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  1. Fulltext The use of complementary and alternative medicine among malaysian chronic kidney disease patients
    Muhammad Yusuf, A.S., Abdul Halim, A.G., Shamsul Azhar, S.
    Medicine & Health, 2019;14(2):219-234.
    MyJurnal
    Many of our chronic kidney disease (CKD) patients venture into complementary and alternative medicine (CAM) to seek a cure for the disease beyond conventional management. The objective of this study was to determine the prevalence and pattern of CAM usage; and its association with the progression of CKD in our population. This was a cross-sectional survey recruited CKD patients from Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Data was collected via interview using questionnaires which explore the demographics, type and pattern of CAM use. Patients’ comorbidities and serum creatinine were extracted from the medical notes to assess the association between progression of CKD and usage of CAM. Chi-square, Independent Samples t-test, Mann-Whitney U test and logistic regression were used to evaluate for an association. Three hundred and seventy two eligible patients were recruited. The prevalence of CAM use was 29% in the past year. Younger age, higher education and higher income level were associated with significantly more usage of CAM. Natural products were the commonest type of CAM used (86.1%). The belief in the effectiveness of CAM was the main reason for its uptake and about 57.8% revealed their practice to their physician. We found that the use of CAM in Malaysian CKD patients did not influence the progression of the disease.
  2. Fulltext Isolation and characterization of pulp from sugarcane bagasse and rice straw
    Saiful Azhar, S., Suhardy, D., Kasim, F.H., Nazry Saleh, M.
    Journal of Nuclear and Related Technologies, 2007;2007(1):109-114.
    MyJurnal
    The amount of sugarcane bagasse and rice straw in the state of Perlis (Malaysia) is abundant while its utilization is still limited. One of the alternatives for the bagasse and straw utilization is as pulp raw material. This paper reviews on pulp from sugarcane bagasse and rice straw and its suitability for paper production. In this study, the pulp was extracted by the Soxhlet extraction method. The objective of this study was to investigate the cellulose, lignin and silica content of the pulp from sugarcane bagasse and rice straw. For rice straw, the presence of large amount of pentosanes in the pulp and black liquors, which also contain silica were decreased the using of straw in the paper industry. Therefore, formic acid pulping and NaOH treatment are studied to reduce or prevent silica. The isolated pulp samples were further characterized by Scanning Electron Microscope (SEM) to investigate their fiber dimensions.
  3. Fulltext Clinical evaluation of Dyslipidemia among type II diabetic patients at Public hospital Penang, Malaysia
    Zaki NF, Sulaiman AS, Gillani WS
    Int Arch Med, 2010;3:34.
    PMID: 21092333 DOI: 10.1186/1755-7682-3-34
    Global views emphasize the need for early; effective intervention against the atherogenic dyslipidemia associated with type 2 diabetes and metabolic syndrome to reduce the risk of premature cardiovascular diseases. Our aim was to determine the clinical practices and compliance among dyslipidemia with type II diabetes and hypertension in multiracial society.
  4. Fulltext Religious personality and smoking among form two students in rural schools in Malacca, Malaysia
    Nor Afiah, M.Z., Rahmah, M.A., Salmiah, M.S., Fazilah, I., Shamsul Azhar, S.
    International Medical Journal Malaysia, 2012;11(2):39-44.
    MyJurnal
    Introduction: There is an increasing trend in smoking among rural adolescents compared to urban adolescents in Malaysia. This study was to determine the relationship between religious personality and smoking among form two students from the rural schools in Malacca. Methods: This was an unmatched case-control study conducted from May 2010 to August 2010 among form two school children from rural area in Malacca. There were 484 cases, and 444 controls selected using randomized cluster sampling. The dependent variable was smoking, and the independent factors were religious personality. Validated and reliability-tested questionnaires were used for data collection. Results: The mean age (year) at which smoking was first tried among the cases was 11.39 + 2.107. There were eleven out of twenty three significant differences between religious personality statements in the cases and control group. Those were: reciting the Quran/Holy book/Scriptures even when busy, making efforts to deepen the understanding of the religion, trying to understand the teachings of the religion in the Holy book/Quran, inviting others to perform solat/prayer/religious service, making sure all the family members are following the teachings according to the religion, referring to the learned people when feeling uncertain about the rulings/teachings of the religion, performing work duties enthusiastically because of the religion/God, making efforts to remember death and afterlife often, making efforts to internalize the ethical conduct of the religion in daily life, setting aside money every year for religious purposes and looking for opportunities to give charity. Conclusion: Religious personality is an important factor which may influence adolescents volved in smoking.
