Assessment of Headache Characteristics, Impact, and Managing Techniques among Pharmacy and Nursing Undergraduates-An Observational Study

Managing Stress and Somatization Symptoms Among Students in Demanding Academic Healthcare Environments

INTRODUCTION

Stress is a common concern among healthcare students, due to the demands of their coursework and the elevated expectations they face. Especially among dentistry and nursing students, the phenomenon, although well-documented, covers psychosocial and physiological dimensions, with somatization symptoms being less explored. These manifestations are crucial to identify discipline-specific stressors and health impacts that can lead to targeted interventions for both disciplines.

AIM

This study investigates stress perceptions, somatization, and coping strategies among 271 nursing and dentistry students at the National and Kapodistrian University of Athens.

METHODOLOGY

An e-questionnaire was open for submissions during February and March 2024.

RESULTS

Females reported higher stress somatization (M = 10.22, SD = 5.23) than males (M = 7.94, SD = 6.14; Cohen's d = 0.412, p < 0.05). The interpretation of stress as "restlessness and psychological pressure" was more prevalent in dentistry students compared to nursing students. Moreover, nursing students who perceived stress as the "inability to manage unexpected or difficult situations, insecurity, panic" were more likely to experience stress somatization symptoms, while for dentistry students, stress somatization was related to "pressure to meet daily obligations/long-term goals". Physical symptoms for all students included chest discomfort, digestive issues, and headaches/nausea. Also, dentistry students reported more teeth clenching or grinding than nursing students. Short-term coping strategies included emotional balance, managing stressors, situation analysis, and breathing techniques. Long-term strategies involved distraction and entertainment, physical exercise, and patience. A higher willingness to seek coaching support correlated with higher stress somatization among dental students. Nursing students favored psychological support, while dentistry students suggested curriculum revision and improved infrastructure.

DISCUSSION/CONCLUSIONS

Females exhibited higher stress somatization levels, with themes of insecurity and physical symptoms. Nursing students reported higher somatization linked to insecurity, while dental students associated stress with daily obligations and goals. The study highlights the need for improved support systems, flexible academic procedures, and better communication to address stress in healthcare academia.

Retrospective evaluation of prescribing pattern and utilization of antiepileptic drugs in pediatric, neurosurgery, and psychiatry wards: A comparative study to the standard treatment guidelines

Antiepileptic drugs (AED) are progressively utilized for off-label conditions other than epilepsy, like bipolar disorder and migraine. The objective of this study was to evaluate current prescribing patterns and utilization of AED in pediatric, neurosurgery, and psychiatry wards and to compare them to the standard treatment guidelines. A descriptive, cross-sectional study was conducted in Ayyub Teaching Hospital, Abbottabad from December 1st, 2018 to April 2019. Data on demographic and clinical characteristics, utilization patterns of AED, adherence to standard treatment guidelines, and frequency of potential drug-drug interactions were analyzed using descriptive statistics. Among 410 patients, 54.3% (n = 223) were male, 45.6%(n = 187) were female, and 63.7% (n = 261) were from the 1 to 18 years' age group. The majority 47.3% (n = 194) were from the pediatric ward followed by neurosurgery 28.7%(n = 118). Among the studied patients, 96.1% of them had comorbid conditions other than epilepsy alone. With regards to types of seizures unclassified seizures were the most common seizure type (59.8%; n = 245) followed by generalized tonic clonic seizures 23.4% (n = 96). In this study, the most frequently utilized AED was sodium valproate 59.0% (n = 242) followed by antiepileptic first-generation medicines were commonly used (76.3%). Although a total of 77.6% of the patients showed nonadherence to National Institute for Health and Care Excellence guidelines and 87.6% of them showed drug interactions. Findings from this study showed prescription patterns and utilization of AED in patients with epilepsy and non-epilepsy disorders which may help healthcare providers in making accurate clinical decisions.

