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  1. Fulltext Knowledge and awareness of breast cancer among rural women in Perak
    Subramaniam, Ramani, Hussain, R. A. Saadi
    Asian Journal of Medicine and Health Sciences, 2018;1(1):27-31.
    MyJurnal
    Breast cancer is a major global health problem and the leading cause of death among women of
    all ethnic backgrounds. In Malaysia the incidence of breast cancer among women is 1: 19. Around
    5,000 Malaysian women are diagnosed with breast cancer every year, most of them aged between
    30 and 60 years where, nearly half of those affected are under 50-years of age. In Malaysia,
    screening for breast cancer is mainly based on clinical examination, mammogram and ultrasound
    studies for most of the population. Based on radiological investigations the patients are then
    referred for Fine Needle Aspiration Cytology (FNAC) /or biopsy for final diagnosis. Most women
    over 40 years of age undergo mammogram screening so there has been early detection of cancer
    of breast in the older age group. Mammogram is not advised in younger age groups as lesions will
    be difficult to identify in dense breasts. We did a cross sectional study among 139 rural women in
    Perak. The participants were chosen randomly from the rural areas of different villages. We used
    a pretested self-administered questionnaire. The questionnaire comprised of eight questions based
    on knowledge of breast cancer and few more questions related to imaging of breast. The
    questionnaire was distributed to women between the ages 20- 60 years of all three major ethnic
    groups in Malaysia, namely Malays, Chinese and Indians. The mean age of the participants was
    47.9. The Indians comprised of (59.7%) of participants. Malays (25.2%) and Chinese (15.1 %).
    Just below half of the participants were of secondary educational level (44 .6%) Most of them
    were married (63.3%). Almost half of them were employed (48.9%). The percentage of women
    who had a family history of breast cancer accounted for 11.5%. Among the three major races the
    Chinese had more screening done compared to the Malays and Indians (P value 0.003). 51.1% of
    women showed poor knowledge of breast cancer and 19.4 % had no knowledge of cause of breast
    cancer. Among the several reasons given for not having a mammogram, 40.8 % of participants
    said that it was not advised. The major source of information was (TV, Magazines, papers) 63.4 %
    and (Friends / Relatives) 30.6%.
  2. Fulltext Cleft Lip And Palate Centre: The University Hospital Experience
    Ghani, S.H.A., Hussain, R., Hassan, S., Tan, K.K., Ahmad, M.H.
    Ann Dent, 1996;3(1):-.
    MyJurnal
    The Combined Cleft Clinic at the University Hospital, Kuala Lumpur was organised in 1992. The team consists of Plastic Surgeon, Orthodontists, Speech therapist, Ear, Nose and Throat Surgeon, Audiologist, medical officers and the nurses. We attend the clinic on a regular basis. Specialists from other medical and dental disciplines as well as the members of the Cleft Lip and Palate Association of Malaysia (CLAPAM) do occasionally participate in this set-up.The team members formulate treatment plans for each cleft patient, monitor the patient's growth and development and manage the patient at different stages according to the individual needs. To date, the idea of team approach and an establishment of a centre towards management of cleft patients seem to be the most ideal as the patients are benefiting total treatment and care from various specialists from only one place. The experience of University Hospital as a centre for cleft patients is discussed.
  3. Fulltext Current status and future prospects of pharmacovigilance in Pakistan
    Hussain R, Hassali MA
    J Pharm Policy Pract, 2019;12:14.
    PMID: 31139421 DOI: 10.1186/s40545-019-0178-x
    Countries all around the globe are working to establish robust pharmacovigilance systems. Whereas the majority of the developed countries have established well-organized pharmacovigilance systems, the developing countries still lack the basic infrastructure to establish such systems. This commentary focuses on the need of pharmacovigilance and its current status and future trends in Pakistan.
  4. Global landscape of community pharmacy services remuneration: a narrative synthesis of the literature
    Hussain R, Babar ZU
    J Pharm Policy Pract, 2023 Oct 09;16(1):118.
    PMID: 37814349 DOI: 10.1186/s40545-023-00626-0
    Community pharmacists form a vital part of the health system all around the globe. Pharmacy remuneration models are aimed to ensure that pharmacies are sustained, and pharmacists could provide cost-effective services to the patients. This review summarizes the pharmacy services remuneration systems from different parts of the globe. Some countries have well-established reimbursement systems that recognize and compensate community pharmacies for their services, others are in the process of expanding the scope of reimbursable services. It further concludes by highlighting the ongoing efforts to incorporate pharmacist-provided services into reimbursement schemes and the need for standardized and consistent approaches to pharmacy remuneration globally.
  5. Fulltext Drive-thru pharmacy services: A way forward to combat COVID-19 pandemic
    Hussain R, Dawoud DM, Babar ZU
    Res Social Adm Pharm, 2021 01;17(1):1920-1924.
    PMID: 32792322 DOI: 10.1016/j.sapharm.2020.07.015
    Countries around the globe have responded to pandemic preparedness and developed strategies to cope with the COVID-19 crisis. In this context, the role of healthcare professionals is of paramount importance. Pharmacists are playing a vital role in dealing, preparedness, prevention, protection, promoting access to medicines and to improve health outcomes during this crisis. In this context, "Drive-thru" pharmacy services improve access to medicines while ensuring the preventive measures suggested by the World Health Organization. This commentary provides an overview of opportunities and challenges related to the implementation of "drive-thru pharmacy services" and their role in improving public health during this crisis.
  6. Fulltext Awareness, attitudes, and perceptions of drive-thru community pharmacy services among the general public in Malaysia during COVID-19: A cross-sectional study
    Ababneh BF, Ong SC, Hussain R
    PLoS One, 2023;18(3):e0282991.
    PMID: 36897873 DOI: 10.1371/journal.pone.0282991
    INTRODUCTION: There is a lack of attention to drive-thru services in the community pharmacy setting, particularly during the COVID-19 period in Malaysia. The main objective of this study was to assess the public awareness, attitudes, and perceptions towards drive-thru community pharmacy services among during COVID-19 in Malaysia.

