A Cross-sectional Survey-based Study of Knowledge, Attitude, and Practice Towards Uses of Cosmetics and Cosmetovigilance in India.

Background: In India, the cosmetics industry has expanded significantly because of changing lifestyles and increased awareness. In terms of earning the most money from the personal care and cosmetics industry in 2021, India is ranked fourth globally. Many cosmetics sold in India include ingredients that cannot be used on humans. Objective: To assess knowledge, attitudes, and practice toward the uses of cosmetics and cosmetovigilance in India. Methods: A cross-sectional study was conducted, from April to May 2022, among the general population living in the Delhi NCR region, India. Study questionnaires (printed and survey link) were distributed in public as well as at workplaces for the survey. Results: Around 268 (54.78%) females and 223 (45.21%) males participated in the survey. Amongst the total respondents - 407 (83%) agreed that they are using cosmetic products on a daily basis, females 229 (85.44%), being the majority users compared to males 178 (80%), with a significant P value = 0.011. Most of the people reported side effects of shampoos - 7.13% (hair fall, hair thinning, dryness of the scalp, itching), followed by allergic reactions to moisturizers - 5.70%. Conclusion: Because of the right safety and effectiveness mentorship of cosmetics, regulatory agencies and stakeholders should adopt this broadly. Cosmetovigilance needs to be put into practice.

A Comprehensive Review of Various Therapeutic Strategies for the Management of Skin Cancer.

Skin cancer (SC) poses a global threat to the healthcare system and is expected to increase significantly over the next two decades if not diagnosed at an early stage. Early diagnosis is crucial for successful treatment, as the disease becomes more challenging to cure as it progresses. However, identifying new drugs, achieving clinical success, and overcoming drug resistance remain significant challenges. To overcome these obstacles and provide effective treatment, it is crucial to understand the causes of skin cancer, how cells grow and divide, factors that affect cell growth, and how drug resistance occurs. In this review, we have explained various therapeutic approaches for SC treatment via ligands, targeted photosensitizers, natural and synthetic drugs for the treatment of SC, an epigenetic approach for management of melanoma, photodynamic therapy, and targeted therapy for BRAF-mutated melanoma. This article also provides a detailed summary of the various natural drugs that are effective in managing melanoma and reducing the occurrence of skin cancer at early stages and focuses on the current status and future prospects of various therapies available for the management of skin cancer.

Knowledge, Attitude, and Practice of using Antibiotics among the Community in Eastern Province, Saudi Arabia.

Objectives: The purpose of this study is to explore and evaluate the knowledge, attitude, and practice of using antibiotics among the community in the Eastern Province, of Saudi Arabia. Methods: A cross-sectional study was conducted, from February 2022 through March 2022, among people in Eastern Province, Saudi Arabia. Results: The study population was 753 of the Saudi community. The questionnaire used open-ended and multiple-choice questions. Out of 753 participants, only 254 (55.6%) think that antibiotics can treat a bacterial infection, whereas 163 (35.7%) and 82 (17.9%) think it treats viral and fungal infections respectively. 26 (5.7%) of the respondents think that they should be stopped when the antibiotics are finished, while 72 (15.8%) think that they should be stopped when the symptoms disappear. The most common side effect in the respondent's opinion was diarrhea 183 (40%), followed by 168 (36.76%) antibiotics resistance. The major reason for taking antibiotics without a prescription was found to be mild symptoms 28 (50.90%), adequate information 21 (38.18%), difficulty in taking appointments 17 (30.90%), long waiting hours during the hospital visits 15 (27.27%). 169 (36.9%) kept the leftover antibiotics for reuse. The most common antibiotics used for self-medication were found to be Amoxicillin and clavulanic acid 23 (41.8%), followed by Amoxicillin 9 (16.36%). Knowledge of antibiotic resistance was highest in the age group 20-30 (62.7%) (P < 0.05). Conclusion: People in Saudi Arabia show a high awareness of antibiotics' proper usage, and this returns to the great awareness campaign held by The Ministry of Health (MoH).

Proton Pump Inhibitors' Use and Risk of Iron Deficiency Anaemia: A Systematic Review and Meta-analysis.

