Publications by authors named "Muhammad Umair Khan"

65 Publications

Adverse Drug Reaction Reporting and Prescribing Trends of Drugs for Attention Deficit Hyperactivity Disorder in Primary Care England, 2010-2019.

J Atten Disord 2021 Mar 5:1087054721997556. Epub 2021 Mar 5.

Ziauddin University, Karachi, Pakistan.

Objective: We investigated the prescription trends and adverse drug reactions (ADRs) of ADHD drugs in primary care, England between 2010 and 2019.

Methods: The Prescription Cost Analysis database presenting the primary care prescriptions data and the Interactive Drug Analysis Profiles presenting all suspected ADRs reported for each drug were screened. The data were analyzed using linear regression analysis to examine the annual average change per year.

Results: The prescription items dispensed for ADHD showed an average 11.07% (95% CI 10.54-11.60,  = .001) increase per year and there was a mean 11.54% (95% CI 11.03-12.06,  = .001) increase per year in the costs. The overall reporting of serious and fatal ADR was reduced by 1.79% per year for ADHD drugs. Guanfacine showed a 40% mean increase per year.

Conclusion: The increasing use of ADHD drugs within primary care in England could be a result of multiple factors such as growing ADHD prevalence.
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http://dx.doi.org/10.1177/1087054721997556DOI Listing
March 2021

Frequency of Blood Transfusion in Percutaneous Nephrolithotomy.

Cureus 2020 Oct 21;12(10):e11086. Epub 2020 Oct 21.

Internal Medicine, Services Institute of Medical Services, Lahore, PAK.

Introduction Percutaneous nephrolithotomy (PNL) has replaced open surgery for the treatment of kidney stones due to its less invasive nature. Bleeding still occurs due to renal vascular injuries, dependent upon the access route of the procedure. Several other factors are also related to the increased risk of bleeding. This study aims to find the association between blood transfusion and other factors such as age, gender, body mass index (BMI), size of the stone, operative time, preoperative hemoglobin (Hb) level, stone surface area, hypertension, and diabetes mellitus. Materials and methods This was a descriptive cross-sectional study conducted over a period of six months between November 2019 and April 2020 at a tertiary care hospital in Karachi, Pakistan. The sample size of 131 patients was calculated using open-source epidemiological software (Open-Epi). Inclusion criteria included patients from both genders and ages between 26 and 70 years. Patients ≤25 years, having a liver disease or bleeding disorders, or refusing to participate in the study, were excluded. Laboratory data included preoperative routine complete blood count, serum creatinine (normal 0.5-1.5 mg/dL), platelet count, bleeding and coagulation profile, and urine culture. All patients also underwent renal ultrasound scans. Treatment was postponed until a negative urine culture was obtained from patients with a positive urine culture.  Results The mean age of the patients was 42.4 ± 15.65 years. One third (29.8%) of the patients were females. The stone size was 850 ± 121.43 mm², the mean operative time of the procedure was 125.76 ± 53.4 minutes, and the mean number of cell packs transfused was 1.10 ± 0.31 units. Blood transfusion was done in 24 (18.3%) of the patients. Gender, diabetes mellitus, stone size, preoperative Hb level, and operative time were significantly related to blood transfusion.  Conclusions Increased bleeding risk while performing PNL has been associated with many factors such as operating time, the gender of the patients, and stone size. Therefore, these factors should be controlled for the procedure to decrease the risk of bleeding and the need for blood transfusion. Furthermore, the kidney vasculature should not be compromised while performing the procedure.
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http://dx.doi.org/10.7759/cureus.11086DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7678882PMC
October 2020

Inkjet printed self-healable strain sensor based on graphene and magnetic iron oxide nano-composite on engineered polyurethane substrate.

Sci Rep 2020 Oct 26;10(1):18234. Epub 2020 Oct 26.

Centre for Advanced Electronics and Photovoltaic Engineering (CAEPE), International Islamic University, H-10, Islamabad, 44000, Pakistan.