    METHODS: A cross-sectional study was conducted using a self-administrated, web-based survey (Google form) among the public in Malaysia between May and June 2022. Descriptive statistics were used to summarize the socio-demographic characteristics of the participants. Associations between the socio-demographic characteristics of the participants and the use of drive-thru community pharmacy services were assessed using a chi-square test. Regression analyses were carried out to determine whether the socio-demographic characteristics of the participants were associated with perceptions towards drive-thru community pharmacy services.

    RESULTS: A total of 565 (70.6%) of the general public completed the survey instrument. The median age of study participants was 40.0 (IQR = 36.0) and about half of them were males (50.6%, n = 286). Although 18.6% (n = 105) of the participants reported the presence of DTCPS in their cities, only 9.0% (n = 51) reported having used this service. Most of the participants were supportive to establish drive-thru services at community pharmacies in the country. Most of the believed advantages among participants were that DTCPS are helpful during COVID-19 and quarantine time 48.0% (n = 271) by enhancing social distancing and reducing the spread of the COVID-19 virus 48.5% (n = 274). Among sociodemographic factors, non-Malaysian nationality (p<0.001), and age above 55 years (p = 0.01) were found to negatively affect participants' perceptions towards drive-thru community pharmacy services.

    CONCLUSION: This study showed positive awareness, attitudes, and perceptions toward drive-thru community pharmacy services during COVID-19 in Malaysia among the public. The participants believed that those services were helpful during COVID-19 to enhance social distancing and to reduce the spread of the COVID-19 virus.

