Displaying publications 1 - 20 of 38 in total

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  1. Jairoun AA, Shahwan M, Zyoud SH
    Sci Rep, 2020 11 02;10(1):18824.
    PMID: 33139833 DOI: 10.1038/s41598-020-76000-w
    A specific safety concern is the possibility that a dietary supplement could be contaminated with heavy metals. This research was undertaken to investigate the daily exposure levels of heavy metals in dietary supplements available in the UAE and to explore the factors associated with the contamination of dietary supplements with heavy metals. A total of 277 dietary supplement samples were collected from the UAE market and prepared for the analysis of selected heavy metal contamination. Inductively coupled plasma mass spectrometry (ICP-MS) was used to determine the presence of heavy metals. The average daily intake of cadmium was 0.73 μg [95% CI 0.61-0.85], compared to the acceptable daily intake (ADI) of 6 μg; the daily intake of lead was 0.85 μg [95% CI 0.62-1.07], compared to the acceptable daily intake (ADI) of 20 μg; and the daily intake of arsenic was 0.67 μg [95% CI 0.57-0.78], compared to the acceptable daily intake of 10 μg. Although the dietary supplements available in the UAE have low levels of heavy metal contamination, numerous individuals are consuming a number of different dietary supplements every day and thereby may experience a cumulative level of toxic exposure. Dietary supplements formulations (Categories), dosage forms and country of origin are strong determents of heavy metal contamination in dietary supplements products.
  2. Jairoun AA, Ping CC, Ibrahim B
    Eur Rev Med Pharmacol Sci, 2023 Nov;27(21):10595-10604.
    PMID: 37975384 DOI: 10.26355/eurrev_202311_34339
    The International Diabetes Federation estimates that by 2035, there will be 592 million people with diabetes worldwide, substantially increasing from the 382 million patients with diabetes recorded in 2013. Diabetes-related nephropathy is a leading cause of end-stage renal disease. Recently, the therapeutic use of statins in patients with chronic kidney disease (CKD) was explored in a series of meta-analyses, which revealed their potential for decreasing mortality and cardiovascular complications in this population, although not in patients undergoing hemodialysis. The current study reviews the current state of knowledge on statin therapy regarding its safety and efficacy concerning renal outcomes in diabetic patients with CKD. The evidence shows that statins may offer a beneficial renoprotective effect in inhibiting the progression of renal function decline. This effect is time-dependent and particularly strong in patients with type 2 diabetes and nephropathy. In addition, whether certain statin types are more beneficial than others in slowing renal function loss and reducing proteinuria remains unclear. Prior research has not examined the impact of high-intensity statin therapy on CKD patient outcomes.
  3. Jairoun AA, Ping CC, Ibrahim B
    Eur Rev Med Pharmacol Sci, 2023 Dec;27(24):12058-12069.
    PMID: 38164868 DOI: 10.26355/eurrev_202312_34804
    Diabetes can have several macrovascular and microvascular complications in addition to diabetic nephropathy, also referred to as diabetic kidney disease (DKD). DKD is found to occur in approximately 40% of patients with type 2 diabetes and 30% of patients with type 1 diabetes. However, research on the effects of antihyperglycemic agents on the renal outcomes of these patients is still in its infancy. The current review explores glycemic management in patients with DKD, focusing on the challenges faced as well as the clinical considerations of antihyperglycemic agents in this population. A comprehensive literature review was conducted using EMBASE, Web of Science, and PubMed databases. This review was completed by the end of March 2023, and the following keywords were used for the search: diabetic nephropathy, diabetic kidney disease, safety, efficacy, and antihyperglycemic therapies. The several concerns about the use of antihyperglycemic agents in treating diabetes in patients with DKD highlight the need for substantial efforts in educating both patients and healthcare practitioners in this regard. In addition, it is suggested that patients receive individualized treatments, considering the potential long-term benefits of each agent; this would entail prospectively modifying doses in line with the stage of DKD to prevent the progression of renal damage. As some classes of agents offer better renoprotective effects for patients with DKD, it would be wise for nephrologists and endocrinologists to collaborate to offer an antihyperglycemic regime for patients with DKD who are at a high risk of further progression. Further study is needed on the beneficial renal effects of specific classes of agents; more knowledge of their mechanisms and renoprotective effects may contribute to the development of novel treatments for patients with DKD.
  4. Jairoun AA, Shahwan M, Zyoud SH
    PLoS One, 2020;15(12):e0244688.
    PMID: 33382790 DOI: 10.1371/journal.pone.0244688
    BACKGROUND: Fish oil supplements that are rich in omega-3 long-chain polyunsaturated fatty acids (n-3 PUFAs). PUFAs are among the most widely-used dietary supplements globally, and millions of people consume them regularly. There have always been public concerns that these products should be guaranteed to be safe and of good quality, especially as these types of fish oil supplements are extremely susceptible to oxidative degradation.

