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  1. Abu-Farha R, Alzoubi KH, Abu Assab M, Awwad O, Gharaibeh L, Mukattash TL, et al.
    Patient Prefer Adherence, 2023;17:2131-2140.
    PMID: 37650044 DOI: 10.2147/PPA.S428470
    OBJECTIVE: This research aimed to explore how telepharmacy is perceived, whether it would be willingly used by the overall population in Jordan, and the associated socioeconomic disparities that might affect its acceptance.

    METHODS: This is a survey-based cross-sectional study involving the general public of Jordan. The study took place in various Jordanian cities from May 2nd to June 1st, 2023. Using Google forms, the questionnaire was shared through various social media channels (such as Facebook and WhatsApp).

    RESULTS: The questionnaire received responses from 800 participants. The data showed that a sizable portion of the Jordanian population were unaware of telepharmacy (n= 343, 42.9%), and a majority had never utilized it (n= 131, 16.4%). The participants viewed the main advantage of telepharmacy as minimizing unnecessary trips to pharmacies (n= 668, 83.5%) and reducing travel time and expenses (n= 632, 79.0%). However, the primary concern was the mental effort required to use this service (n= 465, 58.1%). Of the respondents, 61.3% (n= 490) indicated a willingness to adopt telepharmacy services in the future. Regression analysis indicated that men were more likely to use this service compared to women (OR= 1.947, p<0.001), and people living in northern and southern Jordan exhibited a greater willingness compared to those inhabiting the central region (OR= 2.168, p<0.001).

    CONCLUSION: The results reveal a positive attitude towards and a significant readiness to embrace telepharmacy among the Jordanian population. However, for broader acceptance and utilization, apprehensions regarding the service need to be addressed. Doing so could improve access to pharmaceutical care, particularly for patients living in far-flung areas of Jordan.

  2. Masadeh MM, Bany-Ali NM, Khanfar MS, Alzoubi KH, Massadeh MM, Almomani EM
    Curr Drug Deliv, 2024 Jan 12.
    PMID: 38231065 DOI: 10.2174/0115672018279213240110045557
    BACKGROUND: The misuse of antibiotics leads to a global increase in antibiotic resistance. Therefore, it is imperative to search for alternative compounds to conventional antibiotics. ZnO nanoparticles (Zn NP) are one of these alternatives because they are an effective option to overcome biofilm bacterial cells and a novel way to overcome multidrug resistance in bacteria. The current research study aims to characterize the efficacy of ZnO nanoparticles alone and in combination with other antibacterial drugs against bacterial biofilms.

    METHODS: ZnO NPs were prepared by co-precipitation method, and their anti-biofilm and antibacterial activities alone or combined with four types of broad-spectrum antibacterial (Norfloxacin, Colistin, Doxycycline, and Ampicillin) were evaluated against E. coli and S. aureus bacterial strains. Finally, the cytotoxicity and the hemolytic activity were evaluated.

    RESULTS: ZnO NPs were prepared, and results showed that their size was around 10 nm with a spherical shape and a zeta potential of -21.9. In addition, ZnO NPs were found to have a strong antibacterial effect against Gram-positive and Gram-negative microorganisms, with a minimum inhibitory concentration (MIC) of 62.5 and 125 μg/mL, respectively. Additionally, they could eradicate biofilmforming microorganisms at a concentration of 125 μg/m. ZnO NPs were found to be non-toxic to erythrocyte cells. Still, some toxicity was observed for Vero cells at effective concentration ranges needed to inhibit bacterial growth and eradicate biofilm-forming organisms. When combined with different antibacterial, ZnO NP demonstrated synergistic and additive effects with colistin, and the MIC and MBEC of the combination decreased significantly to 0.976 μg/mL against planktonic and biofilm strains of MDR Gram-positive bacteria, resulting in significantly reduced toxicity.

    CONCLUSION: The findings of this study encourage the development of alternative therapies with high efficacy and low toxicity. ZnO nanoparticles have demonstrated promising results in overcoming multi-drug resistant bacteria and biofilms, and their combination with colistin has shown a significant reduction in toxicity. Further studies are needed to investigate the potential of ZnO nanoparticles as a viable alternative to conventional antibiotics.

