Primary dysmenorrhea (PD) is a common, disregarded, underdiagnosed, and inadequately treated complaint of both young and adult females. It is characterized by painful cramps in the lower abdomen, which start shortly before or at the onset of menses and which could last for 3 days. In particular, PD negatively impacts the quality of life (QOL) of young females and is the main reason behind their absenteeism from school or work. It is suggested that increased intrauterine secretion of prostaglandins F2α and E2 are responsible for the pelvic pain associated with this disorder. Its associated symptoms are physical and/or psychological. Its physical symptoms include headache, lethargy, sleep disturbances, tender breasts, various body pains, disturbed appetite, nausea, vomiting, constipation or diarrhea, and increased urination, whereas its psychological symptoms include mood disturbances, such as anxiety, depression, and irritability. While its diagnosis is based on patients’ history, symptoms, and physical examination, its treatment aims to improve the QOL through the administration of nonsteroidal anti-inflammatory drugs, hormonal contraceptives, and/or the use of non-pharmacological aids (e.g., topical heat application and exercise). Patients must be monitored to measure their response to treatment, assess their adherence, observe potential side effects, and perform further investigations, if needed.

COVID-19 is a pacing pandemic that affected health systems, economy, and social life in the whole world. Currently, there is no treatment for it, but the world is in a race that yielded, in a relatively short time than usual, several approved, promising vaccines in the middle of a storm of debates because of the speed of their production and approval. This study assessed the willingness of Middle Eastern Arab publics to receive COVID-19 vaccines and investigated the factors behind any reluctance to receive them. A self-administered questionnaire was distributed through social media applications in four Arab countries (Jordan, Saudi Arabia, Lebanon, and Iraq). Participants’ demographics, medical history, their experience with COVID-19, and their willingness to receive the available vaccines were obtained and analyzed. A total of 2,925 completed forms were included. Only 25% of the participants were willing to receive a vaccine while 33% were hesitant. Iraqis were the most willing to receive it while Jordanians were the least (35% and 17% of each country, respectively). Interestingly, 60% of the acceptors were ready to pay for the vaccine if not covered by governments. It was also found that American vaccines were preffered by 50% of the acceptors. However, 30% of acceptors were unsure of which vaccine is the best and 11% stated that any vaccine is good. Social media were the major source of information about COVID-19 and its vaccines. Finally, predictors of acceptance of the vaccines included living in Saudi Arabia and Iraq, being unmarried, having monthly income > $1,000, holding a medical degree, having high fear from COVID-19, feeling of being at risk of getting infected with COVID-19, and previous reception of influenza vaccine, whereas predictors of refusal included female sex and previous infection with COVID-19. Middle Eastern Arabs are less likely to accept receiving the COVID-19 vaccines compared with non-Arabs. Health authorities in these countries are advised to intensify their awareness-raising activities about the vaccines while ensuring fair distribution of them.

Background: Acinetobacter baumannii is a major nosocomial pathogen capable of causing life-threatening infections. This bacterium is highly resistant to antibiotics and associated with high mortality rates. Therefore, this study aimed to evaluate A. baumannii's susceptibility patterns to antimicrobials, assess the appropriateness of the initiated antimicrobial therapy, determine the mortality rate, and identify predictors associated with mortality. Methods: A retrospective observational study was conducted among patients infected with A. baumannii at a university hospital in Lebanon through the revision of medical records. Kaplan–Meier survival analysis and log-rank tests were used to analyze time-to-mortality. Binary logistic regression was performed to identify predictors of mortality. Results: The records of 188 patients were screened, and 111 patients with A. baumannii infection were enrolled. Almost all isolates were resistant to carbapenem, and 43% of the isolates were extensively-drug resistant. Almost half of the patients received initial inappropriate antimicrobial therapy (n = 50, 45.1%). The 30-day mortality rate associated with A. baumannii infection was 71.2% (79/111). The time to mortality in patients who received inappropriate antimicrobial therapy (5.70 ± 1.07 days) was significantly shorter than in those who received appropriate antimicrobial therapy (12.43 ± 1.01 days, P < 0.01). Binary logistic regression revealed that inappropriate antimicrobial therapy (adjusted odds ratio [AOR] = 16.22, 95% CI 2.68–9.97, P = 0.002), mechanical ventilation (AOR = 14.72, 95% CI 3.27–6.61, P < 0.001), and thrombocytopenia (AOR = 8.82, 95% CI 1.12–9.75, P = 0.003) were more likely associated with mortality. Conclusions: A. baumannii exhibits an alarming mortality rate among infected patients. Thrombocytopenia, mechanical ventilation, and inappropriate antibiotic administration are associated with mortality in patients infected with A. baumannii. The prompt initiation of appropriate antimicrobial therapy, infection control measures, and effective stewardship program are crucial to reduce the incidence of A. baumannii and improve the treatment outcomes.

