To assess pharmacists' views on the compulsory incorporation of clinical indications in prescription orders in the UAE and to pinpoint significant obstacles and enablers for implementation. A cross-sectional study investigated the experiences of pharmacists with prescription orders that needed clinical indications while also examining their perceptions of mandatory requirements and their assessment of existing obstacles. The research team selected pharmacists who worked at community pharmacies, hospital pharmacies, and ambulatory care settings that served as accessible locations throughout the three major Emirates, which included Dubai, Abu Dhabi, and Sharjah. A structured survey prepared for the purpose of this study was distributed to a total of 260 pharmacists throughout the study period. The survey covered pharmacists' experiences with clinical indications on prescriptions, their perceived benefits, barriers to implementation, and their overall stance on mandatory inclusion. The research indicated that only 41.1% of the prescriptions studied had a clinical diagnosis or medical reason for their prescription. Mandatory inclusion received support from 57.7% of pharmacists, but obstacles arose from software restrictions (52.0%), insurance-related issues (55.8%), absence of complete medical diagnoses for specific drugs (64.3%), and possible privacy risks (57.7%). Further investigation indicated that different practice environments produced different levels of support, which hospital pharmacists demonstrated through their higher support rates because they used integrated electronic health record systems. The results demonstrate that structured policies and technological solutions should help pharmacists make their clinical decisions. The implementation process needs to overcome existing obstacles that currently stand in its way.
To review existing research on medicine dispensing practice in Bangladesh, as well as to determine and assess the role that quacks and drug dealers play in irrational drug usage. The databases PubMed, Scopus, BanglaJOL, Embase, and Web of Science were used to conduct a literature search. To identify publications from the last 24 years, a predetermined search approach focused on implementation context, function, and automation was employed. Using predetermined inclusion/exclusion criteria, two researchers independently filtered the search results sequentially by title, abstract, and full text. A standardized form was used to extract data and evaluate its quality. The inclusion criteria were satisfied with 14 studies. The primary techniques utilized to investigate dispensing mistakes were direct observation and the review of event reports. The classification of dispensing mistakes, study methodology, and dispensing technology all affected the dispensing error rates. The most reported dispensing mistakes were giving the incorrect medication, giving the incorrect dose form, and the incorrect drug strength. The most frequent causes of dispensing mistakes were excessive workload, inadequate staffing, confusion between similar-sounding and similar-looking medications, insufficient expertise or experience, interruptions or diversions, and poor communication among the dispensary personnel. In Bangladesh, training improved the knowledge and behaviors of Grade A pharmacists about medication delivery.
Artificial intelligence (AI) has become an effective tool that leverages personal information to deliver faster solutions to complex problems. A revolutionary approach to drug discovery, formulation, and dosage form testing is presented by promising advances in machine learning and AI. The pharmaceutical industry increasingly uses it to revolutionize drug development at all stages, from discovery to post-market surveillance. Drug development is being revolutionized by AI-driven techniques that make it possible to analyse enormous biological datasets, predict drug-target interactions, and find promising candidates more quickly and precisely than with conventional methods. The pharmaceutical industry is significantly impacted by drug research and discovery, which also has an impact on some human health issues. Despite the promising benefits, there are drawbacks to using AI as well, such as the requirement for regulatory frameworks, data protection issues, and integrating AI with current systems. In the pharmaceutical sector, AI has the potential to significantly increase innovation, lower expenses, and improve patient outcomes.
