Displaying publications 1 - 20 of 68 in total

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  1. Nasution A, Syed Sulaiman SA, Shafie AA
    Value Health Reg Issues, 2013 May;2(1):43-47.
    PMID: 29702851 DOI: 10.1016/j.vhri.2013.02.009
    OBJECTIVES: This study evaluated the clinical and economic impacts of clinical pharmacy education (CPE) on infection management among patients with chronic kidney disease (CKD) stages 4 and 5 in Haji Adam Malik Hospital, Indonesia.

    METHODS: A quasi-experimental economic evaluation comparing CPE impact on 6-month CKD mortality was conducted on the basis of payer perspective. The experimental group (n = 63) received care by health care providers who were given CPE on drug-related problems and dose adjustment. The control group (n = 80) was based on the historical cohort of patients who received care before the CPE. Measure of clinical outcome applied in this study was number of lives saved/100 patients treated. Cost-effectiveness ratios for CKD stages 4 and 5 patients without CPE and with CPE and incremental cost-effectiveness ratios (ICERs) for CKD stages 4 and 5 patients were analyzed.

    RESULTS: Lives saved (%) in the treatment of CKD without CPE: CKD stage 4, 78.57; CKD stage 5, 57.58. Lives saved (%) in the treatment of CKD with CPE: CKD stage 4, 88.89; CKD stage 5, 65.45. Cost-effectiveness ratios for stage 4 with and without CPEs were Rp3,348,733.27 and Rp3,519,931.009, respectively. Cost-effectiveness ratios for stage 5 with and without CPEs were Rp7,137,874.93 and Rp7,871,822.27, respectively. ICERs were Rp2,045,341.22 for CKD stage 4 and Rp1,767,585.60 for CKD stage 5.

    CONCLUSIONS: Treatment of CKD stages 4 and 5 with CPE was more effective and cost-effective compared with treatment of CKD stages 4 and 5 without CPE. The ICERs indicated that extra costs were required to increase life saved in both stages.

  2. Abubakar U, Syed Sulaiman SA, Adesiyun AG
    Int J Clin Pharm, 2018 Oct;40(5):1037-1043.
    PMID: 30054786 DOI: 10.1007/s11096-018-0702-0
    Background Audit of antibiotic prophylaxis is an important strategy used to identify areas where stewardship interventions are required. Objectives To evaluate compliance with surgical antibiotic prophylaxis in obstetrics and gynaecology surgeries and determine the Defined Daily Dose (DDD) of antibiotic. Settings Three public tertiary hospitals located in Northern Nigeria. Methods This prospective study included women who had obstetrics and gynaecology surgeries with no infection at the time of incision. Appropriateness of antibiotic prophylaxis was determined by a clinical pharmacist. DDD of antibiotics was determined using ATC/DDD index 2017 from the World Health Organization Collaborating Centre for Drugs Statistics Methodology. Main outcome measure Compliance with antibiotic prophylaxis and DDD of antibiotic per procedure. Results A total of 248 procedures were included (mean age: 31.7 ± 7.9 years). Nitroimidazole in combination with either beta-lactam/beta-lactamase inhibitor or third generation cephalosporin were the most prescribed antibiotics. Redundant anaerobic antibiotic combination was detected in 71.4% of the procedures. Timing of antibiotic prophylaxis was optimal in 16.5% while duration of prophylaxis was prolonged in all the procedures (mean duration was 8.7 ± 1.0 days). The DDD of antibiotics prophylaxis was 16.75 DDD/procedure. Antibiotic utilisation was higher in caesarean section and myomectomy (17.9 DDD/procedure) than hysterectomy (14.5 DDD/procedure); P 
  3. Abubakar U, Syed Sulaiman SA, Adesiyun AG
    PLoS One, 2019;14(3):e0213395.
    PMID: 30845240 DOI: 10.1371/journal.pone.0213395
    BACKGROUND: Inappropriate and excessive use of surgical antibiotic prophylaxis are associated with the emergence of antibiotic resistance. Antibiotic prophylaxis malpractices are common in obstetrics and gynecology settings and antibiotic stewardship is used to correct such malpractice.

