Displaying publications 1 - 20 of 322 in total

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  1. Jamshed SQ, Ibrahim MI, Hassali MA, Sharrad AK, Shafie AA, Babar ZU
    Adv Med Educ Pract, 2015;6:359-66.
    PMID: 26028981 DOI: 10.2147/AMEP.S27762
    GENERAL OBJECTIVE: To evaluate the understanding and perceptions of generic medicines among final-year Doctor of Pharmacy students in Karachi, Pakistan.

    METHODS: A 23-item survey instrument that included a question on the bioequivalence limits and Likert-type scale questions regarding the understanding and perceptions of generic medicines among the students was executed. Cronbach's alpha was found to be 0.62.

    RESULTS: Responses were obtained from 236 final-year Doctor of Pharmacy students (n=85 from a publicly funded institute; n=151 from a privately funded institute). When comparing a brand-name medicine to a generic medicine, pharmacy students scored poorly on bioequivalence limits. More than 80% of the students incorrectly answered that all the products that are rated as generic equivalents are therapeutically equivalent to each other (P<0.04). Half of the students agreed that a generic medicine is bioequivalent to the brand-name medicine (P<0.001). With regard to quality, effectiveness, and safety, more than 75% of the students disagreed that generic medicines are of inferior quality and are less effective than brand-name medicines (P<0.001). More than 50% of the students disagreed that generic medicines produce more side effects than brand-name medicines (P<0.001).

    CONCLUSION: The current study identified a positive perception toward generic medicines but also gaps in the understanding of generic medicines. Pharmacy students lacked a thorough understanding of the concepts of bioequivalence. Pharmacy academia should address these issues, which will help build confidence in generic medicines and increase the generic medicine use in Pakistan.

  2. Saleem Z, Hassali MA, Godman B, Hashmi FK, Saleem F
    Am J Infect Control, 2019 04;47(4):421-424.
    PMID: 30471976 DOI: 10.1016/j.ajic.2018.09.025
    BACKGROUND: Healthcare-associated infections (HAIs) are seen as a global public health threat, leading to increased mortality and morbidity as well as costs. However, little is currently known about the prevalence of HAIs in Pakistan. Consequently, this multicenter prevalence survey of HAIs was conducted to assess the prevalence of HAIs in Pakistan.

    METHODS: We used the methodology employed by the European Centre for Disease Prevention and Control to assess the prevalence of HAIs in Punjab Province, Pakistan. Data were collected from 13 hospitals using a structured data collection tool.

    RESULTS: Out of 1,553 hospitalized patients, 130 (8.4%) had symptoms of HAIs. The most common HAI was surgical site infection (40.0%), followed by bloodstream infection (21.5%), and lower respiratory tract infection (14.6%). The prevalence of HAI was higher in private sector hospitals (25.0%) and among neonates (23.8%) and patients admitted to intensive care units (33.3%). Patients without HAIs were admitted mainly to public sector hospitals and adult medical and surgical wards.

    CONCLUSIONS: The study found a high rate of HAIs among hospitals in Pakistan, especially surgical site infections, bloodstream infections, and lower respiratory tract infections. This needs to be addressed to reduce morbidity, mortality, and costs in the future, and further research is planned.

  3. Ahmed SI, Hassali MA, Aziz NA
    Am J Pharm Educ, 2009 Feb 19;73(1):15.
    PMID: 19513153
    OBJECTIVE: To evaluate the level of knowledge, attitudes, and risk perceptions of University Sains Malaysia final-year pharmacy students regarding human immunodeficiency virus (HIV) and acquired immunity deficiency syndrome (AIDS).

    METHOD: A cross-sectional study among pharmacy students. Data were analyzed with Chi-square to find difference at p value < 0.05.

    RESULTS: The majority of students (83.07%) responded showing a difference in gender and race. Students showed low willingness (9.2%) to assist patients and low confidence (36.1%) in their education about HIV/AIDS patients. Students recommended HIV testing for health care professionals (69.4%) and patients (75.9%) before surgical procedures. Students knew little about Post Exposure Prophylaxis (18.5%) or about the time for HIV to develop into AIDS (57.4%). About 40% of students were unaware of the inability of antivirals to treat HIV/AIDS. Students had low awareness for opportunistic infections (18.5%), and low agreement on competency to treat and counsel HIV patients (12.9%).

    CONCLUSION: The study highlighted students' misconceptions, negative attitudes, and risk perceptions towards HIV/AIDS.

