Qassim University

Heavy metals are well-known environmental pollutants owing to their toxicity, longevity in the atmosphere, and ability to accumulate in the human body via bioaccumulation. The pollution of terrestrial and aquatic ecosystems with toxic heavy metals is a major environmental concern that has consequences for public health. Most heavy metals occur naturally, but a few are derived from anthropogenic sources. Heavy metals are characterized by their high atomic mass and toxicity to living organisms. Most heavy metals cause environmental and atmospheric pollution, and may be lethal to humans. Heavy metals can become strongly toxic by mixing with different environmental elements, such as water, soil, and air, and humans and other living organisms can be exposed to them through the food chain. Plenty of experimental studies were performed to appraise the promising treatment options from natural products. Additionally, nanotechnology based treatment options are being constantly developed. As an emerging field, nanotechnology is making substantial advances in the analysis and removal of heavy metals from complicated matrices. Removal of heavy metal has been accomplished by the use of a variety of nanomaterials, including graphene and its derivatives, magnetic nanoparticles, metal oxide nanoparticles, and carbon nanotubes, to name a few. Using nanotechnology for heavy metal analysis and removal from food and water resources provides many benefits over traditional methods. These advantages include a broad linear range, low detection and quantification limits, a high sensitivity, and high selectivity. Therefore this review aimed to explore the environmental consequences of the heavy metals, toxicity to the human health, as well as novel therapeutics development from the natural resources. Additionally, nanotechnological and nanomedicinal applications to treat heavy metal toxicity are also highlighted in this review.

The book Research Design: Qualitative, Quantitative and Mixed Methods Approaches by Creswell (2014) covers three approaches— qualitative, quantitative and mixed methods. This educational book is informative and illustrative and is equally beneficial for students, teachers and researchers. Readers should have basic knowledge of research for better understanding of this book. There are two parts of the book. Part 1 (chapter 1-4) consists of steps for developing research proposal and part II (chapter 5-10) explains how to develop a research proposal or write a research report. A summary is given at the end of every chapter that helps the reader to recapitulate the ideas. Moreover, writing exercises and suggested readings at the end of every chapter are useful for the readers.

Dietary polyphenols including phenolic acids, flavonoids, catechins, tannins, lignans, stilbenes, and anthocyanidins are widely found in grains, cereals, pulses, vegetables, spices, fruits, chocolates, and beverages like fruit juices, tea, coffee and wine. In recent years, dietary polyphenols have gained significant interest among researchers due to their potential chemopreventive/protective functions in the maintenance of human health and diseases. It is believed that dietary polyphenols/flavonoids exert powerful antioxidant action for protection against reactive oxygen species (ROS)/cellular oxidative stress (OS) towards the prevention of OS-related pathological conditions or diseases. Pre-clinical and clinical evidence strongly suggest that long term consumption of diets rich in polyphenols offer protection against the development of various chronic diseases such as neurodegenerative diseases, cardiovascular diseases (CVDs), cancer, diabetes, inflammatory disorders and infectious illness. Increased intake of foods containing polyphenols (for example, quercetin, epigallocatechin-3-gallate, resveratrol, cyanidin etc.) has been claimed to reduce the extent of a majority of chronic oxidative cellular damage, DNA damage, tissue inflammations, viral/bacterial infections, and neurodegenerative diseases. It has been suggested that the antioxidant activity of dietary polyphenols plays a pivotal role in the prevention of OS-induced human diseases. In this narrative review, the biological/pharmacological significance of dietary polyphenols in the prevention of and/or protection against OS-induced major human diseases such as cancers, neurodegenerative diseases, CVDs, diabetes mellitus, cancer, inflammatory disorders and infectious diseases have been delineated. This review specifically focuses a current understanding on the dietary sources of polyphenols and their protective effects including mechanisms of action against various major human diseases.

