Displaying publications 1 - 20 of 42 in total

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  1. Vaismoradi M, Jamshed S, Lorenzl S, Paal P
    Risk Manag Healthc Policy, 2021;14:2841-2849.
    PMID: 34262371 DOI: 10.2147/RMHP.S316744
    Older people with long-term mental health conditions who receive care in their own home are vulnerable to the inappropriate use of medications and polypharmacy given their underlying health conditions and comorbidities. Inappropriate use of pro re nata (PRN) medications in these older people can enhance their suffering and have negative consequences for their quality of life and well-being, leading to readmission to healthcare settings and the increased cost of health care. This narrative review on published international literature aims at improving our understanding of medicines management in home care and how to improve PRN medication use among older people with long-term health conditions in their own home. Accordingly, the improvement of PRN medicines management for these older people requires the development of an individualised care plan considering 'reduction of older people's dependence on PRN medications', 'empowerment of family caregivers', and 'support by healthcare professionals.' PRN medication use should be reduced through deprescription and discontinuation strategies. Also, older people and their family caregivers should be encouraged to prioritize the use of non-pharmacologic methods to relieve physical and psychological problems. Besides the empowerment of family caregivers through role development, education and training about PRN medications, and involvement in decision-making, they need support by the multidisciplinary network in terms of supervision, monitoring, and home visits.
  2. Umair Khan M, Ahmad A, Ejaz A, Ata Rizvi S, Sardar A, Hussain K, et al.
    PMID: 26072906 DOI: 10.3352/jeehp.2015.12.28
    PURPOSE: The goal of this study was to compare the knowledge and attitudes of pharmacy and medical students regarding adverse drug reactions (ADRs), as well as their perceptions of barriers to ADR reporting, in a Higher Education Commission-recognised Pakistani university.
    METHODS: A cross-sectional study was conducted among final-year pharmacy (n=91) and medical (n=108) students in Pakistan from June 1 to July 31, 2014. A self-administered questionnaire was used to collect the data. The responses of pharmacy students were compared to those of medical students.
    RESULTS: Pharmacy students had a significantly better knowledge of ADRs than medical students (mean±SD, 5.61±1.78 vs. 3.23±1.60; P<0.001). Gender showed a significant relationship to knowledge about ADRs, and male participants were apparently more knowledgeable than their female counterparts (P<0.001). The attitudes of pharmacy students regarding their capability to handle and report ADRs were significantly more positive than those of medical students (P<0.05). In comparison to pharmacy students, a lack of knowledge of where and how to report ADRs was the main barrier that medical students perceived to ADR reporting (P=0.001).
    CONCLUSION: Final-year pharmacy students exhibited more knowledge about ADRs and showed more positive attitudes regarding their capacity to handle and report ADRs than final-year medical students.
    KEYWORDS: Comparison; Medical; Pakistan; Pharmacovigilance; Pharmacy; Students
  3. Shakeel S, Nesar S, Iffat W, Fatima B, Maqbool T, Jamshed S
    Integr Pharm Res Pract, 2019;8:75-83.
    PMID: 31309080 DOI: 10.2147/IPRP.S196318
    Objectives: The study was conducted with the aim to evaluate the prescribers' approach of interaction with medical representatives for drug promotion. Methods: An explanatory, cross-sectional design was used to evaluate prescribers' interactions with the medical sales representatives (MSRs) through an anonymous, self-filled questionnaire from June to December 2017. Data presented as means±SEM or as percentages and statistically analyzed by one way ANOVA, using significance level of 0.05. Results: A response rate of 82.8% was achieved. More than 70% agreed that knowledge obtained from MSRs is reliable and useful. A large proportion of respondents acknowledged that MSRs are a key link between pharmaceutical companies and health care professionals, and their interactions are beneficial as MSRs perform an important teaching function. More than 45% agreed that gifts are influential; however, physicians cannot be compromised with very expensive gifts. The majority of the respondents (76%) considered that promotional items are ethically appropriate; however, 66.21% thought that promotional items influence the practice of prescribing. More than half (52.18%) deemed a promotional material more reliable than a printed advertisement. More than 80% of the respondents opined that medication samples are considered appropriate; however, they should only be given to those patients who cannot financially afford them. Around 69% thought that company-sponsored meetings promote their own drugs under the disguise of CME programs. Conclusion: The present study emphasizes the importance of employing scientifically sound prescribing decision by prescribers in their day to day practice without being influenced by pharmaceutical company's promotional activities. There is a need for restricting unprincipled practices by the concerned regulatory authorities to evade preventable harm to the patient's well-being.
  4. Shakeel S, Iffat W, Nesar S, Zaidi H, Jamshed S
    Integr Pharm Res Pract, 2020;9:33-39.
    PMID: 32104664 DOI: 10.2147/IPRP.S231134
    Objective: A cross-sectional study was carried out to evaluate the practice of unlicensed and off-label drug prescribing/dispensing in children and neonates by physicians and clinical pharmacists in the metropolitan city of Karachi.

