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PRODUCT REVIEWS
Use of tranexamic acid for skin whitening and melasma therapy: A product review
Halimi Syafiqah Nadiah, Masood Hannah, Kah Seng Lee, Suhaidah Mohd Jofrry, Long Chiau Ming
May 2016, 7(5):43-47
DOI:10.4103/2045-080X.183037  
Purpose: The aim of this study is to assess the usage of tranexamic acid as skin whitening and melasma therapy. Methodology: An electronic search on PubMed, MEDLINE and Cochrane Library with keywords “tranexamic acid,” “oral,” “systemic,” “whitening,” “lightening,” and “melasma” was carried out. The literatures are summarized in the evidence tables. Further search on PBAC, UK, NFSA, SMC, CEDAC, MIMS, and Micromedex was performed for listing reviews of tranexamic acid. Results: The data available are not scientifically proven to demonstrate the role of tranexamic acid as an effective treatment for melasma therapy and whitening agent. Conclusions: As a conclusion, due to the lack of data, it was not possible to reach a conclusion on the use of tranexamic acid as cosmetic products, especially with systematic usage.
  39,823 54 2
REVIEW ARTICLE
Pharmacy education in Nigeria: The journey so far
Joshua Ikoni Ogaji, Candidus Ejembi Ojabo
April-June 2014, 5(2):47-60
DOI:10.4103/2045-080X.132644  
The last four decades have witnessed developmental changes in pharmacy education in Nigeria. The paradigm change in the role of the pharmacist from a product-oriented to patient-oriented focus requires that the overall education of pharmacists be reorganized to meet the increasing changing roles. Curricular of schools of pharmacy in Nigeria are continually reviewed with the aim of attaining the dynamic competency required to reflect the paradigm shift in service focus and the development of the necessary clinical skills that will enable pharmacists to identify and meet the increasingly complex medication needs of patients. This review focuses on the historical development of pharmacy education from one school of pharmacy in the 1920s to about twenty schools 40 years later. The study looked at the continuous efforts made to produce the pharmacist with the requisite competency for the ever-changing roles in meeting the dynamic and varied needs of patients.
  21,212 209 2
A comparison between liposomal and nonliposomal formulations of doxorubicin in the treatment of cancer: An updated review
Yik Hoe Ngan, Manish Gupta
January-March 2016, 7(1):1-13
DOI:10.4103/2045-080X.174930  
Cancer remains a major cause of hospitalization and death every year. From time to time, new formulations of anticancer drugs are available in the market and draw the concern of healthcare professionals in terms of the superiority, toxicology, and cost-effectiveness of the new formulations in comparison to the conventional formulation of the same drugs. Doxorubicin, which is a highly potent chemotherapeutic agent, comes with three formulations (pegylated liposomal, nonpegylated liposomal and nonliposomal conventional formulations). English-language literature in relation to the three formulations has been reviewed to inform the healthcare professionals regarding the differences between these formulations. In terms of efficacy, there is only one study supporting the superiority of liposomal doxorubicin, but there are more data which supports the non-inferiority of liposomal doxorubicin in comparison to conventional non-liposomal doxorubicin. It is emphasized that liposomal doxorubicin promotes better toxicology profile than nonliposomal conventional doxorubicin with an increased cost. The cost-effectiveness of liposomal doxorubicin is not well defined as there are very limited studies in this area. Apart from that, this review highlights the interpatient variability in regards to the clearance and volume of distribution following the administration of liposomal doxorubicin. In conclusion, further studies will be required to better define the superiority of liposomal formulation of doxorubicin regarding the efficacy and dose standardization of liposomal doxorubicin should be sought in the near future.
  10,925 178 2
ORIGINAL ARTICLES
Antibiotics prescribing pattern in the in-patient departments of a tertiary care hospital
Ambili Remesh, Samna Salim, AM Gayathri, Uma Nair, KG Retnavally
April-June 2013, 4(2):71-76
DOI:10.4103/2045-080X.112987  
Context: Antibiotic prescribing by physicians has gained due importance across the globe, mainly because of an increase in antibiotic usage, prevalence of infections, and drug resistances. Aims: The present study aimed to evaluate the prescribing pattern of antibiotics, their adherence to essential medicines list, disease conditions for which they were prescribed, and their adverse effects. Settings and Design: A cross-sectional prospective study was carried out in six inpatients departments (Surgery, Orthopedics, ENT, Ophthalmology, Medicine, and Pediatrics) of a 550-bed tertiary care hospital in Trivandrum, India for two months (July-August 2012). Institutional Research and Ethics Committee clearance were obtained prior to the study. Materials and Methods: The data were collected in a predesigned performa from the medical case sheets, drug charts, and laboratory investigations of 100 in-patients. The enrolled patients were observed from admission till discharge. Descriptive statistics were applied to the collected data and analyzed using Microsoft Excel software. Results: The mean duration of hospitalization among the study population was 5.48 (±4.28) days. Of the 410 medicines prescribed, antibiotics contributed 151 (36.8%). They were mostly indicated for respiratory infections, and the most common antibiotic was Beta-lactams (91 (60.2%). Interestingly, 89 antibiotics (60%) were administered as injections. About 70 (46%) of the antibiotics were prescribed without any combinations. The adherences to World Health Organization's essential medicines list were 122 (81%). A total of seven adverse drug reactions were reported in the current study. Of which, none were serious, and five (70%) were cutaneous reactions. Conclusions: Of the 100 patients analyzed from six in-patient departments, it was observed that the hospital physicians prescribed antibiotics more rationally with no banned drugs and less newer drugs. Rational prescribing of antibiotics would help avoid polypharmacy and prevent drug resistances.