Knowledge of and Attitudes Toward Clinical Trials: A Questionnaire-Based Study of 179 Male Third- and Fourth-Year PharmD Undergraduates from Riyadh, Saudi Arabia

BACKGROUND Clinical Trials (CTs) are essential for the formation of a new medicine. This questionnaire-based study included 179 male third- and fourth-year PharmD undergraduate students from Riyadh, Saudi Arabia, between 18 and 23 years of age, was conducted in 2022, and aimed to evaluate student knowledge and attitudes toward CTs. MATERIAL AND METHODS A cross-sectional study was conducted using self-administered questionnaires. The data was collected using convenience sampling. Part 1 of the study collected demographics, with 6 items; part 2 measured knowledge about CTs (9 items); part 3 measured attitudes (5 items) measured on a 5-point Likert scale. A score of 1 was given for correct, and a score of 0 for each incorrect response. Multiple linear regression was used to evaluate the determinants of knowledge and attitudes about CTs. RESULTS A total of 108 (60.3%) undergraduates reported having heard about CTs, 15% of undergraduates had heard about institutional review boards, while 74.3% of the undergraduates believed that CTs have direct benefits to society. The mean knowledge score of the CTs among the students was 5.75±2.32 (median 6.00), while the mean attitude score of CTs was 16.45±4.56 (median 16.00). However, the results of the simple regression model revealed that age, year of study, and chronic disease status were not predictors of the knowledge and attitude score (P>0.05). CONCLUSIONS This study indicated that half of undergraduates were aware of CTs, were knowledgeable, and showed positive attitudes. Furthermore, the study identified potential misunderstandings about the benefits of CTs.

Assessment of the Mental, Social, and Educational Impact of the COVID-19 Quarantine and Predictors: A Survey-Based- Study from Saudi Parents

Background

Quarantine has had a powerful effect on parents and children in Saudi Arabia in different aspects, namely, educational, mental, and social. Therefore, this study aimed to assess the mental, social, and educational impact of the COVID-19 Quarantine and its predictors among Saudi parents.

Methods

A cross-sectional study was carried out over 6 months in 2020 using structured questionnaires with 42 items, detailing pre-quarantine assistance with childcare, followed by mental, educational, and social challenges answered using a 5-point Likert scale and the factors affecting their children's learning at home during the COVID-19 quarantine. The data was analyzed using the Statistical Package for the Social Sciences (SPSS) version 27.

Results

A response rate of 79.5% (n=831) was obtained. Mental challenges were experienced the most, and 68.1% of the parents worried about their children being infected with COVID-19. This was followed by the educational challenges related to their children's online learning, with 61.2% of the parents attributing it to their children's low motivation towards online learning. The mean score for the education domain was 31.14(±7.02). Similarly, the mean score for the mental impact and social impact was 33.13(±7.82) and 12.81(±2.98). The results of the multiple linear regression analysis revealed participants' gender was found significantly associated with the mean score of the educational domain (p = 0.010).

Conclusion

Social challenges were experienced the least, and parents confirmed that quarantine had helped them strengthen their family relations. Most participants agreed that they had fun spending time with both their partners and children. It is recommended to implement online remote activities and services that assist students and professionals in addressing pandemic concerns, such as virtual group exercise, virtual movie nights, and virtual office hours.

Evaluation of clinical knowledge of drugs causing addiction and associated social determinants among male pharmacy and nursing students in Riyadh, Saudi Arabia - A Cross-Sectional study

Drug abuse is a rising psychological concept in many countries, and its use among individuals is increasing. Therefore, this study aimed to assess the Knowledge and demographic factors associated with drug abuse among male pharmacy and nursing students at King Saud University, Riyadh, Saudi Arabia. This study used a cross-sectional design targeting male entry-level pharmacy and nursing students in their first and second years of Bachelor of Nursing and Doctor of Pharmacy courses. Of them, 85.3 % of the pharmacy and 75.3 % of nursing students thought that cocaine causes drug addiction, followed by heroin (pharmacy 80.7 %; nursing students 71 %), and morphine (pharmacy 75.2 %; nursing students 59.1 %). In this study, 52 % (n = 105) claimed low awareness, whereas 48 % (n = 97) indicated good understanding regarding drug addictions. Furthermore, the mean knowledge score among pharmacy students was higher (7.073 ± 2.570) in comparison to nursing (5.806 ± 2.494) (t = 3.540; p = 0. 0001). In addition, the father's occupation was found to be significantly associated with the mean knowledge score of drug addiction (F = 2.667; p = 0.034). According to the findings, 52 % of male students had insufficient knowledge about drugs that cause addiction. Age, course of study, and father's occupation all had a substantial impact on knowledge scores. The knowledge score on the complications of addictive substances was not significantly associated with the characteristics of the students (p = 0.05). As a result, we advocate for the introduction of educational initiatives that educate students about the harmful consequences of drug addiction and how to avoid issues.