    Methods: The study was conducted for the duration of 5 months - November 2018 to March 2019 - in different clinics and tertiary care hospitals of Karachi, Pakistan. Respondents were interviewed by our researchers using 30 items questionnaire. Descriptive statistics were used to evaluate the answers of respondents to survey items. Pearson correlation and independent sample t-test were employed to recognize the association between the responses of participants and independent variables. P values less than 0.05 were considered statistically significant.

    Results: A total of 421 questionnaires were completed by physicians and clinical pharmacists. The mean age of the study participants was 49.5 years. Around 98% of pharmacists and 93.5% of physicians were well conversant with the definition of unlicensed and off-label drugs. Around 68% of physicians and 77% of pharmacists reported that they were more concerned about the efficacy of such drugs as compared to that of licensed medicines in children. The most frequent off-label categories observed in the study were dose (65.21%) and indication (17.52%). A vast majority (>80%) thought that approving new drugs by regulatory authorities will drop the occurrence of medication errors due to incorrect dosing. The British National Formulary (BNF) for children was used as the best reliable source of information among respondents.

    Conclusion: The present study highlighted the common practice of unlicensed and off-label drug prescribing in pediatrics; however, respondents showed their concern towards decreasing such practice and are likely to welcome initiatives intended to assure medication safety in children.