  7,678 633 1
Prescribing pattern of drugs in stroke patients: A prospective study
Mohammad Yaseen Abbasi, Md Avez Ali
October-December 2012, 3(4):283-288
DOI:10.4103/2045-080X.106253  
Objectives : The population-based estimates confirm a rising trend in both incidence and prevalence of stroke in India. The main objective is to assess the prescribing pattern of drugs in hospitalized stroke patients. Materials and Methods: A Prospective observational study was carried out for a period of 6 months in the inpatient department. The inclusion criteria of the present study are patients of either sex aged ≥ 18 years, patients who were diagnosed as a stroke patient, and admitted in the intensive care unit of the hospital. Results: A total of 102 prescriptions were analyzed during the 6-month study period. This was found to be higher in men 68 (33.33%). A total of 69 (67.64%) were having habits of smoking and alcohol consumption. In the study of 102 patients, 69 (32%) were identified as ischemic stroke patients and 33 (32%) suffered hemorrhagic stroke. The major co-morbidities identified were hypertension and diabetics mellitus, which were seen in 34 (33.33%) and 18 (17.64%), respectively. Among the 102 patients, 77 (75.49%) were administered cerebral activators. In this study of prescriptions of drugs in stroke, majority of the patients were treated with neurotonics drugs. Among the 102 patients, 85 (83.33%) were administered neurotonics drugs. In this study, we observed that the most popular antiplatelet was clopidogrel, which was prescribed to 48 (47.05%). In anticoagulants, only enoxaprain was used in our hospital for stroke patients. This medication was administered to 27 (26.47%) patients. Conclusion: The prescribing pattern of drugs should be based on severity of stroke, associated co-morbid conditions, and currently available evidences in order to promote the quality use of drugs.
  5,833 348 1
PRODUCT REVIEWS
Evidence of Garcinia cambogia as a fat burning and appetite suppressing agents
Wan Nur Asyiken Wan Ab Rahman, Kah Seng Lee, June Choon Wai Yee, Manish Gupta, Long Chiau Ming
May 2016, 7(5):22-28
DOI:10.4103/2045-080X.183033  
Aim: The aim of this study is to assess the uses of products containing Garcinia cambogia to burn fat and suppressed the appetite. Introduction: The availability and popularity of natural dietary supplements for the treatment of obesity have risen dramatically in recent years. Investigation and analysis on the efficacy and effectiveness of the G. cambogia are challenging. Furthermore, consuming the products that claimed the anti-obesity effect without a strong judgment is not an appropriate way to losing weight. The overweight prevalence of 29.71% for the Malaysian adults aged 18–59 years indicates that the overweight problem in Malaysia is almost as serious as that for the developed countries. Methodology: An electronic search of PubMed, CINAHL, ScienceDirect, Clinical Key for studies, case report, trials and reviews using the following search criteria. Examining the product registration in Pharmaceutical Division Services, Ministry of Health. The Malaysian Advertisement Board was referred. Results: Consumers in Malaysia most likely tend to have a fast method in losing the weight. When the product is advertised inappropriately without any strong evidence based, the Malaysian society is solely at risk in buying the product that does not have a confirmed effectiveness and efficacy. The doubts in using G. cambogia are because the marketed product is there is no single formulation that contains only G. Cambogia.
