The COVID-19 pandemic disrupted healthcare worldwide, potentially impacting disease management. T... more The COVID-19 pandemic disrupted healthcare worldwide, potentially impacting disease management. The objective of this study was to assess the self-management behaviors of Saudi patients with diabetes during and after the COVID pandemic period using the Arabic version of the Diabetes Self-Management Questionnaire (DSMQ). A cross-sectional study was conducted in patients aged ≥18 years diagnosed with type 2 diabetes mellitus who had at least one ambulatory clinic visit in each of the specified time frames (
International Journal of Environmental Research and Public Health, Jan 8, 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Journal of The Saudi Pharmaceutical Society, Nov 1, 2021
Background: Due to the COVID-19 pandemic, innovative e-learning solutions should be implemented t... more Background: Due to the COVID-19 pandemic, innovative e-learning solutions should be implemented to deliver knowledge to healthcare students remotely. Presently, there is a paucity of studies in the literature that have examined student-designed assessments in the classroom. Objectives: To examine the educational outcomes comparing the Design Your Exam (DYE) activity versus instructor-designed end-of-class (EOC) quizzes and explore student perceptions and preferences for each teaching modality. Methods: Lectures in the Industrial Pharmacy course were delivered to students by two different approaches: instructor-designed EOC assessments and student-designed DYE. The designed learning model was evaluated via an anonymous questionnaire for quality assurance and future course improvement. Results: Mean exam performance for content taught using the instructor-designed EOC quizzes and DYE activity were 74.4% and 71.9%, respectively (p = 0.092). Average student attendance for lectures taught using instructor-designed EOC quizzes and the DYE activity were 77.6% and 72.1%, respectively (p = 0.524). A post-course survey showed that 72.2% preferred the instructor-designed EOC, 5.6% preferred DYE activity, and 16.7% preferred a combination of the activities. Respondents reported that the EOC quizzes helped them to understand the lecture material and kept them focused during the lecture and that the DYE was useful in developing their personal interaction skills. Conclusion: DYE is a novel active learning model that can be incorporated into student courses as an alternative to traditional didactic lectures. Further development of the DYE technique, such as including supportive audiovisual resources, is necessary in order to increase student acceptance.
International Journal of Environmental Research and Public Health, Mar 25, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Background: Emergence of drug resistant varieties of tuberculosis is posing a major threat to glo... more Background: Emergence of drug resistant varieties of tuberculosis is posing a major threat to global tuberculosis eradication programmes. Although several approaches have been explored to counter resistance, there has been limited success due to a lack of understanding of how resistance emerges in bacteria upon drug treatment. A systems level analysis of the proteins involved is essential to gain insights into the routes required for emergence of drug resistance. Results: We derive a genome-scale protein-protein interaction network for Mycobacterium tuberculosis H37Rv from the STRING database, with proteins as nodes and interactions as edges. A set of proteins involved in both intrinsic and extrinsic drug resistance mechanisms are identified from literature. We then compute shortest paths from different drug targets to the set of resistance proteins in the protein-protein interactome, to derive a sub-network relevant to study emergence of drug resistance. The shortest paths are then scored and ranked based on a new scheme that considers (a) drug-induced gene upregulation data, from microarray experiments reported in literature, for the individual nodes and (b) edge-hubness, a network parameter which signifies centrality of a given edge in the network. High-scoring paths identified from this analysis indicate most plausible pathways for the emergence of drug resistance. Different targets appear to have different propensities for four drug resistance mechanisms. A new concept of 'co-targets' has been proposed to counter drug resistance, co-targets being defined as protein(s) that need to be simultaneously inhibited along with the intended target(s), to check emergence of resistance to a given drug. Conclusion: The study leads to the identification of possible pathways for drug resistance, providing novel insights into the problem of resistance. Knowledge of important proteins in such pathways enables identification of appropriate 'co-targets', best examples being RecA, Rv0823c, Rv0892 and DnaE1, for drugs targeting the mycolic acid pathway. Insights obtained about the propensity of a drug to trigger resistance will be useful both for more careful identification of drug targets as well as to identify target-co-target pairs, both implementable in early stages of drug discovery itself. This approach is also inherently generic, likely to significantly impact drug discovery.