  5. Shakeel S, Nesar S, Rehman H, Jamil K, Mallick IA, Mustafa MS, et al.
    Pharmacy (Basel), 2021 Dec 20;9(4).
    PMID: 34941635 DOI: 10.3390/pharmacy9040203
    Off-label drug prescribing (OLDP) must be based on strong scientific evidence to make sure that patients get the optimum therapeutic outcomes. Adherence to the prerequisites is determined by the physicians' attitude and knowledge. In this context, the present study was conducted with the goal of investigating psychiatrists' perceptions of the use of OLDP in their clinical practice. A total of 14 psychiatrists were interviewed using a semi-structured interview guide. Thematic content analysis was performed. Data saturation was achieved at the 12th interview. Six major themes and fifteen subthemes emerged from qualitative interviews. Among the major themes were knowledge and concepts about the off-label drugs, attitude and current practice of prescribing off-label drugs, and rationale of prescribing and suggestions for reducing the use of off-label drugs. Almost all of the respondents interviewed provided detailed comments concerning the OLDP concept, depicted an optimistic approach and deemed that OLDP is quite common in psychiatry. Off-label usage of benzodiazepines such as clonazepam, diazepam and lorazepam in mania, depression, and obsessive-compulsive disorder were commonly reported. It was observed that the majority of the respondents did not inform the patients before prescribing off-label drugs. The present findings revealed that respondents had awareness; however, they depicted diverse attitudes towards prescribing off-label drugs. Further education and sensitization in regions with impoverished knowledge would certainly assist in preventing the risks associated with the use of OLDP.
  6. Shakeel S, Nesar S, Rahim N, Iffat W, Ahmed HF, Rizvi M, et al.
    J Pharm Bioallied Sci, 2017 Oct-Dec;9(4):266-271.
    PMID: 29456378 DOI: 10.4103/jpbs.JPBS_327_16
    Aims: Despite an increased popularity of print and electronic media applications, there is a paucity of data reflecting doctors' opinions regarding efficient utilization of these resources for the betterment of public health. Hence, this study aimed to investigate the perception of physicians toward the effect of electronic and print media on the health status of patients.
    Setting and Design: The current research is a cross-sectional study conducted from January 2015 to July 2015. The study population comprised physicians rendering their services in different hospitals of Karachi, Pakistan, selected by the nonprobability convenience sampling technique. In this study, 500 questionnaires were distributed through email or direct correspondence.
    Methods and Materials: Physicians' perception toward the impact of electronic and print media on the health status of patients was assessed with a 20-item questionnaire. Different demographic characteristics, such as age, gender, institution, position, and experience of respondents, were recorded. Quantitative data were analyzed with the use of Statistical Package for Social Sciences, version 20.0 (SPSS, Chicago, IL). The association of the demographic characteristics of the responses of physicians was determined by one-way ANOVA using 0.05 level of significance.
    Results: In this study, 254 physicians provided consent to show their responses for research purposes. A response rate of 50.8% was obtained. Nearly one-third of the respondents negated that patients get health benefit using electronic and print media. The majority did not consider electronic and print media as lifestyle-modifying factors. Physicians thought that patients particularly do not rely on mass media for acquiring health information and consider healthcare professionals as unswerving information resource.
    Conclusions: Mass media can be productive resources to augment awareness among patients, although physicians seem unconvinced about the extended usage of print/electronic media.
  7. Shahwan M, Hassan N, Shaheen RA, Gaili A, Jairoun AA, Shahwan M, et al.
    Curr Diabetes Rev, 2021;17(9):e011121190176.
    PMID: 33430750 DOI: 10.2174/1573399817999210111205532
    Diabetes mellitus (DM), which is defined as high blood glucose level, is a major public health issue worldwide. An enormous amount of data has been gathered regarding DM as populations have been living with it for more than a decade; however, continually updating our knowledge of DM remains important. Comorbidities are among the major challenges associated with DM. Poorly controlled DM, especially type 2 DM (T2DM), is considered a risk factor for many diseases, including but not limited to chronic kidney disease (CKD). Complications might appear over time as the aging process changes body functions; moreover, a significant number of antidiabetic medications are eventually cleared by the kidneys, thereby increasing the burden on kidney function and placing diabetic patients at risk. The significantly high number of patients with uncontrolled diabetes resulting from kidney disease shows the impact of this condition on the quality of life of patients. This review presents an overview of the pathophysiology, etiology, and prevalence of CKD and abnormal renal parameters correlated with poorly controlled T2DM, with an emphasis on clinical studies involving the association between vitamin D insufficiency/deficiency and CKD among patients with T2DM.
  8. Samsiah A, Othman N, Jamshed S, Hassali MA
    Int J Clin Pharm, 2020 Aug;42(4):1118-1127.
    PMID: 32494990 DOI: 10.1007/s11096-020-01041-0
    Background Medication errors are the most common types of medical errors that occur in health care organisations; however, these errors are largely underreported. Objective This study assessed knowledge on medication error reporting, perceived barriers to reporting medication errors, motivations for reporting medication errors and medication error reporting practices among various health care practitioners working at primary care clinics. Setting This study was conducted in 27 primary care clinics in Malaysia. Methods A self-administered survey was distributed to family medicine specialists, doctors, pharmacists, pharmacist assistants, nurses and assistant medical officers. Main outcome measures Health care practitioners' knowledge, perceived barriers and motivations for reporting medication errors. Results Of all respondents (N = 376), nurses represented 31.9% (n = 120), followed by doctors (n = 87, 23.1%), pharmacists (n = 63, 16.8%), assistant medical officers (n = 53, 14.1%), pharmacist assistants (n = 46, 12.2%) and family medicine specialists (n = 7, 1.9%). Of the survey respondents who had experience reporting medication errors, 56% (n = 62) had submitted medication error reports in the preceding 12 months. Results showed that 41.2% (n = 155) of respondents were classified as having good knowledge on medication error and medication error reporting. The mean score of knowledge was significantly higher among prescribers and pharmacists than nurses, pharmacist assistants and assistant medical officers (p 
  9. Samsiah A, Othman N, Jamshed S, Hassali MA
    PLoS One, 2016;11(12):e0166114.
    PMID: 27906960 DOI: 10.1371/journal.pone.0166114
    OBJECTIVE: To explore and understand participants' perceptions and attitudes towards the reporting of medication errors (MEs).