  6,045 67 1
ORIGINAL ARTICLES
Evaluation of the drug utilization pattern at a regional psychiatric hospital, in Benin city, Nigeria
Hillary O Odo, Sunday O Olotu, Imafidon O Agbonile, Peter O Esan, Bawo O James
October-December 2013, 4(4):154-159
DOI:10.4103/2045-080X.123222  
Background: Drug utilization research facilitates the rational use of drugs and suggests measures to improve prescribing habits. Irrational use of drugs is a global problem affecting patient care. It results in increased mortality, morbidity, adverse drug events, and wastage of economic resources. Objectives: To evaluate the pattern of drug utilization at a regional neuropsychiatric hospital, in Benin City, Nigeria using some of the World Health Organization (WHO) prescribing indicators. Materials and Methods: Data was obtained retrospectively from a review of 5400 outpatient prescriptions between September 2007 and August 2012. Data were analyzed using the WHO guideline for assessment of drug use in health facilities. The number of DDD per one thousand inhabitants per day was calculated from data on the number and size of dispensed drugs obtained from the out-patient pharmacy. Drug Utilization 90% (DU 90%) method was used to evaluate the quality of drug prescribing. Results: An average of 2.88 drugs was prescribed per encounter, 94.38% of the drugs were prescribed using their generic names, and the percentage of encounters with antibiotics prescribed was 3.2% while 99.2% of all the drugs prescribed were prescribed from the essential drugs list. The drugs whose utilization accounted for about 90% of the entire drug use (DU 90%) were; haloperidol (15.5%), amitriptyline (22.3%), benzhexol (12.6%), trifluoperazine (20.3%), chlorpromazine (15.2%), and carbamazepine (7.9%). Haloperidol was the most utilized drug in this setting with a DDD per 1000 inhabitants per day of 5. In about 70% of the prescriptions encountered, all the drugs prescribed were available from the hospital pharmacy. Conclusion: This study found that polypharmacy was commonly practiced while haloperidol was the most utilized psychotropic agent at the study facility.
  5,381 254 -
Community pharmacy practice in Pakistan
Nousheen Aslam, Rabia Bushra, Muhammad Umair Khan
October-December 2012, 3(4):297-302
DOI:10.4103/2045-080X.106259  
Objectives: This study was planned to determine the extent to which the role of a pharmacists is established in community pharmacies in Pakistan and to determine the need of qualified and experienced pharmacists in provision of healthcare at these medical stores or so called community pharmacies. Materials and Methods: A structured questionnaire was distributed to a random sample of 175 attendants at various medical stores located in different areas of Karachi with a response rate of 90.28%. Questionnaire consisted of 24 closed ended questions whose consistency and reliability were determined by Cronbach's alpha. Statistical analysis were done using SPSS (v.16.0) Results: The result shows that the average age of pharmacy attendant lies between 21 and 30 years. Only 9.49% of attendants have professional pharmacy education. It was noted that only 22.6% check prescriber signature before dispensing prescription, which is quite a low as compared with standard practice. Interestingly 57.6% attendants think that presence of qualified pharmacy at medical stores does not make any difference in the efficacy and the business of medical stores. Conclusion: This study concludes that the current status of community pharmacy practice is below par. There is a need to involve more pharmacists at community level and develop awareness programs to counter patients' routine drug issues and reducing the burden of disease from society.
  5,015 369 7
ORIGINAL RESEARCH
Simulation-based instruction for pharmacy practice skill development: A review of the literature
Syed S Hasan, David W.K Chong, Wong P Se, Suresh Kumar, Syed I Ahmed, Piyush Mittal
April-June 2017, 8(2):43-50
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.
  5,219 25 -
ORIGINAL ARTICLES
Prescribing patterns of celecoxib and prescribers' perceptions among three general hospitals in Northern Malaysia
Huan-Keat Chan, Ema Bakri, Sing-Yi Tan, Mohamed Azmi Hassali, Fahad Saleem, Tahir Mehmood Khan
January-March 2014, 5(1):28-34
DOI:10.4103/2045-080X.128374  
Objectives: This paper describes the clinical use of celecoxib in three major, government-subsidized hospitals across Northern Malaysia. Doctors' perceptions of issues related to celecoxib and other nonsteroidal anti-inflammatory drugs (NSAIDs) were assessed concurrently. Materials and Methods: A total of 365 patients receiving prescriptions containing celecoxib in 2012 were recruited. Their medical records were screened for celecoxib-related information including its indications, risk factors for gastrointestinal bleeding and cardiovascular comorbidities. A self-reported, six-item questionnaire was used to investigate the perceptions of 211 doctors. Results: Patients within a wide range of ages had received celecoxib (15-94 years). General acute pain (23.6%), general chronic pain (20.3%), and osteoarthritis (12.3%) were the most common indications. Less than one-third of patients prescribed with celecoxib (31.5%) were found to have one or more risk factors for gastrointestinal complications. Advanced age (≥65 years) was identified as the most common risk factor (14.8%). Approximately one-third of them (32.4%) were having one or more cardiovascular comorbidities including hypertension and chronic heart diseases. Majority of the doctors (53.1%) believed that celecoxib is more efficacious than conventional NSAIDs in reducing pain and inflammation. The awareness of its better gastrointestinal safety profile was exceptionally high (92.4%) and it remained as the most important factor to consider during prescribing (65.9%). Conclusion: Overall, this study revealed the prescribing patterns of celecoxib among the government-subsidized hospitals in Northern Malaysia. Certain issues like its high usage in patients without gastrointestinal risk factors and in those with cardiovascular comorbidities may require a review from clinical perspectives.
