The Objectives: This study aims to evaluate the value of ChatGPT in helping patients select appropriate self-care and over-the-counter medications for minor ailments compared to community pharmacists (CP).Method: The study used a cross-sectional assessment and a covert simulated patient study, in which three clinical pharmacists prepared 91 clinical scenarios representing the most common OTC indications. These case scenarios were presented to ChatGPT and community pharmacists to compare generated responses in several aspects. Accuracy, patient-centeredness, comprehensiveness, and word count of responses from both ChatGPT and community pharmacists were assessed by three clinical pharmacists.Results: It was found that ChatGPT responses were more accurate (4.51 +/- 0.64 vs 3.78 +/- 0.89), patient-centered (4.46 +/- 0.70 vs 3.68 +/- 0.88), and comprehensive (4.38 +/- 0.71 vs 2.68 +/- 1.26) compared to pharmacists' responses (p<0.001). Cosine similarity showed that the majority (40.7%, n=37) of cases answered by community pharmacists were moderately like that of ChatGPT, with an average score of 0.51 +/- 0.23.Conclusion: The study suggests ChatGPT is an accurate tool for a self-medication advisor for minor ailments. It is important to emphasize that this tool should be used to support patients and pharmacists rather than being the sole source of drug information, as therapy individualization and up-to-date information can't be achieved without pharmacists' intervention. It also underscores the need for enhancing pharmacists' and pharmacy students' training in minor ailments recommendations and management.

Background Hyperkeratotic hand eczema (HHE) is a distinct subtype of hand eczema characterized by sharply defined regions of hyperkeratosis on the palms and occasionally the fingers, with an unclear classification, a pathogenesis, and treatment. Dupilumab is an IgG4 monoclonal antibody used in the treatment of moderate-to-severe atopic eczema with highly satisfactory results; nevertheless, its role in HHE is inadequately characterized. This report offers the first assessment of dupilumab’s effectiveness in managing HHE in the Middle East and North Africa (MENA) region. Methods This case report presents three patients with HHE treated with dupilumab over a four-week period. Results All patients exhibited the characteristic symptoms of HHE, including sharply defined hyperkeratosis on the palms and fingers accompanied by painful fissures, mild itching, and minimal/absent redness. None showcased current atopic dermatitis or had a family history of atopy, palmoplantar keratoderma, or psoriasis. Previous treatments encompassed systemic and topical corticosteroids, acitretin, and biologics, yielding limited efficacy. Skin biopsies indicated the presence of spongiotic eczematous dermatitis, characterized by compact orthokeratosis, parakeratosis, epidermal acanthosis with mild spongiosis, and a mild lymphoid infiltrate devoid of eosinophils. Throughout dupilumab’s four-week course, all patients exhibited significant improvements, with no adverse drug reactions reported. Conclusion This report indicates that dupilumab may serve as an effective and safe treatment option for HHE and constitutes one of the first assessments of its effectiveness in (MENA) region.

Diabetes mellitus has been linked to cognitive impairment and Alzheimer's disease (AD). They share common pathologic pathways, including insulin resistance, mitochondrial dysfunction, oxidative stress, and chronic neuroinflammation. These shared mechanisms have prompted interest in repurposing antidiabetic agents as promising therapies for neurodegenerative diseases. Despite this overlap, these drugs face translational challenges, primarily due to their poor penetration across the blood-brain barrier (BBB) and, consequently, poor central nervous system (CNS) bioavailability. Nanoparticle-based drug delivery offers an alternative route to improve targeting of the CNS by increasing the drug stability and augmenting transport across the BBB. Although preclinical evidence showed promising results, the extent to which these findings translate into clinically tangible outcomes remains uncertain. This review critically evaluates the main preclinical studies on nanoparticle-mediated delivery of antidiabetic agents, with particular emphasis on AD and diabetes-associated cognitive impairment, where most available data are concentrated. We also discuss the main brain-targeting strategies, their limitations, and the translational challenges to their clinical application, particularly for conditions beyond AD, where the evidence remains sparse. Addressing these barriers is crucial for the development of nanomedicine-based approaches from bench to bedside. This review provides a critical standpoint on the field and highlights priorities for future research aimed at the effective translation of nanoparticle-enabled therapies for neurodegenerative diseases.