    METHODS: A qualitative study using in-depth interviews of 31 healthcare practitioners from nine publicly funded, primary care clinics in three states in peninsular Malaysia was conducted for this study. The participants included family medicine specialists, doctors, pharmacists, pharmacist assistants, nurses and assistant medical officers. The interviews were audiotaped and transcribed verbatim. Analysis of the data was guided by the framework approach.

    RESULTS: Six themes and 28 codes were identified. Despite the availability of a reporting system, most of the participants agreed that MEs were underreported. The nature of the error plays an important role in determining the reporting. The reporting system, organisational factors, provider factors, reporter's burden and benefit of reporting also were identified.

    CONCLUSIONS: Healthcare practitioners in primary care clinics understood the importance of reporting MEs to improve patient safety. Their perceptions and attitudes towards reporting of MEs were influenced by many factors which affect the decision-making process of whether or not to report. Although the process is complex, it primarily is determined by the severity of the outcome of the errors. The participants voluntarily report the errors if they are familiar with the reporting system, what error to report, when to report and what form to use.
  10. Samsiah A, Othman N, Jamshed S, Hassali MA, Wan-Mohaina WM
    Eur J Clin Pharmacol, 2016 Dec;72(12):1515-1524.
    PMID: 27637912
    PURPOSE: Reporting and analysing the data on medication errors (MEs) is important and contributes to a better understanding of the error-prone environment. This study aims to examine the characteristics of errors submitted to the National Medication Error Reporting System (MERS) in Malaysia.

    METHODS: A retrospective review of reports received from 1 January 2009 to 31 December 2012 was undertaken. Descriptive statistics method was applied.

    RESULTS: A total of 17,357 MEs reported were reviewed. The majority of errors were from public-funded hospitals. Near misses were classified in 86.3 % of the errors. The majority of errors (98.1 %) had no harmful effects on the patients. Prescribing contributed to more than three-quarters of the overall errors (76.1 %). Pharmacists detected and reported the majority of errors (92.1 %). Cases of erroneous dosage or strength of medicine (30.75 %) were the leading type of error, whilst cardiovascular (25.4 %) was the most common category of drug found.

    CONCLUSIONS: MERS provides rich information on the characteristics of reported MEs. Low contribution to reporting from healthcare facilities other than government hospitals and non-pharmacists requires further investigation. Thus, a feasible approach to promote MERS among healthcare providers in both public and private sectors needs to be formulated and strengthened. Preventive measures to minimise MEs should be directed to improve prescribing competency among the fallible prescribers identified.

  11. Sakeena MHF, Bennett AA, Jamshed S, Mohamed F, Herath DR, Gawarammana I, et al.
    BMC Infect Dis, 2018 05 08;18(1):209.
    PMID: 29739360 DOI: 10.1186/s12879-018-3107-8
    BACKGROUND: Antimicrobial resistance (AMR) is a major challenge for global health care. Pharmacists play a key role in the health care setting to help support the quality use of medicines. The education, training, and experiences of pharmacy students have the potential to impact on patterns of antibiotic use in community and hospital settings. The aim of this study was to investigate antibiotic use, knowledge of antibiotics and AMR among undergraduate pharmacy students at Sri Lankan universities and to compare this between junior and senior pharmacy student groups.

    METHODS: A cross-sectional study was conducted at the six universities in Sri Lanka that offer pharmacy undergraduate programmes. All pharmacy students in each university were invited to participate in this study using a self-administered questionnaire with ethics approval. The study instrument comprised five major sections: demographic information, self-reported antibiotic use, knowledge of antibiotic uses in human health, knowledge of AMR and antibiotic use in agriculture. Descriptive data analyses were conducted and Chi-squared analysis was used to explore associations between different variables and level of pharmacy education.

