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  1. Salman M, Mustafa ZU, Khan TM, Shehzadi N, Hussain K
    Disaster Med Public Health Prep, 2020 Jun;14(3):e44-e45.
    PMID: 32662386 DOI: 10.1017/dmp.2020.247
  2. Shehzadi N, Hussain K, Khan MT, Salman M, Islam M
    Pak J Pharm Sci, 2017 Sep;30(5):1767-1777.
    PMID: 29084700
    The absence of chromophore and/or conjugated system, prerequisite for UV and florescent light detection, or absorbance at very low wavelength necessitates the development of simple and reliable methods for the determination of amikacin sulphate. Therefore, the present study describes for the first time dynamics of the drug derivatization using ninhydrin reagent and development and validation of a simple RP-HPLC method, using diode array detector (DAD). The variables such as heating time, heating type, drug-reagent ratio, reagent composition and storage temperature of the derivative were optimized. The analyte and aqueous ninhydrin solution upon heating for 2.00-5.00 min produced the colored drug-derivative which was stable for one month at refrigeration. The derivatized drug (20.00μL) was eluted through a column - Eclipse DB-C18 (5.00 µm, 4.60×150.00 mm), maintained at 25°C- using isocratic mobile phase comprising water and acetonitrile (70:30, v/v) at a flow rate of 1.00 mL/min, and detected at 400 nm. The method was found to be reliable (98.08-100.72% recovery), repeatable (98.02-100.72% intraday accuracy) and reproducible (98.47-101.27% inter day accuracy) with relative standard deviation less than 5%. The results of the present study indicate that the method is easy to perform, specific and sensitive, and suitable to be used for the determination of amikacin sulphate in bulk and pharmaceutical preparations using less expensive/laborious derivatization.
  3. Salman M, Khan AH, Syed Sulaiman SA, Hughes JD, Khan JH, Shehzadi N, et al.
    J Pak Med Assoc, 2021 May;71(5):1384-1387.
    PMID: 34091619 DOI: 10.47391/JPMA.1162
    Objective: To investigate the prevalence and severity of lower urinary tract symptoms among calcium channel blocker users, and the impact on patients' quality of life.

    METHODS: The cross-sectional study was conducted at one hospital and 2 community pharmacies in Lahore, Pakistan, from November 2017 to July 2018, and comprised patients using calcium channel blockers. Data was collected using standardised scales to assess lower urinary tract symptoms and quality of life. Data was analysed using SPSS 22.

    RESULTS: Of the 410 subjects, 315 (76.8%) were males. The overall median age was 50.84 years, IQR 19 with 126 (30.7%) aged 41-50 years. Of the total, 108 (26.3%) patients were on calcium channel blockers alone, while the rest were taking it in combination with other drugs. Prevalence of lower urinary tract symptoms was 307 (74.9%); mild 103 (25.1%), moderate 201 (49.1%) and severe 106 (25.9%). The symptoms were significantly associated with reduced quality of life (p<0.05).

    Conclusion: Majority calcium channel blockers users had clinically significant lower urinary tract symptoms which significantly reduced patients' quality of life.

  4. Latif A, Hussain K, Shehzadi N, Islam M, Khan MT, Anwar R, et al.
    Pharm Biol, 2017 Dec;55(1):547-553.
    PMID: 27951746
    CONTEXT: Kanji, a liquid preparation of roots of Daucus carota L. ssp. sativus (Hoffm.) Arcang. var. vavilovii Mazk. (Apiaceae), may inhibit glutathione sulfotransferase (GST) activity due to ferulic acid content.

    OBJECTIVES: GST inhibition activity and characterization of Kanji and methanol extract of D. carota roots, and oral absorption pattern of ferulic acid from Kanji in rats.

    MATERIALS AND METHODS: GST inhibition activity of Kanji and methanol extract of D. carota roots in concentration range 0.001-100.00 mg/mL was determined using Sprague Dawley rat liver cytosolic fraction. Methanol extract upon column chromatography gave ferulic acid, which was used to characterize Kanji and determine its oral absorption pattern in Wistar rats.