    OBJECTIVE: To evaluate the impact of antibiotic stewardship interventions on compliance with surgical antibiotic prophylaxis practice in obstetrics and gynecology surgeries.

    METHOD: A prospective pre- and post-intervention study was conducted in two tertiary hospitals between May and December 2016. The duration of the each period was 3 months. Antibiotic stewardship interventions including development of a protocol, educational meeting and audit and feedback were implemented. Data were collected using the patient records and analyzed with SPSS version 23.

    RESULTS: A total of 226 and 238 surgical procedures were included in the pre- and post-intervention periods respectively. Age, length of stay and estimated blood loss were similar between the two groups. However, specialty and surgical procedures varied significantly. There was a significant increase in compliance with timing (from 14.2% to 43.3%) and duration (from 0% to 21.8%) of surgical antibiotic prophylaxis after the interventions. The interventions significantly reduced the prescription of third generation cephalosporin (-8.6%), redundant antibiotic (-19.1%), antibiotic utilization (-3.8 DDD/procedure) and cost of antibiotic prophylaxis (-$4.2/procedure). There was no significant difference in the rate of surgical site infection between the two periods. Post-intervention group (OR: 5.60; 95% CI: 3.31-9.47), elective surgery (OR: 4.62; 95% CI: 2.51-8.47) and hospital attended (OR: 9.89; 95% CI: 5.66-17.26) were significant predictors of compliance with timing while elective surgery (OR: 12.49; 95% CI: 2.85-54.71) and compliance with timing (OR: 58.55; 95% CI: 12.66-270.75) were significantly associated with compliance to duration of surgical antibiotic prophylaxis.

    CONCLUSION: The interventions improve compliance with surgical antibiotic prophylaxis and reduce antibiotic utilization and cost. However, there is opportunity for further improvement, particularly in non-elective surgical procedures.

