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العربية

Samar Thiab

Research

​​​​​​​​​​​​​​​​​Short-term side effects of COVID-19 vaccines: A cross-sectional study in Jordan

Authors : Razan I. Nassar, Dalal Alnatour, Samar Thiab, Ayman Nassar, Feras El-Hajji, Iman A. Basheti​

Abstract : The rapid manufacturing of vaccines has increased hesitancy toward receiving the COVID-19 vaccines. Clarifying what to expect after vaccination and revealing the possible side effects will lower hesitancy toward receiving the COVID-19 vaccine and increase public awareness. This descriptive cross-sectional survey-based study was conducted in Jordan (August 2021) to collect data on the short-term side effects following the COVID-19 vaccines. An extensive literature review was conducted by the research team to assist in developing the first draft of the survey. The survey was tested for face and content validity and piloted test to improve readability and clarity. The survey was organized into two sections (demographics and perceived COVID-19 vaccines’ side effects). Data were analyzed using the Statistical Package for Social Science (SPSS). A total of 1,044 participants were enrolled in the study. The most received vaccine among the participants was Pfizer-BioNTech (51.1%). The most frequently reported side effects were sore arm at the injection site (84.65%), fatigue (84.48%), discomfort (65.43%), muscles/joint pain (61.38%), drowsiness (58.73%), and headache (58.38%). More side effects were significantly associated with being older (p = 0.0​46), having an allergy (p = 0.024) or rheumatoid arthritis (p = 0.023), and participants who take NSAIDs regularly (p = 0.029). Short-term side effects of COVID-19 vaccines seem to be mostly local or transient in nature. Older age and certain comorbidities may increase susceptibility to side effects.

Keywords : COVID-19, pandemics, side effects, vaccine, immunization, Jordan

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​​​​​​​​Evaluation and molecular modelling of bis-Schiff base derivatives as potential leads for management of diabetes mellitus

Authors : ​Safa Daoud, Samar Thiab, Taghreed M. A. Jazzazi, Tareq M. A. Al-Shboul and Saeed Ullah

Abstract : Developing a medication to cure and manage diabetes mellitus complications is of interest in medicinal chemistry. Toward this end, six bis-biphenyl-salicylaldehyde Schiff base derivatives have been evaluated for their α-glucosidase inhibition, antiglycatio​​​n and anti-inflammation potentials. Four compounds (compounds 2–5) showed an excellent α-glucosidase inhibitory effect superior to that produced by acarbose. Additionally, the docking study revealed that these compounds are anchored within the binding pocket of α-glucosidase via hydrogen bonding, π-stacking and hydrophobic interactions, comparable to a high number of hydrogen bonding involved in anchoring acarbose. Interestingly, all tested compounds showed varying degrees of antiglycation activity with superior activity for two of them (compound 1 and compound 6) compared to the standard rutin. Moreover, the results indicated an outstanding anti-inflammatory activity for two compounds (compounds 1 and 6) compared to ibuprofen.

Keywords : bis-Schiff bases, diabetes mellitus, glycation, postprandial hyperglycemia, α-glucosidase, docking study

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​​​​​COVID-19 infected patients' experiences in Syria, and the role of the pharmacists during their infection

Authors : Razan I. Nassar, Samar Thiab, Kinda T. Alkoudsi, Iman A. Basheti​

Abstract : Background: Patients infected with coronavirus have new experiences and hence new needs from the healthcare sector. Acknowledging patients’ experiences can exhibit promising outcomes in coronavirus management. Pharmacists are considered a vital pillar in managing patients’ experiences during their infection. Objective: To assess the experience of individuals who have been infected with coronavirus and the roles played by pharmacists to meet their new needs. Methods: This descriptive cross-sectional survey was developed based on previous literature, validated, and conducted in Syria. The survey included ite​ms related to participants’ COVID-19 experiences, and items concerning the roles played by pharmacists when participants were infected. Items were tested for face validity. Data collection was conducted in May and June 2021. Data was analyzed using the Statistical Package for the Social Sciences (SPSS). Results: The study participants (n=576) had a mean age of 37.99 years. Fatigue was the most reported symptom by the participants. Vitamin C was the most used supplement (76.4%), and 66.5% of the participants used herbs during their infection. More than 60.0% of the participants stated that their anxiety and stress levels increased during their infection. Around 40.0% of the participants needed to Visit a specialist doctor. Only 5.4% needed to use an artificial respiration apparatus. The mean of the participants’ infection severity was 4.97 (SD=2.30) out of 10. The severity of the infection was significantly affected by being older, female, smoking, and having a chronic condition. Doctors followed by pharmacists were the healthcare providers who advised participants to take certain medications/herbs. More than one-third of the participants strongly agreed/agreed that the pharmacist played important and effective roles during their infection. Conclusion: Patients’ experiences indicated that fatigue was the most reported symptom by the participants diagnosed with coronavirus infection, while vitamin C was the most used supplement. Pharmacists have a major role in helping participants manage their infection and are considered a vital pillar in patients’ experiences since they provided patients with the needed medications.

Keywords : Coronavirus; COVID-19; Pandemics; Pharmacists; Patient experience; Syria

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​​​​​Medications and natural products used in Jordan for prevention or treatment of COVID-19 infection during the second wave of the pandemic: A cross-sectional online survey

Authors : ​Samar H.Thiab, Razan I.Nassar, SaraThiab, Iman A.Basheti

Abstract : Worldwide, during the COVID-19 pandemic in 2019, there was an increase in the tendency of misusing prescription drugs as well as self-medicating with over-the-counters. Additionally, an increase in the use of herbs and natural products was reported. A descriptive cross-sectional survey was conducted in Jordan from May 19th to July 29th, 2021, to assess the medications and natural products used in Jordan during the second wave of the pandemic. The survey was developed and validated, then distributed using Google Forms via social media platforms. Data was analyzed using Statistical Package for Social Sciences-24. The study participants (n = 386) had a mean age of 29.35 (SD = 11.90) years. Most of participants were females (72.8%), not married (64.5%), non-smoker (69.2%), have a Jordanian nationality (80.6%), hold a bachelor's degree (73.1%), and living in the middle of Jordan (74.1%). More than 70% of the participants used vitamin C, D and pain relievers. The most used natural products were citrus fruits (78.8%), honey (63.0%) and ginger (53.1%). The participants reported that family and friends (55.4%) played a major role in advising them to use medications and dietary supplements. Pharmacists ranked second (54.1%), followed by social media platforms (43.3%). Multiple logistic regression analysis highlighted that only the age significantly affected the participants’ use of medications and natural products (P < 0.001). The results of this study warrant the need of conducting awareness campaigns guided by trained healthcare providers to educate people and minimize the risk of side effects that may arise from unsupervised use of medications and natural products.

Keywords : COVID-19, Coronavirus, Medication, Supplement, Natural products, Jordan

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​​​​​Knowledge and Perception Regarding the Development and Acceptability of Male Contraceptives Among Pharmacists: A Mixed Sequential Method

Authors : ​Muna Barakat*, Samar Thiab*, Sara Thiab, Raja’a A. Al-Qudah, Amal Akour

Abstract : Community pharmacists play a crucial role in providing comprehensive patient education regarding contraception methods. This study aims to investigate Jordanian pharmacists’ knowledge and perceptions toward male oral contraceptive pills (OCPs). A mixed-explanatory sequential method was divided into two phases. The first was a self-administered electronic survey that was distributed to community pharmacists/trainees in Jorda​n. The second phase was carried out through online semi-structured in-depth interviews targeting the maximum variation purposive sample of community pharmacists. A total of 158 (response rate 98%) questionnaires were included in the analysis. The majority of the participants were female (n = 118, 74.2%). In terms of knowledge, only 25% of participants acknowledged the presence of male OCPs and almost half were uncertain about the mechanism of action and the possible uses. The findings of the interviews confirmed a relatively negative perception toward male OCPs and the identified barriers to male OCPs were cultural norms, side effects, and poor compliance. It is argued that there is a negative perception toward male OCPs due to the majority of pharmacists not believing such products will be successful in Jordan. Once these pills are approved for their effectiveness and safety, men may need further education and encouragement to take an active role in family planning along with their partners.

Keywords : contraceptive pills, males, Jordan, pharmacists

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​​​​​A systematic review of randomized controlled trials assessing phytochemicals and natural ingredients for skin and hair care

Authors : Samar Thiab, Nizar M. Mhaidat, May Abu Taha, Sarah Thiab, Somaya Koraysh, Reem Abutayeh, Iman Basheti​

Abstract : Cosmetics are marketed and used worldwide for various purposes. Several natural products are used for the development of cosmetic preparations. This paper systematically reviews randomized controlled trials (RCTs) investigating plant extracts, herbal preparations, and isolated plant-derived compounds used particularly for skin and hair care. Two independent electronic searches were conducted through PubMed and EMBASE to identify eligible RCTs. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was followed. Data extraction was performed independently by four authors based on standardized extraction forms. The risk of bias was assessed using the Cochrane Collaboration’s tool for assessing the risk of bias in randomized trials. Sixty-three RCTs were identified; 53 were using natural products for skin care and 10 for hair care. The results were summarized in tables including the population, type of intervention, comparisons with placebo or other natural products, outcomes reported, follow-up period (P: Patient, Population; I: Intervention; C: Comparison (or Control); O: Outcome; T: Time), and country in which the study was conducted. Ten plants were identified to be present in different locations in Jordan by referring to the Royal Botanic Gardens’ publication, titled “The Plants of Jordan: An Annotated Checklist.” Some plants were found to have promising findings requiring further investigations in bigger RCTs with robust design and adequate reporting.

Keywords : skin care, hair care, natural cosmetics, randomized controlled trials

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Pharmacists’ awareness of COVID‐19 and perceptions of their roles, barriers, and roles of policymakers: Exploring the Middle East and North Africa (MENA)

Authors : ​Iman A. Basheti, Feras El-hajji, Razan Nassar, Samar Thiab, Muna Barakat, Mariam Basheti, Alberto Berardi, Bandana Saini

Abstract : Background: The coronavirus infection (COVID-19) was declared in January 2020 as a public health emergency of international concern. The Middle East and North Africa (MENA), like other parts of the world, suffered from several epidemics over the years. Pharmacists have vital roles to play to prevent the spread of his virus. Objectives: To assess the awareness of COVID-19 amongst pharmacists from countries located in the MENA countries, and to assess their perspectives of their role, barriers, and roles of the educational institutions and pharmaceutical associations in preparing them for their roles during the pandemic. Methods: An online survey was conducted to run a descriptive cross-sectional study in Jordan from 12th to 22th April 2020. The questionnaire was validated and put on Facebook for pharmacists’ recruitment and assessment of their awareness (20 questions with a score out of 20) about epidemics/pandemics and COVID-19, their perceived roles and barriers, and roles of the educational institutions and pharmaceutical associations. Data were analyzed using Statistical Package for the Social Science (SPSS). Results: Study participants (n= 2589) had a mean age of 29.3 (8.2) years and 1329 (51.5%) were females. Most of the participants were from Egypt 819 (40.8%), Followed by Jordan, Algeria, and Syria. As for the sources of information about coronavirus treatment among the study participants, 60.8% got their information from the social media. Fear as a consequence was identified by the majority of participants (87.7%). The majority of pharmacists identified positive roles for the pharmaceutical association and pharmaceutical associations. Conclusion: Pharmacists from the MENA countries believe they got enough education previously about epidemics/pandemics, and the majority follow on the latest coronavirus updates from social media. Fear was reported as the major barrier that requires resolution by the policymakers. Certain gaps in the awareness about COVID-19 were identified.

Keywords : coronavirus; pandemics; pharmacists; educational institutions; Pharmaceutical association; Middle East; North Africa; MENA

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​​​​​Knowledge and beliefs about the use/abuse of oral contraceptive pills among males: A mixed-method explanatory sequential study in community pharmacy settings

Authors : Muna Barakat, Raja’a Al-Qudah, Amal Akour, Mona Abu-Asal, Samar Thiab, Yahya H. Dallal Bashi​

Abstract : Background: Oral contraceptive pills (OCPs) are considered one of the most important birth control methods globally. However, these pills were designed for female administration rather than males. This study was designed to investigate patterns of OCPs use and abuse among Jordanian males, according to the community pharmacists’ observations. Method: A mixed-method explanatory sequential study was conducted using an online self-administered survey, followed by semi-structured in-depth interviews for registered pharmacists, assistant pharmacists and pharmacy interns. The interviews were utilized using a conceptual framework. Inductive thematic analysis and descriptive/regression analyses were completed using Nvivo and SPSS, respectively. Results: A total of 158 questionnaire responses and 22 interviews were included in our analysis. Around half (48.4%) of the questionnaire responses confirmed that males could use OCPs for hair growth enhancement, muscle gain and acne treatment 12.7%, 31.7% and 4.4%, respectively. Through the interviews, the participating pharmacists highlighted that males use OCPs mostly for bodybuilding purposes, according to recommendations by their coaches at the gym. The most abused OCPs containing estrogen (Ethinyl estradiol) and progestins (Drospirenone or Levonorgestrel). Conclusion: This study provided insight into unexpected uses of OCPs by males in Jordan. Community pharmacists have a crucial role in the management of OCPs use and abuse. However, restricted regulations and monitoring must be released and implemented on the community to limit such practices.

Keywords : Abuse; community pharmacists; Jordan; males; oral contraceptive pills; OCPs

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The perception of Jordanian population towards concomitant administration of food, beverages and herbs with drugs and their possible interactions: A cross‐sectional study

Authors : ​Samar Thiab, Muna Barakat, Raja'a Al-Qudah, Rana Abutaima, Rahma Jamal, Philip Riby

Abstract : Background: Many people are used to administering their drugs with food, beverages, or herbs, which may contain chemicals that interfere with the prescribed drugs that could potentially lead to changes in their efficacy or safety and alteration in their pharmacokinetic properties. Objective: To assess the extent of perception and use of food, beverages and herbs alongside with conventional drugs and their potential interactions among Jordanian society. Methods: This descriptive cross-sectional survey was conducted in Jordan (20 April - 5 May 2020). The survey was developed using Google forms, validated and distributed via social media platforms. Data was analyzed using Statistical Package for Social Sciences-24. Main outcome measure Use and perception of food, beverages, herbs and their drug interactions among Jordanians. Results Of all participants (n = 789, 77.8 % were females, 46.2% were 50-year-old, 69.7% were married, 70.8%) were medically insured, and 51.1% had a bachelor’s degrees. Seventy percent of the study participants reported use of medicinal plants. About 66% of participants agreed that medicinal plants or herbs could treat diseases and 58.6% thought that medications could interact with drugs. In general, the participants’ knowledge about food/beverage/herb-drug interactions was considered poor. However, linear regression analysis illustrated that the level of knowledge was significantly affected (p-value <0.05) by gender, marital status, social status, the educational level, and employment sector. Conclusion Jordanians have a positive perception towards herbs and their ability to treat diseases. However, their knowledge about food/beverage-drug interactions was poor. This call needs to enhance the community awareness on food/beverage/herb-drug interactions.

Keywords : food, beverage, herbs, drug interaction, perception

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​​​​​The Use/Abuse of Oral Contraceptive Pills Among Males: A Mixed-Method Explanatory Sequential Study Over Jordanian Community Pharmacists

Authors : Muna Barakat, Amal Akour, Mona Abu-Asal, Samar Thiab, Yahya Dallal Bashi​

Abstract : Background: Oral contraceptive pills (OCPs) are considered one of the most important birth control methods in the world. However, these pills were designed for female administration rather than males. This study was designed to investigate patterns of OCPs use and abuse among Jordanian males, according to the community pharmacists9 observations. Method: A mixed-method explanatory sequential study was conducted using an online self-administered survey and semi-structured in-depth interviews for community pharmacists. The interviews were utilized using a conceptual framework. Inductive thematic analysis and descriptive/regression analyses were completed using Nvivo and SPSS, respectively. Results: A total of 158 questionnaire responses and 22 interviews were included in our analysis. Around half (48.4%) of the questionnaire responses confirmed that males could use OCPs for hair growth enhancement, muscle gain and acne treatment 12.7%, 31.7% and 4.4%, respectively. Through the interviews, the majority of the pharmacists highlighted that most of the males use OCPs for bodybuilding purposes, according to recommendations by their coaches at the gym. The most abused OCPs containing estrogen (Ethinyl estradiol) and progestins (Drospirenone or Levonorgestrel). Conclusion: This study provided insight into unexpected uses of OCPs by males in Jordan. Community pharmacists have a crucial role in the management of OCPs use and abuse, However, restricted regulations and monitoring must be released and implemented on the community to limit such practices.

Keywords : Abuse; community pharmacists; Jordan; males; oral contraceptive pills; OCPs

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​​​​​Perception of adults toward electronic cigarettes: a cross-sectional study from Jordan

Authors : Authors: Muna Barakat, Areej M Assaf, Samar Thiab, Manar Alhamed, Hala J Al-Obaidi, Feras J Jirjees, Iman Basheti​

Abstract : Introduction: The rate of Jordanian tobacco smokers has been reported to be one of the highest rates in the world. The electronic cigarette (E-cig) has become an option, or an alternative, to tobacco cigarette smoking. This study was aimed to measure the perception of Jordanian adults toward E-cig use. Methods: A cross-sectional study design was used. A self-administered survey was developed and validated to solicit anonymous responses from the study participants. A convenience sample (n = 984) was recruited electronically through social media platforms. Descriptive statistics and correlation analyses were completed using the Statistical Package for the Social Sciences (SPSS). Results: More than half of the participants (53%) were females, and almost all participants had heard about E-cig (99.2%), mainly from their friends (40%) and social media (34.5%). About half of the participants were nonsmokers and around one-third of them (33.1%) were current E-cig users. The majority of the participating E-cig users had replaced tobacco with E-cig (56.4%)/All the E-cig users reported positive beliefs toward the E-cig as a safer alternative for tobacco smoking. About 45% of participants believed that the E-cig is helpful in tobacco smoking cessation, but should be highly regulated. Conclusion: This study illustrated a significant prevalence of E-cig usage among Jordanian adults. E-cig users perceived E-cig as a safer and cheaper alternative to tobacco smoking and that it helps in tobacco smoking cessation. However, health awareness campaigns are needed for the entire Jordanian community about E-cig use, related emerging health findings, and how to promote tobacco smoking cessation.

