Enhancing breast cancer treatment selection through 2TLIVq-ROFS-based multi-attribute group decision making.

Introduction: Breast cancer is an extremely common and potentially fatal illness that impacts millions of women worldwide. Multiple criteria and inclinations must be taken into account when selecting the optimal treatment option for each patient. Methods: The selection of breast cancer treatments can be modeled as a multi-attribute group decision-making (MAGDM) problem, in which a group of experts evaluate and rank alternative treatments based on multiple attributes. MAGDM methods can aid in enhancing the quality and efficacy of breast cancer treatment selection decisions. For this purpose, we introduce the concept of a 2-tuple linguistic interval-valued q-rung orthopair fuzzy set (2TLIVq-ROFS), a new development in fuzzy set theory that incorporates the characteristics of interval-valued q-rung orthopair fuzzy set (IVq-ROFS) and 2-tuple linguistic terms. It can express the quantitative and qualitative aspects of uncertain information, as well as the decision-makers' level of satisfaction and dissatisfaction. Results: Then, the 2TLIVq-ROF weighted average (2TLIVq-ROFWA) operator and the 2TLIVq-ROF weighted geometric (2TLIVq-ROFWJ) operator are introduced as two new aggregation operators. In addition, the multi-attribute border approximation area comparison (MABAC) method is extended to solve the MAGDM problem with 2TLIVq-ROF information. Discussion: To demonstrate the efficacy and applicability of the suggested model, a case study of selecting the optimal breast cancer treatment is presented. The results of the computations show that the suggested MAGDM model is able to handle imprecision and subjectivity in complicated decision-making scenarios and opens new research scenarios for scholars.

On QSAR modeling with novel degree-based indices and thermodynamics properties of eye infection therapeutics.

Topological descriptors are numerical results generated from the structure of a chemical graph that are useful in identifying the physicochemical characteristics of a wide range of drugs. The introduction of molecular descriptors advances quantitative structure-property relationship research. This article focuses on the nine degree-based topological indices and the linear regression model of the eye infection drugs. We introduced two new indices, namely, the "first revised Randic index" and the "second revised Randic index, for the analysis of eye infection drugs. Topological indices are calculated by using edge partitioning, vertex degree counting, and vertex degree labeling. This analysis is done with a scientific calculator and then authenticated with Matlab, a potent tool for examining data. The experimental data and results of the topological indices serve as inputs for the statistical computations and provide the values of intercepts, slopes, and correlation coefficients. All the correlations for the eye-infection drugs are positive, indicating a direct relationship between the experimental and estimated results of the drugs. There are significant results of the p-test for all of the characteristics of eye infection, such as molecular weight, boiling point, enthalpy, flash point, molar refraction, and molar volume, that validate the accuracy of the computations. A significant link was determined in this study between the defined indices with two properties: molar weight and molar refraction. The molar weight and molar refraction have a correlation coefficient ranging from 0.9. These results demonstrate a strong association between the indices and the properties under investigation. The linear regression approach is a valuable tool for chemists and pharmacists to obtain data about different medicines quickly and cost-effectively.

Multifunctional tunable Cu2O and CuInS2 quantum dots on TiO2 nanotubes for efficient chemical oxidation of cholesterol and ibuprofen.

In this study, a CuInS2/Cu2O/TiO2 nanotube (TNT) heterojunction-based hybrid material is reported for the selective detection of cholesterol and ibuprofen. Anodic TNTs were co-decorated with Cu2O and CuInS2 quantum dots (QDs) using a modified chemical bath deposition (CBD) method. QDs help trigger the chemical oxidation of cholesterol by cathodically generating hydroxyl radicals (˙OH). The small size of QDs can be used to tune the energy levels of electrode materials to the effective redox potential of redox species, resulting in highly improved sensing characteristics. Under optimal conditions, CuInS2/Cu2O/TNTs show the highest sensitivity (∼12 530 µA mM-1 cm-2, i.e. up to 11-fold increase compared to pristine TNTs) for cholesterol detection with a low detection limit (0.013 µM) and a fast response time (1.3 s). The proposed biosensor was successfully employed for the detection of cholesterol in real blood samples. In addition, fast (4 s) and reliable detection of ibuprofen (with a sensitivity of ∼1293 µA mM-1 cm-2) as a water contaminant was achieved using CuInS2/Cu2O/TNTs. The long-term stability and favourable reproducibility of CuInS2/Cu2O/TNTs illustrate a unique concept for the rational design of a stable and high-performance multi-purpose electrochemical sensor.

