Introduction. The available studies on the treatment of mental disorders in the Arab world are uncommon. Methods. A literature review was conducted aiming at identifying studies related to the rate and type of treatment of mental disorders in Arab countries from the Middle Eastern Mediterranean region. Results. A total of 23 articles were included in this review. These articles focused mainly on type of services used and/ or the rate of treatment. Findings from several articles showed a paucity of treatment of mental disorders, and when present, individuals were more likely to receive it from the general medical than from the mental health sector. Only two studies have assessed patterns of treatment of mental disorders on a national level from the Arab Middle Eastern countries (Lebanon and Iraq). Conclusion. The need for national studies on mental disorders in this part of the world and the improvement of public awareness in this field were highlighted.
Abstract Background The Accreditation Council for Pharmacy Education (ACPE) standard 10 specifies the need to prepare students to provide patient-centered collaborative care through both the didactic and experiential pharmacy curriculum. The aim of this study is to assess the impact of a newly introduced PPCP based laboratory course on students’ perception of their preparedness to apply PPCP steps in introductory pharmacy practice experiences (IPPEs). Methods In spring of 2017, PPCP was introduced into the Pharmaceutical Care and Dispensing Laboratory course. Students’ self-perception of preparedness to apply PPCP was assessed via a survey composed of questions related to PPCP skillsets. The pre-PPCP laboratory cohort (control group) took the survey after the completion of their experiential rotations. The PPCP laboratory cohort (intervention group) took the same survey prior to taking the course, at the end of the course and then following the completion of their IPPEs. The Pearson’s and McNemar Chi-square tests were used for statistical analysis. Results The findings indicate that the PPCP based laboratory significantly improved students’ perception of their preparedness to apply a standardized pharmacist care process to verify prescriptions, to collect relevant patient information, and to develop an individual patient-centered care plans. This significant impact of the PPCP based laboratory course on students’ perception was maintained through the following year when assessed after IPPEs. Conclusion Introduction of the PPCP model within a dispensing laboratory course, prior to students’ IPPEs, develops students’ perception of preparedness. Incorporating PPCP via active learning and simulation narrows the gap between the didactic and experiential curriculum by establishing a bridge between understanding the concept of PPCP and readiness for applying it in practice experiences.
To investigate the influence of proton pump inhibitors (PPIs) exposure on the diagnosis of Helicobacter pylori (H. pylori) gastritis and intestinal metaplasia.Chronic PPI use is associated with masking of H. pylori infection. Patients with H. pylori infection are predisposed to gastric and duodenal ulcers, and long-term infection with this organism has been associated with gastric mucosal atrophy and serious long-term complications, such as gastric lymphoma and adenocarcinoma. Three hundred patients diagnosed with gastritis between January 2008 and April 2010 were included in our study. The computerized medical database of these patients was reviewed retrospectively in order to assess whether the type of gastritis diagnosed (H. pylori vs non-H. pylori gastritis) is influenced by PPI exposure. H. pylori density was graded as low, if corresponding to mild density following the Updated Sydney System, or high, if corresponding to moderate or severe densities in the Updated Sydney System.Patients were equally distributed between males and females with a median age at the time of diagnosis of 50 years old (range: 20-87). The histological types of gastritis were classified as H. pylori gastritis (n = 156, 52%) and non-H. pylori gastritis (n = 144, 48%). All patients with non-H. pylori gastritis had inactive chronic gastritis. Patients with no previous PPI exposure were more likely to be diagnosed with H. pylori gastritis than those with previous PPI exposure (71% vs 34.2%, P < 0.001). Intestinal metaplasia was more likely to be detected in the latter patients (1.4% vs 6.5%, P = 0.023). Multivariate analysis has also demonstrated that in the presence of previous PPI exposure (OR = 0.217, 95%CI: 0.123-0.385), GERD (OR = 0.317, 95%CI: 0.132-0.763, P = 0.01), alcohol intake (OR = 0.396, 95%CI: 0.195-0.804, P = 0.01), the detection of H. pylori was less likely. Chronic use of PPIs may mask H. pylori infections promoting the diagnosis of non-H. pylori gastritis and leads to a significant drop in H. pylori densities and to an increased risk of intestinal metaplasia.The use of PPIs masks H. pylori infection, promotes the diagnosis of non-H. pylori inactive chronic gastritis diagnosis, and increases the incidence of intestinal metaplasia.
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