As expected, the pharmacists provided more general health advices compared with oral health advices. These results agree with the findings of a British study (Maunder and Landes, 2005). Similar to the findings of present study, other studies (Maunder and Landes, 2005; Amien et al., 2013; Bawazir, 2014) demonstrated that substantial number of pharmacists was approached for providing symptomatic relief for dental pain and oral ulcer. In addition, the clients frequently sought pyrilamine maleate cost pharmacists\’ advices (86%) for tooth whitening products. Only 10.8% of the clients sought advices for dental floss. This may reflect increasing interest in dental esthetics in KSA. On the contrary, Priya et al. observed no customer seeking advice for tooth whitening product in India (Priya et al., 2008).
Similar to the findings reported by Maunder and Landes (2005), majority of pharmacists (77.4%) in our study referred clients complaining of oral/dental pain to dentists. This high percentage of referral to dentists shows a good trend among the pharmacists that can reduce the possibility for misdiagnosis of oral problems and provision of appropriate dental treatment. Maunder and Landes (2005) also showed that one quarter of pharmacists (23.5%) referred clients to physicians and nearly all of them prescribed analgesics in case of oral pain. On the contrary, the present study found only 2.9% of pharmacists referring clients to physicians and 28% prescribed analgesics. This demonstrates increased awareness among pharmacists about the referral of their clients.
In contrast to the results acquired by Maunder and Landes (2005) which showed more than half of pharmacist recommended a dental product based on their personal experience; our study found only 2.2% of respondents used personal experience in prescribing a dental product. However, it was encouraging to see about half of respondents recommending dental product based on its knowledge and only few of them made their decision on the product advertisement. It is important to take into account that although the majority of the participating pharmacists recommended their clients to see a dentist in the nearest clinic, a few of them actually met any member of the dental clinic.
The study included a large random sample of pharmacists from all over the province in comparison with other studies which involved smaller sample of pharmacists collected from a single city (Maunder and Landes, 2005; Priya et al., 2008; Amien et al., 2013). This provided more representative sample and ensured better generalizability of our findings. Nevertheless, our results may not be generalized to the pharmacists working in the hospitals in the province because they were excluded from the study or to other regions of the country. The questionnaires were distributed and collected by dental students and this might raise the possibility for obsequiousness bias and subsequently affect the validity of the study to certain extent (Amien et al., 2013). The response rate was satisfactory. The reason for non-response included lack of time, having no interest in the study, resistance or hesitation due to breach of their confidentiality, and obtaining no prior permission from the administration of the pharmacies.
Conflict of interest
In the 19th century, the dermatologist Moritz Kaposi was the first to describe Kaposi Sarcoma (KS). KS was originally described as plaques affecting the lower limbs of elderly males with Jewish descents (Kaposi, 1872). According to the World Health Organization (WHO) classification of tumors update in 2002, KS has been moved to intermediate neoplasms (rarely metastasizing) (Fletcher et al., 2002).
Kaposi Sarcoma has been defined as “a multi-centric mucocutaneous neoplasm of endothelial origin” which is present in four clinical forms: classic, iatrogenic, endemic, and epidemic (Fatahzadeh et al., 2013). Classic KS is rare and mild with benign behavior. It has propensity for elderly males with Jewish and Mediterranean origins (Régnier-Rosencher et al., 2013; Ruocco et al., 2013). It is mainly cutaneous, but it can involve lymphatic and visceral organs in the respiratory and gastrointestinal tracts (Radu and Pantanowitz, 2013). In addition, association was found between classic KS and diabetes (Anderson et al., 2008).