    RESULTS: Four hundred sixty-six pharmacy students completed the questionnaire. A majority of participants (76%) reported antibiotic use in the past year. More than half (57%) of the junior pharmacy students incorrectly indicated that antibiotic use is appropriate for the management of cold and flu conditions. Senior pharmacy students (n = 206) reported significantly better antibiotic knowledge than junior students (n = 260), p 

  12. Raman H, Jamil A, Rasheed A, Abdulrahman Jairoun A, Lua PL, Ibrahim UI, et al.
    Cureus, 2023 Oct;15(10):e46761.
    PMID: 37954738 DOI: 10.7759/cureus.46761
    INTRODUCTION: Declaration of human monkeypox(HMPX) virus as Public Health Emergency of International Concern (PHEIC) by World Health Organisation (WHO) has raised concerns among the public andlack of knowledge is a prominent challenge in curbing this outbreak. Therefore, assessment ofknowledge level on this outbreak among the medical students is also necessary due to the fact that they are the future healthcare practitioners who will be directly involved in the disease management as well as a major source of knowledge dissemination to the public.

    AIM: The main objective of this study is to assess the knowledge level of medical students at Universiti Sultan Zainal Abidin (UniSZA) regarding the emergence of HMPX. Additionally, the study aims to investigate potential associations between socio-demographic characteristics and knowledge levels, while also identifying factors that predict a high level of knowledge in this context..

    METHODS: A descriptive cross-sectional study was conducted among UniSZA undergraduatemedical students from Year 1 to Year 5. A validated questionnaire comprising six socio-demographic variables and 27 knowledge items was shared online. Descriptive statistics, non-parametric tests and multivariate logistic regression were performed using SPSS software.

    RESULTS: A total of 138 medical students out of 300 participated in this study. Overall, the average knowledge score was 73.95% ±4.43, which indicates that the medical students have moderate knowledge level. Nearly half of them had good knowledge level (n= 68; 49.3%), 43 of them had moderate knowledge level (31.2%), and 27 of them had poor knowledge level (19.6%). There was a significant association between knowledge level and two factors: receiving information on HMPX during their education and seniority (P-value < 0.01 and P-value < 0.05, respectively). Besides, received information on HMPX during their education was a significant predicting factor of good knowledge level (P-value = 0.002).

    CONCLUSION: The knowledge level among the medical students was relatively inadequate.

  13. Rahman AU, Mohamed MHN, Jamshed S, Mahmood S, Iftikhar Baig MA
    J Pharm Bioallied Sci, 2020 Nov;12(Suppl 2):S671-S675.
    PMID: 33828359 DOI: 10.4103/jpbs.JPBS_245_19
    Background: The Fagerstrom test for nicotine dependence (FTND) is the most widely used scale for assessing nicotine dependence on conventional tobacco cigarettes (TCGs). But the FTND does not evaluate the subject's nicotine dependence to electronic cigarette (EC).

    Objective: The aim of this study was to develop and assess an equivalent modified FTND scale that measures the nicotine dependency via EC.

    Materials and Methods: The investigator developed the equivalent modified FTND scale that scores identical to the original scale, that is, 0-10. The developed scale piloted among 15 EC single users, that is, use only EC verified by carbon monoxide (CO) level of <8ppm. The assessment of the scale was done among 69 EC single users and observed for 1 year to determine their nicotine status.

    Results: The modified scale revealed an acceptable Cronbach α value of 0.725. Further test-retest reliability of the scale showed a satisfactory Spearman's rank correlation coefficient value of 0.730 (P > 0.05). A 1-year observation showed that of 69 single users, 11 single users completely stopped nicotine intake, 24 remained as EC single users, 15 shifted to dual-use, and 19 relapsed to TCG. Surprisingly, the EC users who completely stopped nicotine intake after 1 year had a low average nicotine dependence value of 3 that was measured by the modified FTND scale at the baseline.

    Conclusion: The modified FTND scale precisely identifies the physical dependence to nicotine via EC. Therefore, as per this study results the modified FTND scale can be applied in any EC-related studies to assess nicotine dependency via EC.

