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  1. Mohammed AH, Blebil A, Dujaili J, Rasool-Hassan BA
    AIDS Rev, 2020;22(3):151-157.
    PMID: 33118527 DOI: 10.24875/AIDSRev.20000052
    Toward the end of the year 2019, there was the eruption of an acute respiratory syndrome, which is widely referred as coronavirus disease (COVID-19) from Wuhan, Hubei Province. The disease causes a range of respiratory illnesses, which are fatal. The COVID-19 disease has spread globally and has significantly impacted the health delivery systems, travel regulations, and economic activities and has posed and upsurge of responsibilities for the frontline healthcare workers. Due to the nature of the COVID-19 disease, it has typically caused complications which include pneumonia, multiple organ dysfunction together with renal failure, and acute respiratory distress syndrome. As of date, there is no approved vaccine or treatment for COVID-19 though there are ongoing research studies to formulate a treatment. COVID-19 is highly contagious, and the risk of infection is higher for patients with immunesuppressed patients than regular patients. The immunesuppressed conditions include cancer, HIV, and patients with solid organ transplants (SOT). This paper aims to review the risk and impact of COVID-19 on immunesuppressed patients, with a focus on cancer, HIV, and patients with SOT and the essence of special parameters for their care and management. Despite the fatal effects of this global pandemic, the findings of this study indicate the high risk which immunosuppressed patients have to contract the disease; thus, the governments and health delivery systems have to offer them extra support and treatment.
  2. Elkalmi RM, Elnaem MH, Sapar NM, Blebil A
    J Pharm Bioallied Sci, 2021 11 24;13(3):325-330.
    PMID: 35017889 DOI: 10.4103/jpbs.JPBS_577_20
    Objectives: This study aimed to assess the completeness and quality of adverse drug reaction (ADR) reports that were submitted to the Pharmacovigilance Unit (PVU) in clinical training center (CTC), Faculty of Medicine, UiTM Sungai Buloh Campus.

    Materials and Methods: A retrospective study was conducted using all ADR reports that were submitted to the PVU in CTC from December 31, 2000, to December 31, 2018. The completeness was assessed by reviewing all the required elements to be filled in the ADR reports. The quality was assessed by investigating the required information in the ADR reporting form. Descriptive statistics have been used to present the findings.

    Key Findings: In a total of 31 reports that were submitted to the PVU in CTC, 98.9% of patient's information and 100% of ADR descriptions were completed. Suspected drug information and the reporter's details were completed by 52.2% and 79.6%, respectively. Of 58.0% of the information about seriousness recorded, 38.9% (n = 7) is mild, 44.4% (n = 8) is moderate, and 16.7% (n = 3) is severe. Among all the suspected medicines, drug class of antibiotics (32.4%, n = 12) is the most reported suspected drugs that caused ADR, followed by opioid analgesic (8.1%, n = 3) and nonsteroidal anti-inflammatory drugs (8.1%, n = 3).

    Conclusion: Further efforts and relevant interventions should be considered to increase the reporting frequency and to enhance the completeness and the quality of the ADR reports in the study setting.

  3. Omran S, Leong SL, Blebil A, Mohan D, Teoh SL
    Res Social Adm Pharm, 2023 Nov;19(11):1399-1411.
    PMID: 37586945 DOI: 10.1016/j.sapharm.2023.07.012
    BACKGROUND: The field of pharmacogenomics is rapidly advancing, but its adoption and implementation remain slow and lacking. Lack of pharmacogenomics knowledge among healthcare professionals is the most frequently cited barrier to adopting and implementing pharmacogenomics in clinical settings.

    OBJECTIVES: This study aimed to critically evaluate and determine the effectiveness of educational interventions in improving pharmacogenomics knowledge and practice.

