Students' experience and perception of a virtual surgical advanced pharmacy practice elective

Background: This article describes a virtual surgery advanced pharmacy practice experience (APPE) designed during the COVID-19 outbreak for undergraduate students. Additionally, the article evaluates the implementation process of the APPE and students' perceived effectiveness of the virtual experience on their learning. Methods: A virtual four-week APPE course was designed involving 12 interns using Microsoft Teams. All pre-scheduled activities and meetings with students were performed remotely. The virtual APPE was assessed through an overall outcome survey and a weekly quality survey. Results: The implementation of the APPE was successful with students agreeing that they effectively managed to meet the objectives of the rotation. Students believed that APPE enhanced their knowledge and skills in surgical pharmacy practice. Their interest in working in a Perioperative clinical pharmacist position increased after the rotation from 50% to 70%. Conclusion: A virtual surgical APPE that is positively perceived by students can be implemented. Further research is needed to assess the impact of a virtual rotation on clinical skills.

Assessment of anxiety level and sleep quality of medical staff treating patients with COVID-19.

OBJECTIVE: Worldwide transmission of the novel coronavirus (COVID-19) and related morbidity and mortality has presented a global challenge for several reasons. One such underrecognized and unaddressed aspect is the emotional health problems that medical staff have developed during this pandemic. The purpose of this one-month study was to examine anxiety levels and sleep quality of 100 medical staff members who worked in medical clinics treating COVID-19 patients in Saudi hospitals and to investigate the association of both anxiety levels and sleep quality with age, sex, and distinctive demographics. MATERIALS AND METHODS: We investigated anxiety levels and sleep quality of 100 medical staff members (age range 20-60 years) who worked in medical clinics treating COVID-19 patients in Saudi hospitals and the association of both anxiety levels and sleep quality with age, sex, and distinctive demographics. Anxiety levels and sleep quality were measured using the Self-Rating Anxiety Scale and the Pittsburgh Sleep Quality Index (SAS and PSQI, respectively). RESULTS: A significant increment in anxiety and poor sleep quality was found in medical staff caring for COVID-19 patients. Anxiety levels in females were higher than males; however, poor sleep quality was somewhat higher in males vs. females but did not vary between age groups. Age was significantly negatively correlated with anxiety symptoms; individuals < 40 years old vs. ≥ 40 had more significant anxiety levels. We observed that medical staff with top-level salaries demonstrated a significant correlation (p = 0.028) between poor sleep quality and ill effects vs. those who had lower pay rates. A correlation between income and anxiety was not found. CONCLUSIONS: The higher the probability and intensity of exposure to coronavirus patients, the more noteworthy the danger that medical staff will experience the ill effects of mental issues.

Punicalagin and zinc (II) ions inhibit the activity of SARS-CoV-2 3CL-protease in vitro.

OBJECTIVE: Coronavirus 2019 (COVID-19) has now been declared as a worldwide pandemic. Currently, no drugs have been endorsed for its treatment; in this manner, a pressing need has been developed for any antiviral drugs that will treat COVID-19. Coronaviruses require the SARS-CoV-2 3CL-Protease (3CL-protease) for cleavage of its polyprotein to yield a single useful protein and assume a basic role in the disease progression. In this study, we demonstrated that punicalagin, the fundamental active element of pomegranate in addition to the combination of punicalagin with zinc (Zn) II, appear to show powerful inhibitory activity against SARS-CoV-2. MATERIALS AND METHODS: The 3CL protease assay kit was used to quantify 3CL protease action. The tetrazolium dye, MTS, was used to evaluate cytotoxicity. RESULTS: Punicalagin showed inhibitory action against the 3CL-protease in a dose-dependent manner, and IC50 was found to be 6.192 µg/ml for punicalagin. Punicalagin (10 µg/mL) demonstrated a significant inhibitory activity toward 3CL-protease activity (p < 0.001), yet when punicalagin is combined with zinc sulfate monohydrate (punicalagin/Zn-II) extremely strong 3CL-protease activity (p < 0.001) was obtained. The action of 3CL-protease with punicalagin/Zn-II was decreased by approximately 4.4-fold in contrast to only punicalagin (10 µg/mL). Likewise, we did not notice any significant cytotoxicity caused by punicalagin, Zn-II, or punicalagin/Zn-II. CONCLUSIONS: We suggest that these compounds could be used as potential antiviral drugs against COVID-19.

Implementation of virtual surgery advance pharmacy practice experience APPE rotation: Creative solution to combat COVID-19 ramification on pharmacy education

Service or Program: A virtual four week Surgery APPE rotation was designed by four clinical pharmacy faculties at a college of Pharmacy in Saudi Arabia with the aim of providing pharmacy interns with essential pharmaceutical care experience of peri-operative setting. All clinical faculties had experience in integrating simulation in pharmacy education and training. The virtual APPE was implemented using Microsoft Teams, where all pre-scheduled activities and meetings with students were performed remotely. The goals of this rotation included: 1. Understand the role of clinical pharmacist in a surgical unit 2. Enhance knowledge of major surgical procedures and medications used specifically in this unit. 3. Improve communication skills in presence of obstacles. This was achieved through integration of surgical themes and activities described in the ASHP guidelines on Surgery/ Perioperative Pharmaceutical services series. Virtual activities included Topic discussions, simulated patients case presentations, Journal clubs, drug information questions, and a longitudinal protocol development project of perioperative patients in collaboration with the university hospital. Justification/Documentation: While the need of clinical pharmacist involvement in the operating room was previously established, the adaptability in clinical practice is slow and sub-optimal. This was further endorsed due to suspending clinical training of pharmacy interns as part of the ramifications of COVID-19 global pandemic on the educational and health sectors. Motivation and outcomes gained by students indicate success of this virtual rotation. Adaptability: In the presence of a secure, personalized, and professional virtual platform, a distant surgical APPE rotation can be easily adapted by pharmacy schools, preferably with an experience in scenario creation and simulation education. Significance: Offering a virtual surgical APPE rotation creates an opportunity for pharmacy students to enhance pharmacotherapeutic management skills of peri-operative patients and supplement their clinical communication skills, especially in areas where surgical pharmacy practice is not well established.