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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

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

Background: Social stigma is a major problem among patients with multiple sclerosis (MS), which can affect their quality of life. There is limited research from Saudi Arabia on the anticipated stigma among patients with MS. Objectives: To determine the levels of anticipated stigma and its predictors in patients with MS in Saudi Arabia. Methods: This cross-sectional study included adult patients with MS across Saudi Arabia. Sociodemographic and medical information, including age, gender, marital status, educational level, duration of disease, number of MS episodes in the past 12 months, previous diagnosis of mental illness, and performing activities of daily living without assistance, were collected. Anticipated stigma was measured using an Arabic version of the Chronic Illness Anticipated Stigma Scale. Results: A total of 222 patients with MS were included. Moderate to severe anticipated stigma was found among 70.4% of the patients. The highest anticipated stigma mean score was from work colleagues (2.96/5). Predictors of stigma were age (P = 0.049), gender (P = 0.016), marital status (P = 0.015), education level (P = 0.003), number of MS episodes in the previous year (P < 0.001), and previous diagnosis of a mental disorder (P = 0.001). Conclusions: The findings of this study indicate the need for developing programs that reduce the anticipated stigma among patients with MS in Saudi Arabia.

Background: The 2022 Monkeypox virus (Mpox) outbreak had involved multiple countries around the globe. Here, we report clinical features and outcome of human Mpox of the first cases in Saudi Arabia. Methods: We obtained records of confirmed Mpox cases in Saudi Arabia from the public electronic health information system, Health Electronic Surveillance Network (HESN) and the healthcare providers completed a de-identified structured clinical data collection form. Results: The reported seven cases were travel-related and all were males between 24 and 41 years of age (mean age + SD) was 30.14 (+ 6.69) years. Of the cases, three (43 %) had heterosexual contact and the others had other intimate encounters while traveling abroad. They presented with skin lesions (100 %), fever (86 %), and lymphadenopathy (71 %). The illness was mild to moderate, did not require antiviral medications, and lasted 7–15 days. The mean duration of skin rash (+ SD) was 10 (+ 2.68) days. Routine laboratory tests (CBC, BUN, serum electrolytes, and liver enzymes) were within normal limits, and initial screening for HIV was negative. Expanded contact tracing did not reveal secondary cases of Mpox in the community or the healthcare setting. Conclusion: The current study showed heterosexual transmission of Mpox and the clinical course was mild and non-complicated. Therefore, clinicians and public health professionals should consider Mpox among individuals presenting with skin rash especially in the context of the investigation of HIV and other sexually transmitted diseases.

It has been seventy years since a water-soluble version of vitamin E called tocophersolan (also known as TPGS) was produced; it was approved by USFDA in 1998 as an inactive ingredient. Drug formulation developers were initially intrigued by its surfactant qualities, and gradually it made its way into the toolkit of pharmaceutical drug delivery. Since then, four drugs with TPGS in their formulation have been approved for sale in the United States and Europe including ibuprofen, tipranavir, amprenavir, and tocophersolan. Improvement and implementation of novel diagnostic and therapeutic techniques for disease are goals of nanomedicine and the succeeding field of nanotheranostics. Specifically, imaging and treating tumors with nanohybrid theranostics shows promising potential. Docetaxel, paclitaxel, and doxorubicin are examples of poorly bioavailable therapeutic agents; hence, much effort is applied for developing TPGS-based nanomedicine, nanotheranostics, and targeted drug delivery systems to increase circulation time and promote the reticular endothelial escape of these drug delivery systems. TPGS has been used in a number of ways for improving drug solubility, bioavailability improvement, and prevention of drug efflux from the targeted cells, which makes it an excellent candidate for therapeutic delivery. Through the downregulation of P-gp expression and modulation of efflux pump activity, TPGS can also mitigate multidrug resistance (MDR). Novel materials such as TPGS-based copolymers are being studied for their potential use in various diseases. In recent clinical trials, TPGS has been utilized in a huge number of Phase I, II, and III studies. Additionally, numerous TPGS-based nanomedicine and nanotheranostic applications are reported in the literature which are in their preclinical stage. However, various randomized or human clinical trials have been underway for TPGS-based drug delivery systems for multiple diseases such as pneumonia, malaria, ocular disease, keratoconus, etc. In this review, we have emphasized in detail the review of the nanotheranostics and targeted drug delivery approaches premised on TPGS. In addition, we have covered various therapeutic systems involving TPGS and its analogs with special references to its patent and clinical trials.

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.

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

Aim: Self-medication is developed to encourage responsible self-care but is often carried out without sound rationality. This study assesses the reasons, knowledge, attitude, and practices toward self-medication in rural areas of south-western Saudi Arabia. Materials and Methods: A cross-sectional, descriptive, and questionnaire-based study was carried out on respondents visiting the primary healthcare center. Data were collected, analyzed using SPSS software version 23 and presented as frequencies and percentage. Association between variables was established using the Chi-square test, and logistic regression. Results: Among the 500 responses obtained, 58% were female, and 42% were male. Self-medication was practiced for pain (38.3%), influenza (26.3%), cough (24%), and allergy (11.4%). Over 70% failed to consult a physician, lacked awareness of medicine information inserts (71.06%), and failed to check the expiration date (85.2%). Recurrence of symptoms and accessibility of medicines in pharmacies or online stores were a widely accepted reason for self-medication. The respondents were 2.5 times likely to use medications based on others recommendations (odds ratio [OR]: 2.56; 95% of confidence interval [CI]: 1.59–4.13); however, this was lower in females (OR: 0.55; 95% CI: 0.38–0.79; P = 0.002). A significant association was observed between the reasons for self-medication and practices undertaken if symptoms persist with demographic characteristics. Conclusion: Recurrence of symptoms, adopting others advice, the absence of information about medication inserts, and expiration date were issues that can impede responsible self-medication in rural areas. Appropriate patient counseling and conscious dispensing of medications are needed to minimize risks associated with self-medication.

