Assessing the Workplace Cyberloafing Behavior among Pharmacists in Pakistan.

Objective: After the commencement of the Internet and the popularity of various electronic devices, cyberloafing has become prevalent in the workplace regardless of professional type, demographic characteristics, and country. Individuals use the Internet for work-irrelevant purposes during work hours, which is believed to have a controversial role in work productivity. However, rare studies have paid attention to the prevalence of cyberloafing behavior among Pakistan pharmacists. Considering pharmacists' essential role in the health sector, this study investigates the prevalence of cyberloafing activities among workplace pharmacists in Pakistan. Methods: This cross-sectional survey was conducted among 242 registered pharmacists in Pakistan between October 2021 and February 2022 with a structured self-administered online questionnaire. The final sample consisted of 200 valid responses after screening. Data were processed through exploratory factor analysis and confirmatory factor analyses. Pearson Chi-square analysis was also used to test the correlation between factors. Findings: Descriptive analysis shows that pharmacists spend more time on sharing-related activities and least on gambling/gaming-related activities in the workplace. All the items' Cronbach's alpha values range from 0.923 to 0.927. The analysis indicates that (60%) pharmacists have intermediate Internet skills. The results also suggest that age, Internet usage, and work area have a strong relationship with cyberloafing behaviors which also, in turn, are linked with their perceived Internet skills. This study has important practical implications for pharmacy management in Pakistan. Conclusion: Cyberloafing behavior is prevalent among Pakistan pharmacists. Our findings could inspire how managers and all other relevant stakeholders could improve the pharmacy system in Pakistan.

Phytochemical and pharmacological profile with biogenetic correlation of bioactive phytoconstituents from the stems of Cordia sinensis Lam.

Present investigation reports first phytochemical profile of Cordia sinensis Lam. stems utilising GC-FID and GC-MS analyses. Moreover, antibacterial, antifungal, phytotoxic and insecticidal potential of stems was also evaluated. Altogether 33 (∼69%) compounds were identified. n-Hexadecanoic acid (15.62-35.55%), methyl hexadecanoate (11.22-29.49%), methyl octadecanoate (4.10-8.66%) and n-octadecanoic acid (4.24-6.64%), present in all the fractions were the major components identified. Overall 4 hydrocarbons, 7 fatty acids, 12 fatty acid esters, 3 phytosterols, 2 terpenes, a terpenoid and 4 aromatics were identified. It is important to note that methanolic mother extract showed moderate phytotoxic activity at higher dose only. However, GC-MS identifications revealed the presence of several phytoconstituents with reported bioactive potential. Moreover, biogenetic correlation of identified phytoconstituents with other parts of plant confirms their natural existence. Newly identified secondary metabolites of C. sinensis stems may also serve as the chemotaxonomic markers and can be correlated with the genus Cordia and Boraginaceae.

GC-MS & preliminary screening profile of Cordia sinensis leaves - antiglycation, antifungal and insecticidal agents.

Crude extracts and fractions of Cordia sinensis leaves were subjected to gas chromatography-flame ionisation detection (GC-FID), gas chromatography-mass spectrometry (GC-MS) analyses and preliminary screening for biological potentials using antibacterial, antifungal, phytotoxic, cytotoxic, insecticidal, antileishmanicidal and antiglycation bioassays. Overall thirty-one phytochemicals including three hydrocarbons, seven fatty acids, fifteen fatty acid esters, three terpenes, one each of phytosterol, terpenoid, and polyunsaturated aldehyde were identified. n-Hexadecanoic acid (13.2%), methyl hexadecanoate (9.0%), octadec-9Z-enoic acid (8.3%) and methyl octadec-9Z,12Z,15Z-trienoate (7.8%) were the main components. Presumably, this is a first report of twenty, thirteen and twenty phytochemicals from C. sinensis, Cordia and Boraginaceae, respectively. Moreover, ethyl acetate fraction exhibited significant insecticidal and antifungal activity against Sitophilus oryzae and Microsporum canis, respectively. Similarly, n-hexane fraction significantly inhibited (77.4%) advanced glycation end products in antiglycation assay. Conclusively, C. sinensis leaves with bioactive metabolites are a potential source for the development of insecticides, fungicides and pharmaceutically active antidiabetic drugs.