Keywords : beliefs; Jordan; E-cigarettes; E-cig; knowledge; smoking.

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Pharmacists’ perceived barriers towards delivering their emergency roles during the COVID-19 pandemic and perceived policymakers’ responsibilities

Authors : Iman A. Basheti, Razan Nassar, Muna Barakat, Rajaa Alqudah, Rana Abu Farha, Tareq Muqatash, Samar Thiab & Bandana Saini​

Abstract : Rational: In March 2020, the World Health Organization (WHO) declared the coronavirus infectious disease as a pandemic referred to as COVID-19. As an essential service, community pharmacists have been enacting a key role in patient counseling and supply of essential medicines and protective equipment. Objectives: To investigate pharmacists’ perspectives of the role of educational institutes and professional pharmacy organizations in supporting them to take on roles during COVID-19 pandemic and to identify barriers to be able to support themselves and their patients. Methods: This descriptive mixed-method study was conducted via a cross-sectional online survey distributed to pharmacists/pharmacy students in Jordan during the COVID-19 outbreak (15–30 March 2020) using an online questionnaire, followed by an online focus group. Questionnaire items related to participants’ perspectives in being prepared for and supported in their roles during the COVID-19 pandemic, and items were tested for face validity. Data were descriptively analyzed using the Statistical Package for the Social Sciences and triangulated with focus group findings. Results: Considering that fear and anxiety are a consequence of mass social distancing/quarantine, study participants (n = 726, age = 26.9 (SD = 8.0) years, 71.9% females), reported needing training on mental healthcare to be able to support themselves and people during pandemics (90.2%). Most respondents agreed/strongly agreed (59.7%) with the statement around pharmacy educators/educational institutes having a key role in preparing pharmacists for practice during epidemics/pandemics and agreed that their faculties should add a course regarding pandemic preparedness in their curriculum (89.9%). Results were similar regarding roles for the pharmaceutical associations. Focus group findings (n = 7) mirrored the survey findings to a large extent. Conclusions: Most participants believed that pharmacy educators and pharmaceutical associations have a role in preparing them to deal with the COVID-19 pandemic through online educational workshops/webinars. Online education on mental healthcare is specifically needed.

Keywords : Coronavirus, Pandemics, Pharmacy educators, Educational institutes, Faculty of Pharmacy, Pharmaceutical association, Jordan

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​​​​​The development of analytical procedures using ICP-OES and ICP-MS for the analysis of trace metals in pharmaceutical formulations

Authors : Samar Thiab; Mark Wainwright; Philip Riby​

Abstract : New regulations regarding elemental impurities in pharmaceuticals will be implemented in January 2018 and the guidelines include the use of inductively coupled plasma optical emission spectroscopy (ICP-OES) and inductively coupled plasma mass spectrometry (ICP-MS). In this work, a method using each instrument was developed for the analysis of arsenic (As), cadmium (Cd), mercury (Hg), lead (Pb), cobalt (Co), nickel (Ni) and vanadium (V) and validated to meet the international conference of harmonisation (ICH Q3D) guidelines. Liquid and solid samples were prepared using microwave assisted acid digestion method that was developed using reverse aqua regia. The results obtained from the validation showed good linearity (R2>0.995) with low limits of detections (LODs) and limits of quantifications (LOQs). The percentage recoveries for both the standard reference material (SRM) and the spiked samples were between 95-105% with relative standard deviation (RSD) of less than 5. Cold symptoms relief products were purchased and analysed. Levels of Pb and Cd in certain products were found to exceed the permitted daily exposure limit (PDE) when the maximum dose was taken.

Keywords : Elemental impurities; ICP-OES; ICP-MS

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Effect of loratadine on the dissolution and bioavailability of gliclazide from its hydroxypropyl-β-cyclodextrin complex

Authors : Samar H Thiab, Imad I Hamdan, Dina El-Sabawi, Afaf H Al-Nadaf​

Abstract : Gliclazide (GZD) is a hypoglycemic agent that has slow dissolution rate and variable bioavailability. Inclusion complex of GZD with hydroxypropyl-β-cyclodextrin (HPβCD) was prepared with the molar ratio 1:2 by solvent evaporation method. The complex was characterized using Fourier transform infra-red spectroscopy and differential scanning calorimetry. Solubility and in vitro dissolution studies were performed at acidic and neutral pH values. Furthermore, the competitive interactions of the antihistamine loratadine (LOR) on the binding of GZD to HPβCD were studied by performing solubility and in vitro dissolution studies of GZD-HPβCD complex in presence and absence of the competing drug at pH values 4.5 and 6.8. GZD-HPβCD complex was found to enhance the dissolution of the drug in all pH values studied. The presence of LOR with GZD-HPβCD complex led to some pH dependent changes in the dissolution of the complex which supported the results obtained from the solubility studies. Using blood glucose level as a pharmaco​dynamic marker that reflects the bioavailability of GZD, in vivo stud​ies have shown that GZD when given as its HPβCD complex together with LOR exhibits about 25 % lower bioavailability (effect) compared to GZD alone. In an attempt to explain the in vivo and dissolution studies, higher order complexes (aggregates) involving LOR, GZD and HPβCD were proposed. The formation of such larger complexes was supported by stoichiometric and diffusion studies.

Keywords : Hydroxypropyl-b-cyclodextrin; Gliclazide; Loratadine; Dissolution; Displacement

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Evaluation of knowledge, experiences, and fear toward prescribing and dispensing corticosteroids among Egyptian healthcare professionals: A cross-sectional study

Authors : Muna Barakat, Noha O Mansour, Mohamed Hassan Elnaem, Samar Thiab, Rana Abu Farha, Malik Sallam, Ahmed Said Ali, Doaa H Abdelaziz​

Abstract :Background Corticosteroids (CS) are essential drugs in the treatment of several medical conditions. Assuming different roles, physicians and pharmacists play a primary role in prescribing and dispensing these medications to optimize patients' clinical management. The data on assessing knowledge and experience of healthcare professionals toward CS is scarce. Therefore, this study aimed to assess and compare knowledge, experience, and fears towards CS among Egyptian physicians and pharmacists. Methods A cross-sectional, self-administrated, validated online questionnaire was used to collect the data from Egyptian healthcare professionals. The questionnaire consisted of four sections with multiple choice questions: sociodemographic (7 questions), knowledge about CS (13 questions), experience with CS prescription/dispensing (5 questions), and fears and preferences toward CS prescription/dispensing (13 questions). Descriptive and inferential statistics were used to analyze the data. Results A total of 600 responses were analyzed in this study. The study sample was almost two-half of healthcare providers: 303 (50.5%) pharmacists and 297 (49.5%) physicians. Pharmacists had marginally higher knowledge scores as compared to those recorded for physicians (11.29 versus 10.16, respectively; P = 0.047). Physicians had more experience choosing corticosteroids in treatment plans based on their experience (51.8% vs 38.5%) and guideline recommendations (72.8% vs 50.9%) than pharmacists. However, pharmacists had more experience dealing with corticosteroid use based on patients' preferences (19.5% vs 4.9%) and showed a broader scope of experiencing side effects of corticosteroids with their patients. The two professions demonstrated high levels of fear, with pharmacists acknowledging significantly lower concerns about CS than physicians (3.72 versus 4.0, respectively; P = 0.003). Conclusion Discrepancies exist among healthcare professionals in knowledge and experience, favoring better scientific knowledge of pharmacists related to corticosteroids. Based on these findings, the interprofessional collaborative efforts would provide comprehensive, patient-centered care that maximizes the benefits of CS while minimizing their risks.

Keywords :Corticosteroids; Egypt; Fear; Healthcare-Professionals; Knowledge

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A qualitative assessment of anabolic–androgenic steroid use among gym users in Jordan: motives, perception, and safety

Authors :Nawal Izzat, Rana Abu-Farha, Mea’ad M Harahsheh, Samar Thiab ​

Abstract :Background Over the years, the use of anabolic–androgenic steroids (AAS) has become widespread among athletes and bodybuilders. The prevalence of their use has been estimated at around 20 to 50% globally. Unfortunately, many athletes do not have the proper knowledge about the effects of these banned substances Thus, this study aims to qualitatively assess Jordanian gym users’ AAS intentions, perceptions, and safety. Methods Twenty male Jordanian anabolic steroid users were interviewed using in-depth interviews as part of a qualitative study evaluating the motivations, perceptions, and safety of AAS among gym users. Results The findings of this study indicate that the desire to compete in bodybuilding contests was the primary motivation for participants to use AAS. The study participants mentioned using a combination of oral and injectable medications. Gym coaches and trainers were also identified as an essential source of information for AAS use. A very limited number of AAS users were getting their information from healthcare providers, and most of them have experienced some of these medications side effects but are still willing to continue the use of AAS to get what they need in terms of their physical appearance or for winning competitions. Conclusion There is an urgent need for structured awareness campaigns targeting gyms and fitness clubs’ members to increase their knowledge about the side effects and health risks associated with the use of AAS. In addition, sports governing bodies should have stricter measures to tackle this problem and discourage athletes from using such products.

Keywords : nabolic-Androgenic Steroid; gyms; bodybuilders

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​​​​​The battle against COVID-19 in Jordan: A cross-sectional study assessing the experience of Jordanians who have been infected with COVID-19

Authors :Razan I Nassar, Samara Thiab, Iman A Basheti ​

Abstract :Background: Patients infected with coronavirus have new experiences and hence needs from the healthcare sector. Pharmacists can play vital roles in adopting innovative strategies to meet such needs. Objectives: To assess the experience of people who have been infected with coronavirus, and to assess the roles played by pharmacists to meet their new needs. Methods: This descriptive cross-sectional online survey was developed based on previous literature, validated, and conducted in Jordan (3-13 May 2021). Results: The mean age of the study participants (n=470) was 34.31 years (SD=11.75). About three-quarters were females. Out of the study participants, 24.0% reported to having been infected with the coronavirus previously, and 48.9% of them were infected after contacting an infected family member/friend. Only 36.0% ranked their commitment to the preventative measures as "very committed" before getting infected. The most reported symptom was fatigue (77.1%). The most used medicine/supplement was vitamin C (85.3%), followed by pain relievers (77.7%), and zinc tablets (75.3%). More than half of the participants (66.4%) documented that their anxiety and stress levels increased during their infection. More than half of the participants (53.7%) strongly agreed/agreed that pharmacists had an important and effective role during their infection. Conclusion: The experience of individuals who contracted the coronavirus indicated that few were very committed to preventative measures before getting infected. Fatigue was the main experienced symptom, while vitamin C was the supplement used the most. About half of the participants believed that pharmacists have an important role in managing their needs during their COVID-19 infection

Keywords : oronavirus; Covid-19; Jordan; Pandemics; Pharmacists

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erception and attitudes toward COVID-19 vaccines in Jordan: lessons for future pandemics

Authors :alal Alnatour, Razan I Nassar, Yara Salhi, Samar Thiab, Ahmad R Alsayed ​

Abstract :Objective: This study aimed to assess Jordanians' perception and attitudes toward COVID-19 vaccines authorized for use in Jordan. Another objective was to evaluate the population's confidence in vaccine efficacy, their fears of the vaccines, and their perceptions and attitudes after vaccination. Methods: This cross-sectional study was conducted over four months (August 2021- December 2021) and included the general Jordanian population above 18 years old. Results: A total of 398 participants were included in the study, with the majority (around 81.0%) received at least one dose of any of COVID-19 vaccines approved for use in Jordan. Most non-vaccinated participants (67.4%) were either unwilling to receive the COVID-19 vaccine or unsure. The main reasons for receiving the vaccine were: family protection, self-protection, global efforts to fight the virus and local restrictions, with some variability between vaccinated and non-vaccinated. The major reasons for fear of COVID-19 vaccines were limited research, vaccine effectiveness, and vaccine side effects. Pfizer-BioNTech vaccine was the most trusted vaccine by vaccinated and non-vaccinated participants (47.8% and 57.9%, respectively), and Oxford- AstraZeneca was the most feared by them (42.2% and 57.9%, respectively). Internet websites (>85.0%), social media platforms (>70.0%), relatives and friends (>69.0%), and news applications (>60.0%) were the major sources of information about the COVID-19 vaccines among participants. Conclusion: Our results revealed that hesitation in receiving the vaccine remains a challenge in Jordan, as in other countries. The findings also show that participants, regardless of their vaccination status, had many concerns about the four types of vaccines approved for use in Jordan during the study conduction period. Moreover, the participants' perceptions and attitudes towards the vaccines were variable between vaccinated and non-vaccinated participants and were variable for the four types of vaccines.

Keywords : ttitude; Covid-19; Jordan; Perception; Vaccine

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​​​​​The Effects of Medications and the Roles of Pharmacists on the Recovery of Patients with COVID-19 Infection: An Epidemiological Study from the United Arab Emirates

Authors : Iman A Basheti, Hiba Barqawi, Razan I Nassar, Samar Thiab, Noor Atatreh, Eman Abu-Gharbieh​

Abstract :Patients infected with coronavirus have new experiences and hence new needs from the healthcare sector. Acknowledging patients’ experiences can exhibit promising outcomes in coronavirus management. Pharmacists are considered a vital pillar in managing patients’ experiences during their infection. A cross-sectional study was conducted to assess the experiences of COVID-19-infected individuals and the roles of pharmacists in the United Arab Emirates. The survey was face- and content-validated after being developed. Three sections were included in the survey (demographics, experiences of infected individuals, and the roles of pharmacists). Data were analyzed using the Statistical Package for the Social Sciences. The study participants (n = 509) had a mean age of 34.50 (SD = 11.93). The most reported symptoms among participants were fatigue (81.5%), fever (76.8%), headache (76.6%), dry cough (74.1%), muscle or joint pain (70.7%), and sore throat (68.6%). Vitamin C was the most used supplement (88.6%), followed by pain relievers (78.2%). Female gender was the only factor associated with symptom severity. About 79.0% agreed that the pharmacist played an important and effective role during their infection. The most reported symptom was fatigue, with females reporting more severe symptoms. The role of the pharmacist proved to be vital during this pandemic

Keywords :oronavirus; COVID-19; pandemics; pharmacists; United Arab Emirates

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​​​​​Public Knowledge and Perceptions about the Emerging Human Mpox in Jordan: A Cross-Sectional Study

Authors : ​Rana K Abu-Farha, Karem H Alzoubi, Tareq L Mukattash, Rama Alkhawaldeh, Muna Barakat, Samar Thiab

Abstract :Hundreds of human mpox cases are spreading outside of Western and Central Africa, which could be considered a significant world health problem. In this study, we sought to assess public knowledge and perceptions of human mpox. The study was a cross-sectional survey conducted in Jordan in September–October 2022. All participants were approached through social media portals. A total of 1195 participants agreed to participate in this study. The participants showed a low median knowledge score about human mpox (4.0 out of 15.0, IQR = 5.0), with only 27.9% of the participants (n = 334) correctly identifying that human mpox is not a bacterial disease, and around half of them (n = 589, 49.3%) knowing that this disease affects both genders. Higher monthly income (≥400 JD/month) was significantly associated with better knowledge about the disease. Social media was the most comprehensive source of information about mpox (n = 1018, 85.2%). Finally, 57.3% of the participants (n = 685) believed that mpox would affect social and economic life, like the COVID-19 pandemic. These findings highlight the urgent need for systematic strategies that should be promoted to increase public knowledge of mpox, which will be critical in improving the capacity to respond to the disease.