  4. Hassali MA, Shafie AA, Awaisu A, Mohamed Ibrahim MI, Ahmed SI
    Am J Pharm Educ, 2009 Nov 12;73(7):136.
    PMID: 19960093
    OBJECTIVES: To develop and implement a new course on public health into the bachelor of pharmacy (BPharm) curriculum in Malaysia.

    DESIGN: A required 2-credit-hour course was designed to provide an overview of public health pharmacy roles and the behavioral aspects of human healthcare issues. Graded activities included nursing home visits, in-class quizzes, mini-projects, and poster sessions, and a comprehensive final examination.

    ASSESSMENT: The majority of the students performed well on the class activities and 93 (71.5%) of the 130 students enrolled received a grade of B or higher. A Web-based survey was administered at the end of the semester and 90% of students indicated that they had benefited from the course and were glad that it was offered. The majority of students agreed that the course made an impact in preparing them for their future role as pharmacists and expanded their understanding of the public health roles of a pharmacist.

    CONCLUSIONS: A public health pharmacy course was successfully designed and implemented in the BPharm curriculum. This study highlighted the feasibilities of introducing courses that are of global relevance into a Malaysian pharmacy curriculum. The findings from the students' evaluation suggest the needs to incorporate a similar course in all pharmacy schools in the country and will be used as a guide to improve the contents and methods of delivery of the course at our school.

  5. Hasan SS, Kwai Chong DW, Ahmadi K, Se WP, Hassali MA, Hata EM, et al.
    Am J Pharm Educ, 2010 Nov 10;74(9):166.
    PMID: 21301600
    OBJECTIVES: To identify and evaluate factors affecting the career preferences of fourth-year bachelor of pharmacy (BPharm) students in Malaysia in the presence of a 4-year period of mandatory government service.

    METHODS: A validated self-administered questionnaire was used in this cross-sectional study to collect data from final-year BPharm students enrolled at 3 government-funded universities and 1 private university in Malaysia. Both descriptive and inferential statistics were used for data analysis.

    RESULTS: Three hundred fourteen students responded (213 from public universities and 101 from the private university). Approximately 32% of public university students and 37% of private university students ranked their own interest in pharmacy as the reason for undertaking pharmacy degree studies; 40.4% of public and 19.8% of private university respondents stated that they would enter a nonpharmacy-related career upon graduation if given the choice. Public university students ranked hospital pharmacy as their choice of first career setting (4.39, p = 0.001), while private students ranked community pharmacy first (4.1, p = 0.002). On a scale of 1 to 5, salary received the highest mean score (3.9 and 4.0, p = 0.854) as the extrinsic factor most influencing their career choice.

    CONCLUSIONS: Final-year students at Malaysian public universities were most interested in hospital pharmacy practice as their first career step upon graduation, while private university students were most interested in community pharmacy. The top 3 extrinsic factors rated as significant in selecting a career destination were salary, benefits, and geographical location.

  6. Elkalmi RM, Hassali MA, Ibrahim MI, Widodo RT, Efan QM, Hadi MA
    Am J Pharm Educ, 2011 Jun 10;75(5):96.
    PMID: 21829270 DOI: 10.5688/ajpe75596
    To assess senior pharmacy students' knowledge of and perceptions about pharmacovigilance and reporting of adverse drug reactions (ADRs) at 5 public universities in Malaysia.
  7. Saleem Z, Saeed H, Hassali MA, Godman B, Asif U, Yousaf M, et al.
    PMID: 31768252 DOI: 10.1186/s13756-019-0649-5
    Background: The inappropriate use of antibiotics in hospitals increases resistance, morbidity, and mortality. Little is currently known about appropriate antibiotic use among hospitals in Lahore, the capital city of Pakistan.

    Methods: Longitudinal surveillance was conducted over a period of 2 months among hospitals in Lahore, Pakistan. Antibiotic treatment was considered inappropriate on the basis of a wrong dosage regimen, wrong indication, or both based on the British National Formulary.

    Results: A total of 2022 antibiotics were given to 1185 patients. Out of the total prescribed, approximately two-thirds of the study population (70.3%) had at least one inappropriate antimicrobial. Overall, 27.2% of patients had respiratory tract infections, and out of these, 62.8% were considered as having inappropriate therapy. Cephalosporins were extensively prescribed among patients, and in many cases, this was inappropriate (67.2%). Penicillins were given to 283 patients, out of which 201 (71.0%) were prescribed for either the wrong indication or dosage or both. Significant variations were also observed regarding inappropriate prescribing for several antimicrobials including the carbapenems (70.9%), aminoglycosides (35.8%), fluoroquinolones (64.2%), macrolides (74.6%) and other antibacterials (73.1%).

