Bio Med Vision Journal

The main purpose of pharmacovigilance (PV) is to ensure medication safety through detecting, assessing, and preventing adverse drug reactions (ADRs). Healthcare providers (HCPs) are the main contributors in PV systems all over the world. However, their knowledge, attitudes, and practices (KAP) of PV and ADRs reporting vary among different medical professions and different countries. Aim: To assess the knowledge, attitudes, and practices among the HCPs in the Middle East, toward PV and ADRs reporting. Methods: A systematic review was performed. EBSCO, PubMed, and Semantic Scholar, FreeFullPDF and Google Scholar were searched for articles published from January 2014 to December 2024. The selected observational studies were written in English and focused mainly on the knowledge, attitudes, practice, and perceived barriers regarding PV and ADR reporting among HCPs in the Middle East countries. Results: The overall knowledge levels were shown variation across different countries of the Middle East, with various studies indicating a lack of knowledge. The attitudes of HCPs toward PV were generally positive, with the highest levels attained among pharmacists. The HCPs' practices of PV and ADRs reporting were disappointing. A significant under-reporting was observed among physicians and nurses. Conclusion: Improving the PV systems in the Middle East requires a multi-faceted approach that combines education, technological advancements and continuous professional initiatives to ensure improved patient outcomes and safer healthcare practices.

Incorporating modern technology into education is becoming imperative. Numerous pharmacy institutions are incorporating virtual reality (VR) technology training into their curricula to enhance educational experience. This review examines the current state, historical evolution, and application of VR programs in pharmacy education and training. The review also provides details about the main challenges and limitations associated with the use of this technology. The VR technology, including virtual laboratories and simulations, significantly improves clinical training and educational outcomes. The utilization of VR in clinical teaching encounters numerous barriers, including ethical concerns and technological constraints, as well as other restrictions in its execution related to these challenges. Studies suggest that VR can enhance student engagement and develop critical skills, including knowledge retention and clinical decision-making, through realistic simulations. However, outcomes may vary depending on design factors; for instance, while immersive VR environments increase presence, some evidence indicates they may not always correlate with improved learning efficiency. Despite the challenges of incorporating VR into clinical education and training, its revolutionary potential is substantial, even when accounting for the prohibitive costs and the necessity for fair access.

Osteoporosis is a disorder caused by bone remodeling imbalance in which bone resorption outpaces bone production, resulting in weaker bone structure. Factors such as heredity and insufficient calcium and vitamin D consumption. This study included an examination of 80 female patients of different ages (40-58 years) in Mosul. The participants were divided into two groups: 20 individuals served as the control group, while the rest 60 were osteoporotic women based on clinical cases and taking X ray DEXA. The blood samples are divided into two parts serum for biochemical tests and blood for genetic diversity in genes associated to Vitamin D Receptor (VDR) was then examined. The results indicated the presence of mutations in the VDR gene at location (rs7975232). Furthermore, an observed variance in numbers of nucleotide after sequencing. there was also a significant decrease in vitamin D and Calcium levels in the blood serum of osteoporotic woman as compared to the control group.

Background and aim: Duodenal atresia (DoA) is a congenital condition that is characterized by complete or incomplete duodenal obstruction. This condition needs urgent surgical intervention that carries risks of postoperative complications especially in low-birth-weight babies and with associated comorbidities. The success rate of the surgical procedure was reported to be higher than 90%. This case study details a neonate's clinical course reporting the challenge in the management of delayed stricture and malnutrition after the primary surgery. Case presentation and results: A female neonate was born at 38 weeks of gestation with 2.6 kg weight. During the immediate postnatal period, she was presented with upper abdominal distention and bilious vomiting. Duodenal atresia was the diagnosis, prompting duodenoduodenostomy surgery. She was discharged five days later after tolerating oral feeds. However, few days later she was readmitted to the hospital because of recurrent vomiting, feeding intolerance, and weight loss then progressed to passage of dark bloody stool. She was resuscitated with intravenous fluids, antibiotics, and antiacids medications. She needed blood transfusion as her Hb level was dropped to 7 g/dL. Adjusted total parenteral nutrition (TPN) as per the body weight and biochemical profile was prescribed to improve the general condition. Water soluble contrast was performed which revealed a stricture at the site of the original pathology. Revision surgery was performed with the insertion of a nasojejunal tube to enhance early feeding distal to the anastomotic site. The baby had uneventful postoperative recovery and tolerated full oral feeds. Conclusion: Despite the reported surgical success rate, this case illustrates delayed stricture formation. The nasojejunal tube enhanced the recovery and reduced potential postoperative risks due to malnutrition. Therefore, proactive monitoring and structured operative strategies can reduce morbidity and improve survival in neonates with postoperative complications.

The bones are cushioned by a thin layer of hyaline cartilage that permits physical activity to be performed without experiencing any discomfort. However, these tissues are susceptible to several diseases involving osteoarthritis and rheumatoid arthritis resulting in cartilage degradation. Sirtuins (SRTs) and SRT-activating molecules have been shown in previous studies to affect cartilage and chondrocytes positively. This review aims to explore the potential protective effects of SRTs on cartilage and chondrocytes. It also highlighting various SRT-activating substances and their potential therapeutic applications in managing cartilage-related diseases. Google Scholar, Cochrane Library, and PubMed were used to search about related studies. The impacts of SRTs on cartilage and chondrocytes are beneficial. Additionally, numerous SRT-activating substances may enhance chondrocyte viability and cartilage anabolism which provide a potential therapeutic option in the management of cartilage-related diseases. However, additional studies are essential to clarify the effectiveness of such candidates in the treatment of these diseases.