Keywords : pox; human mpox virus; knowledge; perception; outbreak; Jordan

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​​​​​Web-Based Reporting of Post-Vaccination Symptoms for Inactivated COVID-19 Vaccines in Jordan: A Cross-Sectional Study

Authors : Razan I Nassar, Muna Barakat, Samar Thiab, Feras El-Hajji, Hiba Barqawi, Waseem El-Huneidi, Iman A Basheti, Eman Abu-Gharbieh​

Abstract : Background The perception of COVID-19 vaccines as being unsafe is a major barrier to receiving the vaccine. Providing the public with accurate data regarding the vaccines would reduce vaccine hesitancy. Methods A cross-sectional study was conducted to collect data on the side effects experienced by the vaccinated population to assess the safety of the inactivated COVID-19 vaccine. Results The majority of the study participants (n = 386) were female (71.9%), and 38.6% of them were under 30 years old. Around half of the participants (52.8%) reported side effects after receiving the inactivated COVID-19 vaccine. Fatigue (85.1%), a sore arm at the site of the injection (82.1%), and discomfort (67.2%) were the most commonly reported side effects after the first dose. Reporting side effects was significantly associated with the female sex (p-value = 0.027). Significant associations between being female and experiencing chills, muscle or joint pain, anorexia, drowsiness, and hair loss were also found, as well as being above the age of 30 and experiencing a cough. Being a smoker was significantly associated with experiencing a cough, and a headache. Furthermore, chills, and a sore throat were significantly associated with individuals who had not been infected before. Conclusion Mild side effects were reported after receiving the inactivated COVID-19 vaccine. Fatigue was the most commonly reported side effect. Females, older adults, smokers, and those who had never been infected with COVID-19 had a greater susceptibility to certain side effects

Keywords : coronavirus; COVID-19; side effects; vaccines; inactivated COVID-19 vaccine; Jordan

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​​​​​short-term side effects of COVID-19 vaccines: A cross-sectional study in Jordan

Authors :Razan I Nassar, Dalal Alnatour, Samar Thiab, Ayman Nassar, Feras El-Hajji, Iman A Basheti ​

Abstract : The rapid manufacturing of vaccines has increased hesitancy toward receiving the COVID-19 vaccines. Clarifying what to expect after vaccination and revealing the possible side effects will lower hesitancy toward receiving the COVID-19 vaccine and increase public awareness. This descriptive cross-sectional survey-based study was conducted in Jordan (August 2021) to collect data on the short-term side effects following the COVID-19 vaccines. An extensive literature review was conducted by the research team to assist in developing the first draft of the survey. The survey was tested for face and content validity and piloted test to improve readability and clarity. The survey was organized into two sections (demographics and perceived COVID-19 vaccines’ side effects). Data were analyzed using the Statistical Package for Social Science (SPSS). A total of 1,044 participants were enrolled in the study. The most received vaccine among the participants was Pfizer-BioNTech (51.1%). The most frequently reported side effects were sore arm at the injection site (84.65%), fatigue (84.48%), discomfort (65.43%), muscles/joint pain (61.38%), drowsiness (58.73%), and headache (58.38%). More side effects were significantly associated with being older (p = 0.046), having an allergy (p = 0.024) or rheumatoid arthritis (p = 0.023), and participants who take NSAIDs regularly (p = 0.029). Short-term side effects of COVID-19 vaccines seem to be mostly local or transient in nature. Older age and certain comorbidities may increase susceptibility to side effects

Keywords :COVID-19, pandemics, side effects, vaccine, immunization, Jordan

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​​​​​Evaluation and molecular modelling of bis-Schiff base derivatives as potential leads for management of diabetes mellitus

Authors : Safa Daoud, Samar Thiab, Taghreed Jazzazi, Tareq Al-Shboul, Saeed Ullah​

Abstract :Developing a medication to cure and manage diabetes mellitus complications is of interest in medicinal chemistry. Toward this end, six bis-biphenyl-salicylaldehyde Schiff base derivatives have been evaluated for their α-glucosidase inhibition, antiglycation and anti-inflammation potentials. Four compounds (compounds 2–5) showed an excellent α-glucosidase inhibitory effect superior to that produced by acarbose. Additionally, the docking study revealed that these compounds are anchored within the binding pocket of α-glucosidase via hydrogen bonding, π-stacking and hydrophobic interactions, comparable to a high number of hydrogen bonding involved in anchoring acarbose. Interestingly, all tested compounds showed varying degrees of antiglycation activity with superior activity for two of them (compound 1 and compound 6) compared to the standard rutin. Moreover, the results indicated an outstanding anti-inflammatory activity for two compounds (compounds 1 and 6) compared to ibuprofen

Keywords :bis-Schiff bases; diabetes mellitus; glycation; postprandial hyperglycemia; α-glucosidase; docking study

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Flavonoid-based nanomedicines to target tumor microenvironment

Authors : Wamidh H Talib, Alaa Abuawad, Samar Thiab, Areen Alshweiat, Asma Ismail Mahmod​

Abstract :Cancer cells arise and grow in tumor microenvironment which consists of stromal cells and extracellular matrix. The dynamic interaction between cancer cells and different components of the tumor microenvironment is a critical step in cancer development and progression. Several therapeutic strategies were explored as promising approaches to target tumor microenvironment. Flavonoids have gained increasing importance in cancer therapy due to their high bioavailability, low toxicity, and affordability. Many flavonoids showed potent activities as potential cytotoxic agents and multiple nano- formulations were tested to enhance the therapeutic effect of flavonoids. In this review, a comprehensive analysis of flavonoid-based nanomedicine was provided with special emphasis on tumor microenvironment components as therapeutic targets. Studies discussed in this review provide a solid ground for researchers and physicians to consider flavonoid based nano- formulations as possible adjuvant therapies with conventional anticancer agents.

Keywords :Flavonoids, Polyphenols, Natural products, Cancer, Nano-formulation, Dendritic cells

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Assessing health-related behaviors among Jordanian children during COVID-19 pandemic: A cross-sectional study

Authors : Samar Thiab, Muna Barakat, Raja' Qudah, Iman Basheti, Safa Daoud​

Abstract : Background: The coronavirus disease identified in 2019 (COVID-19) led to extreme actions being taken by the governments to restrict the spread of this virus. Closure of schools, sport clubs and playgrounds were among these actions; children had to stay indoors and were not allowed to pursue their normal lifestyle activities. Objectives: To assess the differences in health-related behaviors among Jordanian school-aged children (6-16 years) before and during COVID-19 quarantine and to evaluate public's perception of the role of pharmacists regarding children's health-related behaviors management. Methods: A cross-sectional study was conducted from August 2020 to January 2021 using an anonymous web-based survey. The survey was developed based on previously published surveys. Evaluation of the validity and reliability of the survey were conducted by a professional committee of clinical pharmacists and a statistician. Results: A total of 230 children, aged 9.02± 2.977 participated in the study. Physical activity and healthy balanced meals decreased (less than 1 hr or 1-3 hrs/week vs 2 meals/day, p= <0.001), whereas daily screen time (1-3 hrs/week vs 4-6 hrs/week, p= <0.001), sleep hours (8-9 hrs/day vs 10-11 hrs/day, p= <0.001) and the ingestion of unhealthy snacks had increased (1-2 meals/day vs. 2-3 meals/day, p=<0.001). A positive perception of pharmacists' role during the pandemic was revealed. Conclusion: The present study showed that a significant change in children's health- related behavior happened during the COVID-19 pandemic. Such changes can lead to social, physical and mental health problems. The public perceived community pharmacists as trusted health care professionals during the pandemic.

Keywords :hildren; covid-19; health-related behavior; pharmacists' role; quarantine

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Anticancer effect of spices used in Mediterranean diet: preventive and therapeutic potentials

Authors : Wamidh Hadi Talib, Mallak J AlHur, Rawand E Ahmad, Arkan Hadi Al-Yasari, Anfal AL-Dalaeen, Samar Thiab, Asma Mahmod​

Abstract :Cancer is one of the leading causes of death worldwide, with almost 10 million cancer-related deaths worldwide in 2020, so any investigation to prevent or cure this disease is very important. Spices have been studied widely in several countries due to their therapeutic uses. This review highlighted chemo-therapeutic and chemo-preventive effect of ginger, pepper, rosemary, turmeric, black cumin and clove. Moreover, the mechanisms of action for each one of them were figured out such as anti-angiogenesis, antioxidant, altering signaling pathways, induction of cell apoptosis, and cell cycle arrest, for several type of cancer.

Keywords : pices, ginger, cell apoptosis, chemo-prevention, anti-angiogenesis.

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F​​​​​lavonoid-Based Nanomedicines to Target Tumor Microenvironment

Authors :Wamidh H Talib, Alaa Abuawad, Samar Thiab, Areen Alshweiat, Asma Ismail Mahmod ​

Abstract :Cancer cells arise and grow in tumor microenvironment which consists of stromal cells and extracellular matrix. The dynamic interaction between cancer cells and different components of the tumor microenvironment is a critical step in cancer development and progression. Several therapeutic strategies were explored as promising approaches to target tumor microenvironment. Flavonoids have gained increasing importance in cancer therapy due to their high bioavailability, low toxicity, and affordability. Many flavonoids showed potent activities as potential cytotoxic agents and multiple nano- formulations were tested to enhance the therapeutic effect of flavonoids. In this review, a comprehensive analysis of flavonoid-based nanomedicine was provided with special emphasis on tumor microenvironment components as therapeutic targets. Studies discussed in this review provide a solid ground for researchers and physicians to consider flavonoid based nano- formulations as possible adjuvant therapies with conventional anticancer agents.

Keywords : avonoids, Polyphenols, Natural products, Cancer, Nano-formulation, Dendritic cells.

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Assessing health-related behaviors among Jordanian children during COVID-19 pandemic: A cross-sectional study

Authors : ​Samar Thiab, Muna Barakat, Raja' Qudah, Iman Basheti, Safa Daoud

Abstract :Background: The coronavirus disease identified in 2019 (COVID-19) led to extreme actions being taken by the governments to restrict the spread of this virus. Closure of schools, sport clubs and playgrounds were among these actions; children had to stay indoors and were not allowed to pursue their normal lifestyle activities. Objectives: To assess the differences in health-related behaviors among Jordanian school-aged children (6-16 years) before and during COVID-19 quarantine and to evaluate public’s perception of the role of pharmacists regarding children’s health-related behaviors management. Methods: A cross-sectional study was conducted from August 2020 to January 2021 using an anonymous web-based survey. The survey was developed based on previously published surveys. Evaluation of the validity and reliability of the survey were conducted by a professional committee of clinical pharmacists and a statistician. Results: A total of 230 children, aged 9.02± 2.977 participated in the study. Physical activity and healthy balanced meals decreased (less than 1 hr or 1-3 hrs/week vs 2 meals/day, p= <0.001), whereas daily screen time (1-3 hrs/week vs 4-6 hrs/week, p= <0.001), sleep hours (8-9 hrs/day vs 10-11 hrs/day, p= <0.001) and the ingestion of unhealthy snacks had increased (1-2 meals/day vs. 2-3 meals/day, p=<0.001). A positive perception of pharmacists’ role during the pandemic was revealed. Conclusion: The present study showed that a significant change in children’s healthrelated behavior happened during the COVID-19 pandemic. Such changes can lead to social, physical and mental health problems. The public perceived community pharmacists as trusted health care professionals during the pandemic.

Keywords : COVID-19; Quarantine; Pharmacists’ role; Children; Health-related behavior

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​​​​​Research Title :Insights into medication adherence among Jordanian patients with dyslipidemia: evaluating health literacy, well-being, and doctor-patient communication

Authors :Muna Barakat, Samar Thiab, Shaymaa B Abdulrazzaq, Marah Al-Jamal, Fotoh AlHariri, Rakan Bassam Ammari, Sara Mansour, Sami El Khatib, Souheil Hallit, Basile Hosseini, Diana Malaeb, Hassan Hosseini ​

Abstract :Background: This study aimed to assess medication adherence among Jordanian patients with dyslipidemia and evaluate the impact of health literacy, well-being, and doctor-patient communication on adherence in this population. Dyslipidemia is a prevalent condition that significantly increases the risk of cardiovascular diseases, and understanding the factors influencing medication adherence is crucial for improving patient outcomes. Methods: An observational cross-sectional study was conducted from March to July 2023. A convenience sample of adult Jordanians diagnosed with dyslipidemia was surveyed in a tertiary hospital using validated scales: the Lebanese Medication Adherence Scale-14 (LMAS-14), the Doctor-Patient Communication Scale (DPC), the WHO well-being index, and the health literacy scale. Bivariate analysis and linear regression models were employed to analyze associations. Results: Among 410 participants (mean age 58.62 ± 12.11 years), the mean scores were LMAS-14 (35.10), DPC (55.77), WHO well-being (47.53), and health literacy (38.96). Higher medication adherence was associated with older age (B = 0.093, p = 0.049), university education (B = 2.872, p = 0.017), prior surgery (B = 2.317, p = 0.021), medium income level (B = 3.605, p = 0.006), and better doctor-patient communication (B = 0.166, p = 0.003). Conversely, cigarette smoking (B = −3.854, p = 0.001) and health insurance (B = −2.146, p = 0.039) were linked to lower adherence. Conclusion: The findings underscore the substantial interplay of sociodemographic and clinical factors affecting medication adherence. Enhanced public health interventions focusing on improving health literacy, communication quality, and addressing socio-economic conditions are vital for better adherence and patient outcomes in Jordan.

Keywords :Dyslipidemia; medication adherence; health literacy; doctor patient communication; Jordan

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​​​​​Research Title :Pharmacological evaluation of the protective effect of hydroalcoholic extract of walnut (Juglans regia L.) leaf on 6-mercaptopurine-induced hepatotoxicity in rats

Authors :Afaf H Al-Nadaf, Samar Thiab, Raghd Obidat, AL-Arman Samia, Nisreen Abu Shahin ​

Abstract :Chemical hepatotoxicity can cause liver illnesses like hepatitis and cirrhosis. Mercaptopurine, an anti-tumor medication, has potential myelotoxicity. Natural plants contain hepatoprotective phytoconstituents. The study aimed to explore the protective effect of J. Reia hydroalcoholic leaf extract against MTP-induced liver injury in rats. Seven groups of rats were randomly selected: Control received only distilled water and food; MP at 40 mg kg-1 b.w; Silymarin at 50 mg kg-1 b.w; Juglans Leaf extract 400 mg kg-1 b.w; Juglans Leaf extract 400 mg kg-1 and 6-MP 40 mg kg-1; Silymarin 50 mg kg-1 and 6-MP 40 mg kg-1; Juglans Leaf extract (200 mg kg-1); silymarin 25 mg kg-1, and 6-MP 40 mg kg-1. Blood samples were collected on days: zero, 10 and 21 days. Liver injury was assessed by serum biochemical parameters (SGOT, SGPT, ALP), bilirubin, albumin and total protein in addition to histopathology changes. Administration of J. Reia leaf extract significantly lowered SGOT, SGPT, ALP levels and bilirubin in MTP-treated rats. Histopathological evaluation of livers showed that J. Regia leaves extract reduced cell swelling, fatty degeneration, and inflammation in MTP-treated rats. These findings indicate that J. Regia extract has a protective impact on Oxidative injury in rat liver caused by MTP. Moreover, extract is an effective antioxidant and hepatoprotective agent for reducing hepatocellular damage.

Keywords :Juglans regia L.; Leaf; Hepatoprotective; Mercaptopurine; Hydroalcoholic extract

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​​​​​Research Title :Insights and perceptions: Investigating pregnant women’s attitudes, understanding, and factors influencing knowledge regarding medication usage during pregnancy—A cross-sectional study

Authors : Abdullah R Al-Khawlani, Qutaiba A Qasim, Abdulsalam M Halboup, Samar Thiab, Mohammed Zawiah, Fahmi Y Al-Ashwal​

Abstract :Background Medication use during pregnancy is a critical concern due to potential risks to both the mother and fetus. To the extent of our knowledge, there has been no prior research to assess medication use and identify the specific factors of pregnant women within the Yemeni community. This study aimed to investigate the knowledge, beliefs, and practices of Yemeni pregnant women regarding medication use and assess the factors associated with the knowledge during pregnancy. Methods A cross-sectional multi-center study was conducted through face-to-face interviews using a validated structured questionnaire. The study was conducted on pregnant women receiving antenatal care at tertiary care hospitals in four governorates in Yemen. Univariable and multivariate logistic regressions were employed to examine the relationship between participant variables and their knowledge. A P-value of less than .05 was considered statistically significant. Results Out of the 1003 pregnant women, 35.4% (n = 355) were aged 21–25 years, 33.9% (n = 340) had primary education, 73.6% (n = 738) lived in urban areas, 12.2% (n = 122) were smokers, 38.3% (n = 384) reported chewing khat, and the majority (90.2%, n = 905) were unemployed. Also, 65.5% (n = 657) of the participants reported taking folic acid in their current pregnancy. A total of 2,623 medications were utilized during pregnancy, with 17.8% during the first trimester (n = 468). Around 39.3% (n = 1,037) of medications used fell under the blood and blood-forming organs category. Education level (AOR: 4.00, P < .001), insurance status (AOR: 1.71, P = .026), information about medication risks to the fetus (AOR: 1.96, P = .023), the use of folic acid either in a previous pregnancy (AOR: 1.65, P < .008) or in the current pregnancy (AOR: 4.26, P < .001), and checking the medication leaflet (AOR: 5.67, P < .001) were predictors of higher knowledge. Conclusion The findings underscore the pressing need for educational interventions aimed at pregnant women. By bridging knowledge gaps and promoting informed decision-making, such initiatives can contribute to a safer and healthier pregnancy journey, reducing the inclination towards self-medication.

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​​​​​Research Title :Investigation of the knowledge, attitudes, and perceptions regarding the utilization of rosemary among the population in Jordan

Authors : ​Samar Thiab, Razan I Nassar, Saif Alislam Alamleh, Abdullah Aboqubo, Abdullah Aljebori

Abstract :Background Rosemary (Rosmarinus officinalis) has a rich historical use for various reasons due to its beneficial characteristics including stimulating hair growth, providing antioxidant and antibacterial effects, and functioning as a skin conditioner and fragrance enhancer. The plant is cultivated in Jordan and using it is gaining popularity among the population. Aim of the study To assess the knowledge, attitude and perception of rosemary use among Jordanians. Materials and methods A cross-sectional study was conducted targeting at least 385 participants via social media platforms. Face and content validity of the questionnaire was performed by independent researchers. The questionnaire was divided into three main sections including the demographics section, the knowledge section and the attitude toward rosemary use. Statistical analysis was conducted using SPSS including descriptive statistics, chi-square tests, and multiple linear regression. Results The study’s participants (n = 407) had a mean age of 30.98 years old (SD = 12.76). The mean knowledge score for the participants ranged from -5 to 7, with a mean of 2.96 (SD = 2.61), with younger participants exhibiting higher knowledge scores regarding rosemary. Approximately half of the participants (48.2%) reported using rosemary for medical purposes. About three-quarters reported using rosemary oil, but a higher percentage reported using the leaves. Around three quarters administered it orally or applied it topically. Most participants obtained rosemary by growing it at home or from herbalists. Family and friends were the main influencers for rosemary users. Most of the study participants strongly agreed/agreed that plants possess a healing power (94.4%). The most reported reason for using rosemary was improving the hair condition (82.1%) followed by gastrointestinal problems (67.9%). Conclusions The study highlights the widespread use of rosemary for different reasons through different methods of application. Addressing misconceptions and enhancing knowledge dissemination may allow informed decision-making and promote the safe and effective use of herbal therapies.

