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Papers by Sheraz Ali

Journal of Pharmacy And Bioallied Sciences

Background: It is crucial to follow rational prescribing practices while prescribing antibiotics ... more Background: It is crucial to follow rational prescribing practices while prescribing antibiotics for burn patients, thus leading to better patient outcomes. The objective of this study was to assess the initiation of empirical antibiotics in the burn unit. Methods: A prospective cross-sectional study was conducted in a large tertiary care setting of the Kingdom of Saudi Arabia between August 2016 and December 2018. Results: A total of 102 hospitalized burn patients were included in this study, of whom 84 (82.4%) were males. Burns were classified as first degree, second degree, third degree, or fourth degree depending on their severity and extent of penetration into the skin. The majority (81.3%) of the patients suffered from flame burn, followed by scald (9.85), chemical (6.9%), and electrical (2%) types of burns. Broad-spectrum antibiotic such as piperacillin/tazobactam (40.57%) was the most common empirically prescribed antibiotic. In 35 patients (34.3%), there was a change in antibiotic after culture findings. Conclusion: This study demonstrated that 40% of antibiotic therapy decisions followed the recommended clinical guidelines. This study also found that Gram-negative microorganisms such as Pseudomonas aeruginosa and Methicillin-resistant Staphylococcus aureus were ubiquitous in our burn unit. The study results will facilitate to develop antibiogram for our study setting, thus reducing antibiotic resistance. Further studies are needed to explore the extent and consequences of irrational antibiotic prescriptions in critically ill burn patients.

Cureus

Background: Due to the need for early and effective medications for coronavirus disease (COVID-19... more Background: Due to the need for early and effective medications for coronavirus disease (COVID-19), less attention may have been paid to medication safety during this pandemic. Objectives: This study aimed to examine the incidence, nature, and seriousness of medication errors (MEs) and adverse drug reactions (ADRs) among hospitalized patients with COVID-19. Materials and methods: This is a retrospective study of MEs and ADRs reported at the King Saud Medical City (KSMC) between April 2020 and September 2020. Results: A total of 343 MEs and 416 ADRs were reported during the study period. The incidence of MEs was 19% (19/100). Seventy-five MEs (21.5%) reached the patient but did not cause any harm. Wrong dose (n=101, 29.4%) was the most common type of MEs. Physicians were the most common source of MEs (87.5%). Antibiotics (32%) and antineoplastics (25%) were the most common drug categories involved in MEs and ADRs, respectively. Thirty-nine percent (n=163) of the ADRs were of serious nature. 24% (n=100) required hospitalization, 5% (n=21) were life-threatening, 16 (3.8%) required intervention to prevent permanent impairment or damage, and 6.2% (n=26) resulted in the discontinuation of treatment. Conclusion: The reporting of MEs appears to be high among COVID-19 patients in a large tertiary care setting in the Kingdom of Saudi Arabia (KSA). The majority of MEs were caused by dosing errors and errors in drug frequency, mostly ascribed to physicians, which may be indicative of burnout or stress among them. The reporting of MEs and ADRs can be improved by providing incentives to healthcare professionals (HCPs) and promoting a non-punitive culture. Further studies should explore the clinical consequences of medication misadventures in hospitalized COVID-19 patients.

Expert Opinion on Drug Safety

Advances in Social Sciences Research Journal, 2020

The basic aim of the paper is to critically evaluate the Sindh school education sector plans (i.e... more The basic aim of the paper is to critically evaluate the Sindh school education sector plans (i.e. First plan 2014-18, and second sector plan, 2019-24) as a case study. It also attempts to find missing links of enhancing education access to girls as a policy tool in greater human interest. Paper also provides recommendations for improvement in the proposed plan in public interest. The Study concludes that investment in the education of girls may well be the highest-return investment available in the developing world so plans, policies, and programs must be focused on access educational incentives to girls for sustainable economic growth and development.

Annals of Saudi Medicine, 2021

BACKGROUND: Multiple studies have investigated medication errors in hospitals in Saudi Arabia; ho... more BACKGROUND: Multiple studies have investigated medication errors in hospitals in Saudi Arabia; however, prevalence data on prescribing errors and associated factors remains uncertain. OBJECTIVE: Assess the prevalence, type, severity, and factors associated with prescribing errors. DESIGN: Retrospective database review. SETTING: Large tertiary care setting in Riyadh. PATIENTS AND METHODS: We described and analyzed data related to prescribing errors in adults (>14 years of age) from the Medication Error Electronic Report Forms database for the two-year period from January 2017 to December 2018. MAIN OUTCOME MEASURE: The prevalence of prescribing errors and associated factors among adult patients. SAMPLE SIZE: 315 166 prescriptions screened. RESULTS: Of the total number of inpatient and outpatient prescriptions screened, 4934 prescribing errors were identified for a prevalence of 1.56%. The most prevalent types of prescribing errors were improper dose (n=1516; 30.7%) and frequency (...

