Displaying publications 1 - 20 of 53 in total

Abstract:
Sort:
  1. Ul Mustafa Z, Batool A, Ibrar H, Salman M, Khan YH, Mallhi TH, et al.
    Expert Rev Anti Infect Ther, 2024 Apr;22(4):229-240.
    PMID: 38146949 DOI: 10.1080/14787210.2023.2299387
    INTRODUCTION: Previous studies in Pakistan have shown considerable over prescribing of antibiotics in patients hospitalized with COVID-19 despite very low prevalence of bacterial infections. Irrational use of antibiotics will worsen antimicrobial resistance (AMR).

    METHODS: Retrospective analysis of medical records of patients in the COVID-19 wards of three tertiary care hospitals to assess antibiotic use during the sixth COVID-19 wave.

    RESULTS: A total of 284 patients were included, most were male (66.9%), aged 30-50 years (50.7%) with diabetes mellitus the most common comorbidity. The most common symptoms at presentation were cough (47.9%) and arthralgia-myalgia (41.5%). Around 3% were asymptomatic, 34.9% had mild, 30.3% moderate, and 23.6% had severe disease, with 8.1% critical. Chest X-ray abnormalities were seen in 43.3% of patients and 37% had elevated white cell counts, with 35.2% having elevated C-reactive protein levels. Around 91% COVID-19 patients were prescribed antibiotics during their hospital stay, with only a few with proven bacterial co-infections or secondary bacterial infections. Most antibiotics were from the 'Watch' category (90.8%) followed by the 'Reserve' category (4.8%), similar to previous COVID-19 waves.

    CONCLUSION: There continued to be excessive antibiotics use among hospitalized COVID-19 patients in Pakistan. Urgent measures are needed to address inappropriate prescribing including greater prescribing of Access antibiotics where pertinent.

