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   Table of Contents - Current issue
Coverpage
April-June 2017
Volume 8 | Issue 2
Page Nos. 43-84

Online since Monday, April 17, 2017

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ORIGINAL RESEARCH  

Simulation-based instruction for pharmacy practice skill development: A review of the literature p. 43
Syed S Hasan, David W.K Chong, Wong P Se, Suresh Kumar, Syed I Ahmed, Piyush Mittal
DOI:10.4103/app.app_68_16  
Background: Simulation is attractive for its potential for applying a control over learning environment, content complexity, teacher time, costs and risk. Simulation-based instruction (SBI) is poised to expand in pharmacy practice and education. This systematic review synthesises published, SBI in first-degree pharmacy programmes, especially those pertaining to psychomotor or cognitive skill development. Materials and Methods: MEDLINE, Cumulative Index to Nursing and Allied Health Literature, and some education journals were searched for relevant articles published between January 2000 and December 2015. Results: Of 108 articles identified, 12 were included, which were covering four major simulation-based interventions. These simulation-based interventions were diverse, and they covered a range of competencies and outcome measures. Nine studies included medication, and five studies included physical examination/procedure-related competencies as outcome measures. The evidence from nine studies suggested that skills could be improved through interventions involving human patient simulation. Conclusion: Despite improvements in students’ ability to perform, there is a lack of evidence on how this translates to real settings and to patient satisfaction.
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RESEARCH ARTICLES Top

Awareness, perception, attitude, and knowledge regarding complementary and alternative medicines (cams) among the pharmacy and medical students of a public university in Saudi Arabia p. 51
Rizwan Ahmad, Atta A Naqvi, Niyaz Ahmad, Mohamed Baraka, Mohammad Mastour, Saleh Al Sharedah, Shatha Al Ghamdi, Ghada Al Rabae, Mastour S Al Ghamdi
DOI:10.4103/app.app_74_16  
Introduction: The use of natural products, that is, herbs for clinical and domestic purposes, is quite common in Saudi Arabia. Studies have reported an increasing use of complementary and alternative medicines (CAMs). This study aims to investigate the perception, attitude, and knowledge of the students regarding CAMs and their use. Materials and Methods: A quantitative, cross-sectional study targeting the students of the pharmacy and medical colleges at the University of Dammam, Saudi Arabia was conducted for a 6-month duration. It employed a survey questionnaire termed as CAMs inventory. Results: The majority of the respondents were females (N = 180, 60.8%), and a major segment (N = 170, 57.4%) belonged to the age group between 21 and 23 years. Nearly half of the students (N = 121, 40.9%) strongly agreed on the need for integration of CAMs-related courses in medical and allied health education, and a similar proportion (N = 129, 43.6%) of the target population acknowledged using CAMs, based on family recommendations (N = 134, 45.3%). Half of the students (N = 142, 48%) had no knowledge about CAMs. Some of the CAMs were more prevalent in males and vice versa (P value <0.05). Conclusion: A positive perception and attitude toward CAMs was observed. It is influenced by their traditional use and partly by the recent induction of CAMs-related education in pharmacy. The majority of the students agreed on integrating CAMs-related courses in their curriculum. It was also observed that the knowledge regarding the subject was inadequate. Lastly, gender has the potential to influence the use of particular CAMs.
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ORIGINAL RESEARCH Top

