Levels of vitamin D and vitamin D pathway gene polymorphisms in adults: Results based on rural agriculture workers in Punjab province of Pakistan

Published in: https://www.mattioli1885journals.com/index.php/progressinnutrition/article/view/8180

Oct 01, 2020

Hussain N Shaban A Baig M

Background and aims: Worldwide low levels of vitamin D (< 30ng/dL) is prevalent and linked to bone disorders, diabetes and coronary heart disease. Deficiency in Vitamin D is a diagnostic challenge in asymptomatic individuals. The present study aimed to assess the environmental and also the genetic determinants affecting vitamin D deficiency in an asymptomatic rural agricultural population sample of Punjab province of Pakistan. Material and method: An interview based questionnaire and blood samples for measuring serum markers were obtained. These include calcium levels, parathyroid hormone and serum 25(OH) vitamin D. DNA was extracted from the blood samples for genotyping. Results: From 510 study participants, 435 (85.2%) individuals had < 30 ng/dL (low) of vitamin D. Males versus females had a unremarkable difference in the status of Vitamin D (61.3% vs 56.2%), (p = 0.134). When calcium levels were compared between the deficiency and insufficiency groups versus the vitamin D sufficiency group, no significant difference was observed (p = 0.526, 0.155 respectively). Consumption of single milk serving every day (250 ml) (p = 0.818) and sunlight exposure every day for more than 30 minutes (p = 0.579) also had non-significant associations with the estimated vitamin D levels. However, oral vitamin D supplementation was significantly associated (p = 0.024) with the vitamin D levels. Eight SNPs were studied and none showed any statistical significant association with observed vitamin D levels. Conclusions: We noted a considerable proportion of asymptomatic individuals from the rural population with low vitamin D levels. There appear to be multifactorial causes of deficiency in vitamin D and this burgeoning health issue requires further investigations.

Influence of Health Literacy on Medication Adherence Among Elderly Females With Type 2 Diabetes in Pakistan

Published in: International Quarterly of Community Health Education

Oct 01, 2020

Hussain N Shaban A Khan Z

Health literacy is how well the patients are able to attain, deal with, and understand basic health information. This is particularly important when it comes to comprehending prescribed medication instructions. To improve the communication strategies for health-care professionals during patient counseling, our study aimed to assess the influence of health literacy and medication adherence in older patients. The objectives of the study were to evaluate associations that occur between the level of health literacy and medication adherence. This study used a convenience sampling method of females (older than 60 years) attending the diabetic clinic in two hospital settings (N = 524). All study participants filled three validated questionnaires: these were the Literacy Assessment for Diabetes, the Diabetes Numeracy Test, and a modified Brief Adherence Rating Scale. To assess the spectrum of health literacy differences, we used χ2 analysis and linear regression analysis. Individuals with adequate health literacy were more likely to remember to take their medications compared with those with inadequate health literacy, χ2(4) = 11.6, p =.04. Adequate literacy level study participants were more likely to not change the dose of their medications without medical advice (12.3%) compared with those individuals with inadequate health literacy (2.8%), χ2(4) = 11.13, p =.03. The results in our study suggest that health-care professionals should focus on appropriate communication attuned to the assessment of health literacy levels particularly in older female patients when discussing medication instructions. © The Author(s) 2019.

Physicians’ and pharmacists’ perception and practice of hospital pharmacist professional role in Egypt

