Clinical and Pharmaceutical Sciences Journal

Exploring Antibiotic Use and Stewardship Awareness Among Turkish University Students

Faiz Ullah Khan — 2026-07-01

Antimicrobial resistance (AMR) is a global health threat driven by the misuse of antibiotics. Understanding students’ knowledge is vital for strengthening antimicrobial stewardship (AMS); however, gaps remain across disciplines. This study aimed to explore undergraduate students’ knowledge, attitudes, and practices regarding antibiotics, antimicrobial resistance (AMR), and antimicrobial stewardship (AMS). A qualitative study design was employed, involving face-to-face, semi-structured interviews with students from various faculties, conducted between May and July 2022. A total of 50 students from four different faculties were included in the study, and the data were analyzed using NVivo for thematic analysis. An inductive thematic analysis approach was utilized to identify key themes, subthemes, and categories. A total of 50 participants were interviewed: medicine (n = 15), nursing (n = 13), pharmacy (n = 12), and dentistry (n = 10), with a mean interview duration of 17 minutes. The majority were male (n = 30; 60%), and most participants were between 18 and 22 years of age (n = 28; 56%). While most participants demonstrated a basic understanding of the term “antibiotic,” many lacked detailed knowledge regarding its appropriate use, including correct selection and duration of therapy. Notably, students from the nursing faculty exhibited lower levels of awareness regarding antibiotic resistance and safe antibiotic use, whereas students from the medical faculty demonstrated comparatively greater understanding. In conclusion, the findings highlight a moderate level of knowledge and awareness across all faculties regarding antibiotic use and resistance. These results emphasize the need for targeted educational interventions to improve undergraduate students’ understanding of antimicrobial stewardship principles, particularly among nursing students, and to enhance their engagement with AMS practices.

Development and Stability Evaluation of an Aromatherapy Roll-On Containing Lily (Lilium auratum) Essential Oil

Muhammad Ma'ruf — 2026-07-01

Aromatherapy is a complementary approach that utilizes essential oils for fragrance-based applications and the promotion of well-being. Lily (Lilium auratum) flowers are known to contain essential oils with a distinctive calming aroma, making them a potential active ingredient for aromatherapy formulations. This study aimed to formulate and evaluate aromatherapy roll-on preparations containing lily essential oil at concentrations of 0% (F0), 5% (F1), 10% (F2), and 15% (F3). The study involved several stages, including quality characterization of lily essential oil according to the Indonesian National Standard (SNI 06-4267-1996), covering organoleptic properties, specific gravity, refractive index, solubility, and acid value. Chemical constituents were analyzed using gas chromatography–mass spectrometry (GC–MS), followed by formulation and physical stability evaluation of the roll-on preparations over 28 days of storage. The quality assessment demonstrated that all evaluated parameters met the established standards. The essential oil exhibited a clear yellowish appearance, a characteristic floral aroma, a specific gravity of 1.049, a refractive index of 1.531, an ethanol solubility ratio of 1:2, and an acid value of 0.967, indicating good purity and stability. GC–MS analysis identified five major constituents: heneicosane (24.6%), pentadecane (18.5%), heptadecane (9.3%), hexadecane (8.9%), and 8-heptadecene (7.1%), which contribute to the characteristic aroma profile of the essential oil. Physical evaluation showed that all formulations remained stable throughout the storage period, with viscosity values ranging from 2.8 to 4.6 cP and pH values ranging from 6.5 to 7.0. Hedonic testing revealed that increasing concentrations of lily essential oil improved panelists’ preferences regarding aroma, color, and overall appearance, with the highest scores recorded for F3 (aroma: 4.95; color: 4.85; appearance: 4.80). In conclusion, lily essential oil shows considerable potential as a natural ingredient for aromatherapy roll-on formulations due to its satisfactory physicochemical characteristics, formulation stability, and favorable hedonic acceptance.