  14. Rahim N, Iffat W, Shakeel S, Naeem MI, Qazi F, Rizvi M, et al.
    J Pharm Bioallied Sci, 2017 Apr-Jun;9(2):144-151.
    PMID: 28717338 DOI: 10.4103/jpbs.JPBS_328_16
    AIMS: In flu pandemics, pharmacy students' knowledge, attitudes, and practices are critical to save patients life. The objective of study was to determine the knowledge of and attitude toward the pandemic influenza among the pharmacy students of Karachi, Pakistan.
    SETTINGS AND DESIGNS: The cross-sectional study was conducted from September to December 2014 by adopting a prevalidated questionnaire distributed to senior pharmacy students (final year) in seven private and public sector universities of Karachi.
    MATERIALS AND METHODS: A total of 443 pharmacy students responded the survey. Data regarding sociodemographic characteristics of the students, perceptions, level of knowledge and attitudes toward influenza, and prophylactic measures were collected.
    STATISTICAL ANALYSIS: To compute the correlation between different variables, data were analyzed using Pearson's Chi-square statistic method. P < 0.05 was considered statistical significance for all analysis.
    RESULTS: Influenza was identified as a viral disease (n = 423; 95.48%) and 282 (71.2%) students correctly identified it as disease affecting humans and pigs. Textbooks reported as most common source of knowledge (n = 282; 64%). Most common symptoms identified were fever (81.94%), sore throat (64.1%), and nonproductive cough (43.34%). The most common preventive measures were covering nose and mouth (268; 60.5%) and wearing protective coverings (254; 57.3%). Only half of the students correctly reported about the route of administration (180; 40.6%) and strains in vaccine (186; 41.98%). The best time for administration of such vaccine was known by only 156 pharmacy students (35.34%). The majority of the students (82.6%) had no idea about the manifestation of influenza pandemic. Knowledge regarding influenza differed according to gender and institutions differing in their affiliation with tertiary care hospitals.
    CONCLUSION: It was observed that knowledge about disease progression, transmission, vaccination, and treatment in pharmacy students, especially those who are not getting clinical training in tertiary care hospitals was limited. There is an urgent need to develop awareness programs to increase knowledge of influenza among clinical pharmacists as they are more susceptible to infections and community as a whole.
  15. Naqvi AA, Hassali MA, Rizvi M, Zehra A, Iffat W, Haseeb A, et al.
    Front Pharmacol, 2018;9:1124.
    PMID: 30356775 DOI: 10.3389/fphar.2018.01124
    Objective: This study aimed to develop and validate a self-reporting adherence tool termed as General Medication Adherence Scale (GMAS) in Urdu language for measuring adherence toward medication use among Pakistani patients with a chronic disease. Methods: A month-long study (December 2017) was conducted in three tertiary health care settings of Karachi, Pakistan. The tool underwent content and face validity as well as factor analyses, i.e., exploratory, partial confirmatory and confirmatory factor analyses. Random sampling was conducted, and sample size was calculated using item response theory. The item-to-respondent ratio was 1:15. Fit indices namely normed fit index (NFI), Tucker Lewis index (TLI), comparative fit index (CFI), goodness of fit index (GFI), absolute goodness of fit (AGFI), parsimony goodness of fit index (PGFI), root mean square error of approximation (RMSEA), and standard root mean square residual (SRMR) were calculated. Additionally, estimation of the convergent, discriminant and known group validities, was conducted. Internal consistency was analyzed by test-retest reliability, McDonald's and Pearson correlation coefficient. The factor analyses were conducted using IBM SPSS version 22 and IBM SPSS AMOS version 25. Results: Content validity index (CVI) was reported at 0.8 (SD 0.147) and the tool was content validated with three hypothetical constructs. Factor analyses highlighted a 3-factor structure. The fit indices were calculated with satisfactory results, i.e., PGFI, GFI, AGFI, NFI, TLI, and CFI were greater than 0.9 and PGFI > 0.5. The values of RMSEA and SRMR were less than 0.07. A Cronbach's alpha value of 0.84 was obtained in reliability analysis. The test-retest Pearson's correlation coefficient value was reported at 0.996 (p-value < 0.01). Convergent and discriminant validities for all constructs and, known group validity for two constructs, were established. A high response rate of 91% was achieved in respondents. Patients without insurance coverage appeared to be low adherent compared to those with insurance coverage (p-value < 0.05). Non-comorbid patients were more likely to be highly adherent as compared to comorbid patients (p-value < 0.01). Conclusion: A novel tool GMAS was developed in Urdu language and was subsequently validated in patients with chronic diseases.
  16. Mubarak N, Arif S, Irshad M, Aqeel RM, Khalid A, Ijaz UEB, et al.
    Antibiotics (Basel), 2021 Oct 03;10(10).
    PMID: 34680785 DOI: 10.3390/antibiotics10101204
    BACKGROUND: Medical and pharmacy students are future healthcare professionals who will be on the forefront in dealing with antibiotics in hospitals or community settings. Whether the current medical and pharmacy education in Pakistan prepares students to take future roles in antibiotic use remains an under-researched area.