Published in: International Journal of Pharmacy Practice

Jun 01, 2020

Said A Hussain N Abdelaty LN

Objectives: This study aimed to investigate physicians’ and pharmacists’ perceptions of the importance of pharmacists’ role in healthcare in Egypt, and actual delivery of these roles in practice. Identifying any differences and inconsistencies between these will inform future strategies that maximize pharmacists’ professional contribution to hospital practice. Methods: A self-administered questionnaire using a 5-point Likert scale was distributed to a convenience sample of physicians (500) and pharmacists (500) practicing in selected private or public hospitals in Egypt. The main sections of the questionnaire comprised statements that pertained to physicians’/pharmacists’ views on the importance of pharmacists’ roles and their actual delivery in practice. Key findings: In this study, physicians showed low scores for both the importance of and the delivery of advanced patient-facing clinical pharmacy roles such as suggesting prescription medications, and designing treatment plans. In comparison, pharmacists were more positive on both of these aspects of their roles. High mean scores were reported by the physicians for pharmacist’s traditional roles such as patient counselling, assessing compliance, preventing medication errors and treating minor illnesses. Both physicians and pharmacists reported poor pharmacists practice as drug information resources despite their high perception of the importance of that role. Conclusion: This study suggested that in hospitals in Egypt, there are significant differences between physicians’ and pharmacists’ perception and practice, and pharmacists’ clinical skills are underutilized in health care. © 2020 Royal Pharmaceutical Society

Physicians’ and Pharmacists’ Perception and Practice of Hospital Pharmacist’ Professional Role in Egypt

Published in: International Journal of Pharmacy Practice

May 06, 2020

Amira Shaaban Nadia Hussain

Levels of Vitamin D and Vitamin D Pathway Gene polymorphisms in adults: results from agriculture workers in Punjab, Pakistan

Published in: Progress in Nutrition

Jan 09, 2020

Nadia Hussain Amira SA Said Mirza Rafi Baig

Background and aims: Worldwide low levels of vitamin D (< 30ng/dL) is prevalent and linked to bone disorders, diabetes and coronary heart disease. Deficiency in Vitamin D is a diagnostic challenge in asymptomatic individuals. The present study aimed to assess the environmental and also the genetic determinants affecting vitamin D deficiency in an asymptomatic rural agricultural population sample of Punjab province of Pakistan. Material and method: An interview based questionnaire and blood samples for measuring serum markers were obtained. These include calcium levels, parathyroid hormone and serum 25(OH) vitamin D. DNA was extracted from the blood samples for genotyping. Results: From 510 study participants, 435 (85.2%) individuals had < 30 ng/dL (low) of vitamin D. Males versus females had a unremarkable difference in the status of Vitamin D (61.3% vs 56.2%), (p = 0.134). When calcium levels were compared between the deficiency and insufficiency groups versus the vitamin D sufficiency group, no significant difference was observed (p = 0.526, 0.155 respectively). Consumption of single milk serving every day (250 ml) (p = 0.818) and sunlight exposure every day for more than 30 minutes (p = 0.579) also had non-significant associations with the estimated vitamin D levels. However, oral vitamin D supplementation was significantly associated (p = 0.024) with the vitamin D levels. Eight SNPs were studied and none showed any statistical significant association with observed vitamin D levels. Conclusions: We noted a considerable proportion of asymptomatic individuals from the rural population with low vitamin D levels. There appear to be multifactorial causes of deficiency in vitamin D and this burgeoning health issue requires further investigations.

Influence of Health Literacy on Medication Adherence Among Elderly Females With Type 2 Diabetes in Pakistan

Published in: International Quarterly of Community Health Education

Jan 01, 2020

Nadia Hussain Amira Shaaban Zainab Khan

Mindfulness-Based Meditation Versus Progressive Relaxation Meditation: Impact on Chronic Pain in Older Female Patients With Diabetic Neuropathy

Published in: Journal of Evidence-Based Integrative Medicine

Nov 07, 2019

Nadia Hussain Amira Shaaban Mirza Baig

The Clinical Significance of Statins - Macrolides Interaction: Comprehensive Review of In vivo, Case-reports and Population Studies, Therapeutics and Clinical Risk Management