Diaphragmatic Dysfunction across the COPD Continuum: From Pathophysiology to Rehabilitation and Mechanical Ventilation

Marwa Eleawa — 2026-07-01

Chronic obstructive pulmonary disease (COPD) remains a leading cause of morbidity and mortality worldwide, frequently diagnosed at advanced stages and often accompanied by significant extrapulmonary complications. Amongst these, diaphragmatic dysfunction plays a central yet often underrecognized role in disease progression, respiratory failure, and poor clinical outcomes. This review synthesises current evidence on diaphragmatic dysfunction in COPD and mechanically ventilated (MV) patients, evaluates diagnostic techniques, and explores therapeutic interventions, particularly pulmonary rehabilitation. A structured literature search of PubMed, Scopus, and Web of Science was conducted between January 2000 and March 2026. Two independent reviewers screened titles, abstracts, and full texts against predefined eligibility criteria. Studies addressing diaphragmatic dysfunction in patients with COPD or MV were included. Findings were synthesised narratively and supplemented by the GOLD 2026 report. No formal risk of bias assessment was performed, consistent with narrative review methodology. Diaphragmatic dysfunction in COPD is characterised by muscle fibre atrophy, fibre-type shifting, hyperinflation-induced shortening, and reduced force-generating capacity, leading to dyspnea, respiratory failure, and increased mortality. Diagnostic approaches include transdiaphragmatic pressure measurement (gold standard), ultrasound, chest radiography, computed tomography (CT), Magnetic resonance imaging (MRI), and fluoroscopy. Pulmonary rehabilitation improves diaphragmatic strength, exercise tolerance, dyspnea, and quality of life. GOLD 2026 supports home-based and tele-rehabilitation as effective alternatives to centre-based programs. However, significant barriers persist, including underdiagnosis, insufficient funding, limited provider awareness, and inequitable access to rehabilitation services. Diaphragmatic dysfunction is an important yet underdiagnosed complication of COPD and MV. Early recognition using appropriate diagnostic tools, combined with targeted rehabilitation, can improve functional outcomes. Future research should optimise stimulation techniques, standardise tele-rehabilitation protocols, and expand evidence to post-exacerbation and multimorbid populations.

Patient Characteristics, Treatment Patterns, and Their Association with Length of Hospital Stay and Clinical Outcomes among Hospitalized COVID-19 Patients in West Kalimantan, Indonesia

Andriana Sari — 2026-07-01

Artificial Intelligence in Eating Disorders: A Narrative Review of Detection, Digital Interventions, and Implementation Challenges

Marwa Eleawa — 2026-07-01

Eating disorders (EDs) are severe psychiatric conditions with rising prevalence, yet access to specialised care remains limited due to resource-intensive assessments. This narrative review critically evaluates the evidence for AI-driven detection and intervention, discusses the significant barriers to real-world deployment, and outlines future directions for the safe, equitable, and effective integration of these powerful tools into clinical practice for individuals with EDs. A systematic search of PubMed, PsycINFO, Scopus, IEEE Xplore, and Google Scholar (inception–March 2026) identified 43 peer-reviewed English-language articles, including original studies, systematic reviews, and policy reports. Data were thematically synthesised across four domains: (1) AI-based screening/risk prediction, (2) comorbidity detection, (3) digital interventions, and (4) ethical/implementation challenges. AI shows promise in early ED screening through electronic health records, linguistic analysis, and social media data. However, detection of psychiatric comorbidities such as depression, anxiety, and obsessive-compulsive disorder remains variable and requires further validation. Chatbot-assisted interventions and smartphone-based monitoring are emerging as scalable tools for symptom tracking and delivering cognitive-behavioural content, potentially improving care continuity. Major implementation barriers persist, including data privacy concerns, algorithmic transparency issues, and low clinician acceptance due to liability fears, lack of interpretability, and poor workflow integration. AI holds considerable potential to enhance ED care through earlier detection and expanded access to digital interventions. Realising this potential requires rigorous prospective validation, clear ethical guidelines, and collaborative frameworks involving clinicians in AI design and oversight to ensure these tools complement, not replace, clinical judgment.