  4,701 213 -
RESEARCH ARTICLES
Awareness, perception, attitude, and knowledge regarding complementary and alternative medicines (cams) among the pharmacy and medical students of a public university in Saudi Arabia
Rizwan Ahmad, Atta A Naqvi, Niyaz Ahmad, Mohamed Baraka, Mohammad Mastour, Saleh Al Sharedah, Shatha Al Ghamdi, Ghada Al Rabae, Mastour S Al Ghamdi
April-June 2017, 8(2):51-63
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.
  4,767 27 3
ORIGINAL ARTICLES
Acceptance of doctor of pharmacy in India: A survey-based study
B Akshaya Srikanth, Akram Ahmad, Ravindra K Reddy, Rajesh Balkrishnan, Anantha Naik Nagappa
July-September 2013, 4(3):93-97
DOI:10.4103/2045-080X.119072  
Aims: The current study aims to assess the attitude of Indian Doctor of Pharmacy (Pharm.D) graduates toward the pharmacy curriculum and pharmaceutical care in India. Settings and Design: Web-based survey Materials and Methods: A nineteen item web-based questionnaire was used to attain the purpose of study. A total of n = 130 pharmacy students were invited for their participation in this study. Descriptive statistics was applied to assess the responses using Microsoft Excel; Results: n = 108 Pharm.D students responded to this survey with a response rate of 83.0%. Results identified acceptance and dissemination in each of the key areas; 96% (mean: 1.04; standard deviation (SD): 0.19) respondents felt that there is a need for the Pharm.D course in India and 76.0% (4.19; 0.85) agreed that there is a need of continuous professional education for a pharmacist. Also, 83.0% (4.14; 1.01) students has shown willingness to be the part of pharmaceutical care process for their patients and 97.0% (4.64; 0.56) agreed that providing pharmaceutical care can increase the quality of service. Nearly 64.0% (3.72;1.07) agreed the Pharm.D program was successful in India. Conclusions: Findings of the current study reflects that Pharm.D curriculum is well accepted in India and pharmacy students get more insight through active participation in patient care. The Pharmacy Council of India (PCI) need to initiate more proactive measures in creating clinical pharmacy jobs for Pharm.D graduates in India, and promote the Pharm.D degree to gain international status, as in United States.
  4,295 442 -
REVIEW ARTICLES
The effectiveness of traditional Malay massage: A narrative review
Nurhanisah Sejari, Kamaria Kamaruddin, Long Chiau Ming
October-December 2014, 5(4):144-148
DOI:10.4103/2045-080X.142048  
The traditional Malay massage (TMM), also known locally as urut Melayu, is one of the fields of traditional and complementary medicine. The practices and understanding are originally related to Malay culture in selected hospitals under the Ministry of Health since 2007. This study is to review the available evidence on the effectiveness of TMM as an alternative therapeutic approach to various conditions. An online electronic search in databases (Ovid , Scopus, EMBASE and PubMed) was performed using keywords such as Malay massage and urut Melayu. Documents including case studies, case reports, and research studies were examined and analyzed. Two case studies and one qualitative research study about TMM for chronic diseases were explored. It was reported that the majority of those having chronic diseases sought TMM as an alternative treatment to improve mobility and quality of life. The second case study explored the effectiveness of TMM for a postpartum stroke patient, and there was improvement of physical function, mobility and optimizing the activity of daily living for this patient. The third article provided treatment-seeking behavior of poststroke patients and their TMM practitioners. From their interviews with 17 volunteers, they reported that Malay massage is very helpful for their body conditions after stroke due to high blood pressure and postdelivery complications. The patients revealed that TMM has provided them positive, beneficial effects. The review indicated that TMM could serve as an alternative treatment for those having chronic diseases, postpartum stroke and poststroke conditions. Therefore, the current review highlights the role TMM has in view of positive, beneficial effects to improve and optimize mobility, physical function, activity, daily living and quality of life.
