Displaying publications 21 - 40 of 183 in total

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  1. Khan TM, Leong JP, Ming LC, Khan AH
    Asian Pac J Cancer Prev, 2015;16(13):5349-57.
    PMID: 26225677
    BACKGROUND: Breast cancer is the most common cancer and the leading cause of cancer mortality among women of all ethnic and age groups in Malaysia. Delay in seeking help for breast cancer symptoms is preventable and by identifying possible factors for delayed diagnosis, patient prognosis and survival rates could be improved.

    OBJECTIVES: This narrative review aimed to understand and evaluate the level of in-depth breast cancer knowledge in terms of clinical breast examination and breast self-examination, and other important aspects such as side-effects and risk factors in Malaysian females. Since Malaysia is multicultural, this review assessed social perceptions, cultural beliefs and help-seeking behaviour in respect to breast cancer among different ethnic groups, since these may impinge on efforts to 'avoid' the disease.

    MATERIALS AND METHODS: A comprehensive literature search of seven databases was performed from December 2015 to January 2015. Screening of relevant published journals was also undertaken to identify available information related to the knowledge, perception and help-seeking behaviour of Malaysian women in relation to breast cancer.

    RESULTS: A total of 42 articles were appraised and included in this review. Generally, women in Malaysia had good awareness of breast cancer and its screening tools, particularly breast self-examination, but only superficial in-depth knowledge about the disease. Women in rural areas had lower levels of knowledge than those in urban areas. It was also shown that books, magazines, brochures and television were among the most common sources of breast cancer information. Delay in presentation was attributed mainly to a negative social perception of the disease, poverty, cultural and religion practices, and a strong influence of complementary and alternative medicine, rather than a lack of knowledge.

    CONCLUSIONS: This review highlighted the need for an intensive and in-depth breast cancer education campaigns using media and community health programmes, even with the existing good awareness of breast cancer. This is essential in order to avoid misconceptions and to frame the correct mind-set about breast cancer among women in Malaysia. Socio-cultural differences and religious practices should be taken into account by health care professionals when advising on breast cancer. Women need to be aware of the risk factors and symptoms of breast cancer so that early diagnosis can take place and the chances of survival improved.

  2. Mallhi TH, Khan YH, Tanveer N, Khan AH, Bukhsh A
    Travel Med Infect Dis, 2017 Jul-Aug;18:75-76.
    PMID: 28709958 DOI: 10.1016/j.tmaid.2017.07.005
  3. Bayat H, Naderi F, Khan AH, Memarnejadian A, Rahimpour A
    Adv Pharm Bull, 2018 Nov;8(4):591-597.
    PMID: 30607331 DOI: 10.15171/apb.2018.067
    Clustered regularly interspaced short palindromic repeats (CRISPR)-associated protein nuclease (Cas) is identified as an adaptive immune system in archaea and bacteria. Type II of this system, CRISPR-Cas9, is the most versatile form that has enabled facile and efficient targeted genome editing. Viral infections have serious impacts on global health and conventional antiviral therapies have not yielded a successful solution hitherto. The CRISPR-Cas9 system represents a promising tool for eliminating viral infections. In this review, we highlight 1) the recent progress of CRISPR-Cas technology in decoding and diagnosis of viral outbreaks, 2) its applications to eliminate viral infections in both pre-integration and provirus stages, and 3) various delivery systems that are employed to introduce the platform into target cells.
  4. Khan YH, Mallhi TH, Sarriff A, Khan AH, Tanveer N
    J Coll Physicians Surg Pak, 2018 Dec;28(12):960-966.
    PMID: 30501836 DOI: 10.29271/jcpsp.2018.12.960
    Chronic kidney disease (CKD) is an asymptomatic disease associated with high morbidity and life-threatening complications that lead to decreased life expectancy. Worldwide prevalence of CKD is escalating at an alarming rate. Large population-based representative surveys have been reported in Western countries to estimate the prevalence of the disease. However, there is paucity of data as far as developing nations are concerned. Asia is the world's largest continent accommodating maximum number of under-developed and developing countries with an unclear picture of prevalence of CKD. Current review attempts to give an insight to the prevalence of CKD in this region by combining population-based surveys. This review will assist in estimating the burden of CKD in Asia, so that appropriate control measures could be designed.
  5. Laghari M, Sulaiman SAS, Khan AH, Memon N
    BMC Infect Dis, 2019 Jan 24;19(1):82.
    PMID: 30678656 DOI: 10.1186/s12879-019-3702-3
    BACKGROUND: Understanding the explanations behind unsuccessful treatment outcomes in tuberculosis (TB) patients is important to improve treatment success. Treatment completion for TB is the mainstay of TB prevention and control. The study was aimed to assess the treatment outcomes and predictors for unsuccessful outcomes among children with TB.

