A site to transform Pubmed publications into these bibliographic reference formats: ADS, BibTeX, EndNote, ISI used by the Web of Knowledge, RIS, MEDLINE, Microsoft's Word 2007 XML.

Akshaya Srikanth Bhagavathula - Top 30 Publications

The Attitude of Medical and Pharmacy Students towards Research Activities: A Multicenter Approach.

Aim: To assess the attitude of medical and pharmacy students in Asian and African universities towards scholarly research activities. Methods: An anonymous, cross-sectional, self-reported online survey questionnaire was administered to medical and pharmacy students studying in various Asian and African universities through social media between May and July 2016. A 68-item close-ended questionnaire consisting of Likert-scale options assessed the students' research-specific experiences, and their attitudes towards scholarly research publications. Results: A total of 512 questionnaires were completed, with a response rate of 92% from Asia and 94% from Africa. More pharmacy students (70.8%) participated than medical students (29.2%). Overall 52.2% of the pharmacy students and 40% of medical students believed that research activities provided a means of gaining respect from their faculty members. Lack of encouragement, paucity of time, gaps in research activities and practices, and lack of research funding were some of the most common barriers acknowledged by the students. A nonparametric Mann-Whitney test showed that a statistically significant difference was observed, in that more than 80% of the pharmacy students viewed scientific writing and research activities as valuable experiences (p = 0.001) and would like to involve their co-students in scholarly research activities (p = 0.002); whereas the majority of the medical students desired to be involved more in scholarly research publications (p = 0.033). Conclusion: Pharmacy students had good attitudes towards research activities and a higher number of medical students desired to be involved more in research publications. Faculties may consider taking special research initiatives to address the barriers and improve the involvement of medical and pharmacy students in scholarly research activities.

Experiences and Perceptions of Pharmacy Students on Practical Skills and Education During Clinical Rotations in India.

Objective. To investigate the overall experience of pharmacy students in India during their clinical rotations and their assessment of primary mentors in imparting the intended clinical skills. Methods. A prospective cross-sectional study using a self-administered survey instrument containing 34 items to obtain feedback from senior PharmD students in the latter three years of their six-year program from November 2014 to February 2015. Results. Of the 415 PharmD students invited for this survey, 261(63% response rate) completed the survey (54% males and 46% females). Of the surveyed participants, 74% were fifth- and final-year interns undertaking clinical training in private hospitals (60.9%). Interestingly, 37.9% of the students ranked their clinical training as "least satisfactory" and remarked that their clinical pharmacy services were not recognized or appreciated in their respective hospitals (42.9%). However, 20% of the students expressed that their site "definitely" provided them with the opportunity to hone clinical pharmacy skills. Only 10% of the students strongly agreed that their mentors encouraged them to use resource materials and learn on their own, met with them regularly to review their work and to provide feedback, and encouraged them to express their opinion in patient-care issues. Conclusion. Majority of PharmD students who completed the survey were "least satisfied" with their clinical training program. Mentors should take more effort to demonstrate practice-based clinical training and provide patient-centered education to PharmD students at their clinical sites.

Anemia in severe heart failure patients: does it predict prognosis?

Anemia is highly prevalent in heart failure (HF) patients. However, the prevalence, clinical impact and prognostic factor of anemia in heart failure patients is widely varies. The aim of this study was to evaluate the prevalence of anemia in patients with HF, to compare baseline clinical characteristic and outcomes of severe HF patients with and without anemia admitted to Gondar University Referral Hospital (GURH), Gondar, Ethiopia.

Ongoing Transmission of HCV: Should Cesarean Section be Justified? Data Mining Discovery.

Over the past few decades, cesarean section (CS) rates are steadily increasing in most of the middle- and high-income countries. However, most of the pregnant women (particularly undergoing CS) are not screened for hepatitis C virus (HCV); hence, neonates born to HCV-positive mother could be a source of future HCV infection. In this study, the role of the CS and other surgical interventions in HCV transmission in Egypt, the highest endemic country of HCV-4, was investigated.

