Community pharmacists are expected to have the necessary knowledge to give advice on safe and appropriate drug use during self-medication. However, the profession of pharmacist in Yemen has become less trustworthy and less reliable. In addition, quality of medication has been raising a lot of questions among consumers and fake medications have been entering the country without quality control checks. The aim of this study was to determine the consumer perception of health care services provided and its impact on self-medication practice in Sana’a city, Yemen. A self-administered questionnaire containing open-ended and closed-ended questions was developed and distributed among 400 consumers attending 10 community pharmacies in Sana’a City. All data obtained from the questionnaires were coded, entered, and analysed using Chi-square test and multiple logistic regressions. Prevalence of self-medication was found to be 90.7 %. The majority of respondents stated that they do not trust the health care services provided by physician (68.8%), community drug dispensers (78.2%), Ministry of Health (70.5%) or the quality of medicine dispensed by community pharmacies (59.7%). The trust of health care services provided by physicians and community drug dispensers were found to be significant predictors of self-medication practice. Those who did not trust health care services provided by physicians were more likely to use self-medication compared to those who did not (OR= 21.212, CI 95% 2.678-168.001, p= 0.004). Those who did not trust health care services provided by community drug dispensers were more likely to use self-medication compared to those who did not (OR= 2.746, CI 95% 1.048-7.195, p= 0.04). Consumers in Sana’a City have a negative overall perception of the services provided by community drug dispensers, physician and Ministry of Health and the quality of medication. An urgent intervention from health care authorities to adopt and to implement a new national drug policy with necessary laws and regulations is needed
Self-medication ; Trust ; Health Care Providers ; Community Pharmacy consumers ; Sana&rsquo ; a City ; Yemen

To assess the antidiabetic effect of Opuntia dillenii seed oil on rats with diabetes mellitus. Methods: A rat diabetes model was established by intraperitoneal injection of rats with 50 mg/kg streptozotocin. Thirty albino Wistar rats were divided into five groups: the diabetic control group and normal control group were treated only with distilled water, two diabetic groups received 1 and 2 mL/kg of oil per day, respectively, for 30 days and one diabetic group received 2 mg/kg of glibenclamide. In addition, blood glucose was determined weekly. Body weight, average daily food, water intake and urinary volume of each animal were determined before and after the treatment period. After the treatment period, hepatic glycogen was determined using the anthrone reagent, and glycosuria, total cholesterol, triglycerides, alanine aminotransferase, aspartate aminotransferase, urea, creatinine and uric acid were estimated using common clinical diagnostic kits. Results: Oral intake of the oil at 1 and 2 mL/kg for the diabetic animals significantly diminished blood glucose, glycosuria, total cholesterol, triglycerides, alanine aminotransferase, aspartate aminotransferase, urea, creatinine and uric acid, accompanied by a noticeable elevation in the amount of hepatic glycogen in comparison with the diabetic control group. Similarly, Opuntia dillenii seed oil significantly increased the food intake and decreased the urinary volume per day in treated rats of the same groups in comparison with the period before the treatment intervention and attenuated body weight loss in the diabetic rats. Moreover, this effect of the oil was dose dependent. On the other hand, the oil did not affect their need for water. Conclusions: The results show that Opuntia dillenii seed oil has a very important antidiabetic effect on streptozotocin-induced diabetic rats. Hence, we suggest it as a preventive control of diabetes mellitus.

