Background Pharmacovigilance, as it is carried out primarily by healthcare professionals is more focused on being very objective in nature. Acknowledging the importance of the subjective experience of patients in pharmacovigilance was underpinned by its unique ability to bring about a more holistic understanding through the deep information unraveled by the patients. Medication safety-related information has to be shared with patients to allow them to be actively involved in their therapy and pharmacovigilance. Despite the advantages of sharing information, it stands to reasons whether sharing information related to possible side effects would negatively affect patients and impinge upon their treatment plan and process. Aim of the Review The purpose of this systematic review was to critically assess the potential negative impact of informing patients about medication side effects by written and/or oral information on medication compliance, occurrence/development of suspected side effects and clinical outcomes. Method A comprehensive search was conducted in PubMed, and Cochrane library to identify potential records between the year 1975 and 2017; then titles, abstracts, and full texts were screened using the inclusion criteria to filter out irrelevant studies. The data extraction, and the results were narratively synthesized and presented in tables. Results A total of 2012 articles were screened for inclusion, 32 full-text articles were assessed for eligibility and finally resulting in the inclusion of 17 randomized control studies which met the set criteria. Findings unraveled that the educational intervention did not result in increased occurrence/reporting of side effects in most of the evaluated studies; except 4 studies, and no significant impact on compliance to medications and negative clinical outcome was observed. Apprehension of negative events to medications were observed in two of the four studies which evaluated these parameters. Conclusion The present review did not find enough evidence to support the over concerns on the potential negative impact of sharing of information on the adverse effects to patients, though the influence could manifest as nocebo-effect. The various components and methods employed for this information sharing process can influence the potential impact of this activity. These concerns about the undesirable effects should not deter the active involvement of patients in pharmacovigilance activities. There is a definite need to have more studies in this area, where much of concern still does exist among the various stakeholders of drug safety information.

Background: Venous thromboembolism (VTE) is a common complication seen during or after hospitalization that manifests as deep venous thrombosis (DVT) and/or pulmonary embolism (PE). PE is considered the commonest preventable cause of death during and/or after hospitalization. Thus, pharmacological and mechanical methods are used to prevent VTE in hospitalized patients. Despite the availability of guidelines for VTE prophylaxis, it is crucial to assess the adherence and adaptation of the institution to these guidelines. Purpose: This study aimed to investigate adherence to the American College of Chest Physicians (ACCP) 2012 VTE prophylaxis guidelines in hospitalized medical patients in a tertiary care hospital in the United Arab Emirates. Methods: An observational prospective design was utilized in this study. To achieve the purpose, primary and secondary end points were identified to be the core of the investigation. The primary end points were: the incidence of bleeding, VTE, and cardiovascular events. While the secondary end points were: dose and indication validity for prophylaxis, VTE and bleeding risk assessments, adverse drug events (ADE) other than bleeding, appropriate monitoring when on low molecular weight heparin (LMWH) and the presence of contraindication at the time of prescribing LMWH. Results: 16 patients (20%) out of the total 80 met one or more of the primary end points. The vast majority of patients (81.25%) developed bleeding, while VTE was seen in one case only during hospitalization. 11 patients (13.75%) received LMWH while a contraindication was present. 15 patients (18.75%) who were prescribed LMWH had an International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) bleeding risk score of ≥7. However, 5 out of 13 patients (38.46%) who developed bleeding had a bleeding score of ≥7, and the relationship between bleeding score of ≥7 and the development of bleeding was statistically significant (p = 0.047). When investigating the doses that were utilized, 40% were prescribed an inappropriate dose. L. AlHajri, N. Gebran 82Conclusion: Various factors played a role in the inappropriateness of VTE prophylaxis such as; poor adherence to VTE guidelines, inappropriate dosing and monitoring, and not evaluating the bleeding risk. Hence, to be able to achieve effective VTE prophylaxis, these factors need to be addressed through adherence to and adaptation of the ACCP 2012 VTE prophylaxis guidelines.

