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El Nekidy W, Abidi E, Nabil S, Kendakji S, Ali M, Aburuz S, Atallah B, Hijazi F, Mallat J, Akour A. The Safety and Effectiveness of Apixaban in Patients with End-Stage Kidney Disease on Dialysis: A Retrospective Observational Study. J Clin Med 2024; 13:1351. [PMID: 38592193 PMCID: PMC10931560 DOI: 10.3390/jcm13051351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 02/18/2024] [Accepted: 02/23/2024] [Indexed: 04/10/2024] Open
Abstract
Background: Apixaban has been increasingly utilized for various FDA-approved indications, including stroke prevention and venous thromboembolism (VTE) treatment in patients with end stage kidney disease (ESKD) on hemodialysis. However, the safety and efficacy of its use in this population is not well established. Hence, the purpose of this study is to evaluate the safety and effectiveness of apixaban by examining outcomes in this population. Methods: This was a retrospective observational study that involved adults with ESKD who were on hemodialysis and prescribed apixaban from our hospital's outpatient pharmacy between 1 May 2015, and 31 March 2022. Demographics, apixaban indications, dose appropriateness, concomitant antiplatelet use, and comorbidities data were collected. Bleeding and thromboembolic events were also collected. Results: Sixty-six patients fulfilled the inclusion criteria, 50% of them males. Median age was 71 (63.5-82) years, and the median BMI 28.2 (59.5-86.25) kg/m2. The median follow-up time was 5 (1.9-12.3) months. Concomitant antiplatelet use (39.4%) and high medication adherence (84.8%) were observed. During follow-up, major bleeding events occurred in 15.2% of cases, with minor bleeding being more common (36.4%), and VTE and stroke events occurred in 4.5% of cases; appropriate dosing was prevalent (62.1%), and there was an overall all-cause mortality rate of 34.8%. Most patients received a 2.5 mg BID apixaban dose (56.1%), including both NVAF and VTE groups. Notably, the multivariate logistic regression analysis indicated that weight, and daily dose were insignificant predictors of bleeding events (p = 0.104, 0.591), however, the BMI was the main independent risk factor for bleeding in this population [OR = 0.9, 95% CI: 0.8-0.99; p = 0.023]. Conclusions: Our analysis of apixaban-treated ESKD patients highlights that the risk of bleeding is significant, and BMI was the main independent risk factor. A larger prospective study is needed to confirm our findings.
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Affiliation(s)
- Wasim El Nekidy
- Department of Pharmacy Services, Cleveland Clinic Abu Dhabi, Abu Dhabi P.O. Box 112412, United Arab Emirates; (E.A.); (B.A.)
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA (J.M.)
| | - Emna Abidi
- Department of Pharmacy Services, Cleveland Clinic Abu Dhabi, Abu Dhabi P.O. Box 112412, United Arab Emirates; (E.A.); (B.A.)
| | - Said Nabil
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; (S.N.); (S.K.); (M.A.); (S.A.)
| | - Saba Kendakji
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; (S.N.); (S.K.); (M.A.); (S.A.)
| | - Moatasem Ali
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; (S.N.); (S.K.); (M.A.); (S.A.)
| | - Salahdein Aburuz
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; (S.N.); (S.K.); (M.A.); (S.A.)
| | - Bassam Atallah
- Department of Pharmacy Services, Cleveland Clinic Abu Dhabi, Abu Dhabi P.O. Box 112412, United Arab Emirates; (E.A.); (B.A.)
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA (J.M.)
| | - Fadi Hijazi
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA (J.M.)
- Critical Care Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi P.O. Box 112412, United Arab Emirates
| | - Jihad Mallat
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA (J.M.)
- Critical Care Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi P.O. Box 112412, United Arab Emirates
| | - Amal Akour
- Critical Care Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi P.O. Box 112412, United Arab Emirates
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman 11942, Jordan
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Akour A, Gharaibeh L, El Khatib O, Hammour KA, AlTaher N, AbuRuz S, Barakat M. Treatment-related problems in neonates receiving parenteral nutrition: risk factors and implications for practice. BMC Pediatr 2024; 24:4. [PMID: 38172740 PMCID: PMC10763224 DOI: 10.1186/s12887-023-04477-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 12/09/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVES Parenteral nutrition (PN) can be associated with several treatment-related problems (TRPs) and complications in neonatal settings. Thus, understanding the extent and type of these problems and related factors is pivotal to prevent negative consequences of these preparations. Thus, the aim of this study is to assess factors affecting TRPs in neonatal patients receiving PN. METHODS This was a retrospective chart review of neonates receiving PN in NICU and other wards. We collected their demographics, and laboratory workup. TRPs related to PN preparations as well as their pharmacotherapy were the primary outcomes. RESULTS Medical charts of 96 neonate were reviewed. The most encountered TRPs related to patients' pharmacotherapy were the lack of frequent monitoring (34.2%) and low dose (17.5%). For PN-related TPRs, a mismatch between patients' nutritional needs and PN composition was observed in third of the patients. Statistically significant positive correlations between number of medications during hospital stay and number of reported TRPs [(r = 0.275, p < 0.01) and (r = 0.532, p < 0.001)] were observed. CONCLUSION In neonates who receive parenteral nutrition (PN), TRPs are often observed. These problems primarily arise from issues in patients' pharmacotherapy, namely monitoring and dosing. Identifying the risk factors for these TRPs emphasizes the full and effective integration of clinical pharmacists into the healthcare team, which can serve as a potential preventive strategy to lower the occurrence of TRPs.
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Affiliation(s)
- Amal Akour
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE.
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan.
| | - Lobna Gharaibeh
- Biopharmaceutics and Clinical Pharmacy Department, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, Jordan
| | - Omar El Khatib
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
| | - Khawla Abu Hammour
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Noor AlTaher
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Salah AbuRuz
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
| | - Muna Barakat
- Department of Clinical Pharmacy and Therapeutics, School of Pharmacy, Applied Science Private University, Amman, Jordan
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Arafat M, Sakkal M, Bostanudin MF, Alhanbali OA, Yuvaraju P, Beiram R, Sadek B, Akour A, AbuRuz S. Enteric-coating film effect on the delayed drug release of pantoprazole gastro-resistant generic tablets. F1000Res 2023; 12:1325. [PMID: 38596002 PMCID: PMC11002526 DOI: 10.12688/f1000research.140607.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/13/2023] [Indexed: 04/11/2024] Open
Abstract
Background: Enteric coating films in acidic labile tablets protect the drug molecule from the acidic environment of the stomach. However, variations in the excipients used in the coating formulation may affect their ability to provide adequate protection. This study is the first to investigate the potential effects of coating materials on the protective functionality of enteric coating films for pantoprazole (PNZ) generic tablets after their recall from the market. Methods: A comparative analysis was conducted between generic and branded PNZ products, using pure drug powder for identification. The in vitro release of the drug was evaluated in different pH media. The study also utilized various analytical and thermal techniques, including differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), X-ray diffraction (XRD), scanning electron microscopy (SEM), Fourier-transform infrared (FTIR), and confocal Raman microscopy. Results: The in vitro assessment results revealed significant variations in the release profile for the generic product in acidic media at 120 min. DSC and TGA thermal profile analyses showed slight variation between the two products. XRD analysis exhibited a noticeable difference in peak intensity for the generic sample, while SEM revealed smaller particle sizes in the generic product. The obtained spectra profile for the generic product displayed significant variation in peaks and band intensity, possibly due to impurities. These findings suggest that the excipients used in the enteric coating film of the generic product may have affected its protective functionality, leading to premature drug release in acidic media. Additionally, the presence of polysorbate 80 (P-80) in the brand product might improve the properties of the enteric coating film due to its multi-functionality. Conclusions: In conclusion, the excipients used in the brand product demonstrated superior functionality in effectively protecting the drug molecule from acidic media through the enteric coating film, as compared to the generic version.
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Affiliation(s)
- Mosab Arafat
- College of Pharmacy, Al Ain University, Al Ain, Abu Dhabi, 64141, United Arab Emirates
| | - Molham Sakkal
- College of Pharmacy, Al Ain University, Al Ain, Abu Dhabi, 64141, United Arab Emirates
| | | | - Othman Abdulrahim Alhanbali
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestinian Territory
| | - Priya Yuvaraju
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, 17666, United Arab Emirates
| | - Rami Beiram
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, 17666, United Arab Emirates
| | - Bassem Sadek
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, 17666, United Arab Emirates
| | - Amal Akour
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, 17666, United Arab Emirates
| | - Salahdein AbuRuz
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, 17666, United Arab Emirates
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Amman Governorate, 11942, Jordan
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Jarab AS, Al-Qerem W, Alzoubi KH, Tharf M, Abu Heshmeh S, Al-Azayzih A, Mukattash TL, Akour A, Al Hamarneh YN. Patterns of drug-related problems and the services provided to optimize drug therapy in the community pharmacy setting. Saudi Pharm J 2023; 31:101746. [PMID: 37649677 PMCID: PMC10462881 DOI: 10.1016/j.jsps.2023.101746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/06/2023] [Indexed: 09/01/2023] Open
Abstract
Introduction Drug-related problems (DRPs) are events or circumstances involving drug therapy that actually or potentially interferes with desired health outcomes. Objectives To assess community pharmacists' knowledge and practice regarding DRP-reduction services, as well as the barriers and factors associated with decreased provision of these services. Methods This cross-sectional study utilized a validated questionnaire to assess pharmacists' knowledge, practice, and barriers to the provision of DRP-reduction services in the community pharmacy setting. Binary regression model was used to assess the variables associated with the practice of DRP-reduction services. Results A total of 412 pharmacists participated in the study. The pharmacists demonstrated strong knowledge but inadequate practice of DRP-reduction services. The most reported DRPs were inappropriate combination of drugs, or drugs and herbal medications, or drugs and dietary supplements (52.4%), patients' inability to understand instructions properly (46.1%), inappropriate drug according to guidelines (43.7%), and too high dose (40.3%). The most common barriers to these services were increased workload (60.5%), limited time (53.2%), and lack of good communication skills (49.8%). The presence of a counselling area in the pharmacy increased the practice of DRP-reduction services (OR: 3.532, 95%Cl: 2.010-5.590, P < 0.001), while increased weekly working hours (OR: 0.966, 95%Cl: 0.947-0.986), P < 0.01) and serving < 10 patients daily (OR = 0.208, 95%Cl: 0.072-0.601, P < 0.01) decreased it. Conclusions Community pharmacists' practice of DRP-reduction services showed a scope for improvement. Future pharmaceutical care initiatives should increase the number of personnel working in the pharmacy and provide them with opportunities for continued education and training in order to improve the provision of DRP services and optimize patients' outcomes.
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Affiliation(s)
- Anan S. Jarab
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
| | - Walid Al-Qerem
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, P.O. Box 130, Amman 11733, Jordan
| | - Karem H. Alzoubi
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad Tharf
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates
| | - Shrouq Abu Heshmeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
| | - Ahmad Al-Azayzih
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
| | - Tareq L. Mukattash
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
| | - Amal Akour
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, Al Ain, United Arab Emirates
| | - Yazid N Al Hamarneh
- Department of Pharmacology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
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Izzat N, Abu Farha R, Alhamad H, Akour A. Knowledge and perception towards anabolic steroid use by gym users in Jordan: a cross-sectional study. Eur Rev Med Pharmacol Sci 2023; 27:8924-8933. [PMID: 37782201 DOI: 10.26355/eurrev_202309_33813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
OBJECTIVE The dispensing of anabolic androgenic steroids (AAS) in Jordan is still unregulated, and AAS are available without a prescription. This study aimed to assess the prevalence of AAS abuse among gym users and their knowledge, perception, and practices towards using these AAS. SUBJECTS AND METHODS This cross-sectional study was conducted online in November-December 2022. Participants were recruited if they were adults attending any gym facility in Jordan. RESULTS A total of 365 adult participants agreed to participate in this study. Concerning participants' knowledge about AAS side effects, the median knowledge score of the participants was 7.0 scores (Interquartile range=7.0) out of 15. Indeed, 14.2% of the participants (n=52) reported using AAS during their gym participation. Participants reported that the most common source for obtaining AAS was the gym trainers (n=38, 70.4%), and the most common reason for using AAS was to increase lean body weight (n=52, 96.3%). Also, among the AAS users, two-thirds reported having never experienced side effects after using AAS. Finally, regression analysis revealed that males had 3.35 times higher usage of AAS than females (OR=3.351, p-value=0.008). CONCLUSIONS The findings of this study show a comparatively high prevalence of AAS use among gymgoers. Therefore, it is critical to have policies prohibiting their usage without a prescription. There should be more awareness about the negative effects of AAS in criminal activities, and it should be included in public awareness programs.
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Affiliation(s)
- N Izzat
- Department of Clinical Pharmacy, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan.