    AIM: This study aims to compare medical and pharmacy students' perceived preparedness, learning practices and usefulness of the education and training on antibiotic use and resistance imparted during undergraduate studies in Pakistan.

    DESIGN AND SETTING: It was amulti-centre cross-sectional survey of medical and pharmacy colleges in Punjab, Pakistan.

    METHOD: A self-administered questionnaire was used to collect data from final year medical and pharmacy students. Descriptive statistics were used for categorical variables while independent t-test and One-way ANOVA computed group differences.

    RESULT: Nine hundred forty-eight respondents (526 medical and 422 pharmacy students) completed the survey from 26 medical and 19 pharmacy colleges. Majority (76.1%) of the pharmacy students had not completed a clinical rotation in infectious diseases. The top three most often used sources of learning antibiotic use and resistance were the same among the medical and the pharmacy students; included textbooks, Wikipedia, and smart phone apps. Overall self-perceived preparedness scores showed no significant difference between pharmacy and medical students. The least prepared areas by medical and pharmacy students included transition from intravenous to oral antibiotics and interpretation of antibiograms. Both medical and pharmacy students found problem solving sessions attended by a small group of students to be the most useful (very useful) teaching methodology to learn antibiotic use and resistance.

    CONCLUSIONS: Differences exist between medical and pharmacy students in educational resources used, topics covered during undergraduate degree. To curb the growing antibiotic misuse and resistance, the concerned authorities should undertake targeted educational reforms to ensure that future physicians and pharmacists can play a pivotal role in rationalizing the use of antibiotics.

  17. Mohamed MHN, Rahman A, Jamshed S, Mahmood S
    BMC Public Health, 2018 Aug 20;18(1):1028.
    PMID: 30126382 DOI: 10.1186/s12889-018-5951-2
    BACKGROUND: Current studies on electronic cigarettes (ECs) have assessed the smoking cessation effectiveness and safety of EC among sole EC users. However, in Malaysia and elsewhere, most EC users also smoke conventional cigarettes (CCs). We aimed to investigate nicotine cessation for both ECs and CCs. Additionally, safety issues among sole EC and dual (EC and CC) users over a six-month period were reported.

    METHODS: We observed 218 sole Malaysian EC and dual users over 6 months from June 2015 to November 2015. Both groups underwent exhaled breath carbon monoxide and saliva cotinine analyses to verify their nicotine cessation from both EC and CC use. Adverse events and withdrawal symptoms were assessed based on self-reports.

    RESULTS: Only 3.3% of observed users quit both ECs and CCs, whereas 20.5% quit smoking CCs. Quitting ECs and CCs was significantly higher among sole EC users (5 vs 2, respectively; OR: 5.62; P = 0.036) than it was among dual users, a result that was similar for CCs smoking (29 vs. 15; OR: 6.33; P ≤ 0.001). No severe health issues were reported over the entire study period.

    CONCLUSION: The rates of quitting CCs and ECs were higher in sole EC users than those in dual users. No serious health effects were reported over 6 months in either group. ECs may serve as a smoking cessation aid in Malaysia, but appropriate regulations are necessary to encourage sole EC use to ensure product quality. Large randomised clinical trials (RCTs) with a longer follow-up are required to better measure the effectiveness and safety of ECs use alone and in combination with CCs.
  18. Mitha S, ElNaem MH, Chandran J, Rajah NP, Fam TY, Babar MG, et al.
    J Pharm Bioallied Sci, 2018 12 21;10(4):216-225.
    PMID: 30568379 DOI: 10.4103/JPBS.JPBS_296_16
    Background and Objectives: Various devices have been used to maintain oral hygiene. These include toothbrush and toothpaste, mouthwash, dental floss, miswak, and toothpick. This study attempts to investigate the use of various oral cleaning devices and their perceived benefits among Malaysians.

    Methods: A quantitative cross-sectional study conducted in two different cities of Malaysia. A convenience sampling approach was adopted. A total of 787 participants agreed to participate in the current research. A validated questionnaire translated into national language was used for data collection.