  2. Kaleem S, Ahmad T, Wahid A, Khan HH, Mallhi TH, Al-Worafi YM, et al.
    PLoS One, 2024;19(2):e0288834.
    PMID: 38300948 DOI: 10.1371/journal.pone.0288834
    The study aims to assess the health-related Quality of Life (HRQOL) and its association with socio-demographic factors among the Afghan refugees residing in Quetta, Pakistan. For this purpose, a cross-sectional, descriptive study design by adopting Euro QOL five dimensions questionnaire (EQ-5D) for the assessment of HRQOL was conducted by approaching Afghan refugees from the camp and other areas of Quetta, Pakistan. Furthermore, this study also involved descriptive analysis to expound participant's demographic characteristics while inferential statistics (Kruskal-Wallis and Mann-Whitney test, P < 0.05) were used to compare EQ-5D scale scores. All analyses were performed using SPSS v 20. Herein, a total of 729 participants were enrolled and were subsequently (n = 246, 33.7%) categorized based on their age of 22-31 years (31.30 ± 15.40). The results of mean EQ-5D descriptive score (0.85 ± 0.20) and EQ-VAS score (78.60 ± 11.10) indicated better HRQOL in the current study respondents as compared to studies conducted in other refugee camps around the globe. In addition, demographic characteristics including age, marital status, locality, years of living as refugees, life as a refugee residing out of Pakistan, place of residence in Afghanistan, educational qualification, occupation, and arrested for crime were the statistically significant predictors (P < 0.05) of EQ-5D index scores. However, gender, living status, monthly income, preferred place of treatment were non-significant predictors (P > 0.05). The results of current study provided evidence for a model that correlated with participant's socio-demographic information and HRQOL. Moreover, this study also revealed a baseline assessment for the health status of Afghan refugees, interestingly, these results could be applied for improving HRQOL of the given participants. In conclusion, the HRQOL of Afghan refugees residing in Quetta, Pakistan can largely be improved by providing adequate healthcare facilities, education and employment opportunities, mental and social support, and providing adequate housing and basic necessities of life.
  3. Masood S, Alkubaisi NA, Aslam M, Salman M, Baraka MA, Mustafa ZU, et al.
    Healthcare (Basel), 2023 Oct 20;11(20).
    PMID: 37893851 DOI: 10.3390/healthcare11202777
    The World Health Organization (WHO) declared the monkeypox outbreak a public health emergency in June 2022. In Pakistan, positive cases of monkeypox were reported in April 2023. Healthcare workers (HCWs) are considered as a front-line force to combat such outbreaks. A questionnaire-based cross-sectional study was conducted among 11 public sector educational institutions in Punjab, Pakistan, during May and June 2023 among final year medical, pharmacy, and nursing students concerning their knowledge of monkeypox. This included the signs/symptoms of monkeypox. Healthcare students were chosen as they are the HCWs of tomorrow. A total of 389 healthcare students participated in the study, with a mean age of 23.17 ± 1.72 years, and the majority were female. The mean knowledge score was 17.69 ± 4.55 (95% CI 17.24-18.14) out of a maximum total knowledge score of 26 (each correct answer was given a score of 1). The proportion of students with good, moderate, and poor knowledge was 21.6%, 43.2%, and 35.2%, respectively. Age (p = 0.017), gender (p < 0.001), and education (p < 0.001) had a significant impact on the knowledge score. In the multivariate linear regression model, education was the only significant factor linked to knowledge scores. Overall, the majority of future HCWs had moderate knowledge of monkeypox. Consequently, educational activities are needed to improve monkeypox-related knowledge among future HCWs. Furthermore, emerging infectious diseases should be routinely incorporated into HCW curricula.
  4. Harmain ZU, Alkubaisi NA, Hasnain M, Salman M, Baraka MA, Mustafa ZU, et al.
    Healthcare (Basel), 2023 Aug 23;11(17).
    PMID: 37685412 DOI: 10.3390/healthcare11172378
    There are typically lower COVID-19 vaccination rates among developing versus higher-income countries, which is exacerbated by greater vaccine hesitancy. However, despite the increasing evidence of safety, parents are still reluctant to vaccinate their children against COVID-19. This is a concern in countries experiencing successive waves, such as Pakistan. Consequently, the objective of this study was to gain better understanding and practice regarding parents vaccinating their children against COVID-19 in Pakistan. A cross-sectional study was conducted to measure parents' attitudes towards vaccinating their children. In total, 451 parents participated in the study, giving a response rate of 70.4%; 67.4% were female, 43.2% belonged to the 40-49 years age group, and 47.7% had three children, with 73% of parents fully immunized against COVID-19. We found that 84.7% of parents did not consider COVID-19 to be a very serious issue, and 53.9% considered that their children were not at high risk of COVID-19. Overall, only a quarter of the study participants had currently vaccinated their children and 11.8% were willing to vaccinate their children in the near future. Parents who had a better knowledge of COVID-19, secondary or higher education, children who had chronic illness, and those parents whose children had been infected with COVID-19 were more likely to have their children vaccinated. The most common reasons for vaccine hesitancy were "my child is not at high risk of COVID-19" (61%) and "I am afraid to put/inject a foreign object inside my child's body" (52.2%). Overall, vaccine acceptance was low among the parents of the children. Those parents with higher education, chronic illnesses, greater knowledge of COVID-19 and its vaccines, and those whose children had been infected with COVID-19 were significantly (p < 0.001) inclined towards vaccinating their children. Effective campaigns as well as awareness sessions are needed to address misinformation and reduce vaccine hesitancy.
  5. Salman M, Mallhi TH, Khan YH, Mustafa ZU, Khan MT, Khan FU, et al.
    Hum Vaccin Immunother, 2023 Aug 01;19(2):2225990.
    PMID: 37350298 DOI: 10.1080/21645515.2023.2225990