In this study, the milk thistle (Silybum marianum Gaertn L.), widespread in Palestine, was selected to study the basic qualitative chemical composition of aqueous, ethanol, chloroform, and hexane extracts from its seeds, and to identify the active compounds present. The results of the phytochemical analysis showed that the seeds of the plant (Silybum marianum Gaertn L.) contain a full range of chemically active compounds in all its extracts, such as: flavonoids, amino acids, carbohydrates, sterols, saponins, anthraquinones, phenolic compounds, steroids, terpenoids, tannins, alkaloids, anthocyanins, quinones, and glycosides. For the first time in Palestine, seventeen amino acids were identified in Silybum marianum Gaertn L. plant seeds using phytochemical analysis, paper and thin-layer chromatography, and standard amino acid assays. As a result of the phytochemical analysis, a range of amino acids were identified in the plant seeds, including: arginine, leucine, valine, lysine, phenylalanine, isoleucine, threonine, histidine, glutamic acid, glycine, serine, proline, aspartic acid, alanine, tyrosine, methionine, cysteine.
Cardiovascular disease (CVD) is a leading cause of mortality in Libya, driven by obesity, hypertension, diabetes, and smoking. Inadequate screening contributes to the widespread undiagnosed status of risk factors, with university staff particularly vulnerable due to occupational and lifestyle factors. This study aimed to assess the prevalence of cardiovascular risk factors, evaluate risk awareness, and determine the impact of a pharmacist-led screening intervention on behavioral intentions among employees in an academic institution in Benghazi, Libya. A cross-sectional interventional study was conducted among 179 university employees. Data were collected in two phases. In the baseline phase, participants completed questionnaires on demographics, lifestyle, medical history, and CVD awareness, followed by clinical measurements. After pharmacist-led counseling and personalized feedback, post-intervention assessments of awareness and behavioral intentions were performed. Participants were mostly female (62.6%), aged 20-35 years (61.5%), and Libyan (89.9%). The most prevalent undiagnosed CVD risk factors were dyslipidemia (66.5%), overweight (63.1%), and hypertension (20.7%). Post-screening awareness was high (mean score 9.06/10), especially for obesity (99.4%) and hypertension (97.2%). The pharmacist-led intervention strongly improved lifestyle intentions: increasing physical activity (97.8%), improving diet (98.9%), attending regular check-ups (92.2%), and using digital monitoring (91.6%). Significant associations were found between socio-demographic factors and CVD risks, as well as between lifestyle habits and clinical outcomes. A high prevalence of undiagnosed CVD risk factors exists among university employees despite good awareness levels. Pharmacist-led workplace screening effectively increased intentions to adopt healthier behaviors, supporting the integration of clinical pharmacists into wellness programs to reduce the CVD burden in Libya.
Polypharmacy, defined as the concurrent use of five or more medications, is highly prevalent among older adults because of the increasing burden of chronic diseases such as diabetes mellitus and hyperlipidemia. In these patients, polypharmacy may complicate disease management, mask clinical manifestations, alter biochemical parameters, and reduce medication adherence, ultimately compromising therapeutic outcomes. Drug-related problems, defined as events or circumstances involving drug therapy that interfere with desired health outcomes, are common in this population because of multiple comorbidities and inappropriate prescribing. This study evaluated the effects of diabetes mellitus, hyperlipidemia, and their coexistence, as well as potential drug-drug interactions, on selected biochemical parameters. Libyan patients were categorized into three groups: Diabetes mellitus, hyperlipidemia, and mixed (patients with both conditions). Fasting blood glucose and glycated hemoglobin levels were significantly higher in the diabetes group than in the hyperlipidemia and mixed groups. Lipid profile parameters were significantly elevated in the hyperlipidemia group compared with the other groups. Liver function tests and serum electrolyte levels remained within normal reference ranges, with no significant differences among the study groups. Within the mixed group, patients receiving insulin plus atorvastatin exhibited a modest but significant increase in total cholesterol and high-density lipoprotein cholesterol compared with those receiving metformin plus atorvastatin. In contrast, triglyceride and low-density lipoprotein cholesterol levels showed no significant differences. The present findings demonstrate distinct biochemical profiles among patients with diabetes mellitus, hyperlipidemia, and their coexistence, while suggesting that the evaluated drug combinations exert limited effects on lipid metabolism.