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Barakat M, Akour A, Malaeb D, Cherri S, Al Safadi W, Al Safadi A, Wazaify M. Perspectives of and Experience toward the Abuse of Antidiarrheal Drug (Loperamide) among Community Pharmacists: A Cross-Sectional Study. Int J Environ Res Public Health 2023; 20:6400. [PMID: 37510632 PMCID: PMC10379004 DOI: 10.3390/ijerph20146400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/07/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023]
Abstract
This study aimed to assess the ability of community pharmacists to recognize cases of loperamide abuse at the point of sale, their perspective of and experience toward potential abuse cases. METHODS A cross-sectional study was conducted in Jordan, using a self-administered online questionnaire. The questionnaire consisted of three main parts: demographics, the experience of pharmacists with abusers' behavior, as well as their perspectives toward loperamide abuse. RESULTS A total of 250 community pharmacists completed the survey, 54% (135) of which were female. Almost one-third (33.2%; 83) of the participants reported exposure to suspected cases of loperamide abuse during the last six months. Pharmacists declared that most of the suspected loperamide abusers were male (60.2%), of middle-low socioeconomic status (69.9%), and between 20 and 30 years of age (57.8%). The largest quantity (packs) of loperamide requested by a single patient was around 33.2 ± 14.9 at once. As reported by pharmacists, the suspected reasons behind loperamide abuse included 50% seeking euphoria, 17% relieving anxiety, and 33% controlling addiction (weaning off other opioids). The multivariate logistic regression analysis demonstrated a significant correlation between the male sex (OR = 1.2, 95% CI 0.12-1.59), pharmacy location in the center of Jordan (OR = 21.2, 95% CI 2.45-183.59), late-night working shift (Shift C, OR = 1.29, 95% CI 0.12-2.08), and abuse to loperamide during the last six months. CONCLUSIONS This study sheds light on loperamide abuse potentials, which could be influenced by different sociodemographic characteristics. Accordingly, close monitoring and thorough tackling of the abuse practices are mandated through an increase in educational and awareness campaigns about proper medication use.
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Affiliation(s)
- Muna Barakat
- Department of Clinical Pharmacy and Therapeutics, School of Pharmacy, Applied Science Private University, Amman 541350, Jordan
- MEU Research Unit, Middle East University, Amman 11831, Jordan
| | - Amal Akour
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman 11942, Jordan
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 15551, United Arab Emirates
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman P.O. Box 4184, United Arab Emirates
- School of Pharmacy, Lebanese International University, Beirut 14404, Lebanon
| | - Sarah Cherri
- School of Pharmacy, Lebanese International University, Beirut 14404, Lebanon
| | - Wala'a Al Safadi
- Department of Pharmaceutics & Pharmaceutical Technology, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman 19328, Jordan
| | - Ala'a Al Safadi
- Department of Clinical Pharmacy and Therapeutics, School of Pharmacy, Applied Science Private University, Amman 541350, Jordan
| | - Mayyada Wazaify
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman 11942, Jordan
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Mulakhudair AR, Naser MS, Akour A, Kh AM. Assessment of the Correlation Between Inflammatory Status and Severity of COVID-19: Experience from Tertiary Hospital in Iraq. Curr Microbiol 2023; 80:283. [PMID: 37450057 DOI: 10.1007/s00284-023-03407-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
As COVID-19 pandemic has strikingly hit the health systems of many countries, thus, the assessment of disease severity and its correlation with clinical and biochemical markers has become a necessity. These predictors can help in the diagnostics and therapeutics of COVID_19 and future viral respiratory tract infections. This was a cross-sectional study to assess the association between inflammatory makers and chronic conditions on computed tomography (CT) severity score, and D-dimer as a surrogate marker of disease severity. The results showed that inflammatory markers, age, were positively and significantly correlated with D-dimer, but inversely with oxygen saturation (SPO2). CT score showed similar pattern with exception of C-reactive protein. Vaccines had positive impact on CT severity score and Neutrophil to lymphocyte ration. These favorable outcomes provide us with affirmation regarding WHO and other international organizations that encourage people to take vaccines and especially patients, who suffer chronic diseases. The ramifications of the results are vast and pave the pathway to manage and assess COVID-19 patients in Iraq healthcare facilities.
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Affiliation(s)
- Ali R Mulakhudair
- Department of Food Health and Nutrition, College of Food Sciences, Al-Qasim Green University, Al-Qasim, Babylon, Iraq.
- University of Sheffield, Sheffield, UK.
| | - Mariam Sabah Naser
- Department of Genetic Engineering, College of Biotechnology, Al-Qasim Green University, Al-Qasim, Iraq
| | - Amal Akour
- Department of Pharmacology & Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 15551, Al Ain, United Arab Emirates
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, P.O. Box 11942, Amman, Jordan
| | - Almurtadha Mula Kh
- Oncology Unit, University Hospital Southampton NHS Foundation Trust, Kent, UK
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Al-Samydai A, Al Qaraleh M, Al Azzam KM, Mayyas A, Nsairat H, Abu Hajleh MN, Al-Halaseh LK, Al-Karablieh N, Akour A, Alshaik F, Alshaer W. Formulating co-loaded nanoliposomes with gallic acid and quercetin for enhanced cancer therapy. Heliyon 2023; 9:e17267. [PMID: 37408902 PMCID: PMC10319229 DOI: 10.1016/j.heliyon.2023.e17267] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 07/07/2023] Open
Abstract
Cancer is considered one of the top global causes of death. Natural products have been used in oncology medicine either in crude form or by utilizing isolated secondary metabolites. Biologically active phytomolecules such as gallic acid and quercetin have confirmed antioxidant, anti-bacterial, and neoplastic properties. There is an agreement that microorganisms could mediate oncogenesis or alter the immune system. This research project aims to develop a novel formulation of co-loaded gallic acid and quercetin into nanoliposomes and investigate the efficacy of the free and combined agents against multiple cancerous cell lines and bacterial strains. Thin-film hydration technique was adopted to synthesize the nanocarriers. Particle characteristics were measured using a Zetasizer. The morphology of nanoliposomes was examined by scanning electron microscopy, Encapsulation efficiency and drug loading were evaluated using High-Performance Liquid Chromatography. Cytotoxicity was determined against Breast Cancer Cells MCF-7, Human Carcinoma Cells HT-29, and A549 Lung Cancer Cells. The antibacterial activities were evaluated against Acinetobacter baumannii, Escherichia coli, Proteus mirabilis, Pseudomonas aeruginosa, and Staphylococcus aureus. Therapeutic formulas were categorized into groups: free gallic acid, free quercetin, free-mix, and their nano-counterparts. Findings revealed that drug loading capacity was 0.204 for the mix formula compared to 0.092 and 0.68 for free gallic acid and quercetin, respectively. Regarding the Zeta potential, the mix formula showed more amphiphilic charge than the free quercetin and free gallic acid formulas (P-values 0.003 and 0.002 receptively). On the contrary, no significant difference in polydispersity indices was reported. Lung cancerous cells were the most affected by the treatments. The best estimated IC50 values were observed in breast and lung cancer lines for the nano-gallic acid and co-loaded particles. The nano-quercetin formula exhibited the least cytotoxicity with an IC50 value of ≥200 μg/mL in both breast (MCF-7) and colorectal adenocarcinoma cell lines (HT-29) with no activity against the lung. A remarkable improvement in the efficacy of quercetin was measured after mixing it with gallic acid against the breast and lungs. The tested therapeutic agents exhibited antimicrobial activity against gram-positive bacteria. Nano-liposomes can either enhance or reduce the cytotoxicity activity of active compounds depending on the physical and chemical properties of drug-loaded and type of cancer cells.
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Affiliation(s)
- Ali Al-Samydai
- Pharmacological and Diagnostic Research Centre (PDRC), Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, 19328, Jordan
| | - Moath Al Qaraleh
- Pharmacological and Diagnostic Research Centre (PDRC), Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, 19328, Jordan
| | - Khaldun M. Al Azzam
- Pharmacological and Diagnostic Research Centre (PDRC), Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, 19328, Jordan
| | - Amal Mayyas
- Faculty of Health Sciences, Department of Pharmacy, American University of Madaba, 11821, Madaba, Jordan
| | - Hamdi Nsairat
- Pharmacological and Diagnostic Research Centre (PDRC), Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, 19328, Jordan
| | - Maha N. Abu Hajleh
- Department of Cosmetic Science, Pharmacological and Diagnostic Research Centre, Faculty of Allied Medical Sciences, Al-Ahliyya Amman University, 19328, Amman, Jordan
| | - Lidia K. Al-Halaseh
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Mutah University, 61710, Al-Karak, Jordan
| | - Nehaya Al-Karablieh
- Department of Plant Protection, School of Agriculture, The University of Jordan, Amman, 11942, Jordan
- Hamdi Mango Center for Scientific Research, The University of Jordan, Amman, 11942, Jordan
| | - Amal Akour
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Jordan
| | - Fatima Alshaik
- Pharmacological and Diagnostic Research Centre (PDRC), Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, 19328, Jordan
| | - Walhan Alshaer
- Cell Therapy Center, The University of Jordan, Amman, 11942, Jordan
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Nakhal MM, Jayaprakash P, Aburuz S, Sadek B, Akour A. Canagliflozin Ameliorates Oxidative Stress and Autistic-like Features in Valproic-Acid-Induced Autism in Rats: Comparison with Aripiprazole Action. Pharmaceuticals (Basel) 2023; 16:ph16050769. [PMID: 37242552 DOI: 10.3390/ph16050769] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/06/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
Based on their proven anti-inflammatory and antioxidant effects, recent studies have examined the therapeutic potential of the sodium-glucose cotransporter 2 (SGLT2) inhibitors in neurodevelopmental disorders such as autism spectrum disorder (ASD). Therefore, the aim of this study is to assess the effects of subchronic systemic treatment with intraperitoneal (i.p.) canagliflozin (20, 50, and 100 mg/kg) compared to aripiprazole (ARP) (3 mg/g, i.p.) in a valproic acid (VPA)-induced rat model of autism. The behavioral characteristics of ASD, oxidative stress, and acetylcholinesterase (AChE) activity in rats with ASD-like behaviors, which were induced by prenatal exposure to VPA, were evaluated. The behavioral assessment methods used for this study were the open field test (OFT), the marble-burying test (MBT), and the nestlet-shredding test (NST) to examine their exploratory, anxiety, and compulsiveness-like actions, while the biochemical assessment used for this study was an ELISA colorimetric assay to measure ASD biomarker activity in the hippocampus, prefrontal cortex, and cerebellum. Rats that were pretreated with 100 mg/kg of canagliflozin displayed a significantly lower percentage of shredding (1.12 ± 0.6%, p < 0.01) compared to the ARP group (3.52 ± 1.6%). Pretreatment with (20 mg/kg, 50 mg/kg, and 100 mg/kg) canagliflozin reversed anxiety levels and hyperactivity and reduced hyper-locomotor activity significantly (161 ± 34.9 s, p < 0.05; 154 ± 44.7 s, p < 0.05; 147 ± 33.6 s, p < 0.05) when compared with the VPA group (303 ± 140 s). Moreover, canagliflozin and ARP mitigated oxidative stress status by restoring levels of glutathione (GSH) and catalase (CAT) and increasing the levels of malondialdehyde (MDA) in all tested brain regions. The observed results propose repurposing of canagliflozin in the therapeutic management of ASD. However, further investigations are still required to verify the clinical relevance of canagliflozin in ASD.
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Affiliation(s)
- Mohammed Moutaz Nakhal
- Department of Biochemistry and Molecular Biology Sciences, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Petrilla Jayaprakash
- Department of Pharmacology & Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Salahdein Aburuz
- Department of Pharmacology & Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
- Zayed Center for Health Sciences, United Arab Emirates University, Al-Ain P.O. Box 17666, United Arab Emirates
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman 11942, Jordan
| | - Bassem Sadek
- Department of Pharmacology & Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
- Zayed Center for Health Sciences, United Arab Emirates University, Al-Ain P.O. Box 17666, United Arab Emirates
| | - Amal Akour
- Department of Pharmacology & Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
- Zayed Center for Health Sciences, United Arab Emirates University, Al-Ain P.O. Box 17666, United Arab Emirates
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman 11942, Jordan
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Al-Qerem W, Bargooth A, Jarab A, Akour A, Abu Heshmeh S. Knowledge, attitudes, and practices of Jordanian patients toward Self-Medication. Saudi Pharm J 2023; 31:482-491. [PMID: 37063441 PMCID: PMC10102443 DOI: 10.1016/j.jsps.2023.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/29/2023] [Indexed: 02/04/2023] Open
Abstract
Background and Objective Self-medication (SM) has significantly increased worldwide in the past decades, which may have detrimental health consequences including antimicrobial resistance, adverse drug reactions, drug-drug interaction, and dependency. Although several studies have evaluated the extent of SM, such studies are still limited in Jordan. The aim of this study was to explore sources of SM information, attitudes toward SM and the practice of SM and its associated factors. Methods The data of this cross-sectional study was collected between February and July 2022. A validated questionnaire was distributed to patients attending pharmacies from different locations in Jordan. The survey evaluated sources of information and attitudes toward SM, extent of SM practice, and attitudes towards SM, symptoms that the participants treat with SM and those that usually requires medical doctor consolation, followed by questions about the classes of medications mostly used for SM and the reasons for SM. Results and Discussion The study enrolled 695 Jordanian adults. The most reported indications for SM included headache (86.9 %), flu (76.4 %), and fever (69.6 %). The most common causes for SM included previous knowledge about the diseases and its treatments (84.2 %), and full knowledge of the medicine to be purchased (55.2 %). Results of the ordinal regression showed that physician counseling frequency was positively and significantly associated with "not being on chronic medication" (p-value = 0.001), and having a positive SM attitude level (p-value = 0.019), while negatively correlated with being in medical field (p-value < 0.001), having no children (p-value = 0.009), and relaying on non-scientific sources to obtain information for SM (p-value = 0.014). The frequency of SM practice was positively associated with being in medical field (p-value < 0.001, having no insurance (p-value < 0.001), and relaying on nonscientific sources (p-value = 0.017). Lastly, having a positive SM attitude level (p-value < 0.001) and not being on chronic medications (p-value = 0.007) were associated with decreased SM practice. Conclusion The study participants demonstrated increased SM practice due to the wrong perceptions toward SM and the reliance on non-scientific source of information about SM practice.
