Background and purpose: The expression and function of P2X₇receptors in osteoclasts is well established, but less is known about their role in osteoblast‐like cells. A study in P2X₇receptor knockout mice suggested the involvement of these receptors in bone formation. We have investigated the expression and pharmacology of several P2X receptors in two human osteosarcoma cell lines to see if they could be involved in bone turnover in man.Experimental approach: Reverse transcriptase‐polymerase chain reaction and Western blotting were used to study P2X₂, P2X₄and P2X₇receptor expression at mRNA and protein levels, respectively, in human osteoblast‐like cells. P2X₇receptor pharmacology was studied by measuring pore formation in the presence of different agonists and antagonists using the YO‐PRO 1 uptake method.Key results: P2X₄and P2X₇receptor mRNA and protein were found to be expressed by these cell lines. No evidence was found for P2X₄/P2X₇receptor heteropolymerization. 2′‐3′‐O‐(4‐benzoylbenzoyl)adenosine 5′‐triphosphate (DBzATP) was equipotent to ATP and the antagonists used were either ineffective or weakly blocked pore formation.Conclusions and implications: This study demonstrates that P2X₄and P2X₇receptors are expressed by human osteoblast‐like cells. The affinities of the different agonists suggest that the P2X₇receptor is mainly responsible for pore formation although P2X₄receptors may also be involved. The low affinity of DBzATP and the weak action of the antagonists support the previously described atypical pharmacology of the P2X₇receptor in osteoblasts. Targeting the P2X₇receptor in osteoblasts could represent a promising new treatment for bone diseases such as osteoporosis and rheumatoid arthritis.

Living with extensive polypharmacy among the elderly population affects their quality of lives and medication compliance. The UK-developed (LMQ-3) which is a valid instrument designed to quantify medicine burden. The objectives of this study were to quantify medicines burden among community-dwelling elderly, describe the numbers and types of drugs used, and identify the risk factors that might need to be addressed. The descriptive cross-sectional study is designed to interview 500 Bahraini over 65 years of age using LMQ-3 questionnaire. Sample size was determined by Sloven’s formula. Data on socio-demographic characteristics and medication consumption patterns were collected then LMQ-3 and domains scores were compared by patient characteristics using descriptive statistics and statistical tests. Results found a wide range of burden among participants in Bahrain; ranging from moderate burden in almost a third of participants to high burden over two- thirds of participants. Burden was mainly driven by concerns about medicines, interferences of medicines with daily life and side effects. Higher LMQ-3 scores were associated with those who were employed, technical, aged ≥75 years, using ≥9 medicines, or using medicines four times a day. Anti-diabetics were the most prescribed medicines for the elderly. In conclusion, over two- thirds of participants experienced high burden. Being employed, technical, aged ≥75 years, using ≥9 medicines, or using medicines 4 times a day had the highest burden. These groups should become the main target for practitioners and pharmacists. Future studies should document potential herb-drug interactions among the elderly.

Tobacco prevention research traditionally focuses upon cigarette smoking, but there is also a need to implement and evaluate the usefulness of waterpipe tobacco smoking (WTS) interventions since it is considered less harmful than cigarettes. This study aimed to assess the impact of an educational intervention on WTS knowledge of health professional students in three academic health institutions in Bahrain. A quasi-experimental design was used to include medical students from the Arabian Gulf University, medical and nursing students from the Royal College of Surgeons in Ireland-Bahrain and nursing students from the University of Bahrain. Two hundred fifty students participated in the three phases of the study during October 2015–June 2016 from an original sample of 335. The participants answered knowledge questions on WTS before and after an intervention, which included a lecture by an expert and a video on the awareness about the health hazards of WTS. The mean age of starting cigarette and WTS was 16.8 ± 2.8 and 17.5 ± 1.7 years, respectively. The prevalence of ever smoking any type of tobacco among students was 22.4% (medical 25.8% and nursing 37.5%) and that of WTS, 17.7% (medical 20.0%, nursing 13.6%). The prevalence of current cigarette smoking was 9.6% among medical and nursing students combined with 10.3 and 8.5% for medical and nursing students, respectively. WTS was prevalent at a proportion of 6.8% among medical and nursing students combined with 6.5% in medical and 14.8% in nursing students. The university curriculum as the main source of knowledge on WTS increased from 14.2 to 33.3% after the intervention (p < 0.005). Knowledge about the hazards of WTS increased in 16 of the 20 statements. The difference in overall knowledge score was significant (p < 0.05) for nursing (77. 5 ± 1.5 vs 85.8 ± 2.2) compared to medical students (85.3 ± 1.0 vs 87.3 ± 0.9) after the intervention. Our educational intervention with health professional students improved their knowledge about the health effects of WTS. Medical and nursing institutions may consider using various methods such as informative videos and expert lectures to include in their teaching curricula as part of WTS prevention strategies.

Assessment of vitamin D levels in newly diagnosed children with type 1 diabetes mellitus comparing two methods of measurement: a facility's experience in the Middle Eastern country of Bahrain Fatima Ahmed Al-Haddad,1 Mansoor H Rajab,2 S Mahmood Al-Qallaf,3 Abdulrahman O Musaiger,4 Kathryn H Hart5 1Dietetic Unit for Hospitals, 2Pediatric Endocrine and Diabetes Team, Pediatric Department, Salmaniya Medical Complex, 3Pharmacy Program, College of Health Sciences, University of Bahrain, Manama, 4Nutrition and Health Studies Unit Deanship of Scientific Research, University of Bahrain, Sakheer, Kingdom of Bahrain; 5School of Biosciences and Medicine, Department of Nutritional Sciences, University of Surrey, Guildford, UK Background: The number of children being diagnosed with type 1 diabetes mellitus (T1DM) is on the rise and has more than doubled in the past 10 years in Bahrain. Some studies have linked low vitamin D levels with an increased risk of diabetes. There are concerns regarding the variations in circulating 25(OH)D levels measured by different laboratories and by using different analytical techniques. Objective: The aim of this study was to evaluate the vitamin D levels of newly diagnosed children with T1DM using the “gold standard method” with high-pressure liquid chromatography–tandem mass spectrometry methods compared to the chemiluminescence micro-particle immunoassay (CMIA) used in a hospital laboratory. Subjects: Eighteen children, aged 6–12 years, who received a confirmed diagnosis of T1DM in 2014 were chosen as subjects. Methods: Serum vitamin D levels were assessed in a hospital, while an extra aliquot of blood collected during routine blood collection after acquiring informed written consents from the subjects, and sent to Princess Al-Jawhara Center for Molecular Medicine and Inherited Disorders to be analyzed by ultra-performance liquid chromatography–tandem mass spectrometry (UPLC-MS/MS). Results: The mean age of the study group was 9±2 years. The mean total of 25(OH)D levels (D3 and D2) assessed by UPLC-MS/MS was 49.7±18.8, whereas the mean total of 25(OH)D levels obtained from the CMIA assay was 44.60±13.20. The difference in classification between the two methods was found to be statistically significant (P=0.004). A Bland–Altman plot showed a poor level of agreement between the two assay methods. The CMIA overestimated insufficient values and underestimated deficiency, when compared to UPLC-MS/MS. Conclusion: There was a statistically significant difference between the two assay methods with CMIA overestimating vitamin D insufficiency. Clinicians should be prudent in their assessment of a single vitamin D reading, when the gold standard method is not available or feasible. Keywords: type 1 diabetes, children, vitamin D, Middle East