The objectives of our study were to assess self-reported knowledge, attitudes and practices (KAP) among pharmacy students regarding self-medication (SM) using artificial intelligence (AI) for personal use, to determine the relationships amongst KAP parameters, and to examine the association between students’ demographics with their KAP. A cross-sectional study was conducted. Four hundred and four pharmacy students completed the Arabic online survey. The survey consisted of four sections demographics, KAP. Mann-Whitney U tests, Kruskal-Wallis H test and Spearman correlation were used to analyze data. The majority of pharmacy students were female (77.5

Background: Over-the-counter (OTC) medications enable self-care but require accurate counseling to prevent misuse, particularly in multilingual settings with limited health literacy. Pharmacists provide expert guidance; however, time constraints hinder comprehensive interactions. Generative artificial intelligence (AI) models such as ChatGPT-4.5 offer potential as decision-support tools, but their performance compared with pharmacists in bilingual OTC counseling remains underexplored. This study compared ChatGPT-4.5 and community pharmacists using standardized gastrointestinal case scenarios in English and Arabic to assess response quality, safety, and appropriateness.Methods: This cross-sectional study evaluated 22 standardized OTC cases (e.g., constipation, diarrhea) from authoritative sources, presented in English and Arabic. Fifty-eight Jordanian community pharmacists (n = 29 per language) solved five cases each. All 44 AI responses were generated via standardized prompts without iteration. Responses were blindly rated by four experts using the CLEAR framework (completeness, lack of false information, evidence-based, appropriateness, and relevance; 5-point Likert scale). Cosine similarity quantified textual overlap; Welch’s t-tests, ANOVA, and correlations analyzed differences (SPSS v.29; α = 0.05). Inter-rater reliability was assessed using ICC.Results: ChatGPT-4.5 achieved higher mean CLEAR scores (4.8/5) than pharmacists (3.7–3.8/5; p < 0.001) across languages and domains, with no language differences (p > 0.05). AI excelled in completeness and lack of false information; pharmacist performance declined with case difficulty. Cosine similarity was low (0.04–0.11), indicating distinct yet coherent AI phrasing. Younger pharmacists scored higher (r = -0.33, p = 0.01). Qualitative analysis showed more consistent structure in AI-generated responses and greater variability among pharmacists.Conclusion: ChatGPT-4.5 demonstrates robust, language-agnostic performance for OTC counseling, suggesting its role as an educational benchmark and clinical adjunct to standardize advice and reduce variability. Pharmacy curricula should integrate AI literacy and targeted training in red-flag recognition to enhance human–AI synergy, fostering safer patient outcomes and interprofessional collaboration.

BACKGROUND:Aging is a complex biological process marked by the decline of physiological functions and heightened susceptibility to chronic illnesses, notably cardiometabolic disorders. Ceramides (Cer) are lipid derivatives linked to aging and metabolic diseases. Sodium-Glucose Cotransporter-2 inhibitors (SGLT2i), widely used in managing type 2 diabetes, have an unclear impact on aging biomarkers and Cer profiles. OBJECTIVE:This study explored the association between SGLT2i use, plasma Cer levels (CerC16:0, CerC18:0, CerC22:0, CerC24:0, and CerC24:1), and aging biomarkers-Human Insulin-Like Growth Factor 1 (IGF-1), mammalian target of rapamycin (mTOR), 5-Methylcytosine (5MC), and Human H2AFX (Histone H2AX) in patients with type 2 diabetes mellitus (T2DM). METHODS:In this retrospective study, 95 participants were divided into three groups: patients on SGLT2i (n = 34), patients on non-SGLT2i anti-diabetic treatments (n = 36), and healthy controls (n = 25). Plasma Cer and aging biomarkers were quantified using Liquid Chromatography with tandem mass spectrometry (LC-MS-MS) and ELISA, respectively. Principal component analysis (PCA) assessed group-based clustering, while ANCOVA evaluated group differences with confounder adjustment. RESULTS:SGLT2i-treated patients showed significantly lower CerC16:0, CerC22:0, and CerC24:1 levels (p < 0.01) and decreased 5MC and H2AX (p < 0.05) compared to non-SGLT2i patients. IGF-1 was significantly elevated in the SGLT2i group (p < 0.01), suggesting a possible protective effect on metabolic health. PCA distinguished control from diabetic groups but revealed overlap between SGLT2i and non-SGLT2i groups. CONCLUSION:Beyond glucose control, SGLT2i may improve plasma Cer and aging markers in diabetic patients, supporting their broader therapeutic potential in aging and age-related diseases. Further large-scale studies are warranted to confirm these effects and underlying mechanisms.