    Conclusion: Educational interventions, institutional guidelines, and antimicrobial stewardship programs need to be developed to enhance future appropriate antimicrobial use in hospitals in Pakistan. Policies by healthcare and Government officials are also needed to minimize inappropriate antibiotic use.

  8. Khan TM, Sulaiman SA, Hassali MA
    Arch Med Sci, 2012 Sep 8;8(4):697-703.
    PMID: 23056083 DOI: 10.5114/aoms.2012.28601
    This study aims to highlight the factors associated with suicidal behavior among patients with depressive disorders.
  9. Hassali MA, Shafie AA, Khalid Y, Hari R
    The aim of this study is to evaluate the knowledge and perceptions of diabetics and non-diabetics at Universiti Sains Malaysia (USM) main campus towards erectile dysfunction (ED). A cross-sectional survey using 40 items questionnaire was conducted in USM main Campus and at the Diabetic Clinic in the main campus. By the end of the study period a total of 200 individuals were surveyed, 52 of them were diabetics and the rest were non-diabetics. The mean total knowledge score obtained by diabetics was significantly higher, (63.7% of the maximum possible total knowledge score) than non-diabetics score (53.8 % of the maximum possible total knowledge score), P=0.002. Diabetics scored significantly lower regarding perception towards sexual activity, (65.1% of the maximum possible score) than non diabetics (70% of the maximum possible score), P=0.012. Diabetic patients scored none significantly higher scores regarding perception towards effect of ED on quality of life, (61.3% of the maximum possible score) compared with non-diabetics (59.7 % of the maximum possible score) P=0.332. Overall, the finding of this study suggested that health care professionals should be more proactive in disseminating health information about ED to the public in order to increase their knowledge and awareness on the disease.
  10. Farooqui M, Hassali MA, Knight A, Shafie AA, Farooqui MA, Saleem F, et al.
    Asian Pac J Cancer Prev, 2013;14(5):3017-21.
    PMID: 23803072
    BACKGROUND: Health Related Quality of Life (HRQoL) is an important aspect in identifying cancer patients' perceptions of being diagnosed with cancer and the assessment of treatment outcomes. The present study aimedto assess the profile and predicators of HRQoL of Malaysian oncology patients.

    MATERIALS AND METHODS: A cross sectional study adopting the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) was conducted. All cancer patients attending Penang General Hospital between August-November 2011 were approached. Descriptive statistics were used to assess demographic and disease related characteristics of the patients. All analyses were performed using SPSS v 16.0.

    RESULTS: Three hundred and ninety three cancer patients met the inclusion criteria and were enrolled in the study. The mean age was 53.9 (SD±13) years. The cohort was dominated by females (n=260, 66.2%). Nearly half (n=190, 48.3%) of the participants were of Malay ethnicity, practicing Islam as their religion (n=194, 49.4%). Two hundred and ninety six (n=296, 75.3%) had beene diagnosed with cancer within six months to 3 years previously. The most common primary cancer site was breast (n=143, 36.4%). The mean Global Health Status (GHS) score was 60.7 (SD=21.3). Females (mean GHS score of 62.3, p=0.035) with Malay ethnicity (mean GHS score of 63.8, p=0.047), practicing Islam as their religion (mean GHS score of 63.0, p=0.011) had better GHS scores. Patients having medical insurance had good scores (mean 65.6, p=0.021). Marital status was significantly associated with GHS scores (p=0.022). Bone cancer patientshad the lowest mean GHS score of 49.2 (p=0.044). Patients at very advanced stages of cancer featured a low GHS mean score of 52.2 (p<0.001).

    CONCLUSIONS: The present study identified many demographic and disease related factors which may contribute to the HRQoL of cancer patients, pointing to the necessity for improved management of disease symptoms and provision of psychological and financial support.

