Jordanian Use of and Beliefs Concerning the Efficacy of Medicinal Plants: A Cross-Sectional Study.

Background: Medicinal herbs are incorrectly believed to be free of risks and are commonly used for self-medication without medical supervision. Jordan does not currently have a national policy on traditional medicine (TM) and/or complementary/alternative medicine (CAM). The present study aims to explore the use of and beliefs about the efficacy of medicinal plants among the Jordanian population. Method: A cross-sectional study was conducted using a self-administrated questionnaire for the duration between April and June 2019. Multiple linear regression analysis was used to identify predictors of positive attitudes towards the use of medicinal plants. Results: A total of 1,057 individuals participated in the study. The participants in our study showed a positive attitude towards the use of medicinal plants and herbs (median score of 33.0 (interquartile range (IQR): 26.0-37.0; equals 68.8% of the maximum total score), and believed in alternative therapies other than chemical drugs for disease treatment, mainly using medicinal herbs and plants. The majority of the participants (77.8% (n = 822)) believe in the efficacy of the use of medicinal herbs and plants and are aware (64.6 % (n = 683)) of the correct and proper way of using these plants and herbs. Pharmacists and herbalist are the main sources of information for the proper use of medicinal herbs and plants. Age was the main predictor of positive attitudes towards the use of medicinal plants and herbs (P<0.001). Conclusion: Efforts must be made to regulate the dispensing of these products, to educate health service providers and to raise consumer awareness.

Hospital admissions due to vasomotor and allergic rhinitis in England and Wales between 1999 and 2019: an ecological study.

BACKGROUND: Allergic rhinitis is among the most prevalent chronic disorders in high-income countries. Its estimated cost is €30-€50 billion annually in the European Union and in the UK, it is approximately €1.8 billion per year. AIM: To study hospital admissions for vasomotor and allergic rhinitis in England and Wales during the past 20 years. METHOD: This was an ecological study using publicly available data extracted from the Hospital Episode Statistics (HES) database in England and the Patient Episode Database for Wales (PEDW). The trend in hospital admissions was assessed using a Poisson model. RESULTS: Admission rate increased by 2.14-fold [from 2.59 (95% CI 2.46-2.73) in 1999 to 8.16 (95% CI 7.93-8.39) in 2020 per 100,000 persons, trend test, p < 001]. The most prevalent hospital admission reasons were allergic rhinitis due to pollen, other allergic rhinitis, and unspecified allergic rhinitis, which accounted for 56.4%, 22.3%, and 15.7%, respectively. The age group 15-59 years accounted for 69.5% of the total number of admissions. Admission rate between males increased by 2.25-fold. Admission rate between females increased by 2.02-fold. CONCLUSION: Vasomotor and allergic rhinitis are common cause of hospital admissions in England and Wales that showed a clear increase in the rate of their admissions in the past 20 years. Allergic rhinitis due to pollen was the most dominant cause of admission, which warrants further investigation to identify its preventable risk factors and decrease the probability of the exacerbation of patients' cases and the need for hospitalization.

Visual health and prevalence of dry eye syndrome among university students in Iraq and Jordan.

Dry eye syndrome (DES), is a multifactorial disease that affects the ocular surface and contributes to the ocular symptoms. The COVID-19 pandemic influenced the general population and university students' health in different ways. The pandemic forced many people including university students around the world to use virtual platforms on their digital devices, such as computers and smartphones, to work from a distance. This study aimed to explore the visual health and prevalence of dry eye syndrome among university students in Iraq and Jordan. This was a cross-sectional study that was conducted in Iraq and Jordan using online questionnaire tool for the duration between November 2021 and January 2022. University students in Jordan and Iraq were invited to participate in this study and formed the study population. No restrictions on study level or field of study were applied. A previously developed and validated questionnaire tools were used in this study (National Eye Institute Visual Functioning Questionnaire - 25 (VFQ-25) and the Women's Health Study Questionnaire (WHS), which was developed by Schaumberg et al.). A total of 1,431 university students were involved in this study (1,018 students from Iraq, 71.1%). Around one third the study participants (29.0%) reported that have been diagnosed by a clinician as having dry eye syndrome. Around15.3% of the total study participants reported that they feel their eyes are dry (not wet enough) and 17.3% reported that they feel their eyes are irritated. Based on Women's Health Study Questionnaire (WHS) criteria, a total of 479 participants (33.4%) are symptomatically diagnosed with DES. Students aged 27-29 years, those at their fifth year of study, and those who wear contact lenses are at higher risk of developing DYS compared to others. Dry eye syndrome is common health problem among university students. Further studies are required to identify other risk factors associated with DES. Future research should focus on identifying strategies that could help reduce the risk of developing DES as a result of the inevitability of long-term use of digital devices among many categories of society, including university students.

Hospital admissions due to infectious and parasitic diseases in England and Wales between 1999 and 2019: an ecological study.

BACKGROUND: Infectious diseases continue to account for considerable illness and death worldwide, and emerging infectious diseases (EIDs) are a significant burden on global economies and public health. This study aimed to investigate the trends in infectious and parasitic disease (IPD) hospital admissions (HA) in England and Wales between 1999 and 2019. METHODS: This is an ecological study using publicly available data taken from the Hospital Episode Statistics database in England and the Patient Episode Database for Wales. Hospital admission data were collected for the period between April 1999 to March 2019. IPDHA were identified using the tenth version of the International Statistical Classification of Diseases system, diagnostic codes (A00-B99). The trend in hospital admissions was assessed using a Poisson model. RESULTS: The overall annual number for IPD hospital admissions for various causes increased by 412.9%, from 151,336 in 1999 to 776,215 in 2019, representing an increase in hospital admission rate of 349.9% from 290.25 (95% CI 288.79-291.71) in 1999 to 1305.88 (95% CI 1303.00-1308.77) in 2019 per 100,000 persons: trend test, p < 0.01. The most common causes of infectious and parasitic disease hospital admissions were intestinal infectious diseases, other bacterial diseases, and other viral diseases, which accounted for 33.6, 27.5, and 23.8%, respectively. Patients aged 15 years and below accounted for 34.2% of the entire number of IPD hospital admissions, followed by the age group 15-59 years with 27.9%, the age group 75 years and above with 22.7%, and then the age group 60-74 years with 15.2%. CONCLUSION: There was an increase in the hospital admission rate due to infectious diseases in the UK from 1999 to 2019. The most common causes of infectious and parasitic disease hospital admissions were intestinal infectious diseases, other bacterial diseases, and other viral diseases.

