Background: Nilotinib belongs to a group of anti-cancer drugs called tyrosine kinase inhibitors (TKIs), which are currently the mainstay treatment of chronic myeloid leukemia (CML). Objectives: In this study, we aimed to investigate the effects of this drug on bones around puberty in vivo. Methods: Juvenile male Wistar rats were divided to three groups and were treated orally once a day. Group 1 was administered vehicle; group 2 was administered nilotinib at a low-dose (30.85 mg/kg) and group 3 was treated with a high-dose (41.13 mg/kg). The treatment continued from week 4 until week 7 of age (pre-pubertal and pubertal life). Methods: Serum calcium, insulin-like growth factor-1 (IGF-1) and procollagen type I (PINP) were measured by enzyme-linked immunosorbent assay (ELISA). Femur bone was collected for histopathological evaluation using Hematoxylin & Eosin stain, and Masson's trichrome (MTC) staining. Immunohistochemistry was performed, using the bone cellular markers antiosteopontin (OPN) and antitartrate-resistant acid phosphatase (TRAP). Results: Serum Calcium, IGF-1 and PINP declined in a dose-dependent manner (p < 0.05). Histopathological evaluation revealed dose-dependent degeneration of bone lamellae and disruption and disorganization of cellular components. Moreover, the study revealed a decrease in collagen, decrease in OPN, and increase in TRAP immunostaining. Conclusion: Nilotinib had deleterious skeletal effects around puberty, possibly requiring long-term monitoring of bone growth and mineralization.

Background: Human papillomavirus (HPV) is a leading cause of cervical cancer and other HPV-related cancers globally. Vaccination against HPV has proven to be a pivotal intervention in reducing the burden of these diseases. However, questions remain regarding long-term efficacy, dosing strategies, and real-world outcomes of HPV vaccines. Objective: We aim to synthesise evidence from randomised controlled trials and long-term follow-up studies on the efficacy, immunogenicity, safety, and real-world impact of HPV vaccines. Methodology: A comprehensive search was conducted in PubMed, Cochrane Library, Embase, Scopus, and Web of Science for studies published in English from 2019 to 2024. Eligible studies included randomised controlled trials and long-term follow-up analyses focusing on HPV vaccine efficacy, dosing regimens, and population-specific outcomes. Data were extracted and synthesised narratively, with findings organised into five thematic areas. Results: Seventeen studies met the inclusion criteria. Findings confirm the high efficacy of HPV vaccines in preventing HPV-related cancers and precancers, with durable immunogenicity observed up to 12 years post-vaccination. Evidence supports the potential of single-dose regimens, which could improve accessibility in resource-limited settings. Real-world data demonstrated significant reductions in HPV-related diseases across diverse populations, reinforcing the global impact of HPV vaccination programs. Conclusion: This review highlights the critical role of HPV vaccines in reducing the burden of HPV-related cancers, with robust efficacy, long-term protection, and favourable safety profiles. The findings underscore the need for continued research into optimised vaccination strategies and the expansion of global vaccination efforts.

Background: Antibiotics have become some of the most widely used and essential tools in the healthcare system, with the advantage of saving millions of lives. However, the overuse and misuse of antibiotics led to the emergence of resistant microorganisms. Objective: To assess community pharmacists’ knowledge, attitude, and practice in relation to dispensing antibiotics without prescription. Methods: In this cross sectional study, a validated survey was distributed in person as Google Forms to community pharmacists across different regions in Jordan using convenience sampling. A quantile regression was conducted to explore the factors associated with attitude and practice of antibiotics dispensing without prescription. Results: Pharmacists (N=351) exhibited moderate knowledge regarding antibiotic use and resistance, with a median score of 4 (range 3-5) out of a possible 7 points. The median attitude score was 22 (20-24), out of maximum possible score of 25, indicating favourable attitudes towards antibiotics prescription. Regression analysis demonstrated that higher knowledge scores were associated with higher attitude scores (coefficient = 0.106, 95%CI: 0.007 - 0.206, p = 0.036). Additionally, higher attitude scores were linked to a reduced likelihood of dispensing antibiotics without a prescription (coefficient = -0.302, 95%CI: 0.588 - 0.929, p = 0.010). Conclusion: The study indicated moderate knowledge of antibiotics among pharmacists and a generally favourable attitude toward their prescription. Greater knowledge was associated with a more positive attitude, which was linked to a lower likelihood of dispensing antibiotics without a prescription. Future initiatives should aim to enhance pharmacists' understanding of antibiotic use and resistance, as well as implement stricter dispensing regulations to reduce the use of antibiotics without prescriptions and address antimicrobial resistance.