    OBJECTIVES: The aim of the current study is to investigate and examine the oxidation status of dietary supplements containing fish oils and to identify important factors related to the oxidation status of such supplements available in the United Arab Emirates (UAE).

    METHODS: A total of 44 fish oil supplements were analysed in this study. For each product, the oxidative parameters peroxide value (PV), anisidine value (AV), and total oxidation (TOTOX) were calculated, and comparisons were made with the guidelines supplied by the Global Organization for EPA and DHA Omega-3s (GOED). Median values for each of the above oxidative parameters were tested using the Kruskal-Wallis and Mann-Whitney U tests. P values < 0.05 were chosen as the statistically significant boundary.

    RESULTS: The estimate for the average PV value was 6.4 with a 95% confidence interval (CI) [4.2-8.7] compared to the maximum allowable limit of 5 meq/kg. The estimate for the average P-AV was 11 with a 95% CI [7.8-14.2] compared to the maximum allowable limit of 20. The estimate for the average TOTOX value was 23.8 meq/kg with a 95% CI [17.4-30.3] compared to the maximum allowable limit of 26 according to the GOED standards.

    CONCLUSION: This research shows that most, although not all, of the fish oil supplements tested are compliant with the GOED oxidative quality standards. Nevertheless, it is clear that there should be a high level of inspection and control regarding authenticity, purity, quality, and safety in the processes of production and supply of dietary supplements containing fish oils.