  4. Albaroodi KA, Syed Sulaiman SA, Shafie AA, Awaisu A, Lajis R
    Value Health, 2014 Nov;17(7):A590.
    PMID: 27202012 DOI: 10.1016/j.jval.2014.08.2023
    Widespread evidence has demonstrated the negative effects of tobacco smoking in patients with diabetes. Although many studies have explored the prevalence of tobacco smoking in the general population, data are lacking regarding its prevalence in a specific population with a chronic disease such as diabetes.
    Objectives: This study aims to determine the prevalence of tobacco smoking among patients with diabetes in Hospital Pulau Pinang, Malaysia.
    Methods: A cross-sectional survey was conducted to study diabetic patients who attended the endocrine clinic at Hospital Pulau Pinang in Malaysia from March to August 2012. All the diabetic patients who attended the endocrine clinic during that period were asked about their smoking status, and their medical records were reviewed. A total of 1,118 patients with diabetes were reviewed to determine the prevalence of tobacco smoking in diabetic patients at the endocrine clinic of Hospital Pulau Pinang.
    Results: The majority of the study population was male, with Malay and Chinese patients in almost equal proportions and a smaller proportion of Indian patients. Most of these patients had started smoking before they were diagnosed with diabetes. Among the 1,118 diabetic patients, only 108 patients smoked; therefore, the prevalence of tobacco smoking in our patients with diabetes was 9.66%.
    Conclusions: A low prevalence of tobacco smoking was estimated in this study. This prevalence is close to the corresponding value in the general population in Malaysia.
    Study site: Endocrine clinic, Hospital Pulau Pinang, Malaysia
  5. Khan TM, Al-Haider I, Syed Sulaiman SA, Hassali MA
    J Ren Care, 2013 Dec;39(4):222-7.
    PMID: 24152068 DOI: 10.1111/j.1755-6686.2013.12038.x
    Pruritus is one of the commonest skin complaints in end-stage kidney disease. Pruritus can be effectively managed if proper assessment is carried out to categorise its severity. The objective of this study is to test the reliability of an Arabic version of the 5D-Itching scale (5D-IS).
  6. Abdulameer SA, Syed Sulaiman SA, Hassali MA, Subramaniam K, Sahib MN
    Osteoporos Int, 2013 Mar;24(3):929-40.
    PMID: 22790611 DOI: 10.1007/s00198-012-2071-1
    In type 2 diabetic patients (T2DM), only 22 % have normal bone mineral density and almost three quarters of the sample population had low self-efficacy towards osteoporosis. These results reflect the need for screening and educational programs to increase the awareness of T2DM towards osteoporosis.
    INTRODUCTION: Our aim was to translate and examine the psychometric properties of the Malay version of the osteoporosis self-efficacy scale (OSES-M) among T2DM and to determine the best cut-off value with optimum sensitivity and specificity. In addition, to assess factors that affects diabetic patients' osteoporosis self-efficacy.
    METHODS: A standard "forward-backward" procedure was used to translate the OSES into Malay language, which was then validated with a convenience sample of 250 T2DM. The sensitivity and specificity of the OSES-M was calculated using receiver operating characteristic curve analysis. Bivariate and multivariate approaches were used to examine multiple independent variables on each dependent variable.
    RESULTS: The mean score of OSES-M was 731.74 ± 197.15. Fleiss' kappa, content validity ratio range, and content validity index were 0.99, 0.75-1, and 0.96, respectively. Two factors were extracted from exploratory factor analysis and were confirmed through confirmatory factor analysis. Internal consistency and test-retest reliability were 0.92 and 0.86, respectively. The optimum cut-off point of OSES-M to predict osteoporosis/osteopenia was 858. Regression analysis revealed that knowledge, health belief, and some demographic data had an impact on OSES-M.
    CONCLUSIONS: The results show that the OSES-M is a reliable and valid instrument for measuring osteoporosis self-efficacy in the Malaysian clinical setting.
  7. Zyoud SH, Awang R, Syed Sulaiman SA, Al-jabi SW
    Hum Exp Toxicol, 2010 Sep;29(9):773-8.
    PMID: 20144962 DOI: 10.1177/0960327110361759
    Hypokalemia is not an isolated disease but an associated finding in a number of different diseases. It is also a commonly neglected condition among patients with acute acetaminophen overdose.
  8. Saheb Sharif-Askari F, Syed Sulaiman SA, Saheb Sharif-Askari N
    Adv Exp Med Biol, 2017;906:101-114.
    PMID: 27628006
    Patients with chronic kidney disease (CKD) are at increased risk for both thrombotic events and bleeding. The early stages of CKD are mainly associated with prothrombotic tendency, whereas in its more advanced stages, beside the prothrombotic state, platelets can become dysfunctional due to uremic-related toxin exposure leading to an increased bleeding tendency. Patients with CKD usually require anticoagulation therapy for treatment or prevention of thromboembolic diseases. However, this benefit could easily be offset by the risk of anticoagulant-induced bleeding. Treatment of patients with CKD should be based on evidence from randomized clinical trials, but usually CKD patients are excluded from these trials. In the past, unfractionated heparins were the anticoagulant of choice for patients with CKD because of its independence of kidney elimination. However, currently low-molecular-weight heparins have largely replaced the use of unfractionated heparins owing to fewer incidences of heparin-induced thrombocytopenia and bleeding. We undertook this review in order to explain the practical considerations for the management of anticoagulation in these high risk population.
  9. Ramatillah DL, Syed Sulaiman SA, Khan AH
    J Glob Infect Dis, 2018 6 19;10(2):37-41.
    PMID: 29910562 DOI: 10.4103/jgid.jgid_85_17
    Background: According to the Association of Nephrologist in Indonesia (Pernefri) recommendation, isolation and using special hemodialysis machines are not necessary for hemodialysis (HD) patients who have been infected by hepatitis C virus (HCV), while according to the Ministry of Health Malaysia recommendation, hepatitis C patients should be dialyzed in a separate room or a separate area with a fixed partition and dedicated machines.

    Aim: The aim of this study was to identify the correlation between the recommendation which had been followed by two HD centers in different countries and the impact of that on the hepatitis C infection issue.

    Methods: A cohort prospective and retrospective study was done in this research. The study included HD patients who were followed up for 9 months and who died in the last 5 years. Universal sampling was used to select the patients based on inclusion criteria.