The management of dyslipidaemia in patients with type 2 diabetes mellitus receiving lipid-lowering drugs: a sub-analysis of the CEPHEUS findings.

Dyslipidaemia is a risk factor for macrovascular complications in patients with type 2 diabetes mellitus (T2DM). Our aim was to assess the use of lipid lowering drugs (LLDs) in patients with T2DM and co-existing dyslipidaemia.

Anti-malarial treatment outcomes in Ethiopia: a systematic review and meta-analysis.

Ethiopia is among countries with a high malaria burden. There are several studies that assessed the efficacy of anti-malarial agents in the country and this systematic review and meta-analysis was performed to obtain stronger evidence on treatment outcomes of malaria from the existing literature in Ethiopia.

Community pharmacists' interest in and attitude to pharmacy practice research in Ethiopia: A cross-sectional study.

Pharmacy practice-research became an important component in the pharmacy practice. However, limited studies were conducted in sub-Saharan Africa to understand the pharmacists' interest and attitude towards pharmacy practice-research. We aimed to assess the community pharmacists' interest and attitude towards pharmacy practice-research in Ethiopia. A cross-sectional survey was conducted among community pharmacists in eight major cities in Ethiopia. A validated 25-item self-administered questionnaire covering interest and attitude related to pharmacy practice-research was distributed. Responses were analysed using descriptive and inferential statistics. A total of 389 community pharmacists responded to the survey (response rate- 88.4%). Most of community pharmacists showed a high level of interest and positive attitude in being involved in all aspects of pharmacy practice-research. The median summary score for interest and attitude were 38 (IQR 20-40) (range possible 10-50) and 30 (IQR 18-39), respectively. Sixty-seven percent of the respondents thought about being involved in research, felt research is important for their career (57.6%), confident to conduct the research (56.2%), and agreed that research is a part of pharmacy practice (48.5%). However, only forty-six percent agreed that they underwent research training. A multivariate analysis showed that females were more interested in pharmacy practice research than males [AOR: 1.50, 95% CI: 0.99-2.27; p<0.05]. Community pharmacists showed high interest towards several areas of research competencies and demonstrated positive attitude towards pharmacy practice-research. Our findings suggest that providing research training to community pharmacists may contribute in undertaking research activities and build the research capacity in Ethiopia.

Sex differences in management and outcomes of patients with atrial fibrillation in the Middle East: Gulf survey of atrial fibrillation events (Gulf SAFE).

Differences in the management of atrial fibrillation (AF) between men and women were investigated by using Gulf SAFE data in the Middle East. The study included 2,043 patients presenting with AF to emergency room (ER) were prospectively enrolled and followed for one-year. Women were older, have higher body mass index (BMI), comorbidities, and health complications than men. With regard to management of AF, cardioversion was recommended more often for men (16.7% vs. 9.3%), and underwent electrical cardioversion (2.2% vs. 1.1%). Women were prescribed digoxin more frequently than men (25.6% vs. 17.4%) and a significant number women received warfarin alone (31.1% vs. 8.7%). No difference between the sexes was noticed in One-year rates of stroke/transient ischemic attacks (TIA) and all-cause of mortality after one-year follow-up (3.1% men vs. 3.3% women, and 7.5% vs. 7.4%). Older age (≥ 65 years), smoking, alcohol use, CHADS2 scores ≥5 were some of the significant risk factors in men with AF. Suboptimal use of anticoagulants, higher mortality and stroke/TIA events at one year are high but similar between the sexes. ER management revealed high use of rate control strategy and high rate of hospital admission was noticed in women.

Patient safety attitudes of pharmacy students in an Ethiopian university: a cross-sectional study.

Patient safety is a major health care concern and is being included in an undergraduate curriculum as it plays a major role in lessening harm. Therefore, we aim to assess the attitude of pharmacy students toward patient safety.

Healthcare Professionals' Awareness, Knowledge, Attitudes, Perceptions and Beliefs about Ebola at Gondar University Hospital, Northwest Ethiopia: A Cross-sectional Study.