Dyslipidemia is a major modifiable risk factor for cardiovascular disease, yet data from Libyan populations remain limited. This study aims to investigate the prevalence, patterns, and demographic determinants of dyslipidemia among residents of Zawia City, Libya, and to provide a concise review of lipid-lowering therapies, including emerging ones. It is a cross-sectional study of 508 individuals of all ages and both sexes registered at many clinical laboratory centers across Zawia City for lipid profile testing from January 1, 2026, to May 31, 2026. Dyslipidemia was defined according to the National Cholesterol Education Program (NCEP) and ATPIII criteria. Statistical analysis was performed on all lipid parameters and expressed as mean ± SD, frequency, and percentage. The prevalence of all dyslipidemia patterns was assessed across age and gender groups. The findings showed that 81.6% of participants had at least one form of dyslipidemia. High LDL-C was the most common lipid abnormality (61.6%), followed by hypertriglyceridemia (36.2%), low HDL-C (36.0%), and hypercholesterolemia (27.8%). Clear gender differences were observed: Females had significantly higher rates of hypercholesterolemia (30.6%/24.3% for female/male, p < 0.05) and high LDL-C (65.1/57.4% for female/male, p < 0.01). By contrast, males exhibited significantly higher rates of low HDL-C (54.8/20.5% for male/female, p < 0.001). The high-risk ratio was twofold higher in males than in females (43.0/19.8% for male/female, p < 0.001). Age-specific analysis showed that all lipid abnormalities peaked in the 41–50-year age group, where the prevalence of hypercholesterolemia, hypertriglyceridemia, high LDL-C, and low HDL-C (36.4%, 45.7%,74.3%, and 44.3%, respectively) was greatest. These results demonstrate that dyslipidemia is highly prevalent among the population in Zawia City, with LDL-C abnormalities predominating and midlife individuals bearing the greatest burden. The presence of gender-specific patterns underscores the need for targeted prevention and control strategies. Routine screening and tailored interventions are urgently required to reduce cardiovascular disease risk in the Libyan population.
Hypertension is a major global public health concern, yet awareness among college students remains inadequate. This study evaluated the effectiveness of a structured educational intervention on hypertension knowledge among college students in Bangladesh using a pre- and post-interventional design. A total of 384 students (236 males, 148 females) aged 18 - 23 years participated, with 175 assigned to the intervention group and 209 to the non-intervention group. Data were collected using a validated semi-structured, pre-tested questionnaire. The intervention was delivered in three sessions at 15-day intervals. Paired t-test and Fisher’s exact test were applied, with p < 0.05 considered significant. The intervention group demonstrated highly significant improvements across all knowledge domains (t = 44.42, 48.31, 36.96, 37.39, and 24.66; p < 0.001), and knowledge levels increased significantly compared with those in the non-intervention group (p < 0.001). No significant change was observed in the non-intervention group (p = 0.825). The findings indicate that structured educational intervention programs are highly effective in improving hypertension awareness among college students.
Urolithiasis is a multifactorial renal disorder characterized by calcium oxalate crystallization, oxidative stress, inflammation, urinary supersaturation, and enzyme-mediated pathological processes. Recent developments in synthetic analogues and natural lead compounds investigated for kidney stone therapy and prevention are critically summarized in this study. Along with nephroprotective, antioxidant, anti-inflammatory, and diuretic properties, 25 natural compounds showed anti-urolithiatic efficacy mainly by suppression of calcium oxalate nucleation, aggregation, and growth. By promoting the development of less adherent calcium oxalate dihydrate and reestablishing urinary citrate and magnesium levels, several extracts also altered crystal shape. In addition, twenty-five synthesized drugs were classified according to dominating processes, such as enzyme-targeted tactics, diuretic-mediated urine regulation, antioxidant-supported crystal suppression, and direct crystallization inhibition. Strong calcium oxalate inhibitory potential was demonstrated by synthetic scaffolds such as phthalimides, barbiturates, imidazoles, benzene sulphonamides, and Schiff bases, while hybrids targeting urease and carbonic anhydrase showed low-micromolar to nanomolar enzyme inhibition, addressing urinary pH imbalance and infection-associated lithogenesis. Relationships between structure and action demonstrated how crucial heterocyclic frameworks, sulfonamide moieties, and electron-donating substituents are for increasing efficacy. The importance of multi-target techniques is shown by the fact that natural and synthetic candidates work together through complementary pathways, including crystal modification, oxidative stress attenuation, urine parameter normalization, and enzyme inhibition. To turn these candidates into successful antiurolithiatic treatments, more pharmacokinetic profiling, safety assessment, and clinical validation are necessary, even if many leads have encouraging preclinical efficacy.