    Vaccine hesitancy (VH) is not a new phenomenon in Pakistan and is regarded as one of the primary causes of unsatisfactory vaccination campaigns. This study determined post-vaccination COVID-19 VH, factors influencing COVID-19 vaccine uptake, and public's intent to receive booster vaccinations. A cross-sectional study was conducted among adult population of Lahore, Pakistan. Participants were recruited via convenience sampling between March and May 2022. SPSS version 22 was used for the data analysis. A total of 650 participants were included in the study (age = 28.1 ± 9.7 years; male-to-female ratio nearly 1: 1). The majority of participants received Sinopharm followed by Sinovac vaccine. The top three reasons of vaccine uptake were "only vaccinated individuals are allowed at the workplace, and educational institutes" (Relative importance index (RII) = 0.749), "only vaccinated people are allowed to go to markets, malls and other public places" (RII = 0.746), and "protect myself from the infection" (RII = 0.742). The mean COVID-19 VH score was 24.5 ± 6.2 (95% CI 23.9-24.9), with not being pro-vaccines and poor economic status were the significant predictors of COVID-19 vaccine hesitancy among immunized individuals (p 
  6. Shabir A, Alkubaisi NA, Shafiq A, Salman M, Baraka MA, Mustafa ZU, et al.
    Vaccines (Basel), 2023 Jun 09;11(6).
    PMID: 37376470 DOI: 10.3390/vaccines11061081
    Prisoners form a population who are highly vulnerable to COVID-19 due to overcrowding, limited movement, and a poor living environment. Consequently, there is a need to ascertain the status of COVID-19 vaccination and factors associated with hesitancy among prisoners. A cross-sectional questionnaire-based study was undertaken among prisoners at three district jails in Punjab Province, Pakistan. A total of 381 prisoners participated and none of the study participants had received an influenza vaccine this year. In total, 53% received at least one dose of a COVID-19 vaccine, with the majority having two doses. The top three reasons of vaccine acceptance were "fear of contracting SARS-CoV-2 infection" (56.9%), "desire to return to a pre-pandemic routine as soon as possible" (56.4%), and "having no doubts on the safety of COVID-19 vaccines" (39.6%). There was no statistically significant difference (p > 0.05) in any demographic variables between vaccinated and unvaccinated prisoners except for age, which was strongly association with COVID-19 vaccine uptake (χ2(3) = 76.645, p < 0.001, Cramer's V = 0.457). Among the unvaccinated prisoners (N = 179), only 16 subsequently showed willingness to receive a COVID-19 vaccine. The top three reasons for hesitancy were: COVID-19 is not a real problem/disease (60.1%), safety concerns (51.1%), and COVID-19 vaccine is a conspiracy (50.3%). Efforts are needed to address their concerns given this population's risks and high hesitancy rates, especially among younger prisoners.
  7. Amjad Z, Maryam I, Munir M, Salman M, Baraka MA, Mustafa ZU, et al.
    Vaccines (Basel), 2023 Apr 27;11(5).
    PMID: 37243008 DOI: 10.3390/vaccines11050904
    COVID-19 vaccine hesitancy continues to be a widespread problem in Pakistan due to various conspiracy beliefs, myths and misconceptions. Since the hemodialysis population is at a higher risk of contracting infections, we sought to investigate the current COVID-19 immunization status and reasons for any vaccine hesitancy among these patients in Pakistan. This cross-sectional study was conducted among maintenance hemodialysis patients at six hospitals in the Punjab Province of Pakistan. Data were collected anonymously using a questionnaire. A total of 399 hemodialysis patients took part in the survey, the majority of them were male (56%) and aged 45-64 years. A calculated 62.4% of the patients reported receiving at least one dose of the COVID-19 vaccine. Of those vaccinated (249), 73.5% had received two doses and 16.9% had received a booster dose. The most common reasons for vaccination were "being aware they were at high risk" (89.6%), "fear of getting infected" (89.2%) and "willingness to fight against COVID-19-pandemic" (83.9%). Of the 150 patients who had not yet been vaccinated, only 10 showed a willingness to take the COVID-19 vaccine. The major reasons for refusal included "COVID-19 is not a real problem" (75%), the "corona vaccine is a conspiracy (72.1%)" and "I don't need the vaccine" (60.7%). Our study revealed that only 62% patients receiving hemodialysis were partially or completely vaccinated against COVID-19. Consequently, there is a need to initiate aggressive approaches to educate this high-risk population in order to address their concerns with vaccine safety and efficacy as well as correct current myths and misconceptions to improve the COVID-19 immunization status in this population.
  8. Mustafa ZU, Iqbal S, Asif HR, Salman M, Jabbar S, Mallhi TH, et al.
    Antibiotics (Basel), 2023 Feb 28;12(3).
    PMID: 36978348 DOI: 10.3390/antibiotics12030481
    Since the emergence of COVID-19, several different medicines including antimicrobials have been administered to patients to treat COVID-19. This is despite limited evidence of the effectiveness of many of these, fueled by misinformation. These utilization patterns have resulted in concerns for patients' safety and a rise in antimicrobial resistance (AMR). Healthcare workers (HCWs) were required to serve in high-risk areas throughout the pandemic. Consequently, they may be inclined towards self-medication. However, they have a responsibility to ensure any medicines recommended or prescribed for the management of patients with COVID-19 are evidence-based. However, this is not always the case. A descriptive cross-sectional study was conducted among HCWs in six districts of the Punjab to assess their knowledge, attitude and practices of self-medication during the ongoing pandemic. This included HCWs working a range of public sector hospitals in the Punjab Province. A total of 1173 HCWs were included in the final analysis. The majority of HCWs possessed good knowledge regarding self-medication and good attitudes. However, 60% were practicing self-medication amid the COVID-19 pandemic. The most frequent medicines consumed by the HCWs under self-medication were antipyretics (100%), antibiotics (80.4%) and vitamins (59.9%). Azithromycin was the most commonly purchase antibiotic (35.1%). In conclusion, HCWs possess good knowledge of, and attitude regarding, medicines they purchased. However, there are concerns that high rates of purchasing antibiotics, especially "Watch" antibiotics, for self-medication may enhance AMR. This needs addressing.
  9. Mustafa ZU, Majeed HK, Latif S, Salman M, Hayat K, Mallhi TH, et al.
    Disaster Med Public Health Prep, 2023 Feb 14;17:e298.
    PMID: 36785528 DOI: 10.1017/dmp.2022.252
    OBJECTIVE: Infection prevention and control (IPC) measures are easily adoptable activities to prevent the spread of infection to patients as well as among health-care workers (HCWs).