In recent years, self-healing property has getting tremendous attention in the future wearable electronic. This paper proposes a novel cut-able and highly stretchable strain sensor utilizing a self-healing function from magnetic force of magnetic iron oxide and graphene nano-composite on an engineered self-healable polyurethane substrate through commercialized inkjet printer DMP-3000. Inducing the magnetic property, magnetic iron oxide is applied to connect between graphene flacks in the nano-composite. To find the best nano-composite, the optimum graphene and magnetic iron oxide blending ratio is 1:1. The proposed sensor shows a high mechanical fracture recovery, sensitivity towards strain, and excellent self-healing property. The proposed devices maintain their performance over 10,000 times bending/relaxing cycles, and 94% of their function are recovered even after cutting them. The device also demonstrates stretchability up to 54.5% and a stretching factor is decreased down to 32.5% after cutting them. The gauge factor of the device is 271.4 at 35%, which means its sensitivity is good. Hence, these results may open a new opportunity towards the design and fabrication of future self-healing wearable strain sensors and their applied electronic devices.
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http://dx.doi.org/10.1038/s41598-020-75175-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7589529PMC
October 2020

Cavitary pulmonary tuberculosis with COVID-19 coinfection.

IDCases 2020 28;22:e00973. Epub 2020 Sep 28.

Department of Medicine, Hamad Medical Corporation, Doha, Qatar.

The COVID-19 pandemic has strained the healthcare system worldwide, leading to an approach favoring judicious resource allocation. A focus on resource preservation can result in anchoring bias and missed concurrent diagnosis. Coinfection (TB) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has implications beyond morbidity at the individual level and can lead to unintended TB exposure to others. We present six cases of COVID-19 with newly diagnosed cavitating pulmonary tuberculosis to highlight the significance of this phenomenon and favorable outcomes if recognized early.
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http://dx.doi.org/10.1016/j.idcr.2020.e00973DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7521360PMC
September 2020

Hepatitis c virus and chronic kidney disease.

Expert Rev Gastroenterol Hepatol 2020 Jul 2;14(7):579-590. Epub 2020 Jul 2.

Weill Cornell Medical College , New York, Qatar.

Introduction: Hepatitis C virus (HCV) infection is associated with an increased incidence and progression of chronic kidney disease (CKD), as well as higher mortality in CKD and renal transplant patients. Direct acting antiviral agents (DAAs) have revolutionized the treatment of HCV, with viral eradication attained in 90-100% of treated patients. DAAs have an excellent safety and tolerability profile in CKD and renal transplant patients.

Areas Covered: In this review, we discuss the association of HCV with incidence and progression of CKD as well as its effect on outcomes and mortality. We also discuss the available treatment options in patients with CKD and renal transplant and in HCV-associated glomerular disease.

Expert Opinion: The availability of newly available direct acting anti-viral agents has revolutionized the treatment of HCV in persons with advanced CKD and undergoing dialysis. With these regimens, viral eradication can be attained in 90-100% of the treated patients. The safety, tolerability, and efficacy of these drugs in renal transplant patients have also made it possible to use HCV-infected grafts and successful virus eradication at a later stage.
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http://dx.doi.org/10.1080/17474124.2020.1776111DOI Listing
July 2020

Printable Highly Stable and Superfast Humidity Sensor Based on Two Dimensional Molybdenum Diselenide.

Sci Rep 2020 Mar 26;10(1):5509. Epub 2020 Mar 26.

National University of Computer & Emerging Sciences (NUCES), Islamabad, Pakistan.

Transition metal dichalcogenides (TMDCs) are promising materials for sensing applications, due to their exceptional high performance in nano-electronics. Inherentely, the chemical and thermal responses of TMDCs are highly stable, hence, they pave way for real time sensor applications. This article proposes inceptively a stable and superfast humidity sensor using two-dimensional (2D) Molybdenum diselenide (MoSe) through printed technlogies. The 2D MoSe ink is synthesized through wet grinding to achieve few-layered nano-flakes. Inter digital electrodes (IDEs) are fabricated via screen-printing on Polyethylene terephthalate (PET) substrate and thin film of MoSe nano-flakes is fabricated through spin coating. The impedance and capacitance response are recorded at 1 kHz between temperature levels ranging from 20-30 °C. The impedance and capacitance hysteresis results are recorded <1.98% and <2.36%, respectively, ensuring very good repeatability during humidification and dehumidification. The stability of impedance and capacitance response are recorded with maximum error rate of ~ 0.162% and ~ 0.183%, respectively. The proposed sensor shows fast impedance response time (T) of ~ 0.96 s, and recovery time (T) of ~ 1.03 s, which has T of ~ 1.87 s, and T of ~ 2.13 s for capacitance. It is aimed to develop a high performance and stable humidity sensor for various monitoring applications.
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http://dx.doi.org/10.1038/s41598-020-62397-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7099085PMC
March 2020

The use of discrete choice experiments in adherence research: A new solution to an old problem.