Cureus, 2021

Background and aim Hypertension possesses significant public health challenges for both developin... more Background and aim Hypertension possesses significant public health challenges for both developing and developed economies. Therefore, it is crucial to evaluate the awareness of hypertension and health-related quality of life (HRQoL) among patients with hypertension. This study aims to evaluate the knowledge of hypertension and HRQoL among hypertensive patients. Materials and methods A cross-sectional study using an anonymous questionnaire was conducted over a period of 4 months (November 2020 to February 2021) in Riyadh, Kingdom of Saudi Arabia (KSA). This study included 437 questionnaires submitted by the hypertensive population. Results A total of 437 participants were included in this study, with 55.4% being males (n=242). The majority (85.1%) were aware of the normal values of blood pressure. Many participants had no problems with mobility, personal care, usual activities, pain or discomfort, and anxiety or depression. Age groups showed a significant association with mobility and usual activities. The knowledge of hypertension was significantly associated with HRQoL. Conclusion This study found that majority of the hypertensive patients were aware of the standard values of blood pressure. HRQoL concerning physical functioning and general health is found to be good based on the EuroQol visual analogue scale (EQ VAS) in the hypertensive population who are aware of their condition. This study reported a weak yet significant association between hypertension-related knowledge and HRQoL scores. Several factors can affect the HRQoL of the hypertensive population including gender, education, occupation, and income status.

International Journal of Health Sciences, 2018

Objective: Little is known about the pattern of antibiotics’ prescribing for hospitalized adult p... more Objective: Little is known about the pattern of antibiotics’ prescribing for hospitalized adult patients in the Kingdom of Saudi Arabia. This study explored the prescribing practices of antibiotics in a large tertiary care setting serving diverse population. Methods: This retrospective cross-sectional study included 1.666 antibiotic prescriptions prescribed over a period of 3 months (January 2016–March 2016) in an adult inpatient department of King Saud Medical City (KSMC). Data were collected from pharmacy electronic database. The World Health Organization (WHO) prescribing indicators were also used. Results: Of the 13.414 prescriptions in pharmacy database, percentage share of antibiotic prescriptions was 12.41. The average number of drugs per encounter was 1.2. 61% of the prescriptions contained parenteral antibiotics. The percentage of drugs prescribed from essential drug list and by generic name was 100% in each indicator. The most frequently prescribed antibiotics were cefurox...

Encyclopedia of Pharmacy Practice and Clinical Pharmacy, 2019

Saudi Medical Journal, 2021

Objectives: To assess the clinical and epidemiological characteristics of hospitalized cancer pat... more Objectives: To assess the clinical and epidemiological characteristics of hospitalized cancer patients with skin and soft-tissue infections (SSTIs).

Current Therapeutic Research, 2021

Background The globalization of clinical research should also benefit the population in developin... more Background The globalization of clinical research should also benefit the population in developing markets. In this context, the approval of tested medicines and the associated expansion of medical care beyond clinical studies would be desirable as a possible long-term benefit. Objectives This study was designed to compare the development of the number of clinical trials with the number of marketing authorizations of medicines on the African continent. To contrast these 2 parameters, the data were analyzed using the model of an ecological study. Methods To reflect the broad spectrum of African developing countries with diverse levels of development, the data collection was based on 2 geographically selected sample countries each from Central, North, East, West, and Southern Africa. Based on the ClinicalTrials.gov registry, the first step was to collect trends data on the development of the clinical trials in the 10 selected countries of the country list of the African Region published by the World Health Organization for the period 2015 to 2018. Subsequently, data on the current number of marketing authorizations of medicines in the selected sample countries were identified using the online registries of the national authorities. The data were utilized in comparative analyses. Results Eight out of 10 model countries showed an increase in the number of clinical trials, with the exceptions of Cameroon and Libya, which showed an overall decline in research activity over the entire time. In direct comparison with drug registrations, the numbers indicate a similar development. The only exception here is Nigeria, a country with a solid performance in clinical research and yet a decrease in medicine registrations since 2015. Conclusions The expected increase in the development of clinical research as result of the globalization trend can basically be observed in most of the model countries. However, this increase does not guarantee an improvement in the number of medicine registrations. Although this is evident in some of the selected model countries, it cannot be projected to the entire African region. This may be linked to the diverse development of the individual countries due to the different political situations and the varying degrees of clinical research infrastructure. (Curr Ther Res Clin Exp. 2022; 82:XXX–XXX)

Archives of Clinical Microbiology, 2017

Mycobacterium Fortuitum is classified as nontuberculous mycobacterium that is described as rapidl... more Mycobacterium Fortuitum is classified as nontuberculous mycobacterium that is described as rapidly growing mycobacteria as they usually grow in subculture within one week. M. Fortuitum is considered the most common RGM from non-respiratory specimens. There have been few reports regarding M. Fortuitum as cause of Red Breast Syndrome after undergoing breast reconstructive surgery with implants. To our knowledge and after literature search, this is the first report of M. Fortuitum cultured status post Breast Reconstructive surgery with tissue expander, not an implant and with no acellular dermal matrix utilized.