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Abu Farha R, Awwad O, Abdurazaq B, Abu Hammour K, Akour A. Evaluation of drug use pattern in adults’ outpatient clinics in a tertiary teaching hospital using WHO core prescribing indicators. Journal of Pharmaceutical Health Services Research 2022. [DOI: 10.1093/jphsr/rmac048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Abstract
Objectives
This study has evaluated the drug use pattern among adults attending the outpatient clinics of the Jordan University Hospital (JUH), by assessing the adherence of prescriptions to the World Health Organization (WHO) core prescribing indicators.
Methods
This is a cross-sectional study that was conducted during the period from October 2011 to January 2022 at JUH. Several prescriptions from 10 different adult outpatient clinics were reviewed to evaluate hospital adherence to the five WHO core prescribing indicators.
Key findings
To assess the WHO core prescribing indicators, data for 2451 prescriptions were reviewed. Around one-third of the patients (33.4%) were receiving polypharmacy (five medications or more). Results revealed that two core prescribing indicators were not following the standard values specified by the WHO; the average number of drugs prescribed per encounter (3.8 medications/prescription), and the percentage of drugs from the essential drug list (EDL) (54.1%). Endocrine clinics showed the highest average of drugs (6.3) per prescription and the highest percentage of prescriptions with injectable medicines (51.7%). On the other hand, ophthalmology clinics showed the highest percentage of prescriptions with antibiotics (29.9%) and the lowest percentage of drugs prescribed from the EDL at JUH (14.1%). Evaluating factors affecting the number of prescribed medications per encounter revealed that elderly patients (> 60 years), being female, referring to the endocrine clinic, and having insurance have a higher average number of medications per encounter compared with others (P < 0.05).
Conclusion
The proper prescribing practices in a sizable tertiary hospital in Amman, Jordan, are clarified by this study. The percentage of medications from EDL and the typical number of drugs/encounters did not comply with WHO requirements. The study findings should guide the Jordanian health policymakers in designing and implementing strategies to limit irrational prescribing practices and raise awareness of and ensure physician adherence to the national EDL.
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Affiliation(s)
- Rana Abu Farha
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University , Amman , Jordan
| | - Oriana Awwad
- Department Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan , Amman , Jordan
| | - Bashar Abdurazaq
- Department Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan , Amman , Jordan
| | - Khawla Abu Hammour
- Department Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan , Amman , Jordan
| | - Amal Akour
- Department Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan , Amman , Jordan
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University , Al Ain , United Arab Emirates
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Nakhal MM, Aburuz S, Sadek B, Akour A. Repurposing SGLT2 Inhibitors for Neurological Disorders: A Focus on the Autism Spectrum Disorder. Molecules 2022; 27:7174. [PMID: 36364000 PMCID: PMC9653623 DOI: 10.3390/molecules27217174] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/13/2022] [Accepted: 10/19/2022] [Indexed: 09/29/2023] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder with a substantially increasing incidence rate. It is characterized by repetitive behavior, learning difficulties, deficits in social communication, and interactions. Numerous medications, dietary supplements, and behavioral treatments have been recommended for the management of this condition, however, there is no cure yet. Recent studies have examined the therapeutic potential of the sodium-glucose cotransporter 2 (SGLT2) inhibitors in neurodevelopmental diseases, based on their proved anti-inflammatory effects, such as downregulating the expression of several proteins, including the transforming growth factor beta (TGF-β), interleukin-6 (IL-6), C-reactive protein (CRP), nuclear factor κB (NF-κB), tumor necrosis factor alpha (TNF-α), and the monocyte chemoattractant protein (MCP-1). Furthermore, numerous previous studies revealed the potential of the SGLT2 inhibitors to provide antioxidant effects, due to their ability to reduce the generation of free radicals and upregulating the antioxidant systems, such as glutathione (GSH) and superoxide dismutase (SOD), while crossing the blood brain barrier (BBB). These properties have led to significant improvements in the neurologic outcomes of multiple experimental disease models, including cerebral oxidative stress in diabetes mellitus and ischemic stroke, Alzheimer's disease (AD), Parkinson's disease (PD), and epilepsy. Such diseases have mutual biomarkers with ASD, which potentially could be a link to fill the gap of the literature studying the potential of repurposing the SGLT2 inhibitors' use in ameliorating the symptoms of ASD. This review will look at the impact of the SGLT2 inhibitors on neurodevelopmental disorders on the various models, including humans, rats, and mice, with a focus on the SGLT2 inhibitor canagliflozin. Furthermore, this review will discuss how SGLT2 inhibitors regulate the ASD biomarkers, based on the clinical evidence supporting their functions as antioxidant and anti-inflammatory agents capable of crossing the blood-brain barrier (BBB).
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Affiliation(s)
- Mohammed Moutaz Nakhal
- Department of Biochemistry, College of Medicine and Health Sciences, Al-Ain P.O. Box 15551, United Arab Emirates
| | - Salahdein Aburuz
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, Al-Ain P.O. Box 15551, United Arab Emirates
- Zayed Center for Health Sciences, United Arab Emirates University, Al-Ain P.O. Box 17666, United Arab Emirates
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman 11942, Jordan
| | - Bassem Sadek
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, Al-Ain P.O. Box 15551, United Arab Emirates
- Zayed Center for Health Sciences, United Arab Emirates University, Al-Ain P.O. Box 17666, United Arab Emirates
| | - Amal Akour
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, Al-Ain P.O. Box 15551, United Arab Emirates
- Zayed Center for Health Sciences, United Arab Emirates University, Al-Ain P.O. Box 17666, United Arab Emirates
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman 11942, Jordan
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Al-Nimri R, Akour A, Kasabri V, Al-Samydai A. The use of complementary and alternative medicine in fertility and gynaecological disorders in Jordan: a mixed-method descriptive study. Journal of Pharmaceutical Health Services Research 2022. [DOI: 10.1093/jphsr/rmac039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Objectives
The aim of the study is to assess the extent of CAM use, with emphasis on herbs, in treating gynecological disorders, and their perceived efficacy and safety.
Methods
This was a mixed-method study of two parts (cross-sectional quantitative and qualitative study) of 338 women suffering from gynecological disorders during the last 3 months. Data were collected using a self-administered questionnaire of three parts: demographics, medical history and the CAM use patterns. Qualitative part was conducted by a 20-min verbal face-to-face interview.
Key findings
During the last 3 months, 232 (68.64%) of participants had used CAM for various gynaecological conditions, of which, 135 (58.19%) used herbal remedies. Almost half of participants have a good awareness about CAM definition, and they mainly used CAM before or concurrently with traditional medicines.
Conclusions
This study provides an overview of various CAM remedies used to treat gynaecological disorders in the Jordanian society, which would draw attention to the necessity of conducting interventional studies to evaluate the efficacy and safety of CAM in treating gynaecological disorders, either as stand-alone or adjuvant treatment.
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Affiliation(s)
- Rana Al-Nimri
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan , Amman , Jordan
| | - Amal Akour
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan , Amman , Jordan
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University , Al-Ain , UAE
| | - Violet Kasabri
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan , Amman , Jordan
| | - Ali Al-Samydai
- Pharmacological and Diagnostic Research Centre, Faculty of Pharmacy, Al-Ahliyya Amman University , Amman , Jordan
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Jarad S, Akour A, Khreisat WH, Elshammari AK, Madae’en S. The Role of Clinical Pharmacist in Pediatrics' Adherence to Antiepileptic Drugs. J Pharm Technol 2022; 38:272-282. [PMID: 36046350 PMCID: PMC9420919 DOI: 10.1177/87551225221097619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023] Open
Abstract
Background Rate of nonadherence to antiepileptic drugs (AEDs) in children is about 33%. Engaging clinical pharmacists in the management of patients has proved to increase adherence to medications which will improve the outcomes of treatment. Objectives To investigate the effect of a clinical pharmacist-led education on the adherence to AEDs in pediatric patients with epilepsy. Secondary outcomes include effectiveness and safety of AEDs, satisfaction with information about AEDs provided to the caregivers, and patients quality of life (QoL). Methods This was an interventional study where pediatric patients were randomly assigned to the intervention (n = 41) or the control (n = 40) group. A 30-minute clinical pharmacist-led educational interview to the parent/caregiver was provided to the first group as add-on to standard medical care received by latter. Outcomes were measured at baseline and after 8-week follow-up. Results The intervention group had an increase in mean adherence score from 6 ± 1.09 at baseline to 7.6 ± 0.9 at follow-up (P value < 0.001), while the control group had no significant change (P value > 0.05), the difference between the 2 groups at follow-up was significant (P value < 0.0001). No significant difference was observed between groups at follow-up with regard to effectiveness (P value > 0.05), and safety (P value = 0.08). While higher satisfaction with information (P value < 0.0001), and higher QoL (P value < 0.05) was observed in the intervention group. Conclusion and relevance Clinical pharmacist-led education had a positive outcome on pediatric patients with epilepsy with regard to adherence, effectiveness, safety, satisfaction with information about AEDs, and QoL.
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Affiliation(s)
- Suha Jarad
- Department of Clinical Pharmacy and Biopharmaceutics, School of Pharmacy, The University of Jordan, Amman, Jordan
- Department of Biochemistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Amal Akour
- Department of Clinical Pharmacy and Biopharmaceutics, School of Pharmacy, The University of Jordan, Amman, Jordan
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, Abu-Dhabi, UAE
| | - Wael H. Khreisat
- Department of Pediatric Neurology, Queen Rania Children’s Hospital, Royal Medical Services, Amman, Jordan
| | - Afrah K. Elshammari
- Department of Pediatric Neurology, Queen Rania Children’s Hospital, Royal Medical Services, Amman, Jordan
| | - Saba Madae’en
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, The Hashemite University, Zarqa, Jordan
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Saad AK, Akour A, Mahboob A, AbuRuz S, Sadek B. Role of Brain Modulators in Neurodevelopment: Focus on Autism Spectrum Disorder and Associated Comorbidities. Pharmaceuticals (Basel) 2022; 15:612. [PMID: 35631438 PMCID: PMC9144645 DOI: 10.3390/ph15050612] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/08/2022] [Accepted: 05/12/2022] [Indexed: 02/04/2023] Open
Abstract
Autism spectrum disorder (ASD) and associated neurodevelopmental disorders share similar pathogenesis and clinical features. Pathophysiological changes in these diseases are rooted in early neuronal stem cells in the uterus. Several genetic and environmental factors potentially perturb neurogenesis and synaptogenesis processes causing incomplete or altered maturation of the brain that precedes the symptomology later in life. In this review, the impact of several endogenous neuromodulators and pharmacological agents on the foetus during pregnancy, manifested on numerous aspects of neurodevelopment is discussed. Within this context, some possible insults that may alter these modulators and therefore alter their role in neurodevelopment are high-lighted. Sometimes, a particular insult could influence several neuromodulator systems as is supported by recent research in the field of ASD and associated disorders. Dopaminergic hy-pothesis prevailed on the table for discussion of the pathogenesis of schizophrenia (SCH), atten-tion-deficit hyperactivity disorder (ADHD) and ASD for a long time. However, recent cumulative evidence suggests otherwise. Indeed, the neuromodulators that are dysregulated in ASD and comorbid disorders are as diverse as the causes and symptoms of this disease. Additionally, these neuromodulators have roles in brain development, further complicating their involvement in comorbidity. This review will survey the current understanding of the neuromodulating systems to serve the pharmacological field during pregnancy and to minimize drug-related insults in pa-tients with ASD and associated comorbidity disorders, e.g., SCH or ADHD.
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Affiliation(s)
- Ali K. Saad
- Department of Pharmacology & Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (A.K.S.); (A.A.); (S.A.)
- Zayed Center for Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates
| | - Amal Akour
- Department of Pharmacology & Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (A.K.S.); (A.A.); (S.A.)
- Zayed Center for Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman P.O. Box 11942, Jordan
| | - Abdulla Mahboob
- Department of Chemistry, College of Sciences, United Arab Emirates University, Al-Ain P.O. Box 15551, United Arab Emirates;
| | - Salahdein AbuRuz
- Department of Pharmacology & Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (A.K.S.); (A.A.); (S.A.)
- Zayed Center for Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman P.O. Box 11942, Jordan
| | - Bassem Sadek
- Department of Pharmacology & Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (A.K.S.); (A.A.); (S.A.)
- Zayed Center for Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates
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Akour A, Halloush S, Nusair MB, Barakat M, Abdulla F, Al Momani M. Gaps in pharmaceutical care for patients with mental health issues: A cross-sectional study. Int J Clin Pharm 2022; 44:904-913. [PMID: 35364752 PMCID: PMC8974808 DOI: 10.1007/s11096-022-01391-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 02/12/2022] [Accepted: 02/17/2022] [Indexed: 11/05/2022]
Abstract
Background Mental health issues such as depression and anxiety are often underdiagnosed and undertreated. Medications are a primary method of managing mental health problems, and pharmacists therefore have a vital role in supporting patients and providing them with information about the safety and efficacy of mental health medications. However, the potential role of pharmacists in managing mental health issues in Jordan has not been well established. Aim This study aimed to assess Jordanian pharmacists’ attitudes and actual practices related to the provision of mental health services. Method This was an exploratory cross-sectional study that used a self-report questionnaire among a convenience sample of 347 pharmacists in Amman, the capital of Jordan. Results The participating pharmacists had positive attitudes towards providing care for patients with mental health problems. However, their actual practices did not resonate with their enthusiasm, particularly in terms of the long-term follow-up of disease symptoms and medication side effects and adherence. The participating pharmacists showed an eagerness to collaborate with their colleagues, but their level of actual cooperation was lower than desired. The most reported barrier to providing care for patients with mental health problems was the lack of education on mental health issues (71.5%), followed by the lack of privacy in pharmacy settings (53.9%). Conclusion To be effectively involved in the provision of care to mental health patients, pharmacists should receive adequate education/training related to mental health issues, and pharmacies should be redesigned to provide private areas for patient counseling.