BACKGROUND: The closure of educational activities in the Kingdom of Saudi Arabia due to the ongoing COVID-19 pandemic resulted in an unplanned shift from traditional learning to a setup that exclusively involves digital teaching and learning. Within this context, the present study aimed to explore undergraduate medical students' perceptions regarding the effectiveness of synchronized online learning at Unaizah College of Medicine and Medical Sciences, Qassim University, Saudi Arabia. METHODS: A qualitative study was conducted using virtual focus group discussions synchronously with the help of a discussion guide consisting of seven open-ended questions. Overall, 60 medical students were recruited using a maximum variation sampling technique; these students then participated in eight focus group discussions. All interviews were recorded, transcribed verbatim, and analyzed for thematic contents using the standard (Mayring, Kiger. M. E. and Braun.V) content analysis framework. RESULTS: A thematic content analysis yielded four core themes: (1) educational impact, (2) time management, (3) challenges encountered, and (4) preferences for the future. The online modality was well-received, and all participants agreed that online sessions were time saving and that their performance was improved due to enhanced utility of time; however, they indicated that they encountered some challenges, including methodological, content perception, technical, and behavioral challenges during sessions and online exams. Most of the preclinical students preferred online learning for the upcoming academic years. CONCLUSION: Synchronized online classes were well-accepted by the medical students. This represents significant and promising potential for the future of medical education. The principles of the online learning model and learning outcomes should be rigorously and regularly evaluated to monitor its effectiveness.

Neem (Azadirachta indica) is a member of the Meliaceae family and its role as health-promoting effect is attributed because it is rich source of antioxidant. It has been widely used in Chinese, Ayurvedic, and Unani medicines worldwide especially in Indian Subcontinent in the treatment and prevention of various diseases. Earlier finding confirmed that neem and its constituents play role in the scavenging of free radical generation and prevention of disease pathogenesis. The studies based on animal model established that neem and its chief constituents play pivotal role in anticancer management through the modulation of various molecular pathways including p53, pTEN, NF-κB, PI3K/Akt, Bcl-2, and VEGF. It is considered as safe medicinal plants and modulates the numerous biological processes without any adverse effect. In this review, I summarize the role of Azadirachta indica in the prevention and treatment of diseases via the regulation of various biological and physiological pathways.

Cancer chemotherapy resistance (MDR) is the innate and/or acquired ability of cancer cells to evade the effects of chemotherapeutics and is one of the most pressing major dilemmas in cancer therapy. Chemotherapy resistance can arise due to several host or tumor-related factors. However, most current research is focused on tumor-specific factors and specifically genes that handle expression of pumps that efflux accumulated drugs inside malignantly transformed types of cells. In this work, we suggest a wider and alternative perspective that sets the stage for a future platform in modifying drug resistance with respect to the treatment of cancer.

Olive from Olea europaea is native to the Mediterranean region and, both the oil and the fruit are some of the main components of the Mediterranean diet. The main active constituents of olive oil include oleic acid, phenolic constituents, and squalene. The main phenolic compounds, hydroxytyrosol and oleuropein, give extra-virgin olive oil its bitter, pungent taste. The present review focuses on recent works that have analyzed the relationship between the major phenolic compound oleuropein and its pharmacological activities including antioxidant, anti-inflammatory, anti-atherogenic, anti-cancer activities, antimicrobial activity, antiviral activity, hypolipidemic and hypoglycemic effect.

Abstract Water scarcity is one of the major problems in the world and millions of people have no access to freshwater. Untreated wastewater is widely used for agriculture in many countries. This is one of the world-leading serious environmental and public health concerns. Instead of using untreated wastewater, treated wastewater has been found more applicable and ecofriendly option. Moreover, environmental toxicity due to solid waste exposures is also one of the leading health concerns. Therefore, intending to combat the problems associated with the use of untreated wastewater, we propose in this review a multidisciplinary approach to handle wastewater as a potential resource for use in agriculture. We propose a model showing the efficient methods for wastewater treatment and the utilization of solid wastes in fertilizers. The study also points out the associated health concern for farmers, who are working in wastewater-irrigated fields along with the harmful effects of untreated wastewater. The consumption of crop irrigated by wastewater has leading health implications also discussed in this review paper. This review further reveals that our current understanding of the wastewater treatment and use in agriculture with addressing advancements in treatment methods has great future possibilities.