  7. Synthesis, characterization and in vitro study of magnetic biphasic calcium sulfate-bioactive glass
    Goh YF, Akram M, Alshemary AZ, Hussain R
    Mater Sci Eng C Mater Biol Appl, 2015 Aug;53:29-35.
    PMID: 26042687 DOI: 10.1016/j.msec.2015.04.013
    Calcium sulfate-bioactive glass (CSBG) composites doped with 5, 10 and 20 mol% Fe were synthesized using quick alkali sol-gel method. X-ray diffraction (XRD) data of samples heated at 700 °C revealed the presence of anhydrite, while field emission scanning electron microscopy (FESEM) and energy dispersive X-ray (EDX) characterization confirmed the formation of nano-sized CSBGs. The UV-vis studies confirmed that the main iron species in 5% Fe and 10% Fe doped CSBGs were tetrahedral Fe(III) whereas that in 20% Fe doped CSBG were extra-framework FeOx oligomers or iron oxide phases. Measurement of magnetic properties of the samples by vibrating sample magnetometer (VSM) showed very narrow hysteresis loop with zero coercivity and remanence for 10% Fe and 20% Fe doped CSBG, indicating that they are superparamagnetic in nature. All samples induced the formation of apatite layer with Ca/P ratio close to the stoichiometric HA in simulated body fluid (SBF) assessment.
  8. Injectable dicalcium phosphate bone cement prepared from biphasic calcium phosphate extracted from lamb bone
    Tariq U, Hussain R, Tufail K, Haider Z, Tariq R, Ali J
    Mater Sci Eng C Mater Biol Appl, 2019 Oct;103:109863.
    PMID: 31349467 DOI: 10.1016/j.msec.2019.109863
    Quick setting and poor injectability due to liquid-solid phase separation have limited the clinical use of brushite and monetite cements. The presence of certain ions in the cement during the setting reaction moderate the setting time and properties of the cement. This study reports the preparation of injectable bone cement by using biphasic calcium phosphate (BCP) extracted from femur lamb bone by calcination at 1450 °C. EDX analysis infers the presence of Mg and Na ions as trace elements in BCP. X-ray diffraction patterns of the prepared cement confirmed the formation of brushite (DCPD) along with monetite (DCPA) as a minor phase. DCPA phase diminished gradually with a decrease in powder to liquid ratio (PLR). Initial and final setting time of 5.3 ± 0.5 and 14.67 ± 0.5 min respectively are obtained and within the acceptable recommended range for orthopedic applications. Exceptional injectability of ≈90% is achieved for all prepared bone cement samples. A decrease in compressive strength was observed with increase in the liquid phase of the cement, which is attributed to the higher degree of porosity in the set cement. Immersion of bone cement in simulated body fluid (SBF) for up to 7 days resulted in the formation of apatite layer on the surface of cement with Ca/P ratio 1.71, which enhanced the compressive strength from 2.88 to 9.15 MPa. The results demonstrate that bone cement produced from BCP extracted from femur lamb bone can be considered as potential bone substitute for regeneration and repair of bone defects.
  9. Fulltext Exploring healthcare professionals' knowledge, attitude, and practices towards pharmacovigilance: a cross-sectional survey
    Hussain R, Hassali MA, Hashmi F, Akram T
    J Pharm Policy Pract, 2021 Jan 04;14(1):5.
    PMID: 33397478 DOI: 10.1186/s40545-020-00287-3
    BACKGROUND: Spontaneous reporting of adverse drug reactions (ADRs) is a method of monitoring the safety of drugs and is the basic strategy for the post-marketing surveillance of the suspected drugs. Despite its importance, there is very little reporting of ADRs by healthcare professionals. The present study has evaluated the knowledge, attitude and practices of health care professionals (HCPs) regarding pharmacovigilance activities in Lahore, Pakistan.

    METHODS: A cross-sectional questionnaire-based survey was employed, and a convenience sampling was opted to collect the data among physicians, pharmacists and nurses working in tertiary care public hospitals of Lahore, Pakistan from September 2018 to January 2019.

    RESULTS: Of the 384 questionnaires distributed, 346 health care professionals responded to the questionnaire (90.10% response rate). Most participants had good knowledge about ADR reporting, but pharmacist had comparatively better knowledge than other HCPs regarding ADR (89.18%) pharmacovigilance system (81.08%), its centres (72.97%) and function (91.89%). Most of the participants exhibited positive attitude regarding ADR reporting, such as 49.1% of physicians (P 

  10. Fulltext A qualitative exploration of knowledge, attitudes and practices of hospital pharmacists towards adverse drug reaction reporting system in Lahore, Pakistan
    Hussain R, Hassali MA, Hashmi F, Farooqui M
    J Pharm Policy Pract, 2018;11:16.
    PMID: 30034811 DOI: 10.1186/s40545-018-0143-0
    Background: Medication safety is a major public health concern and there are well established pharmacovigilance programmes in developed countries. However, there is scarcity of literature on the issue in low and middle income countries. In this context, the current study was aimed to evaluate the knowledge, attitudes and practices of hospital pharmacists towards medication safety and ADR reporting in Lahore, Pakistan.