A poor understanding of Ebola Virus Disease (EVD) among Health Care Professionals (HCPs) may put our lives at risk. We aimed to assess the awareness, knowledge, attitudes, perceptions, beliefs of HCPs towards Ebola at Gondar University Hospital (GUH) in Northwest Ethiopia. We conducted a hospital based, cross-sectional survey among 245 randomly selected HCPs working at GUH from August-October, 2015. A validated, self-administered questionnaire was used to collect the data. We calculated descriptive statistics with P<0.05 being statistically significant. Of the 245 participants, 211 (86.1%) completed the study. The majority had heard about EVD and used news media (62%) as a source of information. Still, many were afraid of getting EVD (56.4%; P=0.001). A significant number of HCPs thought EVD can cause paralysis like polio (45%) and can be treated with antibiotics (28.4%). In addition, 46.4% of the HCPs felt anger or fear towards Ebola infected patients (P=0.006). We identified poor knowledge and negative incorrect beliefs among doctors and allied health professionals. There is a need for intensive training for all HCPs reduce EVD risk.

Risk factors for developing drug-related problems in patients with cardiovascular diseases attending Gondar University Hospital, Ethiopia.

Cardiovascular diseases (CVDs) are often accompanied with comoribidities and complications leading to taking multiple drugs and thus are more liable to be exposed to drug-related problems (DRPs). DRPs can occur at any stages of medication process from prescription to follow-up treatment. However, a few studies have assessed the specific risk factors for occurrence of at least one potential DRP per patient with CVDs in sub-Saharan African region.

Nonadherence to antihypertensive drugs: A systematic review and meta-analysis.

Hypertension drives the global burden of cardiovascular disease and its prevalence is estimated to increase by 30% by the year 2025. Nonadherence to chronic medication regimens is common; approximately 43% to 65.5% of patients who fail to adhere to prescribed regimens are hypertensive patients. Nonadherence to medications is a potential contributing factor to the occurrence of concomitant diseases.

Recreational Use of Phosphodiesterase 5 Inhibitors and Its Associated Factors among Undergraduate Male Students in an Ethiopian University: A Cross-Sectional Study.

To assess the prevalence of phosphodiesterase 5 (PDE5) inhibitor use and associated factors among University of Gondar undergraduate students.

Alternatives to currently used antimalarial drugs: in search of a magic bullet.

Malaria is a major cause of morbidity and mortality in many African countries and parts of Asia and South America. Novel approaches to combating the disease have emerged in recent years and several drug candidates are now being tested clinically. However, it is long before these novel drugs can hit the market, especially due to a scarcity of safety and efficacy data.To reduce the malaria burden, the Medicines for Malaria Venture (MMV) was established in 1999 to develop novel medicines through industry and academic partners' collaboration. However, no reviews were focused following various preclinical and clinical studies published since the MMV initiation (2000) to till date.We identify promising approaches in the global portfolio of antimalarial medicines, and highlight challenges and patient specific concerns of these novel molecules. We discuss different clinical studies focusing on the evaluation of novel drugs against malaria in different human trials over the past five years.The drugs KAE609 and DDD107498 are still being evaluated in Phase I trials and preclinical developmental studies. Both the safety and efficacy of novel compounds such as KAF156 and DSM265 need to be assessed further, especially for use in pregnant women. Synthetic non-artemisinin ozonides such as OZ277 raised concerns in terms of its insufficient efficacy against high parasitic loads. Aminoquinoline-based scaffolds such as ferroquine are promising but should be combined with good partner drugs for enhanced efficacy. AQ-13 induced electrocardiac events, which led to prolonged QTc intervals. Tafenoquine, the only new anti-relapse scaffold for patients with a glucose-6-phosphate dehydrogenase deficiency, has raised significant concerns due to its hemolytic activity. Other compounds, including methylene blue (potential transmission blocker) and fosmidomycin (DXP reductoisomerase inhibitor), are available but cannot be used in children.At this stage, we are unable to identify a single magic bullet against malaria. Future studies should focus on effective single-dose molecules that can act against all stages of malaria in order to prevent transmission. Newer medicines have also raised concerns in terms of efficacy and safety. Overall, more evidence is needed to effectively reduce the current malaria burden. Treatment strategies that target the blood stage with transmission-blocking properties are needed to prevent future drug resistance.