Development and validation of the General Rehabilitation Adherence Scale (GRAS) in patients attending physical therapy clinics for musculoskeletal disorders.

BACKGROUND: Non-adherence to physical therapy ranges from 14 to 70%. This could adversely affect physical functioning and requires careful monitoring. Studies that describe designing and validation of adherence measuring scales are scant. There is a growing need to formulate adherence measures for this population. The aim was to develop and validate a novel tool named as the General Rehabilitation Adherence Scale (GRAS) to measure adherence to physical therapy treatment in Pakistani patients attending rehabilitation clinics for musculoskeletal disorders. METHODS: A month-long study was conducted in patients attending physical therapy sessions at clinics in two tertiary care hospitals in Karachi, Pakistan. It was done using block randomization technique. Sample size was calculated based on item-to-respondent ratio of 1:20. The GRAS was developed and validated using content validity, factor analyses, known group validity, and sensitivity analysis. Receiver operator curve analysis was used to determine cut-off value. Reliability and internal consistency were measured using test-retest method. Data was analyzed through IBM SPSS version 23. The study was ethically approved (IRB-NOV:15). RESULTS: A total of 300 responses were gathered. The response rate was 92%. The final version of GRAS contained 8 items and had a content validity index of 0.89. Sampling adequacy was satisfactory, (KMO 0.7, Bartlett's test p-value< 0.01). Exploratory factor analysis revealed a 3-factor model that was fixed and confirmed at a 2-factor model. Incremental fit indices, i.e., normed fit index, comparative fit index and Tucker Lewis index, were reported > 0.95 while absolute fit index of root mean square of error of approximation was < 0.03. These values indicated a good model fit. The value for Cronbach (α) was 0.63 while it was 0.77 for McDonald's (ω), i.e., acceptable. Test-retest reliability coefficient was 0.88, p < 0.01. Education level was observed to affect adherence (p < 0.01). A cut-off value of 12 was identified. The sensitivity and accuracy of the scale was 95%, and its specificity was 91%. CONCLUSION: The scale was validated in this study with satisfactory results. The availability of this tool would enhance monitoring for adherence as well as help clinicians and therapists address potential areas that may act as determinants of non-adherence.

Development and validation of a novel rheumatoid arthritis knowledge assessment scale in Pakistani patients with rheumatoid arthritis.

AIM: Rheumatoid arthritis (RA) is a chronic progressive disabling disease that mainly affects joints. Studies documenting Pakistani patients' knowledge regarding RA disease are lacking and there is a need for such endeavor. The purpose of this study was to develop and validate a novel research tool to document patient knowledge about RA disease. METHODS: A novel research instrument known as the rheumatoid arthritis knowledge assessment scale (RAKAS) which consisted of 13 items, was formulated by a rheumatology panel and used for this study. This study was conducted in rheumatology clinics of three tertiary care hospitals in Karachi, Pakistan. The study was conducted in March-April 2018. Patients were recruited using a randomized computer-generated list of appointments. Sample size was calculated based on item-to-respondent ratio of 1:15. The validities, factor structure, sensitivity, reliability and internal consistency of RAKAS were assessed. The study was approved by the institutional Ethics Committee. RESULTS: A total of 263 patients responded to the study. Content validity was 0.93 and response rate was 89.6%. Factor analysis revealed a 3-factor structure. Fit indices, namely normed fit index (NFI), Tucker Lewis index (TLI), comparative fit index (CFI) and root mean square of error approximation (RMSEA) were calculated with satisfactory results, that is, NFI, TLI and CFI > 0.9, and RMSEA < 0.06. Internal consistency (α) was 0.62, that is, acceptable. All items had a high discrimination index, that is, >19 and difficulty index <0.95. Sensitivity and specificity of RAKAS were above 90%. The tool established construct and known group validities. CONCLUSION: A novel tool to document disease knowledge in patients with RA was formulated and validated.