Background: Antimicrobial Resistance (AMR) occurs in nature, but the inappropriate and excessive use of antimicrobials, and poor infection prevention, have all contributed to the increasing incidence of this phenomenon. As a result of AMR, infections become harder to treat, spread more easily and cause more severe illness and deaths. Objective: Community pharmacies, thanks to their widespread distribution, local accessibility and extended opening hours, could play a significant role in the fight against AMR. To test this hypothesis we designed the present study with two objectives. Firstly, to evaluate AMR knowledge and behaviours in a sample of community pharmacy customers in the northwest of Piedmont. Secondly, to obtain information to understand the potential role of the pharmacist. Methods: A survey to evaluate the AMR knowledge and behaviours of pharmacy customers was carried out. The work was designed as a survey. Data was collected in 2020-2021 in 46 pharmacies by means of a face-to-face interview using a questionnaire. Each pharmacist attended a training course regarding the administration of the questionnaire to avoid any bias. The course also aimed to enhance pharmacists’ communication skills to give evidence-based AMR-related advice to customers. Results: 1,883 subjects were interviewed. The investigation showed that there was a significant lack of awareness of AMR among the study population. Only 36.59% of respondents were able to identify the correct definition of this term, the rest of the interviewees had little or no knowledge of the problem and the consequences of this condition. The results also suggest that a health education programme might be helpful in achieving significant results: in the sample, those who demonstrated a previous knowledge of the phenomenon, also demonstrated the best behaviour. Conclusions: Community pharmacists could be a useful resource for assessing and improving AMR knowledge and behaviour and potentially take an active role in enhancing information campaigns. This is especially important for elderly populations who are the least informed and are the main users of community pharmacies.

Objective: This study aimed to assess the general population's habits and attitudes toward disposing of expired and unused medications and evaluate their awareness of advanced medication take-back programs using an application system in the UAE. Methods: Over three months, a descriptive cross-sectional study was conducted with a sample size of 411 participants from the seven emirates of the UAE. Data were collected via an online questionnaire and analyzed using SPSS (version 28.0). Results: Half of the participants were aged 18–24, and 58% were university graduates. A total of 78.4% reported having unused medications at home. While 69.6% were unaware of pharmacists' roles in pharmaceutical waste disposal, only 25% had received advice from healthcare professionals. The most common disposal method was throwing medications in the garbage (74%), while only 5.9% returned them to pharmacies. Notably, 77.6% expressed willingness to participate in a mail-back program for expired and unused medications. Conclusion: Implementing an online mail-back program could enhance community awareness of proper medication disposal, reduce risks associated with improper practices, and improve pharmaceutical waste management in the UAE, contributing to a healthier environment.

Objectives: to provide insights into public knowledge and practices toward antibiotic resistance as well as common behaviours related to antibiotic use and resistance in the UAE. Methods: This study is a cross-sectional, observational investigation into the knowledge, and attitudes, of UAE residents toward antibiotic resistance, using a convenience sampling approach. From May to June 2022, the survey was distributed throughout the seven emirates of the UAE. The methodology was adapted from the WHO's "Antibiotic Resistance: Multi-Country Public Awareness Survey". The study followed the Strengthening Reporting of Obser-vational Studies in Epidemiology reporting (STROBE) guideline for cross-sectional studies. Results: A total of 1074 individuals completed the survey. Approximately two thirds of the respondents (66.0%) were familiar with the term “Antibiotic resistance”. The percentage of respondents who believed that antibiotics could be effective against viral infections decreased from 57.8% to 45.4% after the COVID-19 pandemic period. Additionally, 79.1% of respondents incorrectly believed that antibiotic resistance occurs when their bodies become resistant to antibiotics. Studying in the medical field and having a postgraduate degree were significant predictors of adequate knowledge (Odds ratios were 2.15 and 1.77, respectively). Conclusion: The participants in this study were generally aware of antibiotic resistance; however, incorrect descriptions of antibiotic resistance were frequently encountered. Respondents involved in the medical sector during their studies and those with higher educational degree were more likely to possess adequate knowledge about antibiotic resistance. This evidence can be used to contextualize and enhance the efficiency, effectiveness and success of antimicrobial resistance interventions.