Community pharmacy and the extended community pharmacist practice roles: The UAE experiences.

Background: The pharmaceutical care and 'extended' roles are still not practiced optimally by community pharmacists. Several studies have discussed the practice of community pharmacy in the UAE and have shown that most community pharmacists only counsel patients. However, UAE, has taken initiatives to allow and prepare community pharmacists to practice 'extended' roles. Aim of the review: The aim was to review the current roles of community pharmacists in Abu Dhabi Emirate, United Arab Emirates (UAE). Objective: The objective was to encourage community pharmacists toward extending their practice roles. Methods: In 2010, Health Authority Abu Dhabi (HAAD) surveyed community pharmacists, using an online questionnaire, on their preferences toward extending their counseling roles and their opinion of the greatest challenge facing the extension of their counseling roles. Results: Following this survey, several programs have been developed to prepare community pharmacists to undertake these extended counseling roles. In addition to that, HAAD redefined the scope of pharmacist roles to include some extended/enhanced roles. Abu Dhabi Health Services (SEHA) mission is to ensure reliable excellence in healthcare. It has put clear plans to achieve this; these include increasing focus on public health matters, developing and monitoring evidence-based clinical policies, training health professionals to comply with international standards to deliver world-class quality care, among others. Prior to making further plans to extend community pharmacists' roles, and to ensure the success of these plans, it is imperative to establish the views of community pharmacists in Abu Dhabi on practicing extended roles and to gain understanding and information on what pharmacists see as preferred change strategies or facilitators to change. Conclusions: In an attempt to adapt to the changes occurring and to the growing needs of patients and to maximize the utilization of community pharmacists' unique structured strategies are needed to be introduced to the community pharmacy profession.

Retention and Treatment Outcomes of an Undernutrition Program for HIV patients involving Ready-to-Use Therapeutic Food at Gondar University Hospital, Ethiopia: A Cross-Sectional Study.

Despite global efforts to eradicate poverty and hunger, under-nutrition is still a major health problem, especially in Sub-Saharan Africa, where HIV/AIDS prevalence is also a serious burden.

Inappropriate prescribing of antithrombotic therapy in Ethiopian elderly population using updated 2015 STOPP/START criteria: a cross-sectional study.

Inappropriate use of antiplatelets and anticoagulants among elderly patients increases the risk of adverse outcomes. The aim of this study was to assess the prevalence of inappropriate prescribing of antithrombotic therapy in hospitalized elderly patients.

Evaluation of preceptors and skills achievement by clinical pharmacy clerkship students during their clinical rotations at University of Gondar, Ethiopia.

To investigate the overall experiences of clinical pharmacy students during their clinical attachments and to understand the breadth and depth of clinical skills provided by their preceptors.

Extensively drug-resistant tuberculosis in a young child.

Evaluation of rational use of medicines (RUM) in four government hospitals in UAE.

Studies conducted showed that there were gaps regarding the rational use of medicines (RUM).

Evaluation and implementation of behavioral and educational tools that improves the patients' intentional and unintentional non-adherence to cardiovascular medications in family medicine clinics.

There are limited number of studies describing the reasons and interventions of non-adherence to cardiovascular medications in United Arab Emirates (UAE). We aimed to implement and evaluate the behavioral and educational tools that indicate the reasons of non-adherence in patients with cardiovascular diseases and improve patient's adherence to their cardiovascular medications.

Health Professionals' Knowledge, Attitudes and Practices about Pharmacovigilance in India: A Systematic Review and Meta-Analysis.