Evaluating the Relationship between Various Risk Factors and COVID-19 Incidence In People Living with HIV: A Cross-Sectional Study.

INTRODUCTION: People living with HIV (PLWH) are more susceptible to acquiring and having serious consequences from COVID-19. The objective of this study was to examine the correlation between COVID-19 infection and other risk factors in these patients. METHODS: This is a descriptive-analytical study recruiting 160 PLWH referred to the Behavioral Disease Counselling Centre of Imam Khomeini Hospital in Tehran in 2021. The patients were selected through convenient sampling. A checklist was used to collect the necessary data. Descriptive statistical tests, such as mean and standard deviation, were employed alongside inferential statistics, including chi-square, Fisher, independent t-tests, and logistic regression, all evaluated at a significance level of p<0.05 using the R software. RESULTS: The patients' average age was 43.15 ± 11.23. Forty-four women and 116 men were present. A notable association was observed between the incidence of COVID-19 and variables such as hepatitis C and the duration of time since HIV diagnosis (p<0.001). Moreover, a strong correlation was found between the amount of COVID-19 vaccination doses given to patients and their probability of acquiring the disease. The first vaccination dose was linked to a 5.45 percent increase in COVID-19 incidence in patients, whereas the second and third doses (t=2.95, t=7.57) reduced the risk of getting COVID-19. Furthermore, no discernible link (p>0.05) was found between the use of various antiretroviral medications and COVID-19 infection. CONCLUSION: This study finds that vaccine type doesn't impact COVID-19 outcomes in HIV-positive patients, but receiving more doses decreases the probability of occurrence of COVID-19, advocating for multiple vaccinations. However, PLWH, especially those non-compliant with antiretrovirals, need strict adherence to health protocols due to heightened vulnerability to viral illnesses.

Role of Anteromedial Cortical Support for Unstable Intertrochanteric Fractures Being Treated With Cephalomedullary Nails.

INTRODUCTION: Reduction quality is of paramount importance for an optimal outcome in unstable pertrochanteric fractures. The non-anatomical functional anteromedial buttress is proposed to prevent impending mechanical complications. We aimed to evaluate the role of anteromedial cortical support in preventing mechanical complications following fixation with the cephalomedullary nail. MATERIALS AND METHODS: A prospective, single-arm interventional study was conducted in the Orthopaedics Department of a Combined Military Hospital (CMH) in Rawalpindi. The duration of the study was 24 months. Patients were recruited by the purposive sampling technique as per inclusion/exclusion criteria. Preoperatively, the reduction was categorized as per Baumgartner's and Chang's criteria. Post-operatively, weight bearing as tolerated was advised. Radiographs prior to discharge for loss of reduction were evaluated. Follow-up radiographic measurements of neck length, neck shaft angle, and their loss as per protocol were done at three and six months. RESULTS: A total of 202 patients were operated on from October 21 until August 23. Mortality at six months in 39 patients (19.3%) and loss to follow-up in 31 patients (15.3%) resulted in 132 patients with complete follow-up and having developed complications in 12 patients (9.09%). The mean age was 76.3 ± 7.98 years; males were 105 (79.5%), and females were 27 (20.5%). Closed reduction was 58 (43.9%), and additional manoeuvres were required in 74 (56.1%). The mean tip apex distance (TAD) was 24.56 ± 2.76, and the Calcar gap was 5.16 ± 1.27. Cleveland zone centre-centre in 54 (40.9%), inferior-centre in 65 (49.2%), and inferior-posterior (9.9%) were statistically significant for mechanical complications (p≤0.001). There was a significant association between the grading of Chang's and Baumgartner's poor groups for the development of mechanical complications (p≤0.001). The mean time to full weight bearing without support was 21 ± 1.22 weeks. The mean Hip Harris score at six months was 69.27 ± 7.68. CONCLUSION: Results suggest that anteromedial cortical support can lead to fewer potential mechanical complications at six months. A higher Chang's grade drives surgeons to engage in additional manoeuvres. Anteromedial cortical support is worth consideration for unstable pertrochanteric fractures.