Translation and validation of the English version of the general medication adherence scale (GMAS) in patients with chronic illnesses.

Objective: This study aimed to translate the General Medication Adherence Scale (GMAS) into English language and validate it in patients suffering from chronic illnesses. Methods: A 1-month study (January 2018) was conducted in a random sample of patients suffering from chronic illnesses who visited the outpatient departments of four tertiary healthcare facilities in Karachi, Pakistan. Translation of the tool and its content, as well as face validity, was carried out. Factor structure was explored (i.e. exploratory and partial confirmatory factor analyses were carried out) and fit indices were calculated for model fitting. Test-re-test reliability and internal consistency were analyzed. Validity of GMAS-English was established by convergent, discriminant, and concurrent validity analysis. Sensitivity analysis was conducted. Data was analyzed through SPSS version 23. The study was ethically approved by concerned authorities (Letter# NOV:15). Results: The GMAS was translated into English language by standard procedure. Factor analysis indicated a 3-factor model. Fit indices, namely normed fit index, Tucker Lewis index, comparative fit index, and root mean square of error approximation, were calculated with satisfactory results (i.e. NFI, TLI, and CFI > 0.9 and RMSEA < 0.08). Internal consistency (α) was 0.82. A high response rate of 91.6% was reported. GMAS-English established convergent, discriminant, and concurrent validities. The tool was sensitive (>75%) in screening patients with partial-to-low adherence based on their education level. Conclusion: The tool was translated in English language and demonstrated adequate internal consistency. The results indicate that GMAS-English is a valid and reliable tool to measure medication adherence in patients with chronic illness.

A qualitative study investigating perceived barriers to medication adherence in chronic illness patients of Karachi, Pakistan.

OBJECTIVE: The study aimed to perceived barriers to medication adherence in patients with chronic illnesses.. METHODS: A qualitative study was conducted in a tertiary care hospital in Karachi in September 2017, using grounded theory and inductive approach. Interviews were conducted using a checklist in Urdu language from patients of chronic illnesses determined based on medicines dispensed from the out-patient pharmacy in hospital. Interviews were recorded, transcribed verbatim, translated in English and validated. The translated quotations were analysed using a qualitative analysis software, and thematic analysis was conducted. Codes were generated and analysed by semantic linkages and network analysis using ATLAS.ti qualitative research software. RESULTS: Of the 16 patients interviewed, 8(50%) were males and 8(50%) were females. Barriers to medication adherence identified were patient behaviour (intentional and un-intentional non-adherence), comorbidity and pill burden, cost-related non-adherence, and low patient knowledge. The last barrier was associated with the rest. CONCLUSIONS: Counselling has the potential to increase patient knowledge regarding medication use, and active pharmacist-physician collaboration can improve medication adherence..

Dietary Supplement Use Among Students of Pharmacy Colleges in the City of Karachi, Pakistan: Prevalence, Opinions, and Attitudes.

This study was conducted among pharmacy students in Karachi, Pakistan, to document prevalence, opinions and their attitudes toward dietary supplement (DS) use. A cross-sectional study was conducted for a period of four months. The study used a specially formulated dietary supplement questionnaire (DSQ). The prevalence of DS use was reported at 48.2%: 51% in males and 47.3% in females. Physician recommendation was cited by majority of students as reason for DS use (n = 153, 25%). Most of the students used multivitamins (n = 315, 51.5%). The average monthly cost attributed to DS use was reported at PKR 1,396.3 (USD 13.55). For every year increase in age, DS use in students decreased (OR = 0.917). Male students were more likely to recommend DS use (OR = 1.425). The most noteworthy finding was the cautious approach of students as the majority reported DS use only upon recommendation of a physician.

GC-MS profile of antimicrobial and antioxidant fractions from Cordia rothii roots.

