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Purpose Smartphones are the most popular and intriguing technological gadgets that have changed the face of communication and laid an irreversible impact on psychosocial behavior of consumers. A large number of undergraduate nursing students own smartphones and use it effectively for means of communication and acquiring information. Objective This study was designed to evaluate the practice of smartphone use in undergraduate nursing students for educational purposes. Method A cross-sectional survey was conducted in college of nursing (N = 135) in King Saud bin Abdul Aziz University for Health Sciences following IRB approval using a self administered questionnaire, piloted and pre-tested in 30 participants. Results The study showed that 94.8% students carry their phones consciously at all times whereas 92.6% check their phones as soon as they arise in the morning. A large number of students (77.8%) reported that they document information on their smartphones in the class whereas 24.4% always use them in clinical settings. The most prevalent use of smartphones was to access information on the website (93.3%) which was more frequently reported in group study compared to individual study. A large number of students reported that they participate in WhatsApp study group (89.6%). Accessing social media platforms for academic reasons was reported by 85.2% respondents. Conclusion Undergraduate nursing students rely heavily on their smartphones for acquiring information and communication. They bear tendency of smartphone addiction and appear to be potential recipients for active learning techniques that may fit their educational needs.

Unified platform is guaranteed to collective efforts for mutual cooperation and prosperity. The mutual cooperation and collaboration bring stability and development among member countries. Internally, Muslim world is suffering under bad governance, corruption, malpractices, poverty, backwardness, ignorance, social injustices, unemployment, inequality, immoral values. The other are extremisms, terrorism, regional and territorial conflicts are with its full swing in most of the countries of the Islamic world. While, externally the western aggression, Islamophobia and anti-Islamist propaganda, Kashmir, Palestine and misbehave with Muslim minorities by the host countries are another challenges. Some other factors which increase distrust among them are internal sectarian and territorial rivalry, for example, both Iran and Saudi-Arabia have aggressive policy against each other as well as some materialistic and self-governing minded leadership have soft corner towards India, western countries as well as United States (US). Role of Organization of Islamic cooperation OIC in enhancing cooperation among Muslim countries is the dire need of current world by resolving their internal disputes, maintaining global peace and collective security.

Context: Nursing interns are expected to practice safe medication administration. Pharmacology courses in their undergraduate education prepare them for safe medication administration. Most interns are challenged by the practical implementation of theoretical concepts in pharmacology. Aims: The purpose of this study was to describe the experiences of nursing interns with the application of medication knowledge and skills in clinical practice settings. Settings and Design: A qualitative descriptive design was used in health science university in Saudi Arabia. Subjects and Methods: face-to-face in-depth interviews with nursing interns recruited through purposeful sampling in a health science university in Saudi Arabia. Data were collected from December 2019 to January 2020 following Institutional Review Board approval. Statistical Analysis Used: Graneheim inductive approach was used for the content analysis of the data. Standard principles of trustworthiness were applied. Results: Two major themes emerged as “perceived readiness” and “bracing attributes.” There were two subthemes within each theme, which were populated by 13–23 statements. Conclusions: Nursing interns described certain challenges with the application of knowledge and skills in medication administration. Self-perceived lack of knowledge underlined description of most experiences. Learning acquired with case studies, classroom interactions, clinical exposure, and simulation, in undergraduate education was acknowledged in the context of retention of knowledge.

