Background A dramatic increase in the use of natural products and herbal medicines has been observed globally. Simultaneously, there has been an increase in safety concerns regarding the extensive use of these herbal remedies among health care practitioners. The urban and rural populations of Saudi Arabia still rely on traditional Arabic herbal medicines for the treatment of various diseases. Objectives This study aimed to evaluate community pharmacists' knowledge, attitudes, and practices of herbal medicines in the Asir region, Saudi Arabia. Methods An online cross-sectional study was conducted among 233 community pharmacists using a structured questionnaire. Results Pharmacists showed considerable knowledge of the indications of herbal products, with an average score of 84% correct answers, total P value < 0.05 and < 0.001. They were also knowledgeable about contraindications, side effects, and interactions, with an average score of 75% correct answers, total P value < 0.05 and < 0.001. Community pharmacists had a positive attitude towards herbal products, as 71% of them “agreed” or “strongly agreed” that herbal products were efficacious and 77% of them “agreed” or “strongly agreed” that those products should be sold only in a pharmacy. Herbal products were “often” or "always” dispensed by 67.3% of pharmacists in a pharmacy. Conclusion Pharmacists generally exhibited good knowledge, a positive attitude, and effective practice towards herbal products. However, continuing education programs are needed to train pharmacists in providing client counseling on herbal medicine usage and dispensing them.

Pharmacy students expressed some interest in online learning methods within the pharmacy curriculum.

Background: Community adherence to current control measures is one of the vital factors that determines the success of controlling the spread of COVID-19. This adherence depends on the knowledge and attitude of a community toward COVID-19 and their precautionary measures against the disease. Objective: This study aims to evaluate the knowledge and attitude of the community from the Aseer Region, Saudi Arabia, toward COVID-19 and their precautionary measures against the disease. Methods: The descriptive cross-sectional study involved an online sample of participants from the Aseer Region, Saudi Arabia, who were recruited based on a nonprobability convenience sampling method from April to May 2020. The self-administered online questionnaire comprised four parts: the first included the demographic details of the participants; the second consisted of 11 closed-ended questions that assessed the participants' knowledge of COVID-19; the third contained six closed-ended questions that assessed the participants' overall attitude toward COVID-19; and the fourth comprised six closed-ended questions on the participants' precautionary measures against COVID-19. The data were analyzed using Statistisoftware SPSS 21.0. Results: Altogether, 740 participants completed the online questionnaire. The mean knowledge score concerning COVID-19 was 8.08 ± 1.765. Graduate participants scored significantly higher for all knowledge items than those from other educational levels. Furthermore, the main source of COVID-19 information was the Ministry of Health website 661 (89.3%). The mean attitude score regarding COVID-19 was 9.74 ± 1.935, whereas the mean precautionary measures score was 10.09 ± 1.91. University-educated participants scored significantly higher for all knowledge items than those from other educational levels. Female participants had significantly higher precautionary measures scores than male participants. Conclusion: This study confirms that residents of the Aseer Region have high knowledge of, demonstrate a positive attitude toward, and use appropriate precautionary measures against COVID-19, which is associated with obtaining information about the virus from the Ministry of Health website.

Background Mortality rates increase due to iron deposition in the cardiac muscles of thalassemia major (TM) patients. Iron overload cardiomyopathy could be treated with a combination therapy of an iron chelator and an L-type calcium channel blocker. We designed a randomized controlled study to assess the potential of amlodipine, alongside chelation, in reducing myocardial iron concentration in TM patients compared with a placebo. Objectives This study aims to estimate the change in myocardial iron concentration (MIC) determined by magnetic resonance imaging after 6 months of treatment with amlodipine, as well as measuring the changes in the secondary outcomes (liver iron concentration (LIC), serum ferritin level (SF), and left ventricle ejection fraction (LVEF)) of study participants. Methods A single, randomized, placebo-controlled trial was performed in 40 β-Thalassemia major patients aged between 6 and 20 years old, who received either oral amlodipine 2.5–5 mg/day or a placebo, in addition to a Deferasirox chelation regimen in a 1:1 allocation ratio. Results After 6 months, a significant reduction was noted in the MIC of patients receiving amlodipine (n=20), compared with the patients receiving the placebo (n=20). At baseline, the mean was 0.76±0.11 mg/g dry weight, while at 6 months, the mean was 0.51±0.07 mg/g dry weight ( p <0.001). Also, there was a significant change in the myocardial T2* after 6 months; the amlodipine increased the myocardial T2* from 40.63±5.45 ms at baseline to 43.25±5.35 ms ( p <0.001). However, amlodipine did not significantly affect the secondary outcomes by the end of the study. Conclusion The addition of amlodipine to the standard chelation therapy in transfusion-dependent thalassemia major patients improves myocardial iron overload without increasing the adverse effects.

