Marine life has provided mankind with unique and extraordinary chemical structures and scaffolds with potent biological activities. Many organisms and secondary metabolites derived from fungi and symbionts are found to be more environmentally friendly to study than the marine corals per se. Marine symbionts such as Aspergillus sp., a fungus, which can be isolated and grown in the lab would be a potential and continuous source of bioactive natural compounds without affecting the marine environment. The Red Sea is known for its biodiversity and is well-studied in terms of its marine-derived bioactive metabolites. The harsh environmental conditions lead to the development of unique metabolic pathways. This, in turn, results in enhanced synthesis and release of toxic and bioactive chemicals. Interestingly, the Persian Gulf and the Gulf of Oman carry a variety of environmental stresses, some of which are similar to the Red Sea. When compared to the Red Sea, the Persian Gulf has been shown to be rich in marine fungi as well, and is, therefore, expected to contain elaborate and interesting bioactive compounds. Such compounds may or may not be similar to the ones isolated from the Red Sea environment. Astoundingly, there are a very limited number of studies on the bioactive portfolio of marine-derived metabolites from the Persian Gulf and the Gulf of Oman. In this perspective, we are looking at the Red Sea as a comparator marine environment and bioactive materials repertoire to provide a futuristic perspective on the potential of the understudied and possibly overlooked bioactive metabolites derived from the marine life of the Persian Gulf and the Gulf of Oman despite its proven biodiversity and harsher environmental stress.

Objectives This study aimed to determine patient satisfaction with the following pharmacist-led services for inpatients in tertiary care hospitals. Methods Studies were identified from different databases from 2012 to 2020. A total of 1910 articles were identified using the search strategies out of which 1153 were rejected based on the review of titles and abstracts. The search criteria were the roles of inpatient pharmacists and patient satisfaction with inpatient pharmacy services. Multiple keywords were used such as ‘patient satisfaction’/‘inpatient pharmacist’/‘pharmacist hospital services’/‘clinical pharmacist roles’. The quality of each study was measured using the mixed methods appraisal tool, and the same was used to evaluate the risk of bias as well. Key findings A total of 11 cross-sectional studies were included in the evidence synthesis of this meta-analysis. Three studies tested the satisfaction of patients with inpatient counselling with a sample size of n = 742. The odd ratio (OR) was 215.33 (141.77 to 327.05) [95% confidence interval (CI)] showed a significant patient satisfaction (P = 0.00001) with the pharmacist’s inpatient counselling (I2 = 0%). Studies showed a statistically significant satisfaction of patients with discharge counselling P < 0.00001 and OR 55.74 (35.93 to 86.49) and heterogeneity I2 = 0%. In a total of five studies, the healthcare professional (HCP) satisfaction with pharmacist services was reported, and satisfied and unsatisfied HCPs were n = 801 and n = 362, respectively. Results showed high satisfaction (P < 0.00001) and OR 4.62 (95% CI, 3.89 to 5.48). Conclusion This meta-analysis concluded that clinical pharmacist services in an inpatient setting have a significant impact on increasing patient satisfaction with their treatment. The clinical pharmacist services are not very well implemented and are limited in some hospitals, but patients who have received these services were highly satisfied and expected to receive them more often.

The aims of the study were to evaluate the services of emergency medicine pharmacists in patient care and to assess the need to implement clinical pharmacy practice in emergency department. This study analyzed English language articles, which were identified and studied according to the inclusion criteria. The articles were identified from different databases from 1982 to 2020. Two hundred fifty articles were primarily searched for inclusion criteria and a preferred reporting items for systematic reviews and meta-analyses diagram was created to describe qualitative analysis. Quality assessment of the studies was done using the strengthening the reporting of observational studies in epidemiology checklist. A total of 9 studies were quality assessed and included for evidence synthesis. Four studies showed a significant reduction in readmission rate P < 0.0001 with an odds ratio (OR) of 1.6341 for the patients with the pharmacist care group. Patient's in-hospital mortality and appropriateness of medications had an OR of 3.2196 (P = 0.0353) and 0.1444 (P = 0.0001), respectively. The pooled OR (n = 1026) in 4 studies was 1.4534 (95% confidence interval = 0.2844–0.7292) in antibiotic guidelines for pharmacist interventions. In addition, evidence showed a statistically significant reduction in hospital revisits (P < 0.00001, OR = 2.05, 95% confidence interval = 1.76–2.39) with the pharmacist in the emergency department compared with no pharmacist. The meta-analysis concluded that clinical pharmacy interventions in the ambulatory setting had a positive impact on clinical outcomes related to disease management, medication optimization, ensuring patient safety, and providing quality of care. Studies identified did not evaluate the impact of pharmacists on cost-effectiveness, which is a useful direction for future study.