OBJECTIVE:This study aimed to assess the beliefs, barriers, and attitudes towards oocyte cryopreservation in Jordanian females. Understanding these aspects in our region can help healthcare providers identify similarities and differences compared to other geographic areas, which could facilitate a proper approach and informed counseling. METHODS:We conducted a cross-sectional online survey using Google® forms (Google, Mountain View, CA, USA). The questions were designed to target a convenience sample of single women (never married, divorced, or widowed) aged 18-64 years in Jordan. Of the 400 women approached, 345 completed the questionnaire voluntarily. Responses were collected and analyzed using the software program SPSS® 23.0 (IBM, Armonk, NY, USA). RESULTS:The. RESULTS:highlight notable deficiencies in women's understanding of the expenses, procedures, and success rates of oocyte freezing as a feasible method for fertility preservation. Most participants stated that the main barriers to oocyte cryopreservation were cost (87.5%), future husband rejection (76.8%), and social exclusion (72.2%). However, a significant number of participants admitted that this procedure would encourage late marriage and increase the chance of pregnancy in cases of late marriage and fertility problems. CONCLUSION:Women in this study had poor knowledge, but generally had positive attitudes toward oocyte cryopreservation. Educational campaigns are warranted to enhance knowledge and positive attitudes.

Background: The management of COPD typically involves a multifaceted approach and a complex treatment regimen. Poor adherence to prescribed medications can lead to worsened symptoms, increased exacerbations, and reduced quality of life among patients with COPD. Objective: This study aimed to assess medication adherence and associated factors in outpatients with COPD, which remain insufficiently investigated. Methods: A cross-sectional study was conducted at outpatient respiratory clinics in two major Jordanian hospitals. Data collection included sociodemographic and medical parameters. Medication adherence was assessed using a validated Arabic 4-item scale.Logistic regression was conducted to identify the variables associated with medication adherence. Results: Of the 702 participants, 68%reported poor medication adherence. Key determinants of medication adherence included age, inhaler technique, knowledge, comorbidities, concerns about side effects, dosing frequency, disease duration, and depression. Conclusion: Medication adherence in COPD patients, particularly in the elderly, and those with comorbidities, depression, and longer disease duration, is inadequate. Effective counselling and more convenient medication regimens are essential to improving adherence in this patient population.

ObjectivesTo estimate the rate of obstructive sleep apnea (OSA) and associated factors among Lebanese adults.MethodsA cross-sectional study was conducted in February–April 2022; 1,202 Lebanese adults were enrolled. The sample was collected among several Lebanese governorates through an anonymous online self-reported questionnaire. The STOP-BANG questionnaire was used as a screening tool to estimate the OSA risk. “Low OSA risk” is established with 0–2 positive answers, “Intermediate OSA risk” is established by 3–4 positive answers while “High OSA risk” is established by 5–8 positive answers.ResultsThis study showed that 743 (62.4%) of the sample had low risk for OSA, 357 (30.0%) had moderate, and 90 (7.6%) had high risk for OSA. Older age (aOR = 1.05) and having hypertension (aOR = 7.80) were associated with higher odds of moderate OSA. Female sex (aOR = 0.04) was significantly associated with lower odds of moderate OSA compared to males. Older age (OR = 1.17), higher BMI (OR = 1.14), hypertension (OR = 18.55), and having severe COVID-19 infection compared to mild (OR = 4.30) were significantly associated with higher odds of high OSA, whereas female sex (OR = 0.002) and being married compared to single (aOR = 0.23) were associated with lower odds of high OSA.ConclusionThis study showed that most Lebanese adults have low risk for OSA. It also confirmed that sex, age, obesity, hypertension, and severe COVID-19 were associated with high OSA risk. These associated factors call for future research exploring the causes including the potential effect of social, economic, and political instability, local customs, and environmental factors. Moreover, future health campaigns should be assigned to increase awareness among Lebanese population regarding the prevention of OSA through lifestyle modifications.

BACKGROUND:Robotic technology is being rapidly adopted worldwide. The purpose of this study was to quantify the prevalence of robotic technology use among UAE community pharmacists, evaluate their perceived benefits and concerns, and identify factors that predict heightened concern levels. RESEARCH DESIGN AND METHODS:The present study utilized a validated self-administered survey, which was distributed in person to community pharmacists in different regions of Abu Dhabi and other Emirates. The questionnaire comprised sociodemographic and job‑related items, an operational definition of robotics, a 5‑point Likert scale on perceived benefits, a 4‑point Likert scale on perceived concerns (recoded to a 0-14 score), and a checklist of potential robotic pharmacy services. RESULTS:Pharmacists holding only a bachelor's degree and pharmacy owners reported higher median concern scores than those with postgraduate degrees and pharmacists in charge, respectively. Additionally, pharmacists without training on robotic systems and those with heavier workloads dispensing ≥30 prescriptions per day or serving ≥10 patients per day also showed significantly greater concerns than their counterparts. CONCLUSION:It is necessary to implement training initiatives aimed at enhancing awareness and understanding of robotic technologies among pharmacists.