Pharmacological interventions to improve sleep in people with Alzheimer's disease: a meta-analysis of randomized controlled trials.

INTRODUCTION: This systematic review and meta-analysis evaluates the evidence from randomized controlled trials (RCTs) involving pharmacological interventions for improving sleep in people with Alzheimer's disease (AD). METHODS: A systematic literature search in eight databases from January 2000 to July 2023 focusing on RCTs that compared a pharmacological intervention with a placebo for enhancing sleep in people with AD. The authors registered the study protocol at Prospero, followed the PRISMA guidelines, and produced the pooled estimates using random-effect or IVhet models. RESULTS: Eight different interventions and 29 different sleep outcomes were examined in 14 RCTs included in this review. Eszopiclone positively affected sleep efficiency, as did orexin antagonists. However, there was no difference when melatonin was used. The interventions demonstrated low discontinuation rates and a few adverse drug reactions. CONCLUSION: Although melatonin was the most investigated intervention, the evidence for its efficacy is inconclusive. On the other hand, trazodone and orexin receptor antagonists showed promising results; however, more RCTs are needed for definite answers.

A MAGDM approach for evaluating the impact of artificial intelligence on education using 2-tuple linguistic q-rung orthopair fuzzy sets and Schweizer-Sklar weighted power average operator.

The impact of artificial intelligence (AI) in education can be viewed as a multi-attribute group decision-making (MAGDM) problem, in which several stakeholders evaluate the advantages and disadvantages of AI applications in educational settings according to distinct preferences and criteria. A MAGDM framework can assist in providing transparent and logical recommendations for implementing AI in education by methodically analyzing the trade-offs and conflicts among many components, including ethical, social, pedagogical, and technical concerns. A novel development in fuzzy set theory is the 2-tuple linguistic q-rung orthopair fuzzy set (2TLq-ROFS), which is not only a generalized form but also can integrate decision-makers quantitative evaluation ideas and qualitative evaluation information. The 2TLq-ROF Schweizer-Sklar weighted power average operator (2TLq-ROFSSWPA) and the 2TLq-ROF Schweizer-Sklar weighted power geometric (2TLq-ROFSSWPG) operator are two of the aggregation operators we create in this article. We also investigate some of the unique instances and features of the proposed operators. Next, a new Entropy model is built based on 2TLq-ROFS, which may exploit the preferences of the decision-makers to obtain the ideal objective weights for attributes. Next, we extend the VIseKriterijumska Optimizacija I Kompromisno Resenje (VIKOR) technique to the 2TLq-ROF version, which provides decision-makers with a greater space to represent their decisions, while also accounting for the uncertainty inherent in human cognition. Finally, a case study of how artificial intelligence has impacted education is given to show the applicability and value of the established methodology. A comparative study is carried out to examine the benefits and improvements of the developed approach.

On quantitative structure-property relationship (QSPR) analysis of physicochemical properties and anti-hepatitis prescription drugs using a linear regression model.

Numerous studies demonstrate a strong intrinsic relationship between the boiling and melting temperatures, among other chemical properties, of chemical compounds and pharmaceutical and their molecular structures. Using topological indices, researchers can learn more about the physical traits, chemical stability, and bioactivities of these chemical molecular structures. Topological indices on the chemical structure of chemical materials and drugs are investigated in order to make up for the absence of chemical experiments and provide a theoretical basis for the manufacture of medications and chemical materials. According to well-known degree-based topological indices, the chemical structures of drugs used to treat hepatitis (A, B, C, D, and E) are assessed in this study. The atoms are thought of as the vertices of a graph, and the borders that separate them are thought of as the edges. Using degree-based topological indices, a quantitative structure-property relationship (QSPR) investigation was conducted to predict the physical properties of 16 hepatitis medications. These topological indices link the chemical structure to specific physical characteristics, such as the surface tension of hepatitis medication molecules and molecular weight, enthalpy, boiling point, density, vapor pressure, and logP. Using their molecular structures, the study's drugs are represented as molecular graphs, and 14 topological indices are computed.

A novel cell biological tool to explain mechanics and dynamics in fission yeast.