Spontaneous or voluntary reporting of suspected adverse drug reactions (ADRs) is one of the vital roles of all health professionals. In India, under-reporting of ADRs by health professionals is recognized as one of the leading causes of poor ADR signal detection. Therefore, reviewing the literature can provide a better understanding of the status of knowledge, attitude and practice (KAP) of Pharmacovigilance (PV) activities by health professionals.

Pharmacovigilance on sexual enhancing herbal supplements.

The use of herbal medicines continues to expand rapidly across world and many people show positive interest to use herbal products for their health. The safety of herbal supplements has become a globally major concern in national and international health authorities due to increasing adverse events and adulterations. It is difficult to analyze herbal products that cause adverse events due to lack of sufficient information and expertise. Inadequate regulatory measures, weak quality control system and uncontrolled distribution channels are some of reasons that enhance the informal pharmaceutical market. In recent years, the unfulfilled desire for sex has been a subject that has aroused increasing public interest with respect to improve sexual functions. The use of herbal medicines substantially increased due to escalated prevalence and impact of sexual problems worldwide and estimates predicting the incidence to raise over 320 million by year 2025. The various reasons to use herbal supplements in men may be due to experiencing changes in erectile dysfunction (ED) due to certain medical conditions such as diabetes and hypertension and bodily changes as a normal part of life and aging. There is a lack of adequate evidence, no impetus to evaluate and absence of any regulatory obligations to undertake rigorous testing for safety and efficacy of herbal supplements before they sold over-the-counter (OTC). Pharmacovigilance on herbal supplements is still not well established. Sexual enhancing herbals are on demand in men health but informal adulteration is growing issue of concern. Recently, increase in use of herbal supplements for erectile dysfunction has laid a path for many illegal compositions. This paper explores facts and evidences that were observed in different countries attempting to demonstrate the importance of strengthening regulatory system to strengthen the application of pharmacovigilance principles on sexual enhancing supplements. We hereby explore the problem of sexual herbal supplements from pharmacovigilance perspectives. We provide insights into the various concerns and call for collaboration to resolve the problem. We highly recommend to include herbal medicines in national pharmacovigilance systems and to establish comprehensive national pharmacovigilance program to raise the awareness about herbal medicines particularly those used in enhancing sexual desire.

Knowledge of Future Dental Practitioners towards Oral Cancer: Exploratory Findings from a Public University in Malaysia.

Objective. To assess knowledge and awareness of oral cancer in the early identification of risk factors among undergraduate dental students. Methods. A total of 162 undergraduate (third, fourth, and fifth year) dental students at International Islamic University, Malaysia, were approached to participate in the study, and those who agreed were administered. A 9-item pretested questionnaire contains questions on oral examination, oral cancer risk factors, and requests for further information. Descriptive statistics were conducted using chi-square testing. Results. The response rate of the study was 70.3% (114/162), with 26 (22.8%) males and 88 (77.2%) females. All undergraduate dental students were familiar with examining the oral mucosa of their patients and most were likely to advise patients about the risk factors for developing oral cancer (98.2%). Nearly one-third (32.4%) of students reported examining patients with oral lesions as early signs for oral cancer (P < 0.001) and nearly 70% agreed that they did not have sufficient knowledge regarding the prevention and detection of oral cancer (P < 0.001). In addition, more than 95.6% agreed that there is a need for additional information/teaching regarding oral cancer. Further, 61.3% and 14.1% identified tobacco smoking and drinking alcohol as major risk factors for developing oral cancer. Conclusion. This study demonstrated lack of awareness about risk factors among undergraduate dental students regarding oral cancer. Reinforcing awareness and enhancing the benefits of early detection on prevention of oral cancer should be done through training and/or educational intervention.

Novel oral anticoagulants and the 73rd anniversary of historical warfarin.

Across sectional study: the knowledge, attitude, perception, misconception and views (KAPMV) of adult family members of people living with human immune virus-HIV acquired immune deficiency syndrome-AIDS (PLWHA).