Qingxin Kaiqiao Fang decreases Tau hyperphosphorylation in Alzheimer's disease via the PI3K/Akt/GSK3β pathway in vitro and in vivo

ETHNOPHARMACOLOGICAL RELEVANCE

Alzheimer's disease (AD) belongs to the category of "senile dementia" in traditional Chinese medicine. AD is associated with brain emptiness or collaterals blocked by phlegm-heat. "Fumanjian" from Jingyue Quanshu treats dementia by promoting qi circulation, alleviating depression, eliminating turbidity, cultivating positivity, and dispelling evil spirits. Qingxin Kaiqiao Fang (QKF), derived from Fumanjian, is effective in treating AD owing to previously mentioned clinical effects. Elucidating the mechanism(s) of action of QKF on AD associated with phlegm-heat may be beneficial for therapeutic management; however, further research is needed.

AIM OF THE STUDY

This study aimed to determine the role of the PI3K/Akt pathway in AD, especially the specific effector protein involved, and explore the efficacy of QKF in treating AD by modulating the PI3K/Akt signal.

MATERIALS AND METHODS

High-performance liquid chromatography-Q-orbitrap-mass spectrometry was used to analyze the chemical components of QKF. Subsequently, APP/PS1 double-transgenic mice were used for behavioral tests, and hematoxylin-eosin and Nissl staining were used to assess the neuroprotective and cognitive effects of QKF. Cerebrospinal fluid pharmacology was used in in vitro validation, and Aβ25-35 was used to induce PC12 cells to establish the AD cell model. Various methods, including immunohistochemistry, Western blotting, quantitative real-time polymerase chain reaction, morphological assay, cell counting kit-8(CCK-8) assay, and terminal deoxynucleotide transferase (TdT)-mediated dUTP nick-end labeling (TUNEL)staining, were used to evaluate the effect of QKF on Tau hyperphosphorylation and anti-apoptosis. These methods also assessed the influence of QKF on the PI3K/Akt/GSK3β pathway involving the mRNA and protein expressions. Finally, the inhibitor - LY294002 was used for reverse validation.

RESULTS

We identified 295 chemical components in the water extract of QKF.QKF improved spatial cognition and learning memory in APP/PS1 mice, protected PC12 cell morphology, improved cell survival, reduced Aβ25-35-induced apoptosis, and inhibited the hyperphosphorylation of Tau protein via the PI3k/Akt/GSK3β signaling pathway. Furthermore, this protective effect of QKF was reduced by LY294002 in vitro.

CONCLUSIONS

QKF can improve spatial cognition, learning, and memory abilities in APP/PS1 mice and protect PC12 cells. Decreasing the Tau hyperphosphorylation in AD exhibits curative efficacy on AD via the PI3K/Akt/GSK3β pathway in vitro and in vivo.

Knowledge of Cardiovascular Disease Risk Factors and Its Primary Prevention Practices Among the Saudi Public - A Questionnaire-Based Cross-Sectional Study

Background and Objectives

In response to the aging population and rapid rise of chronic diseases, it is important to understand the knowledge about primary prevention. We aim to explore Saudi adults' knowledge of cardiovascular disease (CVD) risk factors and its primary prevention practices among the Saudi public.

Methods

This is a cross-sectional community-based study, conducted among people living in Saudi Arabia to assess the knowledge of CVD risk factors using a total of 24-item questionnaires divided into two sections using the Likert scale, true /False/I do not know. The data were analyzed using the statistical software SPSS v. 26.0 (SPSS Inc., Chicago, IL, USA).

Results

In this study, the 81.8% of participants (n=296) agreed that high blood pressure was a risk factor for CVD, while more than two-thirds (68.8%; n=249) believed that diabetes was a risk factor for CVD. Furthermore, about the same proportion of respondents ((79.8%; n=289) and (78.7%; n=285)) agreed that physical inactivity and smoking were risk factors for CVD. In addition, the vast majority of them (n=324; 89.5%) believed that regular exercise aids in the prevention of CVD. In contrast, 74.9% (n=271) of individuals agreed that quitting smoking helps prevent CVD. This study indicated that 55.8% (n=202) of respondents had strong knowledge of CVD, while 44.2% (n=160) had inadequate awareness of CVD risk factors and prevention methods. In terms of the association between socio-demographic factors and overall participants' knowledge of CVD risk factors and preventative measures, we discovered that age (p=0.000), gender (p=0.011), educational status (p=0.000), and the presence of chronic disease (p=0.000) were all significantly associated with CVD knowledge score levels.

Conclusion

Saudi adults have adequate knowledge of CVD risk factors and prevention interventions, but more effort is needed to raise continuous awareness to reduce the prevalence of CVD.