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​​​​​Research Title :An overview of the experience of Iraqi COVID-19 patients, and the role of the pharmacists during their infection

Authors :Razan Nassar, Iman A Basheti, Alhareth Ahmad, Shaymaa Al-Majmaie, Dima Awajan, Ruaa R Al-Alwany, Ayman Nassar, Samar Thiab ​

Abstract :Background: The global healthcare systems have faced significant challenges due to the COVID-19 pandemic. Pharmacists have been frontline healthcare workers playing a pivotal role during this pandemic. This study aimed to understand the experiences of Iraqi COVID-19 patients and highlight the role of pharmacists during their infection. Methods: A cross-sectional web-based study was conducted among the Iraqi public. Inclusion criteria comprised individuals residing in Iraq who had previously contracted COVID-19. The survey assessed demographic information, the COVID-19 experience of participants, and the role of pharmacists from the patient’s perspective. Results: Over 561 participants from various Iraqi cities responded. Most participants (43.5%) stated that their infection source was mainly contacting infected family or friends. About 40.0% of the participants required a specialist doctor visit during their infection, 5.9% required hospitalization, and 1.6% required admission to the intensive care unit (ICU). Regarding herbal products, 42.8% of the study’s participants used herbs. Fatigue and fever were the most commonly reported symptoms. Vitamin C and analgesics were the most used supplements/medications. Of the participants, 35.0% stated that they visited a pharmacy in person, while 31.2% contacted pharmacists through a third person. Nearly half of the respondents strongly agreed or agreed with the statements highlighting the proactive role of pharmacists in providing medical advice, prevention tips, medication instructions, and drug-to-drug interaction guidance during the COVID-19 pandemic. Conclusion: The study highlights the significant role of pharmacists in Iraq during the COVID-19 pandemic, emphasizing their importance in patient care, medication management, and delivering health advice. Collaborative efforts between pharmacists and other healthcare professionals can further optimize patient care during health crises.

Keywords :covid-19; pharmacists; Iraq; patient care; medication management

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​​​​​Research Title :Current Landscape and Future Directions of Deprescribing and Polypharmacy Practices in Jordan

Authors : Muna Barakat, Razan Nassar, Lobna Gharaibeh, Samar Thiab, Abdulqadir J Nashwan​

Abstract :This review explores the current landscape and future directions of deprescribing and polypharmacy practices in Jordan. The prevalence of polypharmacy, defined as the concurrent use of multiple medications by an individual, has been increasing in recent years due to various factors, such as population aging and the greater availability of medications. However, polypharmacy can lead to adverse drug events, suboptimal medication adherence, increased healthcare costs, and reduced quality of life. Deprescribing, on the other hand, involves the discontinuation or reduction of unnecessary or potentially harmful medications to improve patient outcomes. The findings presented in this review highlight the current state of deprescribing and polypharmacy practices in Jordan, including factors influencing their prevalence. Additionally, it discusses the challenges healthcare professionals face in implementing deprescribing strategies and identifies potential solutions for enhancing these practices in Jordanian healthcare settings. Moreover, this paper provides insights into future directions for deprescribing and polypharmacy practices in Jordan. Overall, this review offers valuable insights into the current landscape of deprescribing and polypharmacy practices in Jordan while also providing recommendations for future directions to optimize medication management strategies that can ultimately benefit patient outcomes within a sound healthcare system framework.

Keywords :  Deprescribing · Polypharmacy · Pharmacy practice · Jordan

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​​​​​Research Title :An evaluation of pharmacists’ general attitudes, knowledge, and phobias regarding medications that include corticosteroids: a cross-sectional study

Authors : Muna Barakat, Samar Thiab, Rana Abu Farha, Anas O Alshweiki, Roa’a Thaher, Asem Alsughaier, Diana Malaeb​

Abstract :Background Corticosteroid-containing medications are widely accessible in various forms, including topical, injectable, and inhaled formulations. Due to uncertain safety profiles, healthcare providers, including pharmacists, often express apprehension when dispensing these drugs. This cross-sectional study assesses the knowledge, attitudes, and phobia of Jordanian pharmacists regarding corticosteroid-containing medications. Methods Conducted through a self-administered online questionnaire. Results the study reveals that dermatological conditions and respiratory disorders are the primary indications for prescribing corticosteroid-containing drugs. The most reported side effects among pharmacists’ patients include increased appetite, diabetes, and skin thinning. Pharmacists generally exhibit acceptable knowledge, with a median score of 9.0 out of 11.0 (IQR = 3.0). Over two-thirds of pharmacists (69.9%) achieve a high knowledge score (Bloom’s cut-off point ≥ 8.8). However, only 55.7% are aware that corticosteroids may induce mood changes. High phobia scores, particularly concerning increased blood pressure and osteoporosis risks, indicate pharmacist reservations in corticosteroid dispensing. Interestingly, pharmacists in rural areas display lower knowledge scores, while those working outside community pharmacies exhibit lower phobia scores compared to their counterparts in urban areas and community pharmacies, respectively. Conclusion Despite generally good knowledge levels, the study underscores high phobia scores among Jordanian pharmacists regarding corticosteroid dispensing, particularly due to concerns about blood pressure elevation and osteoporosis risks. This suggests a potential need for targeted educational interventions and support systems to enhance pharmacist confidence and optimize corticosteroid usage while minimizing associated risks.

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​​​​​Research Title :Superior rat wound-healing activity of green synthesized silver nanoparticles from acetonitrile extract of Juglans regia L: Pellicle and leaves

Authors : Afaf H Al-Nadaf, Areej Awadallah, Samar Thiab​

Abstract :The process of wound healing is complicated. Antimicrobial silver has been one of the substances used for wounds since ancient times. Moreover, traditional medicine has long used Juglans regia L. to promote wound healing. Since eco-friendly nanotechnology has various uses in biomedical research, the aim of this study was to assess the wound-healing capacity of bio-reduced silver nanoparticles (AgNPs). UV, DLS, TEM, and FTIR were used to characterize the prepared AgNPs. Pellicle's bioreduced AgNP (AgNP/P) has a better polydispersity index (PI) of 0.336 compared to its chemically synthesized peers, which have a PI of 0.67. Using incision and excision wound healing models, AgNPs and extracts were compared to Solcoseryl®. Skin-breaking strength, wound contraction, epithelialization time, histology, and cytokines were all assessed. Juglans regia L. pellicle extract (P) has shown significant effectiveness in both models, as well as their bio-reduced partner AgNP/P. The skin's tensile strength following AgNP/P therapy (871 g, p value < 0.05) is comparable to that after Solcoseryl® (928 g), both of which are significantly better than AgNP (592 g) in the incision wound model. Epithelialization time (16.0 and 16.5 days) did not substantially differ from Solcoseryl® (15.3 days) (P value < 0.05). There was an elevated collagen content. Low levels of IL1β (189.0 pg/g) and high levels of TNF-α (1007.1 pg/g) in the case of AgNP/P suggest various cellular kinds of maturation and various wound healing structures that are evident in histopathology investigations. The bioreduced AgNP/P could find use as a pharmaceutical agent for wound healing dressings.

Keywords :Silver nanoparticles; Green synthesis; Juglans regia; Fresh pellicle; Leaves; Wound healing

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​​​​​Research Title :In vivo assessment of black seed oil single dose on prednisolone pharmacokinetics

Authors :Rana Abutaima, Yousef Al-Ebini, Ahmad Alkofahi, Anas Alshishani, Samar Thiab, Kumarappan C Alagammai, Mohammad Khalid ​

Abstract :To investigate the effect of blackseed oil (BSO) single dose on prednisolone pharmacokinetics via p-gp inhibition. Methods Three groups of rats (n = 5) were orally administered the vehicle, verapamil (50 mg/kg) or BSO (5 ml/kg) 15 min prior to prednisolone (5 mg/kg) administration. Blood samples were collected over 24 h and quantified. Non-compartmental analysis was employed to calculate maximum plasma concentration (Cmax), area under the curve (AUC0-last), time to reach Cmax (Tmax), apparent clearance (CL/F), and half-life (t1/2). Statistical significance was considered at p<0.05. Results Prednisolone Cmax and AUC0-last decreased by 65% and 25% in the BSO group compared to the negative control (P < .0001, .0029, respectively) while they increased by 1.75-folds and 8-folds in verapamil group (P < .0001). Tmax was achieved at 0.16, 0.5, and 0.25 h in the negative control, verapamil, and BSO-treated groups, respectively. CL/F in the treatment group was 1.3-fold and 10-fold higher compared to the negative and positive control, respectively, whereas the t1/2 remained comparable. Conclusion Administration of BSO decreased prednisolone Cmax and AUC0-last in rats indicating that there is a herb-drug interaction; however, p-gp inhibition cannot be concluded. Patients relying on folk medicine in chronic illnesses treatment might need to avoid combining BSO with prednisolone.

Keywords :black seed interactions, p-gp inhibition, herb–drug interactions, prednisolone pharmacokinetics

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​​​​​Research Title :Jordanian Medicinal Plants in the Treatment of Diabetes

Authors : Wamidh H Talib, Reem Fawaz Abutayeh, Samar Thiab, Safa Daoud, Leena Omer, Asma Ismail Mahmod​

Abstract :The use of medicinal plants in the treatment of diabetes mellitus is highly popular, especially in the Middle East. Jordan is characterized by great diversity in wild plants, with an estimated 2000 plant species. Many of these plants are widely used to treat different ailments including diabetes. In this chapter, we focus on nine Jordanian plants traditionally used to treat diabetes. Active phytochemicals, therapeutic targets, and mechanisms of action are also discussed.

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​​​​​Research Title :Methanolic extract of S. securidaca flowers, leaves, and seeds’ antihyperlipidemic effects on high fat diet-induced hyperlipidemia in Wistar rats

Authors : ​H Aldal’in, AH Al-Nadaf, A Awadallah, S Thiab, HM Bastoni

Abstract :Significant risk factors for atherosclerosis include hyperlipidemia and oxidative stress, which together rank as three of the most significant risk factors for cardiovascular diseases. Securigera securidaca lowers cholesterol levels in diabetic rats’ blood. This investigation’s objective was to determine how methanolic extracts affected the flowers, leaves, and seeds of plants in rats that were fed a high-fat diet (HFD). Five groups of animals were created (n = 5). A total of 35 days, divided into two intervals, were used for the study. Rats received HFD during the first 15-day interval, while during the second 20-day interval, they also received extracts or the Atorvastatin reference drug. The extract of seeds has a high phenol content as well as DPPH radical antioxidant activity. Extracts were given at a dose of 200 mg/kg; p.o. Methanolic treatment of S. securidaca flowers, leaves, and seeds in HFD-induced hyperlipidemic rats resulted in significant reductions in total cholesterol, triglycerides, LDLC, and VLDL-C levels. HDL-C levels increased significantly because of the leaves. While in hyperlipidemic rats, seeds significantly reduced the activities of the enzymes ALT and ALP. The findings showed that, to a certain extent, seeds, flowers, and leaves may have benefits in reducing hyperlipidemia brought on by HFD in terms of lipid profiles and liver function enzymes. The findings of this study indicate a promising application prospect, but more research is needed to determine the exact mechanism of these novel compounds as antihyperlipidemic agents and to clarify their potential combination effect with synthetic drugs such as Atorvastatin. Combinations can reduce the dose of chemical medications required, which lowers the risk of side effects.

Keywords : S. securidaca, seeds, leaves, flowers, hypolipidemia, methanol extraction, food rich diet

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​​​​​Research Title :Natural Products and Burns: A Tough Case to Crack

Authors :Samar Thiab, Safa Daoud, Rana Abutaima, Muna Barakat, May Abu Taha ​

Abstract :Burns are a type of skin injury that occurs due to close contact with a heat source or corrosive chemicals. The use of natural products to treat burns dates back to ancient civilizations. This chapter discusses naturally derived products from plants, animals and fungi sources. The natural origin, chemical composition, burn healing mechanisms, clinical studies, and used pharmaceutical formulation are also covered.

Keywords :

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​​​​​Research Title :The effect of natural products on inflammatory cytokines production and secretion

Authors : Muna Barakat, Nabeel Kashan Syed, Eliza Hasen, Shaymaa B Abdulrazzaq, Samar Thiab, Mohammad AA Al-Najjar, Amin Omar, Tanzima Tarannum Lucy, ANM Mamun-Or-Rashid, Masayuki Yagi, Yoshikazu Yonei​

Abstract :Background The human body is regulated by the controlled production and secretion of thousands of chemicals, including polypeptides called cytokines. Cytokines play crucial roles in the immune system reaction following tissue injury and/or body invasion by infectious or non-infectious bodies. They are classified as pro and anti-inflammatory cytokines depending on many factors such as structure and function. Some cytokines mediate inflammatory reactions and contribute to several diseases, such as Rheumatoid arthritis. Very few effective treatment strategies exist to tackle these inflammatory diseases and the available strategies for treatment are also associated with several severe side effects. Although we are in the scientific innovations and medical advancements era, natural compounds are still competing with modern artificial drugs and performing well to effectively treat many diseases without causing side effects. The main purpose of this review is to discuss the effect of some natural compounds on inflammatory cytokine production and elaborate their mode of action further based on already available and recently published literature. Methods We have reviewed a selected number of natural compounds (Echinacea, Curcumin, Genistein, Eugenol, 6-Gingerol, Thymoquinone, Allicin, Quercetin, Emodin and Parthenolide) that have shown pronounced effects on cytokine production and secretion in several physiological conditions. Findings and Conclusion Immune cells produce multiple pro-inflammatory and anti-inflammatory cytokines that could be regulated accurately and effectively by using some natural compounds that can block the intracellular machinery and thus reduce cytokine production and secretion. This offers an intriguing background for grasping how these products conduct their activity at a cellular level and sheds light on other natural products to examine efficiency in the same aspect.

Keywords :Cytokines; Inflammation; Natural compounds; Cytokine trafficking

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​​​​​Research Title :Evaluation of knowledge, experiences, and fear toward prescribing and dispensing corticosteroids among Egyptian healthcare professionals: A cross-sectional study

Authors : ​Muna Barakat, Noha O Mansour, Mohamed Hassan Elnaem, Samar Thiab, Rana Abu Farha, Malik Sallam, Ahmed Said Ali, Doaa H Abdelaziz

Abstract :Background Corticosteroids (CS) are essential drugs in the treatment of several medical conditions. Assuming different roles, physicians and pharmacists play a primary role in prescribing and dispensing these medications to optimize patients' clinical management. The data on assessing knowledge and experience of healthcare professionals toward CS is scarce. Therefore, this study aimed to assess and compare knowledge, experience, and fears towards CS among Egyptian physicians and pharmacists. Methods A cross-sectional, self-administrated, validated online questionnaire was used to collect the data from Egyptian healthcare professionals. The questionnaire consisted of four sections with multiple choice questions: sociodemographic (7 questions), knowledge about CS (13 questions), experience with CS prescription/dispensing (5 questions), and fears and preferences toward CS prescription/dispensing (13 questions). Descriptive and inferential statistics were used to analyze the data. Results A total of 600 responses were analyzed in this study. The study sample was almost two-half of healthcare providers: 303 (50.5%) pharmacists and 297 (49.5%) physicians. Pharmacists had marginally higher knowledge scores as compared to those recorded for physicians (11.29 versus 10.16, respectively; P = 0.047). Physicians had more experience choosing corticosteroids in treatment plans based on their experience (51.8% vs 38.5%) and guideline recommendations (72.8% vs 50.9%) than pharmacists. However, pharmacists had more experience dealing with corticosteroid use based on patients' preferences (19.5% vs 4.9%) and showed a broader scope of experiencing side effects of corticosteroids with their patients. The two professions demonstrated high levels of fear, with pharmacists acknowledging significantly lower concerns about CS than physicians (3.72 versus 4.0, respectively; P = 0.003). Conclusion Discrepancies exist among healthcare professionals in knowledge and experience, favoring better scientific knowledge of pharmacists related to corticosteroids. Based on these findings, the interprofessional collaborative efforts would provide comprehensive, patient-centered care that maximizes the benefits of CS while minimizing their risks.

Keywords : Corticosteroids; Egypt; Fear; Healthcare-Professionals; Knowledge

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​​​​​Research Title :A qualitative assessment of anabolic–androgenic steroid use among gym users in Jordan: motives, perception, and safety

Authors :Nawal Izzat, Rana Abu-Farha, Mea’ad M Harahsheh, Samar Thiab ​

Abstract :Background Over the years, the use of anabolic–androgenic steroids (AAS) has become widespread among athletes and bodybuilders. The prevalence of their use has been estimated at around 20 to 50% globally. Unfortunately, many athletes do not have the proper knowledge about the effects of these banned substances Thus, this study aims to qualitatively assess Jordanian gym users’ AAS intentions, perceptions, and safety. Methods Twenty male Jordanian anabolic steroid users were interviewed using in-depth interviews as part of a qualitative study evaluating the motivations, perceptions, and safety of AAS among gym users. Results The findings of this study indicate that the desire to compete in bodybuilding contests was the primary motivation for participants to use AAS. The study participants mentioned using a combination of oral and injectable medications. Gym coaches and trainers were also identified as an essential source of information for AAS use. A very limited number of AAS users were getting their information from healthcare providers, and most of them have experienced some of these medications side effects but are still willing to continue the use of AAS to get what they need in terms of their physical appearance or for winning competitions. Conclusion There is an urgent need for structured awareness campaigns targeting gyms and fitness clubs’ members to increase their knowledge about the side effects and health risks associated with the use of AAS. In addition, sports governing bodies should have stricter measures to tackle this problem and discourage athletes from using such products.

