Objective: This study aimed to develop and validate a self-reporting adherence tool termed as General Medication Adherence Scale (GMAS) in Urdu language for measuring adherence toward medication use among Pakistani patients with a chronic disease. Methods: A month-long study (December 2017) was conducted in three tertiary health care settings of Karachi, Pakistan. The tool underwent content and face validity as well as factor analyses, i.e., exploratory, partial confirmatory and confirmatory factor analyses. Random sampling was conducted, and sample size was calculated using item response theory. The item-to-respondent ratio was 1:15. Fit indices namely normed fit index (NFI), Tucker Lewis index (TLI), comparative fit index (CFI), goodness of fit index (GFI), absolute goodness of fit (AGFI), parsimony goodness of fit index (PGFI), root mean square error of approximation (RMSEA), and standard root mean square residual (SRMR) were calculated. Additionally, estimation of the convergent, discriminant and known group validities, was conducted. Internal consistency was analyzed by test-retest reliability, McDonald’s and Pearson correlation coefficient. The factor analyses were conducted using IBM SPSS version 22 and IBM SPSS AMOS version 25. Results: Content validity index (CVI) was reported at 0.8 (SD 0.147) and the tool was content validated with three hypothetical constructs. Factor analyses highlighted a 3-factor structure. The fit indices were calculated with satisfactory results, i.e., PGFI, GFI, AGFI, NFI, TLI, and CFI were greater than 0.9 and PGFI > 0.5. The values of RMSEA and SRMR were less than 0.07. A Cronbach’s alpha value of 0.84 was obtained in reliability analysis. The test-retest Pearson’s correlation coefficient value was reported at 0.996 (p-value < 0.01). Convergent and discriminant validities for all constructs and, known group validity for two constructs, were established. A high response rate of 91% was achieved in respondents. Patients without insurance coverage appeared to be low adherent compared to those with insurance coverage (p-value < 0.05). Non-comorbid patients were more likely to be highly adherent as compared to comorbid patients (p-value < 0.01). Conclusion: A novel tool GMAS was developed in Urdu language and was subsequently validated in patients with chronic diseases.

This review article underlines individual Traditional Islamic and Arabic plant (TAI) and their role in treating cancer. The aim of the study is to specifically evaluate the progress of herbs, Arabic and Islamic traditional herbs in particular, applied in cancer treatment, so far. Islamic and Arabic plants were selected and identified through different literature survey using "Google scholar", "Web of science", "Scopus" and "PubMed". Each plant, from identified Arabic and Islamic plants list, was search individually for the most cited articles in the aforementioned databases using the keywords, "Anticancer", "Uses in cancer treatment", "Ethno pharmacological importance in cancer" etc. The current review about Islamic and Arabic plants illuminates the importance of Islamic and Arabic plants and their impact in treating cancer. There is a long list of Islamic and Arabic plants used in cancer as mentioned in review with enormous amount of literature. Each plant has been investigated for its anticancer potential. The literature survey as mentioned in table shows; these plants are widely utilized in cancer as a whole, a part thereof or in the form of isolated chemical constituent. This review strongly supports the fact; Arabic and Islamic traditional plants have emerged as a good source of complementary and alternative medicine in treating cancer. Traditional Arab-Islamic herbal-based medicines might be promising for new cancer therapeutics with low toxicity and minimal side effects. The plants used are mostly in crude form and still needs advance research for the isolation of phytochemicals and establishing its cellular and molecular role in treating cancer.

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.

Objective: Medication adherence is defined as taking medications as advised and prescribed by health care professionals for stated duration. Diabetes mellitus (DM) is one of the most common chronic illnesses in Saudi Arabia. This study aimed to document medication adherence in Saudi patients with type 2 diabetes. Methods: A quantitative cross-sectional study was conducted in Saudi out-patients with type 2 DM in the city of Khobar, Saudi Arabia. The study used the General Medication Adherence Scale (GMAS) to document medication adherence in this population. Data was analyzed through SPSS version 23. Study was ethically approved. Results: Data was collected from 212 patients. Few patients (35.8%) had high adherence to anti diabetic medications. The correlation between Hb_A1c level and adherence score was negative and significantly strong (ρ = -0.413, p < 0.0001). Most patients (N = 126, 59.4%) modified their medication therapy during month of Ramadan and on Eid occassion. Education level was not a determinant of adherence in this population. Conclusion: This study highlighted that medication adherence is influenced by religious and social factors. Patient counseling is required to improve patient beliefs and increase awareness of adhering to prescribed anti diabetic pharmacotherapy. A pharmacist can play constructive role of a disease educator and patient counselor.

Ey was conducted in the university. The survey included the English version of 10-item Perceived Stress Scale (PSS) to report self-perceived stress. Student responses were analyzed by SPSS version 22 software. Results: The majority of students (85%) perceived examinations as a stressor. Most of the students (64%) had perceived moderate stress that increased as students progressed from preparatory year to 4th year. It declined in students of 5th and 6th year. The prevalence of stress related was reported at 39.58%. Highest prevalence of stress-induced self-medication was reported from College of Nursing (59.09%) and lowest (29.69%) from clinical pharmacy. Most common drug used to self-medicate during stress was caffeine (49.5%). The PSS score was significantly associated with colleges and study levels. Conclusion: Students studying in health cluster colleges reported high academic stress and self-medication practice. The major stressors identified were examination and course load. Student counseling sessions and counseling by pharmacists regarding self-care may help in the reduction of such stressors and may promote responsible self-medication. Self-evaluation and quality assurance process of curriculum may highlight areas for improvement in the courses. This may help in lowering academic stress among students....