  5. Jairoun AA, Ping CC, Ibrahim B
    Sci Rep, 2024 Apr 19;14(1):9014.
    PMID: 38641627 DOI: 10.1038/s41598-024-58574-x
    Predicting the course of kidney disease in individuals with both type 1 and type 2 diabetes mellitus (DM) is a significant clinical and policy challenge. In several regions, DM is now the leading cause of end-stage renal disease. The aim of this study to identify both modifiable and non-modifiable risk factors, along with clinical markers and coexisting conditions, that increase the likelihood of stage 3-5 chronic kidney disease (CKD) development in individuals with type 2 DM in the United Arab Emirates (UAE). This was a single-center retrospective cohort study based on data derived from electronic medical records of UAE patients with DM who were registered at outpatient clinics at Tawam Hospital in Al Ain, UAE, between January 2011 and December 2021. Type 2 DM patients aged ≥ 18 years who had serum HbA1c levels ≥ 6.5% were included in the study. Patients with type 1 DM, who had undergone permanent renal replacement therapy, who had under 1 year of follow-up, or who had missing or incomplete data were excluded from the study. Factors associated with diabetic patients developing stage 3-5 CKD were identified through Cox regression analysis and a fine and gray competing risk model to account for competing events that could potentially hinder the development of CKD. A total of 1003 patients were recruited for the study. The mean age of the study cohort at baseline was 70.6 ± 28.2 years. Several factors were found to increase the risk of developing stage 3-5 CKD: advancing age (HR 1.005, 95% CI 1.002-1.009, p = 0.026), a history of hypertension (HR 1.69, 95% CI 1.032-2.8, p = 0.037), a history of heart disease (HR 1.49, 95% CI 1.16-1.92, p = 0.002), elevated levels of serum creatinine (HR 1.006, 95% CI 1.002-1.010, p = 0.003), decreased levels of estimated glomerular filtration rate (eGFR) (HR 0.943, 95% CI, 0.938-0.947; p 
  6. Jairoun AA, Al-Hemyari SS, Shahwan M, Zyoud SH
    Molecules, 2021 Nov 16;26(22).
    PMID: 34833995 DOI: 10.3390/molecules26226903
    Weight loss supplements that have illegal additives of pharmaceutical drugs or analogues have additional health risks, and customers may not be aware of what they are taking. This research is an essential investigation and quantification of illegally added pharmaceuticals or prescription medications, specifically fluoxetine, phenolphthalein, and sibutramine, in herbal weight loss supplements offered for sale in the United Arab Emirates (UAE). In this case, 137 weight loss supplements were collected and analyzed in this study. Reversed-phase high-performance liquid chromatography with UV absorption detection coupled to tandem mass spectrometry (RP-HPLC-MS/MS) analyses were used to determine the presence of the pharmaceutical chemicals. Among the weight loss supplements, 15.3% (95% CI: 9.2-21.4) contained undeclared sibutramine, 13.9% (95% CI: 8.01-19.7) contained undeclared phenolphthalein, and 5.1% (95% CI: 1.4-8.8) contained undeclared fluoxetine. Amongst all weight loss supplements, 17.5% (95% CI: 11.07-24) contained significant concentrations of either sibutramine, phenolphthalein, or fluoxetine. Whilst weight loss herbal supplements offered for sale in the UAE have relatively low percentages of undeclared pharmaceuticals, many people take several different supplements daily and may encounter quite high levels of combined exposure to toxic compounds.
  7. Jairoun AA, Al-Hemyari SS, Shahwan M, El-Dahiyat F, Jamshed S
    BMC Public Health, 2020 Oct 22;20(1):1595.
    PMID: 33092568 DOI: 10.1186/s12889-020-09707-0
    BACKGROUND: Since the time of declaration of global pandemic of COVID-19 by World Health Organization (WHO), falsified hand sanitizers surfaced regularly in markets, posing possible harm to public due to unlisted inclusion of methanol. The current research is an attempt to develop and validate a tool to document falsified hand sanitizer in the UAE community.

    METHOD: A descriptive cross-sectional community-based study was conducted among 1280 randomly selected participants. Respondents were sent a web-based electronic link to the survey via email. Content validity, factor analyses and known group validity were used to develop and validate a new scale to identify falsified hand sanitizer. Test-retest reliability, internal consistency, item internal consistency (IIC), and intraclass correlation coefficients (ICCs) were used to assess the reliability of the scale. SPSS version 24 was used to conduct data analysis.

    RESULTS: A total of 1280 participants were enrolled in the study. The content validity index (CVI) was 0.83 with the final scale of 12 items. The Kaiser-Meyer-Olkin (KMO) value was 0.788, with the Bartlett test of sphericity achieving statistical significance (p 