Background Research that focuses on the health‐related quality of life of patients with sickle cell disease remains challenging in Saudi Arabia. Aims This study aims to assess the health‐related quality of life of sickle cell disease patients and determine the factors that contribute to a poorer quality of life in the Asir Region or southern region, compared with other regions in Saudi Arabia. Methods Sickle cell disease patients attending Asir General Hospital and Abu Aresh General Hospital were consecutively invited to enrol in the study from November 2019 to April 2020. The Medical Outcomes Study (SF‐36) questionnaire was used to assess the health‐related quality of life of patients with sickle cell disease. Results This study included 107 individuals (22 males and 85 females) with sickle cell disease, with a mean age of 25 ± 7.851. The mean physical health summary and mental health summary were 60.6 ± 23.4 and 52.12 ± 22.37, respectively. Exercise and family support affected the physical health, mental health and vitality scores positively, while swelling and fever had a negative effect on physical and mental health. Furthermore, more educated patients demonstrated significantly better mental health than uneducated or less educated patients (P = .031). Conclusion Patients with sickle cell disease exhibited a poor health‐related quality of life. Interventions such as a comprehensive center for sickle cell disease should consider improvements in health‐related quality of life important outcomes

Background The use of T2* magnetic resonance imaging (MRI) has been promoted by recent studies as a noninvasive method for the detection of iron overload in thalassemia major patients. This study aims to estimate the iron load in the heart and liver of thalassemia major patients using T2* MRI and to determine its correlation with the left ventricle ejection fraction and serum ferritin level. Methods Forty β-Thalassemia major patients were included in the study. We evaluated the serum ferritin level, echocardiography, cardiac T2*, myocardial iron concentration (MIC), liver iron concentration (LIC) and hepatic T2* in all patients. CMR T2* findings were categorized as normal cardiac T2* (T2* >20 ms) or abnormal cardiac T2* (T2* <20 ms). Results The study found that 85% of patients had a normal cardiac T2* value. The median serum ferritin level was 2189. A significant inverse correlation was found between the serum ferritin level and the cardiac T2* (r=−0.381, =0.015); however, the correlations between serum ferritin and the hepatic T2* and liver iron concentration were statistically non-significant ( P =0.539 and P =0.637, respectively). Additionally, the LVEF correlation was statistically non-significant with SF, hepatic T2* and cardiac T2*. Conclusion Regardless of the serum ferritin level or left ventricle function, a cardiac T2* MRI should be done for all patients with β-Thalassemia major in order to estimate the myocardial iron concentration.

Objectives Adherence to glaucoma medications is a central factor to control intraocular pressure and manage glaucoma effectively. This study aims to assess the level of adherence of glaucoma patients to ocular hypotensive agents and determine factors contributing to non-adherence in the Aseer region. Methods This was a single-centre, prospective cross-sectional study carried out in Aseer Hospital, Saudi Arabia. Data were collected through a customized questionnaire adapted from the Morisky, Green and Levine Medication Adherence Questionnaire (MGLS). Key findings Of the 102 glaucoma patients, 63 (61.8%) were non-adherent to their glaucoma medications. About 48 (76.2%) of them reported that they have no background information about glaucoma. Older participants (37, 58.7%; &gt;50 years) showed a low adherence level compared with the younger individuals. Contributing factors to non-adherence include forgetting the dose time (32, 50.8%), illiteracy (31, 49.2%; P = 0.313), economic problems (26, 41.3%; P = 0.286) and lack of information about prescribed medications (15, 23.8%; P = 0.188). Conclusions No significant relationship was found between medication adherence and patient’s demographic data or their background knowledge about glaucoma. Despite the need for improving the glaucoma patient’s knowledge of their disease and the importance of medication adherence, an additional strategy as alerts by smartwatches should be encouraged to improve the adherence level.

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