  11. Hassan BA, Yusoff ZB, Hassali MA, Othman SB
    Asian Pac J Cancer Prev, 2011;12(10):2753-8.
    PMID: 22320987
    INTRODUCTION: Anemia is considered as one of the most frequent hematological demonstration of malignant diseases, which lead to momentous impairment in every tissues and organs of cancer patients and put them under serious stress. This major problem may arise because of the underlining diseases (i.e., cancer diseases) or radiotherapy or chemotherapy treatment received. This present study tries to find the association between anemia onset and severity with different chemotherapeutics regimens used in the treatment of several solid cancers and to find the association of anemia onset and severity with different doses of these chemotherapeutics drugs.

    METHODS: This retrospective observational study was conducted in Penang General Hospital on 534 anemic solid cancer patients who were admitted between 2003 and 2009. The main statistical tests used were Chi-square test and Logistic regression test for categorical data. While for continues data the main statistical tests were Linear regression and correlation test. The significance of the result will be when the P<0.05, while the confidence interval for this study was 95%.

    RESULTS: FEC, 5-FU+5-FU, Docetaxel and Cisplatin+ 5-FU regimen has strong association and correlation with anemia onset and severity. However the associations and correlations with anemia severity were stronger than those with the onset. Different doses of 5-FU, cyclophosphamide, docetaxel and cisplatin play a critical role in anemia onset and severity.

    CONCLUSION: Monitoring and determination of hemoglobin levels for cancer patients treated with FEC, 5-FU+5-FU, Docetaxel, Cisplatin+ 5-FU specifically with high doses must be emphasized and a focus of particular attention.

  12. Hassan BA, Yusoff ZB, Hassali MA, Bin Othman S
    Asian Pac J Cancer Prev, 2011;12(11):2841-5.
    PMID: 22393951
    INTRODUCTION: Thrombocytopenia denotes abnormal decreases in platelet numbers and is a major detrimental side effect of the chemotherapy or cancer disease itself which cal lead to hemorrhage from vital organ. This is particularly a problem for the brain specifically within solid cancer patients and has a great negative effect on cancer patients quality of life (QOL). It ranges from mild bleeding from small blood vessels to severe bleeding from large blood vessels. The present study was conducted to evaluate the effectiveness of treatment guidelines for thrombocytopenia among solid cancer patients in Penang hospital and to find associations between these treatments and thrombocytopenia onset and severity and to suggest changes in the guidelines.

    METHODS: This retrospective observational study, conducted in a government hospital on Penang island included 341 cancer patients with thrombocytopenia who were admitted in the period between 2003 to 2009. The main statistical tests used were Chi-square test and Logistic regression test. The level of significance was set at P < 0.05.

    RESULTS: Of the total of 341, 21 (6.2%) showed thrombocytopenia before receiving chemotherapy and the remaining 320 (93.8%) after chemotherapy. The majority suffered from moderate thrombocytopenia (n=172; 53.8%), followed by mild a (n=97; 30.3%) and finally severe (n=51; 15.9%). For treatment, chemotherapy was delayed/ reduced (n=223; 65.4%) or platelets were transfused (n=51; 34.6%). However, thrombocytopenia problems were only temporarily solved.

    CONCLUSION: Effectiveness of thrombocytopenia treatment guidelines was found to be insufficient. It is advisable that thrombopoietin be used as a cornerstone even for patients who suffer from moderate thrombocytopenia and platelets transfusion should be used just for emergency cases when thrombocytopenia leads to a critical situation.

  13. Hassan BA, Yusoff ZB, Hassali MA, Othman SB, Weiderpass E
    Asian Pac J Cancer Prev, 2012;13(9):4373-8.
    PMID: 23167346
    INTRODUCTION: Hypercalcemia is mainly caused by bone resorption due to either secretion of cytokines including parathyroid hormone-related protein (PTHrP) or bone metastases. However, hypercalcemia may occur in patients with or without bone metastases. The present study aimed to describe the effect of chemotherapy treatment, regimens and doses on calcium levels among breast and lung cancer patients with hypercalcemia.

    METHODS: We carried a review of medical records of breast and lung cancer patients hospitalized in years 2003 and 2009 at Penang General Hospital, a public tertiary care center in Penang Island, north of Malaysia. Patients with hypercalcemia (defined as a calcium level above 10.5 mg/dl) at the time of cancer diagnosis or during cancer treatment had their medical history abstracted, including presence of metastasis, chemotherapy types and doses, calcium levels throughout cancer treatment, and other co-morbidity. The mean calcium levels at first hospitalization before chemotherapy were compared with calcium levels at the end of or at the latest chemotherapy treatment. Statistical analysis was conducted using the Chi-square test for categorical data, logistic regression test for categorical variables, and Spearman correlation test, linear regression and the paired sample t tests for continuous data.

