Mohammad Jaffar Sadiq Mantargi

Background: Herb-drug interactions can affect the outcomes of antiretroviral regimens among people living with HIV. Our study aimed to assess perceptions and practices regarding herbal medicine use among people living with HIV attending Bushenyi Health Center IV in Western Uganda. Methods: We conducted a cross-sectional, interview-based survey in September 2025 using a pre-validated questionnaire to assess their perceptions and practices of herbal medicine. Participants who were aged more than 18 years, of both genders, on antiretrovial therapy, and who consented to participate were enrolled. Herbal medicine use was defined as the current use of herbal medicine alongside ART. Binary and multiple logistic regression analyses were applied to identify associations with herbal medicine use. Results: Among 375 participants, 108 (29%) were concurrently using herbal medicine with ART. Ginger (21%) and garlic (27%) are the commonly consumed herbal products. General health (75%) and boosting immunity (22%) were common reasons for taking herbal medicine. Sixty five (60%) of herbal medicine users did not disclose their use of herbal medicine to their healthcare providers. Low perceived concern (vs. high; AOR = 2.77; 95% CI 1.13-6.82) was positively associated, while low perceived benefit (vs. high; AOR = 0.06; 95% CI 0.02–0.25) was negatively associated with herbal medicine use. Presence of comorbidities, opportunistic infections, experience of side effects of antiretroviral therapy, and non-antiretroviral therapy medication use were significantly associated with herbal medicine use in unadjusted analysis. Conclusion: Our study findings underscore the need for open patient-provider communication through co-designed, participatory education models to engage both people living with HIV and healthcare providers in promoting the safe use of herbal medicines alongside antiretroviral therapy. These models address the disclosure gaps and reduce the risk of potential herb-drug interactions.

Purpose: Isotretinoin remains the most effective treatment for moderate-to-severe acne vulgaris; however, its use is frequently associated with mucocutaneous and metabolic adverse effects that may necessitate active clinical intervention. Data evaluating predictors of clinically significant toxicity in Saudi populations remain limited. Patients and Methods: A retrospective cohort study was conducted at a tertiary academic hospital in Saudi Arabia. Electronic medical records of patients with acne vulgaris treated with isotretinoin between January 2020 and December 2024 were reviewed. Demographic variables, acne severity, isotretinoin dosing characteristics, laboratory findings, adverse effects, management strategies, and treatment outcomes were extracted. Multivariable regression analysis was performed to identify predictors of adverse effects requiring clinical intervention. Results: A total of 444 patients were included. Most participants were aged 21– 30 years (60.4%), and females represented 50.9% of the cohort. Clinical intervention was required in 70.7% of patients, including supportive care, treatment reduction and dose discontinuation to manage isotretinoin-related adverse effects. Mucocutaneous adverse effects, particularly cheilitis and xerosis, were the most frequently documented complications. Laboratory abnormalities were observed less frequently, although elevated LDL levels were identified in 9.9% of patients, followed by elevated total cholesterol (7.2%) and triglycerides (4.5%). Elevated liver enzymes were relatively uncommon (AST 4.1%, ALT 3.2%). Higher cumulative dose, dose escalation during therapy, and higher maximum dose significantly increased the likelihood of requiring clinical intervention. Female sex and higher body weight were associated with lower odds of intervention. Major improvement was achieved in 37.4%, complete clearance in 28.8%, giving a combined rate of 66.2% while recurrence after discontinuation occurred in 19.4%. Conclusion: Isotretinoin, proved efficacious clinically in the management of acne vulgaris, however was identified to be associated with high number of adverse effects which require active management. Multivariable regression identified that the increasing dose and cumulative dose were the most influential determinants of the drug therapy. Particularly, lipid abnormalities (elevated LDL) were clinically relevant for the included cohort of patients. The outcomes therefore emphasize the need for a personalised approach to dosing along with continuous monitoring to achieve the optimal results.