Translation and psychometric analysis of the Malaysian version of medication understanding and use self-efficacy scale (m-muse) for diabetes mellitus p. 64
Safaa A Al Abboud, Sohail Ahmad, Mohamed B.L Bidin, Nahlah E Ismail
DOI:10.4103/app.app_45_16  
Introduction: Enhancing diabetes self-efficacy (SE) level can improve the self-management behaviour in patients living with diabetes mellitus (DM). This study aimed to translate and assess the psychometric properties of Malaysian version of diabetes Medication Understanding and Use Self-Efficacy Scale (M-MUSE). Methods: Following the translation of English version of MUSE to Malay language using established international standard translation guidelines, 252 adult diabetics (≥ 18 years old; DM type 1 or 2) attending the Endocrine Clinic at Hospital Kuala Lumpur, Malaysia, were recruited in this cross-sectional study. After testing the face and content validity, the psychometric properties of the final M-MUSE were evaluated using the Classical Test Theory (CTT) for reliability (Cronbach’s alpha (α) and intra-class correlation coefficient (ICC)) and construct validity (factor analysis (FA)). Results: The semantic and conceptual problems in M-MUSE were identified and modified by a qualified professional translation committee. The final version showed good reliability values for internal consistency (Cronbach’s α = 0.89) and one month test-retest reliability (ICC = 0.72). The Bartlett’s test of sphericity and the Kaiser-Meyer-Olkin tests proved the suitability of M-MUSE for factor analysis. The extracted single component M-MUSE (eigenvalue > 1) explained a total variance of 57.58% with an eigenvalue of 4.60. The two factor structures; namely taking medication (item # 1, 6, 7 and 8) and learning about medication (item # 2, 3, 4 and 5) explained a total variance of 59.25% with good factor loading values (ranged from 0.63 to 0.89 for taking medication, and 0.66 to 0.83 for learning about medication). Conclusion: The M-MUSE appears to be a linguistically reliable and valid measure that is conceptually equivalent to the original version. The M-MUSE can be used in Malaysian healthcare settings to evaluate the SE in understanding and using prescribed diabetes medications.
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The impact of risk factors on ECG parameters and quality of life in post-myocardial infarct patients p. 70
Alen Džubur, Azra Nalbantić, Amela Džubur, Esad Pepić, Mevludin Mekić, Jasmin Mušanović, Pešto Senad
DOI:10.4103/app.app_35_16  
Introduction: Many epidemiological studies have shown that there are numerous risk factors for acute coronary disease. The aim is to determine the effect of risk factors on the echocardiographic changes and quality of life in patients treated with different methods 1 year after myocardial infarction. Methods: The research was a prospective–retrospective, clinical, epidemiological study and was conducted at the Clinic of Cardiology, University Clinical Center Sarajevo. Patients were divided into four groups based on the therapy treatment they got. The patients were divided into four groups based on the therapy treatment they received. The first group consisted of 40 patients who had had myocardial infarction and were treated with medications. The patients in the groups II and III were treated with percutaneous coronary intervention (PCI) [who immediately after incident underwent primary PCI or delayed PCI], and each group consisted of 40 patients. The group IV consisted of 40 patients, who underwent surgical revascularization (coronary artery bypass surgery). After the treatments have finished, an echocardiogram was performed on every patient. The Short Form (SF)-36 health survey was used for testing the life quality. Echocardiogram and the quality of life (QoL) testing were repeated a year after the treatment. Results: The study included 160 patients with a history of myocardial infarction, of which 130 (81.3%) were men, and 30 (18.8%) were women. The average age in the total sample was 54.9 ± 8.8 years. The review of risk factors’ presence showed that in the total sample, most present was hypertension with 134 (83.8%), smoking with 120 (75.0%), and hypercholesterolemia with 110 or 68.8% of patients. Hypertension showed a statistically significant negative effect on the SF-scales only in the group III according to the mental health (P = 0.020), social functioning (P = 0.013), and pain (P = 0.011). A statistically significant effect of smoking was observed in the group III according to left ventricular internal dimension in end-diastole (P = 0.000) and left ventricular internal dimension in end-systole (P = 0.001) in the sense that smokers have the higher values of these parameters, and negative to ejection fraction (EF) (P = 0.001) in the sense that smokers have lower EF. In the group IV, positive correlation was observed to EF (P = 0.038), and negative toward the mitral regurgitation (P = 0.032). Conclusion: High blood pressure negatively affected the QoL. Smoking is negatively associated with all observed echocardiographic parameters in all the groups except with the size of the left atrium.
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Quality of methodological reporting of randomized clinical trials of sodium-glucose cotransporter-2 (sglt2) inhibitors p. 78
Hadeel Alfahmi, Lina Aldawood, Bayan Baz, Mahmoud Elrggal, Hadeel Yahya Alsharif, Saad A Alkahtani
DOI:10.4103/app.app_78_16  
Sodium-glucose cotransporter-2 (SGLT2) inhibitors are a new class of medicines approved recently for the treatment of type 2 diabetes. To improve the quality of randomized clinical trial (RCT) reports, the Consolidated Standards of Reporting Trials (CONSORT) statement for methodological features was created. For achieving our objective in this study, we assessed the quality of methodological reporting of RCTs of SGLT2 inhibitors according to the 2010 CONSORT statement. We reviewed and analyzed the methodology of SGLT2 inhibitors RCTs that were approved by the Food & Drug Administration (FDA). Of the 27 trials, participants, eligibility criteria, and additional analyses were reported in 100% of the trials. In addition, trial design, interventions, and statistical methods were reported in 96.3% of the trials. Outcomes were reported in 93.6% of the trials. Settings were reported in 85.2% of the trials. Blinding and sample size were reported in 66.7 and 59.3% of the trials, respectively. Sequence allocation and the type of randomization were reported in 63 and 74.1% of the trials, respectively. Besides those, a few methodological items were inadequate in the trials. Allocation concealment was inadequate in most of the trials. It was reported only in 11.1% of the trials. The majority of RCTs have high percentage adherence for more than half of the methodological items of the 2010 CONSORT statement.
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CASE REPORT Top

Unusual case of lamivudine-associated skin rashes in an HIV/AIDS patient: a case presentation p. 82
Kashif U Khan, Amer H Khan, Syed A Sulaiman, Chow T Soo, Syed I Ahmad
DOI:10.4103/app.app_64_16  
In patients with human immunodeficiency virus (HIV) infection, lamivudine is used as a first-line drug for antiretroviral therapy. Lamivudine is relatively nontoxic in nature, and it can also be used during pregnancy. Herein, we describe a 43-year-old, HIV-positive female hospitalized with maculopapular, pruritic rash that appeared first on the extremities and gradually spread with systemic symptoms such as fever and myalgia after lamivudine therapy.
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LETTER TO EDITOR Top

Pharmacy without pharmacist: Body without soul p. 84
Noman Ul Haq, Sohail Riaz, Aqeel Nasim
DOI:10.4103/2045-080X.204492  
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