Pakistan Journal of Women's Studies: Alam-e-Niswan, 2020

The study aims to identify factors which contribute to the prevalence of alcoholism and drug addi... more The study aims to identify factors which contribute to the prevalence of alcoholism and drug addiction among sexually abused women in an ultra-conservative society. A qualitative research design is used in conjunction with interviews from women and physicians, categories which included both psychiatrists and sexologists, across six districts of Khyber Pakhtunkhwa. The phenomena of drug addiction and alcoholism were more pronounced in victims working for the commercial sex sector. The findings suggest Post-Traumatic Stress Disorders (PTSD) as a driving factor of alcoholism and drug abuse, which in turn cascades into secondary and tertiary levels of trauma. Sexual victimization and re-victimization, familial rejection, stigmatisation and social degradation were contributing factors to relentless stress. Drugs in vogue among victims were Valium-two (Diazepam) and Lexotanil that contained Bromazepam. Hashish and alcohol were consumed sparingly by victims, while the use of cocaine and he...

Saudi Pharmaceutical Journal, 2020

Background: Medication errors (MEs) in hospital settings are attributed to various factors includ... more Background: Medication errors (MEs) in hospital settings are attributed to various factors including the human factors. Human factors researches are aiming to implement the knowledge regarding human nature and their interaction with surrounding equipment and environment to design efficient and safe systems. Human Factors Frameworks (HFF) developed awareness regarding main system's components that influence healthcare system and patients' safety. An in-depth evaluation of human factors contributing to medication errors in the hospital pharmacy is crucial to prevent such errors. Objective: This study, therefore, aims to identify and categorize the human factors of MEs in hospital pharmacy using the Human Factors Framework (HFF). Method: A qualitative study conducted in King Saud Medical City, Riyadh, Kingdom of Saudi Arabia. Data collection was carried out in two stages; the first stage was the semi-structured interview with the pharmacist or technician involved in the medication error. Then, occupational burnout and personal fatigue scores of participants were assessed. Data analysis was done using thematic analysis. Results: A total of 19 interviews were done with pharmacists and technicians. Themes were categorized using HFF into five categories; individual, organization and management, task, work, and team factors. Examples of these themes are poor staff competency, insufficient staff support, Lack of standardization, workload, and prescriber behaviour respectively. Scores of fatigue, work disengagement, and emotional exhaustion are correlating with medium fatigue, high work disengagement, and high emotional exhaustion, respectively. Conclusions: The study provided a unique insight into the contributing factors to MEs in the hospital pharmacy. Emotional stress, lack of motivation, high workload, poor communication, and missed patient information on the information system, are examples of the human factors contributing to medication errors. Our study found that among those factors, organizational factors had a major contribution to medication safety and staff wellbeing.

Advances in Social Sciences Research Journal, 2020

This study is to assess the viability status of educational institutions inthe Sindh region and u... more This study is to assess the viability status of educational institutions inthe Sindh region and understand the factors for increasing non-viable schools on the ground. The study further highlights the school viability challenges associated with evidence-based planning and de-allocating resources from dysfunctional institutions. The viability of school is the basic requirement for access to education for all and the ultimate goal is to the optimization of resources and laid foundation towards good governance and quality education in the greater public interest. The findings of this study can be used for by the planners, decision-makers, policy-makers and implementing authorities for evidence based planning to enhance the performance within stipulated time frame and given limited resources in the school education department in greater public interest which leads to destinations of SDGs 04 quality education for all in the region.

Therapeutic Advances in Drug Safety, 2018

Background: Underreporting is a common problem with spontaneous adverse drug reaction (ADR) repor... more Background: Underreporting is a common problem with spontaneous adverse drug reaction (ADR) reporting. In this study, we aim to describe the reporting of ADRs in a tertiary hospital and determine the effect of incentives to healthcare professionals on ADR reporting. Methods: In this interventional study, a time series analysis was used to determine the effect of incentives on ADR reporting in a tertiary hospital between 2015 and 2016. The incentive strategy included public commendation of health care providers and nomination for a monthly award. Results: A total of 967 ADRs were reported over a 2-year period. After the introduction of incentives in January 2016, the number of ADR reports per month increased by 40.6 (95% confidence interval: 26.1–55.1). The proportion of serious ADRs reported was significantly higher in 2016 (39/800) than 2015 (0/167) ( p < 0.001). In 2016, there was a significant association between profession and serious ADR reporting ( p < 0.001). A total of...

Hospital Pharmacy, 2020

Background: Spontaneous reporting systems are essential as they help detect serious unknown adver... more Background: Spontaneous reporting systems are essential as they help detect serious unknown adverse drug reaction (ADR). However, underreporting of ADR is a commonly associated problem. This research work aims to assess knowledge, barriers, and factors that encourage the reporting of ADR among physicians. Methods: A total of 600 physicians working at a tertiary referral hospital in Riyadh, Saudi Arabia, were included in this cross-sectional study. A pretested questionnaire was used. Results: Out of the 600 physicians, 240 (40%) completed the questionnaire. Most of the participants (85.4%) could correctly define ADR; nearly 75% physicians were unaware of the spontaneous reporting of ADR in Saudi Arabia. A total of 175 (72.9%) physicians had not reported any ADR among their patients in the last year; 40% of the physicians said that they did not report ADR because they were unaware of the online reporting of ADR. Providing guidelines and regular bulletins on the reporting of ADR is a c...