In recent years, there is a growing interest towards the green synthesis of metal nanoparticles, particularly from plants; however, yet no published study on the synthesis of ZnO.NPs using the Deverra tortuosa extract. Through this study, zinc oxide nanoparticles (ZnO.NPs) have been synthesized based on using the environmentally benign extract of the aerial parts of D. tortuosa as a reducing and capping agent. ZnO.NPs synthesis was confirmed using UV-Visible (UV-Vis) spectroscopy, Fourier Transform Infrared Spectroscopy (FTIR), X-ray Diffraction (XRD) and High Resolution-Transmission Electron Microscope (HR-TEM). The qualitative and quantitative analyses of plant extract were done. The potential anticancer activity was in vitro investigated against two cancer cell lines (human colon adenocarcinoma "Caco-2" and human lung adenocarcinoma "A549") compared to their activities on the human lung fibroblast cell line (WI38) using the MTT assay. Both the aqueous extract and ZnO.NPs showed a remarkable selective cytotoxicity against the two examined cancer cell lines.

BACKGROUND: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emerging infection causing a widely spread pandemic of Coronavirus disease 2019 (COVID-19). The current COVID-2019 pandemic is prompting fear of falling sick, dying, helplessness and stigma, urgent and timely understanding of mental health status is needed to help the community. Our investigation designed to survey the general population in Saudi Arabia to assess the degree of psychological impact during the pandemic. METHODS: During the early stage of the outbreak, we conducted an online-based survey using a snowballing sample technique. The surveys collected data about several aspects of participant sociodemographic, knowledge, concerns, psychological impact, and mental health status. We assessed the psychological impact and mental health status using the Impact of Event Scale-Revised (IES-R), and the Depression, Anxiety, and Stress Scale (DASS-21). RESULTS: Our survey recruited 1160 respondents of the general public of Saudi Arabia. Of them, 23.6% reported moderate or severe psychological impact of the outbreak, 28.3%,24%, and 22.3% reported moderate to severe depressive, anxiety, and stress symptoms, respectively. Females reported IES-R (B: 5.46, 95% CI: 3.61 to 7.31) and DASS subscales B coefficient ranged from 1.65 to 2.63, along with high-school students, working in the medical field, and poor self-reported health status was significantly associated with a high level of IES-R and DASS scales (p < .05). Experiencing breathing difficulty and dizziness showed a stronger association with higher IES-R and DASS subscales than other somatic symptoms (e.g., headache and fever);(p < .001). Respondents who practiced specific preventative measures (e.g., hand washing, social distancing) demonstrated a protective effect against stress, anxiety, and depression symptoms. Social distancing appeared to be protective on stress and anxiety subscales (B: -1.49, 95% CI: -2.79 to -0.19),(B: -1.53, 95% CI: -2.50 to -0.57),respectively; and hand hygiene on depression subscale (B: -2.43, 95% CI: -4.44 to -0.42). CONCLUSION: Throughout the early stage of the COVID-19 outbreak in Saudi Arabia, the results showed that nearly one-fourth of the sampled general population experienced moderate to severe psychological impact. Following specific precautionary measures appeared to have a protective effect on the individual's mental health. Our findings can be used to construct psychological interventions directed toward vulnerable populations and to implement public mental health strategies in the early stages of the outbreak.

Abstract The utilization of dyes in textile industries has enormously increased in recent years and has created several environmental problems. Currently, several methods are in practice to treat wastewaters. Effective and efficient treatment techniques before the discharge of used water in the environment are the need of the hour. This short review covers the research and recent developments in advanced wastewater treatment techniques such as nanophotocatalysis, ceramic nanofiltration membranes, and biofilms. The primary intent of this review article is to contribute the ready-made references for the active researchers and scientists working in the field of wastewater treatment. This review has mainly focused on advanced physico-chemical and biological techniques for the treatment of textile dye wastewaters. Further, the influence of various operating factors on the treatment, advantages, and disadvantages of various techniques was also discussed. The recently developed materials for wastewater treatment are also summarized based on the latest available literature. Graphic abstract