Res Social Adm Pharm 2020 Oct 21;16(10):1487-1492. Epub 2020 Feb 21.

Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia. Electronic address:

Theory can play an important role in providing the framework, and underpinning the design and implementation of interventions to improve medication adherence. Interventions that are grounded in a theory are relatively more effective in improving medication adherence than interventions which do not have a theoretical support. However, a large body of adherence research does not appear to be linked to any theory or model, which therefore may have resulted in interventions that are either ineffective or not sustainable. Interventions that are based on theory have mainly employed socio-behavioural models to explain, and design interventions to address, the complex phenomenon of adherence. Yet, the effectiveness of these interventions is inconclusive, supporting the argument that socio-behavioural models alone have limited applicability in explaining behaviour associated with medication-taking. An important reason for this limitation may be the complex and dynamic nature of adherence. There is a need to include a wide variety of factors in a model and examine adherence in the context of its three phases (initiation, implementation, and discontinuation). One possible way forward is to also examine medication-taking behaviour from an economic perspective, for example, by using a discrete choice experiment (DCE), which provides a different approach to understanding human behaviour about medication-taking and the complexities of decision-making in adhering to medication. DCEs can help in understanding how patients decide to initiate, continue or discontinue taking medication, factors that influence their decision, and the relative importance of those factors, which can assist researchers to prioritise interventions to improve medication adherence. Integration of multiple theories is needed to examine adherence from multiple perspectives and design interventions that are effective and sustainable. This commentary focusses on the pros and cons of some of the commonly used socio-behavioural models in adherence research and suggests a way forward by incorporating DCEs in adherence research.
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http://dx.doi.org/10.1016/j.sapharm.2020.02.013DOI Listing
October 2020

Exploring factors influencing initiation, implementation and discontinuation of medications in adults with ADHD.

Health Expect 2020 Feb 7. Epub 2020 Feb 7.

The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia.

Background: Adherence to ADHD medication is a complex phenomenon as the decision to adhere is influenced by a range of factors. To design tailored interventions to promote adherence, it is important to understand the factors that influence adherence in the context of its three phases: initiation, implementation and discontinuation.

Objective: The objective of this study was to explore the phase-specific factors that influence adherence to medication in adults who have a diagnosis of ADHD.

Methods: Three focus groups (FGs) were conducted with twenty adults with ADHD in different metropolitan areas of Sydney, Australia. FGs were transcribed verbatim and thematically analysed.

Results: Participants' decision to initiate medication (the initiation phase) was influenced by their perceived needs (desire to improve academic and social functioning) and concerns (fear of side-effects) about medication following a similar process as defined by the Necessity-Concerns Framework (NCF). The balance between benefits of medication (needs) and side-effects (concerns) continued to determine participants' daily medication-taking (the implementation phase) and persistence (or discontinuation) with their medication. Forgetfulness and stigma were reported as concerns negatively impacting the implementation phase, while medication cost and dependence influenced the discontinuation phase of adherence.

Conclusions: Adults' decision to initiate, continue or discontinue medication is influenced by a range of factors; some are unique to each phase while some are common across the phases. Participants balanced the needs for the medication against their concerns in determining whether to adhere to medication at each phase. It appears that the NCF has applicability when decision making about medication is explored at the three phases of adherence.
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http://dx.doi.org/10.1111/hex.13031DOI Listing
February 2020

Exploring Factors Influencing Medication Adherence From Initiation to Discontinuation in Parents and Adolescents With Attention Deficit Hyperactivity Disorder.

Clin Pediatr (Phila) 2020 03 24;59(3):285-296. Epub 2020 Jan 24.

The University of Sydney, Camperdown, New South Wales, Australia.