Knowledge and awareness of warning signs about Lung cancer among Pharmacy and Nursing undergraduates in Riyadh, Saudi Arabia - an observational study

Background: Cancer is becoming more common, regardless of gender or type. Cancer was determined to be the leading cause of death, with lung cancer (LC) patients having the highest rate of cancer-related deaths. The purpose of this study was to analyze undergraduates' knowledge and awareness of LC early warning signs in Riyadh, Saudi Arabia. Methods: Between May and September 2022, a cross-sectional, prospective paper-based survey-type study was conducted among undergraduates (n=202) from the faculty of pharmacy and nursing at King Saud University (KSU) in Riyadh, Saudi Arabia. The data was gathered from third and fourth-year undergraduates. The statistical package for social science (SPSS Inc., Chicago, IL, U.S.) was used to perform the analysis. Results: The mean age of the undergraduates was 22.47 ± 2.35(SD) years. Most of them were from nursing 54% (n=109), while 46% (n=93) belonged to a pharmacy. In terms of awareness of warning signs of lung cancer, 48.6% of the students believed that unexplained weight loss, followed by persistent chest infection (36.6%) and cough that does not go away easily (37.6%). Over 45.1 % of students opted that coughing up blood, pain during the cough (46.5%), and worsening or change in an existing cough (42.1%) were reported as a sign of LC. In this study, the overall good awareness score was 60(29.7%). The awareness was significantly associated with gender (p = 0.0001), the course of study (p=0.018), the educational level (p = 0.003), smoking cigarettes (p = 0.003), and chronic disease status (p = 0.0001). Conclusion: Undergraduates attending university in this study indicated various levels of awareness of LC symptoms. The undergraduate's educational background, study program, and gender all greatly influence their level of awareness. It is necessary to inform future medical professionals about this growing condition.

Community pharmacists' knowledge, prospective and practice towards health related illness at Hajj and Umrah: A cross sectional study

Objectives

To assess the community pharmacists' (CPs) knowledge, attitude, and perception of health-related illness among pilgrims, and to investigate the common diseases and the pattern of medications dispensed by CPs during Hajj and Umrah seasons.

Method

A cross-sectional study was carried out in Riyadh, Saudi Arabia over two months in 2022, through electronic platform using prevalidated questionnaires adopted from the literature. The questionnaires were divided into 4 sections assessing the CP's knowledge, attitude, and perception about health-related illness, common dispensed agents, and required vaccination during Hajj and Umrah.

Results

A total of 544 CPs, mostly between the age of 31-40 (69.9%), participated in this research. About 87.9% of the CPs received a pilgrim after performing their rituals coming to the pharmacy complaining of infection or health problem. In this study, 99.8%(n = 544), 99.6%(n = 543), and 92.7% (n = 505) of the CPs identified influenza, food poisoning, and diarrhea/gastroenteritis as the most common issues during the Hajj & Umrah season respectively. As results, anti-diarrheal agents (96.3%), painkillers (87.3%), inhalers (89.4%), and sunscreens (88.3%) were the most requested pharmaceutical agents. Additionally, 96.7%(n = 527) of the CPs agreed that vaccination is safe to be given to Hajj and Umrah pilgrims particularly for those aged ≥ 65 years, and 89.4%(n = 487) of them reported awareness of vaccines that are required by Saudi Ministry of Health. Both Influenza and meningococcal meningitis vaccines were identified by 99.8% of the CPs, but polio vaccine was identified by 33.9%.

Conclusion

Community pharmacists provided pharmaceutical care services for Hajj and Umrah pilgrims. The majority of CPs had adequate knowledge about viral diseases during Hajj and Umrah and their requirement for vaccination.

Evaluation of Headache Trends among Undergraduate First Responders for Medical Emergencies at Saudi University in Riyadh, Saudi Arabia