    Statistical Analysis Used: Data analysis was performed using Statistical Package for Social Sciences version 20.

    Results: About 302 respondents were in the age range of 18 - 25 years old (38.4%). There were marginally more females (55.7%) than males (44.3%). Although 99.9% of the participants used a toothbrush, a significant majority (n = 590, 75%) used more than a single device to maintain their oral hygiene. Only 311 respondents knew that toothpicks were inappropriate to use to remove food between teeth and gums, while a majority (n = 592, 75.2%) did not realize that some mouthwashes can stain the teeth. Less than half (42.1%) knew that improper use of miswak might harm the teeth.

    Conclusions: Although their oral hygiene behaviors are relatively at a higher level, their perceived oral health benefits did not compare well.

  19. Majeed N, Jamshed S
    J Nurs Manag, 2021 Mar;29(2):229-239.
    PMID: 32881098 DOI: 10.1111/jonm.13144
    AIM: To explore the influence of leader emotional intelligence on the working culture prevailing in teams that ultimately impacts nurses' intent to leave the job.

    BACKGROUND: Global shortages of nursing professionals have been concerning issues of extreme vitality in the delivery of superior services. Though the state-of-the-art system provides relief, the hospital management continued worrying about losing highly skilled nursing professionals due to a higher level of emotional exhaustion exhibiting progressive turnover.

    METHODS: A survey technique was employed for data collection from nurses. Further data were analysed by structural equation modelling in the light of 313 substantial responses by using SmartPLS.

    RESULTS: The findings revealed that leader emotional intelligence impulses critical constructive effects by fulfilling the needs of nurses and has an impact on their turnover intentions simultaneously.

    CONCLUSION: The research provides an empirical lens of leadership and culture, which noticeably explain turnover intention. This study affirmed solid connections amongst the leader emotional intelligence, team culture and turnover intentions.

    IMPLICATIONS FOR NURSING MANAGEMENT: The study provides valuable insight for health management organisations to focus on factors that decrease the turnover intention of nurses. Considering a global shortage of nurses, nursing management must consider crucial aspects of the work environment and plan interventions to restrain nursing turnover intentions.

  20. Khan Z, Karatas Y, Martins MAP, Jamshed S, Rahman H
    Curr Med Res Opin, 2022 01;38(1):145-154.
    PMID: 34694167 DOI: 10.1080/03007995.2021.1997287
    BACKGROUND: Globally, pharmacovigilance (PV) is crucial for the patient's safety and proper use of drugs. Spontaneous reporting of adverse drug reaction (ADR) is a professional obligation of every healthcare professionals (HCPs). The purpose of this systematic review was to analyze the existing literature about the knowledge, attitude, and practices (KAP) level of HCPs regarding PV and ADRs reporting in Turkey.

    METHODS: A systematic and comprehensive articles search strategy was carried out in different seven electronic databases (PubMed, PubMed Central, Goggle Scholar, Ovid-SP, MEDLINE, Wiley Online Library, DergiPark) from 2010 to 2020. We searched to identify existing literature about cross-sectional observational studies investigating the KAP of HCPs regarding PV and ADRs reporting in different geographical regions of Turkey. Quality assessment and risk of bias were assessed among included studies.

    RESULTS: Fifteen studies were chosen for full-text analysis. Finally, according to inclusion criteria, seven research articles were selected for systematic review. Overall, the KAP of HCPs varies across the studies. The lack of a standardized validated measuring tool to evaluate the KAP and differences in questionnaire items were the main limitations in included studies. Around, 69.1% (range: 54.6-100%) of HCPs were not aware of the national pharmacovigilance center in Turkey. About, 37.5% (range: 7.1-75.7%) of HCPs believed that reporting of ADRs is not important and 87.5% (range: 69.3-100%) stated that they never reported ADR previously during their practice. The most frequently highlighted barriers to PV were lack of time, uncertainty and did not know where to report.

    CONCLUSION: This systematic review revealed a major KAP gap in Turkey towards PV activities. Low ADR reporting practice of HCPs was a major identified issue. The creation of a mandatory unified PV education intervention for future HCPs to rationally report ADR of drugs are crucial for a better healthcare system.

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