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Background Muscle-building supplements (MBS) are increasingly used by athletes and young adults to enhance muscle mass, recovery, and performance. However, inappropriate use and misinformation pose significant health risks. Community pharmacists are well-positioned to provide guidance, yet their readiness in this domain remains underexplored in Saudi Arabia. Methods A descriptive, cross-sectional study was conducted among licensed community pharmacists across Saudi Arabia. A structured, self-administered questionnaire assessed knowledge, attitudes, counseling practices, perceived barriers, and training needs related to MBS. Descriptive statistics, linear regression, and ordinal logistic regression were used to analyze factors associated with knowledge, attitudes, and counseling frequency. A p-value < 0.05 was considered statistically significant. Results A total of 708 pharmacists participated. Higher knowledge scores were associated with male gender, age 26–35, over 10 years of experience, formal training, and frequent supplement-related inquiries. Positive attitudes were linked to male gender, mid-level experience, higher knowledge scores, and frequent customer questions, while formal training was paradoxically associated with slightly lower attitude scores. Counseling frequency was predicted by male gender, age 36–45, and frequent inquiries. Over half of participants supported MBS-related training (54.8%), curriculum integration (55.2%), and standardized counseling guidelines (54.4%). Conclusion Community pharmacists in Saudi Arabia demonstrate varied levels of knowledge and counseling behavior regarding MBS, influenced by demographic factors, training, and customer demand. These findings highlight the need for targeted educational initiatives and national guidance to optimize pharmacists’ role in ensuring the safe use of muscle-building supplements.

Digital health misinformation on social media and emerging AI platforms poses a growing challenge for healthcare systems. Community pharmacists are often the first point of contact for patients influenced by online health content, yet limited evidence exists from Saudi Arabia, where social media engagement is among the highest globally. To examine how community pharmacists in Saudi Arabia experience digital health misinformation, including its sources, patient impacts, confidence in addressing misinformation, and training needs. A descriptive cross-sectional online survey was conducted among licensed community pharmacists in Saudi Arabia between March and April 2025. Using a convenience-plus-snowball sampling strategy, A total of 768 completed survey responses from licensed community pharmacists were included in the analysis. These responses were obtained through an anonymous, nationally distributed electronic questionnaire. The survey explored exposure to misinformation, pharmacists' confidence, and preferred training modalities. Descriptive statistics and regression analyses were used to identify predictors of key outcomes. Most pharmacists (89.6%) reported encountering patient-derived digital health misinformation, with 51.6% experiencing such encounters weekly or daily. Facebook (39.3%) and WhatsApp (27.7%) were identified as the most common sources, while 10% of encounters involved AI-generated content. Common misinformation themes included supplement misuse (27.1%) and concerns about medication safety (25.7%). Only 34.5% of pharmacists felt confident in identifying or correcting misinformation. Age, years of experience, and frequency of exposure were significantly associated with higher confidence and with perceived patient-behaviour impact. More than half (59.5%) supported formal training in misinformation management. Digital misinformation is now a routine component of community pharmacy practice in Saudi Arabia and has tangible implications for patient behaviour and medication safety. Although confidence in managing misinformation was low, digitally active community pharmacists expressed strong readiness for targeted training. These findings underscore the need for structured educational initiatives and coordinated policy responses to strengthen digital health literacy and misinformation management within pharmacy practice.

Background Sleep disturbances are among the most disabling non-motor symptoms in Parkinson’s disease (PD), particularly affecting older adults, in whom age-related vulnerability and multimorbidity may exacerbate sleep dysfunction. Despite their high prevalence, interventional evidence reporting sleep-related outcomes in PD remains incompletely characterized, and methodological heterogeneity limits the comparability of findings across studies. This registry-based descriptive review aimed to characterize the landscape of late-stage interventional trials reporting sleep-related outcomes in PD, with attention to study design, older-adult eligibility, and intervention types. Methods A descriptive analysis of completed late-stage interventional studies registered on ClinicalTrials.gov was conducted. Late-stage was operationally defined as Phase III–IV interventional trials and explicitly linked open-label extension/rollover studies. Eligible studies permitted enrolment of adults aged ≥ 65 years with Parkinson’s disease and reported at least one sleep-related outcome. Extracted data included intervention type, study design, sleep outcome measures, and study duration. Results Twenty-one trials met inclusion criteria. Most focused on dopaminergic or adjunctive pharmacologic interventions, including rotigotine, pramipexole, and levodopa–carbidopa intestinal gel. Reported sleep-related outcomes were primarily derived from subjective instruments such as the Parkinson’s Disease Sleep Scale (PDSS/PDSS-2) or SCOPA-Sleep, while objective assessments such as polysomnography or actigraphy were infrequently specified. No completed late-stage trials evaluating structured behavioral or circadian-oriented interventions, including cognitive-behavioral therapy for insomnia, exercise, or bright-light therapy, were identified. Eligibility criteria suggested that clinically vulnerable populations, including frail or cognitively impaired individuals, were likely underrepresented. Conclusions Late- stage interventional evidence reporting sleep-related outcomes in PD remains predominantly pharmacologic, short-term, and methodologically heterogeneous. The absence of completed behavioral or multimodal trials and eligibility criteria that may limit inclusion of clinically vulnerable individuals highlight important evidence gaps. Future research should prioritize inclusive, geriatric-informed, and multimodal designs incorporating both subjective and objective sleep measures.