    Methods: A qualitative approach was used to conduct this study. A semi-structured interview guide was developed, 10 hospital pharmacists were recruited and interviewed through convenience sampling technique. All interviews were audio-taped, transcribed verbatim, and were then analyzed for thematic contents analysis.

    Results: Thematic content analysis of the interviews resulted in 6 major themes, including (1) Familiarity with medication safety & adverse drug reaction concept (2) Current system of practice and reporting of adverse drug reaction in hospital setting, (3) Willingness to accept the practice change (4) Barriers to adverse drug reaction reporting, (5) Policy change needs and (6) The recognition of the role. Majority of the hospital pharmacists were familiar with the concept of medication safety and ADR reactions reporting however they were unaware of the existence of national ADR reporting system in Pakistan. Several barriers hindering ADR reporting were identified including lack of awareness and training, communication gap between the hospitals and regulatory authorities.

    Conclusion: The study revealed that that hospital pharmacists were good in understanding of medication safety and ADR reporting; however they don't practice this in real sense. The readiness of the hospital pharmacist towards the practice change has indicated that they are all set to be actively involved in the provision of medication safety in hospital setting. Involvement of key stake holders from ministry of health, academia, pharmaceutical industry and healthcare professionals is warranted to promote safe and effective use of medicines.

  11. Fulltext Physicians' Understanding and Practices of Pharmacovigilance: Qualitative Experience from A Lower Middle-Income Country
    Hussain R, Hassali MA, Ur Rehman A, Muneswarao J, Hashmi F
    Int J Environ Res Public Health, 2020 03 25;17(7).
    PMID: 32218355 DOI: 10.3390/ijerph17072209
    Developed countries have established pharmacovigilance systems to monitor the safety of medicines. However, in the developing world, drug monitoring and reporting are facing enormous challenges. The current study was designed to explore the challenges related to the understanding and practices of physicians in reporting adverse drug reactions in Lahore, Pakistan. Through the purposive sampling technique, 13 physicians were interviewed. All interviews were audio-recorded, transcribed verbatim, and analyzed for a thematic content analysis. The thematic content analysis yielded six major themes: (1) Familiarity with medication safety and adverse drug reaction (ADR) concept, (2) Knowledge about pharmacovigilance activities, (3) Practices related to ADR reporting, (4) Barriers impeding ADR reporting, (5) Acknowledgement of the pharmacist's role, and (6) System change needs. The majority of the physicians were unaware of the ADR reporting system; however, they were ready to accept practice changes if provided with the required skills and training. A lack of knowledge, time, and interest, a fear of legal liability, poor training, inadequate physicians' and other healthcare professionals' communication, and most importantly lack of a proper reporting system were reported as barriers. The findings based on emerging themes can be used to establish an effective pharmacovigilance system in Pakistan. Overall, physicians reported a positive attitude towards practice changes, provided the concerned authorities support and take interest in this poorly acknowledged but most needed component of the healthcare system.
  12. Fulltext Self-medication during Covid-19 pandemic: challenges and opportunities
    Malik M, Tahir MJ, Jabbar R, Ahmed A, Hussain R
    Drugs Ther Perspect, 2020;36(12):565-567.
    PMID: 33041621 DOI: 10.1007/s40267-020-00785-z
  13. Strontium doped injectable bone cement for potential drug delivery applications
    Taha A, Akram M, Jawad Z, Alshemary AZ, Hussain R
    Mater Sci Eng C Mater Biol Appl, 2017 Nov 01;80:93-101.
    PMID: 28866230 DOI: 10.1016/j.msec.2017.05.117
    Microwave assisted wet precipitation method was used to synthesize calcium deficient strontium doped β-tricalcium phosphate (Sr-βTCP) with a chemical formula of Ca2.96-xSrx(PO4)2. Sr-βTCP was reacted with monocalcium phosphate monohydrate [Ca(H2PO4)2.H2O, MCPM] in presence of water to furnish corresponding Sr containing brushite cement (Sr-Brc). The samples were characterized by using X-ray diffractometry (XRD), Fourier transform infrared spectroscopy (FTIR) and field emission scanning electron microscopy (FESEM). Strontium content in the prepared samples was determined by using inductively coupled plasma optical emission spectrometry (ICP-OES). The effect of Sr2+ions on the structural, mechanical, setting properties and drug release of the cement is reported. Incorporation of Sr2+ions improved the injectability, setting time and mechanical properties of the Brc. The release profiles of antibiotics incorporated in Brc and Sr-Brc confirmed that the Sr incorporation into the Brc results in the efficient release of the antibiotics from the cement.
  14. Fulltext Attitudes, awareness, and perceptions of general public and pharmacists toward the extended community pharmacy services and drive-thru pharmacy services: a systematic review
    Ababneh BF, Ong SC, Mahmoud F, Alsaloumi L, Hussain R
    J Pharm Policy Pract, 2023 Mar 02;16(1):37.
    PMID: 36864499 DOI: 10.1186/s40545-023-00525-4
    BACKGROUND: Several extended and newly added pharmacy services were evaluated in different countries. This review aims to provide a summary of studies on attitudes, awareness, or perceptions toward various extended and drive-thru pharmacy services at community settings among pharmacists and the general public.