Background: Hyperlipidemia or dyslipidemia has been a concern for a long time, with various guidelines emphasizing the importance of managing the lipid profile to prevent cardiac incidences. Although statins have been found to be highly effective, resistance and intolerability to side effects will continue to be a stumbling block for certain patients. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors tackle lipid profile via a novel mechanism and therefore provide an additional effective option for managing lipid profile. The overarching aim of this systematic review was to evaluate the efficacy of evolocumab among various populations with hypercholesterolemia. Methods: A comprehensive search was conducted in ProQuest Health & Medical Complete, Google Scholar, ScienceDirect, and PubMed to identify potential records; then titles, abstracts, and full texts were screened using the inclusion criteria to filter out irrelevant studies. Data extraction and quality assessment were undertaken using standardized tools and the results were narratively synthesized and presented in tables. Results: Eight studies were included in this systematic review after screening 1191 records. All studies demonstrated a statistically significant reduction in low-density lipoprotein cholesterol (LDL-C) values in the groups that received evolocumab compared with the comparator groups (p < 0.05). The decline in LDL-C levels from baseline in the majority of studies ranged from 40% to 80%, whether used alone or in combination with other agents. Also, high-density lipoprotein cholesterol, lipoprotein (a) and apolipoprotein B were improved with the use of evolocumab. Conclusions: This study helped to collate evidence from studies that tested the effectiveness of evolocumab in the management of hyperlipidemia. Evolocumab seems to be highly effective in reducing LDL-C and other lipid parameters. Hence, it provides an excellent alternative for patients with refractory disease or patients who develop intolerable side effects, therefore helping to overcome the stumbling block to achieving optimal lipid management.

This study helped to amalgamate evidence with regard to the use of edoxaban for VTE prophylaxis post-lower limb orthopedic surgery. In line with the results of the reviewed studies, edoxaban seems to be highly effective in reducing VTE post-lower limb orthopedic surgery.

Background Osteoporosis is common in postmenopausal women. Some studies have demonstrated the usefulness of vitamin K through the action of bone-specific proteins and osteoblast and osteoclast activities. However, no systematic review had explored this aspect in postmenopausal women. Hence, this systematic review aimed to explore the effect of vitamin K 2 alone or in combination with other agents (vitamin D 3 or calcium) on various bone turnover markers (BTMs) and bone mineral density (BMD) in postmenopausal women. Methods MEDLINE, ScienceDirect, PubMed, and Google Scholar were searched to identify relevant studies using specific inclusion criteria. Data extraction and quality assessment were carried out using standardized tests, and the results were narratively synthesized and presented in the form of tables. Results Vitamin K 2 was beneficial in inducing an improvement or preventing deterioration, as evidenced by the BMD and osteocalcin (OC), undercarboxylated OC (ucOC), carboxylated OC (cOC), and γ-carboxylated OC levels. However, its effect was not conclusive when procollagen type 1 N-terminal propeptide, carboxyterminal propeptide of type I procollagen, C-terminal telopeptide of type I collagen, bone alkaline phosphatase, deoxypyridinoline, and N-terminal telopeptide levels (NTX) and ucOC:cOC or cOC:ucOC, and NTX:creatinine ratios were examined. Conclusions Vitamin K 2 supplementation combined with vitamin D and calcium was found to be advantageous. However, vitamin K 2 supplementation cannot replace the existing treatment options. In addition, vitamin K 2 should be used with caution, considering its interactions with food and other drugs.

COVID-19, which has become a worldwide pandemic, prompted various healthcare organizations to take measures to stop or slow its spread. These measures require behavioral change. According to the health belief model, knowledge and awareness are needed to establish an assessment of threat and determine whether a behavior will be changed. Since the situation is related to a viral infection, it is expected that people with health backgrounds will have more knowledge and awareness about COVID-19. This study aims to compare the levels of COVID-19 knowledge and awareness of faculty, staff, and students in health sciences and non-health sciences disciplines at an all-female college in Dubai. This will help anticipate the risk for individuals, and predict compliance with regulations. A cross-sectional study was conducted using a self-administered online questionnaire. The results were analyzed using chi-square or Fisher’s exact test. Participants’ knowledge and awareness regarding contagiousness, transmission, incubation period, recovery and mortality rate, susceptibility of elderly people, and the stay-at-home policy were generally high, regardless of their background. This high level of knowledge could be attributed to the rapid dissemination of information through social media. Participants from the health sciences were significantly more knowledgeable about certain preventive measures, the causative pathogen, and its transmission through animals ( p < .05). Overall, there was a high level of knowledge and awareness among the participants, regardless of their background, yet there are some areas that needs enhancement. Assessing knowledge and awareness is important for ensuring that people understand and change their behavior to mitigate its spread.