BACKGROUND: The principal goal of this study was to determine the importance of high-sensitivity troponin T (hs-TnT) and creatine kinase MB isoenzyme (CK-MB) in predicting cardiovascular events in asymptomatic end-stage renal disease (ESRD) patients. METHODS: This study included 110 participants; 54 ESRD patients undergoing hemodialysis and 56 healthy control participants. Biochemical parameters and cardiac markers were estimated. Comparative utilities were assessed through logistic regression and receiver operating characteristic (ROC) analyses. RESULTS: We found that 96.3% of ESRD patients had an elevated level of hs-TnT (mean, 0.049 ± 0.0324 μg/L) compared to healthy participants. Among patients with ESRD, hs-TnT showed significant correlations with the low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (HDL-C) (P = 0.042, r = 0.278) and total cholesterol/HDL-C (P = 0.044, r = 0.276) ratios. CK-MB (odds ratio [OR], 1.138; P = 0.04) and hs-TnT (OR, 2.153; P = 0.017) predicted cardiovascular events on logistic regression analysis, and the prediction was improved by the model that combined two cardiac markers. The diagnostic performance of hs-TnT and CK-MB alone and the combination of the two biomarkers was assessed by the area under the ROC curve (AUC). The highest AUC was produced by the combination of hs-TnT and CK-MB markers (0.920) compared to hs-TnT or CK-MB alone. CONCLUSION: In asymptomatic patients with ESRD, hs-TnT appeared to be an important predictor for cardiovascular mortality, and its diagnostic accuracy improved with CK-MB. This study provides new insights into the predictive value of multiple biomarkers for identifying cardiovascular events in ESRD patients on hemodialysis.
Area Under Curve ; Biomarkers ; Cardiovascular Diseases ; Cholesterol ; Creatine Kinase* ; Creatine* ; Healthy Volunteers ; Humans ; Kidney Failure, Chronic* ; Lipoproteins ; Logistic Models ; Mortality ; Renal Dialysis ; ROC Curve ; Troponin T* ; Troponin*

Objective: To investigate the hepatoprotective effect of Opuntia dillenii seed oil (ODSO) on CCl4 provoked liver injury in rat. Methods: Animals were treated orally with ODSO at a concentration of 2 mL/kg, once daily for one week before the first intraperitoneal injection of CCl4, and thereafter the administration of the oil was continued for 7 days until the introduction of the second injection of CCl4. Fourteen hours after the last dose of CCl4, rats were sacrificed, and the relative liver weight, weight gain, alkaline phosphatase, aspartate amino transferase, alanine aminotransferase, direct bilirubin, total bilirubin, triglycerides, total cholesterol, very low density lipoprotein, low density lipoprotein, high density lipoprotein, plasmatic glucose, urea, creatinine, acid uric and malondialdehyde were determined. Results: The significant increase was found in relative liver weight and plasma levels of alanine aminotransferase, aspartate amino transferase, alkaline phosphatase, total bilirubin, direct bilirubin, triglycerides, very low-density lipoprotein, urea, uric acid and malondialdehyde. Likewise, the significant decrease was indicated in the weight gain and the level of glucose plasmatic, and high-density lipoprotein levels in CCl4 produced liver injury in rats were re-established to normal levels when treated with ODSO.While, no change was observed in the total cholesterol, low-density lipoprotein and creatinine in all animals. Conclusions: We conclude that the ODSO has a protective effect on CCl4-mediated liver injury. Hence, we suggest its inclusion as a preventive control of liver disorders.

The current study aimed to determine the effect of silver and chitosan nanoparticles of size 10 to 30 nm on the dead of lice in vitro and in vivo to determine the optimal time and concentration to combat chicken lice. 100 local chickens Gallus gallus domesticus were collected from Al-Diwaniyah province and 6 species of local chicken lice were isolated: Menacanthus stramineus, Menacanthus pallidullus, Menacanthus cornutus, Goniodes gigas, Cuclotogaster heterographus and Bonomiella columbae. The results of treating lice with chitosan and silver nanoparticles at concentrations (40, 60, and 80) mg/mL in vitro and at different periods (5, 10, 15, and 30) minutes after treatment showed that chitosan and silver nanoparticles at a concentration of 80 mg/mL are the most effective in killing lice. The dead rate of lice reached 100% after 15 minutes of treatment with chitosan nanoparticles and 100% in the case of silver nanoparticles after 30 minutes. The results of spraying chitosan and silver nanoparticles on the body of chickens infected with lice experimentally, based on the relative therapeutic efficacy within 30 minutes, indicated that silver nanoparticles were the most effective in completely killing lice in the group treated with a concentration of 80 mg/kg after 30 minutes, where the percentage of therapeutic efficacy was 96.7%. This was followed by chitosan nanoparticles at a concentration of 80 mg/kg, and the percentage of therapeutic efficiency was 91.5%. Chitosan and silver nanocomposite have a promising effect in the elimination of lice infestation in chickens.