  5. Fulltext Factors influencing childhood immunization defaulters in Sabah, Malaysia
    Shamsul Azhar, S., Rohaizat, H., Azimatun Noor, A., Rozita, H., Nazarudin, S., Nirmal, K.
    International Medical Journal Malaysia, 2012;11(1):17-22.
    MyJurnal
    Introduction: The purpose of this study was to determine the prevalence of defaulters of immunization, and their associated risk factors among children age 12 to 24 months. Materials and Methods: A cross-sectional study was conducted in all government's maternal child health clinics in District of Kota Kinabalu, Sabah. Data was collected using a standardised questionnaire from July to November 2006. Results: The prevalence rate for defaulting immunization was 16.8% from the 315 respondents. Bivariable analysis showed various significant factors associated with defaulters such as mother’s employment status, family mobility, transportation and cost. Nonetheless, multivariable analysis showed only mother’s age, mother employment status and family size were the significant predictors for defaulting immunization. Immunization that had the highest rate of defaulters was DPT–OPV booster dose (56.6%), followed by MMR immunization (43.4 %) and
    DPT-Hib/OPV and Hep B third dose (37.7%).Conclusion: Employed mothers with bigger family size should be more closely monitored and advised to reduce the chance of defaulting on the immunization. Health promotion activities also should focus to these groups of mothers.
  6. Fulltext Smoking behaviour among adolescents in rural schools in Malacca, Malaysia - a case-control study
    Nor Afiah, M.Z., Rahmah, M. A., Salmiah, M.S., Lye, M.S., Shamsul Azhar, S., Fazilah, I.
    Pertanika Journal of Science & Technology, 2015;23(1):13-28.
    MyJurnal
    Smoking among rural adolescents in Malaysia is on the rise with a significant difference seen between urban and rural youths. Therefore, this study was carried out to determine a predictive model of smoking among the rural-school adolescents population in Malacca, Malaysia. An unmatched case-control study was conducted in 2010 involving 484 cases and 444 controls of Form Two students in Malacca, Malaysia, using cluster sampling. Smoking was the dependent factor of this study while the independent factors were individual, family, school and environment. Data were obtained through a self-administered questionnaire. The response rate of the study was 100% whereas the smoking prevalence was 20.9%. Binary logistic regression was used to determine the smoking predictive model. Strong predictors of smoking behaviour were: influenced by artistes who smoke (Adjusted OR=8.67, 95% CI 5.53-13.58); the male gender (Adjusted OR=6.7, 95% CI 4.14-10.83); Muslim (Adjusted OR=4.46, 95% CI 2.36-8.44); and the belief that smoking is not dangerous when the teacher is seen smoking as well (Adjusted OR=3.95, 95% CI 2.19-7.10). Other predictors were: being offered cigarettes by friends (Adjusted OR=2.81, 95% CI 1.79-4.42); the belief that smoking will relax the mind (Adjusted OR=2.45, 95% CI 1.33-4.51); having friends who smoke (Adjusted OR=2.32, 95% CI 1.29-4.81); forced by friends to smoke (Adjusted OR=2.17, 95% CI 1.15-4.12); have heard of the national No-Smoking Campaign (Adjusted OR=1.89, 95% CI 1.06-3.37); have problems with the school management (Adjusted OR=1.75, 95% CI 1.07-2.88); parental consent to watch sexual activities, drug use or violence on television or at the cinema (Adjusted OR=1.73, 95% CI 1.06-2.83); and have lunch in school (Adjusted OR=1.58, 95% CI 1.04-2.41). This paper ends with the recognition of the need for intervention in dismantling the predictors that can lead to the development of smoking among Malaysian adolescents in rural schools. of different pathological entities.