AIM: Various research was conducted during the last decade, with inconsistent findings regarding iron death anaemia (IDA) perils vis-à-vis utilization of proton-pump inhibitors (PPIs). Consequently, recent systematic review and meta-analysis were implemented to evaluate IDA-related perils concerning the utilization of proton-pump inhibitors. METHODS: The databases of EBSCOhost, PubMed® and Cochrane Central were searched from the research outset until February 28, 2021 purposely to identify all research with objectives that align with the present research investigation. The Newcastle-Ottawa Scale (NOS) was utilized for the evaluation of the research investigation standard. The prime (1º) goal of the research was to gauge IDA peril among users of proton-pump inhibitors (PPI). For data processing, RevMan (Review Manager) version 5.4 was employed. RESULTS: In total, fourteen investigations research was employed in this systematic review and metaanalysis. The combined relative risk of nine research exhibited a numerically consequential interrelation betwixt the utilization of proton-pump inhibitors and IDA peril (RR 2.56 [95% CI 1.43-4.61], p < 0.00001). Contemporary systematic review and meta-analysis examination posit that proton-pump inhibitor consumers are prone to greater peril of coming down with IDA in comparison to non-PPI users. CONCLUSION: In keeping with the findings of my research, prescriber physicians should exercise caution when prescribing PPIs to individuals taking it for a long time to avoid the peril of IDA. Additionally, their serum iron level should be checked to ensure that proton-pump inhibitors are safe.

Global Epidemiology, Clinical Features, Diagnosis and Current Therapeutic Novelties in Migraine Therapy and their Prevention: A Narrative Review.

INTRODUCTION: The current article reviews the latest information on epidemiology, clinical features, diagnosis, recent advancements in clinical management, current therapeutic novelties, and the prevention of migraines. In a narrative review, all studies as per developed MeSH terms published until February 2023, excluding those irrelevant, were identified through a PubMed literature search. METHODS: Overall, migraine affects more than a billion people annually and is one of the most common neurological illnesses. A wide range of comorbidities is associated with migraines, including stress and sleep disturbances. To lower the worldwide burden of migraine, comprehensive efforts are required to develop and enhance migraine treatment, which is supported by informed healthcare policy. Numerous migraine therapies have been successful, but not all patients benefit from them. RESULTS: CGRP pathway-targeted therapy demonstrates the importance of translating mechanistic understanding into effective treatment. In this review, we discuss clinical features, diagnosis, and recently approved drugs, as well as a number of potential therapeutic targets, including pituitary adenylate cyclase-activating polypeptide (PACAP), adenosine, opioid receptors, potassium channels, transient receptor potential ion channels (TRP), and acid-sensing ion channels (ASIC). CONCLUSION: In addition to providing more treatment options for improved clinical care, a better understanding of these mechanisms facilitates the discovery of novel therapeutic targets.

Prevalence of side-effects associated with the booster dose of Pfizer-BioNTech (BNT162b2) of COVID-19 Vaccine among vaccinated adults in the Eastern province of Saudi Arabia.

Background: Reports of local and systemic side-effects of COVID-19 vaccination may play an important role in public confidence in the acceptance of the COVID-19 vaccine booster dose. Methods: We conducted a retrospective cross-sectional study among adults living in Eastern Province of Saudi Arabia. A link to the survey was distributed to community members via WhatsApp, SMS, or e-mail. Participants' general and demographic information was also collected, as well as information about any local and systemic side-effects reported following vaccination. Results: A total of 370/390 (94.87%) of respondents reported one or more side-effects. Pain or redness at the site of injection (88.92%), fatigue (43.78%), body pain fever (37.84%), and headache (15.95%) were the most commonly reported side-effects. Moreover, 2.43% of the participants reported side-effects needed to see a physician; only four were admitted to the hospital. The non-healthcare respondents (n=273 (97.15%), OR (95% CI) = 5.22 (2.02, 13.48, P <0.001) were more likely to report side-effects compared to the healthcare related respondents (n=36 (85.71%), OR (95% CI) = 0.25 (0.10, 0.70), P=0.013). Conclusion: According to this study, the Pfizer-BioNTech (BNT162b2) COVID-19 vaccine was safe when given to Saudi Arabian adults. All reported side-effects were mild to moderate. The findings will likely persuade vaccine-hesitant individuals and pessimists to accept booster dose of COVID-19 vaccine.

Evaluation of Prevalence of Side-Effects Associated with Booster Dose of mRNA-Based COVID-19 Vaccine Among Healthcare Workers in Eastern Province, Saudi Arabia: A Descriptive Cross-Sectional Study.