    METHODS: To find qualitative and descriptive quantitative studies, that reported on the attitudes, awareness, or perceptions of the general public and pharmacists toward the practice of any extended community pharmacy service and drive-thru pharmacy services in a community setting and conducted from March 2012 to March 2022. Researchers used databases such as Embase, Medline PubMed, Scopus, Web of Science, and Science Direct. The reviewers extracted data independently using the PRISMA checklist.

    RESULTS: There were 55 studies found according to the inclusion criteria. Various extended pharmacy services (EPS) and drive-thru pharmacy services were noted in the community setting. Pharmaceutical care services and healthcare promotion services were the noticeable performed extended services. There were positive perceptions and attitudes toward extended and drive-thru pharmacy services among pharmacists and the public. However, some factors, such as lack of time and shortage of staff, affect the practice of those services.

    CONCLUSION: Understanding the major concerns toward the provision of extended and drive-thru community pharmacy services and improving pharmacists' skills through more training programs to provide such services efficiently. In the future, more reviews for EPS practice barriers are recommended to faceup all concerns and find standardized guidelines by stakeholders and organizations for efficient EPS practices.

  15. Fulltext Development and validation of an assessment tool for public perceptions toward drive-thru community pharmacy services in Malaysia during COVID-19
    Ababneh BF, Ong SC, Alsaloumi L, Hussain R
    Front Public Health, 2023;11:1144466.
    PMID: 37601205 DOI: 10.3389/fpubh.2023.1144466
    INTRODUCTION: Community pharmacists' roles have expanded and undergone a significant transition over the last few years. Consequently, new and different pharmacy services, such as drive-thru pharmacy services, have emerged. Drive-thru pharmacy services began three decades ago and continued even during outbreaks such as the COVID-19 pandemic. Patients' perceptions are essential to the successful implementation and satisfaction with any new service. This study examines the reliability and validity of the assessment tool of public perceptions toward drive-thru community pharmacy services in Malaysia during COVID-19.

    METHODS: A cross-sectional study was conducted. The developed tool consists of 28 items to evaluate believed advantages toward drive-thru community pharmacy services, believed disadvantages toward drive-thru community pharmacy services, differences between drive-thru community pharmacy services and instore drug refill services, perceptions toward drive-thru community pharmacy services and feelings regarding how the introduction of drive-thru pharmacy services may affect the image of community pharmacists. Exploratory factor analysis (EFA) was performed to identify the factors of the developed tool, and confirmatory factor analysis (CFA) evaluated the model fitness.

    RESULTS: The EFA identified five elements and 25 items for the tool, and through CFA results, the observed model of the 25 items structure of the tool was verified as an excellent fit for the data [χ2 (265, N = 565) = 819.586, p < 0.001, IFI = 0.931, CFI = 0.93, RMSEA = 0.064]. The results of the CFA indicated a good model fit between the observed model and the proposed model. The internal reliability of the entire tool and each factor was very satisfactory as Cronbach's Alpha for the whole structured tool was 0.843 and for each factor was as follows, first factor (believed advantages) = 0.909, second factor (believed disadvantages) = 0.921, third factor (differences between drive-thru and instore refill) = 0.647, fourth factor (perceptions) = 0.926, and fifth factor (feelings) = 0.681.