  8. Shahwan M, Hassan N, Shaheen RA, Gaili A, Jairoun AA, Shahwan M, et al.
    Curr Diabetes Rev, 2021;17(9):e011121190176.
    PMID: 33430750 DOI: 10.2174/1573399817999210111205532
    Diabetes mellitus (DM), which is defined as high blood glucose level, is a major public health issue worldwide. An enormous amount of data has been gathered regarding DM as populations have been living with it for more than a decade; however, continually updating our knowledge of DM remains important. Comorbidities are among the major challenges associated with DM. Poorly controlled DM, especially type 2 DM (T2DM), is considered a risk factor for many diseases, including but not limited to chronic kidney disease (CKD). Complications might appear over time as the aging process changes body functions; moreover, a significant number of antidiabetic medications are eventually cleared by the kidneys, thereby increasing the burden on kidney function and placing diabetic patients at risk. The significantly high number of patients with uncontrolled diabetes resulting from kidney disease shows the impact of this condition on the quality of life of patients. This review presents an overview of the pathophysiology, etiology, and prevalence of CKD and abnormal renal parameters correlated with poorly controlled T2DM, with an emphasis on clinical studies involving the association between vitamin D insufficiency/deficiency and CKD among patients with T2DM.
  9. Jairoun AA, Al-Hemyari SS, Shahwan M, Humaid Alnuaimi GR, Zyoud SH, Jairoun M
    Res Social Adm Pharm, 2023 Jul;19(7):975-976.
    PMID: 37061346 DOI: 10.1016/j.sapharm.2023.03.012
  10. El-Dahiyat F, Jairoun AA, Al-Hemyari SS, Shahwan M, Hassan N, Jairoun S, et al.
    Int J Pharm Pract, 2023 Jun 30;31(4):387-395.
    PMID: 37116892 DOI: 10.1093/ijpp/riad027
    OBJECTIVES: Deprescribing is a novel strategy whereby medical professionals aim to optimize a patient's prescription program by removing redundant medications. Few studies have looked at the viewpoints of community pharmacists and other healthcare professionals on deprescribing in daily practice. This study's objectives included evaluating community pharmacists' deprescribing knowledge, attitudes and practices, as well as identifying the obstacles to and enablers of deprescribing in daily practice.

    METHODS: Five pharmacy students in the last year of their studies polled employees of neighbourhood pharmacies in Abu Dhabi, Dubai, and the Northern Emirates from April 2022 to July 2022. The study's questionnaire was divided into two sections: questions that inquired about the respondents' demographic data and questions that evaluated the respondents' understanding and usage of the deprescribing of potentially harmful medications for patients. The original Bloom's cutoff points were revised and modified to assess the general knowledge and deprescribing practices of United Arab Emirates (UAE) community pharmacists. Multivariate logistic regression identified the variables influencing respondents' deprescribing knowledge and practice.

    KEY FINDINGS: The average age of the participants was 30.8 ± 6.4 SD. Of the total, 255 (37.7%) were male and 422 (62.3%) were female. Pharmacists from independent pharmacies constituted 52.9% of the study sample and 47.1% were from Chain pharmacies. Among the participants, 58.8% (n = 398) had 1-5 years of experience and 41.2% (n = 279) had more than 5 years. Nearly three-quarters of the pharmacists (72.1%, 488) graduated from local universities and 27.9% (n = 189) graduated from regional/international universities. The vast majority of the study sample (84.8%, 574) were bachelor's degree holders and 88.3% (n = 598) were pharmacists in charge. Of the total, 69.3% (n = 469) received deprescribing training to treat patients with multimorbid diseases. The knowledge and practice score was 71.3% with a 95% confidence interval [70.2%, 72.4%]. Of the total participants, 113 (16.7%) had poor knowledge and practice about deprescribing, 393 (58.1%) had moderate knowledge and practice and 171 (25.3%) had good knowledge and practice.

    CONCLUSION: This study highlights the level of understanding of community pharmacists about deprescribing in the UAE. Although most of the respondents in this study received training on deprescribing, less than half of the community pharmacists were unaware of certain classes (long-acting sulfonylureas, anti-diabetic, antihyperlipidemic and psychotropic drugs) of drugs that are candidates for potential deprescribing. This finding indicates that their knowledge about deprescribing was insufficient. Several barriers community pharmacists face in deprescribing were also identified, with patients' resistance and insufficience being the most prevalent. Therefore, there is a need for improved deprescribing practices to ensure drug safety.