We intended to assess knowledge, attitude, perception, misconception and views (KAP-MV) of family members of PLWHA. A cross-sectional retrospective study conducted in Anti-retroviral centre of Mahatma Gandhi Memorial-MGM hospital, Warangal, Telangana, South-India from July to September 2014. A questionnaire containing 41 items was distributed among adult family members accompanying patients living with HIV/AIDS-PLWHA. Level of KAP-MV was categorized into poor (0-28), average (29-55) and good (56-82). Analysis was performed by Pearson's Chi square, analysis of variance and Spearman's correlation test on 41 variables using SPSS version 21 and p < 0.01. 538 questionnaires were distributed, response rate was (96 %). On knowledge scale, respondents had a mean score of 8.0 ± 1.7, attitude 5.8 ± 3.4, perception 23.4 ± 4.1, misconceptions 8.0 ± 2.1 and views 8.0 ± 3.9. The respondents mean score was 53.2 ± 9.1 (64.9 %). Overall, level of education, marital status, religious beliefs, and employment status has significant (p < 0.001) associations with KAP-MV. Knowledge was significantly correlated with respondents' attitude (r = -0.15, p < 0.001), perception (0.39; p < 0.001), and views (0.381; p < 0.001). Family members of PLWHA with less knowledge score had more negative attitude, perception and views. Level of education, marital status, religious beliefs and employment status were identified as key barriers. Interventions targeting family members of PLWHA are warranted. Practice implications are as follows: Encourage role of family members.Deploy interventions.Minimize barriers.Change misconceptions.

The Value of U/S to Determine Priority for Upper Gastrointestinal Endoscopy in Emergency Room.

In countries endemic for liver and GIT diseases, frequent emergency department (ED) patients contribute to a disproportionate number of visits consuming substantial amount of medical resources. One of the most frequent ED visits is patients who present with hypovolemic shock, abdominal pain, or confusion with or without signs of upper gastrointestinal bleeding (UGIB). The use of conventional two-dimensional ultrasound (2D-U/S) may provide immediate and useful information on the presence of esophageal varices, gastrointestinal tumors, and other GIT abnormalities.The current study investigated the feasibility of using (2D-U/S) to predict the source of UGIB in ED and to determine patients' priority for UGE.Between February 2003 and March 2013, we retrospectively reviewed the profiles of 38,551 Egyptian patients, aged 2 to 75 years old, who presented with a history of GI/liver diseases and no alcohol consumption. We assessed the value of 2D-U/S technology in predicting the source of UGIB.Of 38,551 patients presenting to ED, 900 patients (2.3%), 534 male (59.3%) and 366 female (40.7%) developed UGIB. Analyzing results obtained from U/S examinations by data mining for emergent UGE were patients with liver cirrhosis (LC), splenomegaly, and ascites (42.6% incidence of UGIB), followed by LC and splenomegaly (14.6%), LC only (9.4%), and was only 0.5% who had no morbidity finding by 2D-U/S.Ultrasonographic instrumentation increases the feasibility of predictive emergency medicine. The area has recently not only gained a fresh impulse, but also a new set of complex problems that needs to be addressed in the emergency medicine setting according to each priority.

Pharmacy school journals: a scholarly idea?

Impact of clerkship attachments on students' attitude toward pharmaceutical care in Ethiopia.

The study objective is to investigate the impact of mandatory clinical clerkship courses on 5th-year pharmacy students' attitudes and perceived barriers toward providing pharmaceutical care (PC).

Consistent condom use in HIV/AIDS patients receiving antiretroviral therapy in northwestern Ethiopia: implication to reduce transmission and multiple infections.

Human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) is one of the greatest public health problems of sub-Saharan African countries. Consistent condom use, among others, remains the most effective barrier method against HIV transmission. However, existing reports on frequency of consistent condom use have targeted the general public, rather than HIV/AIDS patients due, to the assumption that condom use is not important in HIV-infected persons. Since consistent condom use among HIV/AIDS patients is vital, to prevent the virus transmission from the infected to noninfected as well as to prevent multiple infections among already infected persons, its frequency and determining factors need to be investigated.