    RESULTS: The GST inhibition activity of Kanji (100.00 μg/mL), methanol extract of D. carota roots (100.00 μg/mL) and tannic acid (10.00 μg/mL, positive control) was found to be 0.162 ± 0.016, 0.106 ± 0.013 and 0.073 ± 0.004 μM/min/mg, respectively. Different Kanji samples and methanol extract contained ferulic acid (0.222-0.316 mg/g) and 0.77 mg/g, respectively. Ferulic acid did not appear in plasma after oral administration of Kanji.

    DISCUSSION: Kanji having solid contents 80.0 μg/mL, equivalent to 0.0025 μg/mL ferulic acid, does not inhibit the activity of GST. The oral administration of Kanji, in human equivalent dose (528 mg/kg, 16.67 μg ferulic acid), to rats indicated poor absorption of ferulic acid.

    CONCLUSION: Kanji having solid contents 14-36 mg/mL does not inhibit GST activity, hence may not interfere with drugs that are the substrates of GST, if taken concomitantly.

  5. Salman M, Khan AH, Adnan AS, Sulaiman SA, Hussain K, Shehzadi N, et al.
    Rev Assoc Med Bras (1992), 2016 Nov;62(8):742-747.
    PMID: 27992014 DOI: 10.1590/1806-9282.62.08.742
    Objective:: Anemia, a common complication of chronic kidney diseases (CKD), is involved in significant cardiovascular morbidity. Therefore, the objective of our study was to investigate the prevalence and severity of anemia in pre-dialysis patients, as well as to determine the predictors of anti-anemic therapy.

    Method:: A retrospective, observational study was conducted on adult pre-dialysis patients receiving treatment at the Hospital Universiti Sains Malaysia from January 2009 to December 2013.

    Results:: A total of 615 eligible cases were included. The mean age of patients was 64.1±12.0 years. The prevalence of anemia was 75.8%, and the severity of anemia was mild in 47.7% of the patients, moderate in 32.2%, and severe in 20%. Based on morphological classification of anemia, 76.9% of our patients had normochromic-normocytic anemia whereas 21.8 and 1.3% had hypochromic-microcytic anemia and macrocytic anemia, respectively. Oral iron supplements were prescribed to 38.0% of the patients and none of the patients was given erythropoietin stabilizing agents (ESA) or intravenous iron preparations. In logistic regression, significant predictors of anti-anemic preparation use were decreased hemoglobin and hematocrit, and advanced stages of CKD.

    Conclusion:: The results of the present study suggest that the prevalence of anemia in pre-dialysis patients is higher than currently accepted and it is found to be correlated with renal function; prevalence increases with declined renal function. An earlier identification as well as appropriate management of anemia will not only have a positive impact on quality of life but also reduce hospitalizations of CKD patients due to cardiovascular events.

  6. Salman M, Khan AH, Syed Sulaiman SA, Khan JH, Hussain K, Shehzadi N
    Biomed Res Int, 2017;2017:4269875.
    PMID: 29124064 DOI: 10.1155/2017/4269875
    Background: Numerous medications are known to be associated with the development of lower urinary tract symptoms (LUTS). One such medication group is calcium channel blockers (CCB).

    Objective: To critically examine the literature regarding the involvement of CCB in manifestation of LUTS in humans.

    Methods: A systematic literature search was conducted on PubMed, SciELO, Scopus, and OpenGrey databases to find all potentially relevant research studies before August 2016.

    Results: Five studies met the inclusion criteria and were included in this review. Three out of five studies stated that CCB were involved in either precipitation or exacerbation of LUTS. As for the remaining two studies, one study found out that only the monotherapy of CCB was associated with increased prevalence of nocturia and voiding symptoms in young females, whereas the other study reported an inverse association of CCB with LUTS. The methodological quality of studies was considered high for four studies and low for one study.

    Conclusion: Healthcare providers should make efforts for an earlier identification of the individuals at risk of LUTS prior to the commencement of CCB therapy. Moreover, patients should be counselled to notify their healthcare provider if they notice urinary symptoms after the initiation of CCB.