Background and Objective: A large number of university teachers in Saudi Arabia comprise of expatriates. Their experiences are unique in context of the challenges and benefits of academic expatriation. The purpose of this study was to describe the experiences of expatriate university teachers in Saudi Arabia. Methods: A qualitative descriptive design was used based on in-depth interviews with academic expatriates, recruited through snowball sampling in a Health Science University in Saudi Arabia. The study was conducted from 12 September 2019 to 20 October 2019 after IRB approval. Graneheimian inductive approach was used for content analysis of the data. Standard principles of trustworthiness were applied. Results: Three major themes emerged as ‘conscious venture’, ‘spirit at work’ and ‘coping strategies’. Each theme had 2-3 subthemes, populated by 14-23 statements. Conclusion: Expatriate faculty members described antecedents for their motivations at work. They shared their experiences regarding job adjustments, work environment and professional commitment. doi: https://doi.org/10.12669/pjms.36.4.1896 How to cite this:Asif U, Bano N, Al-Najjar H. Experiences of expatriate university teachers in a health science university in Saudi Arabia-A Qualitative study. Pak J Med Sci. 2020;36(4):799-803. doi: https://doi.org/10.12669/pjms.36.4.1896 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background The term ‘predatory journals’ initially appeared in PubMed in 2012 and was coined by Professor Jeffrey Beall in a note published in the Nature Journal. It is used to denote fake journals with questionable peer review, fast track publishing processes against monetary payment and a predatory approach to target researchers through spam email. Purpose This study aimed to explore the experiences of nursing faculty concerning publication in predatory journals. Methods A simple qualitative design was used. The setting included a college of nursing in Jeddah Saudi Arabia. A purposive sampling technique, with eight faculty members, were included in the study. In-depth interviews were conducted, audio-recorded and analyzed using a simple content analysis approach. Results Three themes emerged with nine subthemes namely: i) research professional obligations; publishing pressure, research competitiveness, professional enhancement and promotion; ii) fast publications; escaping peer review, paying for quick service; iii) after-effects; emotional turmoil; characteristics of predatory journals. Conclusion This study showed that publishing in a predatory journal has serious consequences, both professional and personal. The findings also highlighted that anyone in the academic setting could fall prey to these journals. Lastly, despite the increasing knowledge of predatory publishing, there is still a lack of awareness about this dark side of publications. Hence, educational awareness of predatory journals is needed. It is also recommended that research, including other disciplines, be completed.

The hepatoprotective effects of Boerhaavia diffusa was studied against the hepatotoxicity induced by oxaliplatin. Male Wistar rats were divided in three groups.Group N* control group (0.9% normal saline), Group NP0 oxaliplatin treated group and Group NP2 were prophylactically treated with Boerhaavia diffusa and then with oxaliplatin in order to assess the protective effects of Boerhaavia diffusa against the toxicity of oxaliplatin. The levels of liver enzymes ALT, AST and γ-GT were significantly reduced in the group prophylactically treated with Boerhaavia diffusa (NP2) compared with the group treated with oxaliplatin (NP0). Boerhaavia diffusa was effective in reducing risk of hypercholestremia associated with oxaliplatin. Histopathological examination of rat liver revealed that prophylactically treated group with Boerhaavia diffusa was effective in reducing oxidative stress induced steatohepatitis by oxaliplatin.

Objectives: Oxaliplatin causes hematological toxicities in clinical setting whichlimits its efficacy. The aim of this study is to investigate the therapeutic effects of Andrographispaniculata against hematological toxicity caused by oxaliplatin. Study design: Experimentalanimal study. Period: Study takes 8 month from March 2015 to Oct 2015. Setting: Dow universityanimal house. Method: Wistar albino male rats, divided into 3 equals groups (n=6): GroupN* was a control group (0.9% normal saline), Group NP0 was Oxaliplatin treated group andGroup NP1 was prophylactically treated with Andrographis paniculata followed by Oxaliplatinin order to assess the protective effects of Andrographis paniculata against the hematologictoxicity caused by Oxaliplatin. Results: Prophylactic treatment with Andrographis paniculata(NP1) significantly increases the levels of platelets and neutrophile count compared with thestandard (NP0) (p

Background: Nomophobia is described as the fear of losing contact with mobile phones. It is widely reported in nursing students who may also experience depression, anxiety, and stress. Little is known about the relationship of nomophobia with depression, anxiety, and stress. Objectives: This study was designed to (a) assess nomophobia in nursing students and to (b) evaluate the impact of depression, anxiety, and stress on nomophobia in nursing students. Material and Methods: The study was carried out in College of Nursing, Jeddah, Saudi Arabia. Study sample (n = 311) comprised students enrolled in all levels of bachelor of science in Nursing degree. A self-administered survey was conducted using the Nomophobia Questionnaire tool for nomophobia and DASS-21 for depression, anxiety, and stress. Results: Undergraduate nursing students were presented with mild (12.9%), moderate (46.9%), and severe (40.2%) nomophobia. The highest mean score yielded for nomophobia Factor 1 – not being able to communicate (4.74 ± 1.77), whereas the lowest score was noted for nomophobia Factor 2 – losing connectedness (4.07 ± 1.96). A significant positive correlation was noted between depression and Factor 4 – giving up convenience of nomophobia (r = 0.11, P