The Rho guanosine triphosphatase hydrolase enzyme (GTPase) is required for the control of the actin cytoskeleton, but its activation in vivo condition is unknown. The study's goal was to find a new synthetic nanobody VHH (P-36 tagged with mNeonGreen) that interacts strongly with the Rho GTPase. We present the first novel synthetic nanobody, VHH (P-36 tagged with mNeonGreen), tested in fission yeast cells and found to have a particular interaction with Rho1GTPase. Plasmids were constructed by using of certain enzymes to digest the pDUAL-pef1a vector plasmid to produce a protein that was encoded by cloned genes. A varied VHH library was created synthetically, then transformed into yeast cells, and positive clones were chosen using chemical agents. To investigate protein interactions and cellular reactions, several studies were carried out, such as live cell imaging, growth curve analysis, coimmunoprecipitation, structural analysis, and cell therapies. Prism and RStudio were used for the statistical analysis. The presence of VHH (P-36) has no effect on the growth pattern making it an appropriate model for studying cytokinesis in vivo. According to a computational biological study, its affinity to interact with Rho1GTPase with all the complementarity-determining region (CDR) regions found on VHH (P-36) is extremely strong. We were able to track its subcellular target by localization using a fluorescent confocal microscope, ensuring the maintenance of cell polarity and morphology. Spheroplast analysis revealed a circular-shaped cell with an even distribution of Rho1 tagged VHH (P-36), indicating that the interaction occurs near the plasma membrane. The introduction of latrunculin-A (Lat-A) disrupted Rho GTPase localization, demonstrating the control over actin production, and the cell did not show evidence of mitotic phase commencement while Lat-A was present. Finally, this important biological tool can aid in our understanding of the mechanics and dynamics of cytokinesis in relation to Rho1GTPase.

Lived experiences of Turkish community pharmacists toward person-centric care: a qualitative analysis.

Background: In Turkey, the SMART pharmacist program was launched to enable community pharmacists to deliver patient-centric care services. However, how far this programme has achieved success and what are the challenges faced by the programme need to be evaluated. Objective: This study aimed to explore the experiences of community pharmacists in providing person-centric care services in pharmacies and provide recommendations for improved care effectiveness. Methods: A phenomenological approach was adopted in this study. To conduct qualitative interviews, a semi-structured interview guide was devised to gather insights from the pharmacists. The interviews were coded verbatim. Subsequently, various themes and sub-themes were developed based on the aim and objectives of the study. A total of 14 pharmacists engaged in semi-structured interviews conducted between May and August 2023. Results: Two main themes emerged from the data: challenges in person-centric care and recommendations to improve person-centric care. Barriers were subdivided into patient-related challenges and personal challenges. Recommendations consisted of pharmacists' professional tasks and recommendations. Conclusion: The findings of this study, suggest that the concerned healthcare authorities should re-evaluate the 'SMART pharmacist' program in Turkey and address professional and personal challenges faced by community pharmacists in delivering effective person-centric care. Pharmacists recommend patient follow-up (follow-ups), providing a counselling environment, collaboration with physicians, expansion of pharmacy services.

Raising awareness among pharmacists can be achieved through initiatives like the 'SMART Pharmacist Program', aimed at enhancing the provision of person-centric pharmaceutical care to patients.Government policies may be required revision to community pharmacists greater authority.Academic institutions could contemplate revising the existing pharmacy education curriculum to emphasise person-centric pharmacy education.Likewise, professional organisations may need to reevaluate the continuing professional development prerequisites for community pharmacists.

Environmental deterioration in the age of industrialization and production: do industrial competition and renewable energy reduce the ecological burden?

The modern era of globalization, economic development, and increase in manufacturing activity pose severe risks to the natural environment. In this context, industries must prioritize sustainable economic growth and development. Thus, the purpose of this study is to provide insight into industrial competition, renewable energy, economic freedom, manufacturing value added, economic growth, and carbon dioxide emissions (CO2 emissions) in the top ten high-income countries from 1997 to 2019. The results from panel cross-sectional autoregressive distributed lag (CS-ARDL), augmented mean group (AMG), and common correlated effects mean group (CCEMG) techniques revealed that economic growth and industrial production have a harmful influence on CO2 emissions. Meanwhile, industrial competitiveness, renewable energy, and economic freedom are all negatively associated with CO2 emissions. This specifies that industrial competitiveness, renewable energy, and economic freedom are favorably related to environmental sustainability by limiting CO2 emissions in the top ten high-income countries. These findings imply that governments and responsible authorities/policymakers develop strategies to reduce the environmental impact of manufacturing value addition and economic growth in the top ten high-income countries and allocate more financial resources to renewable energy and promote industrial competition.

