Challenges of having a child with thalassemia in Pakistan: A phenomenological study.

BACKGROUND: Thalassemia is a persistent hemolytic disease and has debilitating effects on patients and their parents. Parents of these children experience pain and suffer from additional emotional strain as they provide daily and lifetime care and are mostly concerned about the health and future of their children. AIM: The study aimed to understand the experiences of parents of children with thalassemia related to their family, financial, social, treatment, and psychological issues in Pakistan. METHODS: This descriptive phenomenological study recruited 21 parents of children with thalassemia through purposive sampling until data saturation was achieved. Analysis of transcribed interviews was performed through Colaizzi's method and themes and subthemes revolving around diagnosis, challenges, and treatment issues were extracted. FINDINGS: A total of 21 Pakistani parents participated in this study. Most of the participants were females (n = 16, 76.19%), housewives/stay-at-home moms (n = 13 (61.90%), and were uneducated (n = 6, 28.57%). Regarding genetic traits, only three (14.28%) parents declared that they had genetic traits of thalassemia. The findings of our study revealed that thalassemia is enormously influenced by psychosocial and economic problems because of this disease in their families. CONCLUSION: Our findings indicated that parents of these children face multi-faceted challenges, such as physical, socio-emotional, financial, and familial. These findings may lead to an adequate understanding of their individual needs and efficient utilization of supportive and care programs. PRACTICE IMPLICATIONS: An understanding of such experiences, involving those distinctive to Pakistani culture, is especially vital to inform the care of these children and enhance their quality of life.

A qualitative insight into the perceptions and COVID-19 vaccine hesitancy among Pakistani pharmacists.

A qualitative exploration of pharmacists' perceptions regarding COVID-19 conspiracies and their willingness to get vaccinated. A semi-structured questionnaire guide was developed using ground theory to conduct in-depth interviews. A total of 36 participants gave consent for an audio-recorded interview. Results have shown that most of the respondents believed that SARS-CoV-2 is a natural virus, not man-made, that causes a disease just like other viruses and it is absurd to believe that the vaccine is being used by foreign powers for the implantation of microchips just to control humans. A general opinion thatwhich reflected from the in-depth interview is that the pharmaceutical companies may be hiding some important information on COVID-19 to promote the sale of their product. Some doubts on the reliability and trustworthiness on the COVID-19 vaccine safety and efficacy data were noticed among the respondents. Factors leading to COVID-19 vaccine hesitancy were adverse reaction, cost of COVID-19 vaccine, and limited data on safety and efficacy profile of COVID-19 vaccine. COVID-19 vaccine hesitancy among health professionals is a major hindrance to our current fight against COVID-19 pandemic. Findings of this study are alarming, and the stakeholders must consider this ongoing vaccination campaign as an opportunity to formulate a mechanism to ensure high vaccination rate among general public and healthcare providers in Pakistan.KEY POINTSWhat was already known?According to World Health Organization (WHO), vaccine hesitancy is one of the ten major threats to global healthcare system and it is a major barrier to achieve herd immunity around the globe.Pakistan has begun vaccinating its people in a systematic phase-wise manner under which the healthcare workers and elderly people are prioritized for vaccination.Previous experience tells us that vaccine hesitancy is a major problem in Pakistan and it is better to understand perceptions of pharmacists about COVID-19 vaccine who are the primary source of information for most of general population.What this study adds:This study is first of its kind to explore vaccine hesitancy among Pakistani pharmacists and the results of this study show that majority of the participants were willing to get COVID-19 vaccine and few of them have even got themselves vaccinated at the start of vaccination campaign.Many among the willing participants considered cost of vaccine, adverse reactions, limited data, safety, and efficacy as major hindrance to their decision to get vaccine.Few participants were found highly vaccine-hesitant because of their staunch belief in the prevalent myths and rumors about COVID-19 vaccine.

Key Elements of Pharmacoinformatics for the Degrees of Bachelor and Master of Pharmacy.

The Internet and rapid development of technology has led to the application of pharmacoinformatic technologies in improving the efficiency of the medication use process. By integrating pharmacoinformatics in pharmacy education, a qualified workforce of pharmacists well trained in the perspective of both pharmacy practice and informatics for safe and positive health-related outcomes can be produced. This survey assessed the level of importance of the suggested topics for pharmacoinformatics courses for pharmacy bachelor's and master's degrees by giving a questionnaire to pharmacy lecturers in both public and private universities, and to pharmacists registered with the Ministry of Health, Malaysia. Briefly the study of pharmacoinformatics was classified into 5 major areas: Drug Information Services, Information Technology & Internet, Drug Formulary Management, Supply Chain Management, and Health Policy. The relative importance of all relevant topics were evaluated and reported. It was found that compared with the undergraduate level, master's degree had higher expectations, and thus a more in-depth pharmacoinformatics curriculum content. In addition, the experiential method of learning instead of formal lectures alone was used on pharmacy master's courses. The findings from this survey could serve as a guide to improve pharmacoinformatics curricula in order to produce pharmacists who can safely and effectively utilize pharmacy informatics to disseminate information in drug use.

Effectiveness of posthemodialysis administration of pregabalin (75 mg) in treatment resistance uremia pruritus.