Objective: To evaluate the in vitro antioxidant power of cactus pear seed oil [. Opuntia ficus-indica L. MILL. (CPSO)] and its protective effect against chemically induced diabetes mellitus in mice. Methods: The in vitro antioxidant effect of CPSO was evaluated using 2,2-diphenyl-1-picrylhydrazyl (DPPH) scavenging assay. The preventive effect was conducted on Swiss albino mice treated with CPSO (2 mL/kg, per os), before and after a single intraperitoneal alloxan administration (100 mg/kg). Survival rate, body weight and fasting blood glucose were measured and histopathological analysis of pancreas was performed to evaluate alloxan-induced tissue injuries. Results: CPSO exhibited an antioxidant effect in DPPH scavenging assay. Moreover, the administration of CPSO (2 mL/kg) significantly attenuated alloxan-induced death and hyperglycemia (P < 0.001) in treated mice. Morphometric study of pancreas revealed that CPSO significantly protected islets of langerhans against alloxan induced-tissue alterations. Conclusions: Based on theses results, CPSO can prevente alloxan-induced-diabetes by quenching free radicals produced by alloxan and inhibiting tissue injuries in pancreatic β-cells.

Aims: Antibiotic resistance in Staphylococcus pseudintermedius is increasing gradually towards those antibiotics that are frequently used leading to limited therapeutic options due to multidrug resistance. The objectives of the study were to investigate the antibiotic resistance profiles of S. pseudintermedius isolates from pet and stray dogs and cats in Selangor, Malaysia and to detect the resistance genes (mecA and BlaZ) within the isolates. Methodology and results: A total of 200 stray and pet dogs and cats were sampled. The samples were cultured onto Mannitol Salt agar and all the presumptive colonies were subcultured, then identified using biochemical tests and confirmed by PCR assay targeting the nuc gene. The isolates were subjected to antibiotic susceptibility test against 12 antibiotics. Twenty three isolates (11.5%) were positive to S. pseudintermedius (stray cats, 11/50; stray dogs, 9/50; pet dogs, 3/50 and pet cats, 0/50). One hundred percent (100%) of the S. pseudintermedius isolates were found to be resistant to penicillin, erythromycin and tetracycline while they showed 100% susceptible to oxacillin, amoxicillinclavulanic acid, gentamicin, chloramphenicol, vancomycin, ciprofloxacin, enrofloxacin, cephalexin and rifampicin. The blaZ gene which codes for β-lactamases production was found in all of the isolates that were resistant to penicillin but not to methicillin. Conclusion, significance and impact of study: A high number of S. pseudintermedius from dogs and cats developed antibiotic resistance which is a public health concern.

BACKGROUND: Targeted therapy has revolutionized the management of Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL); however, relapse still occurs because of the presence of quiescent stem cells, termed leukemia propagating cells (LPCs). This study aimed to assess the phenotypic diversity of LPCs in adult patients with Ph+ B-Acute ALL (B-ALL) and to assess its prognostic impact. METHODS: Seventy adults with newly diagnosed Ph+ B-ALL were recruited at the Mansoura Oncology Center. Multiparameter flow cytometry studies of mononuclear blast cells for cluster of differentiation (CD)34, CD38, and CD58 were performed. RESULTS: Seventeen patients had blasts with the pattern of LPCs (CD34+CD38−CD58−), while 53 cases had other diverse phenotypic patterns. The rate of complete response was significantly lower in patients with the LPC phenotype (47% vs. 81%, P=0.006). The median time to achieve a complete response was prolonged in patients with the CD34+CD38−CD58− phenotype (48 vs. 32 days, P=0.016). The three-year overall survival was significantly lower in patients with the CD34+CD38−CD58− phenotype (37% vs. 55% respectively, P=0.028). Multivariate analysis showed that the CD34+CD38− CD58− phenotype was an independent risk factor for overall survival. CONCLUSION: The presence of CD34+CD38−CD58− LPCs at diagnosis allows rapid identification of higher risk patients. Risk stratification of these patients is needed to further guide therapy and develop effective LPCs-targeted therapy to improve treatment outcome.
Adult ; Diagnosis ; Flow Cytometry ; Humans ; Leukemia* ; Multipotent Stem Cells ; Multivariate Analysis ; Phenotype* ; Philadelphia Chromosome ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Prognosis* ; Recurrence ; Risk Factors ; Stem Cells ; Treatment Outcome