    METHODS: Four electronic databases were searched: MEDLINE, EMBASE, CENTRAL, and PsycINFO. Studies on pharmacogenomics educational interventions for health care professionals and students with pre- and post-intervention assessments and results were included. No restrictions were placed on time, language, or educational contexts. The educational outcomes measured include both objective and subjective outcomes. The pharmacogenomics competency domains used to judge educational interventions are based on the competency domains listed by the American Association of Colleges of Pharmacies (AACP). The National Heart, Lung, and Blood Institute of the National Institutes of Health was used for the quality assessment of pre-post studies with no control group and the controlled intervention studies. No meta-analysis was conducted; the data were synthesized qualitatively. The systematic review was reported in accordance with the PRISMA statement.

    RESULTS: Fifty studies were included in this review. All included studies integrated the AACP pharmacogenomics competency domains into their educational interventions. Most of the studies had educational interventions that integrated clinical cases (n = 44; 88%). Knowledge was the most frequently evaluated outcome (n = 34; 68%) and demonstrated significant improvement after the educational intervention that integrated AACP pharmacogenomics competency domains and employed active learning with clinical case inclusion.

    CONCLUSION: This review provided evidence of the effectiveness of educational interventions in improving pharmacogenomics knowledge and practice. Incorporating pharmacogenomics competency domains into education and training, with patient cases for healthcare professionals and students, dramatically improved their pharmacogenomics knowledge, attitudes, and confidence in practice.

  4. Mohammed AH, Blebil A, Dujaili J, Hassan BAR
    J Cosmet Dermatol, 2021 Jul;20(7):1992-2000.
    PMID: 33834600 DOI: 10.1111/jocd.14147
    BACKGROUND: The use of cosmetics is growing among both male and female consumers due to the availability of different brands. While there is an increase in the usage of cosmetic products, it is concerning whether the consumers are aware of the safety of the products.

    AIMS: This study aimed to widely explore consumers' perceptions and attitudes toward cosmetics within the context of the COVID-19 pandemic.

    METHODS: A cross-sectional study was carried out among adults in Selangor, Malaysia. Thirty-three questions divided into three dimensions (socio-demographic parameters, assessment of perception, and assessment of attitude) were developed and validated to be answered by cosmetics consumers. Descriptive and inferential statistical analysis was done using SPSS.

    RESULTS: A response rate of 87% was achieved, and the mean age of participants was 33 ± 7.2. The overall perception of consumers indicates low levels of perception and moderate level of attitude toward cosmetic products. There was a positive correlation and high relationship between participants' perception and attitude (p = 0.001, r = 0.72). A significant association was observed between demographic data of respondents and their attitude and perception toward cosmetic products. Participants were unaware that sharing of cosmetic products could lead to bacterial infection and possibly increased the chance of contracting COVID-19.

    CONCLUSION: This study displayed a nonchalant perception and attitude of Malaysian adults toward cosmetic products by focusing on aesthetics rather than health safety. Therefore, it is recommended to raise awareness on the composition and effects of cosmetic products, increase the practice of hygiene and dissuade the sharing of cosmetics to reduce transmissions of COVID-19.

  5. Ahmed A, Saqlain M, Akhtar N, Hashmi F, Blebil A, Dujaili J, et al.
    Health Qual Life Outcomes, 2021 Feb 08;19(1):48.
    PMID: 33557861 DOI: 10.1186/s12955-021-01693-0
    BACKGROUND: Reliable Health-Related Quality of Life (HRQoL) assessment will be useful in identifying health issues and in identifying health care actions. Due to the lack of a psychometrically valid tool in Urdu, we aim to translate and examine the psychometric and cross-cultural adaptation of WHOQOL HIV Bref among people living with HIV/AIDS (PLWHA) in Pakistan.

    METHODS: The standard forward-backwards translation technique was used to convert English version of the WHOQOL HIV Bref into Urdu. After cognitive debriefing, final Urdu version of instrument was developed. Based on the principle of at least 5 subjects for each item, a sample of 182 patients was used using a universal random sampling technique from the Pakistan Institute of Medical Sciences, Islamabad. The Cronbach's alpha and intra-class correlation coefficients (ICC) were estimated to assess internal validity and reliability of the translated version. Exploratory factor analysis was carried out to determine the factor structure and independent associations between the instrument domains and CD-4T-cell count were assessed using multivariable linear regression RESULTS: High Cronbach alpha 0.93 was found for all WHOQOL HIV Bref facets. The test-retest reliability demonstrated a statistically significant ICC ranged from 0.88 to 0.98 (p 