    Results: There was a significant relationship between HCV during the first checkup and HCV during the second checkup during the 9-month follow-up of HD patients in a HD center, Jakarta, Indonesia. The total number of patients who had hepatitis C during the first and second checkups was also different in this HD center.

    Conclusion: Besides providing special HD rooms and machines for HD patients with hepatitis C, minimizing blood transfusion to the patients on HD is also important to reduce the chance for the patients to acquire hepatitis C and to increase the percentage of survival.

  10. Ramatillah DL, Syed Sulaiman SA, Khan AH, Meng OL
    J Pharm Bioallied Sci, 2017 Oct-Dec;9(4):229-238.
    PMID: 29456373 DOI: 10.4103/jpbs.JPBS_191_17
    Background: Quality of life is one of the parameters to check the improvement of hemodialysis treatment among hemodialysed patients. Those patients will be dealing with this treatment in long term if this treatment is the only way for them to replace their kidney function and this thing will affect their quality of life.
    Objective: To evaluate the quality of life patients on hemodialysis using kidney disease quality of life-short term 24 (KDQoL-SF24) Malaysian Version.
    Materials and Methods: Cohort observational study was conducted in this study. The study included 78 hemodialysed patients in HD center Penang, Malaysia.
    Results: There were 9 components which had the lower of the mean and standard deviation (SD) than the standard form; work status (15.01 ± 35.57), cognitive function (75.66 ± 13.75), quality of life social interaction (76.32 ± 16.11), sleep (55.86 ± 15.30), social support (59.61 ± 22.08), patient satisfaction (43.24 ± 15.32), physical functioning (50.06 ± 42.81), general health (29.62 ± 25.56), and role emotional (54.27 ± 49.92). In this HD center, the group of patient's age who had the lower mean ± SD from the KDQoL-SF Manual Standard were the first and the sixth groups of patient's age (≤20 and 61-70).
    Conclusion: The study conducted in HD center, Penang, Malaysia showed that the scoring of work status, cognitive function, quality of social interaction, sleep, social support, patient satisfaction, physical functioning, general health, and role emotional were low than standard form.
  11. Hammad MA, Syed Sulaiman SA, Abubakar U, Mohamed Noor DA
    Diabetes Metab Syndr, 2019 01 16;13(2):1035-1040.
    PMID: 31336440 DOI: 10.1016/j.dsx.2019.01.001
    AIMS: The study intended to investigate the impact of controlled glycemia on morbidity and estimated 10-year survival (ES-10Y).

    METHODS: A cross-sectional investigation was conducted at General Penang Hospital, Malaysia. Demographic criteria and laboratory tests of patients were investigated. Controlled glycemia (CG) was recognized as glycated hemoglobin (HbA1c) ≤7% depending on American Diabetes Association guidelines 2018. Charlson Comorbidity Index (CCI) was used to estimate the confounding influence of co-morbidities and predict ES-10Y. Data was managed by IBM-SPSS 23.0.

    RESULTS: A total of 400 cases categorized to (44.25%) patients with CG, and (55.75%) cases had uncontrolled glycemia (UCG). HbA1c mean in CG and UCG group was (6.8 ± 0.9 vs 9.5 ± 1.6, P-value: 0.001). Fasting blood glucose was (7 ± 2.3 vs. 9.9 ± 4.3, P-value: 0.001) in CG and UCG group. CCI was (3.38 ± 2.38 vs. 4.42 ± 2.70, P-value: 0.001) and, ES-10Y was (62% vs 46.2%, p-value: 0.001) in CG vs. UCG respectively. Spearman test indicates a negative correlation between CG and CCI (r: 0.19, p-value: 0.001). Logistic regression confirmed HbA1c as a significant predictor of CCI (r2: 0.036, P-value: 0.001). CG has a positive correlation with survival (r: 0.16, P-value: 0.001) and logistic regression of survival (r2: 0.26, P-value: 0.001).

    CONCLUSIONS: More than one-half of the investigated persons had UCG. Controlled HbA1c was associated with lower co-morbidities and higher ES-10Y.