Pharmacogenetics (PGx) may support more individualized pediatric therapy by accounting for genetic variability in drug response, toxicity, and dose requirements. However, the extent and manner in which pharmacogenetic and biomarker-related components are incorporated into pediatric clinical trials remain incompletely characterized. To qualitatively examine how pharmacogenetic and biomarker-related components are represented and operationalized in pediatric clinical trials registered on ClinicalTrials.gov, with emphasis on disease distribution, apparent roles within trial design, and the primary and secondary outcome domains reported in these studies. A registry-based qualitative analysis was conducted using ClinicalTrials.gov. Interventional Phase II to IV trials enrolling participants younger than 18 years of age were screened from database inception through July 2025 using pharmacogenetic-related search terms. Eligible studies included pediatric trials incorporating pharmacogenetic or pharmacogenomic components relevant to drug response, efficacy, toxicity, pharmacokinetics/pharmacodynamics, dose optimization, or treatment selection. Included trials were classified by primary clinical disease category, apparent level of pharmacogenetic integration, and primary and secondary outcome domains. A total of 198 pediatric trials met the inclusion criteria. Infectious diseases and oncology were the most frequently represented primary clinical disease categories, each accounting for 37 (18.7%) of included trials, followed by psychiatry and respiratory diseases at 20 (10.1%) each. Exploratory or observational incorporation of pharmacogenetic or biomarker-related information was the most common pattern, accounting for 121 (61.1%) of trials, whereas guided intervention and decision-informing use accounted for 39 (19.7%) and 25 (12.6%), respectively. At the primary outcome level, clinical efficacy was the dominant domain, accounting for 82 (41.4%) of trials, followed by biomarkers/molecular outcomes at 48 (24.2%). Among secondary outcomes coded as inclusive occurrences, biomarkers/molecular outcomes were the leading category at 116 (27.0%), followed by clinical efficacy at 103 (24.0%). Pediatric pharmacogenetic trials appear to be advancing but remain largely positioned at an intermediate translational stage. Pharmacogenetic and biomarker-related components were more often exploratory than treatment-guiding, highlighting the need for clearer registry reporting and more explicit trial designs that distinguish exploratory, decision-informing, and clinically actionable PGx roles.

IntroductionArtificial intelligence (AI) is increasingly applied in prostate cancer screening and diagnostic evaluation; however, the structure, methodological characteristics, and clinical positioning of AI-focused trials remain incompletely characterized. This study aimed to map the clinical trial landscape of AI applications in prostate cancer diagnosis using registry-based evidence mapping.MethodsA registry-based evidence-mapping analysis was conducted using ClinicalTrials.gov. Trials registered up to 15 November 2025 were systematically identified using search terms related to prostate cancer and AI-based methodologies. Eligible studies included interventional and observational trials evaluating AI applications for diagnostic purposes. Data were extracted on study design, diagnostic modality, functional role of AI, comparator framework, and validation strategy. Descriptive statistics and cross-tabulation analyses were used to characterize patterns across studies. The study selection process was presented using a PRISMA-style flow diagram.ResultsA total of 84 trials met the inclusion criteria. Imaging-based AI applications predominated, accounting for 52.4% of studies, with magnetic resonance imaging (MRI) representing the most frequently investigated modality (34.5%). Biomarker-based (16.7%), multimodal (15.5%), and computational pathology (7.1%) approaches were less frequently reported. The most common functional applications were classification and risk prediction (48.8%) and lesion detection and segmentation (29.8%). Most studies employed prospective observational designs (84.5%) and frequently relied on stand-alone AI evaluation frameworks (39.2%). Histopathology or biopsy confirmation was the most commonly reported reference standard (56.0%). Only a limited number of trials incorporated workflow integration or clinical decision-support evaluation.ConclusionAI research in prostate cancer diagnostics appears to be primarily centered on imaging-based, early-phase, and performance-oriented studies. Current evidence suggests that AI systems are predominantly positioned as decision-support tools rather than fully integrated clinical solutions. Greater emphasis on multicenter validation, standardized reporting, and clinically relevant outcome evaluation may be required to support broader clinical implementation.