BackgroundCoronavirus disease-2019 (COVID-19) is caused by severe acute respiratory syndrome-coro... more BackgroundCoronavirus disease-2019 (COVID-19) is caused by severe acute respiratory syndrome-coronavirus (SARS-CoV) and represents a major public health threat that aggressively promotes increased morbidity and mortality. Changes in public behavior were more common during the pandemic to protect against the infection. Suboptimal behavioral practices for a specific disease would increase the susceptibility of the public to infection. This study aimed to determine changes in behaviors of the general public during the COVID-19 pandemic.MethodsA cross-sectional study was conducted using an online questionnaire survey to determine the extent of public behavioral changes in Saudi Arabia during the COVID-19 pandemic. Data were collected with a self-reported survey, and analysis was conducted using Statistical Package for the Social Sciences version 26 (SPSS). A chi-square test was performed to determine the association among variables. A P ≤ 0.05 was considered statistically significant.Re...
Background: Cancer patients are at high risk for mental illness and, in turn, poorer health-relat... more Background: Cancer patients are at high risk for mental illness and, in turn, poorer health-related quality of life. This study used nationally representative United States (US) data to examine nuances of the impact of depression and/or anxiety on HRQoL in different cancer groups (e.g., cancer only, cancer and depression, cancer and anxiety, cancer and both conditions). Methods: Adult patients aged 18 years and older with a cancer diagnosis were identified from the Medical Expenditure Panel Survey data for 2012–2016. HRQoL was measured using the SF-12 Physical and Mental Component Summary (PCS & MCS) scores. Multivariate linear regressions were used, controlling for a multitude of factors. Results: Around 12% of the 1712 identified patients with cancer had depression, 13% had anxiety, and 8.4% had both depression and anxiety. Patients with comorbid depression and anxiety had the lowest mean scores of both PCS and MCS compared to patients in other groups. In addition, cancer patients...
International Journal of Environmental Research and Public Health
Background: Distance learning has come to the forefront of educational delivery throughout the wo... more Background: Distance learning has come to the forefront of educational delivery throughout the world due to the COVID-19 pandemic. Presently, there is a paucity of studies that have utilized interactive e-lectures as a model for remote flipped learning. Objectives: To compare educational outcomes for the remote interactive flipped e-learning (iFEEL) activity versus paper-based in-class group learning (PICkLE). Methods: During the spring 2021 semester, tutorials in pharmaceutical quality control and good manufacturing practice were remotely delivered to students by two different approaches: PICkLE and iFEEL. In the latter activity, interactive e-lectures were software-designed and included several audiovisual enhanced illustrations to encourage students to interact with the lecture material prior to attending the virtual class. The class time was reserved for in-class quizzes and discussion. Mean exam scores were compared and voluntary questionnaires were distributed among the partic...
Interprofessional education (IPE) has potential benefits for improving the quality of patient car... more Interprofessional education (IPE) has potential benefits for improving the quality of patient care, but its implementation is challenged with multiple barriers. The primary objectives of this study were to explore the challenges, benefits, and incentives to establishing IPE from the perspective of healthcare faculty at King Saud University. Forty-five faculty members attended six focus groups, each consisting of 6-8 faculty members representing the five colleges. The focus group interview guide included the benefits of and barriers to establishing IPE in this academic institution, curricular design, and the feasibility of support from the colleges and University administration. A SWOC (Strengths, Weaknesses, Opportunities, Challenges) frame work was utilized to guide the focus group discussions, and the data were analyzed inductively using thematic analysis. Three main themes emerged and were related to (i) barriers, (ii) benefits, (iii) opportunities to facilitate the introduction ...
Background: The current study aimed to design a novel combination of lansoprazole (LNS) and curcu... more Background: The current study aimed to design a novel combination of lansoprazole (LNS) and curcumin (CUR) solid oral dosage form using bioactive self-nanoemulsifying drug delivery systems (Bio-SSNEDDS). Methods: Liquid SNEDDS were prepared using the lipid-excipients: Imwitor988 (cosurfactant), Kolliphor El (surfactant), the bioactive black seed (BSO) and/or zanthoxylum rhetsa seed oils (ZRO). Liquid SNEDDS were loaded with CUR and LNS, then solidified using commercially available (uncured) and processed (cured) Neusilin® US2 (NUS2) adsorbent. A novel UHPLC method was validated to simultaneously quantify CUR and LNS in lipid-based formulations. The liquid SNEDDS were characterized in terms of self-emulsification, droplet size and zeta-potential measurements. The solidified SNEDDS were characterized by differential scanning calorimetry (DSC), X-ray powder diffraction (XRD), scanning electron microscopy (SEM), in vitro dissolution and stability in accelerated storage conditions. Resul...