European Journal of Clinical Pharmacology, 2019

Purpose The purpose of the study is to conduct a systematic review of studies examining the assoc... more Purpose The purpose of the study is to conduct a systematic review of studies examining the association between anticholinergic burden and mortality in older individuals. Methods A literature search was performed to identify relevant studies, using MEDLINE, EMBASE, PsycINFO and CENTRAL, from January 1990 to December 2018. We included studies of patients with a mean age of 65 years or older where the anticholinergic burden was estimated using anticholinergic risk assessment tools, and associations between anticholinergic load and mortality were investigated. The primary outcome of interest was the association between anticholinergic burden and mortality. Results Twenty-seven studies were included. These were three cross-sectional, one nested case-control and 23 prospective or retrospective cohort studies. Most studies were determined to be of good quality. A total of 15 studies reported a positive correlation between anticholinergic burden and mortality, while the remaining 10 studies did not report a significant association. Eighteen out of 27 studies (80%) had a short follow-up period of 1 year or less. Among the five high-quality studies that met all the domains of the quality assessment criteria, four showed a positive association. Conclusion The variation in results could relate to the quality of the studies, follow-up period, anticholinergic risk assessment tool used and the study setting. Sixty-three percent ( n = 17) of all the included studies, but almost all of the high-quality studies with an extended follow-up, reported a positive correlation between anticholinergic burden and mortality. Further high-quality research, using standardized measures and with adequate follow-up periods, is required to confirm the relationship between anticholinergic burden and mortality.

Pediatric Quality & Safety, 2019

Individual QI projects from single institutions INTRODUCTION Sepsis is a leading cause of mortali... more Individual QI projects from single institutions INTRODUCTION Sepsis is a leading cause of mortality and morbidity in neonates, particularly in developing countries, 1,2 where about 30% of all neonatal deaths are attributed to severe bacterial infections. 3 Approximately 750,000 deaths from neonatal sepsis occur annually worldwide. 4 There is an inverse relationship between the incidence of neonatal sepsis and birth weight. 5,6 The World Health Organization currently recommends ampicillin or cloxacillin (if the staphylococcal infection is suspected) and gentamicin for the empiric treatment of suspected neonatal clinical sepsis. 1 However, third-generation cephalosporins, particularly cefotaxime, are also commonly utilized. Late-onset neonatal sepsis is usually caused by neonatal intensive care units (NICUs)-acquired pathogens and changes in antimicrobial susceptibility patterns necessitate a regular review of antibiotics regimen. Gram-positive organisms, particularly coagulase-negative Staphylococcus and group B streptococci, are major causative agents of late-and early-onset neonatal sepsis, respectively. 7,8 A recent study by Al-Mouqdad et al showed that the incidence of infection with Grampositive microorganisms was 57% in a Saudi Arabian hospital's NICU and coagulase-negative Staphylococcus was the predominantly isolated pathogen. They also reported that Gram-negative microorganisms, mainly Escherichia coli, Klebsiella sp., and Pseudomonas aeruginosa, accounted for 38% of isolated organisms. 9 The study found that over 90% of the Gram-negative organisms were susceptible to gentamicin and amikacin. 9 The United Kingdom's Health Protection Agency's national bacteremia surveillance also reported that over 95% of organisms causing neonatal sepsis were susceptible to

International Journal of Clinical Trials, 2018

Unlike North America and European Union (EU), Asian continent appears to be an ideal destination ... more Unlike North America and European Union (EU), Asian continent appears to be an ideal destination for conducting cost-effective clinical trials utilizing the pool of treatment naïve subjects. With a population approaching 4.5 billion, recruitment of subjects can be done without a fear of limited patient pool across Asia. The burden of infectious and chronic diseases is also higher in Asian countries. The emerging clinical trial markets particularly China, South Korea, and Taiwan offers genetic diversity in population group, thus promoting the quality and generalizability of clinical trial’s data. Nonetheless, several challenges also exist for the Western sponsors in majority of the Asian countries; regulatory, operational and infrastructural challenges are at the forefront. Challenges under the heads regulatory, operational, infrastructural, language and cultural, ethics, and future challenges have been discussed. SWOT analysis of Asian clinical trial’s market exhibits enormous oppor...

Journal of Pharmacy And Bioallied Sciences, 2019

Objective: To investigate the appropriateness of acid-suppressive therapy (AST) for stress ulcer ... more Objective: To investigate the appropriateness of acid-suppressive therapy (AST) for stress ulcer prophylaxis (SUP) in noncritically ill hospitalized patients. Materials and Methods: A prospective, observational study with 384 subjects was conducted between October and December 2017 in the emergency and internal medicine departments. The Herzig clinical risk scoring system and the guidelines of the American Society of Health-System Pharmacists guidelines were used to assess risk factors and determine risk scores for gastrointestinal (GI) bleeding. Results: The mean age of subjects was 51.9±19.4 years, and 220 (57.3%) of them were males. Among the absolute risk factors, coagulopathy was observed in 2 (0.5%) patients, mechanical ventilation in 15 (3.9%), and a history of GI bleeding in 1 (0.3%). Of 384 patients with SUP, 370 (96.4%) had a clinical risk score ≤ 9 and 14 (3.6%) had a risk score between 10 and 12 for nosocomial GI bleeding. A statistically significant relationship was found between the risk factor indication and demographics. Conclusion: SUP is frequently administered to noncritically ill hospitalized patients lacking risk factors for GI bleeding. Proton pump inhibitors are the overwhelming first choice of AST among prescribers. Practitioners should follow international guidelines when prescribing ASTs outside the critical-care setting.