  11. Jairoun AA, Al-Hemyari SS, Shahwan M, Zyoud SH, Jairoun M
    Saudi Pharm J, 2024 Mar;32(3):101965.
    PMID: 38313821 DOI: 10.1016/j.jsps.2024.101965
    OBJECTIVES: To assess the characteristics of patients with heart failure with reduced ejection fraction (HFrEF) and heart failure with mid-range ejection fraction (HFmrEF), as well as the current application of guideline-directed medical therapy (GDMT) in Palestine.

    METHODS: This retrospective cohort study involved a population of heart failure (HF) patients who visited cardiology clinics at An-Najah National University Hospital and the National Hospital, Palestine. The primary outcome measures of interest were the proportions of patients prescribed guideline-based cardiovascular medications (GBCMs), such as angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin II receptor blockers (ARBs), β-blockers, and mineralocorticoid receptor antagonists (MRAs), and the corresponding optimized doses at ≥ 50 % of targets and the reasons underlying the non-prescription of GDMT.

    RESULTS: A total of 70.5%, 56.6%, and 88.6% of patients were on ACEIs/ARBs, MRAs, and β-blockers, respectively. Of all patients, 38.7% were on the triple GDMT regimen.

    CONCLUSION: Less than half the patients received the triple combination treatment. Age, diabetes mellitus, chronic renal disease, and admission to the hospital for HF all had significant independent relationships with the reduced utilization and inadequate dosage of GDMT.

  12. Jairoun AA, Al-Hemyari SS, Shahwan M, Jairoun O, Zyoud SH
    Risk Manag Healthc Policy, 2024;17:663-675.
    PMID: 38528943 DOI: 10.2147/RMHP.S440482
    BACKGROUND: p-Phenylenediamine (PPD) has been used over the past five decades as a primary precursor in the production of oxidative hair dyes. Numerous health dangers are associated with the short- and long-term use of PPD, raising concerns about its safety. For instance, mounting data suggests that PPD is linked to dermatitis and allergy cases.

    OBJECTIVE: To quantify the PPD content in hair dyes by measuring the PPD concentration after mixing the ingredients of commercial hair dyes.

    METHODS: A total of 290 permanent hair dyes were tested. RP-HPLC-DAD analysis was performed to determine and quantify the PPD content.

    RESULTS: The estimated mean of the PPD limit was 0.89 (95% CI [0.81-0.96]). Of the 290 tested hair dyes, 7.2% (n = 21) exceeded the recommended PPD concentration after mixing. Significantly more hair dyes manufactured in India and China had a PPD content exceeding 2% after mixing compared to dyes from other regions (P = 0.001). Moreover, hair dyes manufactured in India and the UAE were more likely to have incomplete descriptions of the conditions of use and warnings on the label (P = 0.002).

    CONCLUSION: The effectiveness of the current regulations relevant to these products should be reevaluated. Moreover, through the use of good manufacturing procedures (GMPs), research, and the reporting of adverse reactions, hair dyes should be subjected to better control and monitoring in terms of their safety and quality.