CONTEXT: An ethnobotanical survey of Cordia rothii Roem. & Schult. (Boraginaceae) reveals it as a medicinal plant. OBJECTIVE: Antimicrobial and antioxidant potential evaluation and identification of chemical constituents via GC-MS of C. rothii roots fractions. To the best of our knowledge, this is the first systematic investigation of the roots exploiting GC-MS. MATERIALS AND METHODS: Extraction and fractionation of C. rothii roots furnished various fractions using solvents of varying polarity, i.e., n-hexane, chloroform, ethyl acetate, acetone and methanol. In vitro antimicrobial and antioxidant screening was performed using disk diffusion and DPPH methods, respectively. MIC of active fractions was also determined using disk diffusion method. GC-MS was used to identify constituents which may be responsible for these activities. RESULTS: Among various fractions from C. rothii roots, fraction KA-C showed strong antibacterial activity against 17 microorganisms tested, with MIC ranging from 250-31.25 µg/mL. Fractions KA-A, KM and KM-A exhibited significant antioxidant potential with EC50 46.875 µg/mL, while fractions KEA-PE, KM-PE and KM-M were good with EC50 93.750 µg/mL. Forty-five phytochemicals were identified in GC-MS studies including eight hydrocarbons, six free fatty acids, 11 fatty acids esters, two phenylpropanoids, four aromatics, four terpenoid quinones/hydroquinones, three triterpenes, four phytosterols, two hexose metabolites and a DNA base. Of these, 32 constituents have been reported for the first time from C. rothii, 24 from genus Cordia and 15 from Boraginaceae. DISCUSSION AND CONCLUSION: Strong antibacterial and antioxidant potential of C. rothii roots may be due to the contribution of phytoconstituents identified through GC-MS studies.

Chemical analysis and calcium channel blocking activity of the essential oil of Perovskia abrotanoides.

The aim of this study was to investigate the chemical composition and provide a pharmacological base for the medicinal use of the essential oil of Perovskia abrotanoides (Pa.Oil) in gastrointestinal disorders, such as colic. The chemical investigation resulted in the identification of 26 compounds, of which tricyclene, beta-trans-ocimene, terpinene-4-acetate, terpinen-4-ol, caran-3beta-ol, linalyl acetate, beta-caryophyllene oxide and alpha-elemene had not previously been reported from P. abrotanoides. Major constituents were 1,8-cineol and delta-3-carene, which constituting 50% of the oil. In the isolated rabbit jejunum preparation Pa.Oil caused inhibition of spontaneous and high K+ (80 mM)-induced contractions, with respective EC50 values of 0.13 (0.08-0.20; n = 4) and 0.90 mg/mL (0.50-1.60; n = 5), thus showing that spasmolytic activity is mediated possibly through calcium channel blockade (CCB). The CCB activity was confirmed when pre-treatment of the tissue with Pa.Oil (0.03-0.1 mg/mL) caused a rightward shift in the Ca++ concentration-response curves, similar to that caused by verapamil, a standard calcium channel blocker. These data indicate that the essential oil of P. abrotanoides possesses spasmolytic activity mediated possibly through inhibition of voltage-dependent calcium channels, which may explain its medicinal use in colic and possibly diarrhea.

Chemical and antimicrobial studies on the essential oil from Salvia santolinifolia Boiss.

In view of the reputation of genus Salvia in folklore medicine and its abundance in our region, the chemical composition and antimicrobial activity of essential oil from S. santolinifolia Boiss. was analyzed. Chemical analysis, using gas chromatography and gas chromatography mass spectrometry, retention indices and C-13 nuclear magnetic resonance spectroscopy has resulted in identification of 116 constituents, comprising about 97% of the total constituents. Out of these 116, 78 constituents are hitherto unreported from this source. The species belongs to α-pinene chemotype. In antibacterial assay, gram negative gastropathogens (Shigella boydii, S. flexneri, S. dysenteriae, Vibrio cholerae); causative agent of urinary tract infection (Proteus mirabilis and P. vulgaris) and pneumonia (Klebsiella pneumoniae) were found sensitive to this essential oil while Corynebacteria species and Staphylococcus epidermidis were significantly inhibited in antibacterial assay against gram positive bacteria. Clinical and Laboratory Standards Institute protocol was used for determining antimicrobial activity. Thus the essential oil from this species can be utilized as potential chemotherapeutic agent.