Displaying publications 1 - 20 of 44 in total

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  1. Mubarak N, Raja SA, Khan TM, Zin CS
    J Pak Med Assoc, 2021 Mar;71(3):950-965.
    PMID: 34057955 DOI: 10.47391/JPMA.058
    Medicine use review is a tool to improve medication adherence and safety. Current narrative review was planned to explore global policies and practices of medicine use review by community pharmacists in chronic diseases and its impact and way forward for low- and middle-income countries. Key words, such as ″medicine use review″, ″medication therapy management″ and ″community pharmacy″ were used for search on PubMed and CINAHL databases for articles published from 2004 to 2019. Medicine use review has opened an avenue of ongoing collaboration between community pharmacists and general practitioners. High-income countries have witnessed a gradual yet cautious adoption of these services through effective policy shift. In terms of practices and impact, the situation in high-income countries was promising where on an average ″type-II″ medicine use review was widely in practice and had improved clinical, humanistic and economic outcomes in chronic disease. However, in low- and middle-income countries, a paucity of effective policies was noted. Nevertheless, an emergent recognition of the potential of community pharmacists to contribute to the management of chronic diseases was evident.
  2. Isa ZM, Ibrahim N, Ismail NH, Jaafar MH, Tamil AM, Yusof KH
    J Pak Med Assoc, 2021 Feb;71(Suppl 2)(2):S68-S73.
    PMID: 33785945
    OBJECTIVE: To identify the prevalence of hypertension and its relationship with dietary sodium intake among the Malay population in Selangor, Malaysia.

    Methods: Respondents were recruited from the year 2013 to 2015 from households in Klang Valley (urban area) and several settlements of the Federal Land Development Authority (FELDA) in Selangor (rural area). Data were collected using two questionnaires, a sociodemographic questionnaire and a food frequency questionnaire.

    RESULTS: A total of 3,453 adults participated in this study. The mean age of the respondents was 50.9 (±10.23) years. The prevalence of hypertension was 23.3%. Mean dietary sodium consumption was 3.6 (±6.63) grams/day, 1.6 grams higher than the current WHO recommendation. The prevalence of hypertension was higher among males aged 60 years and older; among rural population with low education level; among housewives and those with high dietary sodium intake. After adjusting for age, gender and marital status in a multiple logistic regression analysis, rural location (OR = 5.81) and high sodium intake (OR = 2.33) have been shown to affect the incidence of hypertension.

    CONCLUSIONS: A substantial proportion of Malay population in Selangor was hypertensive with a higher sodium intake than the WHO recommendation. Hypertension was associated with rural location and high sodium intake. Sustainable and cost-effective population-based health promotion and prevention interventions using a multi-sectoral approach are needed to ensure sufficient community sodium intake.

  3. Ding CH, Wahab AA, Muttaqillah NA, Tzar MN
    J Pak Med Assoc, 2014 Dec;64(12):1375-9.
    PMID: 25842581
    To determine the proportion of albicans and non-albicans candiduria in a hospital setting and to ascertain if fluconazole is still suitable as empirical antifungal therapy based on antifungal susceptibility patterns of Candida species.
  4. Mushtaq K, Ashraf M, Thaver IH
    J Pak Med Assoc, 2020 Dec;70(12(B)):2460-2463.
    PMID: 33475564 DOI: 10.47391/JPMA.770
    This descriptive cross-sectional research study was conducted to determine the characteristics of the women who intend to use a modern family planning method. For this 154 women were selected in a small village and faceto- face interviews were conducted. The findings indicate that 86 (56%) women intended to use a contraceptive method. The regression model showed that women who had the knowledge about different methods, those who had previously ever used family planning method and those who had never used any traditional method are more likely to adopt modern contraceptive methods.
  5. Ashraf M, Ismail A, Idris IB, Thaver I
    J Pak Med Assoc, 2021 02;71(2(A)):518-523.
    PMID: 33819241 DOI: 10.47391/JPMA.477
    OBJECTIVE: To identify the key factors that contribute to the successful scale-up of pilot projects, with emphasis on factors that are proven helpful in the successful scaling up of health interventions.

    METHODS: Grey literature was searched at the library of the University of Kebangsaan, Malaysia, on database engines Google Scholar and Science Direct with specific key words to screen papers published from January 2001 to June 2016. They were reviewed to identify the key factors affecting scaling up of health-related pilot projects. Full-text articles were selected, and their reference lists were checked to look for relevant papers. They were short-listed and analysed using thematic approach.

