saudi Arabia, about the cause, prognosis, and therapy of asthma in preventing and handling emergency asthmatic attacks in their children. Materials and Methods: Caregivers were interviewed with the help of a questionnaire (35 items) about pediatric asthma. The questionnaire was adapted from the Chicago Community Asthma Survey. Results: The results revealed that information regarding complications of pediatric asthma, behavioral skills, and knowledge on its management that are required to practice during an emergency was very little among the caregivers of asthmatic children. Lack of proper education, insufficient knowledge of asthma, underprivileged socioeconomic class, and substandard living conditions came out as reasons for poor knowledge and behavior among them. Conclusion: The study recommends that there is an urgent and pressing need to educate caregivers and provide continuous training on the right practice during asthma attacks to take proper and efficient care of their children.

BackgroundThe Drug and Poison Information Center (DPIC) at King Khalid University Hospital, Riyadh, Saudi Arabia, was founded in 1983. Since then it has responded adequately to queries from medical and non-medical callers from all over the Kingdom. Queries ranged from simple material identification to poisoning cases.ObjectivesTo assess the pattern and circumstances of poisoning in the Kingdom of Saudi Arabia through reviewing data from DPIC in King Khalid University hospitals.MethodsThis is a retrospective study of referred cases and calls received by DPIC. All records and documentation forms during the study period were investigated.ResultsThis study included 1161 cases. There were 7.9% infants, 52.9% under 5years old, 7.2% between 6–12years old and 32.0% more than 12years old. Number of males with toxic exposure was almost equal to that of females. More than 92% of cases were toxic exposure through oral route. Causes of poisoning include drugs among 76.7% of cases followed by household chemicals (6.8%). Suicidal intention was reported among 25.6% of cases. Using multivariate regression analysis, significant predictors of suicidal attempts are more than 12years old, patients who were exposed to more than one toxin and patient who came to the hospital within 1–3h since poisoning.RecommendationsEstablishing and operating DPIC centers throughout the kingdom, in addition to implementing of legislations to ban over the counter selling of medications and to sell potentially dangerous chemicals in childproof containers.

Background Parents’ false beliefs about signs and symptoms associated with teething have been documented in many studies around the world. This study was conducted to assess parental knowledge on infant teething process and to investigate parents’ practices used to alleviate teething disturbances. Methods A cross-sectional survey was conducted among parents of children of 6 months–5 years old in Taif, Saudi Arabia during April 2013. Convenience method of sampling was adopted and the data was collected by mean of a structured-questionnaire. Data was processed by SPPS. Logistic regression analysis was performed. P value

Non-alcoholic steatohepatitis (NASH) has a relation to obesity. It may lead to hepatocellular carcinoma. To date, the therapeutic options are limited due to complex pathogenesis. This study aimed to investigate the effect of atorvastatin and omega 3 fatty acids on experimentally-induced NASH. Sixty male albino rats were divided into 6 equal groups; control group, high fat emulsion/sucrose (HFE/S) diet, HFE/S+carboxymethyl cellulose, HFE/S +Atorvastatin, HFE/S+Fish oil and HFE/S+Atorvastatin+Fish oil. Serum alanine aminotransferase, total cholesterol (TC), triglycerides (TG), high density lipoproteins, insulin, glucose, C-reactive protein and quantitative insulin sensitivity check index were measured. Also, hepatic TC, TG, malondialdehyde, tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6) and transforming growth factor beta 1 (TGF-β1) were determined. Liver sections were examined histopathologically. Atorvastatin improved lipid profile, inflammation and oxidative stress but did not improve insulin resistance, hepatic TGF-β1 or body weight while fish oil improved lipid profile, decreased inflammation and oxidative stress, improved insulin resistance, hepatic TGF-β1 and body weight compared to HFE/S group. Atorvastatin/fish oil combination produced significant improvement in the lipid profile, inflammation, oxidative stress, insulin resistance, hepatic TGF-β1 and body weight compared to the use of each of these drugs alone. This might be attributed to the effect of fish oil on the lipid profile, inflammatory cytokines, insulin resistance and TGF-β1 which potentiates the effect of atorvastatin on NASH.