The use of active learning strategies in healthcare colleges in the Middle East questionnaire. (D... more The use of active learning strategies in healthcare colleges in the Middle East questionnaire. (DOCX 16 kb)
International Journal of Environmental Research and Public Health
Objectives: Increasing national influenza vaccination rates continues to be a challenge for Saudi... more Objectives: Increasing national influenza vaccination rates continues to be a challenge for Saudi Arabia. Therefore, the purpose of this study was to explore the Saudi public perceptions toward seasonal influenza vaccination and their association with the rate of vaccination. Methods: Individuals aged 15 years and older were surveyed about their knowledge, attitudes, and practices toward the seasonal influenza vaccine using a previously developed and validated 19-item online questionnaire. The impact of the participants’ perceptions toward the seasonal influenza vaccine on their past influenza vaccination history was assessed using multiple linear regressions. Results: The rate of regular vaccination among the 790 surveyed participants was 12.65%, and those who were aged <24 years had the highest rate (57%). The vast majority of the participants with chronic diseases (>90%) reported irregular vaccination histories against seasonal influenza. Participants who believed that the ...
The aim of this retrospective chart review study was to examine the cost effectiveness of angiote... more The aim of this retrospective chart review study was to examine the cost effectiveness of angiotensin-converting enzyme inhibitors (ACEIs); angiotensin receptor blockers (ARBs); and dihydropyridine calcium channel blockers (CCBs) such as amlodipine, monotherapies in the management of essential hypertension among adult patients (≥18 years) without cancer, cardiovascular disease, and chronic kidney disease in the primary care clinics of a university-affiliated tertiary care hospital. Patients were followed up for at least 12 months from the initiation of therapy. Propensity score bin bootstrapping with 10,000 replications was conducted to generate the 95% confidence intervals (CI) for both treatment outcome (e.g., reduction of the systolic (SBP) and diastolic blood pressures (DBP) in mmHG) and the cost (e.g., costs of drugs, clinic visits, and labs in Saudi riyals (SAR)). Among the 153 included patients who met the inclusion criteria, 111 patients were on ACEIs/ARBs, while 44 patients...
The COVID-19 pandemic disrupted healthcare worldwide, potentially impacting disease management. T... more The COVID-19 pandemic disrupted healthcare worldwide, potentially impacting disease management. The objective of this study was to assess the self-management behaviors of Saudi patients with diabetes during and after the COVID pandemic period using the Arabic version of the Diabetes Self-Management Questionnaire (DSMQ). A cross-sectional study was conducted in patients aged ≥18 years diagnosed with type 2 diabetes mellitus who had at least one ambulatory clinic visit in each of the specified time frames (
International Journal of Environmental Research and Public Health, Jan 8, 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Journal of The Saudi Pharmaceutical Society, Nov 1, 2021
Background: Due to the COVID-19 pandemic, innovative e-learning solutions should be implemented t... more Background: Due to the COVID-19 pandemic, innovative e-learning solutions should be implemented to deliver knowledge to healthcare students remotely. Presently, there is a paucity of studies in the literature that have examined student-designed assessments in the classroom. Objectives: To examine the educational outcomes comparing the Design Your Exam (DYE) activity versus instructor-designed end-of-class (EOC) quizzes and explore student perceptions and preferences for each teaching modality. Methods: Lectures in the Industrial Pharmacy course were delivered to students by two different approaches: instructor-designed EOC assessments and student-designed DYE. The designed learning model was evaluated via an anonymous questionnaire for quality assurance and future course improvement. Results: Mean exam performance for content taught using the instructor-designed EOC quizzes and DYE activity were 74.4% and 71.9%, respectively (p = 0.092). Average student attendance for lectures taught using instructor-designed EOC quizzes and the DYE activity were 77.6% and 72.1%, respectively (p = 0.524). A post-course survey showed that 72.2% preferred the instructor-designed EOC, 5.6% preferred DYE activity, and 16.7% preferred a combination of the activities. Respondents reported that the EOC quizzes helped them to understand the lecture material and kept them focused during the lecture and that the DYE was useful in developing their personal interaction skills. Conclusion: DYE is a novel active learning model that can be incorporated into student courses as an alternative to traditional didactic lectures. Further development of the DYE technique, such as including supportive audiovisual resources, is necessary in order to increase student acceptance.