  7. Fulltext Awareness of school students on sexually transmitted infections (STIs) and their sexual behavior: a cross-sectional study conducted in Pulau Pinang, Malaysia
    Anwar M, Sulaiman SA, Ahmadi K, Khan TM
    BMC Public Health, 2010;10:47.
    PMID: 20113511 DOI: 10.1186/1471-2458-10-47
    BACKGROUND: Sexually transmitted Infections (STIs) rank among the most important health issues for the people especially the young adults worldwide. Young people tend to engage in sexual activity at younger ages in the past decade than in the 1970s, and 1980s. Knowledge is an essential precursor of sexual risk reduction. A cross-sectional study was conducted in Pulau Pinang, Malaysia, to produce the baseline information about school students' awareness and perception about sexually transmitted Infections (STIs) and their sexual activity to help establish control and education programmes.
    METHODS: Students from form 4 (aged between 15 to 16 years), form 5 (aged between 16 to 17 years) and form 6 (aged between 18 to 20 years) in their class rooms were approached and asked to complete self administered and anonymous pre-validated questionnaires. SPSS for windows version 13 was used to analyze the results statistically and results were presented in tabular form.
    RESULTS: Data was collected from 1139 students aged between 15 to 20 years, 10.6% of which claimed that they never heard about STIs. Sexual experience related significantly with gender, race, and education level. Approximately 12.6% claimed to have sexual experience of which 75.7% had their sexual debut at 15-19 years and 38.2% were having more than 3 partners. Sexual experience was found to be significantly associated with gender (p = 0.003), ethnicity (p = 0.001) and education level (p = 0.030). However, multiple partner behaviour was significantly associated only with gender (p = 0.010). Mean knowledge score was 11.60 +/- 8.781 and knowledge level was significantly associated with religion (p = 0.005) education level (p = 0.000), course stream (p = 0.000), socioeconomic class (p = 0.000) and sexual experience (p = 0.022).
    CONCLUSIONS: It was concluded that school students have moderate level of knowledge about STIs although they are sexually active. Interventions such as reinforcing the link between STIs and HIV/AIDS, assessing the current status of sexuality education in schools and arranging public talks and seminars focusing on STIs prevention education are needed to improve their awareness.
  8. Fulltext Parental concerns and control in feeding of 9 to 12-year-old children in a primary school in Kuala Lumpur, Malaysia
    Noor AM, Muthupalaniappen L, Shamsul AS, Hizlinda T, Khairani O, Fatimah A
    Malays J Nutr, 2012 Apr;18(1):47-55.
    PMID: 23713229 MyJurnal
    Body weight of children is affected by many factors including food habits which are influenced by their parents. Studies in the West have shown that parents tend to control child feeding in response to their child's weight status. The aim of this study was to assess Malaysian parental concerns about child weight and the control they exert on child feeding.
  9. Fulltext Bacteraemia in haematopoietic stem cell transplant recipients in a single tertiary referral centre
    Nurul Iman, P., Ramliza, R., Wan Fariza, W.J., Shamsul Azhar, S., Nor Azimah, I., S. Fadilah, A.W.
    Medicine & Health, 2019;14(2):60-76.