Heightened awareness among consumers regarding the adverse effects of synthetic chemicals in hair care products has driven growing interest in plant-based cosmetic formulations. Conventional anti-dandruff shampoos typically incorporate harsh anionic surfactants - most notably sodium lauryl sulfate (SLS) and sodium Lauretha sulfate - which, when used repeatedly over time, are known to cause scalp irritation, excessive dryness, allergic sensitization, and disruption of the scalp's natural acidic mantle. The present study was undertaken to develop a fully SLS-free, plant-derived anti-dandruff shampoo that delivers both clinical effectiveness and gentle tolerability. The formulation incorporated five well-established medicinal botanical ingredients: Sapindus mukorossi (Reetha) as a naturally derived foaming agent, Azadirachta indica (Neem) for its potent antifungal and antimicrobial properties, Acacia concinna (Shikakai) serving as a mild cleanser and hair conditioner, Aloe vera for scalp hydration and soothing activity, and Phyllanthus emblica (Amla) as an antioxidant-enriched hair tonic. Three experimental variants (F1, F2, and F3) were prepared with systematically varied concentrations of Reetha extract and Xanthan gum to identify the most suitable viscosity and performance profile. All three variants maintained a scalp-compatible pH in the range of 5.0 - 5.2. Formulation F2 exhibited the most favorable combination of properties, including optimal viscosity (2430 ± 18 cP), the greatest cleansing efficiency (82.6%), acceptable foam retention (75.0%), and superior cosmetic appeal. In antifungal testing against Malassezia furfur, a zone of inhibition of 17.0 ± 0.3 mm was recorded, confirming the therapeutic effectiveness of the formulation. Accelerated stability testing conducted at 40 °C / 75.0% RH over 30 days revealed no significant alterations in appearance, pH, viscosity, or microbial safety. Collectively, these findings support the developed shampoo as a viable, biodegradable, and consumer-friendly substitute for synthetic anti-dandruff products.
Oxidative stress and inflammation contribute substantially to the various chronic diseases in the world. Many routine drugs are available and in use, but a large proportion of them produce undesirable effects. The study investigated the antioxidant and anti-inflammatory properties and sought to identify the likely compounds present in Tapinanthus bangwensis. Antioxidant activity was determined using thiobarbituric acid reactive species (TBARS) and hydrogen peroxide (H202) assays. Bovine Serum Albumin Denaturation (BSAD) and Anti-Proteinase (AP) tests were used to assess anti-inflammatory activity. Identification of the compounds was via gas-chromatography-Mass Spectroscopy (GC-MS), while using FTIR (Fourier transition Infrared) to analyze the functional groups. The TBARs result showed that the reference drug (ascorbic acid), ad HECF 1, exhibited a more substantial inhibition compared to HECF 2. Likewise, the reference drug showed a more substantial inhibitory activity on H202 compared to the fractions. But the inhibition level of HECF 1 increased compared to HECF 2. Aspirin demonstrated a more substantial anti-inflammatory effect compared to the fractions. But that of the HECF 2 was higher compared to the HECF 1. The FTIR result showed the presence of a Carbonyl group (C=O), hydroxyl (OH), and amine group (N-H), suggesting that phenols, carboxylic acids, and fatty acids were likely present. The GC-MS result showed four compounds with reports of antioxidant and anti-inflammatory activity: 2-Pentadecanone, 6, 10, 14-trimethyl, Octacosane, 2, 4-di-tert butyl phenol, and Phytol. Thus, these compounds may contribute to the traditional use of T. bangwensis in treating oxidative and inflammatory diseases.
