International Journal of Medical Sciences and Pharma Research

Reported Medication Adherence Behaviour and Obstacles to Continued Asthma Care in Hospitalized Children

2026-04-26T22:57:28+02:00

Asthma is a chronic respiratory condition that significantly affects children worldwide, leading to recurrent hospitalizations, impaired quality of life, and increased healthcare costs. Despite the availability of effective pharmacological therapies, medication adherence remains a major challenge in paediatric asthma care. This study aimed to evaluate reported medication adherence behaviour and identify obstacles to continued asthma care among hospitalized children. A prospective observational study was conducted in Fortis Hospital Jaipur, India, enrolling 986 asthmatic children below 15 years of age and their caregivers. Data were collected using structured interviews, medical record reviews, and validated adherence scales, including the Morisky Medication Adherence Scale (MMAS). Baseline characteristics revealed that males constituted 59.5% of the study population, with the majority aged between 5–10 years. Urban residents accounted for 55.1% of cases, and fathers were the primary caregivers in 43.2% of instances. Most caregivers had secondary education, and private employment was the predominant occupation. The majority of children had asthma for 1–3 years, and two medications per day was the most common therapy pattern. Prescriptions predominantly included β‑agonists (74.3%), steroids (47.2%), cromolyn (17.7%), and xanthines (5.6%), with inhalers being the most frequently used formulation (51.2%). Adherence rates declined with longer disease duration, with only 7.4% adherence among children with asthma for 1–3 years. Reported barriers to adherence included therapy duration (80.4%), route of administration (77.4%), dosing frequency (61.1%), and sensory attributes such as taste, smell, and color. Caregivers additionally cited cost (73.4%), beliefs (68.0%), lack of immediate benefit (66.3%), frequent regimen modifications (63.6%), and fear of side effects (45.9%) as major obstacles. Concordance between prescribed medications and reported use was high for β‑agonists and xanthines but lower for steroids and cromolyn, indicating preventive therapies were more vulnerable to discontinuation. Children’s self‑reports revealed greater lapses than caregiver accounts, with 45% admitting to forgetting doses and nearly half intentionally avoiding medication. Appointment‑keeping was inadequate, with only 29.4% of parents receiving scheduled follow‑ups and 60% successfully keeping them. Structured pharmacist‑led health education significantly improved adherence, with 72.2% of children achieving medium/high MMAS scores post‑intervention. In conclusion, medication adherence in pediatric asthma is influenced by a constellation of behavioral, familial, and systemic factors. Hospitalization offers an opportunity to identify these barriers and implement corrective strategies. Strengthening caregiver education, reducing financial burdens, simplifying regimens, and reinforcing follow‑up systems are essential to improve adherence and long‑term outcomes in children with asthma.

Evaluation of abnormal phlegm (Ghair Tabayi Balgham) in Unani Medicine: A clinical and comparative study with contemporary biomedical perspectives

2026-07-16T05:33:53+02:00

Background: In Unani medicine, Balgham (phlegm) is one of the four fundamental humors responsible for maintaining tissue nourishment, lubrication, and physiological homeostasis. Alterations in its qualitative or quantitative characteristics result in Ghair Tabayi Balgham (abnormal phlegm), a pathological state traditionally implicated in the development of several chronic diseases. However, its relevance to contemporary biomedical concepts has not been comprehensively investigated.

Objective: To evaluate the concept of Ghair Tabayi Balgham through classical Unani literature, clinical observations, and comparison with current biomedical evidence.

Methods: A hospital-based observational descriptive study was conducted at the Department of Kulliyat-e-Tib, Aligarh Unani & Ayurvedic Medical College and ACN Hospital, Aligarh, from May 2024 to September 2025. Classical Unani texts were critically reviewed, and patients presenting with Balghami features underwent detailed clinical assessment based on established Unani diagnostic principles. The findings were interpreted in the context of contemporary biomedical literature.

Results: Eight classical variants of Ghair Tabayi Balgham were identified. Impaired digestion, diminished innate heat, sedentary lifestyle, and excessive intake of cold and moist foods emerged as the principal etiological factors. Clinical observations demonstrated associations with obesity, hypothyroidism, bronchial asthma, chronic bronchitis, arthritis, metabolic syndrome, and chronic fatigue. Patients managed with dietary modification, regimenal therapy, and Unani pharmacotherapy exhibited improvements in digestive function, respiratory symptoms, metabolic status, and overall well-being.

Conclusion: The findings indicate that Ghair Tabayi Balgham is a clinically meaningful pathological construct with notable similarities to metabolic, inflammatory, endocrine, and respiratory disorders recognized in modern medicine. Integrating classical Unani concepts with contemporary biomedical evidence may strengthen evidence-based Unani practice and facilitate future translational research in integrative healthcare.

Keywords: Unani medicine; Ghair Tabayi Balgham; Balgham; humoral theory; Mizaj; metabolic syndrome; chronic inflammation; integrative medicine

Universal Access to HIV Testing in Africa: WHO Frameworks, Innovations, and Progress Toward Early Diagnosis

2026-04-26T22:56:11+02:00

Universal access to HIV testing is fundamental to effective HIV prevention, timely treatment initiation, and epidemic control. Africa continues to shoulder the highest global burden of HIV, where delayed diagnosis remains a major driver of morbidity, mortality, and ongoing transmission. The World Health Organization (WHO) has provided sustained normative leadership through evidence-based frameworks, rights-centered policies, and programmatic innovations designed to expand HIV testing coverage and promote early diagnosis across diverse African settings. This narrative review synthesizes WHO guidance on provider-initiated and community-based testing, differentiated service delivery, and ethical standards, alongside key innovations such as HIV self-testing, integrated and dual rapid diagnostics, and mobile outreach models. Progress toward early diagnosis and the first UNAIDS targets is examined, highlighting gains in antenatal testing, male and adolescent engagement, and test-and-treat implementation. Persistent gaps—including late presentation, stigma, health system constraints, and sustainability challenges—are also discussed. The review concludes by outlining strategic priorities for strengthening equitable, data-driven, and resilient HIV testing services. Sustained implementation of WHO-led frameworks remains central to achieving universal access and ending AIDS as a public health threat in Africa.

Keywords: HIV testing, universal access, early diagnosis, World Health Organization, Africa