This study explored factors influencing parents' and adolescents' decisions to initiate, continue, and discontinue medication for attention deficit hyperactivity disorder (ADHD). Three focus groups were conducted with parents (n = 23) of children with ADHD, and 2 with adolescents diagnosed with ADHD (n = 11). Parents and adolescents independently discussed the complexities surrounding their decisions to adhere to ADHD medication. Parents' negative beliefs about medication (fear of side effects) discouraged them from initiating therapy. Once initiated, parents struggled in balancing the need to medicate (improvements in learning and behavior) and concerns (weight loss, perceived delayed development) about the medication. Parents who had more concerns about the medication were more in favor of discontinuation. For adolescents, the desire for self-expression without being medicated was the primary factor determining nonadherence and/or discontinuation of the medication. Adolescents' medication-related concerns were relatively different from the parents. Phase- and group-specific interventions are required to improve medication adherence in people with ADHD.
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http://dx.doi.org/10.1177/0009922819900973DOI Listing
March 2020

Reduction of radiation exposure to operating physician and assistant using a real-time auditory feedback dosimeter during femoral artery puncturing: a study on swine model.

Eur Radiol Exp 2019 09 23;3(1):38. Epub 2019 Sep 23.

Department of Electronic Systems Engineering, Hanyang University, 55 Hanyangdeahak-ro, Sangnok-gu, Ansan, Gyeonggi-do, 15588, South Korea.

Background: Real-time dosimeters may create a relatively safer environment not only for the patient but also for the physician and the assistant as well. We propose the use of a real-time radiation measurement dosimeter having auditory feedback to reduce radiation exposure.

Methods: Radiation dose rates were measured for 30 fluoroscopy-guided puncturing procedures of femoral arteries in swine. Fifteen puncturing procedures were performed with real-time radiation measurement dosimeter having auditory feedback and other 15 were performed without auditory feedback dosimeter by an interventional cardiologist with 10 years of experience.

Results: The left body side of the operating physician (38%, p < 0.001) and assistant (25%, p < 0.001) was more exposed as compared to the right body side. Radiation dose rate to the left hand, left arm and left leg were reduced from 0.96 ± 0.10 to 0.79 ± 0.12 mSv/h (17% reduction, p < 0.001), from 0.11 ± 0.02 to 0.07 ± 0.01 mSv/h (36% reduction, p < 0.001) and from 0.22 ± 0.06 to 0.15 ± 0.02 mSv/h (31% reduction, p < 0.001) with the use of auditory feedback dosimeter, respectively. The mean fluoroscopic time was reduced from 4.8 ± 0.43 min to 4.2 ± 0.53 min (p < 0.001). The success rate of performing arterial puncturing was 100%.

Conclusions: The use of auditory feedback dosimeter resulted in reduction in effective dose. The sound beep alerted the physician from the danger of exposure, and this approach induced awareness and protective mindset to the operating physician and assistant.
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http://dx.doi.org/10.1186/s41747-019-0116-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6757085PMC
September 2019

A review of measures used to examine medication adherence in people with ADHD at initiation, implementation and discontinuation of pharmacotherapy.

Res Social Adm Pharm 2020 Mar 6;16(3):277-289. Epub 2019 Jun 6.

The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia.

Background: Adherence to prescribed medication is a dynamic process that changes over time. Whilst several measures have been used to examine adherence in patients with ADHD, it is not clear how these measures have been used to measure adherence in the context of its three phases (initiation, implementation, discontinuation).

Objective: To examine measures used to assess medication adherence at its three phases in people with ADHD.

Methods: The PRISMA guidelines were followed for this review. Six databases (Medline, PubMed, IPA, CINAHL, Embase, and PsycINFO) were systematically searched in October 2018, without any limitations on the start dates. Keywords reflecting three broad concepts (adherence, ADHD and measures) were used as part of the search strategy. Studies that assessed medication adherence in people with ADHD and described methods used to assess adherence were selected for this review.

Results: Forty-nine studies were included. Most (69.3%) examined adherence at the implementation phase. Claims databases, self-reported questionnaires, and prescription-refill records were used to measure adherence at the initiation, implementation, and discontinuation phase, respectively. Overall, self-reported questionnaires were the most frequently used measure at the implementation phase, but the psychometric properties were not reported in almost half of the studies that used these measures.

Conclusions: Initiation and discontinuation phases of adherence have been relatively less examined in people with ADHD. Although self-reported questionnaires were the commonly used measures, the validity and reliability of these measures are of concern in guiding evidence-based practice. Measures with improved psychometric properties are needed that can examine adherence across its three phases.
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http://dx.doi.org/10.1016/j.sapharm.2019.06.001DOI Listing
March 2020

Reduction of operator radiation exposure using a passive robotic device during fluoroscopy-guided arterial puncture: an experimental study in a swine model.