Topical formulations have been widely used for the treatment of dermatological conditions. This study aims to develop and evaluate a polyherbal cream gel formulation for topical application using leaf extracts of Calendula officinalis, Hibiscus rosa-sinensis, Bryophyllum pinnatum, and Rosa spp. The formulation was designed to integrate the benefits of cream and hydrogel systems to improve skin hydration, lubricity, and therapeutic efficacy. The cream gel was formulated using Carbopol 940 as a gelling agent with suitable excipients such as glycerine and propylene glycol to improve wetting and penetration. The developed formulation was evaluated for important physicochemical parameters, including texture, smoothness, pH, viscosity, and spreadability. The formulation showed a semi-solid consistency with smooth texture, good uniformity, and viscosity in the range of 500-1000 cps, indicating reasonable rheological behaviour. The diffusion capacity was found to be 11.33 g cm/sec, indicating ease of application, while the pH of 6.56 was within the acceptable range for a topical preparation. Biological evaluation showed significant antioxidant activity and remarkable antimicrobial activity against Staphylococcus aureus. The formulation also showed excellent moisturizing properties due to the presence of humectants and hydrophilic polymers. Stability studies confirmed that the formulation remained stable with no changes in physical properties, and irritation testing indicated that it was safe and non-irritating for topical use. Overall, the developed polyherb cream gel demonstrated promising physicochemical and biological properties, indicating its potential application in wound healing, topical drug delivery, and skin care as a natural alternative to synthetic formulations.
Throughout a product's shelf life, the stability of pharmaceuticals (drugs) is a crucial factor in determining drug safety, efficacy, and quality. In tropical areas, where high relative humidity and high temperatures speed up chemical, physical, and microbiological degradation processes, the problem is more prevalent. Several countries in Asia, Africa, and Latin America are located in climatic zones III and IV of the International Council for Harmonization, where traditional packaging systems and formulations designed for temperate climates frequently fall short of stability standards. This review offers a comprehensive discussion of how tropical weather affects pharmaceutical dosage forms, with a focus on formulation-related issues, drug degradation pathways, and workable mitigation techniques. This article will serve as a practical reference for formulation scientists, and quality professionals working in tropical markets.
The current research aimed to increase patient adherence, bioavailability, and medication release by developing and evaluating Alfuzosin HCI extended-release tablets. Ethyl Cellulose, Carbopol 940, and HPMC K4 were among the polymers used in the direct compression technique to develop a range of compositions. All pre-compression metrics, including bulk density, tapped density, angle of repose, Carr's index, and Hausner's ratio, were found to be within acceptable ranges in the manufactured tablets, indicating that the flow properties were satisfactory. The tablets that were crushed were tested for additional characteristics after compression, such as hardness, thickness, weight fluctuation, friability, drug content, and in vitro drug release. Again, they were determined to be satisfactory. F6, which contains Carbopol 940, showed the best results among all the formulations. It had an extended-release profile, releasing 99.83% of the medication over 12 hrs. The evaluation criteria revealed that formulation F6 was the most promising candidate for the treatment of benign prostatic hyperplasia with its extended-release dosage form.
