The wide diversity of microbiota at the genera and species levels across sites and individuals is related to various causes and the observed differences between individuals. Efforts are underway to further understand and characterize the human-associated microbiota and its microbiome. Using 16S rDNA as a genetic marker for bacterial identification improved the detection and profiling of qualitative and quantitative changes within a bacterial population. In this light, this review provides a comprehensive overview of the basic concepts and clinical applications of the respiratory microbiome, alongside an in-depth explanation of the molecular targets and the potential relationship between the respiratory microbiome and respiratory disease pathogenesis. The paucity of robust evidence supporting the correlation between the respiratory microbiome and disease pathogenesis is currently the main challenge for not considering the microbiome as a novel druggable target for therapeutic intervention. Therefore, further studies are needed, especially prospective studies, to identify other drivers of microbiome diversity and to better understand the changes in the lung microbiome along with the potential association with disease and medications. Thus, finding a therapeutic target and unfolding its clinical significance would be crucial.

The high proportion of 5-MTHF in the epidermis, which is further emphasized in subjects with a lower (10-20-nmol/L) serum folate status, points to a special role for this form of folate in skin, perhaps as a protectant from ultraviolet-induced photosensitization reactions. 5-MTHF may also maintain methylation reactions that influence the proliferative activity. These results may help to individualize the treatment of psoriasis patients with methotrexate and folate.

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Background: Pharmaceutical care (PC) services have expanded in recent years, resulting in improved patient outcomes. However, such PC services are currently available for free in the majority of Arabic countries. During the coronavirus disease (COVID-19) pandemic, telemedicine is especially beneficial since it allows for continuity of care while allowing for social distancing and minimizing the risk of infection. Objective: To assess the community’s attitude, opinion, and willingness to pay for telemedicine and PC services during COVID-19 pandemic, as well as to create a website provision for telemedicine and PC services. Methods: This cross-sectional study was conducted, over five months (December 2020– April 2021), among the general population in Arabic countries, excluding pharmacists, physicians, and pharmacy students. Results: A total of 1717 participants were involved, most of them were from Jordan (52.2%) and Iraq (24.8%). Sixty two percent of participants seek pharmacists’ advice whenever they have any medication changes and 45.1% of the participants agreed with the idea of paying pharmacists to decrease medication errors. Interestingly, 89.5% of participants encouraged the idea of creating a website that provides a PC, and 35.5% of them would pay for it. The failure to document the medical information of the patients had most applicants’ agreement as a reason of medical errors (M=4.17/5, SD=0.787). More than three-quarters of participants agreed that creating a database containing the patients’ medical information will reduce medical errors. Conclusion: From a patients’ perspective, this study suggests a large patient need for expanding PC services in Arabic countries and introduces a direct estimate of the monetary value for the PC services to contribute to higher savings. The majority of participants supported the idea of creating a website provision of telemedicine and PC services, and a considerable proportion of them agreed to pay for it.

Purpose: Outcomes investigating the effect of vitamin D3 (VD3) and omega-3 fatty acids (Omega-3FA) on serum estradiol (E2) are scarce and conflicting. No previous study has investigated the effect of VD3 combination with Omega-3FA on E2 levels. This study was designed to investigate the effect of VD3, Omega-3FA and VD3 plus Omega-3FA on serum E2 levels in premenopausal females diagnosed with vitamin D deficiency (VDD). Subjects and methods: This randomized, placebo-controlled clinical trial was designed to evaluate the effects of 50,000 IU VD3 taken weekly, 300 mg Omega-3FA taken daily and their combination by the study participants for 8 weeks. The mid-follicular serum levels of E2 and 25-hydroxy vitamin D (25OHD) were assessed at 8 weeks. The study was conducted during winter on a convenience sample of healthy premenopausal Jordanian females with diagnosed VDD. Fasting serum levels for 25OHD and E2 were assessed at baseline and the end of the trial (after 8 weeks). Data were entered into SPSS and analyzed. Results: Healthy premenopausal Jordanian females (N=86) with diagnosed VDD, mean age 32.8±8.9 years, were recruited into the study. Supplementation of VD3 alone resulted in a significant increase in serum 25OHD (13.4±7.9-28.2±7.1 ng/mL, P<0.001) and a significant decrease in E2 levels (85.7±16.5-60.3±20.6 pg/mL, P=0.001). Omega-3FA intake led to a significant decrease in serum 25OHD levels (21.2±12.8-13.6±9.2 ng/mL, P=0.001) and a significant increase in E2 levels (56.3±19.2-78.4±23.7 pg/mL, P=0.006). Combination therapy (VD3 plus Omega-3FA) resulted in a significant increase in both 25OHD (12.0±4.7-35.1±9.5 ng/mL, P<0.001) and E2 (43.0±23.4-57.3±31.5 pg/mL, P=0.028) levels. Conclusion: Results of this study provide vital insight into the effects of D3, Omega-3FA and a combination of their supplementation on premenopausal Jordanian females with diagnosed VDD. Eight weeks of therapy led to decreased E2 level by VD3 and increased level by Omega-3FA supplementation. With regard to 25OHD, its level was increased by VD3 and decreased by Omega-3FA supplementation. Combination of VD3 plus Omega-3FA increased the levels of both E2 and 25OHD. Trial registration: This trial was registered at clinicaltrials.gov as NCT03333564.