Lichen Planus Eruption Following Oxford-AstraZeneca COVID-19 Vaccine Administration: A Case Report and Review of Literature.

Lichen planus is an autoimmune inflammatory disease that can be associated with infections, drugs, and vaccines. Recently, it has been reported to occur following mRNA-based COVID-19 vaccines, particularly the Pfizer/BioNTech vaccine. We present the first reported case of lichen planus that developed after five days following the administration of the first dose of the Oxford-AstraZeneca vaccine in a 46-year-old healthy male. The skin eruption was purple, ill-defined, non-scaly, itchy, and distributed over his face, abdomen, back, and legs. The clinical appearance of the skin eruption and histopathology confirmed the diagnosis of lichen planus. The skin lesions were not responding well to topical steroid and oral antihistamine treatment. Thus, the patient was commenced on systemic hydroxychloroquine. The mechanism of lichen planus development following the administration of COVID-19 vaccines is unclear and needs more investigations and explanations. Healthcare providers should be aware of this possible adverse reaction following the administration of different severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines. The histopathological features of lichen planus in our case are different from those found in the lichenoid drug eruption. This finding indicates different pathophysiology that needs further investigation.

Hospital Admission Trends Due to Viral Infections Characterised by Skin and Mucous Membrane Lesions in the Past Two Decades in England and Wales: An Ecological Study.

OBJECTIVES: This study aimed to investigate the trends in hospital admissions due to viral infections characterized by skin and mucous membrane lesions in England and Wales between 1999 and 2019. METHODS: This is an ecological study using publicly available databases in England and Wales; the Hospital Episode Statistics database in England and the Patient Episode Database for Wales. Hospital admissions data were collected for the period between April 1999 and March 2019. Hospital admissions due to viral infections characterized by skin and mucous membrane lesions were identified using the tenth version of the International Statistical Classification of Diseases system, diagnostic codes B00-B09. The trend in hospital admissions was assessed using a Poisson model. RESULTS: Hospital admissions for different causes increased by 51.9% (from 25.67 (95% CI 25.23-26.10) in 1999 to 38.98 (95% CI 38.48-39.48) in 2019 per 100,000 persons, trend test, p < 0.01). The most prevalent viral infections characterized by skin and mucous membrane lesions hospital admissions causes were zoster (herpes zoster), varicella (chickenpox), herpesviral (herpes simplex) infections, and viral warts, which accounted for 26.9%, 23.4%, 18.7%, and 17.6%, respectively. The age group below 15 years accounted for 43.2% of the total number of admissions. Females contributed to 50.5% of the total number of admissions. Hospital admission rate in males increased by 61.1% (from 25.21 (95% CI 24.59-25.82) in 1999 to 40.60 (95% CI 39.87-41.32) in 2019 per 100,000 persons). The increase in females was 43.2% (from 26.11 (95% CI 25.49-26.72) in 1999 to 37.40 (95% CI 36.70-38.09) in 2019 per 100,000 persons). CONCLUSION: Our study demonstrates an evident variation in hospital admission of viral infections characterized by skin and mucous membrane lesions based on age and gender. Efforts should be directed towards vaccinating high-risk groups, particularly the elderly and females. Moreover, efforts should be focused on vaccinating the young population against varicella, particularly females who are more susceptible to acquiring the infection. Further observational and epidemiological studies are needed to identify other factors associated with increased hospital admission rates.

The safety and efficacy of the use of oral anticoagulant medications in patients with diabetes mellitus: A systematic review.

AIMS: Diabetes mellitus (DM) and atrial fibrillation (AF) commonly co-exist. Oral anticoagulants (OACs) are widely used in patients with DM. This review aims to summarise the available literature on the safety (hypoglycaemia or bleeding) and efficacy (stroke or systemic embolism) of the use of OACs in patients with DM. METHODS: We searched the Medline, the Excerpta Medica dataBASE (Embase) and Cochrane databases up to the 10th of December 2020. The search strategy was conducted using both keywords and MeSH terms. We included randomised controlled trials (RCTs) and observational studies that reported on the safety and efficacy of the use of OACs in patients with diabetes from all age groups. Study selection, data extraction and quality assessment were conducted independently by two reviewers. RESULTS: A total of 3,976 articles were identified through the search process, of which seven studies met the inclusion criteria of the systematic review: four observational studies and three studies that were randomised controlled trials, with a total of 703,855 patients. Two observational studies reported that the use of warfarin was associated with a higher risk of hypoglycaemic events, specifically with sulfonylurea. One observational study and three randomised controlled trials reported that the use of warfarin compared to other oral anticoagulants was associated with a higher risk of bleeding. In addition, three randomised controlled trials reported that the use of warfarin compared to other oral anticoagulants was associated with a lower risk of stroke or systemic embolism. CONCLUSIONS: This systematic review found that DOACs had a better efficacy outcome and safer clinical outcomes in comparison to warfarin in patients with diabetes.