Background: Insomnia prevails globally and nationally as a serious public health issue with a global prevalence of 48% and is significantly linked to morbidity and productivity loss. Community pharmacists play a vital role in addressing the issue through over-the-counter (OTC) medications and lifestyle advice, yet insomnia management practices remain unexplored in Saudi Arabia. Hence, this study addresses the gap using a simulated patient (SP) methodology. Methods: A cross-sectional study employing SP was conducted to evaluate community pharmacists’ approach to insomnia management across three regions of Saudi Arabia. A total of 251 visits were identified under the standard scenario. Data collected included pharmacist behavior, consultation duration, and recommendations. Data analysis included descriptive statistics, the chi-square test, Pearson correlation, and binary logistic regression to identify the predictors of pharmacists’ history taking and patient counseling. Results: A total of 251 simulated visits to pharmacies were completed (urban area 43.4%, suburban area 49.4%, and rural 7.2%), consultation lasted for only 1.5 min (interquartile range [IQR] 1–2 min), most pharmacists inquired about sleep patterns (55.4%) and triggers (51%), recommended OTC medications (e.g., melatonin, 64.5%), and non-pharmacological advice were less frequent (9.6%). Safety information was infrequent (4.9%). Pharmacist professionalism was high (85.7%), but privacy, self-introduction, and referrals were low, with significant regional variation among pharmacies ( p < 0.001, χ ² ). Binary logistic regression identified multiple strong predictors across all domains, including day of visit (odds ratio [OR] = 509.979), interaction duration (OR = 0.338), and key questioning behaviors. Discussion: Saudi pharmacists opted for safer OTC melatonin for the management of insomnia with brief consultation (IQR = 1–2 min), incomplete history taking, limited safety counseling (<5%), and rare non-pharmacological advice (9.6%). Regional variations and time pressures highlight the need for workflow improvements to enhance patient-centered care. The day of the visit displayed a strong effect (OR = 509.979), whereas longer pharmacist interactions were associated with lower odds of missing key questions (OR = 0.338). Accompanying symptoms (OR = 6567.348) and chronic health issues (OR = 941.751) were identified as strong predictors. Conclusion: Although pharmacists were accessible, gaps in insomnia management may risk patient safety. Targeted training for pharmacists (continuous professional development [CPD] programs), formulating community guidelines for pharmacists, and systemic changes are important to optimize their role in sleep health.

The emerging potential of senotherapeutics in the management of chronic pulmonary diseases focuses on the pivotal role of cellular senescence in the pathogenesis of conditions such as idiopathic pulmonary fibrosis (IPF), asthma, and chronic obstructive pulmonary disease (COPD). Senescent cells, characterized by irreversible cell cycle arrest and a pro-inflammatory secretory phenotype, accumulate with age and contribute to chronic inflammation, tissue remodeling, and disease progression in the lungs. The chapter provides an in-depth understanding of the mechanisms by which senescent cells influence pulmonary pathology and presents senolytics and senomorphics as innovative therapeutic strategies. These approaches aim to either eliminate or modulate the effects of senescent cells. While challenges such as adverse drug reactions remain, recent advancements—such as the development of FOXO4-DRI, a senolytic peptide—highlight the therapeutic promise of senotherapy in improving lung function and reducing disease burden. Ultimately, targeting senescent cells offers a dual benefit: alleviating symptoms and addressing the root causes of chronic lung disorders.

Introduction: artificial intelligence (AI) is increasingly transforming clinical decision-making and diagnostic accuracy across healthcare systems worldwide. However, despite growing interest in Saudi Arabia, the perceptions and readiness of healthcare professionals toward AI integration remain underexplored. This study aimed to evaluate healthcare professionals’ perceptions, experiences, and challenges regarding the use of AI-powered diagnostic and predictive analytics tools in hospital settings in Jeddah, Saudi Arabia, and to examine the factors influencing their adoption and confidence levels.Methods: a descriptive cross-sectional study was conducted among 240 healthcare professionals, including physicians, nurses, specialists, and allied health staff from selected hospitals in Jeddah. Data were collected using a validated bilingual questionnaire assessing familiarity, training, usage patterns, perceived benefits, and barriers to AI implementation. Quantitative data were analyzed using descriptive statistics and Chi-square tests, while qualitative responses underwent thematic SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis.Results: overall, 59.2% of participants reported using AI tools, primarily in diagnostic imaging. Although most participants demonstrated moderate familiarity with AI, only 30% expressed confidence in AI-based diagnostics. Significant associations were observed between professional roles, years of experience, and AI utilization (p < 0.05). Major challenges included limited training, cost, and lack of institutional support. SWOT analysis revealed a strong willingness to adopt AI but highlighted patient resistance and ethical concerns as persisting threats.Conclusion: AI integration in Saudi hospitals is advancing yet constrained by training and trust gaps. Strengthening institutional frameworks, implementing national AI competency programs, and aligning initiatives with Vision 2030 are essential to ensure effective, ethical, and sustainable AI adoption.