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Affiliation(s)
- Amal Akour
- Department of Biopharmaceutics and Clinical Pharmacy, The School of Pharmacy, The University of Jordan, Amman, Jordan. .,Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Abu Dhabi, United Arab Emirates.
| | - Shiraz Halloush
- Department of Clinical Pharmacy and Therapeutics, The School of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Mohmmad B Nusair
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, Irbid, Jordan
| | - Muna Barakat
- Department of Clinical Pharmacy and Therapeutics, The School of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Fatima Abdulla
- Department of Public Health, The School of Medicine, The University of Jordan, Amman, Jordan
| | - Malik Al Momani
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, Irbid, Jordan
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Barakat M, Thiab S, Thiab S, Al-Qudah RA, Akour A. Knowledge and Perception Regarding the Development and Acceptability of Male Contraceptives Among Pharmacists: A Mixed Sequential Method. Am J Mens Health 2022; 16:15579883221074855. [PMID: 35135388 PMCID: PMC8832602 DOI: 10.1177/15579883221074855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Community pharmacists play a crucial role in providing comprehensive patient education regarding contraception methods. This study aims to investigate Jordanian pharmacists’ knowledge and perceptions toward male oral contraceptive pills (OCPs). A mixed-explanatory sequential method was divided into two phases. The first was a self-administered electronic survey that was distributed to community pharmacists/trainees in Jordan. The second phase was carried out through online semi-structured in-depth interviews targeting the maximum variation purposive sample of community pharmacists. A total of 158 (response rate 98%) questionnaires were included in the analysis. The majority of the participants were female (n = 118, 74.2%). In terms of knowledge, only 25% of participants acknowledged the presence of male OCPs and almost half were uncertain about the mechanism of action and the possible uses. The findings of the interviews confirmed a relatively negative perception toward male OCPs and the identified barriers to male OCPs were cultural norms, side effects, and poor compliance. It is argued that there is a negative perception toward male OCPs due to the majority of pharmacists not believing such products will be successful in Jordan. Once these pills are approved for their effectiveness and safety, men may need further education and encouragement to take an active role in family planning along with their partners.
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Affiliation(s)
- Muna Barakat
- Department of Clinical pharmacy and therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Samar Thiab
- Department of Pharmaceutical Chemistry and Pharmacognosy, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Sara Thiab
- College of Pharmacy, Qatar University, Doha, Qatar
| | - Raja'a A Al-Qudah
- Department of Clinical pharmacy and therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Amal Akour
- Department of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan.,Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
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AL-Samydai A, Hajleh MNA, Akour A, Shalan N, Jaber N, Al-Halaseh LK, Alzweiri M. Investigation into the prophylactic and therapeutic activity of coenzyme Q10 against COVID-19. TROP J PHARM RES 2021. [DOI: 10.4314/tjpr.v20i11.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose: To evaluate the anti-SARS CoV-2 effect of Coenzyme Q 10, Ubiquinol-10, and idebenone, which have beneficial therapeutic applications against diverse virus types, using molecular docking approach.Methods: The potential activity of Coenzyme Q10, Ubiquinol-10, and Idebenone against viral infections was explored through the collection of data from relevant literature, and by modelling these compounds virtually, using in silico investigation methods.Results: Coenzyme Q10 and ubiquinol-10 showed significant docking performance. They interacted with numerous amino acid residues of the main protease of SARS-CoV-2 ACE2 (7C8J), Alpha thrombin (1AE8), TYRO (4TS1) protein targets sides, SARS-coronavirus Orf7a accessory protein (1XAK), TNF (1RJ8), and Cytokine/receptor (1I1R).Conclusion: The findings of our study showed promising inhibitory activities of the selected compounds against the main proteases of SARS-CoV-2. Consequently, these compounds have theoretical effects on inhibiting the viral entry, reproduction, and ultimately the prevention and/or treatment of the SARSCoV2 infection.
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Al-Tammemi AB, Barakat M, Al Tamimi D, Alhallaq SA, Al Hasan DM, Khasawneh GM, Naqera KA, Jaradat RM, Farah FW, Al-Maqableh HO, Abuawad A, Othman B, Tarhini Z, Odeh H, Khatatbeh M, Akour A, Aljaberi MA, Kolozsvári LR. Beliefs Toward Smoking and COVID-19, and the Pandemic Impact on Smoking Behavior and Quit Intention: Findings from a Community-Based Cross-Sectional Study in Jordan. Tob Use Insights 2021; 14:1179173X211053022. [PMID: 34866951 PMCID: PMC8637701 DOI: 10.1177/1179173x211053022] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The relationship between smoking and coronavirus disease-2019 (COVID-19) is still topical with mixed epidemiological evidence. However, the pandemic may affect people's beliefs toward smoking as well as their smoking behavior and quit intentions. Considering high smoking rates in Jordan, our current study aimed to assess the following domains in a community-based sample from Jordan: (i) the beliefs that surround smoking/vaping and COVID-19 and (ii) the pandemic impact on smoking behavior and quit intention. METHODS A cross-sectional study was conducted in Jordan from March 9 to March 16, 2021, utilizing a web-based structured questionnaire. The questionnaire comprised 13 items on sociodemographic, health, and smoking profiles, 14 items to assess beliefs surrounding COVID-19 and the use of combustible cigarettes (CCs), waterpipe (WP), and electronic cigarettes (ECs), and 12 items to assess the pandemic impact on smoking behavior and quit intention. RESULTS Of 2424 survey respondents who participated in our study, there were 1163 never-smokers, 1044 current smokers, and 217 ex-smokers. The mean age of participants was 35.2 years (SD: 11.06). Most participants have reported anti-smoking beliefs with around 72.9% believed that WP smoking is related to the risk of contracting COVID-19. Also, 71.7% believed that smoking CC may worsen the COVID-19 clinical course, while 74.1% of respondents believed that smoking has no protective effect against COVID-19. During the pandemic, about 28.1% and 19.3% of current smokers reported increased or reduced smoking, respectively. Besides, 459 current smokers have expressed their plans/intention to quit smoking during the pandemic, of whom 27.5% (n = 126) confirmed that the driving force for their decision is a COVID-19-related reason, such as self-protection (n = 123) and protection of family members (n = 121) which were the most cited reasons. Also, around 63 participants have successfully ceased smoking during the pandemic. However, only 22 of them reported that the main driving motivation of their successful quit attempt was the COVID-19 pandemic. CONCLUSION Most participants' beliefs and attitudes were against smoking during the pandemic. Nevertheless, the double-edged effect of the pandemic on smoking habits should be carefully considered, and reliable anti-smoking measures should be strengthened and sustained in the country.
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Affiliation(s)
- Ala'a B Al-Tammemi
- Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Muna Barakat
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Dua'a Al Tamimi
- Department of Community Health Nursing, Princess Muna College of Nursing, Mutah University, Amman, Jordan
| | - Sami A Alhallaq
- Department of Internal Medicine, Division of Pulmonology, King Hussein Medical City, Jordanian Royal Medical Services, Amman, Jordan
| | - Dima M Al Hasan
- Department of Dental Technology, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Ghena M Khasawneh
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Khalil Abu Naqera
- Department of Health, The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Jordan Field Office, Amman, Jordan
| | - Raghad M Jaradat
- Department of Internal Medicine, King Hussein Medical City, Jordanian Royal Medical Services, Amman, Jordan
| | - Fadi W Farah
- Department of Internal Medicine, Al-Basheer Hospital, Jordanian Ministry of Health, Amman, Jordan
| | - Hindya O Al-Maqableh
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Alaa Abuawad
- Department of Pharmaceutical Sciences and Pharmaceutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Bayan Othman
- Department of Pharmaceutical Sciences and Pharmaceutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Zeinab Tarhini
- CAPTuR Laboratory, Control of Cell Activation in Tumor Progression and Therapeutic Resistance, Limoges, France
- Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | - Hamza Odeh
- International Medical Corps (IMC), Amman, Jordan
| | - Moawiah Khatatbeh
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Amal Akour
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Musheer A Aljaberi
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Faculty of Medicine and Health Sciences, Taiz University, Taiz, Yemen
| | - László Róbert Kolozsvári
- Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
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Elayeh E, Akour A, Haddadin RN. Prevalence and predictors of self-medication drugs to prevent or treat COVID-19: Experience from a Middle Eastern country. Int J Clin Pract 2021; 75:e14860. [PMID: 34516713 PMCID: PMC8646359 DOI: 10.1111/ijcp.14860] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/10/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The lack of definitive cure for COVID-19 and the late introduction of a vaccine were responsible to push the general public to look for a remedy to treat or prevent COVID-19. The objective of this study was to evaluate patterns and factors that affect self-medication practices in Jordan during the pandemic. METHODS This was a cross-sectional study using an online questionnaire that was developed, piloted and distributed to the general public via various social media platforms. The questionnaire assessed the type of drugs and treatments used to self-medicate, the reasons behind their self-medication, and the factors affecting their practices. RESULTS A total of 1179 participants (females 46.4%) with a mean age of 32 (SD = 12.5) completed the questionnaire. The overall prevalence of the use of at least one product to treat or prevent COVID-19 was 80.4%. The most commonly used products to self-medicate were vitamin C (57.6%), followed by paracetamol (51.9%), zinc (44.8%) and vitamin D (32.5%). Female gender (odds ratio [OR]) = 1.603, working in the medical field (OR = 1.697), and history of COVID-19 infection (OR = 2.026) were variables associated with self-medication. The most common sources of participants' information about drugs to prevent or treat COVID-19 were newspapers (n = 519, 44.0%), followed by pharmacists (43.4%), friends (33.8%) and internet searching such as Google (30.7%). CONCLUSION This study identified the main drugs and supplements used during COVID-19 and the motives behind their use. It also identified the most influential source of information on the public during the pandemic. Self-medication can lead to worsening of the patient's health and delay seeking medical advice from healthcare professionals. Efforts should be done to help mitigate risks of self-medications by active involvement of pharmacists and other members of healthcare team to refute false claims about drug, especially in the media.
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Affiliation(s)
- Eman Elayeh
- Department of Biopharmaceutics and Clinical PharmacySchool of PharmacyThe University of JordanAmmanJordan
| | - Amal Akour
- Department of Biopharmaceutics and Clinical PharmacySchool of PharmacyThe University of JordanAmmanJordan
- Department of PharmacySchool of PharmacyAl‐Zaytoonah University of JordanAmmanJordan
| | - Randa N. Haddadin
- Department of Pharmaceutics and Pharmaceutical TechnologySchool of PharmacyThe University of JordanAmmanJordan
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Akour A, AlMuhaissen SA, Nusair MB, Al-Tammemi AB, Mahmoud NN, Jalouqa S, Alrawashdeh MN. The untold story of the COVID-19 pandemic: perceptions and views towards social stigma and bullying in the shadow of COVID-19 illness in Jordan. SN Soc Sci 2021; 1:240. [PMID: 34693341 PMCID: PMC8475478 DOI: 10.1007/s43545-021-00252-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 08/26/2021] [Indexed: 11/25/2022]
Abstract
Stigmatization towards COVID-19 patients can lead to negative outcomes like social exclusion and bullying, and it may hinder the willingness of people to undergo testing. This study aimed to measure and explore the perception of stigmatization and bullying towards COVID-19 patients in Jordan. This was a web-based cross-sectional survey. Participants were recruited from social media platforms employing a snowball convenience sampling. The perception of bullying, beliefs regarding social consequences of infection, views on measures towards violators of patients' privacy, and how to reduce the stigma were assessed by self-reported measures. 397 participants returned completed questionnaires. The majority of respondents believed that COVID-19 patients in Jordan are getting bullied (n = 255, 64.3%) and over 80% believed that people enjoy sharing identities, or news about COVID-19 patients. Although most respondents had adequate knowledge regarding transmission/prevention of COVID-19, they believed that all or some of the COVID-19 patients practiced something wrong to get infected (n = 358, 90.2%). Moreover, 86.9% of respondents reported that people in Jordan were crossing their lines with bullying behaviors towards COVID-19 patients. However, these negative views would not discourage most respondents to get tested and follow the government's instructions if they or any of their acquaintances were suspected to be infected. Our study sheds the light on a high degree of stigma and bullying of COVID-19 patients during the early stage of the pandemic in Jordan. Hence, there is a need to develop and implement effective anti-stigma/anti-bullying campaigns that refute the misperception, raise public knowledge about COVID-19, and spread encouraging messages.
