@article {45, title = {Doctors{\textquoteright} Knowledge, Attitude and Objective Adherence with Hypertension Guidelines in Quetta, Pakistan: A Cross-sectional Analytical Study}, journal = {Journal of Pharmacy Practice and Community Medicine}, volume = {6}, year = {2020}, month = {January 2021}, pages = {57-63}, type = {Research Article}, chapter = {57}, abstract = {

Background: There is scarcity of published information about doctors{\textquoteright} knowledge, attitude and adherence with hypertension guidelines from Pakistan. Objectives: To evaluate doctors{\textquoteright} knowledge, attitude and objective adherence with the recommendations of Clinical Practice Guidelines (CPG) developed by American Society of Hypertension/International Society of Hypertension. Methods: This cross-sectional questionnaire-based study included 95 doctors from various health care facilities in Quetta, Baluchistan to evaluate doctors{\textquoteright} knowledge of and attitude towards guidelines. Physicians{\textquoteright} endearment with ASH/ISH (2014) guidelines was evaluated by the prescriptions they wrote to 1900 hypertensive individuals (20 prescriptions of each enrolled doctor). Data was analysed using SPSS 20. Results: 58.9\% doctors had sufficient knowledge of guidelines. Doctors{\textquoteright} with specialization and consultants, doctors of age \>35 years and who were in clinical practice for \>5 years had significantly (p-value\<0.05) greater knowledge and more guidelines adherent practices than their counterparts. There was a significant association between doctors{\textquoteright} knowledge and practice scores. (rs=0.758, p-value \<0.001). Overall, doctors had positive attitudes towards guidelines. A total of 1385 (72.9\%) prescriptions were judged guidelines adherent. In multivariate analysis, guidelines adherence had statistically significant positive association with the presence of any comorbidity (OR=2.804, p-value\<0.001), heart failure (OR=5.101, p-value\<0.001), chronic kidney disease (OR=2.384, p-value\<0.001) and benign prostatic hyperplasia (OR=3.137, p-value=0.009) and negative association with diabetes mellitus (OR=0.265, p-value\<0.001). Conclusion: Only 58.9\% doctors were adequately aware of guidelines recommendations. A fair number of patients (72.9\%) received guidelines adherent prescriptions. Doctors{\textquoteright} poor knowledge of guidelines preferred antihypertensive agents in diabetic hypertensive patients reflected in their practices.

}, keywords = {Diabetes Mellitus, Duration of clinical practice, Guidelines adherence, Hypertension, Pakistan}, doi = {10.5530/jppcm.2020.4.17}, author = {Mirza Khan and Nafees Ahmed and Abdul Wahid and Syed Liaquat Ali Khan and Asad Khan and Zarka Akbar and Palwasha Bibi} } @article {15, title = {Pharmacotherapeutic Consideration of Gastro Esophageal Reflux Disease among Geriatric Type 2 Diabetic Patients}, journal = {Journal of Pharmacy Practice and Community Medicine}, volume = {5}, year = {2019}, month = {December 2019}, pages = {69-74}, type = {Research Article}, chapter = {69}, abstract = {

Background: Gastro-esophageal Reflux disorder is return of the stomach{\textquoteright}s contents back up into the esophagus. Whereas diabetes is a metabolic disorder in which there is either no production of insulin or there is resistance to insulin being produced by body. Objectives: The aim of the systematic review is to study the pharmacotherapeutic consideration of GERD among elderly type 2 diabetes patients. Methods: This study analyzed 15 articles identified and selected according to the study criteria. PRISMA guidelines were used for identification and screening of literature. Data search covered several primary databases, including PubMed/MedLine, Wiley library, Scopus, Clinical Trial Registry, etc. Result and Findings: The data shows obese patients with BMI \> 30kg/m2 with type 2 diabetes have higher chances of GERD. The findings also suggested increase in socioeconomic status shows increase incidence of type 2 diabetes mellitus with time and it also plays vital role to lifestyle modifications such as physical exercise e and dietary habits. The prevalence values of GERD by skipping breakfast, snacking during bedtime, late night eating and eating fast were 32.0\%, 13.7\%, 27.1\%, 28.8\% and 44.4\%, respectively. Late night eating was independently positively associated with GERD in patients with type 2 diabetes; the adjusted odds ratio was 1.46 (95\% CI 1.03 to 2.05). No relationships were found between not eating breakfast, snacking at bedtime or eating fast and GERD. Conclusion: The review findings suggested that patients with type 2 diabetes are at double risk of GERD as the metabolic disorder are making it worst. GERD can be avoided by minimizing the risk of type 2 diabetes either by controlling obesity by bariatric surgery or by exercise and more active lifestyle. There are some important considerations to decrease the incidence of GERD by evaluation and treatment in the older patients.

}, keywords = {Diabetes Mellitus, Diet, Gastroenterology, GERD, Geriatric}, doi = {10.5530/jppcm.2019.4.18}, author = {Mahin Gulzar Ahmed and Syed Wasif Gillani and Issam Haddad and Khawla Mohamad Karim Ahmad and Rukkaya Musa Abdullahi and Fatima Danlami Bello and Nastaran Mohamadi} }