Background In the evolving landscape of pharmacy, the shift towards patient-centred care necessitates continuous professional development (CPD) for pharmacists. This study aims to assess the awareness, perception, motivators, and barriers to CPD implementation among pharmacists.Methods A cross-sectional study was conducted, utilising a structured questionnaire. Convenience sampling was employed, inviting 250 pharmacists from diverse practice settings to participate. Descriptive statistics were used for analysis.Results Out of the 210 pharmacists who participated in the study, more than half (51.7%) were unfamiliar with CPD, while only a small percentage (3.8%) were very familiar with it. Engagement in learning activities was common, reported by 80% of participants, with varying frequencies: weekly (19%), monthly (30.5%), yearly (27.6%), and rarely (22.9%). However, the implementation of CPD cycle elements was minimal, with only 8.6% reflecting, 5.7% planning, 10.5% taking action, and 7.2% evaluating their learning activities more than 75% of the time. Most pharmacists supported mandatory CPD (80.6%) and integration into a legal framework (81.3%). Anticipated benefits, such as keeping knowledge updated (92.9%) and improving patient care (91%), were highly endorsed. Motivators for CPD included proximity to the workplace (82.3%) and flexible schedules (84.7%), while barriers included time constraints (73.7%) and lack of information (74.2%).Conclusion Pharmacists demonstrate low awareness and implementation of CPD, underscoring the necessity for educational initiatives and legislative support. Motivators such as proximity and flexible schedules could enhance CPD uptake, while addressing barriers like time constraints and lack of information is crucial for successful CPD integration in pharmacy practice.

Background: Atopic Dermatitis (AD) is a chronic relapsing and remitting inflammatory skin disease characterized primarily scaly, pruritic, and erythematous skin lesions, all of which can have a profound negative impact on a patient's quality of life. Dupilumab, is currently used for treating moderate-to-severe AD with promising efficacy and safety outcomes, however, limited data about long-term outcomes is available. Objective: To assess the long-term safety and efficacy of Dupilumab therapy, as well as the quality of life in patients with moderate-to-severe AD in the UAE. Methods: This retrospective observational study was conducted in Al-Qassimi and Tawam Hospitals, UAE. Patients' data were extracted from the electronic medical records. Long-term efficacy and quality of life upon Dupilumab use were assessed by multiple validated assessment tools for patients with AD (SCORAD, EASI, DLQI/CDLQI, vIGA, and Pruritus NRS). The safety of therapy was also assessed through documented adverse events. The change in the scores of the assessment tools was determined by paired t-test and repeated measures ANOVA. Results: This study included 96 patients with moderate-to-severe AD from two hospitals in the UAE between 2019 and 2023, who were followed-up over 36 months (3 years). Mean age was 23.7 +/- 13.8 years old and nearly half of the patients were females (52.1%, n= 50). In the study sample, AD most commonly appeared on the upper (88.5%, n= 85), lower extremities (71.3%, n= 78), and head-neck region (77.1%, n= 74). There was a significant improvement in patients' symptoms and quality of life, which was observed in SCORAD, EASI, DLQI/CDLQI, vIGA, and Pruritus-NRS scores (p<0.001) over three consequence years of receiving Dupilumab therapy (weeks 2,6,12,24,52,104, and 156). Dupilumab demonstrated considerable safety with few patients reporting side effects such as drowsiness, injection site reaction, flaring AD, and conjunctivitis. Conclusion: This study demonstrated that Dupilumab therapy was effective in the management of moderate-to-severe AD over long-term use and significantly improved patients' quality of life with an acceptable safety profile among children and adults.