    RESULTS: Of a total 1,023 of breast cancer and 814 lung cancer patients identified, 292 had hypercalcemia at first hospitalization or during cancer treatment (174 breast and 118 lung cancer patients). About a quarter of these patients had advanced stage cancers: 26.4% had mild hypercalcemia (10.5-11.9 mg/dl), 55.5% had moderate (12-12.9 mg/dl), and 18.2% severe hypercalcemia (13-13.9; 14-16 mg/dl). Chemotherapy lowered calcium levels significantly both in breast and lung cancer patients with hypercalcemia; in particular with chemotherapy type 5-flurouracil+epirubicin+cyclophosphamide (FEC) for breast cancer, and gemcitabine+cisplatin in lung cancer.

    CONCLUSION: Chemotherapy decreases calcium levels in breast and lung cancer cases with hypercalcemia at cancer diagnosis, probably by reducing PTHrP levels.

  14. Ho KC, Russell V, Nyanti L, Chan MW, Hassali MA, Dawood OT, et al.
    Asian J Psychiatr, 2020 Feb;48:101899.
    PMID: 31901584 DOI: 10.1016/j.ajp.2019.101899
    INTRODUCTION: Most primary care in Malaysia is provided by general practitioners in private practice. To date, little is known about how Malaysian General Practitioners (GPs) manage patients with depression. We surveyed privately practising primary care physicians in the state of Penang, Malaysia, in relation to their experience of the Malaysian Clinical Practice Guideline (CPG) in Major Depressive Disorder, their current practice and perceived barriers in managing depression effectively.

    MATERIAL AND METHODS: A questionnaire based on the study aims and previous literature was developed by the authors and mailed to all currently registered GPs in private clinics in Penang. Survey responses were analysed using SSPS version 21.

    RESULTS: From a total of 386 questionnaires distributed, 112 (29%) were returned. Half of the respondents were unaware of the existence of any CPG for depression. One quarter reported not managing depression at all, while one third used anxiolytic monotherapy in moderate-severe depression. Almost 75 % of respondents reported making referrals to specialist psychiatric services for moderate-severe depression. Time constraints, patient non-adherence and a lack of depression management skills were perceived as the main barriers to depression care.

    CONCLUSIONS: Our findings highlight the need to engage privately practising primary care physicians in Malaysia to improve their skills in the management of depression. Future revisions of the Malaysian Depression CPG should directly involve more GPs from private practices at the planning, development and implementation stages, in order to increase its impact.

  15. Hashmi FK, Hassali MA, Khalid A, Saleem F, Aljadhey H, Babar ZUD, et al.
    BMC Health Serv Res, 2017 07 19;17(1):500.
    PMID: 28724411 DOI: 10.1186/s12913-017-2442-6
    BACKGROUND: In recent decades, community pharmacies reported a change of business model, whereby a shift from traditional services to the provision of extended roles was observed. However, such delivery of extended pharmacy services (EPS) is reported from the developed world, and there is scarcity of information from the developing nations. Within this context, the present study was aimed to explore knowledge, perception and attitude of community pharmacists (CPs) about EPS and their readiness and acceptance for practice change in the city of Lahore, Pakistan.

    METHODS: A qualitative approach was used to gain an in-depth knowledge of the issues. By using a semi-structured interview guide, 12 CPs practicing in the city of Lahore, Pakistan were conveniently selected. All interviews were audio-taped, transcribed verbatim, and were then analyzed for thematic contents by the standard content analysis framework.

    RESULTS: Thematic content analysis yielded five major themes. (1) Familiarity with EPS, (2) current practice of EPS, (3) training needed to provide EPS, (4) acceptance of EPS and (5) barriers toward EPS. Majority of the CPs were unaware of EPS and only a handful had the concept of extended services. Although majority of our study respondents were unaware of pharmaceutical care, they were ready to accept practice change if provided with the required skills and training. Lack of personal knowledge, poor public awareness, inadequate physician-pharmacist collaboration and deprived salary structures were reported as barriers towards the provision of EPS at the practice settings.

    CONCLUSION: Although the study reported poor awareness towards EPS, the findings indicated a number of key themes that can be used in establishing the concept of EPS in Pakistan. Over all, CPs reported a positive attitude toward practice change provided to the support and facilitation of health and community based agencies in Pakistan.

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