Journal of Pharmacy And Bioallied Sciences

Background: It is crucial to follow rational prescribing practices while prescribing antibiotics ... more Background: It is crucial to follow rational prescribing practices while prescribing antibiotics for burn patients, thus leading to better patient outcomes. The objective of this study was to assess the initiation of empirical antibiotics in the burn unit. Methods: A prospective cross-sectional study was conducted in a large tertiary care setting of the Kingdom of Saudi Arabia between August 2016 and December 2018. Results: A total of 102 hospitalized burn patients were included in this study, of whom 84 (82.4%) were males. Burns were classified as first degree, second degree, third degree, or fourth degree depending on their severity and extent of penetration into the skin. The majority (81.3%) of the patients suffered from flame burn, followed by scald (9.85), chemical (6.9%), and electrical (2%) types of burns. Broad-spectrum antibiotic such as piperacillin/tazobactam (40.57%) was the most common empirically prescribed antibiotic. In 35 patients (34.3%), there was a change in antibiotic after culture findings. Conclusion: This study demonstrated that 40% of antibiotic therapy decisions followed the recommended clinical guidelines. This study also found that Gram-negative microorganisms such as Pseudomonas aeruginosa and Methicillin-resistant Staphylococcus aureus were ubiquitous in our burn unit. The study results will facilitate to develop antibiogram for our study setting, thus reducing antibiotic resistance. Further studies are needed to explore the extent and consequences of irrational antibiotic prescriptions in critically ill burn patients.

Cureus

Background: Due to the need for early and effective medications for coronavirus disease (COVID-19... more Background: Due to the need for early and effective medications for coronavirus disease (COVID-19), less attention may have been paid to medication safety during this pandemic. Objectives: This study aimed to examine the incidence, nature, and seriousness of medication errors (MEs) and adverse drug reactions (ADRs) among hospitalized patients with COVID-19. Materials and methods: This is a retrospective study of MEs and ADRs reported at the King Saud Medical City (KSMC) between April 2020 and September 2020. Results: A total of 343 MEs and 416 ADRs were reported during the study period. The incidence of MEs was 19% (19/100). Seventy-five MEs (21.5%) reached the patient but did not cause any harm. Wrong dose (n=101, 29.4%) was the most common type of MEs. Physicians were the most common source of MEs (87.5%). Antibiotics (32%) and antineoplastics (25%) were the most common drug categories involved in MEs and ADRs, respectively. Thirty-nine percent (n=163) of the ADRs were of serious nature. 24% (n=100) required hospitalization, 5% (n=21) were life-threatening, 16 (3.8%) required intervention to prevent permanent impairment or damage, and 6.2% (n=26) resulted in the discontinuation of treatment. Conclusion: The reporting of MEs appears to be high among COVID-19 patients in a large tertiary care setting in the Kingdom of Saudi Arabia (KSA). The majority of MEs were caused by dosing errors and errors in drug frequency, mostly ascribed to physicians, which may be indicative of burnout or stress among them. The reporting of MEs and ADRs can be improved by providing incentives to healthcare professionals (HCPs) and promoting a non-punitive culture. Further studies should explore the clinical consequences of medication misadventures in hospitalized COVID-19 patients.

Expert Opinion on Drug Safety

Advances in Social Sciences Research Journal, 2020

The basic aim of the paper is to critically evaluate the Sindh school education sector plans (i.e... more The basic aim of the paper is to critically evaluate the Sindh school education sector plans (i.e. First plan 2014-18, and second sector plan, 2019-24) as a case study. It also attempts to find missing links of enhancing education access to girls as a policy tool in greater human interest. Paper also provides recommendations for improvement in the proposed plan in public interest. The Study concludes that investment in the education of girls may well be the highest-return investment available in the developing world so plans, policies, and programs must be focused on access educational incentives to girls for sustainable economic growth and development.

Annals of Saudi Medicine, 2021

BACKGROUND: Multiple studies have investigated medication errors in hospitals in Saudi Arabia; ho... more BACKGROUND: Multiple studies have investigated medication errors in hospitals in Saudi Arabia; however, prevalence data on prescribing errors and associated factors remains uncertain. OBJECTIVE: Assess the prevalence, type, severity, and factors associated with prescribing errors. DESIGN: Retrospective database review. SETTING: Large tertiary care setting in Riyadh. PATIENTS AND METHODS: We described and analyzed data related to prescribing errors in adults (>14 years of age) from the Medication Error Electronic Report Forms database for the two-year period from January 2017 to December 2018. MAIN OUTCOME MEASURE: The prevalence of prescribing errors and associated factors among adult patients. SAMPLE SIZE: 315 166 prescriptions screened. RESULTS: Of the total number of inpatient and outpatient prescriptions screened, 4934 prescribing errors were identified for a prevalence of 1.56%. The most prevalent types of prescribing errors were improper dose (n=1516; 30.7%) and frequency (...