  12. Iqbal MZ, Khan AH, Iqbal MS, Syed Sulaiman SA
    J Pharm Bioallied Sci, 2019 10 18;11(4):299-309.
    PMID: 31619911 DOI: 10.4103/jpbs.JPBS_138_19
    A strict and adherence treatment is required by the patient with diabetes mellitus and it demands a proper self-medication by the patient. Pharmacists are involved in providing self-management support to the patients. This review evaluates the interventions of pharmacist for patients to improve self-management with diabetes mellitus and also to improve the clinical outcomes of diabetes mellitus. A comprehensive literature search was performed by using different keywords "pharmacist-led intervention," "diabetes," "effect of pharmacist on outcome of diabetes," and "self-management of diabetes" with the help of various electronic databases such as PubMed, Science Direct, Embase, Web of Science, and the Cochrane Library from the beginning of the database through September 2018. The primary outcome was glycated hemoglobin (HbA1c), whereas the secondary outcomes were blood glucose level, blood pressure (BP) measure, body mass index, lipids, adherence to medication, and quality of life. Twenty-five studies comprising 2997 diabetic patients were included in the analysis. Pharmacist-led intervention was involved in all included studies in the form of education on diabetes and its complications, medication adherence, lifestyle, and education about self-management skills. Pharmacist-led interventions are able to reduce HbA1c levels with a mean of 0.75%. Most studies do not expose the material and methods used in pharmacist-led intervention. The variation in the reduction of HbA1c, fasting blood sugar, BP, and lipid profile was due to the lack of this standardization. The included studies indicated that pharmacist-led interventions in diabetes mellitus can significantly improve the outcomes of diabetes mellitus and its complication later on. Hence, these long-term improvements in outcomes added more value of pharmacists in health-care system of the world.
  13. Teoh BC, Syed Sulaiman SA, Tan BE
    Arch Rheumatol, 2021 Mar;36(1):63-71.
    PMID: 34046570 DOI: 10.46497/ArchRheumatol.2021.7726
    Objectives: This study aims to improve knowledge on cardiovascular disease (CVD) risk among rheumatoid arthritis (RA) patients using a multi- language leaflet tailored to our multi-ethnic patient population.

    Patients and methods: This was a prospective study conducted in Hospital Pulau Pinang, Malaysia, between March 2015 and June 2015. Educational intervention was provided to 96 patients (11 males, 85 females; mean age 52.4±12.9 years; range, 20 to 83 years) who fulfilled the inclusion/exclusion criteria. Questionnaires to assess knowledge of CVD risk were given to patients to be answered before reading the informative leaflet, after one hour of intervention, and during their next follow-up three months from the intervention. Both the informative leaflet and questionnaires were prepared in English and then translated into Malay and Chinese languages to suit the need of local patients.

    Results: Our results showed that RA patients had good knowledge at baseline regarding risk of smoking, hypertension, and hyperlipidemia on increasing CVD risk and that exercise would not damage their joints. However, they had low knowledge at baseline regarding the amount of exercise needed for lower CVD risks and risk of CVD with use of anti-inflammatory drugs in RA. Total knowledge score increased significantly from baseline immediately after educational intervention. However, total knowledge score decreased after three months compared to immediate post- intervention phase while it was still significantly higher compared to baseline. The improvement was most obvious for knowledge regarding anti- inflammatory drugs and CVD risk and knowledge regarding the number of flares and CVD risk. Our study did not find any significant association between demographic characteristics and traditional cardiovascular risk factors with knowledge of CVD risk.

    Conclusion: Rheumatoid arthritis patients have low knowledge regarding their CVD risk related to their disease. The intervention of providing an informative leaflet effectively improved the knowledge of this group of patients on CVD risk particularly in the field related to RA-specific risk.

  14. Saadah LM, Khan AH, Syed Sulaiman SA, Bashiti IA
    BMC Health Serv Res, 2021 Sep 08;21(1):937.
    PMID: 34496856 DOI: 10.1186/s12913-021-06966-4
    BACKGROUND: Clinical pharmacy interventions (CPI) usually require prior medical authorization. Physicians approve 80% of CPI and reject 20%. If pharmacists show that physicians should authorize all 100% CPI, the profession will step closer to a fully independent prescriber status. This study used an artificial neural network (ANN) model to determine whether clinical pharmacy (CP) may improve outcomes associated with rejected CPI.