Natural products have played a critical role in medicine due to their ability to bind and modulate cellular targets involved in disease. Medicinal plants hold a variety of bioactive scaffolds for the treatment of multiple disorders. The less adverse effects, affordability, and easy accessibility highlight their potential in traditional remedies. Identifying pharmacological targets from active ingredients of medicinal plants has become a hot topic for biomedical research to generate innovative therapies. By developing an unprecedented opportunity for the systematic investigation of traditional medicines, network pharmacology is evolving as a systematic paradigm and becoming a frontier research field of drug discovery and development. The advancement of network pharmacology has opened up new avenues for understanding the complex bioactive components found in various medicinal plants. This study is attributed to a comprehensive summary of network pharmacology based on current research, highlighting various active ingredients, related techniques/tools/databases, and drug discovery and development applications. Moreover, this study would serve as a protocol for discovering novel compounds to explore the full range of biological potential of traditionally used plants. We have attempted to cover this vast topic in the review form. We hope it will serve as a significant pioneer for researchers working with medicinal plants by employing network pharmacology approaches.

BACKGROUND: Pharmacy practice in Yemen was established in 1875 in Aden. OBJECTIVES: To describe pharmacy practice as it currently exists in Yemen, the challenges the profession faces, and to recommend changes that will improve pharmaceutical care services. METHODS: This study has two parts. Part 1 comprised a literature search performed between May and July 2011 to identify published studies on pharmacy practice in Yemen. Full text papers, abstracts, and reports in Arabic or English between 1970 and 2011 were reviewed. Part 2 consisted of a qualitative study with face-to-face interviews with a representative sample of pharmacists, staff from the Ministry of Public Health and Population (MoPHP), and patients. RESULTS: The analysis revealed several issues that plague pharmacy practice in Yemen: Fewer than 10 per cent of pharmacists working in pharmacies and drug stores are graduates of governmentrecognised colleges.Most Yemeni pharmacists are dissatisfied with their work conditions and opportunities.Medicines are expensive and hard to access in Yemen, and counterfeit medicines are a serious problem.Few regulations and standards exist for pharmacists and pharmaceutical care.Pharmaceutical marketing plays an important role in marketing and selling products in Yemen.A dearth of standards, regulations, and laws are hurting pharmacy practice in the country and potentially endangering peoples' lives. CONCLUSION: In order to improve pharmacy practice in Yemen, many changes are needed, including updating the pharmacy curriculum taught, implementing industry standards for pharmacy practice, implementing and reinforcing laws, and integrating pharmacists more fully in the healthcare industry. Additionally, the quality of the pharmacy workforce needs to be improved, and there needs to be increased awareness by the public, physicians, other healthcare professionals, and policy makers about the value of pharmacists.