This retrospective study reports impact of diabetes on incidence rate of dose limiting symptoms of neurological toxicity and chemotherapy induced peripheral neuropathy (CIPN). Post-surgical colorectal cancer (CRC) patients with metastatic disease, treated with four different schedules of FOLFOX were included in this study. Neurological adverse effects were assessed by CTC v2.0. The incidence rate of adverse neurological symptoms in CRC patients, clinically diagnosed with diabetes (n=6) were compared with non-diabetic CRC patients (n=32). The results show that the difference in the incidence rate of paresthesia is significant (p=0.043) between diabetic and non-diabetic patients. The difference in the incidence rates of hypoesthesia (p=0.445), peripheral neuropathy (p=0.889), dizziness (p=0.445), insomnia (p=0.690), taste disturbances (p=0.258), and headache (p=0.498) in diabetic and non-diabetic CRC patients was not significant. The findings indicate that risk of frequent, distal and transient paresthesia within the first few minutes of Oxaliplatin infusion is higher in diabetic CRC patients.

Kidney cells damage and subsequent renal adverse effects with oxaliplatin are less reported phenomena, whereas cisplatin (CDDP, first generation platinum compound) has therapeutic limitations due to renal toxicity. This experimental study reports oxaliplatin (third generation platinum compound) induced direct damage in rat kidney tissues and alterations in renal biochemical profile. Oxaliplatin was administered in albino wistar rats with 5-FU (5 Fluorouracil) to mimic as model of FOLFOX, the mainstay chemotherapeutic regimen in colorectal cancer (CRC). This study reports changes in renal biochemical profile (serum creatinine and urea) in rats treated in different treatment groups with cisplatin, oxaliplatin, 5-FU, cisplatin+5-FU and oxaliplatin+5-FU which are compared with group of rats treated with normal saline (control group). Subjective renal toxicity in tissues was compared among rats treated with oxaliplatin alone and cisplatin, with and without 5-FU by light microscopy. Cast formation, medial hypertrophy of the vessel wall, vacuolization and necrosis was seen in kidney tissues of oxaliplatin treated rat. Changes in serum creatinine well-above diagnostic risk levels were noted. Apparent tubular degenerative sequence associated with vacuolization and cast formation was observed in 5-FU treated rats. Kidney damage ensued after treatment with 5-FU and oxaliplatin are slightly comparable to massive tubular damages, hemorrhage, casts and vacuolization along with multiple foci of alterations induced by cisplatin.

The aim of this study was to determine the effect of multimedia used as a teaching tool, to compare the effect of two different instructional methods on students’ academic achievements and Pakistani Pharmacy student’s perceptions of methods of lecture delivery. A self-constructed, prevalidated questionnaire with close and open ended items was administered on the Pharmacy students of three different institutes of Karachi, Pakistan (January 2012 to June 2012). Students were enrolled following informed consent and knowledge of the purpose of the study. Traditional method was the dominant lecture delivery method among Pharmacy students. They preferred power point presentations as compare to traditional method, but the difference was not significant. However, they welcomed the opportunity to have more interactive sections during lectures. Comparative effectiveness of multimedia instructional method to traditional methods on student’s academic achievements was equal. Overall no difference attitude towards multimedia based lectures was observed among pharmacy students. In the present form of the e-learning program interactive space for students is not fully developed. To improve the overall learning experience of the students, constant source of electricity/power, teaching aids/equipment, a good environment for learning should be provided and lecturers should be trained in the use of modern teaching aids and technology.

Objective: The study was designed to assess the skin and subcutaneous toxicity in patients with advanced colorectal carcinoma treated with four different schedules of FOLFOX. Methods: The patients with histologically confirmed advanced colorectal carcinoma (CRC) were included in the study as per specified inclusion criteria. Toxicity was graded according to CTC v2.0. The frequency of grade 3 and 4 adverse effects were comparatively assessed in each treatment arm. Results: Very severe toxicity was attributed to the FOLFOX7 schedule. The difference between the incidence rate of grade 4 toxicity with all other grades for all parameters of skin and subcutaneous toxicity was highly significant (p=0.00