  13. Jairoun AA, Al-Hemyari SS, Shahwan M, Zyoud SH, El-Dahiyat F
    Sci Rep, 2024 Mar 27;14(1):7284.
    PMID: 38538618 DOI: 10.1038/s41598-024-56765-0
    Adherence to scheduled physician screenings for renal function monitoring in patients with chronic kidney disease (CKD) or those at high risk remains suboptimal despite the endorsement of regular screenings by several clinical practice guidelines. Our study aims to assess the effectiveness of a point-of-care CKD screening program led by these pharmacists using the PICCOLO device while recognizing the unique position of community pharmacists in primary care. We conducted an 11-month prospective point-of-care interventional research study in the United Arab Emirates to evaluate the performance of a community pharmacist-led CKD screening program for high-risk patients. Six diverse community pharmacies were selected based on staff availability, patient volume, and their offered range of services. Eligible individuals with risk factors for CKD were identified during medication evaluations. The PICCOLO Comprehensive Metabolic Panel facilitated on-site blood analysis, delivering estimated Glomerular Filtration Rate (eGFR) results within 10 to 15 min. Data also included eGFR categories, demographic information, and insights into lifestyle and health habits collected through a questionnaire. Pharmacists conducted comprehensive medication reviews and offered referrals and lifestyle guidance as part of the program. The study encompassed a total of 400 patients, with an average age of 69 ± 13.4 years within the study cohort. Notably, 38.8% (155 individuals) of the 400 patients were found to have undiagnosed CKD stages 3-5. Univariate logistic regression analysis revealed a significant association between a higher incidence of CKD stages 3-5 and factors such as older age, a history of hypertension, vascular disease, and diabetes mellitus. In the multivariate regression model, age and a history of diabetes mellitus emerged as significant predictors of an elevated risk of CKD. This study sheds light on the viability and impact of CKD screening programs conducted by community pharmacists, particularly in detecting CKD stages 3-5. The findings have implications for healthcare policies, as they can influence the enhancement of early detection and management of CKD. Moreover, these insights may catalyze focused screening initiatives and strengthen collaboration between community pharmacies and healthcare systems to benefit patients at high risk of CKD.
  14. Jairoun AA, Al-Hemyari SS, Shahwan M, Al-Qirim T, Shahwan M
    Clin Med Insights Endocrinol Diabetes, 2024;17:11795514241235514.
    PMID: 38495947 DOI: 10.1177/11795514241235514
    BACKGROUND: The use of ChatGPT and artificial intelligence (AI) in the management of metabolic and endocrine disorders presents both significant opportunities and notable risks.

    OBJECTIVES: To investigate the benefits and risks associated with the application of ChatGPT in managing diabetes and metabolic illnesses by exploring the perspectives of endocrinologists and diabetologists.

    METHODS AND MATERIALS: The study employed a qualitative research approach. A semi-structured in-depth interview guide was developed. A convenience sample of 25 endocrinologists and diabetologists was enrolled and interviewed. All interviews were audiotaped and verbatim transcribed; then, thematic analysis was used to determine the themes in the data.

    RESULTS: The findings of the thematic analysis resulted in 19 codes and 9 major themes regarding the benefits of implementing AI and ChatGPT in managing diabetes and metabolic illnesses. Moreover, the extracted risks of implementing AI and ChatGPT in managing diabetes and metabolic illnesses were categorized into 7 themes and 14 codes. The benefits of heightened diagnostic precision, tailored treatment, and efficient resource utilization have potential to improve patient results. Concurrently, the identification of potential challenges, such as data security concerns and the need for AI that can be explained, enables stakeholders to proactively tackle these issues.

    CONCLUSIONS: Regulatory frameworks must evolve to keep pace with the rapid adoption of AI in healthcare. Sustained attention to ethical considerations, including obtaining patient consent, safeguarding data privacy, ensuring accountability, and promoting fairness, remains critical. Despite its potential impact on the human aspect of healthcare, AI will remain an integral component of patient-centered care. Striking a balance between AI-assisted decision-making and human expertise is essential to uphold trust and provide comprehensive patient care.

  15. Jairoun AA, Al-Hemyari SS, Shahwan M, El-Dahiyat F, Jairoun M, Al-Tamimi SK, et al.
    Risk Manag Healthc Policy, 2021;14:967-977.
    PMID: 33727873 DOI: 10.2147/RMHP.S283068
    Background: The flux of pharmaceutical data can have a negative impact on the complexity of a pharmacist's decision-making process, which will demand an extensive evaluation from healthcare providers trying to choose the most suitable therapeutic plans for their patients.

    Objective: The current study aimed to assess the beliefs and implementations of community pharmacists in the UAE regarding evidence-based practice (EBP) and to explore the significant factors governing their EBP.

