Propranolol is the first-line drug for managing migraine attacks. D-limonene is a citrus oil known for its neuroprotective mechanism. Thus, the current work aims to design a thermo-responsive intranasal limonene-based microemulsion mucoadhesive nanogel to improve propranolol efficacy. Microemulsion was fabricated using limonene and Gelucire^® as the oily phase, Labrasol^®, Labrafil^®, and deionized water as the aqueous phase, and was characterized regarding its physicochemical features. The microemulsion was loaded in thermo-responsive nanogel and evaluated regarding its physical and chemical properties, in vitro release, and ex vivo permeability through sheep nasal tissues. Its safety profile was assessed via histopathological examination, and its capability to deliver propranolol effectively to rats’ brains was examined using brain biodistribution analysis. Limonene-based microemulsion was of 133.7 ± 0.513 nm diametric size with unimodal size distribution and spheroidal shape. The nanogel showed ideal characteristics with good mucoadhesive properties and in vitro controlled release with 1.43-fold enhancement in ex vivo nasal permeability compared with the control gel. Furthermore, it displayed a safe profile as elucidated by the nasal histopathological features. The nanogel was able to improve propranolol brain availability with C_max 970.3 ± 43.94 ng/g significantly higher than the control group (277.7 ± 29.71 ng/g) and with 382.4 % relative central availability, which confirms its potential for migraine management.

Objectives: Distinct measures were adopted in Lebanon to prohibit the spreading of SARS-CoV-2. These actions provide positive results only if the population chooses to be compliant. Aim: Accordingly, this study aimed to reflect the Lebanese population adherence by determining their level of knowledge and practice during this pandemic. Method: A cross-sectional online survey was performed in April 2020. It involved 410 volunteers from the main 5 Lebanese districts. The questionnaire was divided into 3 parts; sociodemographic, knowledge, and practice. A score was calculated out of 18 points to evaluate the knowledge of the respondents. The last 8 questions reflected the participants' precautionary methods during the pandemic. Descriptive statistics and one-way analysis of variance tests were conducted using SPSS version 20. Results: The overall correct rate of the knowledge questionnaire was 75%. Survey completers of extreme age groups (under 18 and >44), elementary education level, and medical occupation displayed the least level of knowledge compared to other groups (p < 0.05). Most of the participants showed proactive practices to protect themselves against COVID-19. They covered their mouths (81.2%), threw the used tissues (93.7%), and washed their hands (66.6%) after sneezing or coughing. Moreover, they wore face masks if they were sick (59%) or in a crowded place (79.3%). Concerning Hydroxychloroquine, 10% claimed that they would take it if they have COVID-19 symptoms. Conclusion: This survey sheds the light on the fact that one mandatory measure does not fit all the population; there must be a specialized method of prevention for each profession, age group, and area of the country to prevent the outbreak of COVID-19.

Background: Medication non-adherence is a significant barrier to optimal treatment goals. The study explores the association between subjective well-being (SWB) and medication adherence among Lebanese individuals with multiple chronic diseases and identifies additional factors that may influence adherence in this population. Methods: An exploratory, cross-sectional study was conducted for three months at six community pharmacies. Adherence was assessed using the Adherence to Refills and Medication Scale Arabic Lebanese Version (ARMS-A). The SWB was measured using the Arabic Scale of Happiness (ASH), Love of Life Scale (LLS), Arab Hope Scale (AHS), and Satisfaction with Life Scale (SWLS). Spearmen's Rho correlation analyzed the association between ARMS-A and SWB constructs. Binary logistic regression identified predictors of adherence among individuals with chronic diseases and on multiple chronic medications. Results: Of 400 participants, 106 (26.5 %) with a 95 % CI, 0.22–0.31, were adherent. Lower medication adherence (reflected in higher ARMS-A scores) was associated with lower SWB (p = 0.01). Multivariate analysis showed that lower education (OR = 2.21, 95 % CI, 1.01–4.81), lack of a specific diet (OR = 1.64, 95 % CI, 1.01–2.69), and frequent hospital and/or emergency visits (OR = 3.29, 95 % CI, 1.75–6.17 for 2 visits; OR = 2.71, 95 % CI, 1.43–5.14 for ≥3 visits) significantly increased the odds of non-adherence to chronic treatment. However, higher income (OR = 0.06, 95 % CI, 0.01–0.38), healthcare provider occupation (OR = 0.42, 95 % CI, 0.21–0.48), and having diabetes mellitus (OR = 0.59, 95 % CI, 0.36–0.96) correlated with better adherence. Conclusion: A significant portion of participants failed to adhere to their prescribed chronic medications, influenced by multicomplex socioeconomic, psychological, and health-related factors. These findings demonstrate the need for culturally-tailored, pharmacist-led interventions to improve medication adherence and overall health outcomes.

Purpose: Although nonsteroidal anti-inflammatory drugs are widely used to treat a variety of disorders, their administration is associated with gastrointestinal side effects, acute kidney injury and liver enzymes’ elevation. Accordingly, researchers are encouraged to create novel agents with better safety profile. The aim of the current study was to evaluate the chronic efficacy and safety profile of two compounds previously proven to have acceptable acute anti-inflammatory and analgesic activities. Materials and methods: Doses were determined through formalin-induced mice paw edema-based dose–response curves. Granuloma weight was used to assess the chronic effect of the investigated compounds as compared to the vehicle and diclofenac representing the positive and the negative controls, respectively. Mice kidneys, livers and stomachs were histologically examined. Moreover, troponin I, alanine aminotransferase, aspartate aminotransferase, serum creatinine and blood urea nitrogen levels were measured. Results: The results highlight that the granulomas and exudates developed in mice after 7 days of treatment, with compound I and compound II were significantly lower than that of the negative control group. Moreover, compound I showed significantly better anti-inflammatory effect than diclofenac. Troponin level was undetected in all groups. Histopathological examination of the stomach revealed normal mucosa for both tested compounds and controls. Likewise, kidneys showed neither significant histologic alteration nor biomarkers increase as compared to the control over both 7- and 30-day treatment periods. Mice that received the tested compounds or diclofenac exhibited transient liver damage specifically; congestion, vacuolization, necrosis and inflammation after 7 days of treatment which decreased significantly after 30 days of treatment as emphasized by the Suzuki score and biomarker levels. Conclusion: Since the tested compounds, specifically compound I, presented a satisfactory chronic safety profile as well as anti-inflammatory effect, it is worth conducting further molecular pharmacological, toxicological and bioavailability studies to elucidate the efficacy of these potential anti-inflammatory bipyrazole compounds.