Antimicrobial resistance is compromising the potential of livestock systems. The misuse and abuse of antimicrobial drugs are significant drivers of resistance. This study aims to document knowledge, attitudes, and practices related to antimicrobial use in livestock systems and identify associated livelihood factors. The survey used physical and online validated self-designed questionnaires to collect information on antibiotic usage patterns and awareness among farmers in Nigeria. The study included 130 livestock farmers, comprising 84.6% poultry farmers, 9.2% beef farmers, and 6.2% dairy farmers. Of the participants, 71.5% were males and 28.5% were females. 50.0% of the farmers disagreed that antibiotics can treat all animal diseases, but 98.5% believed that antibiotics can treat infections. Additionally, 96.9% were aware of the side effects associated with antibiotic usage, and 96.2% knew that Antibiotic resistance is the loss of antibiotic function. During the survey, 65.4% of farmers intended to use leftover antibiotics, and 70.0% still unconsciously used antibiotics despite being aware of their public health effects. Furthermore, 58.5% of farmers did not follow evidence-based antibacterial therapy. Out of all the participants, 89.2% took advice from other farmers while choosing antibiotics. The study found that despite a high level of awareness about antibiotic use and resistance, there are significant gaps in behavior and decision-making among farmers that may lead to antibiotic resistance. Farmers still intend to use leftover antibiotics despite awareness of their impact on public health.
A simple, precise, and stability-indicating RP-HPLC method was developed and validated for the quantitative determination of Dexlansoprazole in bulk drug and capsule dosage form. Chromatographic separation was achieved on an Inertsil ODS C18 column (250.0 x 4.6 mm, 5.0 um) using a mobile phase of phosphate buffer (pH 7.0) and acetonitrile (55: 45 v/v) at a flow rate of 1.0 ml/min with UV detection at 285 nm. The method was validated in accordance with the ICH guidelines for specificity, linearity, precision, accuracy, and robustness, range, and system suitability. The method exhibited excellent specificity with no interference from excipients or degradation products. Linearity was observed over the selected concentration range with a high correlation coefficient. Precision and accuracy studies showed relative standard deviation values within acceptable limits, confirming methods reliability. Robustness testing demonstrated the method's consistency under small deliberate variations. The validated method is suitable for routine quality control analysis of Dexlansoprazole in bulk and capsule formulation.
Antibiotic misuse is a global issue, especially in developing nations. It has a potentially serious effect, as it leads to the development of antibiotic resistance. This study aims to identify the prevalence of six types of antibiotic misuse and associated factors of use and misuse among the public in Tripoli City, Libya, using a descriptive cross-sectional approach. A validated questionnaire was distributed to a convenience sample of 640 individuals. The response rate was 93.8%. Antibiotics were used by 47.5% (n=285, 95% CI: 43.5-51.5) of the participants in the previous two months. The prevalence of specific antibiotic misuse behaviours included using without medical consultation (27.4%, n=78/285, 95% CI: 22.5-32.9), terminating the course early (24.9%, n=71/285, 95% CI: 19.9-29.9), keeping leftovers for next use (36.1%, n=103/285, 95% CI: 30.5-41.7), throwing leftovers in garbage (21.8%, n=62/285, 95% CI: 17-26.6), compensating for a missed dose by increasing the next dose (2.4%, n=4/170, 95% CI: 0.1-4.5), and self-adjusting the dose by either taking more or less than the recommended dose (14.4%, n=41/285, 95% CI: 10.3-18.5). The recent antibiotic use was significantly associated with the employment status, the frequency of seeking physician consultation, and the practice of receiving a prescription by phone. In contrast, overall antibiotic misuse (any type) was significantly associated with the frequency of seeking physician consultation. There is a need to review the accessibility of antibiotics in pharmacies and to improve the quality of medical consultations.