    METHODS: This cross-sectional study evaluated the adherence to IPC measures among HCWs working at coronavirus disease 2019 (COVID-19) treatment centers in Punjab, Pakistan. HCWs were recruited by means of convenient sampling through Google Form® using the World Health Organization risk assessment tool. All data were analyzed using SPSS 20.

    RESULTS: A total of 414 HCWs completed the survey (response rate = 67.8%), and majority of them were males (56.3%). Most of the HCWs were nurses (39.6%) followed by medical doctors (27.3%). Approximately 53% reported insufficiency of personal protective equipment (PPE), 58.2% did not receive IPC training and 40.8% did not have functional IPC team at their health facilities. The majority of HCWs (90%) used disposable gloves and N95 facemasks while interacting with COVID-19 patients. Nearly 45% used protective face shields and gowns before providing care to their patients. Hand hygiene practices while touching, and performing any aseptic procedure was adopted by 70.5% and 74.1% of HCWs, respectively.

    CONCLUSIONS: In conclusion, the adherence to IPC measures among Pakistani HCWs working in COVID-19 treatment centers is good despite the limited availability of PPEs. Their practices can be optimized by establishing institutional IPC teams, periodic provision of IPC training, and necessary PPE.

  10. Mustafa ZU, Maqbool F, Wahid M, Salman M, Haroon S, Khan YH, et al.
    Rev Soc Bras Med Trop, 2023;56:e0044.
    PMID: 37283345 DOI: 10.1590/0037-8682-0044-2023
    BACKGROUND: Safety and efficacy concerns regarding coronavirus disease 2019 (COVID-19) vaccines are common among the public and have a negative impact on their uptake. We aimed to report the adverse effects currently associated with the vaccine in Pakistan to build confidence among the population for its adoption.

    METHODS: A cross-sectional study was conducted in five districts of the Punjab province of Pakistan between January and March 2022. The participants were recruited using convenience sampling. All data were analyzed using SPSS 22.

    RESULTS: We recruited 1622 people with the majority aged between 25-45 years. Of these, 51% were female, including 27 pregnant women and 42 lactating mothers. Most participants had received the Sinopharm (62.6%) or Sinovac (17.8%) vaccines. The incidences of at least one side effect after the first (N = 1622), second (N = 1484), and booster doses (N = 219) of the COVID-19 vaccine were 16.5%, 20.1%, and 32%, respectively. Inflammation/erythema at the injection site, pain at the injection site, fever, and bone/muscle pain were common side effects of vaccination. No significant differences were observed in the adverse effect scores between all demographic variables except for pregnancy (P = 0.012) after the initial dose. No significant association was observed between any variable and the side effect scores of the second and booster doses of the vaccine.

    CONCLUSIONS: Our study showed a 16-32% prevalence of self-reported side effects after the first, second, and booster COVID-19 vaccinations. Most adverse effects were mild and transient, indicating the safety of different COVID-19 vaccines.