    RESULTS: Of the 47 articles initially screened, 14(29.78%) were shortlisted. Thematic analysis of the selected articles suggested several key factors contributed to the successful scale-up of pilot projects. These factors included evidence-based and effective intervention, community readiness, government support, stakeholders' engagement, and monitoring and supervision.

    CONCLUSIONS: To maximise health coverage in developing and low middle-income countries, scaling up of health interventions on a large scale is essential to improve the health and wellbeing of people. The identified key factors should be considered while planning the scale-up of any health project.

  6. Jameel RA, Khan SS, Abdul Rahim ZH, Bakri MM, Siddiqui S
    J Pak Med Assoc, 2016 Jul;66(7):843-8.
    PMID: 27427133
    To understand early dental erosion induced by different beverages and the equipment for its detection.
  7. Mahfooz M, Noh YE, Teo EW, Savila Z
    J Pak Med Assoc, 2024 Feb;74(2):320-326.
    PMID: 38419234 DOI: 10.47391/JPMA.9343
    OBJECTIVE: To assess student-athletes' knowledge and attitudes towards sport-related concussions and to investigate concussion history and reporting behaviours.

    METHODS: The cross-sectional, survey-based study was conducted from September 2020 to June 2021 after approval from the research ethics committee of Universiti Malaya, Malaysia, and comprised student-athletes of either gender aged 18 years or above at various universities across Pakistan and who played contact or collision sports for their universities. Data was collected using the Urdu version of the Rosenbaum Concussion Knowledge and Attitudes Survey-Student Version. Data was also gathered about the participants' self-reported exposure to formal concussion education, previous sport-related concussion history, and reporting behaviours, where applicable. Data was analysed using SPSS 23.

    RESULTS: Of the 369 participants, 224(60.7%) were males and 145(39.3%) were females. The overall mean age was 19.95±1.75 years. Among the participants, 327(88.6%) had not received formal concussion education. The mean knowledge score was 12.76±2.73 out of a possible 25 points, and the mean attitude score was 38.63±10.30 out of 75 points. Knowledge had a weak positive correlation with attitude towards sport-related concussions SRC (p<0.05). Females displayed better attitudes towards sport-related concussions than their male counterparts (p<0.05). Overall, 126(34%) participants had experienced sport-related concussion symptoms following a blow to the head in the preceding 12 months, and 81(64.3%) of them had continued playing while being symptomatic.

    CONCLUSION: Pakistani university student-athletes lacked adequate concussion knowledge and held poor attitudes towards sport-related concussions.

  8. Engkasan JP, Shun CL, Rathore FA
    J Pak Med Assoc, 2023 Oct;73(10):2123-2125.
    PMID: 37876089 DOI: 10.47391/JPMA.23-77
    Neurogenic bladder is one of the negative consequences following a spinal cord injury (SCI). SCI patients who have neurogenic bladder depend on alternative methods to drain urine from their bladder. These include indwelling catheters, reflex voiding , suprapubic tapping and intermittent catheterisation. This review summarizes evidence from the literature of five selected complications (renal failure, urinary tract infections, calculi, urethral stricture, and bladder cancer) that could result from use of the different bladder drainage methods. There is inconsistent evidence to support the superiority of intermittent over indwelling catheterisation on risk of renal impairment, urethral stricture, and renal calculi. Indwelling catheterisations are associated with higher risk of bladder calculi and cancer. Caution needs to be taken when interpreting this review, as many of its findings are from retrospective studies, and more than a decade old. Clinicians need to communicate the evidence to their patients when making the decision on method of bladder drainage.
  9. Raja NS
    J Pak Med Assoc, 2003 Aug;53(8):373-4.
    PMID: 14558747
  10. Fatima T, Haji Abdul Rahim ZB, Lin CW, Qamar Z
    J Pak Med Assoc, 2016 Aug;66(8):1019-1023.
    PMID: 27524540
    This review will discuss the importance of Zinc in the maintenance of oral health. Zinc (Zn) is a trace element of valuable importance. In the oral cavity, it is naturally present at various sites such as dental plaque, dental hard tissues and saliva. It is proven to be effective against common prevalent oral health problems such as dental caries, gingivitis, periodontitis and malodour. It is being used in various oral health care products to control the formation of dental plaque and inhibiting the formation of dental calculus. It has the potential to sustain and maintain its elevated concentrations for a longer time particularly in the dental plaque and saliva on delivery from the mouth rinses and toothpastes. It has been reported that low concentrations of zinc have the capability to reduce dissolution and promote remineralization under caries simulating conditions. Most importantly low Zn2+ levels in the serum are useful as a tumour marker. Thus taking a note of its potentials, it can be concluded that zinc is a precious element for the maintenance of oral health.
  11. Sharif F, Mahmood F, Azhar MJ, Asif A, Zahid M, Muhammad N, et al.
    J Pak Med Assoc, 2019 May;69(5):632-639.
    PMID: 31105281
    OBJECTIVE: To compare the occurrence, distribution and management of clefts of lip and palate in local patients with the available data from India and China.