  4,468 228 2
ORIGINAL ARTICLES
Assessment and evaluation efficacy of a clinical pharmacist-led inpatient warfarin knowledge education program and follow-up at a Chinese tertiary referral teaching hospital
Guy-Armel Bounda, Cosette Ngarambe, Wei Hong Ge, Feng Yu
October-December 2013, 4(4):168-179
DOI:10.4103/2045-080X.123226  
Background: Oral anticoagulation therapy with warfarin is used to prevent and to treat venous and arterial thrombosis and embolism. Its narrow therapeutic index should be monitored carefully in order to reach the desired outcomes. Objective: This study aims to evaluate the clinical pharmacist-led in-patient warfarin's knowledge education program and to assess a follow-up efficacy in a Chinese tertiary referral teaching hospital. Design and Setting: A cross-sectional and observational study was conducted at the Affiliated Hospital of Medical College of Nanjing University, a 1460-bed tertiary referral teaching hospital in Nanjing. Materials and Methods: One-on-one interview questionnaire was conducted among 47 Chinese patients who had undergone prosthetic valve replacement. Before the patient education program's implemented, at discharge time and 3 months, 6-9 months and 12 months after surgery were considered as time points. A previously validated 17-item questionnaire was used to measure the patient's knowledge level of warfarin and to assess and evaluate a follow-up efficacy of this patient education program run by a clinical pharmacist. Knowledge scores were compared using the Student's t-test or one-way analysis of variance. Main Outcome Measure: Patients' knowledge on the warfarin education program and warfarin knowledge score, drug therapy problems or bleeding complication events associated to warfarin therapy and evaluation of clinical pharmacist's service provided. Results: Patients mean age was 47.68 ΁ 9.70 years (range 23-67). The higher education strata had significantly higher warfarin knowledge scores (P < 0.05). In terms of hospital stay post-surgery, compared with other groups, patients with an average of 11-14 days, were found significantly and statically higher knowledgeable in warfarin (P < 0.05). The clinical pharmacist' service was found very satisfying f(80.85%). Conclusion: Chinese patients on warfarin therapy should benefit from periodic educational efforts reinforcing key medication safety information. Patient education is not a once-off procedure. A complete patient education program run by a clinical pharmacist in a Cardio-thoracic ward can considerably improve and enhance to reduce the hospital stays and significantly enlighten the role of the patient education in adherence to therapy.
  4,358 271 -
Evaluation of knowledge, attitude, and perception regarding Halal pharmaceuticals, among general medical practitioners in Malaysia
Saleha Sadeeqa, Azmi Sarriff, Imran Masood, Maryam Farooqi, Muhammad Atif
October-December 2013, 4(4):139-146
DOI:10.4103/2045-080X.123209  
Objective: To evaluate the knowledge, attitude, and perception (KAP) regarding Halal pharmaceuticals, among general medical practitioners in Malaysia. Materials and Methods: This was a cross-sectional study, carried out between September 2012 and November 2012 period, using a structured, self-administered questionnaire. Clinics were chosen based on systematic random sampling technique across Malaysia. Descriptive statistics (mean, standard deviation, frequency, percentage, median, and interquartile range) were used to summarize the data. Chi-square and Fisher's exact tests were used as appropriate to assess the association between demographic characteristics, and KAP scores. Results: Results revealed that general medical practitioners have a good knowledge and positive attitude and perception towards Halal pharmaceuticals. Mean knowledge score was 7.72 ± 1.65, out of maximum possible score of 9. Mean attitude score was 34.24 ± 6.77 out of maximum score of 45 and mean perception score was 46.98 ± 5.84 out of maximum possible score of 55. Mean overall KAP score out of maximum possible 109 was 88.90 ± 12.75. There was a significant, positive, and fair correlation (0.25-0.5) between knowledge and attitude (r = 0.443, P < 0.001) and knowledge and perception (r = 0.332, P < 0.001), while good correlation (0.5-0.75) between attitude and perception (r = 0.741, P < 0.001). Conclusion: It can be concluded that better knowledge of Halal pharmaceuticals is associated with positive attitude towards the use of Halal pharmaceutical products. However, it still remains unknown how this positive attitude influence prescribing practices of general practitioners.