Background The association between anemia and severity of infection as well as mortality rates among patients infected with COVID-19 has scarcely been studied. This is the first study UAE aimed to assess the influence of anemia on COVID-19 severity, ICU admission, and mortality rate. Methods A retro-prospective chart review of hospitalized COVID-19 patients was conducted in a large COVID-19 referral hospital in UAE. The study included adult patients with confirmed COVID-19. Clinical and laboratory data, severity of the disease, ICU admissions, and mortality rates were analyzed and correlated to the presence of anemia among the patients. Results A total of 3092 patients were included. 362 patients (11.7%) were anemic and most of the cases were between asymptomatic and mild COVID-19 (77.4%, n=2393). Among patients with anemia, 30.1% (n=109) had moderate to severe COVID-19. Statistically, anemia was associated significantly with a higher risk for severe COVID-19 outcome compared to nonanemic patients (AOR:1.59, 95% CI:1.24-2.04, p<0.001). Intensive care unit (ICU) admission was almost 3 times higher among anemic patients compared to nonanemic (AOR:2.83,95% CI:1.89-4.25, p<0.001). In addition, the overall mortality rate of 2.8% (n=87) was 2.5-fold higher in anemic than nonanemic patients (OR:2.56, CI: 1.49-4.06, p<0.001). Moreover, older age (≥48-year-old) and male gender were independent predictors for severe illness (Age: OR=1.26, CI:1.07-1.51, p=0.006; Gender: OR:1.43,CI:1.15-1.78, p<0.001)) and ICU admission (Age: OR:2.08, CI:1.47-2.94, p<0.001; Gender: OR: 1.83, CI:1.12-3.00, p=0.008) whereas only age ≥48 years old contributed to higher mortality rate (OR:1.60, CI:1.04-2.46, p=0.034). Conclusion Anemia was a major risk factor for severe COVID-19, ICU admission and mortality among hospitalized COVID-19 patients. Thus, healthcare providers should be aware of monitoring the hematological parameters among hospitalized patients with COVID-19 and anemia to reduce the risk of disease complications and mortality. This association should also be considered in other infectious diseases.

Objective The purpose of this study was to assess the health-related quality of life (HRQOL) and investigate the variables contributing to reduced HRQOL in patients with rheumatoid arthritis. Methods The present cross-sectional study was conducted on patients diagnosed with rheumatoid arthritis at two teaching hospitals in Jordan using a convenience sampling technique. The participants were interviewed face-to-face during the scheduled appointment at the outpatient rheumatology clinic. The HRQOL was evaluated by the validated EuroQol-5 Dimension (EQ-5D) questionnaire, which included the EQ-5D utility index that evaluated HRQOL in terms of 5 domains, including mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, and the EQ-5D visual analogue scale (EQ-5D(VAS)), which evaluated HRQOL on a vertical scale ranging from 0 (worst imaginable health) to 100 (best imaginable health). The validated short version of the 19-item Compliance Questionnaire for Rheumatology (CQR-5) was used to evaluate medication adherence. The Clinical Disease Activity Index (CDAI) was used to assess disease activity among the study participants. A stepwise quantile regression model (q = 0.5) was conducted to explore the factors associated with the EQ-5D(Utility Index) and EQ-5D(VAS) scores. Results In total, 261 patients with RA participated in the study. The median (interquartile range) of the EQ-5D(Utility Index) and EQ-VAS scores was 0.552 (0.006-0.726) and 0.506 (0.233-0.690), respectively. Regression analysis results demonstrated that medication non-adherence (regression coefficient (beta) = -0.348, P<0.01), not performing regular physical activity (beta = -0.209, P<0.01), and higher disease activity as measured by the CDAI score (beta = -0.015, P<0.01) were significant predictors of a lower EQ-5D(Utility Index) score(.) In addition, medication non-adherence (beta = -0.199, P<0.01), not performing regular physical activity (beta = -0.117, P<0.01), increased body mass index (BMI) (beta = -0.009, P<0.01), and higher CDAI score (beta = -0.009, P<0.01) were significant predictors of low EQ-5D(VAS) score. Conclusions Patients with RA experienced significantly impaired HRQOL. Medication non-adherence, not performing regular physical activity, increased body weight, and increased disease activity were identified as determinants of poor HRQOL among patients with RA in the present study. Treating physicians should encourage regular physical activity, maintaining a healthy body weight, and controlling disease activity to improve HRQOL in patients with RA.