Cureus, 2021

Background and aim Hypertension possesses significant public health challenges for both developin... more Background and aim Hypertension possesses significant public health challenges for both developing and developed economies. Therefore, it is crucial to evaluate the awareness of hypertension and health-related quality of life (HRQoL) among patients with hypertension. This study aims to evaluate the knowledge of hypertension and HRQoL among hypertensive patients. Materials and methods A cross-sectional study using an anonymous questionnaire was conducted over a period of 4 months (November 2020 to February 2021) in Riyadh, Kingdom of Saudi Arabia (KSA). This study included 437 questionnaires submitted by the hypertensive population. Results A total of 437 participants were included in this study, with 55.4% being males (n=242). The majority (85.1%) were aware of the normal values of blood pressure. Many participants had no problems with mobility, personal care, usual activities, pain or discomfort, and anxiety or depression. Age groups showed a significant association with mobility and usual activities. The knowledge of hypertension was significantly associated with HRQoL. Conclusion This study found that majority of the hypertensive patients were aware of the standard values of blood pressure. HRQoL concerning physical functioning and general health is found to be good based on the EuroQol visual analogue scale (EQ VAS) in the hypertensive population who are aware of their condition. This study reported a weak yet significant association between hypertension-related knowledge and HRQoL scores. Several factors can affect the HRQoL of the hypertensive population including gender, education, occupation, and income status.

International Journal of Health Sciences, 2018

Objective: Little is known about the pattern of antibiotics’ prescribing for hospitalized adult p... more Objective: Little is known about the pattern of antibiotics’ prescribing for hospitalized adult patients in the Kingdom of Saudi Arabia. This study explored the prescribing practices of antibiotics in a large tertiary care setting serving diverse population. Methods: This retrospective cross-sectional study included 1.666 antibiotic prescriptions prescribed over a period of 3 months (January 2016–March 2016) in an adult inpatient department of King Saud Medical City (KSMC). Data were collected from pharmacy electronic database. The World Health Organization (WHO) prescribing indicators were also used. Results: Of the 13.414 prescriptions in pharmacy database, percentage share of antibiotic prescriptions was 12.41. The average number of drugs per encounter was 1.2. 61% of the prescriptions contained parenteral antibiotics. The percentage of drugs prescribed from essential drug list and by generic name was 100% in each indicator. The most frequently prescribed antibiotics were cefurox...

Encyclopedia of Pharmacy Practice and Clinical Pharmacy, 2019

Saudi Medical Journal, 2021

Objectives: To assess the clinical and epidemiological characteristics of hospitalized cancer pat... more Objectives: To assess the clinical and epidemiological characteristics of hospitalized cancer patients with skin and soft-tissue infections (SSTIs).

Current Therapeutic Research, 2021

Background The globalization of clinical research should also benefit the population in developin... more Background The globalization of clinical research should also benefit the population in developing markets. In this context, the approval of tested medicines and the associated expansion of medical care beyond clinical studies would be desirable as a possible long-term benefit. Objectives This study was designed to compare the development of the number of clinical trials with the number of marketing authorizations of medicines on the African continent. To contrast these 2 parameters, the data were analyzed using the model of an ecological study. Methods To reflect the broad spectrum of African developing countries with diverse levels of development, the data collection was based on 2 geographically selected sample countries each from Central, North, East, West, and Southern Africa. Based on the ClinicalTrials.gov registry, the first step was to collect trends data on the development of the clinical trials in the 10 selected countries of the country list of the African Region published by the World Health Organization for the period 2015 to 2018. Subsequently, data on the current number of marketing authorizations of medicines in the selected sample countries were identified using the online registries of the national authorities. The data were utilized in comparative analyses. Results Eight out of 10 model countries showed an increase in the number of clinical trials, with the exceptions of Cameroon and Libya, which showed an overall decline in research activity over the entire time. In direct comparison with drug registrations, the numbers indicate a similar development. The only exception here is Nigeria, a country with a solid performance in clinical research and yet a decrease in medicine registrations since 2015. Conclusions The expected increase in the development of clinical research as result of the globalization trend can basically be observed in most of the model countries. However, this increase does not guarantee an improvement in the number of medicine registrations. Although this is evident in some of the selected model countries, it cannot be projected to the entire African region. This may be linked to the diverse development of the individual countries due to the different political situations and the varying degrees of clinical research infrastructure. (Curr Ther Res Clin Exp. 2022; 82:XXX–XXX)

Archives of Clinical Microbiology, 2017

Mycobacterium Fortuitum is classified as nontuberculous mycobacterium that is described as rapidl... more Mycobacterium Fortuitum is classified as nontuberculous mycobacterium that is described as rapidly growing mycobacteria as they usually grow in subculture within one week. M. Fortuitum is considered the most common RGM from non-respiratory specimens. There have been few reports regarding M. Fortuitum as cause of Red Breast Syndrome after undergoing breast reconstructive surgery with implants. To our knowledge and after literature search, this is the first report of M. Fortuitum cultured status post Breast Reconstructive surgery with tissue expander, not an implant and with no acellular dermal matrix utilized.

Pakistan Journal of Women's Studies: Alam-e-Niswan, 2020

The study aims to identify factors which contribute to the prevalence of alcoholism and drug addi... more The study aims to identify factors which contribute to the prevalence of alcoholism and drug addiction among sexually abused women in an ultra-conservative society. A qualitative research design is used in conjunction with interviews from women and physicians, categories which included both psychiatrists and sexologists, across six districts of Khyber Pakhtunkhwa. The phenomena of drug addiction and alcoholism were more pronounced in victims working for the commercial sex sector. The findings suggest Post-Traumatic Stress Disorders (PTSD) as a driving factor of alcoholism and drug abuse, which in turn cascades into secondary and tertiary levels of trauma. Sexual victimization and re-victimization, familial rejection, stigmatisation and social degradation were contributing factors to relentless stress. Drugs in vogue among victims were Valium-two (Diazepam) and Lexotanil that contained Bromazepam. Hashish and alcohol were consumed sparingly by victims, while the use of cocaine and he...