    Setting: Community pharmacies in Dubai and the Northern Emirates, UAE.

    Methods: A descriptive cross-sectional study was conducted over six months between December 2017 and June 2018. Community pharmacists who had three months' professional experience or more and were registered with one of three regulatory bodies (Ministry of Health, Health Authority Abu Dhabi, or Dubai Health Authority) were interviewed by three trained final-year pharmacy students. Face-to-face interviews were then carried out and a structured questionnaire was used.

    Metrics: The average beliefs score was 36% (95% CI: [34%, 39%]) compared to an implementation score of 35% (95% CI: [33%, 37%]).

    Results: A total of 505 subjects participated in the study and completed the entire questionnaire. On average, participants scored higher in beliefs score than implementation score. The results of the statistical modelling showed that younger, female, higher-position pharmacists with more experience and with low percentages of full-time working, and graduates from international/regional universities were more likely to believe in and implement the concept of EBP.

    Conclusion: A gap was identified between the beliefs and implementation of EBP. Developing educational EBP courses in undergraduate pharmacy curricula is of high importance, not only to increase knowledge levels but also to encourage commitment in those pharmacists to strive for professionalism and to support the provided patient care with evidence.

  16. Jairoun AA, Al-Hemyari SS, El-Dahiyat F, Hassali MA, Shahwan M, Al Ani MR, et al.
    J Prim Care Community Health, 2020 3 1;11:2150132720911303.
    PMID: 32111128 DOI: 10.1177/2150132720911303
    Objectives: Presently, limited data are available on dietary supplements (DSs) and their associated effects on health status although the consumption of DS continues to expand. This study is aimed to explore the possible relationship between DSs consumption and suboptimal health status (SHS) in Dubai, United Arab Emirates (UAE). Methods: This study was a cross-sectional research held among a sample of citizens and residents in the Emirate of Dubai in the UAE using a well-structured, self-administered, anonymous survey. Frequency tables, odds ratios, and confidence intervals were generated during the data analysis using SPSS version 23. Results: A total of 618 participants were enrolled in this study and fully completed the questionnaire. In this study, 317 participants (51.3%) (95% CI: 47.3%-55.3%) reported the use of DS products. A significant association between DS consumption and suboptimal health status was detected (P < .001). DS consumers had a 1.5-fold increased odds of suboptimal health status when compared with non-DS consumers (95% CI 1.4-1.7). Conclusion: The findings of this study suggest a need to develop policies and programs that will help minimize the risk of possible adverse events that are associated with the utilization of DSs.
  17. Saeed BQ, Jairoun AA, Ashraf Khamis A, Hatim Abdelrahim L, Abobakr Aljomhi A, Adrees AO, et al.
    Risk Manag Healthc Policy, 2021;14:2733-2741.
    PMID: 34234589 DOI: 10.2147/RMHP.S308754
    Background: Vitamin D deficiency (VDD) and insufficiency (VDI) is a public health problem worldwide. Low blood levels of vitamin D have been associated with many illnesses, including respiratory tract infections (RTIs). This study aims to evaluate the prevalence of VDD and VDI among university students, assess the correlation with demographic and anthropometric factors, and determine the effect of VDD on the respiratory tract infection (RTI) incidence.

    Methods: A cross-sectional and prospective design was used. Our sample consisted of 287 students aged 18-24 years from the University of Sharjah-UAE. Participants were tested for serum 25(hydroxyvitamin)D levels, Body mass index (BMI) was calculated, and the survey was completed. The association between VDD, VDI with the participant's characteristics, and the incidents of RTIs were examined.

    Results: VDD and VDI were highly prevalent among 85% of the students. The median serum 25(OH) D level was 15.8 ng/dl (19.5±11.6). The mean BMI was (24.32±6.3) kg/m. The results showed a significant positive correlation between VDI and VDD with gender and students who were previously diagnosed with VDD (P 

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