    MyJurnal
    Bacteraemia is a common and one of the serious complications in haematopoietic stem cell transplantation (HSCT). To date, there are no published data on antibiotic resistance and clinical outcome among HSCT recipients in Malaysia. The aim of the present study was to analyse the prevalence, antibiotic resistance and clinical outcome of bacteraemia in HSCT recipients, within 100 days following transplantation. We retrospectively analysed the prevalence, antibiotic resistance pattern and mortality rate of early bacteraemia among HSCT recipients in a single centre over a 5-year period (2013-2017). Thirty patients of 85 HSCT recipients developed bacteraemia with 40 positive cultures resulting in prevalence of 47% (40/85). Gram negative bacteria (GNB) accounted for 60.5% of total isolates. Enterobacteriaceae and Coagulase negative Staphylococcus (CoNS) were the commonest pathogens isolated. GNB showed a high resistance rate to ciprofloxacin. Only 30% of recipients responded to first line empirical antibiotics for febrile neutropenia (FN). The mortality rate was 13.3% (4/30), of which 50% was attributed to multi-drug resistance (MDR) Acinetobacter and 25% to extended spectrum beta-lactamase (ESBL) Enterobacteriaceae. Bacteraemia is a frequent and life-threatening early complication among HSCT recipients with MDR GNB being the commonest cause of mortality. The high rate of resistance to ciprofloxacin and failure of the first line empirical antibiotics to treat FN calls for a thorough evaluation of the current antibiotic prophylaxis and empirical treatment protocols. These findings have important clinical implications regarding the use and selection of both prophylactic and empiric antibiotic regimens to treat FN.
  10. Fulltext Prevalence of human papillomavirus genotypes in preinvasive and invasive cervical cancer-a ukm study
    Sharifa Ezat, W.P., Sharifah, N.A., Sayyidi Hamzi, A.R., Norin Rahayu, S., Shamsul Azhar, S., Syed Mohamed, A.
    Medicine & Health, 2010;5(2):66-76.
    MyJurnal
    A cross sectional study was done to determine the prevalence and distribution of human papillomavirus (HPV) genotypes in pre-invasive (cervical intraepithelial neoplasia, grade 3 or CIN 3) and invasive cervical cancer (ICC), in Universiti Kebangsaan Malaysia Medical Centre (UKMMC). A total of 80 paraffin-embedded tumour tissue blocks (20 CIN 3, 60 invasive cancers) between 1999 to 2007 were retrieved from the archives of the Department of Pathology. Patient’s medical records were obtained from the Medical Records Office. Among invasive cancers (n=60), squamous cell carcinoma (SCC) account for 75% and adenocarcinoma 25%. The mean age of cases studied was 52.0 ± 12.2 years and Chinese was the predominant ethnicity (66.3%). Twelve HPV genotypes were identified, namely, HPV 16, 33, 18, 39,52, 45, 58, 59, 31, 35, 6 and 11. The prevalence of HPV was 92.5% with types 16 being the most common (73.8%), followed by types 33 (30%) and 18 (22.5%). A total of 31 cases (38.8%) showed single HPV genotype, while 43 (53.8%) had multiple HPV (two genotypes or more) genotypes. In ICC, HPV 16, followed by types 33, 18, 52 and 39 were the top five common HPV genotypes detected. High prevalence of HPV and multiple HPV infections were major findings among patients with pre-invasive and invasive cervical cancer.
  11. Fulltext Prevalence of complementary alternative medicine use among patients with type II diabetes in Negeri Sembilan, Malaysia
    Baharom N, Shamsul Azhar S, Rotina AB
    Medicine & Health, 2016;11(2):257-266.
    MyJurnal
    The uses of Complementary and Alternative Medicine (CAM) among patients with chronic diseases are becoming increasingly popular. This was a descriptive cross-sectional study conducted in 45 government health clinics across Negeri Sembilan. Respondents at diabetes clinics were selected via systematic random sampling and interviewed using structured questionnaire. CAM usage was divided into three groups; CAM use for diabetes (CAM-DM), CAM use for general health (CAM-G) and Non CAM user. The prevalent use of CAM among type II diabetes mellitus patients in Negeri Sembilan was 58.5% (CAM-DM: 40.6% and CAM-G: 17.9%). For CAM-DM group, bitter gourd (Momordica charantia) was the most popular CAM consumed to help control diabetes, while supplement milk was the most popular choice for the CAM-G group. In conclusion, the use of CAM among type II diabetes mellitus patients in Negeri Sembilan was common. Natural products are the main choice of CAM modality used to help with the management of diabetes. Majority of CAM users never informed their healthcare providers about their CAM use.