  3. Masadeh MM, Al-Tal Z, Khanfar MS, Alzoubi KH, Sabi SH, Massadeh MM
    Curr Pharm Biotechnol, 2024 Jan 12.
    PMID: 38231054 DOI: 10.2174/0113892010279217240102100405
    BACKGROUND: The increase in nosocomial multidrug resistance and biofilm-forming bacterial infections led to the search for new alternative antimicrobial strategies other than traditional antibiotics. Silver nanoparticles [AgNP] could be a viable treatment due to their wide range of functions, rapid lethality, and minimal resistance potential. The primary aim of this study is to prepare silver nanoparticles and explore their antibacterial activity against biofilms.

    METHODS: AgNPs with specific physicochemical properties such as size, shape, and surface chemistry were prepared using a chemical reduction technique, and then characterized by DLS, SEM, and FTIR. The activity of AgNPs was tested alone and in combination with some antibiotics against MDR Gram-negative and Gram-positive planktonic bacterial cells and their biofilms. Finally, mammalian cell cytotoxicity and hemolytic activity were tested using VERO and human erythrocytes.

    RESULTS: The findings of this study illustrate the success of the chemical reduction method in preparing AgNPs. Results showed that AgNPs have MIC values against planktonic organisms ranging from 0.0625 to 0.125 mg/mL, with the greatest potency against gram-negative bacteria. It also effectively destroyed biofilm-forming cells, with minimal biofilm eradication concentrations [MBEC] ranging from 0.125 to 0.25 mg/ml. AgNPs also had lower toxicity profiles for the MTT test when compared to hemolysis to erythrocytes. Synergistic effect was found between AgNPs and certain antibiotics, where the MIC was dramatically reduced, down to less than 0.00195 mg/ml in some cases.

    CONCLUSION: The present findings encourage the development of alternative therapies with high efficacy and low toxicity.

  4. Alrabadi N, Bany-Melhem S, Alzoubi KH, Alzoubi OO, Masadeh M, Abuhammad S, et al.
    PMID: 35549859 DOI: 10.2174/2772432817666220512112913
    Vaccines are important to improve immunity against pathogens and diseases. The current COVID-19 disease is rapidly evolving and spreading among people; therefore, it is important to utilize a proper vaccination strategy against it. Currently, many approved vaccines are available and accessible; however, there is a reported hesitancy against taking them among the public and even the health care workers. Mainly, this is attributed to the fear of the possible side effects and complications. Moreover, inaccurate knowledge disseminated through the media/social media especially by those who lack proper expertise adds confusion and more fear that affects the vaccination decision. For such reasons, it is essential to find strategies to increase the acceptability of vaccines and to enhance confidence in the vaccination process. This should be accompanied by sufficient efforts and proper clinical studies to confirm the value and the safety of the vaccines. Those strategies are important to avoid the further spread of the COVID-19 disease and to abort the pandemic worldwide, especially when considering the likely approach towards a COVID-19 booster vaccination program, in which booster vaccines are re-taken along intervals to adequately contain the rapidly evolving nature of the virus. This review article highlights the factors influencing the acceptability of the COVID-19 vaccination and enrollment in clinical trials among the public and some specific populations. Furthermore, it summarizes the suggested strategies and recommendations that can improve the attitudes towards COVID-19 vaccination programs.
  5. Halboup AM, Alzoubi KH, Khabour OF, Alomari MA, Refat M, Al-Khazzan AY, et al.
    J Multidiscip Healthc, 2023;16:707-716.
    PMID: 36938485 DOI: 10.2147/JMDH.S399405
    BACKGROUND: Following the coronavirus disease (COVID-19) declaration as a pandemic, Yemen has started applying preventive measures to prevent its spread. This study aims to identify the perception regarding the nature of the COVID-19 disease, susceptibility to severe forms of the disease, and its relationship to seasonal influenza among the population of Yemen.

    METHODS: This was a cross-sectional study of the public in Yemen. The relationship between participants' sociodemographic factors and their responses was assessed by the chi-square test.