The development of efficient drug delivery systems is critical for improving therapeutic outcomes and reducing side effects in cancer treatment. This study investigates the potential of iron-doped boron nitride nanoparticles (Fe-BNNPs) as a nanocarrier for Anastrozole, a key aromatase inhibitor used in breast cancer therapy. Using density functional theory (DFT), we systematically analyzed the interaction mechanisms between Anastrozole and Fe-BNNPs, focusing on binding energies, electronic properties, and structural stability. Our results reveal a strong adsorption of Anastrozole on Fe-BNNPs, with binding energies ranging from − 0.6 to − 1.4 eV, indicating a stable and efficient drug-carrier interaction. Iron doping significantly enhances the reactivity of BNNPs, improving drug loading and release capabilities. Nanoparticles passivated with -H and -OH groups and functionalized with iron nanoclusters were examined, demonstrating that -H passivation yields more stable structures compared to -OH, despite minor variations in electronic properties such as energy gaps (e.g., 2.51 eV for -H vs. 2.54 eV for -OH). The incorporation of iron nanoclusters further increases the binding energy of Anastrozole by approximately 40%, highlighting its role in optimizing drug-nanocarrier interactions. Optical absorption spectra reveal distinct peaks for Anastrozole adsorption on -H and -OH passivated surfaces, providing a clear indicator of interaction states. These findings underscore the potential of Fe-BNNPs as a promising nanocarrier for targeted Anastrozole delivery, offering enhanced precision and therapeutic efficacy.

Fungus continues to attract great attention as a promising pool of biometabolites. Aspergillus ochraceus Wilh (Aspergillaceae) has established its capacity to biosynthesize a myriad of metabolites belonging to different chemical classes, such as isocoumarins, pyrazines, sterols, indole alkaloids, diketopiperazines, polyketides, peptides, quinones, polyketides, and sesquiterpenoids, revealing various bioactivities that are antimicrobial, cytotoxic, antiviral, anti-inflammatory, insecticidal, and neuroprotective. Additionally, A. ochraceus produces a variety of enzymes that could have variable industrial and biotechnological applications. From 1965 until June 2022, 165 metabolites were reported from A. ochraceus isolated from different sources. In this review, the formerly separated metabolites from A. ochraceus, including their bioactivities and biosynthesis, in addition, the industrial and biotechnological potential of A. ochraceus are highlighted.

Medication adherence is essential for managing chronic diseases, yet non-adherence remains a significant public health issue globally and regionally. In Saudi Arabia, behavioral and systemic barriers to adherence are understudied, particularly regarding the role of digital tools. To evaluate the knowledge, attitudes, and practices related to medication adherence among adults with chronic conditions in Saudi Arabia and to identify barriers and facilitators influencing adherence, including digital support tools. A cross-sectional survey was conducted in Q1 2025 across multiple regions in Saudi Arabia. Adults with chronic illnesses were recruited using convenience sampling. A validated electronic questionnaire assessed knowledge, attitudes, intentional non-adherence, and digital tool use. Data were analyzed using descriptive statistics and multivariate logistic regression to identify predictors of non-adherence. A total of 950 participants were included (mean age: 48.6 years; 73.9% female). Although 65.9% strongly agreed on the importance of medication, 30.0% reported intentional non-adherence. Middle-aged adults (50–59 years) and males were more likely to alter or skip medications. Forgetfulness and dislike of medications were the most reported reasons. Only 24.2% used digital tools, primarily for reminders. Gender differences were observed in adherence strategies, with women more likely to use organizers and men relying on family or mobile apps. Positive beliefs about medication necessity were significantly associated with higher adherence and digital tool engagement. Medication adherence remains suboptimal among adults with chronic conditions in Saudi Arabia, influenced by demographic, behavioral, and technological factors. Tailored interventions addressing gender-specific needs, behavioral motivations, and digital literacy are warranted to improve long-term adherence and disease outcomes.