    METHODS: The retrospective study was conducted at the Interdisciplinary Research Centre in Biomedical Materials, COMSATS University Islamabad, Lahore Campus, Lahore, Pakistan, and comprised data related to a three-month period from January to March 2015 at two medical centres in Lahore. Data from Pakistani centres was analysed based on province, gender, age and clefts of lip and palate conditions and Spearman's correlation matrix.

    RESULTS: Of the 1574 cases, 1061(67.4%) were from Punjab, 361(23%) Khyber Pakhtunkhwa, 85(5%) Sindh and 67(4.2%) were from Azad Jammu and Kashmir. The incidence of clefts of lip and palate was higher in males than females. There was higher awareness of the need for timely management in new borns with clefts of lip and palate. Some patients seeking secondary treatment were also being surgically corrected. There is no national registry of children born with cleft defect, making it difficult to assess the full scale of the problem..

    CONCLUSIONS: Based on available data, it is likely that there are many adults who have not been treated when younger..

  12. Naqvi AA, Hassali MA, Aftab MT, Nadir MN
    J Pak Med Assoc, 2019 Feb;69(2):216-223.
    PMID: 30804587
    OBJECTIVE: The study aimed to perceived barriers to medication adherence in patients with chronic illnesses..

    METHODS: A qualitative study was conducted in a tertiary care hospital in Karachi in September 2017, using grounded theory and inductive approach. Interviews were conducted using a checklist in Urdu language from patients of chronic illnesses determined based on medicines dispensed from the out-patient pharmacy in hospital. Interviews were recorded, transcribed verbatim, translated in English and validated. The translated quotations were analysed using a qualitative analysis software, and thematic analysis was conducted. Codes were generated and analysed by semantic linkages and network analysis using ATLAS.ti qualitative research software.

    RESULTS: Of the 16 patients interviewed, 8(50%) were males and 8(50%) were females. Barriers to medication adherence identified were patient behaviour (intentional and un-intentional non-adherence), comorbidity and pill burden, cost-related non-adherence, and low patient knowledge. The last barrier was associated with the rest.

    CONCLUSIONS: Counselling has the potential to increase patient knowledge regarding medication use, and active pharmacist-physician collaboration can improve medication adherence..

  13. Thaver I, Ahmad AM, Ashraf M, Asghar SK, Mirza MS
    J Pak Med Assoc, 2020 Dec;70(12(A)):2092-2101.
    PMID: 33475578 DOI: 10.47391/JPMA.1218
    OBJECTIVE: To investigate the effect on maternal and infant health of iron plus folate and multiple micronutrient supplements, along with deworming and health education session provided to pregnant women in rural, nonagrarian and food-insecure areas.

    METHODS: The quasi-experimental study was conducted in Tharparker and Umerkot districts, Sindh, Pakistan, in 2013-14, and comprised pregnant women in their earlier weeks of pregnancy. The enrolment and follow-up phase entailed 3 visits to each subject. Areas covered by lady health workers were designated as intervention areas, and those with non-LHW population were labelled as non-intervention areas.

    RESULTS: Of the 1204 subjects, 600(49.8%) were in the intervention group and 604(50.2%) were in the nonintervention group. By the end of the follow-up phase, significantly more women had increased number of meals in the intervention group compared to the non-intervention group (p<0.001). There was a significantly higher increase in mean haemoglobin levels and body mass index of women in the intervention arm after 3 and 6 months of interventions (p<0.05). Significantly higher mean birth weight was recorded in intervention areas compared to nonintervention areas (p<0.05).