Background: The world is witnessing tremendous development in the field of new digital tools, including artificial intelligence (AI), in all sectors, including the health and medical sectors. However, educational and training opportunities in the field of artificial intelligence remain nascent and limited. Hence, this study aims to assess the awareness, attitudes, and knowledge of artificial intelligence among students of health specialties in Saudi universities and to assess whether artificial intelligence is viewed as a beneficial innovation or a potential threat to healthcare roles. Methods: This cross-sectional study included 498 male and female students from various health colleges at different Saudi universities. The participants completed an online questionnaire adapted from previous studies to assess their awareness, attitudes, and knowledge of artificial intelligence. Descriptive statistics and chi-square analyses were conducted to explore the associations between variables related to artificial intelligence and other factors. Results: Most students showed a high level of awareness of artificial intelligence, with social media being identified as their main source of information about artificial intelligence. While students’ attitudes towards AI were generally positive, for example, 89.2% of the students believed that AI would be crucial to the future of healthcare, 76.7% supported AI education, and 78.3% were keen to increase their knowledge of AI. In terms of assessing students’ knowledge of AI, the study revealed that the participating students had moderate knowledge of AI principles and skills, with significant gaps in understanding specific AI capabilities and functions. Conclusions: While healthcare students in Saudi Arabia demonstrate strong awareness and positive attitudes towards AI, there are significant gaps in practical knowledge. These findings underscore the need for tailored educational strategies to better integrate AI into curricula, thus preparing future healthcare professionals to effectively leverage AI.

Background: Medication use (MU) during pregnancy can increase the risk of maternal and fetal health consequences. Women's knowledge, attitude, and practice (KAP) regarding safe MU can influence pregnancy outcomes. The study aimed to assess and explore women's KAP regarding safe MU during pregnancy and identify possible determinants.Methods: A cross‐sectional analytical, interview‐based survey was conducted among pregnant women attending antenatal care (ANC) visits in the obstetrics and gynaecology department of Kyegegwa General Hospital, Kyegegwa district, Western Uganda. A 24‐item pre‐designed, validated structured questionnaire was used to assess the KAP of MU among pregnant women. Binary and multiple logistic regression analyses were used to identify factors associated with KAP about MU.Results: A total of 415 pregnant women with a mean (SD) age of 26.51 (5.15) years were included. Most of the women have a positive attitude (78.60%) towards safe MU, but less than half only hold adequate knowledge (42.60%), and rational practice (34.50%). Factors such as secondary education level or less (AOR = 0.15; 95% CI = 0.01–0.38), urban residence (AOR = 1.54; 95% CI = 2.68–4.49), profession (AOR = 1.94; 95% CI = 2.36–10.59), regular ANC visits (AOR = 1.22; 95% CI = 1.06–3.48), GP visit during pregnancy (AOR = 2.54; 95% CI = 1.09–5.91), and using at least one medication (AOR = 9.00; 95% CI = 2.78–6.43) were significantly associated with adequate knowledge regarding MU. The practice domain revealed that age less than 30 years (AOR = 0.53; 95% CI = 0.28–0.98), profession (AOR = 2.56; 95% CI = 1.86–7.59), regular ANC visits (AOR = 1.79; 95% CI = 1.05–3.74), and GP visit during pregnancy (AOR = 1.73; 95% CI = 1.02–3.25) were significantly associated with rational practice.Conclusion: The study concludes that three‐fourths of the pregnant women have a positive attitude regarding safe MU, still there is an extensive gap in transforming this positive attitude into rational practice due to lack of adequate knowledge. So, to address the gap identified in the knowledge and practice domain, hospital‐based educational interventions on safe MU can be initiated by targeting young age, lower or no education, rural residents, and participants working in non‐healthcare profession.