Saudi Pharmaceutical Journal, 2020

Background: Medication errors (MEs) in hospital settings are attributed to various factors includ... more Background: Medication errors (MEs) in hospital settings are attributed to various factors including the human factors. Human factors researches are aiming to implement the knowledge regarding human nature and their interaction with surrounding equipment and environment to design efficient and safe systems. Human Factors Frameworks (HFF) developed awareness regarding main system's components that influence healthcare system and patients' safety. An in-depth evaluation of human factors contributing to medication errors in the hospital pharmacy is crucial to prevent such errors. Objective: This study, therefore, aims to identify and categorize the human factors of MEs in hospital pharmacy using the Human Factors Framework (HFF). Method: A qualitative study conducted in King Saud Medical City, Riyadh, Kingdom of Saudi Arabia. Data collection was carried out in two stages; the first stage was the semi-structured interview with the pharmacist or technician involved in the medication error. Then, occupational burnout and personal fatigue scores of participants were assessed. Data analysis was done using thematic analysis. Results: A total of 19 interviews were done with pharmacists and technicians. Themes were categorized using HFF into five categories; individual, organization and management, task, work, and team factors. Examples of these themes are poor staff competency, insufficient staff support, Lack of standardization, workload, and prescriber behaviour respectively. Scores of fatigue, work disengagement, and emotional exhaustion are correlating with medium fatigue, high work disengagement, and high emotional exhaustion, respectively. Conclusions: The study provided a unique insight into the contributing factors to MEs in the hospital pharmacy. Emotional stress, lack of motivation, high workload, poor communication, and missed patient information on the information system, are examples of the human factors contributing to medication errors. Our study found that among those factors, organizational factors had a major contribution to medication safety and staff wellbeing.

Advances in Social Sciences Research Journal, 2020

This study is to assess the viability status of educational institutions inthe Sindh region and u... more This study is to assess the viability status of educational institutions inthe Sindh region and understand the factors for increasing non-viable schools on the ground. The study further highlights the school viability challenges associated with evidence-based planning and de-allocating resources from dysfunctional institutions. The viability of school is the basic requirement for access to education for all and the ultimate goal is to the optimization of resources and laid foundation towards good governance and quality education in the greater public interest. The findings of this study can be used for by the planners, decision-makers, policy-makers and implementing authorities for evidence based planning to enhance the performance within stipulated time frame and given limited resources in the school education department in greater public interest which leads to destinations of SDGs 04 quality education for all in the region.

Therapeutic Advances in Drug Safety, 2018

Background: Underreporting is a common problem with spontaneous adverse drug reaction (ADR) repor... more Background: Underreporting is a common problem with spontaneous adverse drug reaction (ADR) reporting. In this study, we aim to describe the reporting of ADRs in a tertiary hospital and determine the effect of incentives to healthcare professionals on ADR reporting. Methods: In this interventional study, a time series analysis was used to determine the effect of incentives on ADR reporting in a tertiary hospital between 2015 and 2016. The incentive strategy included public commendation of health care providers and nomination for a monthly award. Results: A total of 967 ADRs were reported over a 2-year period. After the introduction of incentives in January 2016, the number of ADR reports per month increased by 40.6 (95% confidence interval: 26.1–55.1). The proportion of serious ADRs reported was significantly higher in 2016 (39/800) than 2015 (0/167) ( p < 0.001). In 2016, there was a significant association between profession and serious ADR reporting ( p < 0.001). A total of...

Hospital Pharmacy, 2020

Background: Spontaneous reporting systems are essential as they help detect serious unknown adver... more Background: Spontaneous reporting systems are essential as they help detect serious unknown adverse drug reaction (ADR). However, underreporting of ADR is a commonly associated problem. This research work aims to assess knowledge, barriers, and factors that encourage the reporting of ADR among physicians. Methods: A total of 600 physicians working at a tertiary referral hospital in Riyadh, Saudi Arabia, were included in this cross-sectional study. A pretested questionnaire was used. Results: Out of the 600 physicians, 240 (40%) completed the questionnaire. Most of the participants (85.4%) could correctly define ADR; nearly 75% physicians were unaware of the spontaneous reporting of ADR in Saudi Arabia. A total of 175 (72.9%) physicians had not reported any ADR among their patients in the last year; 40% of the physicians said that they did not report ADR because they were unaware of the online reporting of ADR. Providing guidelines and regular bulletins on the reporting of ADR is a c...