  6. Blebil A, Dujaili J, Elkalmi R, Tan HLK, Tai MS, Khan TM
    J Pharm Bioallied Sci, 2020 01 29;12(1):64-71.
    PMID: 32801602 DOI: 10.4103/jpbs.JPBS_152_19
    Introduction: Pharmacists have been well recognized as an active and have a more integrated role in the preventive services within the National Health Services. This study assessed the community pharmacists' attitudes, beliefs, and practices toward oral health in the Malaysian setting.

    Materials and Methods: A cross-sectional survey-based study was used to conduct this project. An anonymous self-administered questionnaire was developed and distributed among community pharmacists within Kuala Lumpur and Selangor states areas, Malaysia. The data collection was carried out from the beginning of November to the end of December 2018.

    Results: Of the 255 pharmacists, 206 agreed to participate in the study, yielding a response rate of 80.8%. Overall, approximately half of the pharmacists provided two to five oral health consultations per week and two to five over the counter (OTC) oral health products recommendations per week. The main services provided by community pharmacists in were the provision of OTC treatments (93.7%), referral of consumers to dental or medical practitioners when appropriate (82.5%), and identify signs and symptoms of oral health problems in patients (77.2%). In addition, more than 80% of the pharmacists viewed positively and supported integrating oral health promotion and preventive measures into their practices. The most commonly reported barriers to extending the roles of pharmacists in oral health care include lack of knowledge or training in this field, lack of training resources, and lack of oral health educational promotion materials.

    Conclusion: The study shows that community pharmacists had been providing a certain level of oral health services and play an important role in oral health. The findings highlighted the need of an interprofessional partnership between the pharmacy professional bodies with Malaysian dental associations to develop, and evaluate evidence-based resources, guidelines, the scope of oral health in pharmacy curricula and services to deliver improved oral health care within Malaysian communities.

  7. Kc B, Alrasheedy AA, Hing Goh B, Blebil A, Bangash NSA, Mohamed Ibrahim MI, et al.
    Patient Prefer Adherence, 2021;15:1755-1762.
    PMID: 34408408 DOI: 10.2147/PPA.S325851
    Purpose: The aims of this study are to explore the types and patterns of use of health mobile apps among pharmacy clients in Selangor, Malaysia, and to explore the users' experiences and views regarding the benefits of and issues with the use of the health apps.

    Patients and Methods: A cross-sectional survey was conducted with 278 pharmacy clients who were using health apps on their smartphones. A survey was developed, piloted, and rolled out, comprised of socio-demographic characteristics, information regarding the common types and the pattern of health app use, the benefits of health apps, and issues that users faced while using these apps. Statistical analysis was performed using IBM SPSS version 21.

    Results: The mean (±SD) age of health app users was 29.8 (±11.74) years old, and over half of them (51.8%) were male, while less than half were female (48.2%). There were 48 different types of mobile health apps used by the participants in this study. The two most common were multi-purpose general health apps (53.6%) and fitness apps (38.1%). In terms of pattern of use, 33.5% of the participants reported using their health apps daily, 36.7% at least once weekly, and 25.2% monthly. The main benefits reported by the users were tracking of health status (47%), motivation (41%), and knowledge about health and fitness (9%). The main issues reported by the participants included inaccuracy of the app (24%), inconvenience (20.7%), and not being user-friendly (18.5%).

    Conclusion: The study showed that the participants used many different types of mobile health apps for several purposes, including general health, wellness, fitness, and self-management of diseases. These apps helped the participants to track their health-related activities and motivated them to maintain their wellness and fitness. Further areas of improvement were identified to ensure evidence-based and effective utilization of apps to achieve required health outcomes.