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Affiliation(s)
- Amal Akour
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, 11942 Jordan
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, 11942 Jordan
| | - Suha A. AlMuhaissen
- Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Mohammad B. Nusair
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, Irbid, Jordan
| | - Ala’a B. Al-Tammemi
- Department of Epidemiology and Global Health, Umeå University, 90187 Umeå, Sweden
- Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, H-4032 Debrecen, Hungary
| | - Nouf N. Mahmoud
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, 11942 Jordan
| | - Sarah Jalouqa
- Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, The University of Jordan, Amman, Jordan
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22
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Barakat M, Al-Qudah R, Akour A, Abu-Asal M, Thiab S, Dallal Bashi YH. Knowledge and beliefs about the use/abuse of oral contraceptive pills among males: A mixed-method explanatory sequential study in community pharmacy settings. PLoS One 2021; 16:e0251302. [PMID: 33961665 PMCID: PMC8104375 DOI: 10.1371/journal.pone.0251302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 04/26/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Oral contraceptive pills (OCPs) are considered one of the most important birth control methods globally. However, these pills were designed for female administration rather than males. This study was designed to investigate patterns of OCPs use and abuse among Jordanian males, according to the community pharmacists' observations. METHOD A mixed-method explanatory sequential study was conducted using an online self-administered survey, followed by semi-structured in-depth interviews for registered pharmacists, assistant pharmacists and pharmacy interns. The interviews were utilized using a conceptual framework. Inductive thematic analysis and descriptive/regression analyses were completed using Nvivo and SPSS, respectively. RESULTS A total of 158 questionnaire responses and 22 interviews were included in our analysis. Around half (48.4%) of the questionnaire responses confirmed that males could use OCPs for hair growth enhancement, muscle gain and acne treatment 12.7%, 31.7% and 4.4%, respectively. Through the interviews, the participating pharmacists highlighted that males use OCPs mostly for bodybuilding purposes, according to recommendations by their coaches at the gym. The most abused OCPs containing estrogen (Ethinyl estradiol) and progestins (Drospirenone or Levonorgestrel). CONCLUSION This study provided insight into unexpected uses of OCPs by males in Jordan. Community pharmacists have a crucial role in the management of OCPs use and abuse. However, restricted regulations and monitoring must be released and implemented on the community to limit such practices.
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Affiliation(s)
- Muna Barakat
- Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
- * E-mail:
| | - Raja’a Al-Qudah
- Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Amal Akour
- Faculty of Pharmacy, Department of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Mona Abu-Asal
- Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Samar Thiab
- Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
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Akour A, Elayeh E, Tubeileh R, Hammad A, Ya’Acoub R, Al-Tammemi AB. Role of community pharmacists in medication management during COVID-19 lockdown. Pathog Glob Health 2021; 115:168-177. [PMID: 33573528 PMCID: PMC8079017 DOI: 10.1080/20477724.2021.1884806] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Preventive and control measures implemented by many countries to mitigate the spread of COVID-19 may negatively impact medication and chronic disease management, which can interfere with achieving patients' therapeutic goals. This study aims to evaluate the effect of the COVID-19 lockdown on these aspects, while exploring the role of community pharmacists. A cross-sectional study was conducted via a web-based questionnaire that targeted individuals who suffer from chronic diseases in Jordan. Participants were recruited by convenience sampling and were asked to self-report their ability to access medication, and the perceived role of community pharmacists. Among the 431 participants, the mean age ± SD (years) was 53.8 ± 13.7 and 60.1% (n= 259) were females. Participants mainly reported difficulties in accessing medication (n=198, 45.9%), reduced supplies or unavailability of medications (n=213, 49.4%), nonadherence to medications due to lack of access (n=98, 22.7%) and high costs (n=85, 19.7%). Participants avoided follow-ups due to a fear of infection (n=367, 82.5%) or prolonged waiting time in clinics (n=322, 74.7%). An increased reliance on the community pharmacy for medical advice was reported by 39.9% (n=172) of the participants, with half of them (n=217, 50.3%) depending on the pharmacists for advice regarding over-the-counter medications and COVID-19-related information (n=119, 27.6%). There is an urgent need to involve community pharmacists in medication and chronic disease management with a focus on patient adherence to ensure the optimal management of such vulnerable patient groups. Future studies to assess the effect of pharmacists' contributions towards enhancing medication/disease management are warranted.
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Affiliation(s)
- Amal Akour
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, the University of Jordan, Amman, Jordan
- Department of Pharmacy, School of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Eman Elayeh
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, the University of Jordan, Amman, Jordan
| | - Razan Tubeileh
- Department of Pharmacy, Faculty of Pharmacy, Middle East University, Amman, Jordan
| | - Alaa Hammad
- Department of Pharmacy, School of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Rawan Ya’Acoub
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, the University of Jordan, Amman, Jordan
| | - Ala’a B. Al-Tammemi
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
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Akour A, Abuloha S, Mulakhudair AR, Kasabri V, Al-Tammemi AB. Complementary and alternative medicine for urinary tract illnesses: A cross-sectional survey in Jordan. Complement Ther Clin Pract 2021; 43:101321. [PMID: 33548746 DOI: 10.1016/j.ctcp.2021.101321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 01/09/2021] [Accepted: 01/25/2021] [Indexed: 11/25/2022]
Abstract
The aim of this study was to assess the extent of Complementary and Alternative Medicine (CAM) usage, especially herbal preparations, in treating urinary tract illnesses, and their perceived efficacy. This was a cross-sectional survey that used a convenience sample of 278 adults who reported having any form of urinary tract illness. During the last 3 months, 105 (37.8%) of participants had used CAM for various urinary tract conditions, of which, 87 (82.9%) used herbal remedies. Urinary tract infections (UTIs) were the most reported urinary condition (n = 77, 73.3%) among CAM users. The most commonly used herbs were, parsley (n = 54, 19.2%), followed by chamomile (n = 29, 10.4%), barley (n = 20, 7.4%) and ginger (n = 18, 6.7%).The study provides an overview of various CAM remedies used to treat urinary tract illnesses in the Jordanian society, which would draw attention to the necessity of conducting interventional studies to evaluate the efficacy and safety of CAMs in treating urinary tract illnesses, either as stand-alone or adjuvant treatment.
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Affiliation(s)
- Amal Akour
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan; Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah Univeristy of Jordan, Amman, Jordan.
| | - Sumaya Abuloha
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Ali R Mulakhudair
- Department of Food Health and Nutrition, College of Food Science, Al-Qasim Green University, Babylon, Iraq
| | - Violet Kasabri
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Ala'a B Al-Tammemi
- Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, Umeå, Sweden; Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
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Barakat M, Al-Qudah R, Akour A, Al-Qudah N, Dallal Bashi YH. Unforeseen uses of oral contraceptive pills: Exploratory study in Jordanian community pharmacies. PLoS One 2020; 15:e0244373. [PMID: 33347511 PMCID: PMC7751968 DOI: 10.1371/journal.pone.0244373] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 12/08/2020] [Indexed: 02/08/2023] Open
Abstract
Background The use of oral contraceptive pills (OCPs) as a birth control method is very common worldwide. OCPs have many other labeled non-contraceptive indications, and as a result there is an associated risk of improper use, as with any other medications. This study was designed to assess the unforeseen improper uses of OCPs observed by community pharmacists in Jordan. Method A cross-sectional study design was conducted using a self-administered survey. A convenience sample (n = 380) of Jordanian community pharmacists, were recruited through social media resources. The survey included multiple-choice and open-ended questions. Descriptive statistics and correlation analyses were completed using SPSS. Results More than half of the recruited pharmacists (55.3%) were female, and the mean age of the participants was 32.58 ± 9.94. The majority of the pharmacists (85%) had good knowledge about the non-contraceptive indications of OCPs. About 53% of them confirmed their exposure to cases of the improper use of OCPs. About 67.5% of the pharmacists who confirmed exposure to such cases, reported the topical use of OCPs for the enhancement of hair growth. Around 15% of those pharmacists stated that OCPs were used to give negative results for addictive drug screening tests. In the event that the pharmacists suspected improper use, more than 90% suggested they would refrain from dispensing the pills. Conclusion This study has spotlighted many unforeseen uses of OCPs in Jordan and highlighted the need for restricted national regulations on the monitoring of OCP prescription/selling patterns in Jordan by policymakers. Moreover, there is a need for the establishment of national educational programs for the Jordanian community regarding the safe proper use of OCPs.
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Affiliation(s)
- Muna Barakat
- Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
- * E-mail:
| | - Raja’a Al-Qudah
- Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Amal Akour
- Faculty of Pharmacy, Department of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
- School of Pharmacy, Department of Biopharmaceutics and Clinical Pharmacy, The University of Jordan, Amman, Jordan
| | - Najem Al-Qudah
- Faculty of Medicine, Al-Balqa Applied University, Al-Salt, Jordan
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Akour A, Farha RA, Alefishat E, Kasabri V, Bulatova N. Insulin resistance and levels of cardiovascular biomarkers in night-shift workers. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Jaber D, Tahaineh L, Akour A, Albsoul-Younes A. Awareness of combined oral contraceptives use among Jordanian women: A cross-sectional study. TROP J PHARM RES 2020. [DOI: 10.4314/tjpr.v19i10.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose: To investigate Jordanian women’s knowledge, attitude, awareness and practice regarding combined oral contraceptives (COCs) benefits and risks.Methods: A cross-sectional study was conducted on 300 Jordanian women attending the Obstetrics and Gynecology clinics at Jordan University Hospital, Amman, Jordan. A closed- and open-ended questionnaire was used to explore Jordanian participants' knowledge, attitude and practice regarding COCs use, effect and side effects. Structured interviews were conducted by a trained research team. Thus, it was a pharmacist-assisted survey, and lay language was used to explain difficult medical terminologyResults: Most of participants were prescribed COCs by their physicians (77.1 %), half of them depend on others' experiences and media as sources of information rather than consulting their healthcare team. Half of participants have an idea of non-contraception uses of COCs (50.3 %). One fourth of women (26.0 %) believed that using COCs decreases fertility or even causes infertility, especially if used before their first pregnancy (43.3 %). Women in their middle age were more uncertain about the relation between COCs use and anemia (p = 0.014) or dysmenorrhea pain (p = 0.005). While women who used COCs believed more that the pills regulate menstruation (p < 0.001) and decrease dysmenorrhea pain (p < 0.001) compare with women who had never used COCs pills. Women in general are uncertain if COCs use has negative or positive relation with some types of cancer such as ovarian, cervical and breast. Women who are not affiliated to the healthcare professions were more uncertain about the relation between COCs use and atherosclerosis risk (p = 0.002), MI (p = 0.025) and stroke risk (p = 0.035).Conclusion: There is insufficient awareness and knowledge of the beneficial and non-contraceptive uses of COCs. Educational programs are needed to improve women’s awareness of the benefits and risks of COCs.
Keywords: Combined oral contraceptives, COCs, Knowledge, Attitude, Practice, Beliefs, Benefits, Risks
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Al-Tammemi AB, Akour A, Alfalah L. Is It Just About Physical Health? An Online Cross-Sectional Study Exploring the Psychological Distress Among University Students in Jordan in the Midst of COVID-19 Pandemic. Front Psychol 2020; 11:562213. [PMID: 33240151 PMCID: PMC7677563 DOI: 10.3389/fpsyg.2020.562213] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 10/16/2020] [Indexed: 12/21/2022] Open
Abstract
Background Since the spread of COVID-19 on a global scale, most of efforts at national and international levels were directed to mitigate the spread of the disease and its physical harm, paying less attention to the psychological impacts of COVID-19 on global mental health especially at early stages of the pandemic. Objectives This study aimed to assess and explore (i) The levels of psychological distress and its correlates (ii) Motivation for distance learning (iii) Coping activities and pandemic related concerns, among university students in Jordan in the midst of COVID-19 pandemic. Methods A cross-sectional study was conducted using an online self-administered questionnaire. The measure of psychological distress was obtained using the 10-item Kessler Psychological Distress Scale, while other questions have explored our study's second and third aims. Results A total of 381 completed questionnaires were included in the analysis. Female participants slightly predominated the sample (n = 199, 52.2%). The respondents aged 18-38 years (mean 22.6 years, SD: 3.16). Concerning distress severity, most of respondents were regarded as having severe psychological distress (n = 265, 69.5%). 209 students (54.9%) reported that they had no motivation for distance learning. Ordinal logistic regression revealed a significant correlation between distress severity and many predictors. Among the predictors that were found to act as protective factors against higher levels of distress included older age (aOR = 0.64, P = 0.022; 95% CI: 0.44-0.94), and having a strong motivation for distance learning (aOR = 0.10, P = 0.048; 95% CI: 0.01-0.96). In contrary, being a current smoker (aOR = 1.99, P = 0.049; 95% CI: 1.10-3.39), and having no motivation for distance learning (aOR = 2.49, P = 0.007; 95% CI: 1.29-4.80) acted as risk factors for having higher levels of psychological distress among the students. The most common coping activity reported was spending more time on social media platforms (n = 269, 70.6%), and 209 students (54.9%) reported distance learning as their most distressing concern. Conclusion The COVID-19 pandemic and related control measures could impact the mental health of individuals, including students. We recommend a nationwide psychological support program to be incorporated into Jordan's preparedness plan and response strategy in combating the COVID-19 pandemic.