BACKGROUND: For more than three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has provided a framework to quantify health loss due to diseases, injuries, and associated risk factors. This paper presents GBD 2023 findings on disease and injury burden and risk-attributable health loss, offering a global audit of the state of world health to inform public health priorities. This work captures the evolving landscape of health metrics across age groups, sexes, and locations, while reflecting on the remaining post-COVID-19 challenges to achieving our collective global health ambitions. METHODS: The GBD 2023 combined analysis estimated years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 375 diseases and injuries, and risk-attributable burden associated with 88 modifiable risk factors. Of the more than 310 000 total data sources used for all GBD 2023 (about 30% of which were new to this estimation round), more than 120 000 sources were used for estimation of disease and injury burden and 59 000 for risk factor estimation, and included vital registration systems, surveys, disease registries, and published scientific literature. Data were analysed using previously established modelling approaches, such as disease modelling meta-regression version 2.1 (DisMod-MR 2.1) and comparative risk assessment methods. Diseases and injuries were categorised into four levels on the basis of the established GBD cause hierarchy, as were risk factors using the GBD risk hierarchy. Estimates stratified by age, sex, location, and year from 1990 to 2023 were focused on disease-specific time trends over the 2010-23 period and presented as counts (to three significant figures) and age-standardised rates per 100 000 person-years (to one decimal place). For each measure, 95% uncertainty intervals [UIs] were calculated with the 2·5th and 97·5th percentile ordered values from a 250-draw distribution. FINDINGS: Total numbers of global DALYs grew 6·1% (95% UI 4·0-8·1), from 2·64 billion (2·46-2·86) in 2010 to 2·80 billion (2·57-3·08) in 2023, but age-standardised DALY rates, which account for population growth and ageing, decreased by 12·6% (11·0-14·1), revealing large long-term health improvements. Non-communicable diseases (NCDs) contributed 1·45 billion (1·31-1·61) global DALYs in 2010, increasing to 1·80 billion (1·63-2·03) in 2023, alongside a concurrent 4·1% (1·9-6·3) reduction in age-standardised rates. Based on DALY counts, the leading level 3 NCDs in 2023 were ischaemic heart disease (193 million [176-209] DALYs), stroke (157 million [141-172]), and diabetes (90·2 million [75·2-107]), with the largest increases in age-standardised rates since 2010 occurring for anxiety disorders (62·8% [34·0-107·5]), depressive disorders (26·3% [11·6-42·9]), and diabetes (14·9% [7·5-25·6]). Remarkable health gains were made for communicable, maternal, neonatal, and nutritional (CMNN) diseases, with DALYs falling from 874 million (837-917) in 2010 to 681 million (642-736) in 2023, and a 25·8% (22·6-28·7) reduction in age-standardised DALY rates. During the COVID-19 pandemic, DALYs due to CMNN diseases rose but returned to pre-pandemic levels by 2023. From 2010 to 2023, decreases in age-standardised rates for CMNN diseases were led by rate decreases of 49·1% (32·7-61·0) for diarrhoeal diseases, 42·9% (38·0-48·0) for HIV/AIDS, and 42·2% (23·6-56·6) for tuberculosis. Neonatal disorders and lower respiratory infections remained the leading level 3 CMNN causes globally in 2023, although both showed notable rate decreases from 2010, declining by 16·5% (10·6-22·0) and 24·8% (7·4-36·7), respectively. Injury-related age-standardised DALY rates decreased by 15·6% (10·7-19·8) over the same period. Differences in burden due to NCDs, CMNN diseases, and injuries persisted across age, sex, time, and location. Based on our risk analysis, nearly 50% (1·27 billion [1·18-1·38]) of the roughly 2·80 billion total global DALYs in 2023 were attributable to the 88 risk factors analysed in GBD. Globally, the five level 3 risk factors contributing the highest proportion of risk-attributable DALYs were high systolic blood pressure (SBP), particulate matter pollution, high fasting plasma glucose (FPG), smoking, and low birthweight and short gestation-with high SBP accounting for 8·4% (6·9-10·0) of total DALYs. Of the three overarching level 1 GBD risk factor categories-behavioural, metabolic, and environmental and occupational-risk-attributable DALYs rose between 2010 and 2023 only for metabolic risks, increasing by 30·7% (24·8-37·3); however, age-standardised DALY rates attributable to metabolic risks decreased by 6·7% (2·0-11·0) over the same period. For all but three of the 25 leading level 3 risk factors, age-standardised rates dropped between 2010 and 2023-eg, declining by 54·4% (38·7-65·3) for unsafe sanitation, 50·5% (33·3-63·1) for unsafe water source, and 45·2% (25·6-72·0) for no access to handwashing facility, and by 44·9% (37·3-53·5) for child growth failure. The three leading level 3 risk factors for which age-standardised attributable DALY rates rose were high BMI (10·5% [0·1 to 20·9]), drug use (8·4% [2·6 to 15·3]), and high FPG (6·2% [-2·7 to 15·6]; non-significant). INTERPRETATION: Our findings underscore the complex and dynamic nature of global health challenges. Since 2010, there have been large decreases in burden due to CMNN diseases and many environmental and behavioural risk factors, juxtaposed with sizeable increases in DALYs attributable to metabolic risk factors and NCDs in growing and ageing populations. This long-observed consequence of the global epidemiological transition was only temporarily interrupted by the COVID-19 pandemic. The substantially decreasing CMNN disease burden, despite the 2008 global financial crisis and pandemic-related disruptions, is one of the greatest collective public health successes known. However, these achievements are at risk of being reversed due to major cuts to development assistance for health globally, the effects of which will hit low-income countries with high burden the hardest. Without sustained investment in evidence-based interventions and policies, progress could stall or reverse, leading to widespread human costs and geopolitical instability. Moreover, the rising NCD burden necessitates intensified efforts to mitigate exposure to leading risk factors-eg, air pollution, smoking, and metabolic risks, such as high SBP, BMI, and FPG-including policies that promote food security, healthier diets, physical activity, and equitable and expanded access to potential treatments, such as GLP-1 receptor agonists. Decisive, coordinated action is needed to address long-standing yet growing health challenges, including depressive and anxiety disorders. Yet this can be only part of the solution. Our response to the NCD syndemic-the complex interaction of multiple health risks, social determinants, and systemic challenges-will define the future landscape of global health. To ensure human wellbeing, economic stability, and social equity, global action to sustain and advance health gains must prioritise reducing disparities by addressing socioeconomic and demographic determinants, ensuring equitable health-care access, tackling malnutrition, strengthening health systems, and improving vaccination coverage. We live in times of great opportunity. FUNDING: Gates Foundation and Bloomberg Philanthropies.