  8. Christopher CM, Kc B, Blebil A, Alex D, Ibrahim MIM, Ismail N, et al.
    Healthcare (Basel), 2021 Nov 18;9(11).
    PMID: 34828622 DOI: 10.3390/healthcare9111577
    This review and meta-analysis aimed to determine the clinical and humanistic outcomes of community pharmacy-based interventions on medication-related problems of older adults at the primary care level. We identified randomized controlled trials (RCTs) examining the impact of various community pharmacy-based interventions from five electronic databases (namely, MEDLINE (Ovid), EMBASE (Ovid), CINAHL, APA PSYInfo, and Scopus) from January 2010 to December 2020. Consequently, we assessed these interventions' clinical and humanistic outcomes on older adults and compared them with non-intervention. We included 13 RCTs in the current review and completed a meta-analysis with six of them. The included studies had a total of 6173 older adults. Quantitative analysis showed that patient education was significantly associated with an increase in the discontinuation of sedative-hypnotics use (risk ratio 1.28; 95% CI (1.20, 1.36) I2 = 0%, p < 0.00001). Moreover, the qualitative analysis showed that medication reviews and education with follow-ups could improve various clinical outcomes, including reducing adverse drug events, reducing uncontrolled health outcomes, and improving appropriate medication use among the elderly population. However, medication review could not significantly reduce the number of older adults who fall (risk ratio 1.25; 95% CI (0.78, 1.99) I2 = 0%, p = 0.36) and require hospitalization (risk ratio 0.72; 95% CI (0.47, 1.12) I2 = 45%, p = 0.15). This study showed that community pharmacy-based interventions could help discontinue inappropriate prescription medications among older adults and could improve several clinical and humanistic outcomes. However, more effective community pharmacy-based interventions should be implemented, and more research is needed to provide further evidence for clinical and humanistic outcomes of such interventions on older adults.
  9. Ahmed A, Saqlain M, Bashir N, Dujaili J, Hashmi F, Mazhar F, et al.
    Qual Life Res, 2021 Jun;30(6):1653-1664.
    PMID: 33582967 DOI: 10.1007/s11136-021-02771-y
    BACKGROUND: Health-related quality of life (HRQoL) is considered to be the fourth 90 of UNAIDS 90-90-90 target to monitor the effects of combination antiretroviral therapy (ART). ART has significantly increased the life expectancy of people living with HIV/AIDS (PLWHA). However, the impact of chronic infection on HRQoL remains unclear, while factors influencing the HRQoL may vary from one country to another. The current study aimed to assess HRQoL and its associated factors among PLWHA receiving ART in Pakistan.

    METHODS: A cross-sectional descriptive study was conducted among PLWHA attending an ART centre of a tertiary care hospital in Islamabad, Pakistan. HRQoL was assessed using a validated Urdu version of EuroQol 5 dimensions 3 level (EQ-5D-3L) and its Visual Analogue Scale (EQ-VAS).

    RESULTS: Of the 602 patients included in the analyses, 59.5% (n = 358) reported no impairment in self-care, while 63.1% (n = 380) were extremely anxious/depressed. The overall mean EQ-5D utility score and visual analogue scale (EQ-VAS) score were 0.388 (SD: 0.41) and 66.20 (SD: 17.22), respectively. Multivariate linear regression analysis revealed that the factors significantly associated with HRQoL were: female gender; age  > 50 years; having primary and secondary education;  > 1 year since HIV diagnosis; HIV serostatus AIDS-converted; higher CD 4 T lymphocytes count; detectable viral load; and increased time to ART.

    CONCLUSIONS: The current findings have shown that PLWHA in Pakistan adherent to ART had a good overall HRQoL, though with significantly higher depression. Some of the factors identified are amenable to institution-based interventions while mitigating depression to enhance the HRQoL of PLWHA in Pakistan. The HRQoL determined in this study could be useful for future economic evaluation studies for ART and in designing future interventions.