Oxaliplatin, a third generation novel platinum compound is the most effective first line chemotherapeutic agent for colorectal cancer (CRC) in combination with 5FU and leucovorin. It is indicated for pancreatic, gastric and testicular cancers combined with bevacuzimab, capecitabine, irinotecan and other cytotoxic agents. However, moderate to severe hypersensitivity reactions (HSR) during or after oxaliplatin infusion usually require cessation of chemotherapy or substitution of the key therapeutic drug which largely interferes with improved patient prognosis. This mini- review showcases recent and accepted opinions/approaches in oxaliplatin induced HSR management. Physicians and oncologists have varying attitudes regarding the decision to rechallenge the patient after an HSR experience, efficacy of desensitization protocols, effectiveness and selection of drugs for premedication and possibilities of cross sensitivity to other platinum agents (e.g. carboplatin). A brief insight into underlying molecular mechanisms and clinical manifestations of oxaliplatin induced HSR is offered. We have also discussed the management of oxaliplatin induced HSR and risk stratification for a successful and complete chemotherapeutic plan.

Background: Pharmacology is perceived as a difficult course by nursing students who find it difficult to retain drug names and complex pharmacokinetic and pharmacodynamics processes. Team-based learning is a student-centered instructional design associated with improved academic outcomes. Purpose: To explore experiences of postgraduate nursing students with team-based learning in clinical pharmacology course. Methods: A descriptive qualitative design comprising of in-depth interviews was used. Study sample comprised of post graduate midwifery nursing students enrolled in clinical pharmacology course conducted with team-based learning. Content analysis following Graneheimian inductive approach was used to yield themes and subthemes. Results: Two themes emerged as 'Learning environment' and 'Intellectual process', comprising of 3-4 subthemes. Students absorbed concepts in a relaxed yet challenging environment. Intellectual process showcased improvements in knowledge retention, grasping concepts, confidence and thinking. Conclusion: Postgraduate midwifery nursing students had positive learning experiences in clinical pharmacology course conducted with team-based learning.

Emerging resistance against broad-spectrum antibiotics for standard empiric therapy is a global concern. Ceftriaxone (broad spectrum, third generation cephalosporin) is widely used in tertiary care settings to treat severe bacterial infections usually non-responsive to other antibiotics. The aim of the study is to evaluate the current sensitivity pattern of ceftriaxone (30μg/disk) among different clinical isolates. For this purpose, three hundred clinical isolates including Escherichia coli (25%), Staphylococcus aureus (30%), Salmonella typhi (17%) and Klebsiella pneumoniae(20%) were collected from different pathological laboratories of Karachi, Pakistan. The in-vitro sensitivity of different Gram positive and Gram-negative bacteria was determined by disk-diffusion technique using 0.5 McFarland standard. Results showed that ceftriaxone was highly sensitive against Escherichia coli (90%) and least sensitive against Klebsiella pneumoniae (65%). It is concluded that the sensitivity of ceftriaxone is progressively decreasing in comparison with past studies creating an alarming situation. Therefore, continuous surveillance is required to determine the current resistance status of clinical pathogens and for effective anti-microbial therapy.

Adverse drug reactions (ADRs) are the undesirable effects of drugs even when administered in daily normal doses. It has been seen that ADRs may arise even after single administration of drug(s), however, long term therapies are more prone to ADRs. Currently it has become a burning issue all around the world and connected with financial expansion owing to hospitalization. Pharmacists are the custodians of drugs especially clinical pharmacists play a vital role in preventing the risks of ADRs. This review deals with the factors leading to possible ADRs, its prevention and the role of pharmacist in management of ADRs.

Background: There are different types of medication errors which are experienced by the pharmacists in hospital settings.In Pakistan number of attending Pharmacist per bed is low and is a major cause of fatal and life threatening events. Aim: The aim of present retrospective study was to assess the extent and type of medication error in inpatient medical charts. Method: The physician’s orders were analyzed by the clinical pharmacists in hospital setting during 2007- 2008 in different wards. Various types of prescription errors had been reported and expressed in percentages. Result:Out of 450 medical treatment charts, 381 medication errors were found in 350 charts. The highest rate of error was the wrong dose (25%) prescribed by physicians.Infrequent errors were lack of dosage frequency, protocol for treatment, dosage form and continuation of antibiotic after prescribed treatment days. However, most frequently occurring serious errors were wrong dosing frequency (17%) and no dose adjustment according to creatinine clearance (12.8%).3.41% errors were related to directions for use of medicines. Conclusion:Our study has demonstrated large number of prescription errors and high proportion of themwere of serious nature therefore careful counter checking of medical charts is suggested.