Background: The COVID-19 pandemic has overburdened the healthcare facilities, which demanded the use of alternative and effective methods for delivering healthcare services. The use of telehealth has become a necessity to provide initial health services.Objective: To identify the pharmaceutical care provided by community pharmacists to suspected high-risk COVID-19 patients using telehealth.Methods: A simulated patient (SP) phoned 100 randomly-selected community pharmacies throughout Lebanon using a standard scenario of uncontrolled diabetes mellitus with typical symptoms of COVID-19. Pharmacists’ responses were compared with pre-defined ideal recommendations using a special form.Results: The mean of the retrieved medical information score obtained by the pharmacists was 2.48 ± 2.79 (out of 21), with 34 % of the participants not retrieving any relevant medical data from the SP. The relative patient information, the exposure to COVID-19, and the possible COVID-19 symptoms were not retrieved by 61 %, 70 %, and 41 % of the pharmacists, respectively. Two percent of the pharmacists assured that the SP’s symptoms were related to common cold, while 5 % confirmed that the SP is infected with COVID-19. Notably, 35 % of the pharmacists did not offer any recommendation. Among them, 14 % claimed that they were too busy to respond. Only 39 % of the pharmacists provided an appropriate recommendation by referring the SP to her physician to seek medical attention within 24 h since the SP is a high-risk patient, and 41 % recommended doing a PCR test. Antipyretics, antibiotics, and dietary supplements were recommended by 27 %, 7 %, and 16 % of the pharmacists, respectively. Less than 16 % of the pharmacists recommended using protective measures against COVID-19. In addition, the overall communication skills of the pharmacists were generally below expectations.Conclusions: This study is the first to assess the quality of pharmaceutical care provided by community pharmacists in the Middle East via Telehealth. An unsatisfactory level of preparedness through means of telehealth technology was evident. This resulted in the quality of pharmaceutical-care services provided to high-risk patients via telehealth to be below expectations. Therefore, health authorities should encourage community pharmacists to effectively adopt telehealth, by providing appropriate training, as well as recognizing their extra efforts with financial compensations, aiming to optimize patients’ health outcomes.

Objectives: To assess the incidence, types, the causes of as well as the factors associated with dispensing errors in community pharmacies in Lebanon. Methods: An observational cross-sectional study was conducted in 286 pharmacies located all over Lebanon. Data were collected by senior pharmacy students during their experiential learning placement. Collected data included information on the types of dispensing errors, the underlying causes of errors, handling approaches, and used strategies for dispensing error prevention. Data were analyzed using multiple logistic regression to determine factors that were associated with dispensing errors. Results: In the twelve thousand eight hundred sixty dispensed medications, there were 376 dispensing errors, yielding an error rate of 2.92%. Of these errors, 67.1% (252) corresponded to dispensing near-miss errors. The most common types of dispensing errors were giving incomplete/incorrect use instructions (40.9% (154)), followed by the omission of warning(s) (23.6% (89)). Work overloads/time pressures, illegible handwriting, distractions/interruptions, and similar drug naming/packaging were reported as the underlying causes in 55% (206), 23.13% (87), 15.15 % (57), and 7% (26) of the errors respectively. Besides, high prescription turnover volume, having one pharmacist working at a time, and extended working hours, were found to be independent factors that were significantly associated with dispensing errors occurrence (p<0.05). Conclusions: This study sheds light on the need to establish national strategies for preventing dispensing errors in community pharmacies to maintain drug therapy safety, considering identified underlying causes and associated factors.

Community pharmacists (CPs) are among the frontline healthcare providers who have been exposed to a high risk of being infected with SARS-CoV-2 during the pandemic. Unfortunately, there have been limited studies in the Middle East that provide an occupational risk analysis among CPs. Therefore, this study aims to evaluate the risk of COVID-19 exposure among Middle Eastern CPs and to identify the infection predictors. A cross-sectional survey was conducted using an online, self-administered questionnaire that was distributed to CPs across KSA, Lebanon, and Jordan between November and December 2020. The bivariate logistic regression test was used to analyse the predictors associated with COVID-19. CPs were more susceptible to acquiring SARS-CoV-2 than the general public (12.9% vs. 1.5%). The significant predictors of infection included a family member with confirmed COVID-19 infection, age <40 years, encountering patients in pharmacy without a protective glass-barrier, and contact with confirmed COVID-19 patients or colleagues with confirmed COVID-19 during practice. Additionally, the mean level of the respondents’ expected rate of infection was 3.27 ± 1.04 (out of 5). This level was significantly higher among female pharmacists and Lebanese pharmacists. This study demonstrates that CPs are at a higher risk of acquiring COVID-19 compared with the general public. This is attributed to several occupational factors that increase the risk of exposure to COVID-19. Therefore, healthcare authorities are advised to enforce strict occupational guidelines for CPs.