Eur Radiol Exp 2019 05 29;3(1):20. Epub 2019 May 29.

Department of Electronic Systems Engineering, Hanyang University, 55 Hanyangdeahak-ro, Sangnok-gu, Ansan, 15588, Gyeonggi-do, South Korea.

Background: Vascular interventions imply radiation exposure to the operating physician (OP). To reduce radiation exposure, we propose a novel passive robotic device for fluoroscopy-guided arterial puncturing.

Methods: X-ray dose rates were measured for a total of 30 fluoroscopy-guided puncture femoral arteries in 15 pigs. Fifteen punctures were performed with the device while the other 15 were performed without the device by an interventional cardiologist with 10 years of experience. Parametric t test was used.

Results: The success rate with the device was 100%. Overall, the OP received more radiation (0.41 mSv/h) as compared to the assistant (0.06 mSv/h) (p <  0.001) and, amongst OP's body parts, hands received more radiation than other body parts (p <  0.001). The radiation dose rate to the OP's hands during arterial puncturing performed manually without the device was 0.95 ± 0.25 mSv/h whereas it was 0.14 ± 0.006 mSv/h using the device, resulting in an 85% reduction (p <  0.001). For the head, the dose was reduced from 0.16 mSv/h to 0.08 mSv/h (50% reduction, p <  0.001), and for the dominant arm, from 0.12 mSv/h to 0.07 mSv/h (42% reduction, p <  0.001). The fluoroscopy time was reduced from 4.5 ± 0.15 min to 4.3 ± 0.11 min device (p = 0.002).

Conclusions: In a swine model, fluoroscopy time and radiation exposure for the OP puncturing femoral artery were significantly reduced by using the passive robotic device.
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http://dx.doi.org/10.1186/s41747-019-0098-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6541679PMC
May 2019

A Review of Factors Influencing the Three Phases of Medication Adherence in People with Attention-Deficit/Hyperactivity Disorder.

J Child Adolesc Psychopharmacol 2019 08 23;29(6):398-418. Epub 2019 May 23.

Faculty of Medicine and Health, The University of Sydney School of Pharmacy, The University of Sydney, Camperdown, Australia.

Factors affecting adherence to medications in people with attention-deficit/hyperactivity disorder (ADHD) are not well understood in the context of their influence on the different phases of adherence, that is, initiation, implementation, and discontinuation. This review aimed to identify the factors affecting the three phases of medication adherence in people with ADHD. Six electronic databases, including Medline, PubMed, IPA, CINAHL, Embase, and PsycINFO, were systematically searched from inception through October 2018 with the limitations of English language and human studies. The search strategy was based on three concepts (adherence, ADHD, and factors) and their relevant terminologies. Considerable variability was observed with regards to the criteria used to define adherence in identified studies ( = 48). Most studies focused on the implementation phase of adherence ( = 27), while only a handful focused on the initiation ( = 6) and discontinuation ( = 5) phase of adherence. The remaining studies ( = 10) examined multiple phases of adherence. Conflicting information received about medication, medication frequency, and fears of medication's effect on growth were the unique factors impacting initiation, implementation, and discontinuation, respectively. Moreover, factors within each phase of adherence also differed with different populations such as parents, children, adolescents, and adults. Fear of addiction, medication effectiveness, psychiatric comorbidity, and medication side effects were the most common factors identified in all three phases of adherence. This review found some unique factors in each phase of adherence while some overlap was also noted. Future interventions to improve adherence should be phase- and group specific rather than consider adherence as a single variable.
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http://dx.doi.org/10.1089/cap.2018.0153DOI Listing
August 2019

Bio-compatible organic humidity sensor based on natural inner egg shell membrane with multilayer crosslinked fiber structure.

Sci Rep 2019 04 9;9(1):5824. Epub 2019 Apr 9.

Department of Ocean System Engineering, Jeju National University, 102 Jejudaehakro, Jeju, 63243, Republic of Korea.