  11. Mallhi TH, Salman M, Khan YH, Khan FU, Butt MH, Ung COL, et al.
    Front Pediatr, 2023;11:1298691.
    PMID: 38078334 DOI: 10.3389/fped.2023.1298691
  12. Mustafa ZU, Tariq S, Iftikhar Z, Meyer JC, Salman M, Mallhi TH, et al.
    Antibiotics (Basel), 2022 Dec 13;11(12).
    PMID: 36551463 DOI: 10.3390/antibiotics11121806
    Healthcare-associated infections (HAIs) have a considerable impact on morbidity, mortality and costs. The COVID-19 pandemic resulted in an appreciable number of hospitalized patients being admitted to intensive care units (ICUs) globally with a greater risk of HAIs. Consequently, there is a need to evaluate predictors and outcomes of HAIs among COVID-19 patients admitted to ICUs. A retrospective study of patients with COVID-19 admitted to ICUs of three tertiary care hospitals in the Punjab province over a five-month period in 2021 was undertaken to ascertain predictors and outcomes of HAIs. Of the 4534 hospitalized COVID-19 patients, 678 were admitted to ICUs, of which 636 patients fulfilled the inclusion criteria. Overall, 67 HAIs were identified among the admitted patients. Ventilator-associated lower respiratory tract infections and catheter-related urinary tract infections were the most frequent HAIs. A significantly higher number of patients who developed HAIs were on anticoagulants (p = 0.003), antithrombotic agents (p < 0.001), antivirals (p < 0.001) and IL-6 inhibiting agents (p < 0.001). Secondary infections were significantly higher in patients who were on invasive mechanical ventilation (p < 0.001), had central venous access (p = 0.023), and urinary catheters (p < 0.001). The mortality rate was significantly higher in those with secondary infections (25.8% vs. 1.2%, p < 0.001). Our study concluded that COVID-19 patients admitted to ICUs have a high prevalence of HAIs associated with greater mortality. Key factors need to be addressed to reduce HAIs.
  13. Salman M, Mustafa ZU, Raza MH, Khan TM, Asif N, Tahir H, et al.
    Disaster Med Public Health Prep, 2022 Jan 10;17:e104.
    PMID: 35000668 DOI: 10.1017/dmp.2022.4
    OBJECTIVE: The aim of this study is to ascertain the psychological impacts of coronavirus disease (COVID-19) among the Pakistani health care workers (HCWs) and their coping strategies.

    METHODS: This web-based, cross-sectional study was conducted among HCWs (N = 398) from Punjab Province of Pakistan. The generalized anxiety scale (GAD-7), patient health questionnaire (PHQ-9), and Brief-COPE were used to assess anxiety, depression, and coping strategies, respectively.

    RESULTS: The average age of respondents was 28.67 years (SD = 4.15), with the majority being medical doctors (52%). Prevalences of anxiety and depression were 21.4% and 21.9%, respectively. There was no significant difference in anxiety and depression scores among doctors, nurses, and pharmacists. Females had significantly higher anxiety (P = 0.003) and depression (P = 0.001) scores than males. Moreover, frontline HCWs had significantly higher depression scores (P = 0.010) than others. The depression, not anxiety, score was significantly higher among those who did not receive the infection prevention training (P = 0.004). The most frequently adopted coping strategies were religious coping (M = 5.98, SD = 1.73), acceptance (M = 5.59, SD = 1.55), and coping planning (M = 4.91, SD = 1.85).

    CONCLUSION: A considerable proportion of HCWs are having generalized anxiety and depression during the ongoing COVID-19 pandemic. Our findings call for interventions to mitigate mental health risks in HCWs.

  14. Salman M, Mustafa ZU, Asif N, Shehzadi N, Hussain K, Khan TM, et al.
    Disaster Med Public Health Prep, 2021 Aug 09;17:e31.
    PMID: 34369343 DOI: 10.1017/dmp.2021.261
    BACKGROUND: COVID-19 outbreak has been accompanied by a massive infodemic, however, many vulnerable individuals such as illiterate or low-literate, older adults and rural populations have limited access to health information. In this context, these individuals are more likely to have poor knowledge, attitudes, and preventive practices related to COVID-19. The current study was aimed to investigate COVID-19's awareness of the illiterate population of Pakistan.

    METHODS: A cross-sectional survey was conducted among illiterate Pakistanis of ages ≥ 18 years through a convenient sampling approach. The study participants were interviewed face to face by respecting the defined precautionary measures and all data were entered and analyzed using SPSS version 22 (IBM, Armonk, NY).