Keywords :Anabolic-Androgenic Steroid; gyms; bodybuilders

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​​​​​Research Title :The battle against COVID-19 in Jordan: A cross-sectional study assessing the experience of Jordanians who have been infected with COVID-19

Authors :Razan I Nassar, Samara Thiab, Iman A Basheti ​

Abstract :Background: Patients infected with coronavirus have new experiences and hence needs from the healthcare sector. Pharmacists can play vital roles in adopting innovative strategies to meet such needs. Objectives: To assess the experience of people who have been infected with coronavirus, and to assess the roles played by pharmacists to meet their new needs. Methods: This descriptive cross-sectional online survey was developed based on previous literature, validated, and conducted in Jordan (3-13 May 2021). Results: The mean age of the study participants (n=470) was 34.31 years (SD=11.75). About three-quarters were females. Out of the study participants, 24.0% reported to having been infected with the coronavirus previously, and 48.9% of them were infected after contacting an infected family member/friend. Only 36.0% ranked their commitment to the preventative measures as "very committed" before getting infected. The most reported symptom was fatigue (77.1%). The most used medicine/supplement was vitamin C (85.3%), followed by pain relievers (77.7%), and zinc tablets (75.3%). More than half of the participants (66.4%) documented that their anxiety and stress levels increased during their infection. More than half of the participants (53.7%) strongly agreed/agreed that pharmacists had an important and effective role during their infection. Conclusion: The experience of individuals who contracted the coronavirus indicated that few were very committed to preventative measures before getting infected. Fatigue was the main experienced symptom, while vitamin C was the supplement used the most. About half of the participants believed that pharmacists have an important role in managing their needs during their COVID-19 infection

Keywords :Coronavirus; Covid-19; Jordan; Pandemics; Pharmacists

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​​​​​Research Title :Perception and attitudes toward COVID-19 vaccines in Jordan: lessons for future pandemics

Authors : ​Dalal Alnatour, Razan I Nassar, Yara Salhi, Samar Thiab, Ahmad R Alsayed

Abstract :Objective: This study aimed to assess Jordanians' perception and attitudes toward COVID-19 vaccines authorized for use in Jordan. Another objective was to evaluate the population's confidence in vaccine efficacy, their fears of the vaccines, and their perceptions and attitudes after vaccination. Methods: This cross-sectional study was conducted over four months (August 2021- December 2021) and included the general Jordanian population above 18 years old. Results: A total of 398 participants were included in the study, with the majority (around 81.0%) received at least one dose of any of COVID-19 vaccines approved for use in Jordan. Most non-vaccinated participants (67.4%) were either unwilling to receive the COVID-19 vaccine or unsure. The main reasons for receiving the vaccine were: family protection, self-protection, global efforts to fight the virus and local restrictions, with some variability between vaccinated and non-vaccinated. The major reasons for fear of COVID-19 vaccines were limited research, vaccine effectiveness, and vaccine side effects. Pfizer-BioNTech vaccine was the most trusted vaccine by vaccinated and non-vaccinated participants (47.8% and 57.9%, respectively), and Oxford- AstraZeneca was the most feared by them (42.2% and 57.9%, respectively). Internet websites (>85.0%), social media platforms (>70.0%), relatives and friends (>69.0%), and news applications (>60.0%) were the major sources of information about the COVID-19 vaccines among participants. Conclusion: Our results revealed that hesitation in receiving the vaccine remains a challenge in Jordan, as in other countries. The findings also show that participants, regardless of their vaccination status, had many concerns about the four types of vaccines approved for use in Jordan during the study conduction period. Moreover, the participants' perceptions and attitudes towards the vaccines were variable between vaccinated and non-vaccinated participants and were variable for the four types of vaccines.

Keywords : Attitude; Covid-19; Jordan; Perception; Vaccine

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​​​​​Research Title :The Effects of Medications and the Roles of Pharmacists on the Recovery of Patients with COVID-19 Infection: An Epidemiological Study from the United Arab Emirates

Authors : ​Iman A Basheti, Hiba Barqawi, Razan I Nassar, Samar Thiab, Noor Atatreh, Eman Abu-Gharbieh

Abstract :Patients infected with coronavirus have new experiences and hence new needs from the healthcare sector. Acknowledging patients’ experiences can exhibit promising outcomes in coronavirus management. Pharmacists are considered a vital pillar in managing patients’ experiences during their infection. A cross-sectional study was conducted to assess the experiences of COVID-19-infected individuals and the roles of pharmacists in the United Arab Emirates. The survey was face- and content-validated after being developed. Three sections were included in the survey (demographics, experiences of infected individuals, and the roles of pharmacists). Data were analyzed using the Statistical Package for the Social Sciences. The study participants (n = 509) had a mean age of 34.50 (SD = 11.93). The most reported symptoms among participants were fatigue (81.5%), fever (76.8%), headache (76.6%), dry cough (74.1%), muscle or joint pain (70.7%), and sore throat (68.6%). Vitamin C was the most used supplement (88.6%), followed by pain relievers (78.2%). Female gender was the only factor associated with symptom severity. About 79.0% agreed that the pharmacist played an important and effective role during their infection. The most reported symptom was fatigue, with females reporting more severe symptoms. The role of the pharmacist proved to be vital during this pandemic

Keywords : coronavirus; COVID-19; pandemics; pharmacists; United Arab Emirates

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​​​​​Research Title :Public Knowledge and Perceptions about the Emerging Human Mpox in Jordan: A Cross-Sectional Study

Authors :Rana K Abu-Farha, Karem H Alzoubi, Tareq L Mukattash, Rama Alkhawaldeh, Muna Barakat, Samar Thiab ​

Abstract :Hundreds of human mpox cases are spreading outside of Western and Central Africa, which could be considered a significant world health problem. In this study, we sought to assess public knowledge and perceptions of human mpox. The study was a cross-sectional survey conducted in Jordan in September–October 2022. All participants were approached through social media portals. A total of 1195 participants agreed to participate in this study. The participants showed a low median knowledge score about human mpox (4.0 out of 15.0, IQR = 5.0), with only 27.9% of the participants (n = 334) correctly identifying that human mpox is not a bacterial disease, and around half of them (n = 589, 49.3%) knowing that this disease affects both genders. Higher monthly income (≥400 JD/month) was significantly associated with better knowledge about the disease. Social media was the most comprehensive source of information about mpox (n = 1018, 85.2%). Finally, 57.3% of the participants (n = 685) believed that mpox would affect social and economic life, like the COVID-19 pandemic. These findings highlight the urgent need for systematic strategies that should be promoted to increase public knowledge of mpox, which will be critical in improving the capacity to respond to the disease.

Keywords :mpox; human mpox virus; knowledge; perception; outbreak; Jorda

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​​​​​Research Title :Web-Based Reporting of Post-Vaccination Symptoms for Inactivated COVID-19 Vaccines in Jordan: A Cross-Sectional Study

Authors : ​Razan I Nassar, Muna Barakat, Samar Thiab, Feras El-Hajji, Hiba Barqawi, Waseem El-Huneidi, Iman A Basheti, Eman Abu-Gharbieh

Abstract :Background The perception of COVID-19 vaccines as being unsafe is a major barrier to receiving the vaccine. Providing the public with accurate data regarding the vaccines would reduce vaccine hesitancy. Methods A cross-sectional study was conducted to collect data on the side effects experienced by the vaccinated population to assess the safety of the inactivated COVID-19 vaccine. Results The majority of the study participants (n = 386) were female (71.9%), and 38.6% of them were under 30 years old. Around half of the participants (52.8%) reported side effects after receiving the inactivated COVID-19 vaccine. Fatigue (85.1%), a sore arm at the site of the injection (82.1%), and discomfort (67.2%) were the most commonly reported side effects after the first dose. Reporting side effects was significantly associated with the female sex (p-value = 0.027). Significant associations between being female and experiencing chills, muscle or joint pain, anorexia, drowsiness, and hair loss were also found, as well as being above the age of 30 and experiencing a cough. Being a smoker was significantly associated with experiencing a cough, and a headache. Furthermore, chills, and a sore throat were significantly associated with individuals who had not been infected before. Conclusion Mild side effects were reported after receiving the inactivated COVID-19 vaccine. Fatigue was the most commonly reported side effect. Females, older adults, smokers, and those who had never been infected with COVID-19 had a greater susceptibility to certain side effects.

Keywords :coronavirus; COVID-19; side effects; vaccines; inactivated COVID-19 vaccine; Jordan

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​​​​​Research Title :Short-term side effects of COVID-19 vaccines: A cross-sectional study in Jordan

Authors :Razan I Nassar, Dalal Alnatour, Samar Thiab, Ayman Nassar, Feras El-Hajji, Iman A Basheti ​

Abstract :The rapid manufacturing of vaccines has increased hesitancy toward receiving the COVID-19 vaccines. Clarifying what to expect after vaccination and revealing the possible side effects will lower hesitancy toward receiving the COVID-19 vaccine and increase public awareness. This descriptive cross-sectional survey-based study was conducted in Jordan (August 2021) to collect data on the short-term side effects following the COVID-19 vaccines. An extensive literature review was conducted by the research team to assist in developing the first draft of the survey. The survey was tested for face and content validity and piloted test to improve readability and clarity. The survey was organized into two sections (demographics and perceived COVID-19 vaccines’ side effects). Data were analyzed using the Statistical Package for Social Science (SPSS). A total of 1,044 participants were enrolled in the study. The most received vaccine among the participants was Pfizer-BioNTech (51.1%). The most frequently reported side effects were sore arm at the injection site (84.65%), fatigue (84.48%), discomfort (65.43%), muscles/joint pain (61.38%), drowsiness (58.73%), and headache (58.38%). More side effects were significantly associated with being older (p = 0.046), having an allergy (p = 0.024) or rheumatoid arthritis (p = 0.023), and participants who take NSAIDs regularly (p = 0.029). Short-term side effects of COVID-19 vaccines seem to be mostly local or transient in nature. Older age and certain comorbidities may increase susceptibility to side effects.

Keywords : COVID-19, pandemics, side effects, vaccine, immunization, Jordan

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​​​​​Research Title :Evaluation and molecular modelling of bis-Schiff base derivatives as potential leads for management of diabetes mellitus

Authors :Safa Daoud, Samar Thiab, Taghreed Jazzazi, Tareq Al-Shboul, Saeed Ullah ​

Abstract :Developing a medication to cure and manage diabetes mellitus complications is of interest in medicinal chemistry. Toward this end, six bis-biphenyl-salicylaldehyde Schiff base derivatives have been evaluated for their α-glucosidase inhibition, antiglycation and anti-inflammation potentials. Four compounds (compounds 2–5) showed an excellent α-glucosidase inhibitory effect superior to that produced by acarbose. Additionally, the docking study revealed that these compounds are anchored within the binding pocket of α-glucosidase via hydrogen bonding, π-stacking and hydrophobic interactions, comparable to a high number of hydrogen bonding involved in anchoring acarbose. Interestingly, all tested compounds showed varying degrees of antiglycation activity with superior activity for two of them (compound 1 and compound 6) compared to the standard rutin. Moreover, the results indicated an outstanding anti-inflammatory activity for two compounds (compounds 1 and 6) compared to ibuprofen.

Keywords :bis-Schiff bases; diabetes mellitus; glycation; postprandial hyperglycemia; α-glucosidase; docking study

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​​​​​Research Title :Flavonoid-based nanomedicines to target tumor microenvironment

Authors : Wamidh H Talib, Alaa Abuawad, Samar Thiab, Areen Alshweiat, Asma Ismail Mahmod​

Abstract :Cancer cells arise and grow in tumor microenvironment which consists of stromal cells and extracellular matrix. The dynamic interaction between cancer cells and different components of the tumor microenvironment is a critical step in cancer development and progression. Several therapeutic strategies were explored as promising approaches to target tumor microenvironment. Flavonoids have gained increasing importance in cancer therapy due to their high bioavailability, low toxicity, and affordability. Many flavonoids showed potent activities as potential cytotoxic agents and multiple nano- formulations were tested to enhance the therapeutic effect of flavonoids. In this review, a comprehensive analysis of flavonoid-based nanomedicine was provided with special emphasis on tumor microenvironment components as therapeutic targets. Studies discussed in this review provide a solid ground for researchers and physicians to consider flavonoid based nano- formulations as possible adjuvant therapies with conventional anticancer agents.

Keywords :Flavonoids, Polyphenols, Natural products, Cancer, Nano-formulation, Dendritic cells

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​​​​​Research Title :Assessing health-related behaviors among Jordanian children during COVID-19 pandemic: A cross-sectional study

Authors : Samar Thiab, Muna Barakat, Raja' Qudah, Iman Basheti, Safa Daoud​

Abstract :Background: The coronavirus disease identified in 2019 (COVID-19) led to extreme actions being taken by the governments to restrict the spread of this virus. Closure of schools, sport clubs and playgrounds were among these actions; children had to stay indoors and were not allowed to pursue their normal lifestyle activities. Objectives: To assess the differences in health-related behaviors among Jordanian school-aged children (6-16 years) before and during COVID-19 quarantine and to evaluate public's perception of the role of pharmacists regarding children's health-related behaviors management. Methods: A cross-sectional study was conducted from August 2020 to January 2021 using an anonymous web-based survey. The survey was developed based on previously published surveys. Evaluation of the validity and reliability of the survey were conducted by a professional committee of clinical pharmacists and a statistician. Results: A total of 230 children, aged 9.02± 2.977 participated in the study. Physical activity and healthy balanced meals decreased (less than 1 hr or 1-3 hrs/week vs 2 meals/day, p= <0.001), whereas daily screen time (1-3 hrs/week vs 4-6 hrs/week, p= <0.001), sleep hours (8-9 hrs/day vs 10-11 hrs/day, p= <0.001) and the ingestion of unhealthy snacks had increased (1-2 meals/day vs. 2-3 meals/day, p=<0.001). A positive perception of pharmacists' role during the pandemic was revealed. Conclusion: The present study showed that a significant change in children's health- related behavior happened during the COVID-19 pandemic. Such changes can lead to social, physical and mental health problems. The public perceived community pharmacists as trusted health care professionals during the pandemic.

Keywords :children; covid-19; health-related behavior; pharmacists' role; quarantine

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​​​​​Research Title :Anticancer effect of spices used in Mediterranean diet: preventive and therapeutic potentials

Authors :Wamidh Hadi Talib, Mallak J AlHur, Rawand E Ahmad, Arkan Hadi Al-Yasari, Anfal AL-Dalaeen, Samar Thiab, Asma Mahmod ​

Abstract :Cancer is one of the leading causes of death worldwide, with almost 10 million cancer-related deaths worldwide in 2020, so any investigation to prevent or cure this disease is very important. Spices have been studied widely in several countries due to their therapeutic uses. This review highlighted chemo-therapeutic and chemo-preventive effect of ginger, pepper, rosemary, turmeric, black cumin and clove. Moreover, the mechanisms of action for each one of them were figured out such as anti-angiogenesis, antioxidant, altering signaling pathways, induction of cell apoptosis, and cell cycle arrest, for several type of cancer.

Keywords :spices, ginger, cell apoptosis, chemo-prevention, anti-angiogenesis.

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​​​​​Research Title :Flavonoid-Based Nanomedicines to Target Tumor Microenvironment

Authors : Wamidh H Talib, Alaa Abuawad, Samar Thiab, Areen Alshweiat, Asma Ismail Mahmod​

Abstract :Cancer cells arise and grow in tumor microenvironment which consists of stromal cells and extracellular matrix. The dynamic interaction between cancer cells and different components of the tumor microenvironment is a critical step in cancer development and progression. Several therapeutic strategies were explored as promising approaches to target tumor microenvironment. Flavonoids have gained increasing importance in cancer therapy due to their high bioavailability, low toxicity, and affordability. Many flavonoids showed potent activities as potential cytotoxic agents and multiple nano- formulations were tested to enhance the therapeutic effect of flavonoids. In this review, a comprehensive analysis of flavonoid-based nanomedicine was provided with special emphasis on tumor microenvironment components as therapeutic targets. Studies discussed in this review provide a solid ground for researchers and physicians to consider flavonoid based nano- formulations as possible adjuvant therapies with conventional anticancer agents.

Keywords :Flavonoids, Polyphenols, Natural products, Cancer, Nano-formulation, Dendritic cells.

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​​​​​Research Title :Assessing health-related behaviors among Jordanian children during COVID-19 pandemic: A cross-sectional study

Authors :Samar Thiab, Muna Barakat, Raja' Qudah, Iman Basheti, Safa Daoud ​

Abstract :Background: The coronavirus disease identified in 2019 (COVID-19) led to extreme actions being taken by the governments to restrict the spread of this virus. Closure of schools, sport clubs and playgrounds were among these actions; children had to stay indoors and were not allowed to pursue their normal lifestyle activities. Objectives: To assess the differences in health-related behaviors among Jordanian school-aged children (6-16 years) before and during COVID-19 quarantine and to evaluate public’s perception of the role of pharmacists regarding children’s health-related behaviors management. Methods: A cross-sectional study was conducted from August 2020 to January 2021 using an anonymous web-based survey. The survey was developed based on previously published surveys. Evaluation of the validity and reliability of the survey were conducted by a professional committee of clinical pharmacists and a statistician. Results: A total of 230 children, aged 9.02± 2.977 participated in the study. Physical activity and healthy balanced meals decreased (less than 1 hr or 1-3 hrs/week vs 2 meals/day, p= <0.001), whereas daily screen time (1-3 hrs/week vs 4-6 hrs/week, p= <0.001), sleep hours (8-9 hrs/day vs 10-11 hrs/day, p= <0.001) and the ingestion of unhealthy snacks had increased (1-2 meals/day vs. 2-3 meals/day, p=<0.001). A positive perception of pharmacists’ role during the pandemic was revealed. Conclusion: The present study showed that a significant change in children’s healthrelated behavior happened during the COVID-19 pandemic. Such changes can lead to social, physical and mental health problems. The public perceived community pharmacists as trusted health care professionals during the pandemic.