In this paper, we propose a novel bio-compatible organic humidity sensor based on natural inner egg shell membrane (IESM) with multilayer cross linked fiber structure that can be used as a substrate as well as a sensing active layer. To fabricate the proposed sensors, two different size inter digital electrodes (IDEs) with 10 mm × 4 mm for sensor 1 and 12 mm × 6 mm for sensor 2 are printed on the surface of the IESM through Fujifilm Dimatix DMP 3000 inkjet material printing setup, which have finger width of 100 μm and space of 100 μm. The fabricated sensors stably operates in a relative humidity (RH) range between 0% RH to 90% RH, and its output impedance and capacitance response are recorded at 1 kHz and 10 kHz. The response time (T) and recovery time (T) of sensor 1 are detected as ~1.99 sec and ~8.76 sec, respectively and the T and T of sensor 2 are recorded as ~2.32 sec and ~9.21 sec, respectively. As the IESM for the humidity sensor, the natural materials can be implemented in our daily life as they open a new gate way for bio-compatible devices.
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http://dx.doi.org/10.1038/s41598-019-42337-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6456733PMC
April 2019

The need for a paradigm shift in adherence research: The case of ADHD.

Res Social Adm Pharm 2019 03 30;15(3):318-320. Epub 2018 Apr 30.

Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia. Electronic address:

Nonadherence to long-term medications attenuates optimum health outcomes. There is an abundance of research on measuring and identifying factors affecting medication adherence in a range of chronic medical conditions. However, there is a lack of standardisation in adherence research, namely in the methods and measures used. In the case of attention deficit hyperactivity disorder, this lack of standardisation makes it difficult to compare and combine findings and to draw meaningful conclusions. Standardisation should commence with a universally accepted categorisation or taxonomy of adherence which takes into consideration the dynamic nature of medication-taking. This should then be followed by the use of valid and reliable measures of adherence which can accurately quantify adherence at any of its phases, and provide useful information which can be utilised in planning targeted interventions to improve adherence throughout the patient medication-taking journey.
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http://dx.doi.org/10.1016/j.sapharm.2018.04.033DOI Listing
March 2019

Antimicrobial resistance in India.

J Pharm Policy Pract 2017 5;10:27. Epub 2017 Sep 5.

Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia.

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http://dx.doi.org/10.1186/s40545-017-0118-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5585895PMC
September 2017

Patient inaccessibility to antifungal drugs in developing nations: The case of Pakistan.

Res Social Adm Pharm 2017 Nov 27;13(6):1218. Epub 2017 Jul 27.

Department of Pharmacy, University of Huddersfield, HD1 3DH, United Kingdom.

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http://dx.doi.org/10.1016/j.sapharm.2017.07.010DOI Listing
November 2017

Pharmaceutical waste and antimicrobial resistance.

Lancet Infect Dis 2017 06;17(6):578-579

Department of Pharmacy, University of Huddersfield, UK.

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http://dx.doi.org/10.1016/S1473-3099(17)30268-2DOI Listing
June 2017

Healthcare Professionals' Awareness, Knowledge, Attitudes, Perceptions and Beliefs about Ebola at Gondar University Hospital, Northwest Ethiopia: A Cross-sectional Study.

J Public Health Afr 2016 Dec 31;7(2):570. Epub 2016 Dec 31.

Department of Clinical Pharmacy, University of Gondar-College of Medicine and Health Sciences, School of Pharmacy , Gondar, Ethiopia.

A poor understanding of Ebola Virus Disease (EVD) among Health Care Professionals (HCPs) may put our lives at risk. We aimed to assess the awareness, knowledge, attitudes, perceptions, beliefs of HCPs towards Ebola at Gondar University Hospital (GUH) in Northwest Ethiopia. We conducted a hospital based, cross-sectional survey among 245 randomly selected HCPs working at GUH from August-October, 2015. A validated, self-administered questionnaire was used to collect the data. We calculated descriptive statistics with P<0.05 being statistically significant. Of the 245 participants, 211 (86.1%) completed the study. The majority had heard about EVD and used news media (62%) as a source of information. Still, many were afraid of getting EVD (56.4%; P=0.001). A significant number of HCPs thought EVD can cause paralysis like polio (45%) and can be treated with antibiotics (28.4%). In addition, 46.4% of the HCPs felt anger or fear towards Ebola infected patients (P=0.006). We identified poor knowledge and negative incorrect beliefs among doctors and allied health professionals. There is a need for intensive training for all HCPs reduce EVD risk.
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http://dx.doi.org/10.4081/jphia.2016.570DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5345406PMC
December 2016

A cross-sectional survey on the attitudes and interests of rural population towards expanded pharmacist prescribing in India.