International Journal of Environmental Research and Public Health, Mar 25, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Background: Emergence of drug resistant varieties of tuberculosis is posing a major threat to glo... more Background: Emergence of drug resistant varieties of tuberculosis is posing a major threat to global tuberculosis eradication programmes. Although several approaches have been explored to counter resistance, there has been limited success due to a lack of understanding of how resistance emerges in bacteria upon drug treatment. A systems level analysis of the proteins involved is essential to gain insights into the routes required for emergence of drug resistance. Results: We derive a genome-scale protein-protein interaction network for Mycobacterium tuberculosis H37Rv from the STRING database, with proteins as nodes and interactions as edges. A set of proteins involved in both intrinsic and extrinsic drug resistance mechanisms are identified from literature. We then compute shortest paths from different drug targets to the set of resistance proteins in the protein-protein interactome, to derive a sub-network relevant to study emergence of drug resistance. The shortest paths are then scored and ranked based on a new scheme that considers (a) drug-induced gene upregulation data, from microarray experiments reported in literature, for the individual nodes and (b) edge-hubness, a network parameter which signifies centrality of a given edge in the network. High-scoring paths identified from this analysis indicate most plausible pathways for the emergence of drug resistance. Different targets appear to have different propensities for four drug resistance mechanisms. A new concept of 'co-targets' has been proposed to counter drug resistance, co-targets being defined as protein(s) that need to be simultaneously inhibited along with the intended target(s), to check emergence of resistance to a given drug. Conclusion: The study leads to the identification of possible pathways for drug resistance, providing novel insights into the problem of resistance. Knowledge of important proteins in such pathways enables identification of appropriate 'co-targets', best examples being RecA, Rv0823c, Rv0892 and DnaE1, for drugs targeting the mycolic acid pathway. Insights obtained about the propensity of a drug to trigger resistance will be useful both for more careful identification of drug targets as well as to identify target-co-target pairs, both implementable in early stages of drug discovery itself. This approach is also inherently generic, likely to significantly impact drug discovery.
BackgroundCoronavirus disease-2019 (COVID-19) is caused by severe acute respiratory syndrome-coro... more BackgroundCoronavirus disease-2019 (COVID-19) is caused by severe acute respiratory syndrome-coronavirus (SARS-CoV) and represents a major public health threat that aggressively promotes increased morbidity and mortality. Changes in public behavior were more common during the pandemic to protect against the infection. Suboptimal behavioral practices for a specific disease would increase the susceptibility of the public to infection. This study aimed to determine changes in behaviors of the general public during the COVID-19 pandemic.MethodsA cross-sectional study was conducted using an online questionnaire survey to determine the extent of public behavioral changes in Saudi Arabia during the COVID-19 pandemic. Data were collected with a self-reported survey, and analysis was conducted using Statistical Package for the Social Sciences version 26 (SPSS). A chi-square test was performed to determine the association among variables. A P ≤ 0.05 was considered statistically significant.Re...
Background: Cancer patients are at high risk for mental illness and, in turn, poorer health-relat... more Background: Cancer patients are at high risk for mental illness and, in turn, poorer health-related quality of life. This study used nationally representative United States (US) data to examine nuances of the impact of depression and/or anxiety on HRQoL in different cancer groups (e.g., cancer only, cancer and depression, cancer and anxiety, cancer and both conditions). Methods: Adult patients aged 18 years and older with a cancer diagnosis were identified from the Medical Expenditure Panel Survey data for 2012–2016. HRQoL was measured using the SF-12 Physical and Mental Component Summary (PCS & MCS) scores. Multivariate linear regressions were used, controlling for a multitude of factors. Results: Around 12% of the 1712 identified patients with cancer had depression, 13% had anxiety, and 8.4% had both depression and anxiety. Patients with comorbid depression and anxiety had the lowest mean scores of both PCS and MCS compared to patients in other groups. In addition, cancer patients...
International Journal of Environmental Research and Public Health
Background: Distance learning has come to the forefront of educational delivery throughout the wo... more Background: Distance learning has come to the forefront of educational delivery throughout the world due to the COVID-19 pandemic. Presently, there is a paucity of studies that have utilized interactive e-lectures as a model for remote flipped learning. Objectives: To compare educational outcomes for the remote interactive flipped e-learning (iFEEL) activity versus paper-based in-class group learning (PICkLE). Methods: During the spring 2021 semester, tutorials in pharmaceutical quality control and good manufacturing practice were remotely delivered to students by two different approaches: PICkLE and iFEEL. In the latter activity, interactive e-lectures were software-designed and included several audiovisual enhanced illustrations to encourage students to interact with the lecture material prior to attending the virtual class. The class time was reserved for in-class quizzes and discussion. Mean exam scores were compared and voluntary questionnaires were distributed among the partic...