Background: The purpose of this study was to examine the mild and moderate side-effects experienced by the healthcare workers (HCWs) in the Eastern Province of Saudi Arabia after receiving the booster dose of the Pfizer-BioNTech/BNT162b2 COVID-19 vaccine. Methods: We directed a descriptive cross-sectional study among adults living in the Eastern Province of Saudi Arabia. A survey link was distributed through WhatsApp, SMS, or e-mail to HCWs. Participants' general and demographic information were also collected, as well as information about any local and systemic side-effects reported following vaccination. Results: The results of this study showed that 81.84% (401/490) of the HCWs who contributed to this study reported the minimum COVID-19 post-vaccination side-effect. Body pain (89%) and pain at the site of injection (88.73%) were the most frequent frequently reported side-effects, followed by headache (28.68%), joint or bone pain (27.18%), muscle pain (26.43%), nausea or vomiting (21.2%), fever (18.95%), skin rashes (10.22%). History of chronic diseases had a 0.44-fold increased risk of side-effects compared to no history of chronic diseases HCWs (adjusted odds ratio (aOR) = 0.44; 95% CI = 0.224, 0.880), and significant association of occupation with side-effects was also 1.61-fold increased risk compared to nonmedical ((aOR) = 1.61; 95% CI = 1.037, 2.513). Conclusion: According to this study, the Pfizer-BioNTech/BNT162b2 COVID-19 vaccine was safe when given to Saudi Arabian HCWs. All reported side-effects were mild to moderate. The outcomes indicated that most participants had body pain and pain at the site of injection and fatigue is among the least reported side-effect post-booster dose. Healthcare was highly connected with more reporting of side-effects.

An Updated Review on Therapeutic Potential and Recent Advances in Drug Delivery of Berberine: Current Status and Future Prospect.

Natural products are well known for their high potency with minimum side effects. Plant extracts are the most commonly used natural products because of their ease of availability and relatively low production cost. Berberine (BBR), a phytochemical component of some Chinese medicinal herbs (most commonly Berberis vulgaris), is an isoquinoline alkaloid with several biological and pharmacological effects including antioxidant, anti-inflammatory, antitumour, antimicrobial, antidepressant, hepatoprotective, hypolipidemic, and hypoglycemic actions. Interestingly, multiple studies have shown that BBR is a potential drug candidate with a multi-spectrum therapeutic application. However, the oral delivery of BBR is challenged owing to its poor bioavailability. Therefore, its oral bioavailability needs to be enhanced before it can be used in many clinical applications. This review provides an overview of the various studies that support the broad range of pharmacological activities of BBR. Also, it includes a section to address the issues and challenges related to the drug and methods to improve the properties of BBR, such as solubility, stability and bioavailability that may be explored to help patients reap the maximum benefit from this potentially useful drug.

Evaluation of drug utilisation pattern and cost associated with diabetes mellitusType 2 management in Saudi Arabia

Abstract Diabetic mellitus is an emerging disease in Saudi Arabia. In this regard, a cross-sectional retrospective study was conducted to evaluate drug utilization pattern and the cost associated with non-insulin-dependent diabetes mellitus disease management in Saudi Arabia. Data retrieved from the electronic pharmacy records during the last one year were employed in this study. World Health Organization (WHO) Defined Daily Dose (DDD) method was employed to compute the daily price of each oral hypoglycaemic agent. The American Diabetes Association (ADA) guidelines and protocols were used to evaluate the level of adherence. A total of 17057 patients were enrolled in the study. Out of the 17057 patients enrolled in the study, 60.06 % (10246) were males and the rest females. In monotherapy, biguanides (metformin) were the most recommended and utilised drugs among 5673 patients (33.25%). The most commonly used drug combination was found to be sitagliptin+metformin (1754 units). The cost per unit dose was highest for liraglutide (A10BJ02) 258.32SR (68.79USD), and lowest for metformin (A10BA02) 0.49SR (0.13 USD). Metformin was the choice drug for the diabetes patients; biguanides (metformin) and DPP-4 (sitagliptins) were the most familiar established dose combination employed. Generic drugs should be used in order to reduce overall cost.

Evaluation of wound healing potential and biochemical estimation of sage oil nanoemulsion on animal model.