Published in: Therapeutics and Clinical Risk Management

Aug 30, 2019

• Abu Mellal A Hussain N Said ASA

The objectives of this article were to review the mechanism and clinical significance of statins-macrolides interaction, determine which combination has the highest risk for the interaction, and identify key patients' risk factors for the interaction in relation to the development of muscle toxicity. A literature review was conducted in PubMed and Embase (1946 to December 2018) using combined terms: statins - as group and individual agents, macrolides - as group and individual agents, drug interaction, muscle toxicity, rhabdomyolysis, CYP3A4 inhibitors, and OAT1B inhibitors, with forward and backward citation tracking. Relevant English language in vivo studies in healthy volunteers, case reports, and population studies were included. The interaction between statins and macrolides depends on the type of statin and macrolide used. The mechanism of the interaction is due to macrolides' inhibition of CYP3A4 isoenzyme and OAT1B transporter causing increased exposure to statins. The correlation of this increased statin's exposure to the development of muscle toxicity could not be established, unless the patient had other risk factors such as advanced age, cardiovascular diseases, renal impairment, diabetes, and the concomitant use of other CYP3A4 inhibitors. Simvastatin, lovastatin, and to lesser extent atorvastatin are the statins most affected by this interaction. Rosuvastatin, fluvastatin, and pravastatin are not significantly affected by this interaction. Telithromycin, clarithromycin, and erythromycin are the most "offending" macrolides, while azithromycin appears to be safe to use with statins. This review presented a clear description of the clinical significance of this interaction in real practice. Also, it provided health care professionals with clear suggestions and recommendations on how to overcome this interaction. In conclusion, understanding the different characteristics of each statin and macrolide, as well as key patients' risk factors, will enable health care providers to utilize both groups effectively without compromising patient safety.

Effects of Alogliptin on hypertensive chronic kidney disease with Type 2 diabetes mellitus

Published in: Australasian medical journal

May 03, 2018

Amira Shaaban Nadia Hussain Farideh Javaid

Background: Diabetes mellitus(DM)is a leading cause of chronic kidney disease (CKD). Theantihyperglycemic treatment options for patients with Type 2 DM are limited because of safety and tolerability concerns. Aims: To retrospectively assess the effect of using Alogliptin; a dipeptidyl peptidase-4 inhibitor (DPP-4i) alongwith conventional gliclazide: a sulphonylurea (SU) on renal outcomes and glycaemiccontrol in T2DM patients with mildCKDand hypertension. Methods: A total of 76 patient records (38 males and 38 females) of patient ages 40–60 were analysed from the kidney unit at Punjab Care hospital, Lahore, Pakistan. All patients had a confirmed history of T2DM with mild CKD and established hypertension.Eligible patients were divided into two groups of 38 individuals each. Group SU received gliclazide monotherapy (SU) or Alogliptin (DPP-4i)+gliclazide (SU) add on therapy. All patients were followed up for 12 months.ResultsThe alogliptin (DPP-4i) plus gliclazide (SU) add on therapy group, in comparison to the group only receiving gliclazide (SU), showed a significant difference in eGFR values. The mean±SD GFR values post 12 months were 74.8±0.31(95%CI:74.8±0.09;74.7–74.9) and 76.1±0.25(95%CI: 76.1±0.08;76.0-76.2) for SU vs.SU+DPP-4i, respectively, with mean calculated effect size of 1.6,.HbA1c, 1,5 AG and ipid profile values have significantly changed(p<0.05) while blood pressure values showed no change. The mean±SD systolic blood pressure readings post 12 months for for SU vs.SU+DPP-4i were 131.4±10.4 (95% CI 131.4±3.3;128.1–134.7), and 131.8±9.9 (95%CI 131.8±3; 128.8–134.8), respectively. Conclusion: In the present study, patients using alogliptin in addition to sulfonyl urea showed improved glycaemic control and lipid profile without increased occurrence of hypoglycaemia. We concluded that, DPP-4iinhibitors are safe treatment options for patients with type 2 diabetes and mild degree of renal impairment. (7) (PDF) Effect of alogliptin on hypertensive chronic kidney disease patients with type 2 diabetes mellitus. Available from: https://www.researchgate.net/publication/323529444_Effect_of_alogliptin_on_hypertensive_chronic_kidney_disease_patients_with_type_2_diabetes_mellitus [accessed Dec 04 2018].