    METHOD: This is a non-interventional, retrospective analysis of documented CPI in a 100-bed, acute-care private hospital in Amman, Jordan. Study consisted of 542 patients, 574 admissions, and 1694 CPI. Team collected demographic and clinical data using a standardized tool. Input consisted of 54 variables with some taking merely repetitive values for each CPI in each patient whereas others varying with every CPI. Therefore, CPI was consolidated to one rejected and/or one accepted per patient per admission. Groups of accepted and rejected CPI were compared in terms of matched and unmatched variables. ANN were, subsequently, trained and internally as well as cross validated for outcomes of interest. Outcomes were length of hospital and intensive care stay after the index CPI (LOSTA & LOSICUA, respectively), readmissions, mortality, and cost of hospitalization. Best models were finally used to compare the two scenarios of approving 80% versus 100% of CPI. Variable impacts (VI) automatically generated by the ANN were compared to evaluate the effect of rejecting CPI. Main outcome measure was Lengths of hospital stay after the index CPI (LOSTA).

    RESULTS: ANN configurations converged within 18 s and 300 trials. All models showed a significant reduction in LOSTA with 100% versus 80% accepted CPI of about 0.4 days (2.6 ± 3.4, median (range) of 2 (0-28) versus 3.0 ± 3.8, 2 (0-30), P-value = 0.022). Average savings with acceptance of those rejected CPI was 55 JD (~ 78 US dollars) and could help hire about 1.3 extra clinical pharmacist full-time equivalents.

    CONCLUSIONS: Maximizing acceptance of CPI reduced the length of hospital stay in this model. Practicing Clinical Pharmacists may qualify for further privileges including promotion to a fully independent prescriber status.

  15. Khan TM, Alhafez AA, Syed Sulaiman SA, Bin Chia DW
    Saudi Pharm J, 2015 Nov;23(6):614-20.
    PMID: 26702255 DOI: 10.1016/j.jsps.2014.10.004
    The aim of this study was to assess the safety and probability of adverse events associated with the use of 75 mg pregabalin post hemodialysis (pHD) among patients with UP.
  16. Saheb Sharif-Askari N, Syed Sulaiman SA, Saheb Sharif-Askari F, Hussain AA
    Int J Clin Pharm, 2015 Feb;37(1):105-12.
    PMID: 25488317 DOI: 10.1007/s11096-014-0046-3
    BACKGROUND: Little is known about the adverse drug reaction (ADR) related admissions among heart failure (HF) patients.

    OBJECTIVE: The aim of this study was to determine the rate, factors, and medications associated with ADR-related hospitalisations among HF patients.

    SETTING: Two government hospitals in Dubai, United Arab Emirates.

    METHODS: This was a prospective, observational study. Consecutive adult HF patients who were admitted between December 2011 and November 2012 to the cardiology units were included in this study. The circumstances of their admission were analysed.

    MAIN OUTCOME MEASURES: ADRs-related admissions of HF patients to cardiology units were identified and further assessed for their nature, causality, and preventability.

    RESULTS: Of 511 admissions, 34 were due to ADR-related hospitalisation (6.65, 95 % confidence interval 4.8-8.5 %). Number of medications taken by HF patients was the only predictors of ADR-related hospitalisations, where higher number of medications was associated with the odd ratio of 1.11 (95 % CI, 1.03-1.20, P = 0.005). More than one-third of ADR-related hospitalisations (35 %) were preventable The most frequent drugs causing ADR-related hospitalisation were diuretics (32 %), followed by non-steroidal anti-inflammatory drugs (15 %), thiazolidinediones (9 %), anticoagulants (9 %), antiplatelets (6 %), and aldosterone blockers (6 %).

    CONCLUSION: ADR-related hospitalisations account for 6.7 % of admissions of HF patients to cardiac units, one-third of which are preventable. Number of medications taken by HF patients is the only predictors of ADR-related hospitalisations. Diuretic induced volume depletion, and sodium and water retention caused by thiazolidinediones and NSAIDs medications are the major causes of ADR-related hospitalisations of HF patients.

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