The development of Nausea and Vomiting in Pregnancy (NVP) is rife, affecting approximately 80% of pregnant females, where only 1% of these might progress to develop a severe form of NVP known as hyperemesis gravidarum [1][2][3] . NVP is commonly seen between the 5 th and the 18 th weeks of gestation, and affect the overall well-being of patients 4 . Importantly, the severity of the NVP varies among pregnants, and consequently, the management will vary as well. Although there are plenty of etiologies and pathophysiological theories underpinning NVP, it is still considered to be an area of controversy 5. The importance of addressing NVP lies behind the possibility of developing dehydration, affecting the pregnancy, affecting the quality of life, productivity, and might lead to depression 6 . Treatment modalities incorporate identifying trigger factors and avoiding them, utilizing pharmacological and complementary agents and supportive therapy 7-9 .Ginger (Zingiber officinale), which is a common ingredient in Asian meals, started gaining momentum as a treatment modality for NVP 10 . Noncompliance to medications and treatment plans is not uncommon among pregnant women which might be gauged by concerns related to fetus health 11 . However, herbal or complementary medicine tends to be more accepted as they are perceived to be a safer option although they might be not 12 . Hence, this systematic review aims at investigating the efficacy of ginger in relieving NVP. Although investigating the safety of this ingredient is imperative, the majority of studies included in this systematic review were conducted for a very short period (e.g. four days), and used different doses and dosage forms, therefore rendered this objective unachievable. AbstractNausea and Vomiting (N/V) are unpalatable manifestations seen commonly during pregnancy, which impinge upon the overall well-being, the productivity and might result in hospitalization. There is growing evidence concerning the efficacy of ginger in alleviating Nausea and Vomiting in Pregnancy (NVP). Therefore, we sought to conduct a systematic review to explore the effectiveness of ginger for NVP. A comprehensive search was conducted in Google Scholar, PubMed, and Science Direct which resulted in identifying five studies. These studies showed that ginger can improve NVP in a statistically significant manner (P< 0.05). Assessing the safety profile of this agent was difficult due to the short duration of intervention, and inconsistency in the dose and dosage form of ginger used. This study helped to glean evidence about the efficacy of ginger in NVP. It also emphasized the need for conducting more studies with a better quality and that are using standardized dose and dosage forms to be able to conduct a meta-analysis.

BACKGROUND COVID-19 which has resulted worldwide pandemic, prompted various healthcare organisations to take meticulous measures to stop or slow down the spread of it. This included: locking down of cities, physical distancing and using various protective methods. Adherence to these measures requires the whole society to amend their behaviour, which cannot be done without having sufficient knowledge and awareness about the pandemic. Since the outbreak is a viral infection, it is expected that people with health backgrounds would have more knowledge and awareness about COVID-19. Therefore, this study aims to compare the level of knowledge and awareness of health sciences to non-health sciences faculty, staff and students at a Females College in Dubai towards COVID-19. OBJECTIVE This study aims to compare the level of knowledge and awareness of health sciences to non-health sciences faculty, staff and students at a Females College in Dubai towards COVID-19. METHODS A cross-sectional observational descriptive study was conducted using a self-administered online questionnaire to test the hypothesis. Participants were recruited via emails and/ or during their virtual lectures randomly. Results were then analyzed using Chi-square or Fisher Exact test for categorical data to compare the differences in proportion. RESULTS Findings brought to light that in general there was a high level of knowledge and awareness amongst participants irrespective of their background. The most popular source of information was the social media. Level of knowledge was significantly higher amongst the health sciences participants regarding the source of pathogen, and certain protective techniques, while they both were aware of the incubation period, symptoms, transmission routes, recovery and mortality rates. CONCLUSIONS Overall, there was a high level of knowledge and awareness amongst participants irrespective of their background. Yet, there were some areas where the knowledge of health sciences group was higher than the non-health sciences group. Assessing knowledge and awareness was important to ensure that people understand and consequently change their behaviour to mitigating the spread of COVID-19.