    Study site: 45 klinik kesihatan, Negeri Sembilan, Malaysia
  12. WALANT technique for percutaneous pinning of distal radioulnar joint
    Azhar S, Abdullah S, Soh E
    J Hand Surg Eur Vol, 2023 Mar;48(3):279-281.
    PMID: 36691295 DOI: 10.1177/17531934221148115
  13. Fulltext A case control study on factors that influence depression among the elderly in Kuala Lumpur Hospital and Universiti Kebangsaan Malaysia Hospital
    Salimah O, Rahmah MA, Rosdinom R, Azhar SS
    Med J Malaysia, 2008 Dec;63(5):395-400.
    PMID: 19803299 MyJurnal
    Depressive illness is common among the aged population. A case control study was conducted, focusing on risk factors influencing depression among the elderly. This study involved 130 elderly patients diagnosed to have depressive illness from the psychiatric clinics of Kuala Lumpur Hospital (HKL) and Universiti Kebangsaan Malaysia Hospital (HUKM). Another group of 130 elderly patients with no history of depressive illness were recruited from the medical specialist clinics. The majority of cases were female (75.4%), aged 60-74 years (92.3%) and from Chinese ethnic group (59.2%). Non-Malay elderly has three times risk (AOR 2.537, 95% CI 1.439-4.471) of suffering the depressive illness compared to the Malay elderly, the elderly with chronic health problems are more likely to be depressed compared to those who do not suffer from any chronic illness (p trend <0.001). Other risk factors identified were family history of depression with four times risk (AOR 4.225, 95% CI 2.017-8.848) and lower social support with eight times risk (AOR 7.949, 95% CI 2.588-24.417). Social support is not only important in encouraging the elderly to practice healthy life style but proven to influence the risk of getting depression among them. Hence, it is very crucial that the elderly is given total attention, respect and love from all parties to ensure prosperity and meaningfulness in life.
  14. Separation of prescribing and dispensing in Malaysia: a summary of arguments
    Shafie AA, Hassali MA, Azhar S, See OG
    Res Social Adm Pharm, 2012 May-Jun;8(3):258-62.
    PMID: 21824823 DOI: 10.1016/j.sapharm.2011.06.002
    The role of pharmacists has transformed significantly because of changes in pharmacists' training and population health demands. Within this context, community pharmacists are recognized as important health personnel for the provision of extended health services. Similarly, in Malaysia, the need to transform community pharmacy practice has been discussed by all interested parties; however, the transition has been slow due in part to the nonexistence of a dispensing separation policy between pharmacists and medical doctors in private community practices. For decades, medical doctors in private community practices have had the right to prescribe and dispense, thus diluting the role of community pharmacists because of overlapping roles. This article explores dispensing separation in Malaysia and, by taking into account the needs of health professionals and health care consumers, suggests a mechanism for how dispensing separation practice can be implemented.
  15. Fulltext Dialysis for end stage renal disease: a descriptive study in Penang Hospital
    Shaza AM, Rozina G, Izham MIM, Azhar SSS
    Med J Malaysia, 2005 Aug;60(3):320-7.
    PMID: 16379187 MyJurnal
    This research was carried out to study the characteristics of ESRD patients and the resources consumed with dialysis treatment as well as to assess the clinical outcomes of ESRD treatment in Penang Hospital. A total of 117 ESRD patients were studied over 30 months. 56.4% of the patients were male and the median age was 40. Diabetic nephropathy was the commonest cause of ESRD (29.9%). Hypertension was the predominant comorbidity (60.6%). A larger proportion started treatment with Continuous Ambulatory Peritoneal Dialysis (59.0%). At the end of the study period, 49.6% of the patients continued their treatment in the same modality and 27.4% died. Average Dialysis Adequacy (Kt/V) achieved was satisfactory, 2.29 in CAPD and 1.50 in Haemodialysis.
  16. Fulltext Assessment of Knowledge, Attitude and Barriers towards Pharmacovigilance among Physicians and Pharmacists of Abbottabad, Pakistan
    Syed A, Azhar S, Raza MM, Saeed H, Jamshed SQ
    Pharmacy (Basel), 2018 Mar 31;6(2).