Safety Assessment of Neoadjuvant Pertuzumab Combined with Trastuzumab in Nonmetastatic HER2-Positive Breast Cancer in Postmenopausal Elderly Women of South Asia

Published in: International Journal of Breast Cancer

Apr 19, 2018

Nadia Hussain Amira Shaaban Zainab Khan

Abstract Aim. To evaluate the safety issues and adverse effects of using TCHP regimen (docetaxel, carboplatin, trastuzumab, and pertuzumab) versus TCP regimen (docetaxel, carboplatin, and trastuzumab) in older postmenopausal women with nonmetastatic HER2-positive breast cancer. HER2 overexpressed in 20–25% of breast cancer signals an aggressive form of breast cancer and is treated with trastuzumab and pertuzumab. Methods. The patient record database was accessed to identify all postmenopausal women in the Punjab Care hospital who were above 65 years old, with stages 1–3 HER2-positive breast cancer and treated with neoadjuvant TCHP and neoadjuvant TCP from 2013 till 2016. Results. In TCH-P group and TCH group, mild fatigue (34% versus 36%) and diarrhea (48% versus 49%) were most common toxicities. Fever in TCH-P group and TCH group (12% versus 13%) was common. Anorexia affected 21% and 16% of patients receiving TCH and TCHP regimen, respectively. Febrile neutropenia was higher in TCH-P group 13% (3/23) versus 4.5% (1/22) in TCH group. Also 27.2% (6/22) of TCH-P group was hospitalized for treatment related toxicities versus 21.7% (5/23) of TCH group. Conclusion. Comparing neoadjuvant TCP and neoadjuvant TCH-P showed TCH-P regimen had an acceptable toxicity profile. Severe cardiac dysfunction was not observed. Using TCH-P regimen can be considered as relatively safe therapeutic option for elderly postmenopausal women with nonmetastatic HER2-positive breast cancer.

Knowledge, attitude, and practice analysis of corticosteroid use among patients: A study based in the United Arab Emirates

Published in: National Journal of Physiology, Pharmacy and Pharmacology

Feb 09, 2017

Amira Shaaban Amina Mahdy Nadia Hussain Doaa Khalidi

Background: Corticosteroids (CS) have long been known as the most powerful of all known anti-inflammatory agents. Since their introduction in 1949, they have shown pivotal role in the treatment of various serious disorders such as autoimmune diseases, allergic processes, organ transplantation, rheumatologic, dermatological, pulmonary, hematological, ophthalmologic, gastrointestinal disorders, and others. Nevertheless, such massive clinical use does not come without risks, where prolonged use has been linked to several serious side effects. Therefore, careful consideration of precautions recommended for safe use of CS is of paramount importance. Aims and Objectives: To assess knowledge, attitude, and practice (KAP) analysis of the proper use of different dosage forms of CS medications in different sets of CS users in the United Arab Emirates (UAE), to explore the extent to which steroid outpatients were well engaged with medication proper use and safety-related behaviors. Materials and Methods: A structured interview-based methodology was adopted to assess the KAPs revolving around steroid usage in patients located in the UAE cities; Dubai, Sharjah, Ajman and Al Ain. Patients (n = 250) were selected randomly from different outpatient clinics all over the previously designated cities. The prepared interview questions were selected based on related therapeutics guidelines regarding aspects of proper patients CS use. Data were collected by well-trained researchers to conduct such interviews. SPSS V16.0 (SPSS Inc., Chicago, USA) was used for data analysis. Standard descriptive and analytical statistics were used to analyze the data. StudentÂ’s t-test was used to compare the mean difference of continuous variables. Results: Overall, our study showed poor KAP results among different UAE patients using different CS dosage forms. Conclusion: Despite the massive use of CS in almost every clinical settings and its inherent associated risks, patients still needs provisions for better education regarding their medication efficacy, safety, and proper use. By careful follow-up of proper CS use instructions, both patients and physicians would positively reach an optimized cost-effective therapeutic approach with much more improved benefit/risk ratio.