  4,152 378 2
EDITORIAL
Use of herbal products in Southeast Asian countries
Nurul’Afifah Sulaiman, Long Chiau Ming
May 2016, 7(5):1-4
DOI:10.4103/2045-080X.183039  
  4,431 79 -
ORIGINAL ARTICLES
The effect of hydrophilic and hydrophobic polymers on release profiles of diclofenac sodium from matrix tablets
Md Imamul Islam, Md Kamal Hossain, Taksim Ahmed, Prabhat Bhusal, Md Sohel Rana, Tanveer A Khan
July-September 2013, 4(3):120-128
DOI:10.4103/2045-080X.119064  
Objective: The current study aimed to develop a matrix type sustained release Diclofenac tablet, using hydrophilic hydroxypropyl methylcellulose (HPMC) and hydrophobic polymer cetyl alcohol (CA). Materials and Methods: Two different polymers, that is, Methocel K15MCR® and CA were used in various proportions as release controlling factor. Matrix tablets were prepared by wet granulation technique. The physicochemical properties of the granules and tablets were evaluated. In vitro dissolution studies of prepared matrix tablet and patent product Voltaren SR® tablet (VSR) were performed at pH 7.4 phosphate buffer at 100 rpm, and at 37 ± 0.5°C, and subjected to in vitro bioequivalence study in terms of similarity and difference factors. Stability studies were conducted for 6 months using optimized formulation for extended period of time, both at room temperature and accelerated conditions. The dissolution data were fit to Zero-order, First-order, Higuchi, and Korsmeyer-Peppas' equations. Results: The formulated tablets showed acceptable weight variation, hardness, drug content uniformity with sustained release matrix characteristics. Hydrophilic Methocel K15 MCR® matrices-based tablets showed zero-order and hydrophobic CA matrices-based tablets followed first-order kinetics except for formulation six (F6 showed zero-order profile). It was found that formulations containing CA showed better dissolution properties with respect to formulations containing Methocel K15 MCR® in terms of similarity and difference factor. Furthermore, the formulations F4, F5, and F6 exhibited similar drug release profile as compared with VSR tablet, which indicated that these formulations could be bioequivalent with VSR tablet in vitro. Tablets were stable both at room temperature and as well as at accelerated conditions. Conclusion: The present study demonstrated that Diclofenac could be successfully prepared using an appropriate amount of Methocel K15 MCR® and CA in the form of matrix tablets with similar dissolution profile of patent product Voltaren SR® . The type of polymers used was found to induce a profound effect on release rate and mechanism.
  4,055 387 3
LETTERS TO THE EDITOR
Diabetes mellitus in Pakistan: A major public health concern
Arshad Hussain, Iftikhar Ali
January-March 2016, 7(1):30-32
DOI:10.4103/2045-080X.174943  
  4,300 95 1
ORIGINAL ARTICLES
Prevalence of adolescent obesity among high school students of Kerala, South India
Ambili Remesh
October-December 2012, 3(4):289-292
DOI:10.4103/2045-080X.106254  
Objectives: To study the prevalence of obesity among high school students of age 15-17 years and identify the associated risk factors. Materials and Methods: A descriptive cross-sectional study involving the measurement of height and weight and calculation of body mass index among high school students of Kottukal and Pallichal localities of Trivandrum districts in Kerala, South India. A study questionnaire was administered among the participants and their parents to understand the relationship of food intake, parental obesity, and physical activity to obesity. Results: Of the 560 students enrolled, 49 (8.75%) were overweight and 27 (4.82%) were obese. With this, the prevalence of obese is computed as 4.8%. The parental obesity posed a significant risk factor among the study population. Conclusion: Creating awareness among adults and school-goers on the negative health effects of obesity, the key for maintaining good health.
  3,953 376 -
Study of factors affecting the productivity of nurses based on the ACHIEVE model and prioritizing them using analytic hierarchy process technique, 2012
Payam Farhadi, Ramin Ravangard, Zahra Sajjadnia, Abdosaleh Jafari, Hajar Ghasemi, Iman Rahgoshay
April-June 2013, 4(2):63-70
DOI:10.4103/2045-080X.112986  
Objective: Improving productivity is one of the most important strategies for social-economic development. Human resources are known as the most important resources in the organizations' survival and success. Aims: To determine the factors affecting the human resource productivity using the ACHIEVEa model from the nurses' perspective and then prioritize them from the perspective of head nurses using Analytic Hierarchy Process (AHP) technique. Settings and Design: Iran, Shiraz University of Medical Sciences teaching hospitals in 2012. Materials and Methods: This was an applied, cross-sectional and analytical-descriptive study conducted in two phases. In the first phase, to determine the factors affecting the human resource productivity from nurses' perspective, 110 nurses were selected using a two-stage cluster sampling method. Required data were collected using the Persian version of Hersey and Goldsmith's Human Resource Productivity Questionnaire. In the second phase, in order to prioritize the factors affecting human resource productivity based on the ACHIEVE model using AHP technique, pairwise comparisons matrices were given to the 19 randomly selected head nurses to express their opinions about those factors relative priorities or importance. Statistical Analysis Used: Collected data and matrices in two mentioned phases were analyzed using SPSS 15.0 and some statistical tests including Independent-Samples T-Test and Pearson Correlation coefficient, as well as, Super Decisions software (Latest Beta). Results: The human resource productivity had significant relationships with nurses' sex (P = 0.008), marital status (P < 0.001), education level (P < 0.001), and all questionnaire factors (P < 0.05). Nurses' productivity from their perspective was below average (44.97 ΁ 7.43). Also, the priorities of factors affecting the productivity of nurses based on the ACHIEVE model from the head nurses' perspective using AHP technique, from the highest priority to the lowest one, respectively, were: Clarity, Ability, Incentive, Evaluation, Help, Environment and Validity.Conclusions: According to the results and the priorities expressed by the head nurses in order to improve the productivity of nurses, providing the orientation, training and retraining courses for nurses, developing performance-based management systems and fair systems of reward and punishment, holding continuous performance evaluation and review meetings between individual nurses and their heads, increasing funding and improving organizational facilities, delegating authority to staff based on their abilities and capabilities, providing more welfare and recreational services and facilities such as nursery schools, transportation services, etc., for the nurses, esp. women nurses, are suggested.