The study was aimed to design a nano emulsion formulations of Sage oil and to determine its effectiveness in healing the wound using rats as a model. Sage oil nanoemulsion (o/w) was formulated by a spontaneous emulsification method and tested for physicochemical parameters. The wound creation methods namely; circular excision and linear incision were utilized in the present study. Many specifications like tensile strength, DNA, total protein, Hexosamine and Uronic acid, were estimated from the tissues collected from incised wounds. The antioxidant and antimicrobial activity of the oil was estimated from the wound tissue homogenate. Finally epithelialization period and concentration of TNF-α were also measured. A Significant rise in collagen content by 77.52% and tensile strength by 56.20% were noticed in comparison to control. Reduction in period of epithelialization was noticed by 42.85% in comparison to control. The treatment groups confirmed significant antimicrobial activity in comparison to control. It was evident from the results that Sage oil nano emulsion could be the accelerator in wound healing process and it may be devoid of other drawbacks which would be possible with synthetic drug.

Cross Sectional Online Survey to Determine the Prevalence, Knowledge, Attitude and Practice of Smoking Tobacco Among Students of Medical Science College in Dammam, Saudi Arabia.

OBJECTIVES: The present study was conducted to examine the prevalence of tobacco smoking among students' of different departments of private medical science college at Dammam, as well as to assess students' attitude, practice, knowledge, and awareness towards smoking and its harmful effects. MATERIALS AND METHODS: A cross-sectional study was performed at Mohammed Al-Mana College for Medical Sciences (MACHS) in February 2020. Data were obtained through adopted pretested validated questionnaire based on the Global Adult Tobacco Survey. The questionnaire contains demographic details, smoking behavior, knowledge, and behavior attitude toward smoking. RESULTS: A total of 388 students completed the questionnaire out of them 108 males (27.8%) and 280 females (76.2%), the prevalence ratio of tobacco use 19.84%. The prevalence ratio of female current smokers was 7.9%, whereas male 11.8%, even though the number of female participants were high. Female students had better knowledge in comparison with male students regarding the harmful effects of tobacco smoking on health (78.7% vs. 82.8%; P ≤ 0.001), and as a risk factor of brain thrombosis (59.2% vs. 60%; P ≤ 0.001), gastric ulcer (55.5% vs. 62.1%; P ≤ 0.001), asthma (62.9% vs. 72.1%; P ≤ 0.001), and lung cancer (81.4% vs. 86.7%; P ≤ 0.001). CONCLUSION: The prevalence of smoking tobacco was relatively low among MACHS students who had good general knowledge regarding the harmful effects of smoking tobacco. This study results showed the harmful effects of smoking and can be used as a basis for the development of tobacco education programs at MACHS and any other institution for providing professional support for students to quit smoking.

Determination of isoniazid acetylation patterns in tuberculosis patients receiving DOT therapy under the Revised National tuberculosis Control Program (RNTCP) in India.

Isoniazid is the most commonly used drug for treatment of tuberculosis, and is administered individually or in combination with other drugs as standard first line therapy. Offsetting its efficacy, severe adverse effects, especially peripheral neuropathy and hepatotoxicity, are associated with isoniazid therapy, limiting its use in tuberculosis. Isoniazid is acetylated in vivo producing hydrazine and acetyl hydrazine, which are responsible for hepatotoxicity. Marked pharmacogenetic differences in acetylation have been reported among different population across the globe. This study evaluates isoniazid acetylation patterns in tuberculosis patients receiving DOT therapy under the Revised National Tuberculosis Control Program (RNTCP) in a specialized tuberculosis hospital in north India. Of 351 patients from whom samples were taken for biochemical analysis of adverse events, 36 were assessed for acetylation patterns. Blood samples were taken 1 h after administration of a 600 mg dose of isoniazid, and plasma concentrations of isoniazid were determined using a validated HPLC method. Of these 36 patients, 20 (55.56%) were slow acetylators and 16 (44.44%) were fast acetylators. Our results are consistent with those of an earlier study conducted in a different region of India. Most biochemical changes produced during long-term isoniazid therapy resolve after therapy is terminated.

Adverse drug reaction prevalence and mechanisms of action of first-line anti-tubercular drugs.