    CONCLUSION: The developed and validated tool would be valuable for assessing the public's perceptions of the drive-thru community pharmacy service during COVID-19 and future pandemics.

  16. Phytoestrogens levels determination in the cord blood from Malaysia rural and urban populations
    Mustafa AM, Malintan NT, Seelan S, Zhan Z, Mohamed Z, Hassan J, et al.
    Toxicol Appl Pharmacol, 2007 Jul 1;222(1):25-32.
    PMID: 17490695
    This study is a result of an analysis of free and conjugated phytoestrogens daidzein, genistein, daidzin, genistin and coumesterol in human cord blood plasma using LCMS. Cord blood was collected from urban and rural populations of Malaysia (n=300) to establish a simple preliminary database on the levels of the analyzed compounds in the collected samples. The study also aimed to look at the levels of phytoestrogens in babies during birth as this may have a profound effect on the developmental process. The sample clean up was carried out by solid-phase extraction using C18 column and passed through DEAE sephadex gel before analysis by LCMS. The mean concentrations of total phytoestrogens were daidzein (1.4+/-2.9 ng/ml), genistein (3.7+/-2.8 ng/ml), daidzin (3.5+/-3.1 ng/ml), genistin (19.5+/-4.2 ng/ml) and coumesterol (3.3+/-3.3 ng/ml). Distribution of phytoestrogen was found to be higher in samples collected from rural areas compared to that of urban areas.
  17. Fulltext Comparison on the use of semi-automated and automated core biopsy needle in ultrasound guided breast biopsy
    Sridharan R, Yunos SM, Aziz S, Hussain RI, Alhabshi SM, Suria Hayati MP, et al.
    Med J Malaysia, 2015 Dec;70(6):326-33.
    PMID: 26988204 MyJurnal
    OBJECTIVE: The aim of this study was to compare the use of semi-automated (Medax Velox 2; Poggio Rusco, Italy) and automated (Bard Magnum Biopsy Instrument; Covington, GA, USA) core biopsy needles, for ultrasound guided breast biopsy.
    MATERIALS AND METHODS: A 14G semi-automatic spring loaded core biopsy needle with a 22-mm-throw (Medax Velox 2; Poggio Rusco, Italy) and 14-gauge automated needle device with a 22-mm-throw biopsy gun (Bard-Magnum Biopsy Instrument, Covington, GA, USA) were used for breast biopsies under ultrasound guidance on alternate months during the study period between July 2009 and May 2011. One hundred and sixty lesions were biopsied and specimens were sent for histological evaluation.
    RESULTS: The automated needle obtained a higher number of histology reports at 84% (67/80) as compared with the semiautomated needle at 60% (48/80) (Fisher exact test, p value=0.023). Inadequate samples with the automated needle were much less at 9% (7/60) than with the semiautomated needle at 23% (18/60) (Fisher exact test, p value=0.028). The semi-automated needle showed slightly less fragmented samples. However, the number of fragmented samples with definitive diagnosis was slightly higher with the automated compared with the semiautomated needle, at 16% (13/80) and 13% (10/80) respectively. Compared with histology of 29 lesions that were excised, the semi-automated needle had higher sensitivity (100%) but lower specificity (75%) and accuracy (90%) compared with the automated needle (88% sensitivity, 100% specificity, 95% accuracy).
    CONCLUSION: Definitive diagnosis from the study samples slightly favours the use of automated core biopsy needle as compared to semi-automated core biopsy needle.
    Study site: Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur
  18. Continuous microwave flow synthesis of mesoporous hydroxyapatite
    Akram M, Alshemary AZ, Goh YF, Wan Ibrahim WA, Lintang HO, Hussain R
    Mater Sci Eng C Mater Biol Appl, 2015 Nov 1;56:356-62.
    PMID: 26249601 DOI: 10.1016/j.msec.2015.06.040
    We have successfully used continuous microwave flow synthesis (CMFS) technique for the template free synthesis of mesoporous hydroxyapatite. The continuous microwave flow reactor consisted of a modified 2.45GHz household microwave, peristaltic pumps and a Teflon coil. This cost effective and efficient system was exploited to produce semi-crystalline phase pure nano-sized hydroxyapatite. Effect of microwave power, retention time and the concentration of reactants on the phase purity, degree of crystallinity and surface area of the final product was studied in detail. X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR) were used to study the phase purity and composition of the product, while transmission electron microscopy (TEM) was used to study the effect of process parameters on the morphology of hydroxyapatite. The TEM analysis confirmed the formation of spherical particles at low microwave power; however the morphology of the particles changed to mesoporous needle and rod-like structure upon exposing the reaction mixture to higher microwave power and longer retention time inside the microwave. The in-vitro ion dissolution behavior of the as synthesized hydroxyapatite was studied by determining the amount of Ca(2+) ion released in SBF solution.
  19. Fulltext Validation and clinical interpretation of the St George's respiratory questionnaire for COPD (SGRQ-C) after adaptation to Malaysian language and culture, in patients with COPD
    Rehman AU, Hassali MAA, Harun SN, Abbas S, Muneswarao J, Ali IABH, et al.
    Health Qual Life Outcomes, 2020 May 13;18(1):138.
    PMID: 32404113 DOI: 10.1186/s12955-020-01393-1
    BACKGROUND: Cultural differences affect the administration and results of health status questionnaires. "Cross cultural adaptation" ensures retention of psychometric properties such as validity and reliability at an item and/or scale level.