  3,950 359 -
SHORT COMMUNICATIONS
Identification of drug-related problems and pharmacist's interventions in asthmatic patients at a private tertiary care facility-Pakistan
Aziz Ullah Khan, Iftikhar Ali, Roheena Zafar, Abdul Khalil
April-June 2015, 6(2):33-37
DOI:10.4103/2045-080X.155511  
Background: Drug-related problems (DRPs) potentially contribute to morbidity, mortality and financial indicators. There is increasing evidence that participation and interventions of clinical pharmacists in health care have a positive influence on clinical practice. Objectives: The main focus of this study was to identify DRPs, evaluate clinical pharmacy services and document pharmacist's interventions. Materials and Methods: A 3 months prospective observational study from October, 2014 to January, 2015 was carried out on 80 asthmatic patients admitted to pulmonology unit at Northwest general hospital and research center, Peshawar, Pakistan. The drug therapy details of the patients were collected from inpatient treatment charts using a predesigned questionnaire. The DRPs were identified, and clinical interventions made by pharmacists were documented. Results: A total of 37 patients (61.25%) presenting 91 DRPs were identified, including potential drug-drug interactions 39 (48.75%), drug selection 27 (33.75%), drug use process 12 (15%), drug monitoring 5 (6.25%), adverse drug reactions 5 (6.25%) and dosing 3 (3.75%). Clinical interventions documented by pharmacist were drug information response 21 (26.25%), patient education and counseling 14 (17.5%), change/clarify medication order 11 (13.5%), proper storage and cost effectiveness 10 (12.5%), medication error/brand duplication 7 (8.75%), change of drug/dosage 3 (3.75%), dose calculation in special population 3 (3.75%) and discharge plan 2 (2.5%). Of 91 interventions, the pharmacists contacted the consultants for 24 (30%) interventions, postgraduate medical officers/registrars 34 (42.5%), nursing staff 21 (26.25%) and the patients/attendant 12 (15%). 15 (18.75%) interventions were approved by concerned prescribers. Conclusion: To minimize the risks of DRPs and prevent their occurrence, drug therapy requires pharmacist's timely and effective interventions at all levels.
  3,900 403 -
ORIGINAL ARTICLES
Gestational diabetes mellitus: Pilot study on patient's related aspects
Zahid Hussain, Zuraidah Mohd Yusoff, Syed Azhar Sulaiman
April-June 2014, 5(2):84-90
DOI:10.4103/2045-080X.132659  
Objective: Gestational diabetes mellitus (GDM) is a common complication during pregnancy and if not managed properly, it can lead to many harmful effects on mother or fetus/baby. Management of GDM largely depends on patient's thoughts, perception and understanding of disease. This study was conducted to evaluate the knowledge, attitude, and treatment satisfaction of GDM patients toward their disease. Methods: This was a descriptive cross-sectional study conducted during the period of month July 2013 at Penang General Hospital, Penang, Malaysia. The sample consists of 30 established patients of GDM who were diagnosed at least 1 month prior to enrolment. Data were collected by means of self-designed Gestational Diabetes Mellitus Knowledge Questionnaire, modified version of Diabetes Integration Scale (ATT-19) and Diabetes Treatment Satisfaction Questionnaire. Descriptive analysis was used for data elaboration by using SPSS 20. Results: The results showed that of 30 patients, 23 patients (76.6%) had adequate knowledge. Only, 7 (23.3%) patients had inadequate knowledge. For attitude, 23 (76.66%) of patients had a negative attitude toward disease and only 7 (23.3%) had a positive attitude. In terms of satisfaction, 25 (83.33%) patients were satisfied with the given treatment and 5 (16.66%) were unsatisfied. Conclusion: We conclude that although participants obtained good score on knowledge and treatment satisfaction, their attitude did not change so as to more effectively cope with their disease.