Int J Clin Pharm 2017 Apr 4;39(2):473-477. Epub 2017 Mar 4.

Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Pinang, Malaysia.

Background Shortage of qualified medical doctors and little or no access to basic medicines and medical facilities are the major rural health concerns in India. Expanding the role of pharmacists to provide prescribing services could improve rural health outcomes. Objective To assess the attitudes of rural population towards pharmacist prescribing and their interest in using expanded pharmacist prescribing services. Setting Rural population of Assam, India. Methods A descriptive, cross-sectional survey was conducted for a period of 2 months from March to April 2016 in the State of Assam, India. A multi-stage sampling was used to recruit (n = 410) eligible participants. Main outcome measure Rural population attitudes towards, and interests in using, pharmacist prescribing services. Results The attitudes of participants were generally positive towards pharmacist prescribing. A large proportion of participants (81.5%) agreed that pharmacists should have a prescribing role in rural India. Participants indicated their interest in using expanded pharmacist prescribing services, with greater interests in receiving medications in emergency situations (79.7%) and getting a treatment plan for their medical problem (75.6%). Participants with low income and tertiary education had better attitudes and showed more interest towards expanded pharmacist prescribing services (p < 0.05). Conclusions Most participants had positive attitudes towards pharmacist prescribing and were interested in using expanded pharmacist prescribing services.
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http://dx.doi.org/10.1007/s11096-017-0443-5DOI Listing
April 2017

Prescription patterns and appropriateness of antibiotics in the management of cough/cold and diarrhea in a rural tertiary care teaching hospital.

J Pharm Bioallied Sci 2016 Oct-Dec;8(4):335-340

Department of Pharmacy Practice, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago.

Background: Acute gastroenteritis and respiratory illnesses are the major causes of morbidity and mortality in children under 5 years of age. The objective of this study was to evaluate the prescription pattern of antibiotic utilization during the treatment of cough/cold and/or diarrhea in pediatric patients.

Methods: A descriptive, cross-sectional study was conducted for 6 months in pediatric units of a tertiary care hospital in South India. Children under 5 years of age presenting with illness related to diarrhea and/or cough/cold were included in this study. Data were collected by reviewing patient files and then assessed for its appropriateness against the criteria developed in view of the Medication Appropriateness Index and Guidelines of the Indian Academy of Pediatrics. The results were expressed in frequencies and percentages. Chi-square test was used to analyze the data. A < 0.05 was considered statistically significant.

Results: A total of 303 patients were studied during the study period. The mean age of the patients was 3.5 ± 0.6 years. The majority of children were admitted mainly due to chief complaint of fever (63%) and cough and cold (56.4%). The appropriateness of antibiotic prescriptions was higher in bloody and watery diarrhea (83.3% and 82.6%; < 0.05). Cephalosporins (46.2%) and penicillins (39.9%) were the most commonly prescribed antibiotics, though the generic prescriptions of these drugs were the lowest (13.5% and 10%, respectively). The seniority of prescriber was significantly associated with the appropriateness of prescriptions ( < 0.05). Antibiotics prescription was higher in cold/cough and diarrhea (93.5%) in comparison to cough/cold (85%) or diarrhea (75%) alone.

Conclusions: The study observed high rates of antibiotic utilization in Chidambaram during the treatment of cough/cold and/or diarrhea in pediatric patients. The findings highlight the need for combined interventions using education and expert counseling, targeted to the clinical conditions and classes of antibiotic for which inappropriate usage is most common.
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http://dx.doi.org/10.4103/0975-7406.199340DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5314834PMC
February 2017

Availability and affordability of life-saving vaccines.

Lancet Infect Dis 2017 02;17(2):136-137

Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, UCSI University, Cheras, Kuala Lumpur 56000, Malaysia. Electronic address:

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http://dx.doi.org/10.1016/S1473-3099(17)30014-2DOI Listing
February 2017

Polio and cross-border management.

Lancet Infect Dis 2017 02;17(2):136

Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, VA, USA.

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http://dx.doi.org/10.1016/S1473-3099(17)30012-9DOI Listing
February 2017

Could an automated machine replace the pharmacist?