Theoretical Investigation of the Nonlinear General Rate Model with the Bi-Langmuir Adsorption Isotherm Using Core-Shell Adsorbents.

Core-shell particles enable the separation of intricate mixtures in a highly efficient and rapid manner. The porous shell particles increased the separation efficiency with expedited flow rates due to an abatement in the pore volume accessible for longitudinal diffusion and a decrease in diffusion path length. This study focuses on the numerical approximation of a nonlinear isothermal general rate model applied to stationary bed columns that are replete with inert core adsorbents featuring double adsorption sites. The transport of solute in heterogeneous porous media can be modeled by a nonlinear convection acquiescent partial differential equation system together with a specific nonlinear algebraic relation: the bi-Langmuir adsorption isotherm. Therefore, it is important to develop accurate and reliable numerical techniques that can perform accurate numerical simulations of these models. We extended and implemented a second-order, semidiscrete, high-resolution finite volume method to simulate the governing equations of the model. Single solute flow and multi component mixture flows are assessed through a series of numerical experiments to theoretically illustrate the repercussions of intraparticle diffusion, film mass resistance, axial dispersion, and the size of the inert core radius upon simulated elution curves. Standard performance criteria are assessed to determine the optimal core radius fraction range for optimizing the separation performance.

A study of text-theoretical approach to S-box construction with image encryption applications.

Data protection is regarded as one of the biggest issues facing companies that have been using public data for a long time. Numerous encryption techniques have been used to address these issues and safeguard data from any malicious attempts and assaults. A substitution box (S-box) is the basic component for modern block ciphers, which helps to ensure robust security of plain data while encryption and permits its lawful decipherment. The goal of this paper is to recommend an effective, original, and straightforward technique for the creation of robust S-boxes. A sample S-box is generated in the proposed work using the word "UNITY" but other words can also be used to generate many powerful S-boxes. The ASCII code is used to translate the word "UNITY" into binary form, after which a distinct matrix is constructed for each character of the word. In the next phase, a linear fractional transformation is constructed using these matrices, which is then utilized to generate the S-box. The constructed S-box was then evaluated against typical security standards to support its high cryptographic authority. The generated S-box's statistical and algebraic resilience is demonstrated by its very low linear probability and differential probability scores of 0.125 and 0.039, respectively, and a high non-linearity score of 111.5. To evaluate the effectiveness of the image encryption scheme, digital images are encoded using the created S-box. The performance and comparative research demonstrate that the suggested S-box is a real candidate for applications in the field of image encryption and has a stronger performance base.

Conserved Domains in Variable Surface Lipoproteins A-G of Mycoplasma hyorhinis May Serve as Probable Multi-Epitope Candidate Vaccine: Computational Reverse Vaccinology Approach.

Mycoplasma hyorhinis (M. hyorhinis) is responsible for infections in the swine population. Such infections are usually cured by using antimicrobials and lead to develop resistance. Until now, there has been no effective vaccine to eradicate the disease. This study used conserved domains found in seven members of the variable lipoprotein (VlpA-G) family in order to design a multi-epitope candidate vaccine (MEV) against M. hyorhinis. The immunoinformatics approach was followed to predict epitopes, and a vaccine construct consisting of an adjuvant, two B cell epitopes, two HTL epitopes, and one CTL epitope was designed. The suitability of the vaccine construct was identified by its non-allergen, non-toxic, and antigenic nature. A molecular dynamic simulation was executed to assess the stability of the TLR2 docked structure. An immune simulation showed a high immune response toward the antigen. The protein sequence was reverse-translated, and codons were optimized to gain a high expression level in E. coli. The proposed vaccine construct may be a candidate for a multi-epitope vaccine. Experimental validation is required in future to test the safety and efficacy of the hypothetical candidate vaccine.

Design and Assessment of a Novel In Silico Approach for Developing a Next-Generation Multi-Epitope Universal Vaccine Targeting Coronaviruses.