  4,028 241 1
Medication errors in the adult emergency unit of a tertiary care teaching hospital in Addis Ababa
Gediwon Negash, Yonathan Kebede, Segewkal Hawaze
October-December 2013, 4(4):147-153
DOI:10.4103/2045-080X.123220  
Background: The emergency unit is a high risk environment for inappropriate medication use due to stressors and time sensitive nature of the service. Objective: To assess incidence and type of Medication Errors in Tikur Anbesa Specialized Hospital. Materials and Methods: A prospective cross-sectional study was conducted on the interventions by prescribing physicians and attending nurses for patients seen at the emergency unit of Tikur Anbesa Specialized Hospital from May 2-20, 2011. Data about interventions were collected from the medication charts. Medication errors were identified by comparing prescriptions and administration records with standard treatment algorithms. Descriptive statistics was used to meet the objective of the study. Results: A total of 742 patient charts were reviewed which contained 1058 prescriptions containing 2968 orders. Medication errors were found to be 22781 (54.84%) with rate of 30.70 errors per patient and 1627.21 errors per day. Prescription errors, administration errors from recorded ones, absence of administration record were 7314 (32.11%), 991 (4.35%), and 14476 (63.54%) respectively. Conclusion: Incidence and types of medication errors committed in Tikur Anbesa Specialized Hospital Adult Emergency Unit were substantiated; moreover, necessary information on factors within the healthcare delivery system that predispose healthcare professionals to commit errors have been pointed, which should be addressed by healthcare professionals through multidisciplinary efforts and involvement of decision makers at national level.
  3,951 296 1
Development of a virtual patient record mobile app for pharmacy practice education
Terry Weiyi Toh, Wai Keung Chui, Kevin Yi-Lwern Yap
April-June 2014, 5(2):66-71
DOI:10.4103/2045-080X.132650  
Introduction: Healthcare students are generally not exposed in the school curriculum to the workings of electronic health records (EHRs) and the types of patient health information (PHI) from EHRs that are relevant to clinical practices. A prototype virtual patient record (VPR) mobile app was created on two Samsung Galaxy Tab tablets to educate pharmacy students on the types of PHI available from EHRs. Materials and Methods: A pilot study was conducted from March-April 2013, whereby students used the app to solve counseling case scenarios. Respondents' demographics, mobile app usage patterns, perceptions regarding the app's usefulness, and its relevance as an EHR simulation tool, were determined through an online 14-item survey. Descriptive statistics, Chi-square tests, Fisher's exact tests and Mann-Whitney U tests were used to analyze the results. Results: Response rate was 100% (n = 31). Medical and healthcare apps were most commonly used (93.5%), and 67.7% of students used apps more than 5 times a day over the past 6 months. The app had 4 features ("PHR", "Case Questions", "Statutes" and "Useful Links"). Most students felt that the app features were understandable and self-explanatory (96.7%). Majority agreed that "PHR" (100%) and "Case Questions" (83.9%) were the most useful features. Majority (90.3%) found the app useful as a teaching aid. Conclusion: A VPR app has been successfully created and implemented as a teaching aid. Future development will involve migrating its features to the mobile web. Resources for health-related and medication-related information will be added. Furthermore, the app will be introduced to lower-year undergraduates before their hospital preceptorship attachments.
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Assessment of patient's satisfaction with pharmaceutical care services in community pharmacies in the United Arab Emirates
Suleiman Ibrahim El-Sharif, Nora Abd Alrahman, Nouray Khaled, Noor Sayah, Esraa Gamal, Azza Mohamed
January-March 2017, 8(1):22-30
DOI:10.4103/2045-080X.199615  
Objective: To determine some aspects of patient's satisfaction of pharmaceutical services provided by the community pharmacist. To assess consumer's attitude towards the services provided in the community pharmacy. Methods: An anonymous pre-piloted questionnaire-based study was conducted in the various Emirates of the United Arab Emirates. Data were analyzed using SPSS and results were expressed as frequency and percentage of respondents. Results: The response rate was 93.8% with more female than male respondents. The majority of participants were Arabs (80.5%) of young age and with no medical background. Slightly more than half of the respondents (198, 52.8%) visited the pharmacy to collect prescriptions, and 50.5% of them were able to collect the prescriptions straight away. Only 31.7% of respondents visited the pharmacy to purchase items and of these group 289 (77.1%) were satisfied with the pharmacist's help. When asked to describe their usual pharmacist, “experienced,” “trustworthy,” and “confident” were the descriptions given by 27.7%, 22.9%, and 67.9% respondents, respectively. The majority (74.1%) of respondents agreed that the pharmacist delivers their medicines in a polite way, and 43.7% agreed that the instructions were clearly labeled by the pharmacist on each medication and 24.5% agreed that the pharmacists provided them with information on drug storage. About 38.4% agreed that the place of pharmaceutical counseling respects their privacy. Conclusion: Results of the present study showed a general patient's satisfaction of the help provided by the community pharmacist. However, the pharmacist needs to fully practice his/her role to the advantage of the patients and the latter needs to be aware of what to expect and demand from the community pharmacist.
  4,042 17 1
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