Objective: The aim of the study was to investigate how COVID 19 impacted the spending on medications that are used to relieve migraine. Another aim of this study was to assess the significant predictors which contributed to increasing the economic burden (EB)among patients with migraine. Methods: A cross-sectional study was conducted on patients with migraine between October 2022 and April 2023 using a predeveloped self-administrative questionnaire. All patients who had a migraine, aged 18 and more and can spoke Arabic were included using convenient sampling procedure. The economic burden (EB) model was developed using simple and multiple regression. Results: After removing samples with extreme value, a total of 198 responses were analyzed. When adjusted for confounding patients age, education level, occupation and level of income were the significant predictors for EB. Older patients’ (AOR: 1.82, p<0.05), low educated (AOR: 3.17, p<0.05), employed (AOR: 1.07, p<0.05) and high-income level patients’ (AOR: 2.46, p<0.05) were more likely to experienced EB than their counterparts. Conclusion: The current study provided an initial picture about the economic burden of COVID 19 on the spending of medications and the number of ER visits from the migraineurs’ perspectives. Patients’ age, education level, occupation and level of income were significant predictors of increasing the economic burden on patients with migraine. Most of the migraine patients avoided going to hospital and preferred to take medications at their homes. More research should warrant focusing on estimating the total migraine cost including direct, indirect, and intangible cost.

Background: The rapid proliferation of community chain pharmacies management models has garnered significant attention. Despite this surge, there is a notable scarcity of research that comprehensively evaluates this model in comparison to traditional independent pharmacies. Objective: This study aims to analyze pharmacists' insights into the status of community pharmacy management models, specifically comparing chain pharmacies to traditional independent pharmacies. We employed a framework assessing 40 aspects across five critical pillars: 1) Pharmaceutical care & Patient Services, (2) Professional development and Working environment, (3) Economic considerations, (4) Legal aspects, and 5) General concerns. Methods: This cross-sectional analytical study utilized a validated and reliable online survey (Lawshe's content validity ratio > 0.741, p < 0.05, Cronbach's alpha = 0.86) distributed among pharmacists. The analysis included measurements of associations and the strength of association to explore significant results. Results: A total of 835 pharmacists responded. Gender, workplace, and responder qualifications exhibited no significant association (P>0.05) with pharmacy model preferences. However, older participants and those with increased years of experience demonstrated a very strong statistically significant association toward preferring independent pharmacies (P<0.001, Cramer's V (ϕc) for age > 48 = 0.7) and experience (P<0.001, (ϕc) for > 6-year experience = 0.52). Overall, independent pharmacies were favoured over chain pharmacies (43.7% vs 29.5%, P<0.001). Quality of pharmaceutical care parameters indicated that independent pharmacies were perceived as superior to chains in patient consultation (p<0.001), reduced waiting time for patients (p<0.001), and better longer-term relationships (p<0.001). Regarding economic impact, chain pharmacies were perceived to yield higher profits and more sales for non-medical products (P<0.001). Independent pharmacies generally exhibited a superior profile in legislative parameters compared to chain pharmacies, including compliance with ownership regulations (P<0.001) and bequeathable practices (P<0.001). Chain pharmacies were perceived to provide better professional development to their staff compared to independent pharmacies (P<0.001). Conclusion: The significant expansion of chain pharmacies in the market highlights the imperative need for the establishment of new regulations and criteria. These measures are crucial to guarantee stability and equity for both chain and independent pharmacies operating within the market.

Introduction: Hypoxia mediates cancer hallmarks and results from low oxygen levels due to irregularities in tumor vascularization or when the bulk of the tumor prevents oxygen diffusion and stimulates angiogenesis to compensate for low oxygen. Aims: This study aims to identify significant biomarkers associated with tumor hypoxia, focusing on prolonged exposure to hypoxic conditions. Methods: The breast cancer cells (MCF7) were exposed to 8-hour hypoxic episodes (1% oxygen) three times per week for 60 episodes and once weekly for 72 hours for a maximum of 12 episodes. After 60 and 12 episodes of hypoxia, changes in gene expression were profiled using a hypoxia RT- PCR array and compared to normoxic cells. An assay was performed after 60 and 12 episodes of hypoxia to determine the effect of hypoxia on angiogenesis migration. Results: The expression of the Hepatocyte Nuclear Factor 4 gene increased by 32.71-fold following exposure to 12 hypoxic injections and by an additional 14.95-fold following exposure to 60 hypoxic injections. After twelve episodes of hypoxia, the capacity for cell migration increased. Conclusions: This study provides empirical support for the notion that cellular exposure to prolonged durations of hypoxia, specifically three months, induces expression changes distinct from those induced by fleeting durations of hypoxia, which are less than weeks and hours. The study hypothesized that HNF4A could serve as a viable biomarker for tumor hypoxia and a major contributor to the response of MCF7 breast cancer cells to protracted hypoxic conditions.

Pharmacy Practice is a free full-text journal with a scope on the practice of pharmacy. Pharmacy Practice covers pharmaceutical care, social pharmacy, pharmacy education, process and outcome research, health promotion and education, health informatics, pharmacoepidemiology