Background: Parents’ knowledge and attitudes towards immunization are likely influence uptake. The objective of this study was to assess parental knowledge, and attitudes on childhood immunization among Saudi parents. Methods: A cross-sectional survey was conducted during April 2013 in Taif, Saudi Arabia. Convenient method of sampling was adopted. Parents with children of 0-12 years old were invited to participate. Data was collected through face- to -face interview method using a pre-tested structured questionnaire. Data was processed using the software Statistical Package for Social Science (SPPS) (Version 21). Descriptive statistics were used to describe all variables. Association between dependent variables (knowledge, and attitudes) and independent ones (parents’ demographics) were tested using Chi-square test. P values of < 0.05 were considered statistically significant. Results: A total of 731 parents were recruited. Parents had good knowledge on aspects related to the general role of vaccination in prevention of some infectious diseases 672(91.9%), timing of the first dose in vaccination schedule 635(86.9%). However, poor knowledge was documented among parents in other aspects like the importance of administration of multiple doses of the same vaccine to child immunity 304(41.6%), administration of multiple vaccines at the same time have no negative impacts on child immunity 271(37.1%), vaccination of children against seasonal influenza 334(45.7%) and contraindication to vaccination 287(39.3%). Parents attitudes towards immunization was positive expect in some aspects related to vaccination side effects 316 (34.2%) and the probability of occurrence of diseases against which the child was vaccinated 288(39.4%). Gender, residence and educational level were found to be significantly associated with both parents’ knowledge and attitudes towards immunization. Conclusions and recommendations: Although parents had good knowledge and positive attitudes on some aspects related childhood immunization, gaps in both studied domains were identified. Educational interventions are needed to upgrade parents’ knowledge with special emphasis on less educated and residents of rural areas.

Objective Medication use during pregnancy is a major concern for most women. The aim of the present study was to assess medication use, knowledge and beliefs about medications among pregnant women in Saudi Arabia. Methods More than 760 pregnant women, attending the obstetric clinic, filled a semi-structured questionnaire. Data were collected about their sociodemographic background, medication use during pregnancy, medication/pregnancy risk awareness, sources of drug information and beliefs about medications. Results Most women had a positive attitude toward medications in general but they believed pregnant women should be more cautious regarding drug-use during pregnancy. A significant association was found between participants’ education and occupation, and beliefs about medications. In this context, well educated women and those working in a health-related career demonstrated more correct beliefs about medications. Women with health-related occupations were more knowledgeable about the life saving effect of drugs on unborn children. Women indicated inadequate provision of drug-related information from physician and pharmacist; they rely on medication pamphlet to get such information. The most frequently used drugs were paracetamol and vitamins (13.2%). Most pregnant women (59.2%) were able to identify drugs to-be avoided in pregnancy that agreed roughly with FDA categories with 23 hits out of 32. They indicated that newborn anomalies (6.5%) were not attributed to drug-use during pregnancy. Conclusion During pregnancy, women were more conservative and skeptic toward medication, health-care professionals should be aware of such attitudes when advising pregnant women to take medication.

We present the genome sequences of a new clinical isolate of the important human pathogen, Aspergillus fumigatus, A1163, and two closely related but rarely pathogenic species, Neosartorya fischeri NRRL181 and Aspergillus clavatus NRRL1. Comparative genomic analysis of A1163 with the recently sequenced A. fumigatus isolate Af293 has identified core, variable and up to 2% unique genes in each genome. While the core genes are 99.8% identical at the nucleotide level, identity for variable genes can be as low 40%. The most divergent loci appear to contain heterokaryon incompatibility (het) genes associated with fungal programmed cell death such as developmental regulator rosA. Cross-species comparison has revealed that 8.5%, 13.5% and 12.6%, respectively, of A. fumigatus, N. fischeri and A. clavatus genes are species-specific. These genes are significantly smaller in size than core genes, contain fewer exons and exhibit a subtelomeric bias. Most of them cluster together in 13 chromosomal islands, which are enriched for pseudogenes, transposons and other repetitive elements. At least 20% of A. fumigatus-specific genes appear to be functional and involved in carbohydrate and chitin catabolism, transport, detoxification, secondary metabolism and other functions that may facilitate the adaptation to heterogeneous environments such as soil or a mammalian host. Contrary to what was suggested previously, their origin cannot be attributed to horizontal gene transfer (HGT), but instead is likely to involve duplication, diversification and differential gene loss (DDL). The role of duplication in the origin of lineage-specific genes is further underlined by the discovery of genomic islands that seem to function as designated “gene dumps” and, perhaps, simultaneously, as “gene factories”., Author Summary Aspergillus is an extremely diverse genus of filamentous ascomycetous fungi (molds) found ubiquitously in soil and decomposing vegetation. Being supreme opportunists, aspergilli have adapted to overcome various chemical, physical, and biological stresses found in heterogeneous environments. While most species in the genus are saprophytes, a surprising number are able to infect wounded plants and animals. Remarkably, the allergic human host also responds abnormally to the aspergilli with lung and sinus disease. The advent of immunosuppressive agents and other medical advances have created a large worldwide pool of human hosts susceptible to some Aspergillus species, including the world's most harmful mold and the causative agent of invasive aspergillosis, Aspergillus fumigatus. In this study, we have used the power of comparative genomics to gain insight into genetic mechanisms that may contribute to the metabolic versatility and pathogenicity of this important human pathogen. Comparison of the genomes of two A. fumigatus clinical isolates and two closely related, but rarely pathogenic species showed that their genomes contain several large isolate- and species-specific chromosomal islands. The metabolic capabilities encoded by these highly labile regions are likely to contribute to their rapid adaptation to heterogeneous environments such as soil or a living host.