  10. Hassan BAR, Mohammed AH, Wayyes AM, Farhan SS, Al-Ani OA, Blebil A, et al.
    Curr Psychol, 2022 Feb 03.
    PMID: 35136327 DOI: 10.1007/s12144-022-02779-8
    Governments worldwide have imposed lockdowns in their countries to restrict unnecessary movement and curb the spread and transmission of the Covid-19 as a mitigation measure. The education sector has also implemented rapid changes, and this has transformed the operational procedures for both students and lecturers. As the pandemic has progressed, its emotional and psychological toll is equally bearing on students, leading to lockdown fatigue. This study aimed to investigate the level of lockdown-induced fatigue and its correlation with personal resilience and coping skills among university students in Iraq. This study used quantitative methods of research using a cross-sectional study design. A questionnaire survey was distributed electronically among 819 university students in Iraq. The study used three standardised scales: the lockdown fatigue scale, brief resilience scale, and coping behaviours questionnaire for data collection. Descriptive and inferential statistical analysis were done using SPSS. Overall, students indicated a high level of lockdown fatigue with a mean score of 33.48out of 50. Fear of personal safety and the wellbeing of the family was the most fear expressed by the students. The ability to go through stressful times and unpleasant events was the most common worry among the students. Female, urbanised, and science field students were the most students who suffered from lockdown-induced fatigue. However, positive coping behaviours and personal resilience were significantly correlated with decreasing fatigue levels during the lockdown period. Level of lockdown fatigue accelerated in an alarming stage among university students in Iraq. Hence, students need to build their emotional resilience and learn how to navigate surviving hard times and bounce back after a loss. This could be facilitated by counselling services being availed to educational and social institutions to benefit university students.
  11. Xin RKW, Yee TW, Qin WZ, Kaiyee L, Mohammed AH, Blebil A, et al.
    Explor Res Clin Soc Pharm, 2024 Mar;13:100410.
    PMID: 38389828 DOI: 10.1016/j.rcsop.2024.100410
    BACKGROUND: The utilization of vitamins and dietary supplements (DSs) among consumers in Malaysia has seen a notable increase. However, there is limited research available on how pharmacists in Eastern countries manage the provision of these products.

    OBJECTIVE: This study aims to assess the knowledge, attitudes, and practices of community pharmacists in Malaysia regarding the provision of counselling services on vitamins and DSs. The findings will inform education strategies in this area.

    METHODS: A cross-sectional quantitative study was conducted from February to April 2022 using a validated online-based questionnaire. The survey was distributed to community pharmacists across Malaysia through social media channels. t-test and ANOVA test were used for data analysis.

    RESULTS: Among the 260 participants, 73.5% were categorized as having average product knowledge. Key concerns included a lack of knowledge about the indications of new products and when to discontinue their use. Regarding dosing in specific patient groups, 33.5% of pharmacists only occasionally consulted references and primarily relied on product labels. Furthermore, 29% of pharmacists believed it was unnecessary to refer patients to doctors when they experienced ongoing symptoms while taking vitamins or DSs. Interestingly, 44.6% of pharmacists believed there was a correlation between the efficacy of vitamins and their price, often recommending more expensive brands despite similar content.

    CONCLUSION: There is an opportunity to enhance the knowledge of pharmacists in Malaysia regarding vitamins and DSs. Education interventions should focus on areas such as dosing for specific patient groups, when to discontinue products, understanding new products, evidence-based efficacy of products for specific conditions, and providing a framework for appropriate referral to support pharmacists in their practice.

  12. Mohammed AH, Hassan BAR, Blebil A, Dujaili J, Wayyes AM, Abdulhamid OA, et al.
    Health Sci Rep, 2024 Feb;7(2):e1865.
    PMID: 38343667 DOI: 10.1002/hsr2.1865
    BACKGROUND AND AIMS: The Corona Virus Disease 2019 (COVID-19) pandemic brought to the forefront various public health approaches, including the consumption of dietary supplements (DS) as a protective measure. With misinformation regarding the virus and the associated benefits of DS prevalent, this study aimed to understand knowledge, habits, and beliefs related to DS usage as a protective measure during the pandemic in Malaysia and Iraq, two countries with deep-rooted traditions in herbal and supplement usage.

    METHODS: A cross-sectional research study was conducted between September 2021 and March 2022 using a validated online survey. The participants included Malaysians and Iraqis aged 18 years and above who currently consume DS. Using the SurveyMonkey® platform, data were collected from 2425 respondents (response rate = 60.6%), with analysis carried out using SPSS version 28.

