Survival after Trastuzumab Therapy in Patients with Locally Advanced or Metastatic HER2-Positive Gastric or Gastroesophageal Junction Cancer: A Meta-Analysis of Randomized Controlled Trials.

Background: In the Trastuzumab for Gastric Cancer study, it was found that trastuzumab combined with doublet chemotherapy (fluoropyrimidine and platinum) was the gold-standard treatment for gastroesophageal adenocarcinoma (GEA) that was locally advanced, unresectable, or metastatic (HER2+). Materials and Methods: We performed a meta-analysis of randomized phase II/III studies testing trastuzumab in combination or alone. Results: This meta-analysis's findings involved 2048 patients in total. The treatment arm and hormone receptor status were used to stratify the combined HR. Overall, the PFS (Random model) HR [0.80] and 95% confidence intervals (CI) [0.68-0.95] were significantly higher for regimens containing trastuzumab, fluoropyrimidine, and platinum compared to regimens containing fluoropyrimidine and platinum. Conclusions: The results of this meta-analysis provide additional support for trastuzumab's use in treating HER2-positive GEA, particularly in cases where the disease lacks a HER2+ receptor.

Knowledge, Attitude, and the Practice of Community Pharmacists to Dispense Opioid-Related and Opioid-Containing Medication in Eastern Province, Saudi Arabia.

Objectives: This study was done to evaluate the knowledge of community pharmacists-working in Saudi Arabia-regarding over-the-counter opioid-related and opioid-containing medications. Materials and Methods: A quantitative cross-sectional study was conducted using an online questionnaire that was distributed through social media and taken to the community pharmacists in person. A total of 101 responders were reached in a period of around 3 weeks. Results: Most of the pharmacists working in community pharmacies in Saudi Arabia are non-Saudi (85.15%), males (88.12%), and the majority are holders of bachelor's degrees (85.15%). More than half of the participants spend a considerably sufficient time with the patient 6-10 minutes (60.4%). The availability of a private counseling room in community pharmacies is significantly low (21.78%). Only (69.41%) of participants always counsel the patient before dispensing opioid-related medications. Most of the participants (84.76%) believe that all over-the-counter opioid-related and opioid-containing medications should be restricted to avoid drug abuse. Conclusion: A little neglect from pharmacists' side regarding dispensing such medications was observed; thus, there is a significant need to raise their awareness regarding over-the-counter opioid abuse.

Bilateral Endometriotic Cystic Ovaries and Huge Splenic Epithelial Cyst With Elevated CA-125, CA19-9: A Report of a Rare Case.

Histologically benign splenic cysts (SCs) resemble splenic sacs. SCs are rare. Here, we present and discuss a new case of bilateral endometriotic cystic ovaries with massive SCs. A 26-year-old single female visited the hospital with left lower quadrant discomfort and suprapubic pain for three months, accompanied by anorexia, weight loss for these three months, and persistent dysmenorrhea for two years. Splenic examination revealed a soft abdomen with left hypochondria, suprapubic tenderness, and a lump in the upper left quadrant. All laboratory results were normal, except for two cancer antigens (CA-125 and CA 19-9). Therefore, magnetic resonance imaging was used to make the definitive diagnosis, which revealed bilateral ovarian endometrioma with a left upper abdominal cystic mass of splenic origin. When CA-125 and CA-19-9 readings are high, physicians should investigate endometriotic and SCs. Imaging aids diagnosis. Histopathological results are essential. Tools and follow-up should rule out malignancy, and surgery is the best treatment option.

Community Pharmacist's Knowledge, Attitude, and Practices towards Vitamin Supplements in Al-Khobar Region, Saudi Arabia: A Descriptive Cross-Sectional Study.

AIMS AND OBJECTIVES: To foster a podium for assessing and evaluating knowledge, attitudes, and professional practices of Saudi community pharmacists in counseling patients regarding the safe usage of dietary supplements. MATERIALS AND METHODS: A cross-sectional descriptive study was conducted between January 2017 and April 2017. Collection of data was carried out by using a set of 44 semi-structured self-administrated questionnaires. Study was conducted among community pharmacies in Al-Khobar Region, Saudi Arabia, with target sample of 250 pharmacists. RESULTS: A total of 102 pharmacists contributed in this study. The mean average score of the participants in subjective assessment of knowledge was 62.45%. Half of the participants (51.96%) achieved good and excellent score in objective assessment regarding knowledge of vitamin, 66.67% of the respondents thought that pharmacists should be knowledgeable regarding vitamin supplements, and 81.37% declared that they inform the patients about possible adverse effects by the use of dietary supplements. CONCLUSION: The study revealed a positive attitude of community pharmacists in Al-Khobar Region on their role in patients' counseling about the safe usage of vitamins as dietary supplements. However, their level of knowledge about vitamin supplements needs to be improved to meet consumer's needs regarding usage of dietary supplements.

A Questionnaire-based Study for Weight Loss by Using Herbal Drugs in Dammam (Eastern Region), Kingdom of Saudi Arabia.

BACKGROUND: Obesity is a common health problem and it is increasing around the world. Herbal drugs are the most commonly used alternative treatment for weight reduction. The aim of this study was to identify the most commonly used plants for the treatment of obesity or to reduce the weight of patients with obesity and to determine the usage rate of herbal drugs in Dammam, Kingdom of Saudi Arabia. MATERIALS AND METHODS: This cross-sectional study was performed on people who were overweight and obese in Dammam (Eastern Region), Kingdom of Saudi Arabia, by using pretested questionnaire. Participants were randomly selected for this questionnaire study. P value was calculated by using chi-square test. RESULTS: A total of 500 participants were selected, of which 355 participants completed the questionnaire-based study and the remaining 145 were excluded from the study. The majority (n = 190, 53.52%, P > 0.05) used herbal drugs to reduce weight. The most commonly used herbal drugs included green tea (53.52%, P > 0.05), ginger (31.54%, P < 0.01), and flax seed (17.46%, P < 0.01). However, nearly 35% of participants stated that they had unwanted effects; therefore, majority of the participants stated they would use herbal drugs in future to reduce weight. CONCLUSION: This investigation showed that the treatment to reduce weight of those who were overweight or obese by herbal drugs and the usage rate of herbal drugs/fruits/vegetables were high in Dammam. Further investigations are required to prove the efficacy of herbal drugs and their side effects for the treatment of obesity. A community awareness program is essential to explain the positive and adverse effects of herbal drugs.