Objectives: To evaluate the frequency and prevalence of using herbal drugs in treatment of diabetes in Taif area, Kingdom of Saudi Arabia. Materials and Methods: Structured questionnaire was the main instrument used to collect information to evaluate the attitude of respondents towards use of herbal medicine. In all, 228 diabetic patients were subjected to this study from clinics in 3 major hospitals in Taif - KSA (King Faisal Hospital (KFH), King Abdul-Aziz Hospital (KASH), Alhada Armed Forces Hospital over a 4-month and 20-day period. Results: Out of the 228 diabetics, (24.6%) of those patients were using herbs, more than half of them 31 (55.4%) were males and half of them 28 (50%) and were aged 50 years and above. Interestingly, when exploring the commonly used herbs, a total of 20 different herbal names were reported to be used by the surveyed diabetics. The top four used herbs were fenugreek, nigella, myrrh and garlic with a frequency of 57.1, 44.6, 42.9 and 32.1%, respectively. Conclusion and recommendation: About one-fourth of diabetic patients in this study were using herbs and the most frequently used herbs were fenugreek, nigella, myrrh and garlic. Pharmacists should be referred for consultation regarding the use of herbal remedies. In addition, knowledge about herbal drugs should be updated to the pharmacists and physicians through continued scientific programs. Public awareness about herbal remedies should be considered to guide the public for the trusted and safe source of information when it is needed.

Objective: The study was to determine the Sudanese pharmacy students' opinions and to measure their satisfaction about education instructions and to reveal their impact on the future carrier. Materials and Methods: Cross-sectional study was conducted by using pretested self-administered questionnaire among final year pharmacy students in Sudan. Results: A total of 455 students from both public and private colleges were participated in the study. Combined one-way direct with interactive method was dominant (74.5%) and was preferred by (74.3%). The English was the major instruction language (62.9%), which was preferred by (66.6%) of the participants. More than 3-quarters of the students had chosen the pharmacy as first choice. Students believed that pharmacy provides good future career. There was a significant association between the students' satisfaction about choosing pharmacy as career and current academic performance ( P = 0.004). Conclusion: The obtained results provide an insight into students' opinions on different issues concerning pharmacy education instructions. These data could be utilized as an indicator of the general trends and a guideline for improving pharmacy education in Sudan.

Context: The increased use of generic medicines has been associated with remarkable cost saving and is one of several strategies aimed to reduce pharmaceutical expenditure. Aims: To identify consumers' perceptions on generic medicines. Settings and Design: A cross-sectional survey was conducted during April-June 2011 in Taif City in Saudi Arabia. Materials and Methods: Adult consumers (aged >18 years) were recruited. Data were collected by face-to-face interview using a pre-tested questionnaire. Statistical Analysis Used: Associations between different variables were tested by using Chi-square tests or Fisher exact tests when appropriate. All statistical tests were conducted at an a priori significance level of P Results: Overall; 450 participants were recruited (males were 78.4% and 77.8% their ages were 60 years, 6 (75.0%)); ( P = 0.015). Interviewees who did not prefer using generic medicines because of their low prices compared to brand ones were 223 (51.8%). Participants who believed that generic medicines have low efficiency compared to brand ones were 176 (39.1%). Respondents who thought that generic medicines have more side effects than brand ones were 110 (24.4%). Conclusions: The results showed general unawareness on generic medicines and generic substitution. No single variable was found to be associated with consumers' knowledge on generic medicines.