Background: Breast cancer (BC) is one of the most common malignancies in women, characterized by the malignant proliferation of breast epithelial cells that significantly impairs patients' quality of life. Astaxanthin (ASN), a marine-derived xanthophyll carotenoid, is known for its antioxidant and anti-inflammatory properties. Emerging evidence suggests that ASN may exert anti-neoplastic effects by inhibiting tumorigenesis and suppressing the growth and progression of BC cells. This systematic review aims to critically evaluate the therapeutic potential of ASN as a pharmacological agent in the prevention and management of breast cancer. Methodology: Following PRISMA 2020 guidelines, a comprehensive literature search was conducted in PubMed, Web of Science, and Google Scholar using keywords (e.g., "astaxanthin", "carotenoid", "breast cancer"). Studies were screened based on predefined inclusion and exclusion criteria with a focus on recent mechanistic insights. Ten studies meeting these criteria were included for analysis. Results: The included studies (nine in vitro and one in vivo) demonstrate that ASN exerts significant antiproliferative, pro-apoptotic, and cytotoxic effects on BC cells. Mechanistically, these effects involve downregulation of mutated p53 and upregulation of pro-apoptotic markers. ASN also suppressed metastasis and angiogenesis, associated with increased expression of metastasis-suppressor genes such as BRMS1, maspin, MKK-4, and CD-82. Conclusion: ASN shows promising anti-cancer potential in BC by targeting key pathways in cell proliferation, apoptosis, and metastasis. Additionally, it may enhance chemosensitivity and reduce chemotherapy-induced toxicity. These findings support the potential role of ASN as an adjuvant therapeutic candidate in BC treatment strategies.

Objectives: to assess the knowledge regarding the diagnosis of endodontically affected teeth and the decision-making abilities regarding specific clinical situations among the dental residents in dental specialist center/left bank/ Mosul / Iraq. Materials & method: A self-administered questionnaire consisting of 20-questions was distributed to the dental residents at the Dental Specialist Center on the Left Bank in Mosul city, Iraq, in order to assess their diagnostic skills and decision-making abilities in relation to endodontically involved teeth. Additionally, the impacts of taking an endodontic course were investigated. SPSS version 21 was used for data analysis. Results: Forty-one dental residents participated in the survey. The results indicated that there is no statically significant effect of endodontic course on response (P>0.05). Our research found that the respondents do necessary steps in the diagnosis of endodontically involved teeth, however 29.3% managed emergency acute pain by non-steroidal anti-inflammatory (NSAIDs). According to this study, most of the participants had a good knowledge about sensibility test principle, however, 34% used it to distinguish between periapical and periodontal abscess. Furthermore, there was a significant variation among the participants' answers regarding how to manage the most common clinical scenarios. Conclusion: This study showed that dental residents have a good knowledge regarding the endodontically involved teeth diagnosis; however, additional training interventions are required to promote the availability of advanced diagnostic technique and enhance treatment outcomes. In addition, there is a need to establish clear guidelines to improve the diagnostic principles among the dental residents.

Helicobacter pylori is a Gram-negative bacterium associated with peptic ulcer disease and gastric cancer. The study aimed to evaluate its prognosis and its relationship to sex, age, thyroid function, IL-6, and blood groups. 120 blood samples were collected from patients with gastrointestinal disorders at Al-Salam Hospital in Mosul between May and October 2024. The samples underwent clinical examination, including anti-H. pylori antibodies (chromatography and IgA ELISA to confirm active infection), thyroid hormones (Minvidus), interleukin-6 (ELISA), and blood typing using serological techniques. The study results revealed that the rapid test revealed 40 positive cases out of 120, while the ELISA (IgA) test revealed 36 out of 40. The two approaches did not vary statistically substantially (p=0.346), but the difference between positive and negative samples when using both methods was significant (p=0.0001). The frequency of disease among males and females seemed to differ significantly (p=0.004), with the infection being higher among females (72.2%). A significant difference was also found when comparing infected males (p=0.002) and females (p=0.024) to the control group. Regarding thyroid disorders, statistically significant differences (p=0.0001) were found between individuals infected and uninfected with H.pylori. The incidence of thyroid disorders (hyperthyroidism and hypothyroidism) in the H. pylori-infected group was 47.2% (17 out of 36), compared to 16.7% (6 out of 36) in the uninfected group. Individuals with H. pylori infected showed a substantial rise (p=0.0001) in IL-6 levels, with a mean of 35.76±15.46 pg/ml compared to 4.03±4.85 pg/ml in uninfected patients. Blood group A was more common among infected patients than among uninfected patients, with a statistically significant difference (p=0.0001). The present investigation discovered a clear connection between elevated IL-6 concentrations and thyroid issues and the bacteria H. pylori infection.