In the past two decades, there have been three coronavirus outbreaks that have caused significant economic and health crises. Biologists predict that more coronaviruses may emerge in the near future. Therefore, it is crucial to develop preventive vaccines that can effectively combat multiple coronaviruses. In this study, we employed computational approaches to analyze genetically related coronaviruses, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its variants, focusing on the spike glycoprotein as a potential vaccine candidate. By predicting common epitopes, we identified the top epitopes and combined them to create a multi-epitope candidate vaccine. The overall quality of the candidate vaccine was validated through in silico analyses, confirming its antigenicity, immunogenicity, and stability. In silico docking and simulation studies suggested a stable interaction between the multi-epitope candidate vaccine and human toll-like receptor 2 (TLR2). In silico codon optimization and cloning were used to further explore the successful expression of the designed candidate vaccine in a prokaryotic expression system. Based on computational analysis, the designed candidate vaccine was found to be stable and non-allergenic in the human body. The efficiency of the multi-epitope vaccine in triggering effective cellular and humoral immune responses was assessed through immune stimulation, demonstrating that the designed candidate vaccine can elicit specific immune responses against multiple coronaviruses. Therefore, it holds promise as a potential candidate vaccine against existing and future coronaviruses.

Attitude and Acceptance towards COVID-19 Booster Doses among Literacy Advantaged Population in Pakistan: A Cross-Sectional Study.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has affected billions of lives and is expected to impose a significant burden on the economy worldwide. Vaccination is the only way to prevent the infection. However, convincing people to get themselves vaccinated is challenging in developing countries such as Pakistan. Therefore, a cross-sectional questionnaire-based study was conducted (n = 982 participants) all over Pakistan to evaluate the perception, knowledge, attitude, and acceptance of the general public towards the SARS-CoV-2 vaccine, in general, and a booster dose of SARS-CoV-2, in particular. The highest number of participants were from the province of Punjab (84.5%), followed by Islamabad (3.8%), Sindh (3.7%), Khyber Pakhtunkhwa (2.7%), Baluchistan (2.6%), Gilgit Baltistan (1.4%), and Azad Jammu and Kashmir (1.4%). A total of 915 participants were vaccinated against COVID-19, out of which 62.2% received one booster dose, followed by double booster doses (25.5%) and single vaccine shots (12.3%). The highest number of vaccinated participants were from Punjab (85.8%), followed by Islamabad (3.9%), Sindh (2.8%); Khyber Pakhtunkhwa (2.6%); Baluchistan (2.3%); Gilgit-Baltistan (1.3%); and Azad, Jammu, and Kashmir (1.2%). Among the vaccinated individuals, 71.4% were unemployed, 27.4% were employed (653), and 1.2% were retired from service. However, no significant association was observed among genders and educational levels in regard to acceptance of the booster vaccine. The outcomes of the study revealed that the increased acceptance of booster doses of the SARS-CoV-2 vaccines among the public was associated with the intent of personal and family protection. Moreover, individuals with low socioeconomic status and pregnant females showed the least acceptance towards the vaccine inoculation. The study also revealed a decline trend of accepting SARS-CoV-2 vaccine among children.

Impact of an educational program on community pharmacist's preparedness to conduct pharmacist-led diabetes clinic in Saudi Arabia.

BACKGROUND: Demand for diabetes care and prevention has increased due to Saudi Arabia's high prevalence of diabetes mellitus and its insufficient treatment. This raised awareness of the significance of community pharmacists in Saudi Arabia, who may significantly improve diabetes treatment by setting up pharmacist-led diabetic clinics. Thus, to assess community pharmacists' readiness to lead diabetes clinics in Saudi Arabia, this study evaluated the usefulness of an educational session on diabetes care. METHOD: The preparation of community pharmacists for diabetes treatment and management was assessed using a validated diabetes-specific questionnaire. An engaging and thorough diabetes education class was presented by two licensed diabetes educators. One-way ANOVA, chi-square, and the Mann-Whitney U-test were used to statistically assess the pre- and post-knowledge and attitude scores of community pharmacists. RESULTS: Following a learning session, the community pharmacists had a significant increase in understanding oral hypoglycemic medicines, monitoring the disease's course, and dosing of insulin for diabetics (p = 0.01). Additionally, the community pharmacist's perspective and attitude score on managing diabetes increased from 49.74 to 52.74 (p = 0.01). CONCLUSION: The study's findings demonstrated a marked improvement in community pharmacist's knowledge of and attitude toward running pharmacist-led diabetic clinics following a session on diabetes education in collaboration with the Pharmacy College. The study's findings also emphasized the significance of developing a structured programme for diabetes education in Saudi Arabia to address the demands of community pharmacists in terms of professional development.