Res Social Adm Pharm 2017 Mar - Apr;13(2):399. Epub 2016 Nov 18.

Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, VA, USA.

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http://dx.doi.org/10.1016/j.sapharm.2016.10.019DOI Listing
August 2018

Muslim Scholars' Knowledge, Attitudes and Perceived Barriers Towards Polio Immunization in Pakistan.

J Relig Health 2017 Apr;56(2):635-648

Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.

Pakistan is one of the two countries where polio remains endemic. Among multiple reasons of polio prevalence, false religious beliefs are accounted as major barriers towards polio immunization in Pakistan. Within this context, religious scholars are now engaged in polio immunization campaigns to dismantle the myths and battle the resurgence of polio in Pakistan. The objective of this study was to assess knowledge, attitudes and perceived barriers of Muslim scholars towards polio immunization in Pakistan. A descriptive, cross-sectional survey of Muslim scholars was conducted in Quetta and Peshawar divisions of Pakistan. From October to December 2015, a convenience sample of 770 Muslim scholars was recruited from the local mosques and religious institutions to participate in this study. Knowledge, attitudes, and perceived barriers were assessed by using self-administered, anonymous and pretested questionnaire. Descriptive and regression analyses were used to express the results with p < 0.05 taken as significant. Three hundred and forty-eight (45.2 %) participants exhibited good knowledge about polio with a mean score of 7.16 ± 2.12 (based on 14 questions). Knowledge gaps were identified about the transmission (32.6 %) and consequences of poliovirus (39.9 %). Overall, 527 (68.4 %) participants showed positive attitudes towards polio immunization with a mean attitude score of 27.35 ± 2.68 (based on nine statements). The majority of participants agreed on the need of depoliticizing polio immunization issues (87.1 %), while reservations were noted about their willingness to participate in future polio immunization programs (44.6 %). Security (75.8 %) and vaccine management issues (64 %) were reported by the participants as the major barriers towards polio immunization in Pakistan. The findings showed poor knowledge of Muslim scholars towards polio; however, their attitudes were positive towards polio immunization. More studies are required to assess the knowledge and attitudes of Muslim scholars at the national level to validate the findings of this study.
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http://dx.doi.org/10.1007/s10943-016-0308-6DOI Listing
April 2017

Are healthcare workers ready for Ebola? An assessment of their knowledge and attitude in a referral hospital in South India.

J Infect Dev Ctries 2016 Aug 2;10(7):747-54. Epub 2016 Aug 2.

UCSI University, No. 1 Jalan Menara Gading, Taman Connaught, Cheras, Kuala Lumpur, Malaysia.

Introduction: The World Health Organization (WHO) declared the Ebola virus disease (EVD) epidemic to be a public health emergency of international concern. Healthcare workers (HCWs) are at the highest risk of infection, as they may come into contact with patients' blood or fluids. This study was conducted to assess knowledge and attitudes of HCWs towards EVD in India.

Methodology: A descriptive, cross-sectional study was conducted in a multispecialty public sector referral hospital of Telangana, India. Knowledge and attitude of HCWs were evaluated using a pre-validated questionnaire. A sample of 278 participants was selected to participate in this study. The Chi-squared test was used to assess the relationship between attitudes and demographic characteristics. Logistic regression was used examine the association between knowledge and study variables.

Results: Of 257 participants who responded (92.4% response rate), 157 (61.1%) were females. The majority of the respondents were physicians (n = 117, 45.5%). Radio and television were the major sources of information about EVD reported by participants (89%). Overall knowledge of HCWs was poor (mean knowledge score: 6.57 ± 2.57). Knowledge of physicians and experienced workers (≥ 10 years) was significantly higher than their respective groups. The overall attitude of the participants was positive (mean attitude score: 1.62 ± 0.57). Significant positive correlations between knowledge and attitude were observed.

Conclusions: The findings indicate that participants lack basic understanding of EVD. We recommend future studies be conducted across India to identify and subsequently bridge the knowledge gaps among HCWs.
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http://dx.doi.org/10.3855/jidc.7578DOI Listing
August 2016

Fixed-dose combination antibiotics in India: global perspectives.

Lancet Glob Health 2016 08;4(8):e521

School of Medicine, University of Virginia, Charlottesville, VA, USA.

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http://dx.doi.org/10.1016/S2214-109X(16)30093-6DOI Listing
August 2016