  7. Salman M, Khan AH, Adnan AS, Sulaiman SA, Hussain K, Shehzadi N, et al.
    Sao Paulo Med J, 2015;133(6):502-9.
    PMID: 26760124 DOI: 10.1590/1516-3180.2015.005
    CONTEXT AND OBJECTIVE: Chronic kidney disease (CKD) is an escalating medical and socioeconomic problem worldwide. Information concerning the causes of CKD, which is a prerequisite for reducing the disease burden, is sparse in Malaysia. Therefore, this study aimed to evaluate the attributable causes of CKD in an adult population at a tertiary referral hospital.

    DESIGN AND SETTING: Retrospective study at Hospital Universiti Sains Malaysia (HUSM).

    METHODS: This was an analysis based on medical records of adult patients at HUSM. Data regarding demographics, laboratory investigations, attributable causes and CKD stage were gathered.

    RESULTS: A total of 851 eligible cases were included. The patients' mean age was 61.18 ± 13.37 years. CKD stage V was found in 333 cases (39.1%) whereas stages IV, IIIb, IIIa, and II were seen in 240 (28.2%), 186 (21.9%), 74 (8.7%) and 18 (2.1%), respectively. The percentage of CKD stage V patients receiving renal replacement therapy was 15.6%. The foremost attributable causes of CKD were diabetic nephropathy (DN) (44.9%), hypertension (HPT) (24.2%) and obstructive uropathy (9.2%). The difference in the prevalence of CKD due to DN, HPT and glomerulonephritis between patients ≤ 50 and > 50 years old was statistically significant.

    CONCLUSION: Our results suggest that DN and HPT are the major attributable causes of CKD among patients at a Malaysian tertiary-care hospital. Furthermore, the results draw attention to the possibility that greater emphasis on primary prevention of diabetes and hypertension will have a great impact on reduction of hospital admissions due to CKD in Malaysia.

  8. Salman M, Khan AH, Adnan AS, Syed Sulaiman SA, Shehzadi N, Asif N, et al.
    Saudi J Kidney Dis Transpl, 2017 5 26;28(3):517-523.
    PMID: 28540887 DOI: 10.4103/1319-2442.206451
    Chronic kidney disease (CKD) patients suffer from multiple comorbidities and complications as a cause or consequence of kidney disease. Information regarding medication- prescribing patterns in predialysis patients is sparse. We conducted a retrospective study to evaluate the medication prescription patterns among predialysis patients. Medical records (both paper based and computerized) of patients at CKD Resource Centre, Hospital Universiti Sains Malaysia, were reviewed. A total of 615 eligible cases were included in the study. The mean number of medications prescribed per patient was 8.22 ± 2.81, and medication use was correlated to the renal function (stage 3a < stage 3b < stage 4 < stage 5; P <0.001). The top three prescribed medication groups were found to be lipid-lowering agents, calcium channel blockers, and antiplatelet agents. Some medication classes such as nonaluminum/noncalcium phosphate binders, erythropoietin-stimulating agents, and renin-angiotensin-aldosterone system blockers, particularly in advanced stage, were found to be underutilized. In conclusion, predialysis patients are prescribed a large number of medications. Our findings highlight the need for assessing the impact of current medication-prescribing patterns on morbidity and mortality rates in Malaysian predialysis population.
  9. Salman M, Shehzadi N, Hussain K, Saleem F, Khan MT, Asif N, et al.
    Am J Infect Control, 2017 Feb 01;45(2):e23-e25.
    PMID: 28159068 DOI: 10.1016/j.ajic.2016.11.019
    This cross-sectional study aimed to evaluate the knowledge of a Pakistani university population (students and employees) regarding Ebola virus disease. A total of 2,200 individuals were approached and 1,647 were enrolled in the study. We observed that the vast majority of study participants (91.8%) had inadequate knowledge of Ebola virus disease (knowledge score ≤ 12). Our findings highlight the need to increase the knowledge of Ebola virus disease by using multidimensional approach involving awareness campaigns, print, electronic, and social media.
  10. 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.

  11. 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.

  12. 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 
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