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Affiliation(s)
- Ala'a B Al-Tammemi
- Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, Umeå, Sweden.,Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Amal Akour
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan.,Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Laith Alfalah
- Department of Internal Medicine, School of Medicine, The University of Jordan, Amman, Jordan
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Kasabri V, Akour A, Bulatova N, Suyagh M, Yousef AM, Al Hawari H, Al Shelleh S, Bzour J, Fahmawi H. A Pre-Post Study of Vitamin D Supplement Effects on Urinary Megalin: The Emerging Predictive Role of Megalin in Diabetic Nephropathy Progression. Endocr Metab Immune Disord Drug Targets 2020; 20:1552-1557. [DOI: 10.2174/1871530320666200525012811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 02/14/2020] [Accepted: 04/06/2020] [Indexed: 11/22/2022]
Abstract
Introduction:
Megalin is a renal proximal tubular protein that reabsorbs vitamin D from
glomerular filtrates. Previous studies found significantly higher levels of urinary megalin in chronic
microvascular complications of diabetes with associated metabolic derangements. This study aimed at
testing the effect of vitamin D supplements on urinary megalin levels in diabetic nephropathy (DN)
patients with vitamin D hypovitaminosis.
Methods:
Sixty-three participants with vitamin D deficiency and diabetic nephropathy (DN) were enrolled
in the pre-post study; urinary megalin levels with various clinical parameters and serum levels of
vitamin D3 were measured and compared to the baseline at 3- and 6-month intervals.
Results:
Interestingly, a supplementation related increase in serum vitamin D3 levels at 3- and 6-
month interventions affected a constellation of ameliorations in the DN progression of clinical and
metabolic factors. There was a decrease in ACR with a concomitant decrease in urinary megalin and a
decrease in blood pressure, fasting plasma glucose (FPG), and low-density lipoprotein – cholesterol
(LDL-C) – but an increase in glomerular filtration rate (GFR). Principally, pellet urinary megalin associated
positively (p < 0.05) with vitamin D hypovitaminosis and the albumin-to-creatinine ratio (ACR)
but negatively (p < 0.05) with Ca2+ and body mass index (BMI).
Conclusion:
Vitamin D supplementation could elucidate underlying pathophysiological mechanisms
and a prognostic significance of urinary megalin association with DN, obesity/MetS-related dyslipidemia,
and hyperglycemia modification. Megalin is a putative sensitive and precise predictive marker
and an emerging therapeutic target of renal anomalies.
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Affiliation(s)
- Violet Kasabri
- School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Amal Akour
- School of Pharmacy, The University of Jordan, Amman, Jordan
| | | | - Maysa Suyagh
- School of Pharmacy, The University of Jordan, Amman, Jordan
| | | | | | | | | | - Hiba Fahmawi
- School of Pharmacy, The University of Jordan, Amman, Jordan
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Akour A, Al-Tammemi AB, Barakat M, Kanj R, Fakhouri HN, Malkawi A, Musleh G. The Impact of the COVID-19 Pandemic and Emergency Distance Teaching on the Psychological Status of University Teachers: A Cross-Sectional Study in Jordan. Am J Trop Med Hyg 2020; 103:2391-2399. [PMID: 33124547 PMCID: PMC7695050 DOI: 10.4269/ajtmh.20-0877] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The COVID-19 pandemic has struck many countries globally. Jordan has implemented strict nationwide control measures to halt the viral spread, one of which was the closure of universities and shifting to remote teaching. The impact of this pandemic could extend beyond the risk of physical harm to substantial psychological consequences. Our study aimed at assessing 1) psychological status, 2) challenges of distance teaching, and 3) coping activities and pandemic-related concerns among university teachers in Jordan in the midst of COVID-19-related quarantine and control measures. We conducted a cross-sectional study using an anonymous online survey. The measure of psychological distress was obtained using a validated Arabic version of the Kessler Distress Scale (K10). Other information collected included sociodemographic profile, methods used to handle distress, motivation to participate in distance teaching, and challenges of distance teaching as well as the most worrisome issues during this pandemic. Three hundred eighty-two university teachers returned completed surveys. Results of K10 showed that 31.4% of respondents had severe distress and 38.2% had mild to moderate distress. Whereas gender was not associated with distress severity, age had a weak negative correlation (Rho = -0.19, P < 0.0001). Interestingly, most teachers had moderate to high motivation for distance teaching. Engagement with family was the most reported self-coping activity. More than half of the participants were most concerned and fearful about SARS-CoV-2 infection. In conclusion, university teachers have shown to exhibit various levels of psychological distress and challenges during the implementation of precautionary national measures in the battle against COVID-19 in Jordan.
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Affiliation(s)
- Amal Akour
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan.,Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Ala'a B Al-Tammemi
- Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, Umeå, Sweden.,Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Muna Barakat
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Rama Kanj
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Hussam N Fakhouri
- Department of Computer Science, King Abdullah II School for Information Technology, The University of Jordan, Amman, Jordan
| | - Ahmad Malkawi
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center, Maastricht University, Maastricht, The Netherlands
| | - Ghadeer Musleh
- Department of Family and Community Medicine, School of Medicine, The University of Jordan, Amman, Jordan
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Abstract
Understanding mechanisms of the novel SARS-CoV2 infection and progression can provide potential novel targets for prevention and/or treatment. This could be achieved via the inhibition of viral entry and/or replication, or by suppression of the immunologic response that is provoked by the infection (known as the cytokine storm). Probiotics are defined as 'live microorganisms that, when administered in adequate amounts, confer a health benefit on the host'. There is scarcity of evidence about the relationship between COVID-19 and gut microbiota. So, whether or not these supplements can prevent or ameliorate COVID-19-associated symptoms is not fully understood. The aim of this study is to provide an indirect evidence about the utility of probiotics in combating COVID-19 or its associated symptoms, through the review of its antiviral and anti-inflammatory properties in vitro, animal models and human trials. SIGNIFICANCE AND IMPACT OF THE STUDY: The role of probiotics in alleviation of the novel COVID-19 has not been established. This review provides an insight about the anti-inflammatory, antiviral effects of probiotics in vitro, animal models and human. The latter can provide an indirect evidence and/or hypothesis-driven approach to investigate the use of probiotics as adjunctive therapy in the prophylaxis and/or alleviation of COVID-19 symptoms.
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Affiliation(s)
- A Akour
- Department of Biopharmaceutics and Clinical Pharmacy, The School of Pharmacy, The University of Jordan, Amman, Jordan.,Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
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AlKhatib HS, Brazeau G, Akour A, Almuhaissen SA. Evaluation of the effect of items' format and type on psychometric properties of sixth year pharmacy students clinical clerkship assessment items. BMC Med Educ 2020; 20:190. [PMID: 32532278 PMCID: PMC7291500 DOI: 10.1186/s12909-020-02107-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 06/08/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Examinations are the traditional assessment tools. In addition to measurement of learning, exams are used to guide the improvement of academic programs. The current study attempted to evaluate the quality of assessment items of sixth year clinical clerkships examinations as a function of assessment items format and type/structure and to assess the effect of the number of response choices on the characteristics of MCQs as assessment items. METHODS A total of 173 assessment items used in the examinations of sixth year clinical clerkships of a PharmD program were included. Items were classified as case based or noncase based and as MCQs or open-ended. The psychometric characteristics of the items were studied as a function of the Bloom's levels addressed, item format, and number of choices in MCQs. RESULTS Items addressing analysis skills were more difficult. No differences were found between case based and noncase based items in terms of their difficulty, with a slightly better discrimination in the latter. Open-ended items were easier, yet more discriminative. MCQs with higher number of options were easier. Open-ended questions were significantly more discriminative in comparison to MCQs as case based items while they were more discriminative as noncase based items. CONCLUSION Item formats, structure, and number of options in MCQs significantly affected the psychometric properties of the studied items. Noncase based items and open-ended items were easier and more discriminative than case based items and MCQs, respectively. Examination items should be prepared considering the above characteristics to improve their psychometric properties and maximize their usefulness.
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Affiliation(s)
- Hatim S AlKhatib
- Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, The University of Jordan, Queen Rania Street, Amman, 11942, Jordan
| | - Gayle Brazeau
- Department of Pharmaceutical Sciences, School of Pharmacy, Marshall University, Huntington, West Virginia, USA
| | - Amal Akour
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Suha A Almuhaissen
- Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, The University of Jordan, Queen Rania Street, Amman, 11942, Jordan.
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Akour A, Kasabri V, Bulatova N, Al Muhaissen S, Al Tarawneh R, Al-Anati B, Alhourani N. Patterns and perceived efficacy of herbal medicine for weight loss and maintenance: A cross-sectional survey from Jordan. Eur J Integr Med 2020. [DOI: 10.1016/j.eujim.2020.101086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Akour A, Kasabri V, Bulatova N, Al-Motassem Y, Fahmawi H, Momani M, Zayed A, Alquoqa R, AlHawari H. Urinary megalin in association with progression factors of diabetic nephropathy. ACTA ACUST UNITED AC 2019; 120:532-535. [PMID: 31602990 DOI: 10.4149/bll_2019_086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
AIM The aim of this study is to evaluate the association between urinary megalin, renal function, blood pressure, lipid profile, vitamin D and glycemic control in patients with type 2 diabetes mellitus (T2DM). METHODS . This was a cross-sectional study which recruited 209 patients with T2DM. Urinary megalin was positively associated with systolic blood pressure (SBP) (r=0.218, p=0.04) but negatively with glomerular filtration rate (GFR) (r=-0.16, p=0.023). The levels of urinary albumin, triglycerides (TGs) and glycosylated hemoglobin (HbA1c) were higher in the "high-megalin" group, compared to those in "low-megalin" group. Moreover, there was a significant inverse association between vitamin D3 levels and megalin levels in urine (OR=0.281, p=0.047). CONCLUSION Our study showed for the first time that megalin is associated with progression factors of diabetic nephropathy as well as vitamin D deficiency (Tab. 3, Fig. 1, Ref. 15).
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Al Muhaissen SA, Ratka A, Akour A, AlKhatib HS. Quantitative analysis of single best answer multiple choice questions in pharmaceutics. Curr Pharm Teach Learn 2019; 11:251-257. [PMID: 30904146 DOI: 10.1016/j.cptl.2018.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 09/06/2018] [Accepted: 12/05/2018] [Indexed: 06/09/2023]
Abstract
INTRODUCTION The purpose of this study was to: (1) analyze the quality of single best answer multiple choice questions (MCQs) used in pharmaceutics exams, (2) identify the correlation between difficulty index (DIF I), discriminating index (DI), and distractor efficiency (DE), and (3) understand the relationship between DIF I, DI, and DE and the number of MCQ answer options and their cognitive level. METHODS 429 MCQs used in pharmaceutics exams were analyzed. The quality of the MCQs was evaluated using DIF I, DI, and DE. The number of answer options and the cognitive level tested by each item were evaluated. Relationships between DIF I, DI, and DE were measured using Pearson's correlations and t-tests. RESULTS DIF I showed a significant negative correlation with DI within questions that measured information recall. A significant negative correlation between DIF I and DI was observed in questions with four and five answer options regardless of the cognitive level measured. The highest DI values were found in moderate difficulty questions, while the worst DE was observed for the easiest questions. Questions that measured analytical and problem-solving abilities were more difficult than those measuring information recall. Questions with four and five answer options had excellent discrimination. CONCLUSIONS Single best answer MCQs are a valuable assessment tool capable of evaluating higher cognitive skills. Significant correlation between DIF I and DI can indicate the examination quality. Higher quality MCQs are constructed using four and five answer options.
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Affiliation(s)
- Suha A Al Muhaissen
- The University of Jordan, School of Pharmacy, Queen Rania Street, Amman, 11942, Jordan.
| | - Anna Ratka
- Wegmans School of Pharmacy, St. John Fisher College, 3690 East Avenue, Rochester, NY 14618, United States.
| | - Amal Akour
- The University of Jordan, School of Pharmacy, Queen Rania Street, Amman, 11942, Jordan.
| | - Hatim S AlKhatib
- The University of Jordan, School of Pharmacy, Queen Rania Street, Amman, 11942, Jordan.
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Kasabri V, Shawakri E, Akour A, Naffa R, Khawaja N, Al-Sarraf I, Bzour J. Cross-sectional correlates of increased IL-18 but reduced fetuin-A and oxytocin with adiposity and blood indices in metabolic syndrome patients with and without prediabetes. Ther Adv Endocrinol Metab 2018; 9:329-338. [PMID: 30515292 PMCID: PMC6266239 DOI: 10.1177/2042018818788802] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 06/25/2018] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Oxytocin (OXT), fetuin-A and interleukin-18 (IL-18) are involved in the development and progression of metabolic syndrome (MetS) and prediabetes (pre/T2DM). AIMS PARTICIPANTS AND METHODS This study aimed to compare and correlate the plasma levels of OXT, fetuin-A and IL-18 with clinical parameters, haematological indices and adiposity indices in Jordanian MetS subjects. In a cross-sectional study, 30 normoglycaemic lean study participants (control), 30 MetS study participants, and 29 MetS pre/T2DM study participants were recruited. RESULTS Median circulating levels of both OXT and fetuin-A were lower in MetS and MetS pre/T2DM versus control group. OXT (pg/ml; median interquartile range): MetS 1975.4 and MetS pre/T2DM 1403 versus control 4176.6 (p = 0.009 and p = 0.001, respectively). For fetuin-A (ng/ml), MetS (5784) and MetS pre/T2DM (2154) were lower versus control (6756.3) (p = 0.040 and p = 0.007, respectively). Neither biomarker was described as substantially different in MetS versus MetS pre/T2DM (p = 0.071 and p = 0.155, respectively). Conversely, a non-significant increase in IL-18 was observed in the MetS and MetS pre/T2DM groups compared to normoglycaemic lean controls (232 and 287.5, p > 0.05 versus 108 for both). In addition, conicity index (C-index), atherogenicity index (TG-HDL-C), waist to hip ratio, mean platelet volume (MPV; fl) and red cell distribution width (RDW-CV%) in both MetS and MetS pre/T2DM were significantly higher (p < 0.001) versus controls. However all above MetS-related indices were not ascribed any statistically marked variation in the MetS group when compared to the MetS pre/T2DM group. Both total study pool of recruits' fetuin-A (Spearman r = -2.66, p = 0.049) as well as MetS pre/T2DM group IL-18 (Spearman r = 0.380, p = 0.046) were inversely correlated with RDW-CV%. OXT in MetS inversely correlated with waist circumference/hip circumference ratio (Spearman r = -0.387, p = 0.038). No other pronounced associations between biomarkers could be detected in any study arm. CONCLUSION These findings substantiate the clinical relevance and significance of OXT, fetuin-A and IL-18 as surrogate screening/prognostic tools and therapeutic targets to predict/prevent metabolic dysregularities and anomalies.