The aim of this study is to assess self-medication practice among university students in the Al-Qassim Province of Saudi Arabia. A cross-sectional community-based survey was conducted by distributing a self-administered 18-item questionnaire among university students in the Al-Qassim Province of Saudi Arabia in the period between October and December 2012. The participants were selected using a convenience sampling technique. Data were collected from the questionnaire and analyzed using SPSS version 19. A total of 354 male students with an average age of 21.95 (SD ± 3.43) participated in this study. Our study showed that self-medication among male students was high (86.6%) compared to results shown in other studies in the same region. Headache (59.9%), cough/cold (41%) and fever (24.6%) were the most common symptoms associated with self-medication. Congruent with the medical conditions reported, the most widely used medications without prescriptions were paracetamol (34.7%), followed by antibiotics (31.4%) and nonsteroidal anti-inflammatory drugs (28.7%). Our study shows that antibiotics were sometimes irrationally used for self-treatment of cough and fever. Self-medication was highly frequent among the students. Influence of TV advertisements, high accessibility of pharmacies and convenience stores, as well as good buying power were found to be leading factors for self-medication among male university students.

Aim To determine the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of silver nanoparticles against Staphylococcus aureus (S. aureus).Methodology: The antimicrobial efficacy of the silver nanoparticles was determined by the standard methods of Clinical and Laboratory Standards Institute (CLSI). Different concentrations of silver nanoparticles were prepared, and MIC was calculated by tube macro-dilution method. The MBC was determined by the lowest concentration that kills 99.9% of the initial bacterial population. The data were analyzed by ANOVA and Tukey’s post hoc test using SPSS software.Results The MIC and MBC of silver nanoparticles against S. aureus was found to be 0.625 mg/ml.Conclusion The result obtained from this study shows that silver nanoparticles have potential bactericidal effects against S. aureus at a concentration of 0.625 mg/ml. Silver nanoparticles can be incorporated in the root canal medicaments, sealers and irrigants as it possess potent antimicrobial efficacy against S. aureus.

Advanced glycation end-products (AGEs) resulting from non-enzymatic glycation are one of the major factors implicated in secondary complications of diabetes. Scientists are focusing on discovering new compounds that may be used as potential AGEs inhibitors without affecting the normal structure and function of biomolecules. A number of natural and synthetic compounds have been proposed as AGE inhibitors. In this study, we investigated the inhibitory effects of AgNPs (silver nanoparticles) in AGEs formation. AgNPs (~30.5 nm) synthesized from Aloe Vera leaf extract were characterized using UV-Vis spectroscopy, energy-dispersive X-ray spectroscopy (EDX), high resolution-transmission electron microscopy, X-ray diffraction and dynamic light scattering (DLS) techniques. The inhibitory effects of AgNPs on AGEs formation were evaluated by investigating the degree of reactivity of free amino groups (lysine and arginine residues), protein-bound carbonyl and carboxymethyl lysine (CML) content, and the effects on protein structure using various physicochemical techniques. The results showed that AgNPs significantly inhibit AGEs formation in a concentration dependent manner and that AgNPs have a positive effect on protein structure. These findings strongly suggest that AgNPs may play a therapeutic role in diabetes-related complications.