Background and objective: Headache is more common among students and may be a crucial indication of mental health; it can have a detrimental impact if left untreated, especially on students, and may affect their academic performance. Thus, this study aimed to assess the headache trends among undergraduate first responders for medical emergencies at Saudi University in Riyadh, Saudi Arabia. Method: A cross-sectional study was undertaken over three months in 2023 to analyze headache patterns among emergency medical services (EMS) students using prevalidated questionnaires. The data were collected via convenience sampling and processed with the IBM SPSS Statistics 26 program (IBM Inc., Chicago, IL, USA). Results: The current findings show that the majority 90.6% (n = 164) of the participants had at least one episode of headache in the last week. With regard to the number of days students had a headache during the last week, 21.5% (n = 39) of them reported 2 days, while 18.8% (n = 34) reported 1 day only. About slightly less than half (48.6% (n = 88)) of students reported that the usual site of the headache was frontal, followed by temporal 27.1% (n = 49), and 23.3% (n = 42) reported orbital. When students were asked whether a headache aggravates their routine activity, 40.3% agreed with this statement, and 44.2% of students reported that a headache causes them to avoid their routine activity (reading writing, attending college). The majority of the students considered taking analgesics (60.8%), followed by sleeping (26.5%), caffeine (14.4%), and herbal and alternative remedies (7.7%) for the relief of headaches. Although headache episodes were significantly associated with routine activities (reading writing, attending college) (p = 0.018, t = 2.282) daily activities (walking, running) (p = 0.022, t = 2.307). The findings showed that fourth-year EMS students were found to have higher headache pain intensity scores compared to other students (p = 0.046). Similarly, the pain intensity was significantly higher among the students between 1-3 and >7 episodes of headaches (p = 0.001) Conclusion: The findings of this study revealed that Saudi emergency medical services students suffer from headaches. However, the current findings revealed variation in the headache pain intensity scores concerning the year of study.

Knowledge, attitudes, and practices of community pharmacists toward the management of acne vulgaris in Saudi Arabia

Background and objectives

In Saudi Arabia, Acne vulgaris is a very predominant ailment and Pharmacists currently have standardized protocols at their disposal for the treatment of acne. Pharmacists often prescribe medications for minor cases of acne. Therefore, this study aimed to explore community pharmacists (CPs)' knowledge, attitudes, and practice toward acne management in Riyadh, Saudi Arabia.

Methods

An online cross-sectional study was conducted among CPs working in Riyadh, Saudi Arabia from January and April 2021, using a self-administered, questionnaire, was divided into four sections that collected information from the CP's Knowledge, attitudes, and practices and the management of acne vulgaris. The data were analyzed using the Statistical Package for the Social Sciences version 26 (SPSS).

Result

A total of 313 CPs were enrolled in the study who successfully returned the questionnaire. The mean score of knowledge on etiology, pathophysiology, and therapy for AV was 5.3 ± (SD = 1.5). However, the majority of CPs had a moderate level of knowledge (80.8%), followed by mild to moderate (12.8%). This study showed that CPs had an insufficient level of knowledge about ace management, about 6% of CPs have a high level of knowledge. Inadequate knowledge was revealed in their management practice, only 0.3% of CPs treated patients with acne on their own without a referral. In addition, CPs showed a positive attitude toward acne management.

Conclusion

There is a need to improve CPs' understanding of acne care and to contribute to participating in organized training sessions on the management of AV.

Epidemiology of Primary Headache and Its Associated Psychosocial Factors Amongst Undergraduate Medical Students: A Cross-Sectional Study From the Vidarbha Region

Introduction The present study was carried out to investigate the epidemiology of primary headaches amongst undergraduate medical students by determining the prevalence of primary headaches and their associated psychosocial factors. Methods A cross‑sectional study was conducted at a medical college in the Vidarbha region of India from January 2023 to February 2023 amongst 471 medical students. Diagnosis of tension-type headache (TTH) was made according to the International Classification of Headache Disorders (ICHD-3) criteria. Data were collected by interview technique using a pre-designed and pre-tested questionnaire. that consisted of socio-demographic variables and psychosocial factors. Statistical analysis was done using SPSS 24.0 (IBM Corp., Armonk, NY, USA).  Results Prevalence of headache was 80% and was higher in females (87%) than in males (71%). TTH is the most common type with a prevalence of 76% in females followed by 64% in males. Psychosocial factors associated with presence of headache in study subjects were disappointment in relation to academic performance (OR 3.85, CI 1.68-2.71), poor socio-economic status (OR 2.69, CI 1.58-4.57), work overload (OR 0.41, CI 0.24-0.68), irritability (OR 0.33, CI 0.19-0.57) and frequent conflicts (OR 1.45, CI 0.78-2.70). Stress (OR 0.27, CI 0.11-0.71) and anxiety (OR 3.45, CI 1.31-9.08) were associated with headaches only in females and depression (OR 0.50, CI 0.25-1.01) was found to be associated with headaches only in males. Conclusions Psychosocial factors from the personal sphere like stress, overwork, and anxiety were highly prevalent amongst students and these factors need to be addressed meticulously in order to mitigate the problem of primary headache disorders amongst medical undergraduates.