    METHODS: This was a prospective multicenter study conducted in Sindh. Children aged ≤14 years enrolled from June to November 2016 were included. A structured data collection tool was used to gather information with respect to patients' socio-demographic, clinical and microbiological data. Additionally, to collect the information related to socio-economic and education level of caregivers, validated questionnaire was administered to the caregivers. Treatment outcomes were assessed according to the World Health Organization (WHO) guidelines. The relationship of unsuccessful treatment outcome with socio-demographic and clinical attributes of TB patients was analyzed using logistic regression model.

    RESULTS: Childhood TB represented 19.3% (508/2634) of all TB cases in selected hospitals. Of these, 268/508 (52.8%) were females and one third of the children were aged ≤2 years (34.3%). In multivariate analysis, pulmonary smear positive TB (PTB+) (AOR = 5.910, 95%CI = 1.64-21.29), those with adverse drug reactions (AOR = 11.601, 95%CI = 4.06-33.12) and those who had known TB contacts (AOR = 3.128, 95%CI = 1.21-8.06) showed statistically significant association with unsuccessful treatment outcomes.

    CONCLUSIONS: The high proportion of childhood TB cases (19.3%) demonstrates the continuation of TB transmission in the study setting. Furthermore, an increased focus on PTB+ patients, those with adverse drug reactions and household contact with TB is warranted.

  6. Khan K, Khan AH, Sulaiman SA, Soo CT, Akhtar A
    Jpn J Infect Dis, 2016;69(1):56-9.
    PMID: 26073728 DOI: 10.7883/yoken.JJID.2014.246
    In the current study we explored the occurrence of adverse drug reactions (ADRs) to antiretroviral therapy among human immune-deficiency virus (HIV)/AIDS patients. We concluded an observational retrospective study in all patients who were diagnosed with HIV infection and were receiving highly active antiviral therapy from Jan. 2007 to Dec. 2012 at Hospital Pulau Pinang, Malaysia. Patient socio-demographic details along with clinical features and susceptible ADRs were observed during the study period. Out of 743 patients, 571 (76.9%) were men, and 172 (23.1%) were women. Overall 314 (42.2%) patients experienced ADRs. A total of 425 ADRs were reported, with 311 (73.1%) occurring in men and 114 (26.8%) in women, with a significant statistical relationship (P value (P) = 0.02, OR = 1.21). Overall 239 (56.2%) ADRs were recorded among Chinese, 94 (22.1%) in Malay, and 71 (16.7%) in Indian patients, which had a statistically significant association with ADRs (P = 0.05, OR = 1.50). Out of a total 425 among ADRs, lipodystrophy was recorded in 151 (35.5%) followed by skin rashes in 80 (18.8%), anemia in 74 (17.4%), and peripheral neuropathy in 27 (6.3%) patients. These findings suggest a need of intensive monitoring of ADRs in HIV treatment centres across Malaysia.
  7. Khan AH, Israr M, Khan A, Aftab RA, Khan TM
    Am J Med Sci, 2015 Jun;349(6):505-9.
    PMID: 26030612 DOI: 10.1097/MAJ.0000000000000473
    BACKGROUND: Smoking is a risk factor not only for the development of cancer and coronary heart disease but also for tuberculosis (TB). The aim of this study was to determine the prevalence of smoking in patients with TB, identify demographic and clinical characteristics associated with smoking and to evaluate TB treatment outcomes in the smokers.
    METHOD: A retrospective cohort study of patients with TB was conducted at Khyber Teaching Hospital, Peshawar, Pakistan. All patients with pulmonary and extrapulmonary TB and those coinfected with HIV, hepatitis or diabetes mellitus were included in the study. The patients were categorized into smokers and nonsmokers. Treatment outcomes were evaluated by smear testing at the end of the treatment.
    RESULTS: Of 472 enrolled subjects, 68 (14.4%) were smokers. The prevalence of smoking among male and female patients with TB was 11.8% and 2.5%, respectively. Univariate analysis indicated that the gender, age group and marital status of patients with TB were associated with smoking. The results indicated that patient gender (P = 0.05), age: 15 to 24 years (P = 0.05) and age >55 years (P = 0.004) were risk factors associated with smoking among TB patients. Of the 68 smokers with TB, the treatment outcomes among 54 patients (79.4%) were unsuccessful. The treatment outcomes was statistically significantly associated with smoking (odds ratio: 2.58, P = 0.004).
    CONCLUSIONS: Findings from the current study proved smoking to be one of the main factors associated with the occurrence of TB and significantly reducing the outcomes of TB therapy.
  8. 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.
  9. Aftab RA, Khan AH, AbdulRazzaq HA, Adnan AS
    JNMA J Nepal Med Assoc, 2016 12 10;54(202):85-87.
    PMID: 27935930
    Ischemic stroke is due to either local thrombus formation or emboli that occlude a cerebral artery, together with chronic kidney disease represent major mortality and morbidity.Here we present a case of 53 years old Malay man, admitted to a hospital in Malaysia complaining of sudden on set of weakness on right sided upper and lower limb associated with slurred speech. Patient was also suffering from uncontrolled hypertension, hyperlipidemia, chronic kidney disease stage 4, and diabetes mellitus (uncontrolled). He was diagnosed with acute ischemic stroke with cranial nerve 7 palsy (with right hemiparesis), acute on chronic kidney disease precipitated by dehydration and ACE inhibitor, and hyperkalemia. Patients with ischemic disease and chronic kidney disaese require constant monitering and careful selected pharmacotherapy. Patient was placed under observation and was prescribed multiple pharamacotherpay to stabalise detoriating condition.
  10. 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.