    PMID: 29614725 DOI: 10.3390/pharmacy6020029
    OBJECTIVES: Pharmacovigilance in Pakistan needs robust preference in terms of implementation and consistent movement of structured approaches. The objective of this study is to explore the knowledge, attitude and barriers towards adverse drug reaction (ADR) reporting among physicians and pharmacists and to explore the encouraging factors of ADR reporting.

    METHODS: The current research was a cross-sectional study design in which a pre-validated questionnaire was administered to physicians and pharmacists in Abbottabad, Pakistan. The study was conducted for two months from January 2016 to February 2016.

    RESULTS: A total of 194 physicians and pharmacists responded with a response rate of 35.3%. All the respondents either strongly agreed or agreed that ADRs reporting is a part of their duty. Half of the respondents agreed that monitoring of drug safety is important. Around three quarters of respondents (74.2%) stated that they did not report ADRs due to unavailability of reporting forms while 70% cited lack of a proper pharmacovigilance center as one of the key barriers. Half of the respondents (52.2%) did not report due to their insufficient knowledge. A large majority (81.8%) said that they would report ADRs if there is pharmacovigilance center. On the point of incentives, opinion seems to be divided. Slightly less than half (47.8%) cited their wish to have few incentives while the remaining 52.2% either preferred to be neutral or disagreed.

    CONCLUSION: Based on the study findings, barriers were mostly related to general unfamiliarity with ADRs reporting guidelines and the non-existence of a pharmacovigilance center. It is highlighted that the regulatory body should carve a niche for a properly functional pharmacovigilance center and initiate educational programs for strengthening knowledge and attitudes towards ADR reporting.

  17. Fulltext Biochemical aspirin resistance in stroke patients - a cross-sectional single centre study
    Azmin S, Sahathevan R, Rabani R, Nafisah WY, Tan HJ, Raymond AA, et al.
    EXCLI J, 2013;12:907-15.
    PMID: 27092036
    BACKGROUND: Aspirin use is known to reduce the recurrence of stroke. However, the clinical response to aspirin has been mixed. The rate of stroke recurrence whilst on aspirin treatment is still unacceptably high. A plausible explanation for this may be resistance to the effects of aspirin. The causes of aspirin resistance are manifold and multi-factorial. We conducted a study to investigate the prevalence rate of biochemical aspirin resistance in a cohort of aspirin-naïve stroke patients. We also sought to determine the inherent factors that may predispose towards the development of aspirin resistance.
    METHOD: This was a cross-sectional, observational study conducted on patients admitted to our centre with an acute stroke who were aspirin-naïve. The diagnosis of an acute stroke was confirmed by clinical history and brain imaging. Fifty consecutive patients were prospectively enrolled. Socio-demographic data were collected and baseline blood investigations were performed. Patients were tested for biochemical aspirin resistance using Multiplate platelet analyser (Dynabyte, Munich, Germany) after 5 doses of aspirin, corresponding to a total dose of 900 mg.
    RESULTS: The median age of patients was 65.5 years and 54 % of patients were female. There were 11 smokers; of these 10 were male. Twenty-six (52 %) patients were Chinese, 21 (41 %) were Malay and 3 (6.0 %) were Indian. Aspirin resistance was present in 14 % of our patients. There was an inverse relationship between the presence of aspirin resistance and plasma HDL levels (r = -0.394; p = 0.005). There was no relationship observed between aspirin resistance and total cholesterol, triglycerides, LDL, HbA1c, ALT, ALP, urea and creatinine levels. There were no significant differences in demographic profiles or smoking status between the aspirin resistant and non-aspirin resistant groups. We did not find any link between ethnicity and aspirin resistance.
    CONCLUSIONS: Our results indicate that a lower HDL level is associated with biochemical aspirin resistance. This may increase platelet aggregation and consequently increase the risk of a recurrent stroke. The clinical implications for aspirin resistance are far reaching. Any evidence that correctable factors may negatively influence the action of aspirin warrants further investigation. The prevalence rate of biochemical aspirin resistance in our study is comparable to the findings in other studies performed in an Asian population. Further research is required to determine how our findings translate into clinical aspirin resistance and stroke recurrence.