Excessive production of reactive oxygen and nitrogen species under pathological conditions contributes to oxidative stress and chronic inflammation, both of which are central to the development of various diseases. Plant-derived antioxidants and anti-inflammatory agents have gained attention for their potential in mitigating these processes. This study evaluated the antioxidants and anti-inflammatory activities of Tapinanthus bangwensis leaf extracts using aqueous and acetone solvents. Phytochemical analyses revealed significantly higher total phenolic content (27.21±0.18 mg GAE/100 g) and total flavonoid content (18.69±0.31 mg QE/100 g) in the aqueous solvent compared to the acetone solvents. In antioxidants assays, total antioxidant capacity, reducing power, ferric reducing antioxidant power, and free radical scavenging (DPPH and ABTS), consistently showed greater activity in the aqueous solvent. In anti-inflammatory assays, the aqueous solvent demonstrated significantly higher inhibition of protein denaturation in bovine serum albumin (IC50=64.56±2.34 µg/mL) and egg albumin denaturation (IC50=389.45±3.50 µg/mL). Conversely, the acetone solvent exhibited stronger activity in trypsin inhibition (IC50=425.50±12.45 µg/mL) and hypotonic solution-induced hemolysis (IC50=107.75±2.87 µg/mL) assays, suggesting the presence of distinct bioactive compounds with membrane-stabilizing and enzyme-inhibitory effects. The findings supported the traditional use of Tapinanthus bangwensis extracts in the management of diseases. Tapinanthus bangwensis leaf is a promising source of natural therapeutic agents that could be used to prevent oxidative stress and inflammation in the body.
Non-communicable diseases (NCDs) remain a major public health and clinical concern worldwide. In many parts of Africa, traditional medicine remains a vital source of primary healthcare. This study examines the role of traditional medicine in managing of NCDs within the Iringa Care Utilization Model and the concept of medical pluralism. The study assessed how individual perceptions, structural access conditions, and health needs interact to influence treatment choices. To evaluate the knowledge and practices of traditional healers, the types of remedies used, and patient perceptions regarding traditional medicine for NCD management. This study employed a cross-sectional design to examine health-seeking pathways for NCD management in Iringa Region, Tanzania. A mixed-methods, cross-sectional design was employed with 120 respondents, comprising 18 traditional healers and 102 patients. Quantitative data were gathered using structured questionnaires and analyzed using descriptive statistics, while qualitative insights were obtained through in-depth interviews and analyzed thematically. The majority correctly defined NCDs as non-transmissible conditions. The main risk factors identified were low awareness and sugar consumption. Traditional healers administered remedies via oral, topical, and inhalation routes, primarily using plants such as Moringa oleifera, Psidium guajava, and Annona muricata. While half of the respondents found traditional medicine effective and affordable, others expressed concerns about side effects and inconsistent dosages. Traditional medicine was commonly used alongside biomedical care rather than as a substitute, reflecting adaptive and pragmatic responses within a plural health system. This study demonstrates that traditional medicine forms an integral part of health-seeking pathways for NCD management in Iringa Region. These practices should be understood within a plural health system rather than framed as alternatives to biomedical care. Public health policies addressing NCDs should acknowledge medical pluralism and develop context-sensitive strategies that improve coordination, safety, and patient-centered care.
Neonatal hypotension is a critical and frequent condition in the Neonatal Intensive Care Unit (NICU), often requiring pharmacologic intervention. Despite established treatment strategies, considerable variability exists in clinical practice across different healthcare settings. This study aimed to compare the neonatal characteristics, clinical practices, treatment indications, and outcomes of patients admitted to a public hospital and a private clinic in Libya. A cross-sectional comparative study was conducted from December 2024 to April 2025. Data were collected using a validated standardized questionnaire that included neonate demographics, clinical presentation, diagnostic assessment, drug use patterns, outcome, and adverse events. A total of 120 neonates were included in the study. Neonates admitted to the private NICU had significantly more favorable baseline characteristics compared to those in the public NICU. A lower measured blood pressure and higher significant use of echocardiography (p<0.001) were observed in the private NICU. Dopamine was the primary agent used in the public NICU (85.7%) while the private NICU relied on combination therapy, including dobutamine (p<0.001). Clinical response occurred more rapidly in the private NICU. Conversely, a higher rate of mortality was observed in the public NICU compared with the private NICU (p<0.001). The current findings suggest a significant disparity in diagnosis, drug selection, and outcome between public and private NICUs. Thus, establishing standardized protocols and increasing access to diagnostic tools, such as echocardiography, could enhance neonatal outcomes, particularly in resource-limited settings.