Isoquinoline alkaloids constitute one of the most common classes of alkaloids that have shown a pronounced role in curing various diseases. Finding ways to reduce the toxicity of these molecules and to increase their therapeutic margin is an urgent matter. Here, a one-step method for the synthesis of a series of 1-aryl-6,7-dimethoxy-1,2,3,4-tetrahydroisoquinolines was performed in 85–98% yield by the Pictet–Spengler reaction. This was accomplished using the reaction between 3,4-dimethoxyphenylethylamine and substituted benzaldehydes boiling in trifluoroacetic acid. Furthermore, 1-(3′-amino-, 4′-aminophenyl)-6,7-dimethoxy-1,2,3,4-tetrahydroisoquinolines were obtained in 94% and 97% yield by reduction in 1-(3′-nitro-, 4′-nitrophenyl)-6,7-dimethoxy-1,2,3,4-tetrahydroisoquinolines with SnCl2 × 2H2O. The structures of the substances obtained were confirmed by infrared (IR) and nuclear magnetic resonance (1H and 13C NMR) spectra. ADMET/TOPKAT in silico study concluded that the synthesized compounds exhibited acceptable pharmacodynamic and pharmacokinetic properties without carcinogenic or mutagenic potential but with variable hepatotoxicity. The acute toxicity and structure–toxicity relationship (STR) in the series of 20 derivatives of 1-aryl-6,7-dimethoxy-1,2,3,4-tetrahydroisoquinolines (3a–r, 4a, b) was studied via determination of acute toxicity and resorptive action in white mice employing intragastric step-by-step administration. The first compound, 1-phenyl-6,7-dimethoxy-1,2,3,4-tetrahydroisoquinoline hydrochloride (3a), showed the highest toxicity with LD50 of 280 mg/kg in contrast to 1-(3′-bromo -4′-hydroxyphenyl)-6,7-methylenedioxy-1,2,3,4-tetrahydroisoquinoline hydrochloride (3e) which proved to be the safest of the compounds studied. Its toxicity was 13.75 times lower than that of the parent compound 3a. All compounds investigated showed high local anesthetic activity on rabbit eyes in the concentrations studied. Only 3r, 3n, and 4a caused eye irritation and redness. All investigated derivatives (except 4b) in 1% concentration were more active than lidocaine, providing longer duration of complete anesthesia. Therefore, based on the obtained results of in silico tests, local anesthesia, and acute toxicity, a conclusion can be drawn that the experimental compounds need further extensive future investigations and possible modifications so that they can act as promising drug candidates.

Background Congenital impairments, arising from a range of genetic, environmental, dietary, and teratogenic factors, are a significant public health concern. Pharmacists play a key role in preventing these conditions by ensuring pharmaceutical safety and providing maternal health education. However, there is limited research on the knowledge, attitudes, and practices of pharmacists in Saudi Arabia regarding the causes of congenital impairments. Objectives This study aimed to assess pharmacists’ awareness, perceptions, and practices related to these factors and identify key demographic influences on their knowledge and engagement. Methods A cross-sectional survey was conducted among licensed pharmacists based in Saudi Arabia, including those working in clinical, academic, hospital, and community settings. A standardized and validated questionnaire comprising 30 items divided across knowledge, attitude, and practice domains was used to assess pharmacists’ perspectives. The data were analyzed using descriptive statistics and multivariate linear regression to identify the key demographic factors associated with knowledge, attitudes, and practice scores. Results The study included a total of 424 pharmacists, the majority of whom held a master’s degree (60.4%), were male (73.6%), and were aged between 25 and 34 years old (41.5%). Hospital pharmacists achieved significantly higher knowledge (4.39 ± 1.48, P  < 0.001), attitude (29.20 ± 5.49, P  = 0.000), and practice (33.16 ± 6.84, P  < 0.001) scores than community pharmacists. The knowledge gaps identified concerned the impact of environmental contaminants (28.5%) and maternal obesity (30.9%) on fetal development. However, pharmacists showed strong positive attitudes toward preventive measures, with 49.1% supporting increased training and 52.8% endorsing genetic screening as essential interventions. Conclusion The study highlights significant gaps in pharmacists’ understanding and practice concerning congenital impairments, particularly regarding lifestyle and environmental risk factors. Despite strong support for pharmacist training, participation in public health campaigns and patient counseling on teratogenic risks remains limited. To enhance congenital disability prevention efforts in Saudi Arabia, these findings emphasize the need for improved pharmacist knowledge, structured training programs, and more extensive integration of pharmacists within maternal healthcare teams.