The study aims to present recommendations for a revised Doctor of Pharmacy (Pharm-D) curriculum that aligns with regional needs and international standards of pharmacy education.

An exploratory qualitative study involving individual semistructured interviews. Data were collected and reported in accordance with Consolidated Criteria for Reporting of Qualitative Studies.

Face-to-face interviews were conducted in the respective offices of the experts and online interviews were conducted on Zoom and Google Meet.

Purposive and snowball sampling was used to recruit experts due to the eligibility criteria of including associate professors with a PhD, and snowball sampling facilitated the recruitment of experts from all provinces and internationally. Interviews were transcribed verbatim and data were analysed using an inductive thematic approach using NVivo V.15. All interviews were conducted in English.

The study engaged 49 experts from national and international settings with an age range of 25–60 years (median=43 years). The researchers came out with six themes and their subthemes from the data including: (a) understanding current Pharm-D curriculum in Pakistan, (b) inevitable changes required in the Pharm-D curriculum, (c) specific-subject based changes, (d) foundational steps to achieve the required changes, (e) barriers to the implementation of these changes and (f) impact of Pharm-D curriculum change.

The findings highlighted a clear need to revise the curriculum by incorporating enhanced clinical pharmacy content, integrated learning approaches, elective courses, interprofessional education, mandatory hospital and clinical placements, experiential learning through simulation-based methods and research components through a collaborative approach from policy makers and academic stakeholders.

Deep vein thrombosis (DVT) in critically ill patients is often undetected. However, it is unclear whether ultrasound surveillance for early detection of DVT in high-risk medical-surgical intensive care unit (ICU) patients improves patients’ outcomes. The DETECT trial (Diagnosing deep-vein thrombosis early in critically ill patients) evaluates the effect of twice-weekly bilateral lower limb ultrasound compared to usual care on 90-day mortality of critically ill adult patients admitted to medical, surgical and trauma ICUs.

The DETECT trial is an international, parallel-group, open-label, randomised trial, which will recruit 1800 critically ill adults from over 14 hospitals in Saudi Arabia and Kuwait. Eligible patients will be allocated to twice-weekly bilateral lower limb ultrasound or usual care. The primary outcome is 90-day mortality. Secondary outcomes include lower limb proximal DVT, pulmonary embolism and clinically important bleeding. The first patient was enrolled on 21 March 2023. As of 8 April 2025, 711 patients have been enrolled from 14 centres in Saudi Arabia and Kuwait. The first interim analysis was conducted on 14 May 2025. We expect to complete recruitment by December 2026.

Institutional review boards (IRBs) of each participating institution approved the study. We plan to publish the results in peer-reviewed journals and present the findings at international critical care conferences.

Clinicaltrials.gov: NCT05112705, registered on 9-11-2021.

To compare in-hospital and long-term outcomes between culprit-only percutaneous coronary intervention (PCI) and multivessel PCI in patients with acute myocardial infarction complicated by cardiogenic shock and multivessel coronary artery disease.

Retrospective subgroup analysis of the multicentre Gulf-Cardiogenic Shock registry.

13 tertiary care centres across six Gulf countries (Saudi Arabia, Qatar, Oman, UAE, Kuwait and Bahrain) between January 2020 and December 2022.

961 patients with angiographically confirmed multivessel coronary artery disease who underwent PCI were included from the Gulf-Cardiogenic Shock registry. Patients were divided into culprit-only PCI group (n=792, 82.4%) and multivessel PCI group (n=169, 17.6%). Patients with single-vessel disease were excluded.

Patients underwent either culprit-only PCI (intervention limited to the culprit artery) or multivessel PCI (immediate intervention to both culprit and non-culprit arteries during the same procedure).

The primary outcome was in-hospital all-cause mortality. Secondary outcomes included reinfarction, cerebrovascular accident, major and minor bleeding events, target lesion revascularisation, target vessel revascularisation, hospital stay duration and freedom from major adverse cardiac and cerebrovascular events (MACCEs) at 6 and 12 months.

Hospital mortality was comparable between multivessel PCI and culprit-only PCI groups (43.2% vs 46.1%; p=0.493). Freedom from MACCE rates at 6 and 12 months were 62% and 46% for multivessel PCI versus 70% and 49% for culprit-only PCI, respectively (log-rank p=0.711). Subgroup analysis revealed that culprit-only PCI was associated with increased hospital mortality in patients older than 70 years (OR 1.55, 95% CI: 1.01 to 2.39). Multivariable analysis of the interaction between revascularisation strategy and the subgroups revealed that culprit vessel revascularisation was associated with increased mortality in patients with left main disease (OR: 1.99 (95% CI: 1.22 to 3.27), p=0.006) and left anterior descending lesions (OR: 1.54 (95% CI: 1.06 to 2.25), p=0.025).

No statistically significant differences in hospital mortality or long-term MACCE-free survival were observed between culprit-only PCI and multivessel PCI strategies in patients with cardiogenic shock complicating acute myocardial infarction. However, patients older than 70 years may benefit from a multivessel PCI approach. These findings support current guideline recommendations favouring culprit-only PCI due to reduced procedural complexity while highlighting the need for individualised treatment strategies based on patient age and clinical factors. Further prospective randomised studies are needed to validate these age-specific findings and identify optimal patient selection criteria for each revascularisation strategy.