    KEYWORDS: Asia; antiplatelet therapy; aspirin; aspirin resistance; developing countries; ischaemic stroke; risk factors
  18. A survey evaluating nurses' perception and expectations towards the role of pharmacist in Pakistan's healthcare system
    Azhar S, Hassali MA, Mohamed Ibrahim MI, Saleem F, Siow Yen L
    J Adv Nurs, 2012 Jan;68(1):199-205.
    PMID: 21658097 DOI: 10.1111/j.1365-2648.2011.05728.x
    This paper is a report of a study of nurses' perception towards the role of pharmacist in Pakistan healthcare setup.
  19. Fulltext Low back pain and association with whole body vibration among military armoured vehicle drivers in Malaysia
    Rozali A, Rampal KG, Shamsul Bahri MT, Mohd Sidik S, Shamsul Azhar S, Khairuddin H, et al.
    Med J Malaysia, 2009 Sep;64(3):197-204.
    PMID: 20527267 MyJurnal
    A cross sectional study was conducted among military armoured vehicle drivers in the two largest mechanized battalions with the objective to determine the prevalence of low back pain (LBP), and its association with whole body vibration (WBV) and other associated factors. A self-administered questionnaire and Human Vibration Meter were used in this study. A total of 159 respondents participated in this study and 102 (64.2%) of them were subjected to WBV measurement. One-hundred-and-seventeen respondents complained of LBP for the past 12 months giving a prevalence of 73.6%. The prevalence of LBP among tracked armoured vehicle drivers was higher (81.7%) as compared to wheeled armoured vehicle drivers (67.0%). The mean acceleration at Z-axis in tracked armoured vehicles (1.09 +/- 0.26 ms(-2)) and wheeled armoured vehicles (0.33 +/- 0.07 ms) were the dominant vibration directions. The mean estimated vibration dose value (eVDV) for eight-hour daily exposure at Z-axis (19.86 +/- 4.72 ms(-1.75)) in tracked armoured vehicles showed the highest estimation. Based on the European Vibration Directive (2002), the mean eVDV at Z-axis in tracked armoured vehicles exceeded exposure action value (EAV) (> 9.1 ms(-1.75), but did not exceed exposure limit value (ELV) (<21.0 ms(-1.75)). Logistic regression analysis revealed that only driving in forward bending sitting posture (OR = 3.63, 95% CI 1.06-12.42) and WBV exposure at X-axis (OR = 1.94, 95% CI 1.02-3.69) were significant risk factors to LBP. Preventive measures should be implemented to minimize risk of WBV and to improve ergonomic postures among drivers.
  20. Fulltext The role of pharmacists in developing countries: the current scenario in Pakistan
    Azhar S, Hassali MA, Ibrahim MI, Ahmad M, Masood I, Shafie AA
    Hum Resour Health, 2009;7:54.
    PMID: 19594916 DOI: 10.1186/1478-4491-7-54
    During the past few years, the pharmacy profession has expanded significantly in terms of professional services delivery and now has been recognized as an important profession in the multidisciplinary provision of health care. In contrast to the situation in developed countries, pharmacists in developing countries are still underutilized and their role as health care professionals is not deemed important by either the community or other health care providers. The aim of this paper is to highlight the role of pharmacists in developing countries, particularly in Pakistan. The paper draws on the literature related to the socioeconomic and health status of Pakistan's population, along with background on the pharmacy profession in the country in the context of the current directions of health care. The paper highlights the current scenario and portrays the pharmacy profession in Pakistan. It concludes that although the pharmacy profession in Pakistan is continuously evolving, the health care system of Pakistan has yet to recognize the pharmacist's role. This lack of recognition is due to the limited interaction of pharmacists with the public. Pharmacists in Pakistan are concerned about their present professional role in the health care system. The main problem they are facing is the shortage of pharmacists in pharmacies. Moreover, their services are focused towards management more than towards customers. For these reasons, the pharmacist's role as a health care professional is not familiar to the public.
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