Abstract Background Appropriate drug prescribing in the pediatric population is challenging, given this age group’s unique pharmacokinetics. This has inevitably led to a high incidence of adverse drug reactions in this population. To address this issue, the Pediatric Pharmacy Association (PPA) compiled a list of 67 drugs that are inappropriately used in the pediatric population called the Key Potentially Inappropriate Drugs “KIDs list”. Aim To estimate the prevalence of potentially inappropriate medications (PIM) use in pediatric wards based on the KIDs list criteria. Methods A retrospective observational study was conducted and included pediatric patients who were admitted to five pediatric wards during 3 years (2019–2021). The drugs in the KIDs list were matched to the hospital formulary and 11 matched drugs were included in the study. For each individual drug, the patient’s electronic file was reviewed to determine the prescription appropriateness according to the KIDs list criteria. Results Among 3,166 pediatric patients admitted to pediatric wards, a total of 415 patients received a PIM listed in the KIDs list. The mean age was 8.6 (± 4.9) years old, and 60.0% (n = 251/415) were males. The overall prevalence of PIM use was 13.0% (n = 415/3166). Among the prescribed PIM, metoclopramide was the most commonly prescribed PIM 42.8% (n = 178/415), followed by tramadol 37.6% (n = 156/415). Conclusion Given the high prevalence of inappropriate medication use in the pediatric wards, future research on strategies and interventions should be recommended to limit the use of PIMs and provide safer alternatives for the pediatric population.

Introduction: Brain histamine is considered an endogenous anticonvulsant and histamine H1 receptor. H1R antagonists have, in earlier studies, been found to induce convulsions. Moreover, research during the last two decades has provided more information concerning the anticonvulsant activities of histamine H3R (H3R) antagonists investigated in a variety of animal epilepsy models.Methods: Therefore, the in vivo anticonvulsant effect of the H3R antagonist DL76, with proven high in vitro affinity, in vitro selectivity profile, and high in vivo antagonist potency in mice against maximal electroshock (MES)-induced seizures in mice, was assessed. Valproic acid (VPA) was used as a reference antiepileptic drug (AED). In addition, DL76 was tested for its reproductive and fetal toxicity in the same animal species.Results and discussion: Our observations showed that acute systemic administration (intraperitoneal; i.p.) of DL76 (7.5 mg/kg, 15 mg/kg, 30 mg/kg, and 60 mg/kg, i.p.) provided significant and dose-dependent protection against MES-induced seizures in female and male mice. Moreover, the DL76-provided protective effects were comparable to those offered by the VPA and were reversed when animals were co-administered the CNS-penetrant selective H3R agonist R-(α)-methylhistamine (RAM, 10 mg/kg, i.p.). Furthermore, the administration of single (7.5 mg/kg, 15 mg/kg, 30 mg/kg, or 60 mg/kg, i.p.) or multiple doses (3 × 15 mg/kg, i.p.) of H3R antagonist DL76 on gestation days (GD) 8 or 13 failed to affect the maternal body weight of mice when compared with the control mice group. No significant alterations were detected in the average number of implantations and resorptions between the control and DL76-treated groups at the early stages of gestation and the organogenesis period. In addition, no significant differences in the occurrence of skeletal abnormalities, urogenital abnormalities, exencephaly, exomphalos, facial clefts, and caudal malformations were observed. The only significant abnormalities witnessed in the treated groups of mice were in the length of long bones and body length. In conclusion, the novel H3R antagonist DL76 protected test animals against MES-induced seizures and had a low incidence of reproductive and fetal malformation with decreased long bone lengths in vivo, signifying the potential therapeutic value of H3R antagonist DL76 for future preclinical as well as clinical development for use in the management of epilepsy.

Microbes have inhabited the earth for hundreds of millions of years longer than humans. The microbiota–gut–brain axis (MGBA) represents a bidirectional communication pathway. These communications occur between the central nervous system (CNS), the enteric nervous system (ENS), and the emotional and cognitive centres of the brain. The field of research on the gut–brain axis has grown significantly during the past two decades. Signalling occurs between the gut microbiota and the brain through the neural, endocrine, immune, and humoral pathways. A substantial body of evidence indicates that the MGBA plays a pivotal role in various neurological diseases. These include Alzheimer’s disease (AD), autism spectrum disorder (ASD), Rett syndrome, attention deficit hyperactivity disorder (ADHD), non-Alzheimer’s neurodegeneration and dementias, fronto-temporal lobe dementia (FTLD), Wilson–Konovalov disease (WD), multisystem atrophy (MSA), Huntington’s chorea (HC), Parkinson’s disease (PD), multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), temporal lobe epilepsy (TLE), depression, and schizophrenia (SCZ). Furthermore, the bidirectional correlation between therapeutics and the gut–brain axis will be discussed. Conversely, the mood of delivery, exercise, psychotropic agents, stress, and neurologic drugs can influence the MGBA. By understanding the MGBA, it may be possible to facilitate research into microbial-based interventions and therapeutic strategies for neurological diseases.