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Affiliation(s)
| | - Esraa Shawakri
- School of Pharmacy, The University of Jordan,
Amman, Jordan
| | - Amal Akour
- School of Pharmacy, The University of Jordan,
Amman, Jordan
| | - Randa Naffa
- School of Medicine, The University of Jordan,
Amman, Jordan
| | - Nahla Khawaja
- National Center for Diabetes, Endocrinology and
Genetics, Amman, Jordan
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Al-Heety QQ, Kasabri V, Akour A, Naffa R, Abu Rkhaya S. Cross-sectional correlates of paraoxonase 1 and soluble intercellular adhesion molecule-1 in metabolic syndrome patients with and without diabetes. Ther Adv Endocrinol Metab 2018; 9:303-310. [PMID: 30327716 PMCID: PMC6178373 DOI: 10.1177/2042018818787396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 06/15/2018] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Paraoxonase 1 (PON1) and soluble intercellular adhesion molecule-1(sICAM-1) are intricately involved in metabolic syndrome (MetS) and type 2 diabetes mellitus (T2DM) pathophysiology. This study aimed to investigate PON1 and sICAM-1 plasma levels in addition to correlating them with adiposity, atherogenicity and hematological indices in T2DM and MetS. METHODS This cross-sectional study composed of 28 healthy lean subjects (control), 29 normoglycemic MetS subjects and 30 MetS-Pre/T2DM. RESULTS The sICAM-1 levels (ng/ml) were markedly higher in the pre/diabetic MetS group (828 ± 250.37 versus controls' 608.62 ± 184; p < 0.05). Conversely, PON1 levels (mlU/ml) were markedly lower in the pre/diabetic MetS group [252,700 (163,950, 362,800) versus controls' 394,900 (212,550, 469,350); p < 0.05]. sICAM-1 correlated directly with all adiposity indices [conicity index (CI), waist circumference (WC), waist-hip ratio (WHR) waist-to-height (WHtR) ratio, hip circumference (HC) and body adiposity index (BAI)] in addition to the atherogenicity index of plasma (AIP). PON1 correlated negatively and significantly with CI, WC, WHR, WHtR and HC but directly with lymphocyte. Significantly, a reciprocal sICAM-1-PON1 relationship was observed in the total population (r = -0.262, p = 0.015). CONCLUSION Utility of sICAM-1 and PON1 as surrogate prognostic biomarkers and putative therapeutic targets in the management of diabetes and MetS is strongly suggested.
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Affiliation(s)
| | | | - Amal Akour
- School of Pharmacy, The University of Jordan,
Amman, Jordan
| | - Randa Naffa
- School of Medicine, The University of Jordan,
Amman, Jordan
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Alquoqa RS, Kasabri V, Naffa R, Akour A, Bustanji Y. Cross-sectional correlates of myeloperoxidase and alpha-1-acid glycoprotein with adiposity, atherogenic and hematological indices in metabolic syndrome patients with or without diabetes. Ther Adv Endocrinol Metab 2018; 9:283-291. [PMID: 30181855 PMCID: PMC6116770 DOI: 10.1177/2042018818779742] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 05/09/2018] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS) are associated with obesity, which triggers the release of inflammatory substances. Myeloperoxidase (MPO), a peroxidase enzyme, and alpha-1-acid glycoprotein (AGP), an acute-phase protein, are known to be released in patients with inflammatory conditions and cardiovascular disease (CVD). METHODS In this study, we investigated the correlation between MPO and AGP levels in pre/diabetic and MetS patients by conducting a cross-sectional study at The University of Jordan Hospital (UoJH) at the diabetes and endocrinology outpatient clinics. A total of 237 patients were recruited and assessed for eligibility. Of these, 149 patients were excluded, and 88 patients were assigned as: 29 patients in a healthy lean normoglycemic control group; 29 patients in a nondiabetic MetS group; and 30 patients in a prediabetic/newly diagnosed T2DM MetS group. RESULTS MPO levels were only significantly higher in the nondiabetic MetS group compared with the control group (p = 0.026). AGP levels were significantly higher in both nondiabetic MetS and MetS-prediabetic/T2DM groups versus control (p = 0.007 and p = 0.015, respectively). Both biomarkers lacked inter-MetS-group discrepancy. CONCLUSIONS Our results demonstrate an association between MPO and AGP with obesity and hyperglycemia, alongside their correlation with several adiposity, hematology and atherogenicity indices. Our findings reinforce the use of MPO and AGP as potentially putative and surrogate predictive/prognostic tools for MetS and its related disorders.
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Affiliation(s)
| | - Violet Kasabri
- School of Pharmacy, The University of Jordan, Queen Rania Street, Amman 11942, Jordan
| | - Randa Naffa
- School of Medicine, The University of Jordan, Amman, Jordan
| | - Amal Akour
- School of Pharmacy, The University of Jordan, Amman, Jordan
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Al-Sarraf IAK, Kasabri V, Akour A, Naffa R. Melatonin and cryptochrome 2 in metabolic syndrome patients with or without diabetes: a cross-sectional study. Horm Mol Biol Clin Investig 2018; 35:/j/hmbci.ahead-of-print/hmbci-2018-0016/hmbci-2018-0016.xml. [PMID: 29813030 DOI: 10.1515/hmbci-2018-0016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Accepted: 04/25/2018] [Indexed: 12/19/2022]
Abstract
Background Metabolic syndrome (MetS) is a cluster of metabolic risk factors which increases the chances for future cardiovascular diseases, as well as diabetes. The underlying causes of MetS include overweight and obesity, physical inactivity and genetic factors. Our intension here was to focus in this study on the importance of the chronobiology, represented by melatonin (MT) and cryptochrome 2 (CRY2), in developing MetS and type 2 diabetes mellitus (T2DM). Thus, we aimed to compare MT and CRY2 plasma levels and correlate both biomarkers with adiposity, atherogenicity and hematological indices in MetS and T2DM cohorts. Methods In a cross-sectional study, 28 normoglycemic lean subjects (controls), 29 normoglycemic MetS subjects and 30 MetS (pre-diabetic/diabetic) were recruited. Results MT (pg/mL) was elevated significantly in MetS arm p-value < 0.05, whereas CRY2 levels (ng/mL) were markedly higher in both MetS groups (non-diabetic and pre-diabetic/diabetic) (all with p-value < 0.001). A reciprocal MT-CRY2 relationship was observed in the MetS (non-diabetic) group (p-value = 0.003). Of note in the total study population, both MT and CRY2 proportionally correlated with each of the following: atherogenicity index of plasma (AIP), waist circumference (WC) and systolic blood pressure (SBP) (all with p-value < 0.05) for MT and CRY2, respectively). Whereas MT correlated inversely with high-density lipoprotein-cholesterol (HDL-C) (p-value < 0.05). Additionally, CRY2 correlated directly with each of the following: diastolic blood pressure (DBP), total cholesterol (TC), low-density lipoprotein (LDL-C), hip circumference (HC), body adiposity index (BAI), weight-to-height (WHtR) ratio, mean platelet volume (MPV) and platelet/lymphocyte ratio (PLR) (p-value < 0.05). Conclusion These findings substantiate that both metabolic risk biomarkers can be prognostic tools and pharmacotherapeutic targets to slowdown the accelerated nature of T2DM.
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Affiliation(s)
| | - Violet Kasabri
- School of Pharmacy, The University of Jordan, Queen Rania Street, Amman, 11942, Jordan, Phone: +96265355000, Fax: +9625300520
| | - Amal Akour
- School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Randa Naffa
- School of Medicine, The University of Jordan, Amman, Jordan
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Akour A, Kasabri V, Bulatova N, Al Muhaissen S, Naffa R, Fahmawi H, Momani M, Zayed A, Bustanji Y. Association of Oxytocin with Glucose Intolerance and Inflammation Biomarkers in Metabolic Syndrome Patients with and without Prediabetes. Rev Diabet Stud 2018; 14:364-371. [PMID: 29590229 DOI: 10.1900/rds.2017.14.364] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES The aim of this study was to explore the differences in OXT levels in metabolic syndrome (MetS) subjects, newly diagnosed type 2 diabetes mellitus (T2D), and prediabetes subjects vs. MetS subjects without glucose intolerance (non-diabetic MetS). It was also intended to determine the relationship between plasma OXT levels and inflammatory markers in those subjects. METHODS Along with 45 lean and normoglycemic controls, a total of 190 MetS subjects (61 men, 129 women) were enrolled. Colorimetric enzymatic assays of the following components were performed: plasma OXT, high-sensitivity C-reactive protein (hs-CRP), macrophage chemoattractant protein 1 (MCP-1), plasminogen activator inhibitor 1 (PAI-1), matrix metalloproteinase 9 (MMP-9), resistin, adiponectin, leptin, macrophage migration inhibitory factor (MIF), tumor necrosis factor α (TNF-α), thrompospondin 1 (TSP-1), interleukin 10 (IL-10), interleukin 6 (IL-6), and glucagon. RESULTS hsCRP, PAI-1, resistin, leptin-to-adiponection-ratio (LAR), TNF-α, TSP-1, and MIF were significantly higher in both MetS groups (prediabetic and T2DM) than in MetS-only subjects. Leptin and MMP-9 were significantly higher in the MetS-T2DM group (but not in MetS-prediabetics) vs. MetS-only subjects. Conversely adiponectin, OXT, MCP-1, and IL-10 were significantly lower in both MetS groups (prediabetic and T2DM) than in MetS-only subjects. There was no marked discrepancy in either glucagon or IL-6 levels among the three MetS groups. In the entire MetS study population, OXT correlated substantially and proportionally with MCP-1, IL-10, and IL-6; it correlated negatively with HbA1c, fasting plasma glucose (FPG), PAI-1, MMP-9, TNF-α, TSP-1, resistin, adiponectin, leptin, LAR, and MIF. No association could be observed between OXT and glucagon. CONCLUSIONS OXT may be a substantial surrogate predictive/prognostic tool and putative pharmacotherapeutic target in metabolic anomalies and related disorders.
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Affiliation(s)
- Amal Akour
- School of Pharmacy and Medicine, the University of Jordan, Amman, Jordan
| | - Violet Kasabri
- School of Pharmacy and Medicine, the University of Jordan, Amman, Jordan
| | - Nailya Bulatova
- School of Pharmacy and Medicine, the University of Jordan, Amman, Jordan
| | - Suha Al Muhaissen
- School of Pharmacy and Medicine, the University of Jordan, Amman, Jordan
| | - Randa Naffa
- School of Pharmacy and Medicine, the University of Jordan, Amman, Jordan
| | - Hiba Fahmawi
- School of Pharmacy and Medicine, the University of Jordan, Amman, Jordan
| | - Munther Momani
- Endocrinology and Diabetes Unit, the University of Jordan Hospital, Amman, Jordan
| | - Ayman Zayed
- Endocrinology and Diabetes Unit, the University of Jordan Hospital, Amman, Jordan
| | - Yasser Bustanji
- School of Pharmacy and Medicine, the University of Jordan, Amman, Jordan
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Akour A, Bardaweel S, Awwad O, Al-Muhaissen S, Hussein R. Impact of a pharmacist-provided information booklet on knowledge and attitudes towards oral contraception among Jordanian women: an interventional study. EUR J CONTRACEP REPR 2018; 22:459-464. [PMID: 29300110 DOI: 10.1080/13625187.2017.1412425] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Jordan has high rate of unintended pregnancy, which is largely attributed to limited knowledge and misconceptions about contraceptive methods, namely oral contraceptive pills (OCPs). The aim of this study was to examine the effect of a pharmacist-provided information booklet on increasing the knowledge of Jordanian women about safe and effective OCP use. METHODS This was a randomised interventional study. One hundred and sixty women who had used OCPs at least once in their lifetime were randomised to receive conventional counselling (control group) or a pharmacist-provided booklet (intervention group). Knowledge about and attitude towards OCP use were assessed before and immediately after the intervention, and at three-month follow-up. RESULTS The mean knowledge score (out of 5) of women in the intervention group improved significantly from 1.76 at baseline (standard deviation [SD] 1.25) to 5.00 (p < .000) directly after the intervention, which then slightly decreased to 4.93 (SD 0.31; p = .033) at follow-up. The baseline mean knowledge score of the control group was 1.29 (SD 1.12) and did not significantly increase over time. It was also considerably lower than that of the intervention group both immediately after the intervention and at follow-up. As regards mean attitude score (out of 6), the control group demonstrated no changes from baseline, whereas the intervention group improved significantly from 5.15 (SD 1.63) to 5.50 (SD 1.36; p = .014). CONCLUSIONS Provision of an information booklet by pharmacists to women in Jordan using OCPs is highly recommended. Studies with a larger sample size and from different regions of Jordan are recommended.