Background: To assess the frequency and severity of gastrointestinal adverse effects in advanced colorectal carcinoma patients treated with four different schedules of FOLFOX. Materials and Methods: Patients (median age 61 years) who underwent surgery were included in the study. All had measureable disease at CT scan, ultrasonography or clinical examination. Toxicity was graded on a scale of 1-5 according to the general grade definition of CTC v2.0. The severity of adverse effects (Grade 3 and 4) assessed in each treatment arm was compared. Results: Differences between the incidence rates of 3 and 4 toxicity and all grades of toxicity for all parameters in GI toxicity were very highly significant (p

The purpose of the study is evaluation and assessment of parameters of cardiac toxicity in patients subjected to 5-FU based chemotherapy. Cardiac morbidity is a reported outcome in different 5FU/LV regimens; however none of them are definite or proximate. The bimonthly regimen of high dose leucovorin is reported to be less toxic and more effective as compared to the monthly regimen of low dose leucovorin. We report the detailed assessment of few cardiac parameter of toxicity in patients of advanced colorectal carcinoma subjected to two Schedules of high and low dose Folinic Acid, 5-Fluorouracil, bolus and continuous infusion. The correlation of elevated cardiac biomarkers, angina and hypertension is comparatively assessed in patients with normal general status, hyperglycemia and known cardiac disorders subjected to two different 5FU based chemotherapeutic regimen.

The study is designed to assess the frequency and severity of few dose limiting neurological adverse effects of four different schedules of FOLFOX. Patients with histologically confirmed advanced colorectal carcinoma (CRC) were included in the study. Toxicity was graded according to CTC v 2.0. The frequency of grade 3 and 4 adverse effects was comparatively assessed in each treatment arm. The difference in the pattern of toxicity between the treatment schedule was evaluated. The most frequent adverse symptom of neurological adverse effect was grade 1 paresthesia in the patients treated with FOLFOX4 schedule. Grade 4 peripheral neuropathy was reported in few patients of FOLFOX7 treatment arm. Frequency and onset of neurological adverse effects like paresthesia, dizziness, and hypoesthesia were significantly different (), whereas frequency and onset of peripheral neuropathy were highly significant () in each treatment arm of FOLFOX. Peripheral neuropathy was associated with electrolyte imbalance and diabetes in few patients. Frequency of symptoms, for example, paresthesia, is associated with increased number of recurrent exposure to oxaliplatin (increased number of cycles) even at low doses (85 mg/m2), whereas severity of symptoms, for example, peripheral neuropathy, is associated with higher dose (130 mg/m2) after few treatment cycles.

Objective: Evaluation and assessment of response rate, duration and toxicity in patients subjected to 5-FU based chemotherapy. Background: The therapeutic ratio shifts with different 5FU/LV regimens and none yet serve as the internationally accepted Gold Standard . A bimonthly regimen of high dose leucovorin is reported to be less toxic and more effective than monthly low dose regimens. We here compare therapeutic responses and survival benefit of the two regimens in poor prognosis patients with advanced colorectal carcinoma. Patients and Methods: A total of 35 patients with histologically confirmed colorectal carcinoma were subjected to de Gramont and Mayo Clinic regimen. Nineteen patients were treated with high dose folinic acid (200 mg/m 2 ), glucose 5%, 5-FU (400 mg/m 2 ) and 22 hr. CIV (600 mg/m 2 ) for two consecutive days every two weeks. These patients had failed responses to previous chemotherapy and were above sixty years of age with poor general status. Sixteen patients (six below 60 years) with progressive disease were subjected to low dose folinic acid (20 mg/m 2 )for five days, 5FU(425 mg/m 2 ) injection bolus for 5 days, every five weeks. An initial evaluation was made in sixty days and responders were reevaluated at sixty days interval or earlier in case of clinical impairment. Based on positive prognosis, the therapy was continued. Evaluation of treatment response was made on the basis of WHO criteria. Results: The response rate was 44% in thirty four evaluable patients, with 4 complete responses (11.8%) and 11 (32.4%) partial responses. The two schedules were well tolerated, whereas, mild toxicity without WHO Grade ≥2 events was assessed. The response duration was extended (12 months) in a few patients with age above sixty years treated by high dose bimonthly regimen of 5FU/LV. Conclusion: The regimens are safe and effective in advanced colorectal carcinoma patients with poor general status.