Keywords :COVID-19; Quarantine; Pharmacists’ role; Children; Health-related behavior

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​​​​​Research Title :Cannabis and the Immune Response: A Comprehensive Review of Therapeutic Potential and Concerns

Authors :Muna Barakat, Samar Thiab, Lujain F Alzaghari, Shaymaa B Abdulrazzaq, Eliza Hasen, Sara Feras Abuarab, Lara Nasereddin, Amin Omar, Yasmeen Barakat, Dinesh Kumar Chellappan, Mohammad AA Al-Najjar ​

Abstract :Cannabis has long been esteemed for its analgesic, anti-inflammatory, and sedative characteristics. Ancient people such as the Egyptians, Greeks, and Chinese acknowledged the curative value of their medicinal practices. The identification of the endocannabinoid system, which engages with cannabis phytochemicals, has elucidated the mechanisms by which cannabis influences the human immune system, including the central nervous system. Cannabis and its bioactive components, particularly cannabinoids such as delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), have garnered substantial interest for their potential therapeutic effects. This review comprehensively examines the interactions between cannabis and the immune system, focusing on immune cell function, clinical evidence, molecular mechanisms, and ongoing controversies. Cannabinoids modulate immune responses by interacting with cannabinoid receptors (CB1 and CB2) expressed on various immune cells. THC generally exhibits immunosuppressive properties beneficial in conditions such as autoimmune diseases, whereas CBD shows anti-inflammatory effects without broadly suppressing immune function. The review also highlights the complex impact of cannabinoids on T lymphocytes, B lymphocytes, macrophages, dendritic cells, and natural killer cells, influencing cytokine production and immune signaling pathways. Clinical studies suggest that cannabinoids may alleviate symptoms of multiple sclerosis, rheumatoid arthritis, and systemic lupus erythematosus, although their long-term impact on immune competence remains uncertain. Epidemiological studies indicate that chronic cannabis use may alter immune responses, with both beneficial and adverse effects. The review underscores the need for more extensive research to understand the dose-dependent immunomodulatory effects of cannabinoids and their potential for developing personalized therapeutic strategies. Emerging trends in cannabinoid research and the potential for cannabis-based therapies in immune-related diseases are also discussed, highlighting the promise and challenges in this evolving field.

Keywords : Cannabinoids; Immune modulation; THC (Tetrahydrocannabinol); CBD (Cannabidiol) Immunosuppression

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​​​​​Research Title :Carrageenan Matrix for Sustained Levofloxacin Delivery: Formulation Strategies and Dual Evaluation Approaches

Authors :Samaa Abdullah, Samar Thiab, Alaa A Al-Masud, Meshal Marzoog Al-Sharafa, Adel Ardakani ​

Abstract :Purpose This study presents the formulation and evaluation of a sustained-release matrix tablet for levofloxacin (LFX) using carrageenan (CRG) as a natural, multifunctional excipient. Methods The complexation between LFX and CRG was optimized through saturation binding studies, demonstrating stable drug–polymer interactions mediated by hydrogen bonding and electrostatics. Comprehensive physicochemical characterization (FT-IR, DSC, PXRD, SEM) confirmed successful molecular dispersion of LFX within the CRG matrix, resulting in amorphous complex formation. Matrix tablets composed of either CRG or HPMC were assessed for swelling, erosion, in vitro drug release, and in vivo absorption. Results CRG-based systems showed enhanced swelling and erosion properties and provided sustained LFX release, contrasting with the faster release observed from HPMC matrices. In vivo pharmacokinetic studies in Wistar rats confirmed the modified release behavior, with LFX–CRG tablets exhibiting a delayed Tmax (1 h), lower Cmax (1.73 ± 0.15 µg/mL), and higher AUC₀–₂₄ (22.85 ± 1.93 µg·h/mL) compared to HPMC formulations (Cmax = 2.21 ± 0.12 µg/mL, AUC₀–₂₄ = 18.41 ± 1.26 µg·h/mL). Two-compartment pharmacokinetic modeling described the observed absorption kinetics, highlighting formulation-dependent differences in drug release and systemic exposure between CRG and HPMC matrices. These results support enhanced systemic exposure and extended release from CRG matrices. Conclusions These findings highlight the potential of CRG as an effective matrix-forming polymer in oral sustained-release systems. However, given the preclinical nature of this study, further investigations are warranted to confirm these outcomes in human subjects and evaluate formulation stability over time.

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​​​​​Research Title :A multinational cross-sectional study on knowledge, attitudes, and practices towards magnesium supplements

Authors : Rana Abutaima, Muna Barakat, Samar Thiab, Hana M Sawan, Malak Amer, Reem Alzayer, Doaa H Abdelaziz, Noha O Mansour, Fatima Saleh, Wael Abu Dayyih ​

Abstract :Background: Magnesium is a vital mineral with a crucial role in different biochemical reactions. There is a contradicting evidences about its role in maintaining bone, muscle and cardiovascular health. Recently, magnesium supplements gained attention due to claimed effectiveness in improving sleep quality and relieving muscle spasm. Aim: This study aimed to assess Arab communities’ knowledge, attitudes and practices regarding magnesium supplementation. Methods: A cross-sectional self-administered survey was disseminated to collect responses from different Arab countries. Descriptive statistics were calculated for demographics. Data normality was assessed using Shapiro-Wilk test. Associations between sociodemographic variables and knowledge, attitudes and practices were explored using simple and multiple linear regression. Significance level was considered at p < 0.05. Results: A total of 1,445 responses were collected. Mean (±SD) knowledge scores were low 8.61 ± 5.9. Eighty seven percent recognized magnesium role in alleviating muscle spasm and sleep disorders (83%). Magnesium citrate was the mostly used magnesium salt (37.43%). Neutral attitudes were observed with a mean score of 3.02 ± 0.66. Only 31.8% reported using magnesium supplements, 36.1% of them received a medical consultation. Having poly cystic ovary (p = 0.033), relying on scientific articles (0.004), receiving pharmacist consultation (p = 0.019) significantly associated with higher knowledge. Conclusion: Despite the huge debate regarding magnesium benefits in maintaining muscle, bone health and improving sleep quality, this study found that there is a significant gap in knowledge and neutral attitude towards magnesium supplementation in Arab communities. These findings emphasizes the need for educational campaigns targeting the public on the rationale use of supplements

Keywords :magnesium salts, muscle relaxants, spasm, insomnia, magnesium supplements, over the counter, bone health, migraine

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​​​​​Research Title :An experimental investigation evaluating the protective effect of a hydroalcoholic extract of the aerial portion of Alenda (Ephedra fragilis Desf.) against hepatotoxicity caused by mercaptopurine in rats

Authors :Afaf H Al-Nadaf, Nisreen Abu Shahin, Areej Awadallaha, Raghd Obidat, Samia Arman, Samar Thiab ​

Abstract :Chemical hepatotoxicity can lead to various liver illnesses, including hepatitis and cirrhosis. Mercaptopurine (MP) is a potent anti-tumor medication, but its use is restricted due to its potential adverse effects, such as myelotoxicity Plants naturally contain hepatoprotective phytoconstituents that protect the liver from hepatotoxicity and promote liver regeneration. The purpose of the study is to investigate the potential protective impact of hydroalcoholic arial component extract from Ephedra fragilis Alenda (E. fragilis) against MP-induced liver damage in rats. Rats were randomly assigned to seven groups. Silymarin at 50-mg.kg−1 b.w., MP at 40-mg.kg−1 b.w., E. fragilis extract 30-mg.kg−1 b.w., E. fragilis extract 30 mg.kg−1 and MP 40 mg.kg−1, Silymarin 50 mg.kg−1 and MP 40 mg.kg−1, E. fragilis extract (15 mg.kg−1), silymarin dose of 25 mg.kg−1, and MP 40 mg.kg−1 were given to the control group. On days 0,10, and 21, blood samples were taken. The study used serum biochemical markers such as albumin, bilirubin, liver enzymes, and total protein to measure liver damage and histopathological alterations. In rats treated with MP, the administration of E. fragilis extract decreased bilirubin and alkaline phosphatase levels. Histopathological analysis of livers revealed that E. fragilis extract decreased necrosis, fatty degeneration, and in MP-treated rats. These findings indicate that E. fragilis extract potentially protects against liver injury in rats caused by MP. It has a possible protective effect against drug-induced cholestasis. These findings show that Alenda extract might be an effective hepatoprotective agent for improving hepatocellular damage

Keywords : Alenda., Ephedra fragilis, aerial part, hepatoprotective, mercaptopurine, hydroalcoholic extract

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​​​​​Research Title :Insights into medication adherence among Jordanian patients with dyslipidemia: evaluating health literacy, well-being, and doctor-patient communication

Authors : Muna Barakat, Samar Thiab, Shaymaa B Abdulrazzaq, Marah Al-Jamal, Fotoh AlHariri, Rakan Bassam Ammari, Sara Mansour, Sami El Khatib, Souheil Hallit, Basile Hosseini, Diana Malaeb, Hassan Hosseini ​

Abstract :Background: This study aimed to assess medication adherence among Jordanian patients with dyslipidemia and evaluate the impact of health literacy, well-being, and doctor-patient communication on adherence in this population. Dyslipidemia is a prevalent condition that significantly increases the risk of cardiovascular diseases, and understanding the factors influencing medication adherence is crucial for improving patient outcomes. Methods: An observational cross-sectional study was conducted from March to July 2023. A convenience sample of adult Jordanians diagnosed with dyslipidemia was surveyed in a tertiary hospital using validated scales: the Lebanese Medication Adherence Scale-14 (LMAS-14), the Doctor-Patient Communication Scale (DPC), the WHO well-being index, and the health literacy scale. Bivariate analysis and linear regression models were employed to analyze associations. Results: Among 410 participants (mean age 58.62 ± 12.11 years), the mean scores were LMAS-14 (35.10), DPC (55.77), WHO well-being (47.53), and health literacy (38.96). Higher medication adherence was associated with older age (B = 0.093, p = 0.049), university education (B = 2.872, p = 0.017), prior surgery (B = 2.317, p = 0.021), medium income level (B = 3.605, p = 0.006), and better doctor-patient communication (B = 0.166, p = 0.003). Conversely, cigarette smoking (B = −3.854, p = 0.001) and health insurance (B = −2.146, p = 0.039) were linked to lower adherence. Conclusion: The findings underscore the substantial interplay of sociodemographic and clinical factors affecting medication adherence. Enhanced public health interventions focusing on improving health literacy, communication quality, and addressing socio-economic conditions are vital for better adherence and patient outcomes in Jordan.

Keywords :Dyslipidemia; medication adherence; health literacy; doctor patient communication; Jordan

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​​​​​Research Title :Pharmacological evaluation of the protective effect of hydroalcoholic extract of walnut (Juglans regia L.) leaf on 6-mercaptopurine-induced hepatotoxicity in rats

Authors : Afaf H Al-Nadaf, Samar Thiab, Raghd Obidat, AL-Arman Samia, Nisreen Abu Shahin​

Abstract :Chemical hepatotoxicity can cause liver illnesses like hepatitis and cirrhosis. Mercaptopurine, an anti-tumor medication, has potential myelotoxicity. Natural plants contain hepatoprotective phytoconstituents. The study aimed to explore the protective effect of J. Reia hydroalcoholic leaf extract against MTP-induced liver injury in rats. Seven groups of rats were randomly selected: Control received only distilled water and food; MP at 40 mg kg-1 b.w; Silymarin at 50 mg kg-1 b.w; Juglans Leaf extract 400 mg kg-1 b.w; Juglans Leaf extract 400 mg kg-1 and 6-MP 40 mg kg-1; Silymarin 50 mg kg-1 and 6-MP 40 mg kg-1; Juglans Leaf extract (200 mg kg-1); silymarin 25 mg kg-1, and 6-MP 40 mg kg-1. Blood samples were collected on days: zero, 10 and 21 days. Liver injury was assessed by serum biochemical parameters (SGOT, SGPT, ALP), bilirubin, albumin and total protein in addition to histopathology changes. Administration of J. Reia leaf extract significantly lowered SGOT, SGPT, ALP levels and bilirubin in MTP-treated rats. Histopathological evaluation of livers showed that J. Regia leaves extract reduced cell swelling, fatty degeneration, and inflammation in MTP-treated rats. These findings indicate that J. Regia extract has a protective impact on Oxidative injury in rat liver caused by MTP. Moreover, extract is an effective antioxidant and hepatoprotective agent for reducing hepatocellular damage.

Keywords : Juglans regia L.; Leaf; Hepatoprotective; Mercaptopurine; Hydroalcoholic extract

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​​​​​Research Title :Insights and perceptions: Investigating pregnant women’s attitudes, understanding, and factors influencing knowledge regarding medication usage during pregnancy—A cross-sectional study

Authors : Abdullah R Al-Khawlani, Qutaiba A Qasim, Abdulsalam M Halboup, Samar Thiab, Mohammed Zawiah, Fahmi Y Al-Ashwal​

Abstract :Background Medication use during pregnancy is a critical concern due to potential risks to both the mother and fetus. To the extent of our knowledge, there has been no prior research to assess medication use and identify the specific factors of pregnant women within the Yemeni community. This study aimed to investigate the knowledge, beliefs, and practices of Yemeni pregnant women regarding medication use and assess the factors associated with the knowledge during pregnancy. Methods A cross-sectional multi-center study was conducted through face-to-face interviews using a validated structured questionnaire. The study was conducted on pregnant women receiving antenatal care at tertiary care hospitals in four governorates in Yemen. Univariable and multivariate logistic regressions were employed to examine the relationship between participant variables and their knowledge. A P-value of less than .05 was considered statistically significant. Results Out of the 1003 pregnant women, 35.4% (n = 355) were aged 21–25 years, 33.9% (n = 340) had primary education, 73.6% (n = 738) lived in urban areas, 12.2% (n = 122) were smokers, 38.3% (n = 384) reported chewing khat, and the majority (90.2%, n = 905) were unemployed. Also, 65.5% (n = 657) of the participants reported taking folic acid in their current pregnancy. A total of 2,623 medications were utilized during pregnancy, with 17.8% during the first trimester (n = 468). Around 39.3% (n = 1,037) of medications used fell under the blood and blood-forming organs category. Education level (AOR: 4.00, P < .001), insurance status (AOR: 1.71, P = .026), information about medication risks to the fetus (AOR: 1.96, P = .023), the use of folic acid either in a previous pregnancy (AOR: 1.65, P < .008) or in the current pregnancy (AOR: 4.26, P < .001), and checking the medication leaflet (AOR: 5.67, P < .001) were predictors of higher knowledge. Conclusion The findings underscore the pressing need for educational interventions aimed at pregnant women. By bridging knowledge gaps and promoting informed decision-making, such initiatives can contribute to a safer and healthier pregnancy journey, reducing the inclination towards self-medication.

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​​​​​Research Title :Investigation of the knowledge, attitudes, and perceptions regarding the utilization of rosemary among the population in Jordan

Authors : Samar Thiab, Razan I Nassar, Saif Alislam Alamleh, Abdullah Aboqubo, Abdullah Aljebori​

Abstract :Background Rosemary (Rosmarinus officinalis) has a rich historical use for various reasons due to its beneficial characteristics including stimulating hair growth, providing antioxidant and antibacterial effects, and functioning as a skin conditioner and fragrance enhancer. The plant is cultivated in Jordan and using it is gaining popularity among the population. Aim of the study To assess the knowledge, attitude and perception of rosemary use among Jordanians. Materials and methods A cross-sectional study was conducted targeting at least 385 participants via social media platforms. Face and content validity of the questionnaire was performed by independent researchers. The questionnaire was divided into three main sections including the demographics section, the knowledge section and the attitude toward rosemary use. Statistical analysis was conducted using SPSS including descriptive statistics, chi-square tests, and multiple linear regression. Results The study’s participants (n = 407) had a mean age of 30.98 years old (SD = 12.76). The mean knowledge score for the participants ranged from -5 to 7, with a mean of 2.96 (SD = 2.61), with younger participants exhibiting higher knowledge scores regarding rosemary. Approximately half of the participants (48.2%) reported using rosemary for medical purposes. About three-quarters reported using rosemary oil, but a higher percentage reported using the leaves. Around three quarters administered it orally or applied it topically. Most participants obtained rosemary by growing it at home or from herbalists. Family and friends were the main influencers for rosemary users. Most of the study participants strongly agreed/agreed that plants possess a healing power (94.4%). The most reported reason for using rosemary was improving the hair condition (82.1%) followed by gastrointestinal problems (67.9%). Conclusions The study highlights the widespread use of rosemary for different reasons through different methods of application. Addressing misconceptions and enhancing knowledge dissemination may allow informed decision-making and promote the safe and effective use of herbal therapies.