  11. Khan AH, Israr M, Mateen O, Hadi MA, Aftab RA
    West Indian Med J, 2015 Dec 15.
    PMID: 27399217 DOI: 10.7727/wimj.2014.234
    Gender differences among tuberculosis (TB) patients are notable; however, studies evaluating the impact of gender on treatment outcomes have reported inconsistent results.
  12. Ahmad N, Khan AH, Khan I, Khan A, Atif M
    Int J Hypertens, 2018;2018:8524063.
    PMID: 29721335 DOI: 10.1155/2018/8524063
    Aim: To evaluate doctors' knowledge, attitude, and practices and predictors of adherence to Malaysian hypertension guidelines (CPG 2008).
    Methods: Twenty-six doctors involved in hypertension management at Penang General Hospital were enrolled in a cross-sectional study. Doctors' knowledge and attitudes towards guidelines were evaluated through a self-administered questionnaire. Their practices were evaluated by noting their prescriptions written to 520 established hypertensive outpatients (20 prescriptions/doctor). SPSS 17 was used for data analysis.
    Results: Nineteen doctors (73.07%) had adequate knowledge of guidelines. Specialists and consultants had significantly better knowledge about guidelines' recommendations. Doctors were positive towards guidelines with mean attitude score of 23.15 ± 1.34 points on a 30-point scale. The median number of guidelines compliant prescriptions was 13 (range 5-20). Statistically significant correlation (rs = 0.635, P < 0.001) was observed between doctors' knowledge and practice scores. A total of 349 (67.1%) prescriptions written were guidelines compliant. In multivariate analysis hypertension clinic (OR = 0.398, P = 0.008), left ventricular hypertrophy (OR = 0.091, P = 0.001) and heart failure (OR = 1.923, P = 0.039) were significantly associated with guidelines adherence.
    Conclusion: Doctors' knowledge of guidelines is reflected in their practice. The gap between guidelines recommendations and practice was seen in the pharmacotherapy of uncomplicated hypertension and hypertension with left ventricular hypertrophy, renal disease, and diabetes mellitus.
    Study site: Cardiology, nephrology, diabetic, and hypertension clinics of Hospital Pulau Pinang, Malaysia
  13. Laghari M, Sulaiman SAS, Khan AH, Memon N
    PeerJ, 2018;6:e5253.
    PMID: 30065869 DOI: 10.7717/peerj.5253
    Background: Regardless of the advancement in medical technologies, the diagnosis of tuberculosis (TB) in children has remained a challenge. Childhood TB is rampant and an important cause of morbidity and mortality. The objective of this study was to determine the trend of TB and treatment outcomes in children aged ≤14 years registered for TB treatment under DOTS course in three districts of Sindh, Pakistan.

    Methods: For this retrospective study, records of TB children (≤14 years) registered for the treatment of TB from January 2011 to December 2015 in three districts of Pakistan, were collected. Demographic data, baseline weight, clinical manifestations, radiography, histopathology results and treatment outcomes were collected from TB unit registers.

    Results: A total of 2,167 children were treated for TB during the study period. Of these, 1,199 (55.3%) were females and 1,242 (57.3%) were from urban areas. Over three-quarter of patients (76.9%) had pulmonary TB with 13.3% of sputum smear positive cases. The overall treatment success rate was 92.4%. In multivariate analysis, rural residents (OR: 2.146, p 

  14. 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.

