Mukhtar Ansari

Clinical Investigation of the Protective Effects of Palm Vitamin E Tocotrienols on Brain White Matter

Background and Purpose— Previous cell-based and animal studies showed mixed tocotrienols are neuroprotective, but the effect is yet to be proven in humans. Thus, the present study aimed to evaluate the protective activity of mixed tocotrienols in humans with white matter lesions (WMLs). WMLs are regarded as manifestations of cerebral small vessel disease, reflecting varying degrees of neurodegeneration and tissue damage with potential as a surrogate end point in clinical trials. Methods— A total of 121 volunteers aged ≥35 years with cardiovascular risk factors and MRI-confirmed WMLs were randomized to receive 200 mg mixed tocotrienols or placebo twice a day for 2 years. The WML volumes were measured from MRI images taken at baseline, 1 year, and 2 years using a validated software and were compared. Fasting blood samples were collected for full blood chemistry investigation. Results— According to per-protocol (88 volunteers) and intention-to-treat (121 volunteers) analyses, the mean WML volume of the placebo group increased after 2 years, whereas that of the tocotrienol-supplemented group remained essentially unchanged. The mean WML volume change between the 2 groups was not significantly different (P=0.150) at the end of 1 year but was significant at the end of 2 years for both per-protocol and intention-to-treat analyses (P=0.019 and P=0.018). No significant difference was observed in the blood chemistry parameters between the 2 groups. Conclusions— Mixed tocotrienols were found to attenuate the progression of WMLs. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00753532.

Mothers’ beliefs and barriers about childhood diarrhea and its management in Morang district, Nepal

BackgroundIn developing countries, mothers usually manage diarrhea at home with the pattern of management depending on perceived disease severity and beliefs. The study was carried out with the objective of determining mothers’ beliefs and barriers about diarrhea and its management.MethodsQualitative methods involving two focus group discussions and eight in-depth interviews were used to collect the data. The study was conducted at the following places: Tankisinuwari, Kanchanbari and Pokhariya of Morang district, Nepal during the months of February and March 2010. Purposive sampling method was adopted to recruit twenty mothers based on the inclusion criteria. A semi-structured interview guide was used to conduct the interviews. Written informed consent was obtained from all of the participants before conducting the interviews. The interviews were moderated by the main researcher with the support of an expert observer from Nobel Medical College. The interviews were recorded with the permission of the participants and notes were written by a pre trained note-taker. The recordings were transcribed verbatim. All the transcribed data was categorized and analyzed using thematic content analysis.ResultsTwenty mothers participated in the interviews and most (80%) of them were not educated. About 75% of the mothers had a monthly income of up to 5000 Nepalese rupees (US

The role of mothers in the management of childhood diarrhoea in Nepal.

60.92). Although a majority of mothers believed diarrhea to be due to natural causes, there were also beliefs about supernatural origin of diarrhea. Thin watery diarrhea was considered as the most serious. There was diversity in mothers’ beliefs about foods/fluids and diarrhea management approaches. Similarly, several barriers were noted regarding diarrhea prevention and/or management such as financial weakness, lack of awareness, absence of education, distance from healthcare facilities and senior family members at home. The elderly compelled the mothers to visit traditional healers.ConclusionsThere were varied beliefs among the mothers about the types, causes and severity of diarrhea, classification of foods/fluids and beliefs and barriers about preventing or treating diarrhea.

A survey of mothers' knowledge about childhood diarrhoea and its management among a marginalised community of Morang, Nepal.

Diarrhoea is a leading cause of childhood morbidity and mortality in Nepal, a developing country where the larger proportion of the population live in rural areas. Poverty, illiteracy, lack of health care facilities at local level, demographical distribution and traditional beliefs are the major obstacles for getting proper and timely healthcare. There is a necessity to consider the cultural beliefs of different ethnic communities before designing any educational protocol or guideline. Educational protocol or guidelines which respect the local cultural beliefs and stimulate the utilization of their locally available facilities can be easily accepted and would be more suitable to achieve the objectives.

Hospital pharmacy services in teaching hospitals in Nepal: Challenges and the way forward

Background Diarrhoea, a common disease, is one of the major determinants of childhood morbidity and mortality in Nepal.

Perception of Community Pharmacy Personnel towards Patient Counseling and Continuing Pharmacy Education Programs in Aden, Yemen

In Nepal, a developing country in South Asia, hospital pharmacies in teaching hospitals faces a number of challenges. Design and location of the pharmacy is inadequate, the pharmacy is often rented out to private parties, there may be a lack of separation of outpatient and inpatient pharmacy services, medicines are not selected based on objective criteria, too many brands are stocked, pharmaceutical care services are not provided, and pharmaceutical promotion is not regulated within the hospital premises. Furthermore, there is often a lack of pharmacy management software to help dispensing, continuing pharmacy education is not provided, medicines are not compounded or packaged in house, there are problems with medicines availability and medicine quality, and drug utilization studies are not linked with initiatives to promote the rational use of medicines. In this article, the authors examine these challenges and put forward possible solutions.

Comparison of the Knowledge and Perception of Pharmacovigilance Among Pharmacy, Dental and Medical Students in Aden-Yemen

INTRODUCTION Due to easy access and friendly approach, community pharmacies, are the first place patients visit to obtain consultation or treatment for their common ailments. It is a global trend that millions of people visit community pharmacies to meet their health care needs [1]. However, some general practitioners have been dismissive of the role of pharmacists and do not see them as part of the health care team [1]. Community pharmacists have a crucial role to play in terms of optimising medication use and improving patient outcomes. Patient counseling is one of the most vital services provided by them which can reduce medication misuse and further decrease the therapy costs [1,2]. Patient counseling is a major component of the pharmaceutical care processes, especially in community pharmacy settings. Pharmacists need to offer appropriate, comprehensible and relevant information to patients about their medications. Counseling not only improves patient compliance, but also reduces complications due to nonadherence to treatment [3].

Tocotrienols for normalisation of hepatic echogenic response in nonalcoholic fatty liver: a randomised placebo-controlled clinical trial

Background: Adverse drug reactions (ADRs) represent a serious health problem. Despite all the benefits of modern medicines, evidence continues to mount that ADRs to them are common, yet often preventable cause of illness, disability and even death. ADRs are responsible for a significant number of hospital admissions. Healthcare professionals have an important role to play in reducing ADRs. Purpose: The goal of this study was to compare the knowledge and attitudes of pharmacy, dental and medical students regard¬ing adverse drug reactions (ADRs), as well as their perceptions of barriers to ADR reporting, in Aden University, Yemen. Methods A cross-sectional study was conducted among final-year students. A total of 130 pharmacy students, 101 medical and 69 dental students completed the self-administered questionnaire. The study was conducted from July 1 to October 31, 2016. The responses of pharmacy students were compared to those of dental and medical students. Results: The mean ages of the pharmacy, medical and dental students were 25.13 ± 1.90 years. A non-significant gender difference (P Key words: Aden; dental; Pharmacy; Medical; Students; Pharmacovigilance; Comparison; Yemen.