Musculoskeletal disorders (MSDs) represent a significant occupational problem. Only limited research is available about the impact of MSD on the active Calligraphers. Uncertainty remains about MSD prevalence and associated factors among Arabic calligraphers in Saudi Arabia. A cross-sectional study was conducted among 124 Arabic calligraphers in Saudi Arabia. Data were collected by telephonic interviews using a structured questionnaire that consisted of the validated Standardized Nordic Questionnaire, socio-demographics and working characteristics. A total of 124 completed questionnaires were analyzed. The majority were men (96.8 %), worked for less than 10 hours/week (63.7%). The majority had musculoskeletal pain (59.7%) and about half of them worked for less than 15 years. The most commonly reported MSD was back pain (26.6%) followed by neck pain (21.0%) and shoulder pain (12.1%). In multiple logistic regression the significant predictors in the model were: not exercising (OR=7.1, 95% CI 2.6-19.2), age ≤40 (OR=2.8, 95% CI 1.1- 7.3), worked for ≤20 years (OR=3.4, 95% CI 1.3 -9.1) and being a professional calligrapher (OR=2.3, 95% CI 1.1 – 6.2). The total model is significant (p<0.001) and the adjusted r square= 0.37.MSDs among Arabic calligraphers in Saudi Arabia is relatively high; further clinical assessment is needed. We recommend that health authority in Saudi Arabia should increase the awareness among calligraphers about MSDs and its prevention.
Musculoskeletal disorders ; calligraphers ; Saudi Arabia

Aims:Campylobacter infection is one of the leading bacterial food-borne illness and most frequently reported in humans in developed countries. This study was designed to determine the prevalence of multidrug resistant (MDR) Campylobacterand the risk factors associated with their occurrence in broiler chicken meat retailed in markets. Methodology and results:A total of 210 samples consisting of 140 chicken meat and 70 swabs from weighing scales and cutting boards were collected. Isolates were cultured by passive filtration method, identified by biochemical tests and confirmed using PCR assay.Thirty-two(32/210) 15.2% were positive for Campylobacterof which (25/210) 11.9%, (6/210) 2.9% and (1/210) 0.5% were Campylobacter jejuni, C.coli andC.upsaliensis respectively. The isolates showed high resistance to ampicillin (62.5%), enrofloxacin (56.3%) and nalidixic acid (50.0%), while only 3.1% were resistant to streptomycin. Multidrug resistant isolates (resistance to at least one antibiotics in three classes or more) was high at 71.9%. The risk factors significantly (p<0.05) associated with Campylobactercontamination on chicken’smeat included poor workers hygiene {OR: 5.250 (95% CI: 0.988-27.895)}, wearing improper work attire {OR: 2.700 (95% CI: 1.144-6.374)}, poor protective equipment {OR 38.50 (95% CI: 2.915-508.463)}, poor environment/stall hygiene {OR 44.00 (95% CI: 2.193-882.66)}, and using tiled counter top surface {OR 6.667 (95% CI: 0.597-74.506). Conclusion, significance and impact of study:The finding of this study affirmed that lack or poor work hygiene, unclean environmental stall and protective equipment are associated with high occurrence of multidrug resistant Campylobacterspecies isolated from chicken meat