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​​​​​Research Title :An overview of the experience of Iraqi COVID-19 patients, and the role of the pharmacists during their infection

Authors : Razan Nassar, Iman A Basheti, Alhareth Ahmad, Shaymaa Al-Majmaie, Dima Awajan, Ruaa R Al-Alwany, Ayman Nassar, Samar Thiab​

Abstract :Background: The global healthcare systems have faced significant challenges due to the COVID-19 pandemic. Pharmacists have been frontline healthcare workers playing a pivotal role during this pandemic. This study aimed to understand the experiences of Iraqi COVID-19 patients and highlight the role of pharmacists during their infection. Methods: A cross-sectional web-based study was conducted among the Iraqi public. Inclusion criteria comprised individuals residing in Iraq who had previously contracted COVID-19. The survey assessed demographic information, the COVID-19 experience of participants, and the role of pharmacists from the patient’s perspective. Results: Over 561 participants from various Iraqi cities responded. Most participants (43.5%) stated that their infection source was mainly contacting infected family or friends. About 40.0% of the participants required a specialist doctor visit during their infection, 5.9% required hospitalization, and 1.6% required admission to the intensive care unit (ICU). Regarding herbal products, 42.8% of the study’s participants used herbs. Fatigue and fever were the most commonly reported symptoms. Vitamin C and analgesics were the most used supplements/medications. Of the participants, 35.0% stated that they visited a pharmacy in person, while 31.2% contacted pharmacists through a third person. Nearly half of the respondents strongly agreed or agreed with the statements highlighting the proactive role of pharmacists in providing medical advice, prevention tips, medication instructions, and drug-to-drug interaction guidance during the COVID-19 pandemic. Conclusion: The study highlights the significant role of pharmacists in Iraq during the COVID-19 pandemic, emphasizing their importance in patient care, medication management, and delivering health advice. Collaborative efforts between pharmacists and other healthcare professionals can further optimize patient care during health crises.

Keywords :covid-19; pharmacists; Iraq; patient care; medication management

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​​​​​Research Title :Current Landscape and Future Directions of Deprescribing and Polypharmacy Practices in Jordan

Authors : Muna Barakat, Razan Nassar, Lobna Gharaibeh, Samar Thiab, Abdulqadir J Nashwan​

Abstract :This review explores the current landscape and future directions of deprescribing and polypharmacy practices in Jordan. The prevalence of polypharmacy, defined as the concurrent use of multiple medications by an individual, has been increasing in recent years due to various factors, such as population aging and the greater availability of medications. However, polypharmacy can lead to adverse drug events, suboptimal medication adherence, increased healthcare costs, and reduced quality of life. Deprescribing, on the other hand, involves the discontinuation or reduction of unnecessary or potentially harmful medications to improve patient outcomes. The findings presented in this review highlight the current state of deprescribing and polypharmacy practices in Jordan, including factors influencing their prevalence. Additionally, it discusses the challenges healthcare professionals face in implementing deprescribing strategies and identifies potential solutions for enhancing these practices in Jordanian healthcare settings. Moreover, this paper provides insights into future directions for deprescribing and polypharmacy practices in Jordan. Overall, this review offers valuable insights into the current landscape of deprescribing and polypharmacy practices in Jordan while also providing recommendations for future directions to optimize medication management strategies that can ultimately benefit patient outcomes within a sound healthcare system framework.

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​​​​​Research Title :An evaluation of pharmacists’ general attitudes, knowledge, and phobias regarding medications that include corticosteroids: a cross-sectional study

Authors : Muna Barakat, Samar Thiab, Rana Abu Farha, Anas O Alshweiki, Roa’a Thaher, Asem Alsughaier, Diana Malaeb​

Abstract :Background Corticosteroid-containing medications are widely accessible in various forms, including topical, injectable, and inhaled formulations. Due to uncertain safety profiles, healthcare providers, including pharmacists, often express apprehension when dispensing these drugs. This cross-sectional study assesses the knowledge, attitudes, and phobia of Jordanian pharmacists regarding corticosteroid-containing medications. Methods Conducted through a self-administered online questionnaire. Results the study reveals that dermatological conditions and respiratory disorders are the primary indications for prescribing corticosteroid-containing drugs. The most reported side effects among pharmacists’ patients include increased appetite, diabetes, and skin thinning. Pharmacists generally exhibit acceptable knowledge, with a median score of 9.0 out of 11.0 (IQR = 3.0). Over two-thirds of pharmacists (69.9%) achieve a high knowledge score (Bloom’s cut-off point ≥ 8.8). However, only 55.7% are aware that corticosteroids may induce mood changes. High phobia scores, particularly concerning increased blood pressure and osteoporosis risks, indicate pharmacist reservations in corticosteroid dispensing. Interestingly, pharmacists in rural areas display lower knowledge scores, while those working outside community pharmacies exhibit lower phobia scores compared to their counterparts in urban areas and community pharmacies, respectively. Conclusion Despite generally good knowledge levels, the study underscores high phobia scores among Jordanian pharmacists regarding corticosteroid dispensing, particularly due to concerns about blood pressure elevation and osteoporosis risks. This suggests a potential need for targeted educational interventions and support systems to enhance pharmacist confidence and optimize corticosteroid usage while minimizing associated risks.

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​​​​​Research Title :Superior rat wound-healing activity of green synthesized silver nanoparticles from acetonitrile extract of Juglans regia L: Pellicle and leaves

Authors :Afaf H Al-Nadaf, Areej Awadallah, Samar Thiab ​

Abstract :The process of wound healing is complicated. Antimicrobial silver has been one of the substances used for wounds since ancient times. Moreover, traditional medicine has long used Juglans regia L. to promote wound healing. Since eco-friendly nanotechnology has various uses in biomedical research, the aim of this study was to assess the wound-healing capacity of bio-reduced silver nanoparticles (AgNPs). UV, DLS, TEM, and FTIR were used to characterize the prepared AgNPs. Pellicle's bioreduced AgNP (AgNP/P) has a better polydispersity index (PI) of 0.336 compared to its chemically synthesized peers, which have a PI of 0.67. Using incision and excision wound healing models, AgNPs and extracts were compared to Solcoseryl®. Skin-breaking strength, wound contraction, epithelialization time, histology, and cytokines were all assessed. Juglans regia L. pellicle extract (P) has shown significant effectiveness in both models, as well as their bio-reduced partner AgNP/P. The skin's tensile strength following AgNP/P therapy (871 g, p value < 0.05) is comparable to that after Solcoseryl® (928 g), both of which are significantly better than AgNP (592 g) in the incision wound model. Epithelialization time (16.0 and 16.5 days) did not substantially differ from Solcoseryl® (15.3 days) (P value < 0.05). There was an elevated collagen content. Low levels of IL1β (189.0 pg/g) and high levels of TNF-α (1007.1 pg/g) in the case of AgNP/P suggest various cellular kinds of maturation and various wound healing structures that are evident in histopathology investigations. The bioreduced AgNP/P could find use as a pharmaceutical agent for wound healing dressings.

Keywords : Silver nanoparticles; Green synthesis; Juglans regia; Fresh pellicle; Leaves; Wound healing

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​​​​​Research Title :In vivo assessment of black seed oil single dose on prednisolone pharmacokinetics

Authors : Rana Abutaima, Yousef Al-Ebini, Ahmad Alkofahi, Anas Alshishani, Samar Thiab, Kumarappan C Alagammai, Mohammad Khalid ​

Abstract :To investigate the effect of blackseed oil (BSO) single dose on prednisolone pharmacokinetics via p-gp inhibition. Methods Three groups of rats (n = 5) were orally administered the vehicle, verapamil (50 mg/kg) or BSO (5 ml/kg) 15 min prior to prednisolone (5 mg/kg) administration. Blood samples were collected over 24 h and quantified. Non-compartmental analysis was employed to calculate maximum plasma concentration (Cmax), area under the curve (AUC0-last), time to reach Cmax (Tmax), apparent clearance (CL/F), and half-life (t1/2). Statistical significance was considered at p<0.05. Results Prednisolone Cmax and AUC0-last decreased by 65% and 25% in the BSO group compared to the negative control (P < .0001, .0029, respectively) while they increased by 1.75-folds and 8-folds in verapamil group (P < .0001). Tmax was achieved at 0.16, 0.5, and 0.25 h in the negative control, verapamil, and BSO-treated groups, respectively. CL/F in the treatment group was 1.3-fold and 10-fold higher compared to the negative and positive control, respectively, whereas the t1/2 remained comparable. Conclusion Administration of BSO decreased prednisolone Cmax and AUC0-last in rats indicating that there is a herb-drug interaction; however, p-gp inhibition cannot be concluded. Patients relying on folk medicine in chronic illnesses treatment might need to avoid combining BSO with prednisolone.

Keywords :black seed interactions, p-gp inhibition, herb–drug interactions, prednisolone pharmacokinetics

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​​​​​Research Title :Jordanian Medicinal Plants in the Treatment of Diabetes

Authors :Wamidh H Talib, Reem Fawaz Abutayeh, Samar Thiab, Safa Daoud, Leena Omer, Asma Ismail Mahmod ​

Abstract :The use of medicinal plants in the treatment of diabetes mellitus is highly popular, especially in the Middle East. Jordan is characterized by great diversity in wild plants, with an estimated 2000 plant species. Many of these plants are widely used to treat different ailments including diabetes. In this chapter, we focus on nine Jordanian plants traditionally used to treat diabetes. Active phytochemicals, therapeutic targets, and mechanisms of action are also discussed.

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​​​​​Research Title :Methanolic extract of S. securidaca flowers, leaves, and seeds’ antihyperlipidemic effects on high fat diet-induced hyperlipidemia in Wistar rats

Authors : H Aldal’in, AH Al-Nadaf, A Awadallah, S Thiab, HM Bastoni ​

Abstract :Significant risk factors for atherosclerosis include hyperlipidemia and oxidative stress, which together rank as three of the most significant risk factors for cardiovascular diseases. Securigera securidaca lowers cholesterol levels in diabetic rats’ blood. This investigation’s objective was to determine how methanolic extracts affected the flowers, leaves, and seeds of plants in rats that were fed a high-fat diet (HFD). Five groups of animals were created (n = 5). A total of 35 days, divided into two intervals, were used for the study. Rats received HFD during the first 15-day interval, while during the second 20-day interval, they also received extracts or the Atorvastatin reference drug. The extract of seeds has a high phenol content as well as DPPH radical antioxidant activity. Extracts were given at a dose of 200 mg/kg; p.o. Methanolic treatment of S. securidaca flowers, leaves, and seeds in HFD-induced hyperlipidemic rats resulted in significant reductions in total cholesterol, triglycerides, LDLC, and VLDL-C levels. HDL-C levels increased significantly because of the leaves. While in hyperlipidemic rats, seeds significantly reduced the activities of the enzymes ALT and ALP. The findings showed that, to a certain extent, seeds, flowers, and leaves may have benefits in reducing hyperlipidemia brought on by HFD in terms of lipid profiles and liver function enzymes. The findings of this study indicate a promising application prospect, but more research is needed to determine the exact mechanism of these novel compounds as antihyperlipidemic agents and to clarify their potential combination effect with synthetic drugs such as Atorvastatin. Combinations can reduce the dose of chemical medications required, which lowers the risk of side effects.

Keywords : S. securidaca, seeds, leaves, flowers, hypolipidemia, methanol extraction, food rich diet

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​​​​​Research Title :Natural Products and Burns: A Tough Case to Crack16.

Authors : Samar Thiab, Safa Daoud, Rana Abutaima, Muna Barakat, May Abu Taha​

Abstract :Burns are a type of skin injury that occurs due to close contact with a heat source or corrosive chemicals. The use of natural products to treat burns dates back to ancient civilizations. This chapter discusses naturally derived products from plants, animals and fungi sources. The natural origin, chemical composition, burn healing mechanisms, clinical studies, and used pharmaceutical formulation are also covered.

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​​​​​Research Title :The effect of natural products on inflammatory cytokines production and secretion17

Authors : Muna Barakat, Nabeel Kashan Syed, Eliza Hasen, Shaymaa B Abdulrazzaq, Samar Thiab, Mohammad AA Al-Najjar, Amin Omar, Tanzima Tarannum Lucy, ANM Mamun-Or-Rashid, Masayuki Yagi, Yoshikazu Yonei​

Abstract :Background The human body is regulated by the controlled production and secretion of thousands of chemicals, including polypeptides called cytokines. Cytokines play crucial roles in the immune system reaction following tissue injury and/or body invasion by infectious or non-infectious bodies. They are classified as pro and anti-inflammatory cytokines depending on many factors such as structure and function. Some cytokines mediate inflammatory reactions and contribute to several diseases, such as Rheumatoid arthritis. Very few effective treatment strategies exist to tackle these inflammatory diseases and the available strategies for treatment are also associated with several severe side effects. Although we are in the scientific innovations and medical advancements era, natural compounds are still competing with modern artificial drugs and performing well to effectively treat many diseases without causing side effects. The main purpose of this review is to discuss the effect of some natural compounds on inflammatory cytokine production and elaborate their mode of action further based on already available and recently published literature. Methods We have reviewed a selected number of natural compounds (Echinacea, Curcumin, Genistein, Eugenol, 6-Gingerol, Thymoquinone, Allicin, Quercetin, Emodin and Parthenolide) that have shown pronounced effects on cytokine production and secretion in several physiological conditions. Findings and Conclusion Immune cells produce multiple pro-inflammatory and anti-inflammatory cytokines that could be regulated accurately and effectively by using some natural compounds that can block the intracellular machinery and thus reduce cytokine production and secretion. This offers an intriguing background for grasping how these products conduct their activity at a cellular level and sheds light on other natural products to examine efficiency in the same aspect.

Keywords : Cytokines; Inflammation; Natural compounds; Cytokine trafficking

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​​​​​Research Title :Evaluation of knowledge, experiences, and fear toward prescribing and dispensing corticosteroids among Egyptian healthcare professionals: A cross-sectional study

Authors : Muna Barakat, Noha O Mansour, Mohamed Hassan Elnaem, Samar Thiab, Rana Abu Farha, Malik Sallam, Ahmed Said Ali, Doaa H Abdelaziz​

Abstract :Background Corticosteroids (CS) are essential drugs in the treatment of several medical conditions. Assuming different roles, physicians and pharmacists play a primary role in prescribing and dispensing these medications to optimize patients' clinical management. The data on assessing knowledge and experience of healthcare professionals toward CS is scarce. Therefore, this study aimed to assess and compare knowledge, experience, and fears towards CS among Egyptian physicians and pharmacists. Methods A cross-sectional, self-administrated, validated online questionnaire was used to collect the data from Egyptian healthcare professionals. The questionnaire consisted of four sections with multiple choice questions: sociodemographic (7 questions), knowledge about CS (13 questions), experience with CS prescription/dispensing (5 questions), and fears and preferences toward CS prescription/dispensing (13 questions). Descriptive and inferential statistics were used to analyze the data. Results A total of 600 responses were analyzed in this study. The study sample was almost two-half of healthcare providers: 303 (50.5%) pharmacists and 297 (49.5%) physicians. Pharmacists had marginally higher knowledge scores as compared to those recorded for physicians (11.29 versus 10.16, respectively; P = 0.047). Physicians had more experience choosing corticosteroids in treatment plans based on their experience (51.8% vs 38.5%) and guideline recommendations (72.8% vs 50.9%) than pharmacists. However, pharmacists had more experience dealing with corticosteroid use based on patients' preferences (19.5% vs 4.9%) and showed a broader scope of experiencing side effects of corticosteroids with their patients. The two professions demonstrated high levels of fear, with pharmacists acknowledging significantly lower concerns about CS than physicians (3.72 versus 4.0, respectively; P = 0.003). Conclusion Discrepancies exist among healthcare professionals in knowledge and experience, favoring better scientific knowledge of pharmacists related to corticosteroids. Based on these findings, the interprofessional collaborative efforts would provide comprehensive, patient-centered care that maximizes the benefits of CS while minimizing their risks.

Keywords :Corticosteroids; Egypt; Fear; Healthcare-Professionals; Knowledge

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​​​​​Research Title :A qualitative assessment of anabolic–androgenic steroid use among gym users in Jordan: motives, perception, and safety

Authors :Nawal Izzat, Rana Abu-Farha, Mea’ad M Harahsheh, Samar Thiab ​

Abstract :Background Over the years, the use of anabolic–androgenic steroids (AAS) has become widespread among athletes and bodybuilders. The prevalence of their use has been estimated at around 20 to 50% globally. Unfortunately, many athletes do not have the proper knowledge about the effects of these banned substances Thus, this study aims to qualitatively assess Jordanian gym users’ AAS intentions, perceptions, and safety. Methods Twenty male Jordanian anabolic steroid users were interviewed using in-depth interviews as part of a qualitative study evaluating the motivations, perceptions, and safety of AAS among gym users. Results The findings of this study indicate that the desire to compete in bodybuilding contests was the primary motivation for participants to use AAS. The study participants mentioned using a combination of oral and injectable medications. Gym coaches and trainers were also identified as an essential source of information for AAS use. A very limited number of AAS users were getting their information from healthcare providers, and most of them have experienced some of these medications side effects but are still willing to continue the use of AAS to get what they need in terms of their physical appearance or for winning competitions. Conclusion There is an urgent need for structured awareness campaigns targeting gyms and fitness clubs’ members to increase their knowledge about the side effects and health risks associated with the use of AAS. In addition, sports governing bodies should have stricter measures to tackle this problem and discourage athletes from using such products.