    RESULTS: A total of 748 participants agreed to participate in the study. Regarding the nature of the diseases, nearly half of the participants (48.8%, n=352) believed that COVID-19 is a naturally occurring human virus that is a serious and fatal disease (61.2%, n=448). The majority (74.9%; n=518) did not agree that bacteria cause COVID-19. More than half of the participants (57.5%, n=423) believed this disease is transmitted to humans through a host animal. Regarding the vulnerable groups to develop severe COVID-19 infection, most of the participants pointed out that the elderly (94.3%, n=705), people with chronic diseases (89.9%, n=669), and pregnant women (53%, n=365) were more susceptible to severe diseases. Regarding symptoms, the majority (61.9%, n=458) of the participants agreed that the symptoms of COVID-19 are similar to those of seasonal influenza. Additionally, the majority (81.9%, n=579) agreed that some individuals develop more severe symptoms than seasonal influenza, particularly those with chronic illness. Gender, age, and education were found to be associated with participants' perceptions regarding the nature of the virus and susceptibility to severe disease.

    CONCLUSION: Participants demonstrate a good understanding of the nature and susceptibility to complications associated with COVID-19 disease and its relationship to influenza. However, the respondents with a lower level of education might require additional educational campaigns to improve their awareness of the disease.

  6. Zawiah M, Al-Ashwal FY, Gharaibeh L, Abu Farha R, Alzoubi KH, Abu Hammour K, et al.
    J Multidiscip Healthc, 2023;16:4099-4110.
    PMID: 38116306 DOI: 10.2147/JMDH.S439223
    BACKGROUND: The emergence of Chat-Generative Pre-trained Transformer (ChatGPT) by OpenAI has revolutionized AI technology, demonstrating significant potential in healthcare and pharmaceutical education, yet its real-world applicability in clinical training warrants further investigation.

    METHODS: A cross-sectional study was conducted between April and May 2023 to assess PharmD students' perceptions, concerns, and experiences regarding the integration of ChatGPT into clinical pharmacy education. The study utilized a convenient sampling method through online platforms and involved a questionnaire with sections on demographics, perceived benefits, concerns, and experience with ChatGPT. Statistical analysis was performed using SPSS, including descriptive and inferential analyses.

    RESULTS: The findings of the study involving 211 PharmD students revealed that the majority of participants were male (77.3%), and had prior experience with artificial intelligence (68.2%). Over two-thirds were aware of ChatGPT. Most students (n= 139, 65.9%) perceived potential benefits in using ChatGPT for various clinical tasks, with concerns including over-reliance, accuracy, and ethical considerations. Adoption of ChatGPT in clinical training varied, with some students not using it at all, while others utilized it for tasks like evaluating drug-drug interactions and developing care plans. Previous users tended to have higher perceived benefits and lower concerns, but the differences were not statistically significant.

    CONCLUSION: Utilizing ChatGPT in clinical training offers opportunities, but students' lack of trust in it for clinical decisions highlights the need for collaborative human-ChatGPT decision-making. It should complement healthcare professionals' expertise and be used strategically to compensate for human limitations. Further research is essential to optimize ChatGPT's effective integration.

  7. Alrabadi N, Al-Nusair M, El-Zubi FK, Tashtoush M, Alzoubi O, Khamis S, et al.
    Curr Vasc Pharmacol, 2024;22(1):58-66.
    PMID: 38038004 DOI: 10.2174/0115701611260211231115094716
    BACKGROUND: Atrial fibrillation (AF) is the most commonly encountered cardiac arrhythmia in clinical practice. Heart failure (HF) can occur concurrently with AF.

    AIM: We compared different demographic, clinical, and echocardiographic characteristics between patients with AF+HF and patients with AF only. Furthermore, we explored whether concurrent HF independently predicts several outcomes (all-cause mortality, cardiovascular mortality, ischemic stroke/systemic embolism (IS/SE), major bleeding, and clinically relevant non-major bleeding (CRNMB)).

    MATERIALS AND METHODS: Comparisons between the AF+HF and the AF-only group were carried out. Multivariable Cox proportional hazard models were constructed for each outcome to assess whether HF was predictive of any of them while controlling for possible confounding factors.