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Affiliation(s)
- Amal Akour
- a Department of Clinical Pharmacy and Biopharmaceutics, School of Pharmacy , University of Jordan , Amman , Jordan
| | - Sanaa Bardaweel
- b Department of Pharmaceutical Sciences, School of Pharmacy , University of Jordan , Amman , Jordan
| | - Oriana Awwad
- a Department of Clinical Pharmacy and Biopharmaceutics, School of Pharmacy , University of Jordan , Amman , Jordan
| | - Suha Al-Muhaissen
- c Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy , University of Jordan , Amman , Jordan
| | - Rand Hussein
- d Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy , University of Sharjah , Sharjah , United Arab Emirates
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Elayeh E, Akour A, Almadaeen S, AlQhewii T, Basheti IA. Practice of pharmaceutical care in community pharmacies in Jordan. TROP J PHARM RES 2017. [DOI: 10.4314/tjpr.v16i2.27] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Akour A, Kasabri V, Boulatova N, Bustanji Y, Naffa R, Hyasat D, Khawaja N, Bustanji H, Zayed A, Momani M. Levels of metabolic markers in drug-naive prediabetic and type 2 diabetic patients. Acta Diabetol 2017; 54:163-170. [PMID: 27752839 DOI: 10.1007/s00592-016-0926-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 10/03/2016] [Indexed: 10/20/2022]
Abstract
AIMS Type 2 diabetes mellitus (T2DM) and prediabetes (pre-DM) are associated with changes in levels of metabolic markers. The main aim of this study is to compare the levels of omentin, irisin, endothelin-1, nesfatin, hepatocyte growth factor (HGF), fibroblast growth factor, and oxytocin (OXT) between normoglycemic and pre-DM/T2DM obese Jordanian patients. METHODS One hundred and ninety-eight adult Jordanian subjects were recruited. Demographic data and clinical parameters were collected. The serum levels of biomarkers were measured by enzymatic assay procedure. RESULTS Compared to normoglycemic (95 subjects), pre-DM/T2DM (103 subjects) displayed higher HGF (ng/ml) = 78.8 (71.4-104) versus 55.9 (45.3-66.6), p < 0.0001; and nesfatin (ng/ml) = 0.5 (0.4-0.7) versus 0.2 (0.1-0.4), p < 0.0001; betatrophin (ng/ml) = 1.2 (0.8-1.6) versus 0.22 (0.15-0.41), p < 0.0001. On the other hand, they had lower levels of omentin (ng/ml) = 2.1 (0.9-3.3) versus 3.6 (2.0-6.4), p < 0.0001, irisin (ng/ml) = 113.7 (88.9-142.9) versus 132.6 (110.7-147.8), p < 0.0001; and oxytocin (pg/ml) = 1077.9 (667.3-1506.0) versus 2180.1 (1464.5-2795.6), p < 0.0001; respectively. In comparison, FGF-21 (ng/ml) = 0.3 (0.2-0.5) versus 0.2 (0.1-0.4), and endothelin (pg/ml) = 2.7 (1.3-5.2) versus 2.8 (1.6-5.6) did not differ between the two groups (p > 0.05). CONCLUSIONS In the present study, patients with pre-DM and T2DM have higher serum levels of metabolic HGF, nesfatin, and betatrophin and lower levels of omentin, irisin, and OXT. Future longitudinal and interventional studies are required to confirm the utility of these markers as novel progression or therapeutic targets in the pharmacotherapy of diabetes.
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Affiliation(s)
- Amal Akour
- Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Queen Rania Street, Amman, 11942, Jordan.
| | - Violet Kasabri
- Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Queen Rania Street, Amman, 11942, Jordan
| | - Nailya Boulatova
- Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Queen Rania Street, Amman, 11942, Jordan
| | - Yasser Bustanji
- Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Queen Rania Street, Amman, 11942, Jordan
| | - Randa Naffa
- Faculty of Medicine, The University of Jordan Hospital, Amman, Jordan
| | - Dana Hyasat
- National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan
| | - Nahla Khawaja
- National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan
| | - Haidar Bustanji
- National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan
| | - Ayman Zayed
- Endocrinology and Diabetes Unit, Jordan University Hospital, Amman, Jordan
| | - Munther Momani
- Endocrinology and Diabetes Unit, Jordan University Hospital, Amman, Jordan
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Al-Rawashdeh A, Kasabri V, Bulatova N, Akour A, Zayed A, Momani M, Khawaja N, Bustanji H, Hyasat D. The correlation between plasma levels of oxytocin and betatrophin in non-diabetic and diabetic metabolic syndrome patients: A cross sectional study from Jordan. Diabetes Metab Syndr 2017; 11:59-67. [PMID: 27578619 DOI: 10.1016/j.dsx.2016.08.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 08/22/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND Oxytocin (OXT) is a neurohypophyseal hormone that has been recently shown to possess a number of beneficial effects in diabetes and obesity. Betatrophin is a protein expressed in fat and liver that regulates lipid metabolism and promotes pancreatic β-cell proliferation. It is not investigated yet whether OXT and betatrophin levels correlate in metabolic syndrome (MS) or diabetes patients. METHODS The aim was to assess correlations between plasma betatrophin and OXT levels in MS-diabetic or prediabetic (N=89) as compared to MS-non-diabetic (N=69) patients. Competitive binding ELISA was used to evaluate betatrophin and OXT plasma concentrations. Correlations of the above biomarkers and patient clinical characteristics were also detected. RESULTS As compared to the control MS participants (0.32±0.25ng/mL); betatrophin plasma levels were increased (P<0.001) in the MS-pre/T2DM patients (1.23±0.68ng/mL). On the contrary, OXT concentrations were decreased (P<0.001) in the MS-pre/T2DM patients (1222.46±514.55pg/mL) as compared to the MS control subjects (2323.42±848.68pg/mL). OXT concentration correlated negatively (r=-0.492, P<0.001), while HbA1c and FPG correlated positively with betatrophin plasma levels (P<0.001), but were inversely correlated with OXT levels (P<0.001) in the total sample. CONCLUSION Betatrophin levels are increased, while OXT levels are decreased in MS-pre/T2DM. We found an inverse correlation between the levels of the two biomarkers in addition to correlation between their levels and the degree of glycemic control.
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Affiliation(s)
- Amani Al-Rawashdeh
- School of Pharmacy, The University of Jordan, PO Box 11942, Amman, Jordan; Jordan University Hospital, The University of Jordan, PO Box 11942, Amman, Jordan
| | - Violet Kasabri
- School of Pharmacy, The University of Jordan, PO Box 11942, Amman, Jordan; Jordan University Hospital, The University of Jordan, PO Box 11942, Amman, Jordan.
| | - Nailya Bulatova
- School of Pharmacy, The University of Jordan, PO Box 11942, Amman, Jordan; Jordan University Hospital, The University of Jordan, PO Box 11942, Amman, Jordan
| | - Amal Akour
- School of Pharmacy, The University of Jordan, PO Box 11942, Amman, Jordan; Jordan University Hospital, The University of Jordan, PO Box 11942, Amman, Jordan
| | - Ayman Zayed
- School of Pharmacy, The University of Jordan, PO Box 11942, Amman, Jordan; Jordan University Hospital, The University of Jordan, PO Box 11942, Amman, Jordan
| | - Munther Momani
- School of Pharmacy, The University of Jordan, PO Box 11942, Amman, Jordan; Jordan University Hospital, The University of Jordan, PO Box 11942, Amman, Jordan
| | - Nahla Khawaja
- National Center for Diabetes, Endocrinology and Genetics, Queen Rania Street, ox Amman 13165, Jordan
| | - Haider Bustanji
- National Center for Diabetes, Endocrinology and Genetics, Queen Rania Street, ox Amman 13165, Jordan
| | - Dana Hyasat
- National Center for Diabetes, Endocrinology and Genetics, Queen Rania Street, ox Amman 13165, Jordan
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Akour A, Kasabri V, Afifi FU, Bulatova N. The use of medicinal herbs in gynecological and pregnancy-related disorders by Jordanian women: a review of folkloric practice vs. evidence-based pharmacology. Pharm Biol 2016; 54:1901-1918. [PMID: 26911517 DOI: 10.3109/13880209.2015.1113994] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 10/20/2015] [Accepted: 10/25/2015] [Indexed: 06/05/2023]
Abstract
Context National statistical reports in Jordan indicate a decrease in the total fertility rate along with a parallel increase in contraceptive use. The folkloric use of medicinal herbs in gynecological disorders has been growing in Jordan, despite of deficient reports on the evidence-based safety and efficacy of these practices. Objective The aim of this comprehensive article is to review medicinal plants with claimed ethnonpharmacological usage in various gynecological and pregnancy-related issues in Jordan, and to assess their evidence-based pharmacological studies as well as their phytochemistry. Methods The published literature was surveyed using Google Scholar entering the terms "ethnopharmacology AND Jordan AND infertility AND gynecology OR gestation". We included ethnopharmacological surveys in Jordan with available full-text. Results Twelve articles were reviewed. Plant species which are commonly used for female gynecological issues such as Artemisia monosperma Del. and A. herba-alba Asso. (Asteraceae) have been found to exert an antifertility effect. Ricinus communis L. (Euphorbiaceae) and Citrullus colocynthis (L.) Schrad. (Cucurbitaceae) had antifertility effects in male rats, but Nigella sativa oil L. (Ranunculaceae) and Cinnamon zeylanicum J. Presl (Lauraceae) were found to enhance it. Conclusion Using plants for gynecological disorders is a common practice in Jordan. Many of them, whether utilised for gynecological or non-gynecological conditions equally, were found to have detrimental effects on female or male fertility. Thus, couples planning pregnancy should be discouraged from the consumption of these herbs. Further local studies are warranted to confirm the appreciable beneficial pharmacological effects and safety of these plants.
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MESH Headings
- Animals
- Ethnopharmacology
- Evidence-Based Medicine
- Female
- Fertility/drug effects
- Folklore
- Genital Diseases, Female/drug therapy
- Genital Diseases, Female/epidemiology
- Humans
- Infertility, Female/chemically induced
- Infertility, Female/epidemiology
- Infertility, Female/physiopathology
- Infertility, Male/chemically induced
- Infertility, Male/epidemiology
- Infertility, Male/physiopathology
- Jordan/epidemiology
- Male
- Medicine, Traditional
- Phytotherapy
- Plant Preparations/adverse effects
- Plant Preparations/therapeutic use
- Plants, Medicinal
- Pregnancy
- Pregnancy Complications/drug therapy
- Pregnancy Complications/epidemiology
- Risk Assessment
- Risk Factors
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Affiliation(s)
- Amal Akour
- a Faculty of Pharmacy, The University of Jordan , Amman , Jordan
| | - Violet Kasabri
- a Faculty of Pharmacy, The University of Jordan , Amman , Jordan
| | - Fatma U Afifi
- a Faculty of Pharmacy, The University of Jordan , Amman , Jordan
| | - Nailya Bulatova
- a Faculty of Pharmacy, The University of Jordan , Amman , Jordan
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Awwad O, Akour A, Al-Muhaissen S, Morisky D. The influence of patients' knowledge on adherence to their chronic medications: a cross-sectional study in Jordan. Int J Clin Pharm 2015; 37:504-10. [PMID: 25708124 DOI: 10.1007/s11096-015-0086-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Accepted: 02/11/2015] [Indexed: 12/30/2022]
Abstract
BACKGROUND Non-adherence to long-term therapy for chronic illnesses is considered the major reason why patients fail to reach their clinical goals, resulting in suboptimal health outcomes, death, and extra costs on the health care systems. Knowledge about the disease and prescription medications, an understanding of the reason the medication is needed, and good expectations or attitudes toward treatment, all contribute to a better medication-taking behavior and are associated with higher rates of adherence. OBJECTIVE This study examines the relationship between knowledge and adherence of patients receiving long-term therapy for one or more chronic illnesses in Jordan. SETTINGS The study was conducted in the out-patient clinics of two Jordanian hospitals (The University of Jordan Hospital and Jordan Hospital). METHODS This was a cross-sectional study that included 902 patients. The correlation between patients' knowledge about their chronic medications and adherence was assessed. Effects of several sociodemographic characteristics were investigated in regard to knowledge and adherence. MAIN OUTCOME MEASURES Knowledge was assessed by a modified version of the McPherson index, and the Morisky Medication Adherence Scale was used to assess medication adherence. RESULTS A significant correlation was found between patients' knowledge and their adherence to medications (r = 0.357, p < 0.001). Most of the participants had low adherence. Younger age, higher education levels, high income, fewer medications and diseases were significant predictors of higher knowledge levels. Knowledgeable patients were found to be twice as likely to have moderate-to-high adherence as their unknowledgeable counterparts. Similarly, high income and higher education were associated with higher adherence scores. CONCLUSION Forgetfulness and aversion toward medications were the most common barriers to medication adherence. This implicates that clinicians and health care policy makers should direct their effort toward two main strategies to improve adherence increasing awareness and education of effective ways to remind patients about their medications.
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Elayeh E, Akour A, Yousef A, Farah D, Hamaly M, Basheti I. Osteoporosis Amongst Jordanians: Effect of Pharmacist- Directed Brochure Education on People’s Knowledge. TROP J PHARM RES 2015. [DOI: 10.4314/tjpr.v13i12.22] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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