PURPOSE: Understanding the appearance of anti-tubercular drug-related adverse drug reactions (ADRs) in patients receiving tuberculosis (TB) treatment is important, and may be related to morbidity and mortality if not recognized early. Here, we aimed to characterize the mechanisms underlying adverse drug reactions due to combination anti-tuberculosis therapy of the Revised National Tuberculosis Control Program (RNTCP). METHODS: This was a prospective observational study conducted in 9 DOTS centers of New Delhi, India. All enrolled TB patients receiving first-line tuberculosis treatment as per RNTCP guidelines were monitored for ADRs. All ADRs that appeared during the treatment were recorded and analyzed. RESULTS: The study included 1011 TB patients on anti-TB treatment under DOTS. According to Naranjo's probability scale, of a total 351 (34.72%) reported adverse events, 102 (10.09%) were definite, 59 (5.83%) probable, 123 (12.17%) possible, and 67 (6.63%) doubtful. On the Hartwig severity scale, of the 351 adverse drug events, 225 (22.26%) were mild, 105 (10.38%) were moderate, and 21 (2.08%) were severe. Out of 102 reported adverse drug reactions, 81 (79.41%) were moderate and 21 (20.59%), while 65.28% did not experience any ADRs. CONCLUSIONS: Directly Observed Treatment (DOT) is effective and safe compared to daily treatment regimens. Patients receiving DOTS therapy needed close monitoring for adverse events. Therefore, a pharmacovigilance program should be added at the National level to accesses the adverse event incidence.

Knowledge, Practice and Attitudes Toward Pharmacovigilance and Adverse Drug Reactions Reporting Process Among Health Care Providers in Dammam, Saudi Arabia.

BACKGROUND: Pharmacovigilance is the science that plays an essential role in the reduction of ADRs which helps in predicting unwanted effects of drugs in community. Studying adverse drug reaction is an important arm of patient care. It aims at making the safe use of medicines for the treatment or prevention of disease. OBJECTIVES: To assess knowledge, Practice and attitudes toward pharmacovigilance and adverse drug reactions reporting process among Health Care Providers in Dammam, KSA. METHODS: This was a cross-sectional and questionnaire-based study involving health care providers working in different hospitals. 160 questionnaires were distributed to the respondents (25 doctors, 65 nurses, 50 pharmacists and 25 other health care provides). Participants were selected randomly and those not willing to participate were excluded from the study. Chi-square test was used for the calculation of P-Value. RESULTS: 135 participants responded to the questionnaire, while 160 participants were recruited for the study. The majority (n= 99, 73.33%, p=0.007) had no idea about national pharmacovigilance centers of KSA. The standard SFDA adverse drug reaction form was only known to 38.51 %, p=0.028 and only 38.51 %, p=0.002 were aware about electronic reporting of ADR. Only 34 %, p =0.002 of the respondents had ever reported an adverse drug reactions, 76.29 %, p=0.041 have not attended any training on ADR reporting and 86.66%, p=0.045 participants have no idea about impact of ADR reporting. CONCLUSION: The knowledge and attitude to ADR reporting was inadequate, our study has shown that the actual practice of ADR reporting is unsatisfactory. This indicates that there is a need to create an awareness of the importance of ADR reporting through CME/training of ADR reporting among healthcare providers.

Enhancement of Anti-Dermatitis Potential of Clobetasol Propionate by DHA [Docosahexaenoic Acid] Rich Algal Oil Nanoemulsion Gel.

The aim of the present study was to investigate the potential of nanoemulsion formulation for topical delivery of Clobetasol propionate (CP) using algal oil (containing omega-3 fatty acids) as the oil phase. CP has anti-inflammatory, immunomodulatory and antiproliferative activities. However, its clinical use is restricted to some extent due to its poor permeability across the skin. Algal oil was used as the oil phase and was also exploited for its anti-inflammatory effect along with CP in the treatment of inflammation associated with dermatitis. Nanoemulsion formulations were prepared by aqueous phase titration method, using algal oil, tween 20, PEG 200 and water as the oil phase, surfactant, co-surfactant and aqueous phase respectively. Furthermore, different formulations were subjected to evaluate for ex-vivo permeation and in-vivo anti-inflammatory, irritation and contact dermatitis studies. The optimized nanoemulsion was converted into hydrogel-thickened nanoemulsion system (HTN) using carbopol 971 and had a viscosity of 97.57 ± 0.04 PaS. The optimized formulation had small average diameter (120 nm) with zeta potential of -37.01 mV which indicated good long-term stability. In-vivo anti-inflammatory activity indicated 84.55% and 41.04% inhibition of inflammation for drug loaded and placebo formulations respectively. The assessment of skin permeation was done by DSC and histopathology studies which indicated changes in the structure of epidermal membrane of skin. Contact dermatitis reveals that the higher NTPDase activity in the treatment with the CP-loaded nanoemulsion could be related to the higher anti-inflammatory effect in comparison with placebo nanoemulsion gel.