    RESULTS: The mean age of the study participants' (N = 394) was 37.2 ± 9.60 years, with the majority being males (80.7%). All participants were aware of the COVID-19 outbreak and television news channels (75.1%) were the primary source of information. The mean knowledge score was 5.33 ± 1.88, and about 27% of participants had a good knowledge score (score ≥ 7) followed by moderate (score 4 - 6) and poor (score ≤ 3) knowledge in 41.6%, and 31.5% of respondents, respectively. The attitude score was 4.42 ± 1.22 with good (score ≥ 6), average (score 4 - 5), and poor attitude (score ≤ 3) in 19%, 66%, and 15% of the participants, respectively. The average practice-related score was 12.80 ± 3.34, with the majority of participants having inadequate practices.

    CONCLUSION: COVID-19 knowledge, attitude, and preventive practices of the illiterate population in Pakistan are unsatisfactory. This study highlights the gaps in specific aspects of knowledge and practice that should be addressed through awareness campaigns targeting this specific population.

  15. Mallhi TH, Khan YH, Adnan AS
    Am J Trop Med Hyg, 2020 Dec;103(6):2164-2167.
    PMID: 33124548 DOI: 10.4269/ajtmh.20-0794
    Despite myriad improvements in the care of COVID-19 patients, atypical manifestations are least appreciated during the current pandemic. Because COVID-19 is primarily manifesting as an acute respiratory illness with interstitial and alveolar pneumonia, the possibility of viral invasions into the other organs cannot be disregarded. Acute kidney injury (AKI) has been associated with various viral infections including dengue, chikungunya, Zika, and HIV. The prevalence and risks of AKI during the course of COVID-19 have been described in few studies. However, the existing literature demonstrate great disparity across findings amid variations in methodology and population. This article underscores the propensity of AKI among COVID-19 patients, limitations of the exiting evidence, and importance of timely identification during the case management. The prevalence of AKI is variable across the studies ranging from 4.7% to 81%. Evidence suggest old age, comorbidities, ventilator support, use of vasopressors, black race, severe infection, and elevated levels of baseline serum creatinine and d-dimers are independent risk factors of COVID-19 associated with AKI. COVID-19 patients with AKI also showed unsatisfactory renal recovery and higher mortality rate as compared with patients without AKI. These findings underscore that AKI frequently occurs during the course of COVID-19 infection and requires early stratification and management.
  16. Khalid SH, Liaqat I, Mallhi TH, Khan AH, Ahmad J, Khan YH
    J Pak Med Assoc, 2020 Dec;70(12(B)):2376-2382.
    PMID: 33475547 DOI: 10.47391/JPMA.370
    OBJECTIVE: Diabetes mellitus (DM) along with myocardial infarction (MI) carries increased burden on patients in terms of morbidity, mortality and cost. Current study was aimed to investigate the impact of DM on clinico-laboratory characteristics on in-hospital treatment outcomes among MI patients.o compare the outcome of mesh hernioplasty performed under local anaesthesia in relatively young and older patients regarding wound complications and urinary retention.

    METHODS: All MI patients admitted to the emergency department of Faisalabad Institute of Cardiology from April, 2016 to March, 2017 were recruited into the study. The clinico-laboratory profile and in-hospital outcomes of patients with and without DM were compared using chi-squared test or student t-test, where appropriate.

    RESULTS: A total 4063 patients (Mean age: 55.86 ± 12.37years) with male preponderance were included into the study. STEMI was most prevalent (n = 2723, 67%) type of MI among study participants. DM was present in substantial number of cases (n = 3688, 90.8%). Patients with DM presented with increased BMI, higher blood pressure, elevated levels of cholesterol, serum creatinine, and blood urea nitrogen, when compared to the patients without DM (p<0.05). Out of 560 patients who were followed up, cardiogenic shock was frequent (n = 293, 52.3%) adverse outcome followed by heart failure (n = 114, 20.4%), atrial fibrillation (n = 78, 13.9%) and stroke (n = 75, 13.4 %). Moreover, in-hospital adverse outcomes were more prevalent among MI patients with DM than those without DM.

    CONCLUSIONS: MI patients with DM present with varying clinico laboratory characteristics as well as experience higher prevalence of adverse cardiovascular events as compared to patients without DM. These patients require individual management strategy on very first day of admission.