Keywords :Anabolic-Androgenic Steroid; gyms; bodybuilders

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​​​​​Research Title :The battle against COVID-19 in Jordan: A cross-sectional study assessing the experience of Jordanians who have been infected with COVID-19

Authors : Razan I Nassar, Samara Thiab, Iman A Basheti​

Abstract :Background: Patients infected with coronavirus have new experiences and hence needs from the healthcare sector. Pharmacists can play vital roles in adopting innovative strategies to meet such needs. Objectives: To assess the experience of people who have been infected with coronavirus, and to assess the roles played by pharmacists to meet their new needs. Methods: This descriptive cross-sectional online survey was developed based on previous literature, validated, and conducted in Jordan (3-13 May 2021). Results: The mean age of the study participants (n=470) was 34.31 years (SD=11.75). About three-quarters were females. Out of the study participants, 24.0% reported to having been infected with the coronavirus previously, and 48.9% of them were infected after contacting an infected family member/friend. Only 36.0% ranked their commitment to the preventative measures as "very committed" before getting infected. The most reported symptom was fatigue (77.1%). The most used medicine/supplement was vitamin C (85.3%), followed by pain relievers (77.7%), and zinc tablets (75.3%). More than half of the participants (66.4%) documented that their anxiety and stress levels increased during their infection. More than half of the participants (53.7%) strongly agreed/agreed that pharmacists had an important and effective role during their infection. Conclusion: The experience of individuals who contracted the coronavirus indicated that few were very committed to preventative measures before getting infected. Fatigue was the main experienced symptom, while vitamin C was the supplement used the most. About half of the participants believed that pharmacists have an important role in managing their needs during their COVID-19 infection

Keywords :Coronavirus; Covid-19; Jordan; Pandemics; Pharmacists

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​​​​​Research Title :Perception and attitudes toward COVID-19 vaccines in Jordan: lessons for future pandemics

Authors :Dalal Alnatour, Razan I Nassar, Yara Salhi, Samar Thiab, Ahmad R Alsayed ​

Abstract :Objective: This study aimed to assess Jordanians' perception and attitudes toward COVID-19 vaccines authorized for use in Jordan. Another objective was to evaluate the population's confidence in vaccine efficacy, their fears of the vaccines, and their perceptions and attitudes after vaccination. Methods: This cross-sectional study was conducted over four months (August 2021- December 2021) and included the general Jordanian population above 18 years old. Results: A total of 398 participants were included in the study, with the majority (around 81.0%) received at least one dose of any of COVID-19 vaccines approved for use in Jordan. Most non-vaccinated participants (67.4%) were either unwilling to receive the COVID-19 vaccine or unsure. The main reasons for receiving the vaccine were: family protection, self-protection, global efforts to fight the virus and local restrictions, with some variability between vaccinated and non-vaccinated. The major reasons for fear of COVID-19 vaccines were limited research, vaccine effectiveness, and vaccine side effects. Pfizer-BioNTech vaccine was the most trusted vaccine by vaccinated and non-vaccinated participants (47.8% and 57.9%, respectively), and Oxford- AstraZeneca was the most feared by them (42.2% and 57.9%, respectively). Internet websites (>85.0%), social media platforms (>70.0%), relatives and friends (>69.0%), and news applications (>60.0%) were the major sources of information about the COVID-19 vaccines among participants. Conclusion: Our results revealed that hesitation in receiving the vaccine remains a challenge in Jordan, as in other countries. The findings also show that participants, regardless of their vaccination status, had many concerns about the four types of vaccines approved for use in Jordan during the study conduction period. Moreover, the participants' perceptions and attitudes towards the vaccines were variable between vaccinated and non-vaccinated participants and were variable for the four types of vaccines

Keywords :Attitude; Covid-19; Jordan; Perception; Vaccine

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​​​​​Research Title :The Effects of Medications and the Roles of Pharmacists on the Recovery of Patients with COVID-19 Infection: An Epidemiological Study from the United Arab Emirates

Authors : Iman A Basheti, Hiba Barqawi, Razan I Nassar, Samar Thiab, Noor Atatreh, Eman Abu-Gharbieh​

Abstract :Patients infected with coronavirus have new experiences and hence new needs from the healthcare sector. Acknowledging patients’ experiences can exhibit promising outcomes in coronavirus management. Pharmacists are considered a vital pillar in managing patients’ experiences during their infection. A cross-sectional study was conducted to assess the experiences of COVID-19-infected individuals and the roles of pharmacists in the United Arab Emirates. The survey was face- and content-validated after being developed. Three sections were included in the survey (demographics, experiences of infected individuals, and the roles of pharmacists). Data were analyzed using the Statistical Package for the Social Sciences. The study participants (n = 509) had a mean age of 34.50 (SD = 11.93). The most reported symptoms among participants were fatigue (81.5%), fever (76.8%), headache (76.6%), dry cough (74.1%), muscle or joint pain (70.7%), and sore throat (68.6%). Vitamin C was the most used supplement (88.6%), followed by pain relievers (78.2%). Female gender was the only factor associated with symptom severity. About 79.0% agreed that the pharmacist played an important and effective role during their infection. The most reported symptom was fatigue, with females reporting more severe symptoms. The role of the pharmacist proved to be vital during this pandemic.

Keywords :coronavirus; COVID-19; pandemics; pharmacists; United Arab Emirates

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​​​​​Research Title :Public Knowledge and Perceptions about the Emerging Human Mpox in Jordan: A Cross-Sectional Study

Authors : Rana K Abu-Farha, Karem H Alzoubi, Tareq L Mukattash, Rama Alkhawaldeh, Muna Barakat, Samar Thiab​

Abstract :Hundreds of human mpox cases are spreading outside of Western and Central Africa, which could be considered a significant world health problem. In this study, we sought to assess public knowledge and perceptions of human mpox. The study was a cross-sectional survey conducted in Jordan in September–October 2022. All participants were approached through social media portals. A total of 1195 participants agreed to participate in this study. The participants showed a low median knowledge score about human mpox (4.0 out of 15.0, IQR = 5.0), with only 27.9% of the participants (n = 334) correctly identifying that human mpox is not a bacterial disease, and around half of them (n = 589, 49.3%) knowing that this disease affects both genders. Higher monthly income (≥400 JD/month) was significantly associated with better knowledge about the disease. Social media was the most comprehensive source of information about mpox (n = 1018, 85.2%). Finally, 57.3% of the participants (n = 685) believed that mpox would affect social and economic life, like the COVID-19 pandemic. These findings highlight the urgent need for systematic strategies that should be promoted to increase public knowledge of mpox, which will be critical in improving the capacity to respond to the disease.

Keywords : mpox; human mpox virus; knowledge; perception; outbreak; Jordan

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​​​​​Research Title :Web-Based Reporting of Post-Vaccination Symptoms for Inactivated COVID-19 Vaccines in Jordan: A Cross-Sectional Study

Authors :Razan I Nassar, Muna Barakat, Samar Thiab, Feras El-Hajji, Hiba Barqawi, Waseem El-Huneidi, Iman A Basheti, Eman Abu-Gharbieh ​

Abstract :Background The perception of COVID-19 vaccines as being unsafe is a major barrier to receiving the vaccine. Providing the public with accurate data regarding the vaccines would reduce vaccine hesitancy. Methods A cross-sectional study was conducted to collect data on the side effects experienced by the vaccinated population to assess the safety of the inactivated COVID-19 vaccine. Results The majority of the study participants (n = 386) were female (71.9%), and 38.6% of them were under 30 years old. Around half of the participants (52.8%) reported side effects after receiving the inactivated COVID-19 vaccine. Fatigue (85.1%), a sore arm at the site of the injection (82.1%), and discomfort (67.2%) were the most commonly reported side effects after the first dose. Reporting side effects was significantly associated with the female sex (p-value = 0.027). Significant associations between being female and experiencing chills, muscle or joint pain, anorexia, drowsiness, and hair loss were also found, as well as being above the age of 30 and experiencing a cough. Being a smoker was significantly associated with experiencing a cough, and a headache. Furthermore, chills, and a sore throat were significantly associated with individuals who had not been infected before. Conclusion Mild side effects were reported after receiving the inactivated COVID-19 vaccine. Fatigue was the most commonly reported side effect. Females, older adults, smokers, and those who had never been infected with COVID-19 had a greater susceptibility to certain side effects.

Keywords :coronavirus; COVID-19; side effects; vaccines; inactivated COVID-19 vaccine; Jordan

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​​​​​Research Title :Short-term side effects of COVID-19 vaccines: A cross-sectional study in Jordan

Authors : Razan I Nassar, Dalal Alnatour, Samar Thiab, Ayman Nassar, Feras El-Hajji, Iman A Bashe​

Abstract :The rapid manufacturing of vaccines has increased hesitancy toward receiving the COVID-19 vaccines. Clarifying what to expect after vaccination and revealing the possible side effects will lower hesitancy toward receiving the COVID-19 vaccine and increase public awareness. This descriptive cross-sectional survey-based study was conducted in Jordan (August 2021) to collect data on the short-term side effects following the COVID-19 vaccines. An extensive literature review was conducted by the research team to assist in developing the first draft of the survey. The survey was tested for face and content validity and piloted test to improve readability and clarity. The survey was organized into two sections (demographics and perceived COVID-19 vaccines’ side effects). Data were analyzed using the Statistical Package for Social Science (SPSS). A total of 1,044 participants were enrolled in the study. The most received vaccine among the participants was Pfizer-BioNTech (51.1%). The most frequently reported side effects were sore arm at the injection site (84.65%), fatigue (84.48%), discomfort (65.43%), muscles/joint pain (61.38%), drowsiness (58.73%), and headache (58.38%). More side effects were significantly associated with being older (p = 0.046), having an allergy (p = 0.024) or rheumatoid arthritis (p = 0.023), and participants who take NSAIDs regularly (p = 0.029). Short-term side effects of COVID-19 vaccines seem to be mostly local or transient in nature. Older age and certain comorbidities may increase susceptibility to side effects.

Keywords : COVID-19, pandemics, side effects, vaccine, immunization, Jordan

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​​​​​Research Title :Evaluation and molecular modelling of bis-Schiff base derivatives as potential leads for management of diabetes mellitus

Authors : Safa Daoud, Samar Thiab, Taghreed Jazzazi, Tareq Al-Shboul, Saeed Ullah​

Abstract :Developing a medication to cure and manage diabetes mellitus complications is of interest in medicinal chemistry. Toward this end, six bis-biphenyl-salicylaldehyde Schiff base derivatives have been evaluated for their α-glucosidase inhibition, antiglycation and anti-inflammation potentials. Four compounds (compounds 2–5) showed an excellent α-glucosidase inhibitory effect superior to that produced by acarbose. Additionally, the docking study revealed that these compounds are anchored within the binding pocket of α-glucosidase via hydrogen bonding, π-stacking and hydrophobic interactions, comparable to a high number of hydrogen bonding involved in anchoring acarbose. Interestingly, all tested compounds showed varying degrees of antiglycation activity with superior activity for two of them (compound 1 and compound 6) compared to the standard rutin. Moreover, the results indicated an outstanding anti-inflammatory activity for two compounds (compounds 1 and 6) compared to ibuprofen.

Keywords :bis-Schiff bases; diabetes mellitus; glycation; postprandial hyperglycemia; α-glucosidase; docking study

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​​​​​Research Title :Flavonoid-based nanomedicines to target tumor microenvironment

Authors : Wamidh H Talib, Alaa Abuawad, Samar Thiab, Areen Alshweiat, Asma Ismail Mahmod​

Abstract :Cancer cells arise and grow in tumor microenvironment which consists of stromal cells and extracellular matrix. The dynamic interaction between cancer cells and different components of the tumor microenvironment is a critical step in cancer development and progression. Several therapeutic strategies were explored as promising approaches to target tumor microenvironment. Flavonoids have gained increasing importance in cancer therapy due to their high bioavailability, low toxicity, and affordability. Many flavonoids showed potent activities as potential cytotoxic agents and multiple nano- formulations were tested to enhance the therapeutic effect of flavonoids. In this review, a comprehensive analysis of flavonoid-based nanomedicine was provided with special emphasis on tumor microenvironment components as therapeutic targets. Studies discussed in this review provide a solid ground for researchers and physicians to consider flavonoid based nano- formulations as possible adjuvant therapies with conventional anticancer agents.

Keywords :Flavonoids, Polyphenols, Natural products, Cancer, Nano-formulation, Dendritic cells

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​​​​​Research Title : Assessing health-related behaviors among Jordanian children during COVID-19 pandemic: A cross-sectional study

Authors :Samar Thiab, Muna Barakat, Raja' Qudah, Iman Basheti, Safa Daoud ​

Abstract :Background: The coronavirus disease identified in 2019 (COVID-19) led to extreme actions being taken by the governments to restrict the spread of this virus. Closure of schools, sport clubs and playgrounds were among these actions; children had to stay indoors and were not allowed to pursue their normal lifestyle activities. Objectives: To assess the differences in health-related behaviors among Jordanian school-aged children (6-16 years) before and during COVID-19 quarantine and to evaluate public's perception of the role of pharmacists regarding children's health-related behaviors management. Methods: A cross-sectional study was conducted from August 2020 to January 2021 using an anonymous web-based survey. The survey was developed based on previously published surveys. Evaluation of the validity and reliability of the survey were conducted by a professional committee of clinical pharmacists and a statistician. Results: A total of 230 children, aged 9.02± 2.977 participated in the study. Physical activity and healthy balanced meals decreased (less than 1 hr or 1-3 hrs/week vs 2 meals/day, p= <0.001), whereas daily screen time (1-3 hrs/week vs 4-6 hrs/week, p= <0.001), sleep hours (8-9 hrs/day vs 10-11 hrs/day, p= <0.001) and the ingestion of unhealthy snacks had increased (1-2 meals/day vs. 2-3 meals/day, p=<0.001). A positive perception of pharmacists' role during the pandemic was revealed. Conclusion: The present study showed that a significant change in children's health- related behavior happened during the COVID-19 pandemic. Such changes can lead to social, physical and mental health problems. The public perceived community pharmacists as trusted health care professionals during the pandemic

Keywords :children; covid-19; health-related behavior; pharmacists' role; quarantine

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​​​​​Research Title :Anticancer effect of spices used in Mediterranean diet: preventive and therapeutic potentials29

Authors :Wamidh Hadi Talib, Mallak J AlHur, Rawand E Ahmad, Arkan Hadi Al-Yasari, Anfal AL-Dalaeen, Samar Thiab, Asma Mahmod ​

Abstract :Cancer is one of the leading causes of death worldwide, with almost 10 million cancer-related deaths worldwide in 2020, so any investigation to prevent or cure this disease is very important. Spices have been studied widely in several countries due to their therapeutic uses. This review highlighted chemo-therapeutic and chemo-preventive effect of ginger, pepper, rosemary, turmeric, black cumin and clove. Moreover, the mechanisms of action for each one of them were figured out such as anti-angiogenesis, antioxidant, altering signaling pathways, induction of cell apoptosis, and cell cycle arrest, for several type of cancer.

Keywords :spices, ginger, cell apoptosis, chemo-prevention, anti-angiogenesis.

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​​​​​Research Title :Flavonoid-Based Nanomedicines to Target Tumor Microenvironment

Authors : ​Wamidh H Talib, Alaa Abuawad, Samar Thiab, Areen Alshweiat, Asma Ismail Mahmod

Abstract :Cancer cells arise and grow in tumor microenvironment which consists of stromal cells and extracellular matrix. The dynamic interaction between cancer cells and different components of the tumor microenvironment is a critical step in cancer development and progression. Several therapeutic strategies were explored as promising approaches to target tumor microenvironment. Flavonoids have gained increasing importance in cancer therapy due to their high bioavailability, low toxicity, and affordability. Many flavonoids showed potent activities as potential cytotoxic agents and multiple nano- formulations were tested to enhance the therapeutic effect of flavonoids. In this review, a comprehensive analysis of flavonoid-based nanomedicine was provided with special emphasis on tumor microenvironment components as therapeutic targets. Studies discussed in this review provide a solid ground for researchers and physicians to consider flavonoid based nano- formulations as possible adjuvant therapies with conventional anticancer agents.

Keywords :Flavonoids, Polyphenols, Natural products, Cancer, Nano-formulation, Dendritic cells.

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​​​​​Research Title :Assessing health-related behaviors among Jordanian children during COVID-19 pandemic: A cross-sectional study

Authors : Samar Thiab, Muna Barakat, Raja' Qudah, Iman Basheti, Safa Daoud​

Abstract :Background: The coronavirus disease identified in 2019 (COVID-19) led to extreme actions being taken by the governments to restrict the spread of this virus. Closure of schools, sport clubs and playgrounds were among these actions; children had to stay indoors and were not allowed to pursue their normal lifestyle activities. Objectives: To assess the differences in health-related behaviors among Jordanian school-aged children (6-16 years) before and during COVID-19 quarantine and to evaluate public’s perception of the role of pharmacists regarding children’s health-related behaviors management. Methods: A cross-sectional study was conducted from August 2020 to January 2021 using an anonymous web-based survey. The survey was developed based on previously published surveys. Evaluation of the validity and reliability of the survey were conducted by a professional committee of clinical pharmacists and a statistician. Results: A total of 230 children, aged 9.02± 2.977 participated in the study. Physical activity and healthy balanced meals decreased (less than 1 hr or 1-3 hrs/week vs 2 meals/day, p= <0.001), whereas daily screen time (1-3 hrs/week vs 4-6 hrs/week, p= <0.001), sleep hours (8-9 hrs/day vs 10-11 hrs/day, p= <0.001) and the ingestion of unhealthy snacks had increased (1-2 meals/day vs. 2-3 meals/day, p=<0.001). A positive perception of pharmacists’ role during the pandemic was revealed. Conclusion: The present study showed that a significant change in children’s healthrelated behavior happened during the COVID-19 pandemic. Such changes can lead to social, physical and mental health problems. The public perceived community pharmacists as trusted health care professionals during the pandemic.

Keywords :COVID-19; Quarantine; Pharmacists’ role; Children; Health-related behavio

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