    RESULTS: Demographically, the sample had an almost equal distribution of Malaysians (51%) and Iraqis (49%), with a mean age of 30.61. The majority had tertiary education (78.6%), and only a fraction had been infected with COVID-19 (26.2%). Concerning knowledge, a significant portion exhibited poor understanding (84.2%) of DS's functioning and implications. Regarding habits, many respondents consumed multivitamins (75.2%), with influence largely coming from peers (23.5%) and product leaflets (46.7%). Belief-wise, about half (49.2%) utilized herbal or supplemental products as a protective measure during the pandemic, with vitamin C with zinc being the most commonly used (45.4%).

    CONCLUSION: The study underlines a significant inclination towards DS usage in Malaysia and Iraq, influenced by societal connections and available information. While many believe in the protective capacities of DS against COVID-19, a substantial knowledge gap persists. It emphasizes the need for evidence-based awareness campaigns and policies to guide public health decisions.

  13. Mohammed AH, Hassan BAR, Wayyes AM, Gadhban AQ, Blebil A, Alhija SA, et al.
    Vaccine, 2022 Oct 26;40(45):6549-6557.
    PMID: 36207222 DOI: 10.1016/j.vaccine.2022.09.052
    BACKGROUND: The issue around vaccination of children has brought divergent opinions among the populations across the globe and among the Arab population. There has been a low response rate to the calls for vaccination of children and this is reflective of the sentiments which parents may have towards their children being vaccinated. This study aims to explore the parents' health beliefs, intentions, and strategies towards the COVID-19 vaccine for their children among Arab population.

    METHODS: A cross-sectional study using an online survey from October to December 2021, was carried out in five Arab countries in the Middle East. A reliable health belief model (HBM) including five domains: severity, susceptibility, benefits, barriers and cues to action, was adopted. Chi-square, Mann-Whitney test, and multivariable logistic regression were performed for data analysis.

    RESULTS: The survey response rate was 58 % (1154/2000). Only 56 % of Arab parents are intended to vaccinate their children against COVID-19. The mean scores of parental health belief are largely driven by their concern over the vaccine's side effect (p = 0.001) followed by its efficacy, safety (p 

  14. Mohammed AH, Hassan BAR, Wayyes AM, Al-Tukmagi HF, Blebil A, Dujaili J, et al.
    J Cosmet Dermatol, 2023 Jan;22(1):296-305.
    PMID: 35567513 DOI: 10.1111/jocd.15085
    BACKGROUND: The use of cosmetic products is growing in dominance in the Arab population, making it essential to measure its effects on users. The production of cosmetics has been largely driven by consumerism and a bid to keep abreast with the latest trends in the beauty industry with less attention on how the users' quality of life (QoL) is affected.

    AIMS: This study aims to investigate the effect of cosmetic products on users' quality of life in eight Arab countries.

    METHODS: A cross-sectional study was carried out using an online data collection approach. A validated and specialist instrument tool called BeautyQoL, which consists of five domains and a total of 52 questions, was distributed to a sample of 2219 cosmetic users. Descriptive and inferential statistical analysis was done using SPSS® version 26.0.

    RESULTS: The mean age of participants was 34 ± 11.25 years, and more women were represented in the sample (71%) than men. The majority of respondents had oily skin type (39.6%) and tan skin tone (30.4%). QoL through cosmetic use is computed with a mean score of 51 out of 100. The users' mean score satisfaction from cosmetic use is centred on attractiveness (56.1), followed by self-confidence (51.8). Cosmetics have a statistically significant effect on participants who are young adults, women, single, and employed with high income. As the respondents' skin tone deepens from very fair to dark, the mean score for each domain significantly increases, whereas when skin type changes from very oily to dry, the mean score for each domain decreases.

    CONCLUSION: The effect of cosmetics on the users' QoL is limited, contrary to the narrative commonly portrayed in cosmetics' advertisements. Therefore, the use of cosmetics among the Arab population should be from an informed perspective of their specific needs instead of conforming to the viral trends pedaled by influencers and bloggers on social media, which might be irrelevant for them.

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