European Journal of Clinical Pharmacology, 2019

Purpose The purpose of the study is to conduct a systematic review of studies examining the assoc... more Purpose The purpose of the study is to conduct a systematic review of studies examining the association between anticholinergic burden and mortality in older individuals. Methods A literature search was performed to identify relevant studies, using MEDLINE, EMBASE, PsycINFO and CENTRAL, from January 1990 to December 2018. We included studies of patients with a mean age of 65 years or older where the anticholinergic burden was estimated using anticholinergic risk assessment tools, and associations between anticholinergic load and mortality were investigated. The primary outcome of interest was the association between anticholinergic burden and mortality. Results Twenty-seven studies were included. These were three cross-sectional, one nested case-control and 23 prospective or retrospective cohort studies. Most studies were determined to be of good quality. A total of 15 studies reported a positive correlation between anticholinergic burden and mortality, while the remaining 10 studies did not report a significant association. Eighteen out of 27 studies (80%) had a short follow-up period of 1 year or less. Among the five high-quality studies that met all the domains of the quality assessment criteria, four showed a positive association. Conclusion The variation in results could relate to the quality of the studies, follow-up period, anticholinergic risk assessment tool used and the study setting. Sixty-three percent ( n = 17) of all the included studies, but almost all of the high-quality studies with an extended follow-up, reported a positive correlation between anticholinergic burden and mortality. Further high-quality research, using standardized measures and with adequate follow-up periods, is required to confirm the relationship between anticholinergic burden and mortality.

Pediatric Quality & Safety, 2019

Individual QI projects from single institutions INTRODUCTION Sepsis is a leading cause of mortali... more Individual QI projects from single institutions INTRODUCTION Sepsis is a leading cause of mortality and morbidity in neonates, particularly in developing countries, 1,2 where about 30% of all neonatal deaths are attributed to severe bacterial infections. 3 Approximately 750,000 deaths from neonatal sepsis occur annually worldwide. 4 There is an inverse relationship between the incidence of neonatal sepsis and birth weight. 5,6 The World Health Organization currently recommends ampicillin or cloxacillin (if the staphylococcal infection is suspected) and gentamicin for the empiric treatment of suspected neonatal clinical sepsis. 1 However, third-generation cephalosporins, particularly cefotaxime, are also commonly utilized. Late-onset neonatal sepsis is usually caused by neonatal intensive care units (NICUs)-acquired pathogens and changes in antimicrobial susceptibility patterns necessitate a regular review of antibiotics regimen. Gram-positive organisms, particularly coagulase-negative Staphylococcus and group B streptococci, are major causative agents of late-and early-onset neonatal sepsis, respectively. 7,8 A recent study by Al-Mouqdad et al showed that the incidence of infection with Grampositive microorganisms was 57% in a Saudi Arabian hospital's NICU and coagulase-negative Staphylococcus was the predominantly isolated pathogen. They also reported that Gram-negative microorganisms, mainly Escherichia coli, Klebsiella sp., and Pseudomonas aeruginosa, accounted for 38% of isolated organisms. 9 The study found that over 90% of the Gram-negative organisms were susceptible to gentamicin and amikacin. 9 The United Kingdom's Health Protection Agency's national bacteremia surveillance also reported that over 95% of organisms causing neonatal sepsis were susceptible to

International Journal of Clinical Trials, 2018

Unlike North America and European Union (EU), Asian continent appears to be an ideal destination ... more Unlike North America and European Union (EU), Asian continent appears to be an ideal destination for conducting cost-effective clinical trials utilizing the pool of treatment naïve subjects. With a population approaching 4.5 billion, recruitment of subjects can be done without a fear of limited patient pool across Asia. The burden of infectious and chronic diseases is also higher in Asian countries. The emerging clinical trial markets particularly China, South Korea, and Taiwan offers genetic diversity in population group, thus promoting the quality and generalizability of clinical trial’s data. Nonetheless, several challenges also exist for the Western sponsors in majority of the Asian countries; regulatory, operational and infrastructural challenges are at the forefront. Challenges under the heads regulatory, operational, infrastructural, language and cultural, ethics, and future challenges have been discussed. SWOT analysis of Asian clinical trial’s market exhibits enormous oppor...

Journal of Pharmacy And Bioallied Sciences, 2019

Objective: To investigate the appropriateness of acid-suppressive therapy (AST) for stress ulcer ... more Objective: To investigate the appropriateness of acid-suppressive therapy (AST) for stress ulcer prophylaxis (SUP) in noncritically ill hospitalized patients. Materials and Methods: A prospective, observational study with 384 subjects was conducted between October and December 2017 in the emergency and internal medicine departments. The Herzig clinical risk scoring system and the guidelines of the American Society of Health-System Pharmacists guidelines were used to assess risk factors and determine risk scores for gastrointestinal (GI) bleeding. Results: The mean age of subjects was 51.9±19.4 years, and 220 (57.3%) of them were males. Among the absolute risk factors, coagulopathy was observed in 2 (0.5%) patients, mechanical ventilation in 15 (3.9%), and a history of GI bleeding in 1 (0.3%). Of 384 patients with SUP, 370 (96.4%) had a clinical risk score ≤ 9 and 14 (3.6%) had a risk score between 10 and 12 for nosocomial GI bleeding. A statistically significant relationship was found between the risk factor indication and demographics. Conclusion: SUP is frequently administered to noncritically ill hospitalized patients lacking risk factors for GI bleeding. Proton pump inhibitors are the overwhelming first choice of AST among prescribers. Practitioners should follow international guidelines when prescribing ASTs outside the critical-care setting.