    RESULTS: A total of 2020 patients were included in this study: 481 had AF+HF; 1539 had AF only. AF+HF patients were older, more commonly males, and had a higher prevalence of diabetes mellitus, dyslipidemia, coronary artery disease, and chronic kidney disease (p≤0.05). Furthermore, AF+HF patients more commonly had pulmonary hypertension and low ejection fraction (p≤0.001). Finally, HF was independently predictive of all-cause mortality (adjusted HR 2.17, 95% CI (1.66-2.85) and cardiovascular mortality (adjusted HR 2.37, 95% CI (1.68-3.36).

    CONCLUSION: Coexisting AF+HF was associated with a more labile and higher-risk population among Jordanian patients. Furthermore, coexisting HF independently predicted higher all-cause mortality and cardiovascular mortality. Efforts should be made to efficiently identify such cases early and treat them aggressively.

  8. Jirjees F, Hasan S, Krass I, Saidawi W, Al-Juboori MK, Othman AM, et al.
    BMC Public Health, 2024 Aug 28;24(1):2340.
    PMID: 39198786 DOI: 10.1186/s12889-024-19553-z
    Meaningful communication between health service users and providers is essential. However, when stakeholders are unfamiliar with new health services, innovative communication methods are necessary to engage them. The aim of the study was to create, validate, and evaluate a video-vignette to enhance stakeholders' (physicians, pharmacists, and laypeople) engagement and understanding of an innovative pharmacy-based diabetes screening and prevention program. Also, to assess the video-vignette's capacity to measure appetite and appeal for such preventive programs. This mixed-methods study consisted of two phases. In phase one, a video-vignette depicting the proposed screening and prevention program was developed and validated following established international guidelines (n = 25). The video-vignette was then evaluated by stakeholders (n = 99). In phase two, the video-vignette's capacity as a communication tool was tested in focus groups and interviews to explore stakeholders' perspectives and engagement on the proposed service (n = 22). Quantitative data were analyzed descriptively, while qualitative data underwent thematic analysis. In total, 146 stakeholders participated. The script was well-received, deemed credible, and realistic. Furthermore, the video-vignette received high ratings for its value, content, interest, realism, and visual and audio quality. The focus groups and interviews provided valuable insights into the design and delivery of the new service. The video-vignette compellingly portrayed the novel pharmacy-based diabetes screening and prevention service. It facilitated in-depth discussions among stakeholders and significantly enhanced their understanding and appreciation of such health services. The video-vignette also generated significant interest in pharmacy-based diabetes screening and prevention programs, serving as a powerful tool to promote enrollment in these initiatives.
  9. Abu-Farha R, Gharaibeh L, Alzoubi KH, Ahmad RE, Binsaleh AY, Shilbayeh SAR, et al.
    J Pharm Policy Pract, 2024;17(1):2430445.
    PMID: 39605986 DOI: 10.1080/20523211.2024.2430445
    BACKGROUND: Gabapentin is increasingly recognised for its potential for abuse, raising concerns within healthcare communities. Community pharmacists are on the front lines in identifying and addressing instances of gabapentin abuse, making their insights invaluable. This study aims to assess community pharmacists' experiences and perceptions regarding gabapentin abuse in Jordan.

    METHODS: A cross-sectional study was conducted from April to June 2024 using a questionnaire-based approach. The questionnaire, developed in English, was uploaded to Google Forms and distributed through social networking platforms. It consisted of four sections: demographic information, pharmacists' experiences with gabapentin abusers, strategies to limit access to gabapentin, and perceptions of gabapentin abuse, which were assessed using a 5-point Likert scale. A Chi-square test was employed to analyze the association between categorical variables.