    CONCLUSIONS: Community-based provision of multiple micronutrients to women along with deworming, health education and dietary counselling significantly reduced the prevalence of anaemia and reduced the incidence of low birth weight.

  14. Shaikh BT, Azmat SK, Mazhar A
    J Pak Med Assoc, 2013 Apr;63(4 Suppl 3):S67-72.
    PMID: 24386733
    The population of the world reached seven billion in 2012. Pakistan's population stands at more than 180 million, is growing rapidly, and has the highest unmet need for family planning (FP) in isolated rural areas. The low usage of contraception in the rural areas of Pakistan correlates with the level of isolation, poverty, illiteracy, and to a large extent, religious misinterpretations/misconceptions. Almost 25% of couples who desired FP services were not receiving them for a variety of reasons of which religion could be one, especially in the rural remote areas where the media is still not reaching and influencing mind-sets. In this scenario, the role of social marketing in bringing about attitudinal and behavioural change among users in underserved areas and gatekeepers and opinion makers in society must not be neglected. The work in promoting FP, contraception and birth spacing requires authentic evidence from similar sociocultural contexts and this endeavour of compiling case studies from various Islamic countries on their FP initiatives is a good step. Governments around the world, including many in the Islamic world, support FP programmes to enable individuals and couples to choose the number and timing of their children.
  15. Baharuddin D, Said MA, Majid HA
    J Pak Med Assoc, 2023 Nov;73(11):2171-2176.
    PMID: 38013523 DOI: 10.47391/JPMA.7748
    OBJECTIVES: To chart out a protocol for conducting an intervention-based study to compare the efficacy of intermittent fasting intervention and usual diet in reducing elevated blood pressure among working adults.

    METHODS: The quasi-experimental study with single-blinded parallel groups will comprise subjects from two civil departments. The intervention group will be required to conduct 2 days of fasting and 5 days of ad libitum diet in a week, while the control group will follow the usual healthy lifestyle. The largest sample size will be taken to achieve a power of 80% and an alpha value of 5%. Based on the 30% attrition rate, the total sample size needed in the study will be 140 participants, with 70 in each of the two arms. This study will use SPSS 24 for statistical analysis.

    DISCUSSION: The study describes a unique protocol of intermittent fasting mimicking the Muslim Sunnah of fasting among people with elevated blood pressure. The findings will contribute to decrease blood pressure among those with elevated blood pressure. If proven to be effective, the intermittent fasting method would be useful for developing an effective programme to prevent elevated blood pressure among adults. The protocol will contribute to efforts to find whether or not intermittent fasting can improve elevated blood pressure as well as body weight, body mass index, waist circumference and nutrition status among adults.

    CLINICAL TRIAL NUMBER: The study was registered with clinicaltrials.gov (NCT04953650).

  16. Nabi FG, Sundaraj K, Lam CK
    J Pak Med Assoc, 2021 Jan;71(1(A)):41-46.
    PMID: 33484516 DOI: 10.47391/JPMA.156
    OBJECTIVE: Breath sound has information about underlying pathology and condition of subjects. The purpose of this study was to examine asthmatic acuteness levels (Mild, Moderate, Severe) using frequency features extracted from wheeze sounds. Further, analysis was extended to observe behaviour of wheeze sounds in different datasets.

    METHODS: Segmented and validated wheeze sounds was collected from 55 asthmatic patients from the trachea and lower lung base (LLB) during tidal breathing maneuvers. Segmented wheeze sounds have been grouped in to nine datasets based on auscultation location, breath phases and a combination of phase and location. Frequency based features F25, F50, F75, F90, F99 and mean frequency (MF) were calculated from normalized power spectrum. Subsequently, multivariate analysis was performed.

    RESULTS: Generally frequency features observe statistical significance (p < 0.05) for the majority of datasets to differentiate severity level Ʌ = 0.432-0.939, F(12, 196-1534) = 2.731-11.196, p < 0.05, ɳ2 = 0.061-0.568. It was observed that selected features performed better (higher effect size) for trachea related samples Ʌ = 0.432-0.620, F(12, 196-498) = 6.575-11.196, p < 0.05, ɳ2 = 0.386-0.568.

    CONCLUSIONS: The results demonstrated dthat severity levels of asthmatic patients with tidal breathing can be identified through computerized wheeze sound analysis. In general, auscultation location and breath phases produce wheeze sounds with different characteristics.

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