    OBJECTIVE: To develop a Malaysian version of St George's respiratory COPD specific questionnaire (SGRQ-CM), to evaluate the full spectrum of psychometric properties (reliability, validity and responsiveness), to test the factor structure and to assess minimum clinically important difference for the SGRQ-CM, to be used in population of Malaysia.

    METHODOLOGY: SGRQ-C was translated to Bahasa Malaysia using a standard protocol. 240 COPD patients were included in the study. All patients were followed-up for six months. Construct validity, internal consistency, item convergent validity, test-retest ability, responsiveness, factor analysis and MCID of the Malaysian version of SGRQ-C to be used in population of Malaysia were evaluated.

    RESULTS: The Cronbach alpha coefficient and intraclass correlation coefficients (ICC) for SGRQ-CM were reported as 0.87, and 0.88 respectively. Correlation of SGRQ-CM with CAT, EQ-5D-5 L, mMRC dyspnea scales and FEV1%predicted were reported as 0.86, - 0.82, 0.72 and - 0.42 respectively. Correlation coefficient between the subscales and other clinical and health status measures ranged from r = - 0.35 to r = - 0.87. The MCID was reported as 5.07 (- 2.54-12.67).

    CONCLUSION: The Malaysian version of SGRQ-C has a good psychometric property comparable to those of the original version and has a strong evidence of validity, reliability and responsiveness towards disease severity in Malaysian COPD patients. It can be recommended as a reliable quality of life measure for future research.

  20. Fulltext A Qualitative Evaluation of Adverse Drug Reaction Reporting System in Pakistan: Findings from the Nurses' Perspective
    Hussain R, Hassali MA, Ur Rehman A, Muneswarao J, Atif M, Babar ZU
    Int J Environ Res Public Health, 2020 04 27;17(9).
    PMID: 32349339 DOI: 10.3390/ijerph17093039
    The contribution of all key healthcare professionals is vital to promote an efficient adverse drug reaction (ADR) reporting system. In this context, nurses are important as they are in a better position to observe a patient's response regarding the drug therapy and to report an ADR. The aim of the study was to explore the perspectives of nurses about ADR reporting system in Lahore, Pakistan. A total of 21 nurses were interviewed. The thematic content analysis of the qualitative interviews yielded six major themes and eight subthemes. Major themes included: (1) Knowledge about the concept of the medication safety & the ADR; (2) Knowledge regarding pharmacovigilance activities; (3) Willingness to report; (4) Practices related to the ADR reporting; (5) Barriers to the ADR reporting; (6) Facilitators to the ADR reporting. The majority of the nurses were aware of medicine safety and ADRs, but in many cases, they were unable to report these ADRs. The study pointed out considerable concerns regarding the knowledge and practices of nurses about pharmacovigilance activities in their workplace, mainly due to increased workload, due to the absence of a reporting system and legal liability. The main challenges turned out to be the lack of knowledge and training, as well as the implementation of guidelines. Based on the findings, it is suggested that outcome of this study can serve as a guide to design policies that support ADR reporting by nurses in Pakistan.
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