    RESULTS: The study included 209 pharmacists (median age 29.0 years, IQR 8.0 years). Concerning gabapentin, 72.7% of pharmacists received requests to sell it in the past 6 months. Of these, about 75.7% encountered suspected gabapentin abusers, noting behavioural changes (95.9%), frequent refill requests (90.4%), and inconsistent medical histories (87.8%) as key indicators. Most suspected abusers were male (81.7%) and aged 21-30 years (74.8%).Common reasons cited by suspected abusers for requesting gabapentin included neuropathic pain (93.0%), low back pain (89.6%), and mood instability (73.0%). Pharmacists perceived an increase in gabapentin abuse (74.5%) and expressed a need for additional training (83.3%). Additionally, 83.7% recognised their pivotal role in identifying and addressing gabapentin abuse. Finally, significant associations were found between working in chain pharmacies and receiving gabapentin requests (χ² = 9.159, p = 0.002).

    CONCLUSION: Pharmacists have an important role in detecting gabapentin abuse which necessitates adequate education. Pharmacists have concerns regarding this issue and believe stricter regulations are needed.

  10. Mohamed W, Eltantawi MA, Mecheri Y, Zewde YZ, Kamel WA, Al-Mubarak BR, et al.
    Lancet Neurol, 2024 Feb;23(2):140-141.
    PMID: 38267182 DOI: 10.1016/S1474-4422(23)00453-2
  11. Halboup AM, Alzoubi KH, Abu-Farha RK, Harun SN, Al-Mohamadi A, Battah MM, et al.
    J Multidiscip Healthc, 2023;16:3689-3701.
    PMID: 38058461 DOI: 10.2147/JMDH.S442296
    BACKGROUND: The spread of monkeypox (mpox) worldwide poses a severe threat to human life. This virus leads to a disease with symptoms similar to smallpox in humans. To combat this threat, improving public knowledge and perception toward mpox is vital for public health preventive measures.

    METHODS: A cross-sectional survey was carried out in Yemen from December 2022 to March 2023 to investigate public perception and knowledge of mpox. Individuals were approached through social media platforms using a convenient sampling approach. Linear regression was used to determine the association between participants' knowledge (dependent variable) and explanatory variables.

    RESULTS: A total of 853 individuals consented to take part in the study. A significant proportion of respondents had a low knowledge level (N=572, 67.06%). Most participants knew about the nature of the diseases (75%, n=641), transmission mode (78.1%, n=668), hand sanitizer preventive measures, and skin- related symptoms. However, only 20.8% (n= 178) knew that diarrhea is not a symptom, and 25.4% (n= 217) knew antibiotics are unnecessary for mpox management. A proportion of 57.7% (n=492) of the participants feared human mpox, and 47.7% (n= 407) thought it was a conspiracy. Most participants had a good perception of local and international health authorities controlling the disease. Age, education level, having a health-related certificate, and receiving a 2-dose vaccination for COVID-19 had statistically significant associations with mpox knowledge level (P < 0.05). Social media platforms were the most often used information source about mpox (78.3%, n= 668), followed by articles (41.1%, n=351).

    CONCLUSION: The study reveals a low public knowledge about mpox in Yemen, emphasizing the need for targeted educational campaigns, especially via social media, to strengthen public health measures and disease control. Addressing Knowledge gaps and correcting misconceptions is crucial for improving preparedness and response to the disease.

  12. Mohamed W, Eltantawi MA, Agarwal V, Bandres-Ciga S, Makarious MB, Mecheri Y, et al.
    J Integr Neurosci, 2024 Aug 19;23(8):152.
    PMID: 39207075 DOI: 10.31083/j.jin2308152
    Over 80% of genetic studies in the Parkinson's disease (PD) field have been conducted on individuals of European descent. There is a social and scientific imperative to understand the genetic basis of PD across global populations for therapeutic development and deployment. PD etiology is impacted by genetic and environmental factors that are variable by ancestry and region, emphasising the need for worldwide programs to gather large numbers of patients to identify novel candidate genes and risk loci involved in disease. Only a handful of documented genetic assessments have investigated families with PD in AfrAbia, which comprises the member nations of the Arab League and the African Union, with very limited cohort and case-control studies reported. This review article summarises prior research on PD genetics in AfrAbia, highlighting gaps and challenges. We discuss the etiological risk spectrum in the context of historical interactions, highlighting allele frequencies, penetrance, and the clinical manifestations of known genetic variants in the AfrAbian PD patient community.
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