Uremic pruritus (UP) is one of the complications faced by majority of the patients with end stage renal disease (ESRD). Due to complex pathophysiology of UP, most of the anti-inflammatory and tropical lubricants often not provide a long lasting control over pruritus. Recently the uses of certain anti-epileptics are found to demonstrate promising relief to UP. To test the effect of 75 mg pregabalin in patients with treatment resistance pruritus. Data was prospectively collected from a patient with ESRD and suffering from treatment resistance pruritus. Intensity of pruritus was recorded using 5D-itching scale (5D-IS) and visual analogue scale (VAS). Pre and post assessment was done for this patient, on initial assess the parathyroid hormone level of the patient was 70.5 pg/ml with a serum phosphate level of 2.61 mmol/L. Upon initial assess the VAS score was 8 and 5D-IS score was twenty. After the duration of four weeks of pregabalin 75 mg post hemodialysis, 5D-IS score reduced to 8 and VAS score move down to 3. Pregabalin 75 mg post hemodialysis was found to reduce the intensity of UP. Pregabalin 75 mg post hemodialysis can be another option to treat UP.

A prospective study assessing the etiology of Diabetes mellitus among Jordanian patients.

BACKGROUND: Diabetes mellitus has considerable public health implications for communities, individuals, and health services. Increasing prevalence of diabetes all over the world intensifies the demand for health care services, and particularly for inpatient care. AIM: The present study aims to assess the current prevalence of diabetes and its etiology among hospitalized Jordanian adults. METHODS: This was a cross sectional study conducted at Specialist Hospital (SH) in the Jordanian capital of Amman, with data collection taking place between June and August 2015, and data was extracted manually from medical records. Patients were divided into three groups: (a) those with a medical history of diabetes, (b) those with unrecognized diabetes or new hyperglycemia, and (c) those with no diabetes. Data management and analysis were conducted using the SPSS program. Means ±SD were used to present all continuous variables, as well as the numbers and percentages for categorical variables, and we used analysis of variance (ANOVA) to compare between means. For differences between categorical variables, we used (x(2)). A P-value of less than 0.05 was considered significant. RESULTS: A total of 392 patients (266 female, 126 male) were admitted during the 10-week study period. Of these, 204 fell into category (a), 45 into category (b), and 143 into category (c). Diabetes was the principal diagnosis in 52% of the hospitalizations. Patients who had diabetes or new hyperglycemia were considerably older than non-diabetic patients. The five most common reasons for hospitalization were congestive heart failure (25.0%), pneumonia (22.5%), DKA (22.0%), coronary atherosclerosis (16.20%), and septicemia (14.20%). CONCLUSION: The common etiologies for hospitalization were congestive heart failure, pneumonia, DKA, coronary atherosclerosis, and septicemia. Keeping in view the results of this study it is recommend that regular screening should be performed for diabetic patients, as this will increase the chances that many diabetes complications will be prevented, particularly for elderly subjects.

Awareness and attitudes regarding breast cancer and breast self-examination among female Jordanian students.

BACKGROUND: Despite huge efforts to increase the level of breast cancer awareness, breast self-examination (BSE) is still poorly practiced across Jordan. This baseline study aimed to assess the awareness of female Jordanian students about breast cancer and their practice of BSE. MATERIALS AND METHODS: Using a cross-sectional research design, a self-administered survey was used, via a pre-validated pre-piloted questionnaire was distributed to 900 female students aged between 18 and 37 years recruited from the University of Jordan in Amman. The questionnaire was divided into four domains: Socio-demographic characteristics; the respondent's knowledge of breast cancer and BSE; their attitude towards risk factors for breast cancer; their experience of breast cancer screening and BSE. Statistical analysis was performed using Epi-Info version 6.4 statistical Software. RESULTS: The overall response rate was 93.3%. Approximately half of the respondents 435 (51.8%) were aware of breast cancer. Of these, 99 (22.7%) believed that it was caused by a medical condition, followed by old age (71; 16.4%), lack of breastfeeding (58; 13.3%), heredity (56; 12.8%), late marriage (44; 10.3%), pregnancies in older women (33; 7.5%), the use of brassieres (18; 4.1%), excessive breastfeeding (17; 3.9%), being unmarried (14; 3.2%), and spirituality (11; 2.6%). Overall, 152 participants (34.9%) were aware of BSE, but only 93 (11%) had performed it. CONCLUSIONS: The current status of awareness of breast cancer in Jordanian students and their use of BSE are insufficient. Women need to be encouraged to self-monitor in order to detect abnormalities in their breasts. Appropriate educational interventions are urgently required to encourage women to engage in regular BSE.

Risk factors on hypertensive disorders among Jordanian pregnant women.

Eight percent of pregnancies involve hypertensive disorders, which can have serious complications for mothers and children. There has only been minimal research into hypertension in pregnancy in developing countries, including Jordan. Therefore, this study aimed to identify how frequent certain risk factors that apply to hyper-tensive disorders during pregnancy were among women in the Jordanian capital of Amman. A prospective case-control study was conducted on 184 Jordanian pregnant patients with hypertensive disorders and 172 age-matched control subjects recruited from the maternity ward of a tertiary public hospital in Amman city; they were followed-up until 85 days after the birth (late puerperium). A standardized questionnaire pilot-tested was completed by participants that included demographic data and known risk factors for hypertension in pregnancy. Statistical analysis SPSS was conducted to compare the frequency of risk factors using Fisher's exact test, chi-square, Student's t-tests, as well as multivariate logistic regression was conducted to identify independent risk factors. The results showed that chronic hypertension, prenatal hypertension, family history of preeclampsia, diabetes, high BMI, nulliparity, previous preeclampsia history and low education level were identified as risk factors for hypertensive disorders in pregnancy in this population; Moreover, diabetes, chronic hypertension and family history of preeclampsia were found to be independent risk factors. The results of the study contribute to the currently limited knowledge about the modifiable risk factors for hypertensive disorders during pregnancy among the Jordanian population, and could therefore be extremely useful for clinicians providing prenatal care.