Prevalence, types and disclosure of complementary and alternative medicine (CAM) use among chronic kidney disease (CKD) patients in Saudi Arabia.

INTRODUCTION: Despite the paucity of scientific evidence, CAM is widely used for the prevention and treatment of illness among patients with chronic kidney disease, including end-stage renal disease and kidney transplant recipients. It is evident that the irrational use of CAM among CKD patients and its non-disclosure to healthcare providers could lead to adverse drug events. Hence, the current study was conducted to evaluate the prevalence, types, and non-disclosure of CAM use among CKD patients and kidney transplant recipients in Saudi Arabia. METHODS: A cross-sectional study was conducted on 170 CKD patients (121 with stages 3 and 4, two with stage 5 and on hemodialysis, and 47 kidney transplant recipients). Face-to-face questionnaire-based interviews were conducted employing a convenience sampling technique. The study outcomes were the prevalence of CAM, types of CAM use, monthly expenditure on CAM, the source of information about CAM, and CAM disclosure to healthcare providers. A p-value of < 0.05 was considered significant. RESULTS: The study found that out of 170, 60 (35.3%) CKD patients use CAM. The most used CAM was Acacia gum (49, 81.6%) followed by spiritual therapies (34, 56.6%). Female CKD patients had higher use of CAM compared to the male gender (p = 0.015). The monthly expenditures that most users (47, 78.3%) spent on CAM were less than 50 Saudi Riyals (SR). The study results also showed that 55% of CKD patients did not report their CAM use to their physicians. Furthermore, 46.6% of CAM users discontinue their use of CAM after observing no benefit. CONCLUSION: This study reported relatively high use of CAM among CKD patients in Saudi Arabia. The study found that most CKD patients use Acacia gum and spiritual therapies and do not disclose the use of CAM to healthcare professionals, which could lead to adverse drug events. Therefore, the study recommends that healthcare providers should inquire and provide evidence-based counselling about the use of CAM to CKD patients to prevent any adverse drug event or unwanted effect on the renal function of the patients.

Metformin use among obese patients with prediabetes in Qassim, Saudi Arabia: An observational study.

Background and aims: The high prevalence of prediabetes and diabetes mellitus and its secondary complications in Saudi Arabia is a major healthcare concern. Evidence suggests that despite evidence-based efficacy and safety, metformin is underutilized in prediabetic obese patients. Thus, the aim of this study was to investigate the use of metformin in prediabetic obese patients in the Qassim region of Saudi Arabia. Methods: Prediabetic patients' electronic health records were accessed and screened from 2017 to 2021. The inclusion criteria were patients with obesity (BMI ≥ 35) diagnosed with prediabetes, and who received metformin. Patients with chronic kidney disease and those using metformin for other diseases were excluded. The first major endpoint of this study was the rate of metformin use among obese, prediabetic individuals. The second major endpoint was the factors associated with metformin prescribing in our cohort. Descriptive statistics were used to report the primary and secondary outcomes. Data are presented as percentages, means, standard deviations (SDs), medians, and interquartile ranges, as appropriate. All analyses were conducted using Stata version 16.1. Results: A total of 304 prediabetic patients were included in this study after screening the records of 1,789 patients. The average age was found to be 40, and the majority were female (72%). The average BMI was found to be 39.4 kg/m2, while the average HbA1c was 5.8%. In the entire sample, only 25 (8.22%) obese patients received metformin for diabetes prevention. Among obese patients with a BMI ≥ 30, 19 patients (8.7%) received metformin. Metformin users had higher odds of being on statins (OR 2.72, 95% CI 1.01 to 7.36; p = 0.049). Conclusion: According to the study, metformin is not frequently prescribed to prediabetic obese individuals in the Qassim region of Saudi Arabia. This prevention strategy is a missed opportunity in the management of prediabetes in high-risk patients. Future studies are needed to investigate the root causes of the underuse of metformin and potential interventions to promote evidence-based practice in Saudi Arabia.