Background: Ischemic heart disease (CAD), a leading global health burden, arises primarily from atherosclerosis, an inflammatory condition characterized by lipid accumulation and metabolic dysregulation. The precise contribution of inflammatory cytokines (IL-2, IL-6, and TNF-α) to CAD pathogenesis remains an area of significant research. Aim: The primary aim of this study is to examine the IL-2, IL-6, and TNF-α in patients with coronary artery disease (CAD) and compare them with Non-CAD individuals to evaluate their potential as diagnostic biomarkers for CAD. Methodology: A prospective observational study was conducted over 3 years, involving 100 participants divided into CAD and non-CAD groups. Blood samples were isolated and analyzed for IL-2, IL-6, and TNF-α levels utilizing ELISA kits. Biochemical parameters, including lipid profiles, were also assessed. Results: This study observed significantly elevated IL-6 in patients with CAD compared with controls, while IL-2 and TNF-α levels did not reach statistical significance. The CAD group exhibited dyslipidemia characterized by elevated triglycerides and reduced HDL. Furthermore, the CAD group demonstrated alterations in biochemical parameters, including lower albumin and calcium levels, higher urea and uric acid levels, and an elevated erythrocyte sedimentation rate. These findings suggest a systemic inflammatory state and metabolic disturbances in patients with CAD. Conclusions: This study highlights IL-6 as a potential biomarker and key player in CAD pathogenesis. These findings warrant further investigation into the therapeutic potential of targeting inflammatory pathways for cardiovascular risk reduction.

Cyclophosphamide is a widely used chemotherapeutic agent known for its effectiveness in treating various cancers; however, it is associated with significant immunosuppressive side effects. This study investigates the potential of sakuranetin, a natural flavonoid, in mice under cyclophosphamide-induced immunosuppressive conditions. Mice were grouped into four groups: one control group, two treated with cyclophosphamide and two sakuranetin-treated groups receiving different doses (10 and 20 mg/kg). Immune organ indices, lymphocyte proliferation, hematological parameters, nitric oxide levels, cytokines (tumor necrosis factor alpha-TNF-α, interferon γ-IFN-γ), interleukins (interleukin-1β-IL-1β, IL-4, IL-6), immunoglobulin G (IgG), IgM levels, plague-forming cells quantification, qualitative hemolysis, and delayed-type hypersensitivity were assessed. Cyclophosphamide significantly (P < 0.05) reduced immune organ indices, lymphocyte proliferation, changes in hematological parameters, and nitric oxide levels. Treatment with both sakuranetin doses restored these parameters and normalized cytokine, IgG, and IgM levels (P < 0.05). Sakuranetin significantly (P < 0.05) improved the immunomodulatory action with elevated immune response with downregulation in immune response mediated by cells. Sakuranetin effectively counteracts cyclophosphamide-induced immunosuppression by modulating the IFN-γ, TNF-α, IgG, and interleukin pathway, suggesting its potential as a protective agent. Graphical Abstract

Purpose: Rational self-medication (SM) practice among healthcare students is essential to promote the safe, effective, and economical use of medicines for self-diagnosed conditions. The study aimed to assess pharmacy students’ knowledge, attitude, and practice about responsible self-medication. Methodology: A cross-sectional online survey was conducted among Ugandan pharmacy students for one month from March 1 to March 31, 2024. The study included students enrolled in diploma, bachelor, and master of pharmacy programs in Uganda. Informed consent was obtained online by asking a question regarding willingness to participate. A non-probable snowball sampling technique was used to recruit students. A pre-validated questionnaire was used to obtain socio-demographics, self-medication practices, knowledge, attitudes, and practices about responsible self-medication. We used binary and multivariable logistic regression analysis to identify the factors associated with KAP regarding responsible self-medication. Results: The prevalence of self-medication practice among pharmacy students was 96.73%. The self-medication is most common in headache (78.97%), cold, and cough (79.91%) illnesses. Painkillers (90.19%) and antibiotics (53.97%) are the most common medicines used for self-medication. Most pharmacy students have good knowledge (87.38%) and a positive attitude (96.03%) toward responsible self-medication. However, only 27.34% of students practice rational self-medication. Participants’ university and parents’ professions were significantly associated with good knowledge of responsible self-medication. Whereas factors such as gender, residence, and type of illness were significantly associated with rational self-medication practice. Conclusion: The prevalence of self-medication was high among pharmacy students in Uganda. Painkillers and antibiotics are the most preferred drugs for self-medication. About 87.38% of pharmacy students have good knowledge, and 96.03% have a positive attitude toward responsible self-medication. Rational self-medication practice was low among students. We recommended training sessions to enhance safe self-medication practices among pharmacy students.