Objective: The aim of this study was to compare the knowledge, attitude and barriers of pharmacy technicians and pharmacists toward pharmacovigilance, adverse drug reactions (ADRs) and ADR reporting in community pharmacies in Yemen. Methods: This cross-sectional survey was conducted among community pharmacists and pharmacy technicians in the capital of Yemen, Sana’a. A total of 289 community pharmacies were randomly selected. The validated and pilot-tested questionnaire consisted of six sections: demographic data, knowledge about pharmacovigilance, experience with ADR reporting, attitudes toward ADR reporting, and the facilitators to improve ADR reporting. Results: A total of 428 pharmacy technicians and pharmacists were contacted and 179 went on to complete a questionnaire (response rate: 41.8%). Of the 179 respondents, 21 (11.7%) were pharmacists and 158 (88.3%) were pharmacy technicians, of which, 176 (98.3%) were male and 3 (1.7%) were female. The mean age of the respondents was 25.87±2.63 years. There was a significant difference between the pharmacists and pharmacy technicians in terms of knowledge scores ( P <0.05). The mean knowledge scores for pharmacists was 3.33±2.852 compared to 0.15±0.666 for pharmacy technicians. With regard to attitudes toward ADR reporting, all pharmacists (100%) showed a positive attitude, while only 43% of pharmacy technicians showed a positive attitude. Conclusion: Pharmacists have a significantly better knowledge than pharmacy technicians with regard to pharmacovigilance. More than half of pharmacy technicians showed a negative attitude toward ADR reporting. Therefore, educational interventions and training is very important for community pharmacists and pharmacy technicians in Yemen to increase their awareness and participation in ADR reporting. Keywords: pharmacovigilance, adverse drug reactions, knowledge, attitude, community pharmacy, Yemen

OBJECTIVE: The aim of this study was to investigate the completeness and legibility of prescriptions dispensed in community pharmacies located in Sana'a, Yemen. MATERIALS AND METHODS: A cross-sectional study was conducted at 23 randomly selected community pharmacies throughout the capital city of Sana'a, Yemen, from May 2015 to January 2016. A total of 2,178 prescriptions were analyzed for the essential elements of a complete prescription using a validated checklist. RESULTS: Of the 2,178 prescriptions, 19 (0.87%) were considered to be of good quality. The remaining 2,159 (99.12%) were considered as being of very poor quality. Writing errors relating to patients and prescribed medications were the most common errors. CONCLUSION: In this study, the quality of prescription writing was found to be very poor. Hence, continuous professional development programs are recommended to improve the quality of prescription writing among physicians. Future studies in other cities and investigation of the impact of continuous educational programs on the quality of prescription writing are strongly recommended.

Corona Virus Disease (COVID-19) has been announced as a pandemic and is spreading rapidly throughout the world. Early detection of COVID-19 may protect many infected people. Unfortunately, COVID-19 can be mistakenly diagnosed as pneumonia or lung cancer, which with fast spread in the chest cells, can lead to patient death. The most commonly used diagnosis methods for these three diseases are chest X-ray and computed tomography (CT) images. In this paper, a multi-classification deep learning model for diagnosing COVID-19, pneumonia, and lung cancer from a combination of chest x-ray and CT images is proposed. This combination has been used because chest X-ray is less powerful in the early stages of the disease, while a CT scan of the chest is useful even before symptoms appear, and CT can precisely detect the abnormal features that are identified in images. In addition, using these two types of images will increase the dataset size, which will increase the classification accuracy. To the best of our knowledge, no other deep learning model choosing between these diseases is found in the literature. In the present work, the performance of four architectures are considered, namely: VGG19-CNN, ResNet152V2, ResNet152V2 + Gated Recurrent Unit (GRU), and ResNet152V2 + Bidirectional GRU (Bi-GRU). A comprehensive evaluation of different deep learning architectures is provided using public digital chest x-ray and CT datasets with four classes (i.e., Normal, COVID-19, Pneumonia, and Lung cancer). From the results of the experiments, it was found that the VGG19 +CNN model outperforms the three other proposed models. The VGG19+CNN model achieved 98.05% accuracy (ACC), 98.05% recall, 98.43% precision, 99.5% specificity (SPC), 99.3% negative predictive value (NPV), 98.24% F1 score, 97.7% Matthew's correlation coefficient (MCC), and 99.66% area under the curve (AUC) based on X-ray and CT images.