Interprofessional education (IPE) has potential benefits for improving the quality of patient car... more Interprofessional education (IPE) has potential benefits for improving the quality of patient care, but its implementation is challenged with multiple barriers. The primary objectives of this study were to explore the challenges, benefits, and incentives to establishing IPE from the perspective of healthcare faculty at King Saud University. Forty-five faculty members attended six focus groups, each consisting of 6-8 faculty members representing the five colleges. The focus group interview guide included the benefits of and barriers to establishing IPE in this academic institution, curricular design, and the feasibility of support from the colleges and University administration. A SWOC (Strengths, Weaknesses, Opportunities, Challenges) frame work was utilized to guide the focus group discussions, and the data were analyzed inductively using thematic analysis. Three main themes emerged and were related to (i) barriers, (ii) benefits, (iii) opportunities to facilitate the introduction ...
Background: The current study aimed to design a novel combination of lansoprazole (LNS) and curcu... more Background: The current study aimed to design a novel combination of lansoprazole (LNS) and curcumin (CUR) solid oral dosage form using bioactive self-nanoemulsifying drug delivery systems (Bio-SSNEDDS). Methods: Liquid SNEDDS were prepared using the lipid-excipients: Imwitor988 (cosurfactant), Kolliphor El (surfactant), the bioactive black seed (BSO) and/or zanthoxylum rhetsa seed oils (ZRO). Liquid SNEDDS were loaded with CUR and LNS, then solidified using commercially available (uncured) and processed (cured) Neusilin® US2 (NUS2) adsorbent. A novel UHPLC method was validated to simultaneously quantify CUR and LNS in lipid-based formulations. The liquid SNEDDS were characterized in terms of self-emulsification, droplet size and zeta-potential measurements. The solidified SNEDDS were characterized by differential scanning calorimetry (DSC), X-ray powder diffraction (XRD), scanning electron microscopy (SEM), in vitro dissolution and stability in accelerated storage conditions. Resul...
The use of active learning strategies in healthcare colleges in the Middle East questionnaire. (D... more The use of active learning strategies in healthcare colleges in the Middle East questionnaire. (DOCX 16 kb)
International Journal of Environmental Research and Public Health
Objectives: Increasing national influenza vaccination rates continues to be a challenge for Saudi... more Objectives: Increasing national influenza vaccination rates continues to be a challenge for Saudi Arabia. Therefore, the purpose of this study was to explore the Saudi public perceptions toward seasonal influenza vaccination and their association with the rate of vaccination. Methods: Individuals aged 15 years and older were surveyed about their knowledge, attitudes, and practices toward the seasonal influenza vaccine using a previously developed and validated 19-item online questionnaire. The impact of the participants’ perceptions toward the seasonal influenza vaccine on their past influenza vaccination history was assessed using multiple linear regressions. Results: The rate of regular vaccination among the 790 surveyed participants was 12.65%, and those who were aged <24 years had the highest rate (57%). The vast majority of the participants with chronic diseases (>90%) reported irregular vaccination histories against seasonal influenza. Participants who believed that the ...
The aim of this retrospective chart review study was to examine the cost effectiveness of angiote... more The aim of this retrospective chart review study was to examine the cost effectiveness of angiotensin-converting enzyme inhibitors (ACEIs); angiotensin receptor blockers (ARBs); and dihydropyridine calcium channel blockers (CCBs) such as amlodipine, monotherapies in the management of essential hypertension among adult patients (≥18 years) without cancer, cardiovascular disease, and chronic kidney disease in the primary care clinics of a university-affiliated tertiary care hospital. Patients were followed up for at least 12 months from the initiation of therapy. Propensity score bin bootstrapping with 10,000 replications was conducted to generate the 95% confidence intervals (CI) for both treatment outcome (e.g., reduction of the systolic (SBP) and diastolic blood pressures (DBP) in mmHG) and the cost (e.g., costs of drugs, clinic visits, and labs in Saudi riyals (SAR)). Among the 153 included patients who met the inclusion criteria, 111 patients were on ACEIs/ARBs, while 44 patients...
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