  17. Amanullah I, Khan YH, Anwar I, Gulzar A, Mallhi TH, Raja AA
    Postgrad Med J, 2019 Nov;95(1129):601-611.
    PMID: 31434683 DOI: 10.1136/postgradmedj-2018-136364
    The efficacy of vitamin E among patients with non-alcoholic fatty liver disease (NAFLD) is unclear. The current qualitative and quantitative analyses aimed to ascertain the efficacy of vitamin E on clinical outcomes of patients with NAFLD. A systematic search of randomised controlled trials (RCTs) was performed using databases (PubMed, ProQuest, Scopus, EBSCOhost and Ovid) from inception to July 2018. Trials meeting the inclusion criteria were subjected to quality assessment using the Jadad Scoring. All trials meeting the prerequisites information for meta-analysis were subjected to quantitative synthesis of results. Nine RCTs (five in adults and four in children) were included. Four of the five RCTs on adults demonstrated significant improvements in alanine transaminase and other liver function surrogates in patients with NAFLD. On the other hand, only one of the four RCTs conducted on children showed significant improvements in liver functions with the use of vitamin E. Although quantitative synthesis of available data revealed insignificant differences between vitamin E and placebo, still the use of vitamin E improves the level of alanine transaminase and aspartate transaminase by -1.96 and -0.59, with heterogeneity of I2=67% and I2=0%, respectively. Adjuvant vitamin E therapy provides significant biochemical and histological improvements in adult patients with NAFLD, while paediatric patients showed insignificant efficacy compared with placebo. Lifestyle interventions along with vitamin E can provide much better results. Data, including the impact of vitamin E on hepatic histology, are still lacking. Moreover, the short duration of trials limits the conclusion on the safety and efficacy of proposed treatments.
  18. Bukhsh A, Hussain S, Rehman IU, Mallhi TH, Khan YH, Khaliel AM, et al.
    Pak J Pharm Sci, 2019 Jul;32(4(Supplementary)):1789-1796.
    PMID: 31680074
    Seasonal influenza is a highly contagious viral respiratory disorder. Prior knowledge of flu among general community is of paramount importance in order to mitigate its growing burden. In a pandemic, young adults are more likely to be infected increasing the potential for universities to be explosive disease outbreak centers. In this context, current study aims to assess the knowledge and perception of flu among university students from health sciences (HS) and non-HS background. Questionnaire-based cross sectional (August-December 2015) study was conducted among students of 65 universities across Pakistan. The students willing to participate were requested to fill out the self-administered questionnaire and responses were recorded and descriptively analyzed by SPSS. A total of 1694 students (age: 21.12 ± 2.13 years), 95% which belonged to age group 18-25 years, participated in the current study. Most of the participants (91.7%) had suffered from influenza during their life but only 55.7% correctly answered virus as causative agent of flu, while majority of participants, primarily from non-HS disciplines were not aware of flu cause. Very few participants (8.1%) believed that flu can cause death. About 20% students, mainly from non-HS disciplines reported that antibiotic can kill viruses. Similarly, 47.1% respondents agreed on the effectiveness of antibiotic in flu. A large proportion of study population preferred self-medication for influenza. Only 20.1% students were aware of influenza vaccine while majority of students (79.9%) from both disciplines reported that there is no such vaccine. Awareness and health literacy regarding seasonal influenza is poor among university students, especially from non-HS disciplines. These findings necessitate dire need to appropriately structured awareness programs in educational institutes to curb the growing burden of influenza.
  19. Khan YH, Mallhi TH, Sarriff A, Khan AH, Tanveer N
    J Coll Physicians Surg Pak, 2018 Dec;28(12):960-966.
    PMID: 30501836 DOI: 10.29271/jcpsp.2018.12.960
    Chronic kidney disease (CKD) is an asymptomatic disease associated with high morbidity and life-threatening complications that lead to decreased life expectancy. Worldwide prevalence of CKD is escalating at an alarming rate. Large population-based representative surveys have been reported in Western countries to estimate the prevalence of the disease. However, there is paucity of data as far as developing nations are concerned. Asia is the world's largest continent accommodating maximum number of under-developed and developing countries with an unclear picture of prevalence of CKD. Current review attempts to give an insight to the prevalence of CKD in this region by combining population-based surveys. This review will assist in estimating the burden of CKD in Asia, so that appropriate control measures could be designed.
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links