  15. Javaid A, Shaheen Z, Shafqat M, Khan AH, Ahmad N
    Am J Infect Control, 2017 Feb 01;45(2):190-193.
    PMID: 27769706 DOI: 10.1016/j.ajic.2016.07.026
    Among 186 retrospectively evaluated patients with multidrug-resistant tuberculosis, 33.9% were cured, 6.6% completed treatment, 25% died, 18.3% were lost to follow-up, 2.2% failed treatment, and 13.8% were still undergoing treatment by the end of the study period. Rural residence was a risk factor for loss to follow-up (odds ratio [OR], 3.315; P = .016), whereas baseline body weight <40 kg (OR, 2.175; P = .042) and resistance to ofloxacin (OR, 2.889; P = .025) were risk factors for death. Despite programmatic management, treatment outcomes of the current cohort were distressing.
  16. Khan AH, Bayat H, Rajabibazl M, Sabri S, Rahimpour A
    World J Microbiol Biotechnol, 2017 Jan;33(1):4.
    PMID: 27837408
    Glycosylation represents the most widespread posttranslational modifications, found in a broad spectrum of natural and therapeutic recombinant proteins. It highly affects bioactivity, site-specificity, stability, solubility, immunogenicity, and serum half-life of glycoproteins. Numerous expression hosts including yeasts, insect cells, transgenic plants, and mammalian cells have been explored for synthesizing therapeutic glycoproteins. However, glycosylation profile of eukaryotic expression systems differs from human. Glycosylation strategies have been proposed for humanizing the glycosylation pathways in expression hosts which is the main theme of this review. Besides, we also highlighted the glycosylation potential of protozoan parasites by emphasizing on the mammalian-like glycosylation potential of Leishmania tarentolae known as Leishmania expression system.
  17. Danial M, Hassali MA, Ong LM, Khan AH
    BMC Pharmacol Toxicol, 2018 Aug 29;19(1):52.
    PMID: 30157959 DOI: 10.1186/s40360-018-0243-0
    BACKGROUND: Accurate identification and routine preventive practices are crucial steps in lessening the incidence of medications and patients related adverse drug reactions (ADRs).

    METHODS: Three years retrospective study was conducted among chronic kidney disease (CKD) patients at multi-wards in a tertiary healthcare center. Data collected included demographic characteristics, physical examination results, comorbid conditions, laboratory tests and medications taken. Only medication prescribed during the hospital stay were considered in this study.

    RESULTS: From this study only one ADR incident was definitely preventable and majority of other ADRs (88.3%) were possibly preventable. Type of renal replacement therapy (p = 0.023) and stages of renal function (p = 0.002) were significantly associated with survivability of the hospitalized CKD patients after ADRs. Highest percentage of mortality based on categories were 50-59 years (20.0%), male (16.3%), Indian ethnicity (23.7%), obese (15.0%), smoking (17.1%), consumes alcohol (17.4%), conservative management of renal disease (19.5%) and renal function of
  18. Lam FC, Khan TM, Faidah H, Haseeb A, Khan AH
    Syst Rev, 2019 05 31;8(1):130.
    PMID: 31151484 DOI: 10.1186/s13643-019-1039-z
    BACKGROUND: Consuming whey protein supplements, along with physiotherapy and psychotherapy, have been recognised in sports performance. Whey protein supplements (WPS) is one of the commonly used supplements as ergogenic aids for athletes to enhance their muscle performance and recovery during sport-related injuries. The purpose of this systematic review is to investigate the effectiveness of WPS over the blood biochemistry mainly amino acids, creatinine kinase and myoglobin which influence performance and recovery among athletes.

    METHOD: A comprehensive literature search was conducted to identify randomised control trials (RCTs) and non-RCTs that investigated the effectiveness of WPS on amino acids, creatinine kinase and myoglobin among athletes. Risk of Bias in Non-Randomised Studies of Interventions tool (ROBINS-I) and Cochrane Risk of Bias Assessment tool were used to rule out the quality of studies. Meta-analysis was performed using a random effect model with STATA version 14.2. The weighted mean difference was used to estimate the effectiveness of WPS against other supplements.

    RESULTS: A total of 333,257 research articles were identified; of these, 15 records were included to proceed with the analysis. Meta-analysis has shown that WPS has significantly overall increased the level of essential amino acids level by 624.03 nmol/L (CI = 169.27, 1078.8; I2 = 100%; p = 0.00) and branched-chain amino acids level by 458.57 nmol/L (CI = 179.96, 737.18; I2 = 100%; p = 0.00) compared to the control group (without WPS). Moreover, was observed to decrease myoglobin level by 11.74 ng/ml (CI = - 30.24, 6.76; I2 = 79.6%; p = 0.007) and creatine kinase level by 47.05 U/L (CI = - 129.47, 35.37; I2 = 98.4%; p = 0.000) compared to the control group.

    CONCLUSION: The findings revealed that the clinical evidence supports the effectiveness of WPS as a positive ergogenic aid on athletes' amino acids, creatinine kinase and myoglobin.

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