Background: Coronavirus disease-2019 (COVID-19) was declared a “pandemic” by the World Health Organization (WHO) in early March 2020. Globally, extraordinary measures are being adopted to combat the formidable spread of the ongoing outbreak. Under such conditions, people's adherence to preventive measures is greatly affected by their awareness of the disease.Aim: This study was aimed to assess the level of awareness and preparedness to fight against COVID-19 among the healthcare workers (HCWs) and other residents of the South-West Saudi Arabia.Methods: A community-based, cross-sectional survey was conducted using a self-developed structured questionnaire that was randomly distributed online among HCWs and other residents (age ≥ 12 years) of South-West Saudi Arabia for feedback. The collected data were analyzed using Stata 15 statistical software.Results: Among 1,000 participants, 36.7% were HCWs, 53.9% were female, and 44.1% were aged ≥ 30 years. Majority of respondents showed awareness of COVID-19 (98.7%) as a deadly, contagious, and life-threatening disease (99.6%) that is transmitted through human-to-human contact (97.7%). They were familiar with the associated symptoms and common causes of COVID-19. Health organizations were chosen as the most reliable source of information by majority of the participants (89.6%). Hand hygiene (92.7%) and social distancing (92.3%) were the most common preventive measures taken by respondents that were followed by avoiding traveling (86.9%) to an infected area or country and wearing face masks (86.5%). Significant proportions of HCWs (P < 0.05) and more educated participants (P < 0.05) showed considerable knowledge of the disease, and all respondents displayed good preparedness for the prevention and control of COVID-19. Age, gender, and area were non-significant predictors of COVID-19 awareness.Conclusion: As the global threat of COVID-19 continues to emerge, it is critical to improve the awareness and preparedness of the targeted community members, especially the less educated ones. Educational interventions are urgently needed to reach the targeted residents beyond borders and further measures are warranted. The outcome of this study highlighted a growing need for the adoption of innovative local strategies to improve awareness in general population related to COVID-19 and its preventative practices in order to meet its elimination goals.

Background Western dietary habits, coupled with a sedentary lifestyle, are potential contributors to the prevalence and rapid increase in the incidence of obesity in Saudi Arabia. This study aimed to investigate the association between students' weight status and their eating behaviors and practices. Another aim was to assess students' awareness of the health risks associated with obesity. Methods A cross-sectional survey was conducted among a sample of 416 (53% male and 47% female) undergraduate students, aged 18–26 years old, between January 6 and April 6, 2019, from colleges of Health Sciences at Jazan University in the Kingdom of Saudi Arabia (K.S.A). Students completed a self‐administered questionnaire and recorded their measured anthropometric parameters. Results The prevalence of overweight (20.4%) and obesity (14.9%) were relatively high among the participants. There were statistically significant associations between Body Mass Index (BMI) and the different settings of food consumption (i.e., dining on a table (or) in the Islamic way: squatting on the ground) (p

Context: The commercially available oral solid dosage forms are used to prepare suitable liquid dosage forms extemporaneously by the pharmacists for pediatric, geriatric, and other patients with inability of swallowing tablets or capsules. These extemporaneous preparations are not subjected to tests for quality and stability like commercial products. The stability of extemporaneous preparations should be determined in hospital settings, but the practice is to rely on published information. Unavailability of stability data limits the availability of many medicines for special patients. The extemporaneously prepared omeprazole suspension is regularly used in hospital settings. Aim: This research was taken up to perform the stability study of extemporaneous omeprazole oral suspension frequently used in a referral hospital to determine the shelf life. Materials and Methods: Stability studies were performed by keeping the freshly constituted preparations in small containers at 2°C–8°C and 25°C ± 5°C; samples were withdrawn at 0, 7, 14, 21, and 28 days and assayed by spectrophotometric method at 301 nm. The percent degradation or stability was calculated for each preparation, and data were extrapolated to find out the shelf life. Results: It was found that the shelf life (t90%) of omeprazole oral suspension, prepared extemporaneously, is 32 days at room temperature (25°C ± 5°C) and 54 days in refrigerator (2°C–8°C). Conclusion: Study outcomes shall help the hospital pharmacist to improve pharmaceutical services by dispensing the extemporaneous preparations with the knowledge of their stability and storage condition.

Breast cancer is the most widespread malignancy in women worldwide. Nanostructured lipid carriers (NLCs) have proven effective in the treatment of cancer. NLCs loaded with imatinib (IMA) (NANIMA) were prepared and evaluated for their in vitro efficacy in MCF-7 breast cancer cells. The hot homogenization method was used for the preparation of NANIMAs. An aqueous solution of surfactants (hot) was mixed with a 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 NANIMAs revealed a particle size of 104.63 ± 9.55 d.nm, PdI of 0.227 ± 0.06, and EE of 99.79 ± 0.03. All of the NANIMAs revealed slow and sustained release behavior. The surfactants used in the preparation of the NANIMAs exhibited their effects on particle size, zeta potential, encapsulation efficiency, stability studies, and release studies. The cytotoxicity studies unveiled an 8.75 times increase in cytotoxicity for the optimized NANIMAs (IC50 = 6 µM) when compared to IMA alone (IC50 = 52.5 µM) on MCF-7 breast cancer cells. In the future, NLCs containing IMA will possibly be employed to cure breast cancer. A small amount of IMA loaded into the NLCs will be better than IMA alone for the treatment of breast cancer. Moreover, patients will likely exhibit less adverse effects than in the case of IMA alone. Consequently, NANIMAs could prove to be useful for effective breast cancer treatment.

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.