Displaying publications 1 - 20 of 45 in total

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  1. Abu Farha RK, Mukattash TL, Al-Sakran L, Abu Hammour K, Zawiah M
    Int J Clin Pract, 2021 Apr;75(4):e13742.
    PMID: 32991028 DOI: 10.1111/ijcp.13742
    OBJECTIVES: This study aimed to evaluate the prevalence and predictors of polypharmacy in hospitalised patients in Jordan to help guide healthcare efforts in decreasing the burden on the healthcare system.

    METHODS: This cross-sectional study was conducted at the University of Jordan Hospital in Amman, Jordan. During the study period, a convenience sample of patients admitted to the internal medicine and surgical wards were approached to take part in this study. Following patients' recruitments, patients were interviewed and their medical files were reviewed to obtain demographic and clinical information regarding their medical conditions and their regular use of medicines. Then, the prevelence of patients with polypharmacy were identified, and factors predicting polypharmacy among them were determined.

    RESULTS: Among the 300 participants who agreed to participate in this study, females represented 45.3% of the recruited sample (n = 139), and around 48.0% (n = 144) of the study sample were elderly people (≥65 years old). Most of the recruited patients (n = 248, 82.7%) were found to use polypharmacy (≥ 5 medications). Hypertension was the most frequent medical condition among study participants (n = 240, 80.0%) followed by diabetes (n = 185, 61.7%). Results of logistic regression analysis showed that polypharmacy was only significantly affected by patients' age (OR = 2.149, P-value = .024) and monthly income (OR = 0.336, P-value = .009), while other factors were not associated with polypharmacy. Elderly patients (≥65 years) were found to have polypharmacy more significantly than non-elderly patients. Also, those with lower monthly income (<500 JD) were found to use lower polypharmacy compared with those with higher monthly income (>500 JD).

    CONCLUSION: The present study showed that polypharmacy is prevalent among patients in Jordan. While polypharmacy was not affected by smoking status, gender, BMI and educational level, it was significantly affected by monthly income and age. Further plans should be put in place to reduce polypharmacy, starting with effective pharmaceutical care services leading to treatment optimisation and ensuring desired treatment outcomes.

  2. Ahmad WA, Khanom M, Yaakob ZH
    Int J Clin Pract, 2011 Aug;65(8):848-51.
    PMID: 21762308 DOI: 10.1111/j.1742-1241.2011.02714.x
    The treatment of heart failure in pregnant women is more difficult than in non-pregnant women, and should always involve a multidisciplinary team approach. Knowledge required includes hemodynamic changes in pregnancy and the resultant effect on women with pre-existing or pregnancy-related cardiovascular disease, cardiovascular drugs in pregnancy, ethical issues and challenges regarding saving mother and baby. In addition, women having high risk cardiac lesions should be counselled strongly against pregnancy and followed up regularly. Pregnancy with heart failure is an important issue, demanding more comprehensive studies.
  3. Ambaras Khan R, Aziz Z
    Int J Clin Pract, 2018 Oct;72(10):e13245.
    PMID: 30144239 DOI: 10.1111/ijcp.13245
    OBJECTIVES OF THE REVIEW: Antibiotic de-escalation is part of an antibiotic stewardship strategy to achieve adequate therapy for infections while avoiding the prolonged use of broad-spectrum antibiotics. However, there is a paucity of clinical evidence on the clinical impact of this strategy in pneumonia patients in the intensive care unit (ICU). This review aimed to evaluate the impact of antibiotic de-escalation therapy for adult patients diagnosed with pneumonia in the ICU.

    METHODS USED TO CONDUCT THE REVIEW: This review was conducted in accordance with the Meta-analysis of Observational Studies in Epidemiology (MOOSE) recommendation. Electronic databases including MEDLINE, CINAHL, PubMed, Embase, Cochrane Databases and Cochrane Central Register of Controlled Trials were searched up to March 2017 for relevant trials. The methodological quality of included trials was assessed by using a modified version of the Newcastle-Ottawa Quality Assessment Scale for Case-Control and Cohort Studies. A meta-analysis was conducted using the random-effect model to combine the rate of mortality and length of stay outcomes.

    FINDINGS OF THE REVIEW: Nine observational trials involving 2128 patients were considered eligible for inclusion. Although based on low quality evidence, there was a statistically significant difference in favour of the impact of de-escalation on hospital stay but not mortality (MD -5.96 days; 95% CI -8.39 to -3.52).

    INTERPRETATIONS AND IMPLICATIONS OF THE FINDINGS: This review highlights the need for more rigorous studies to be carried out before a firm conclusion on the benefit of de-escalation therapy is supported.

  4. Amudha K, Chee KH, Tan KS, Tan CT, Lang CC
    Int J Clin Pract, 2003 Jun;57(5):369-72.
    PMID: 12846339
    Atherosclerosis is a progressive, disseminated condition that affects all the vascular beds. Peripheral arterial disease (PAD), a manifestation of atherosclerosis, measured non-invasively in the legs by ankle-brachial index (ABI) is associated with increased cardiovascular morbidity and mortality. Though several studies in the western industrialised countries have shown that PAD is widely prevalent in the general older population at risk, not much data are available in the South East Asian developing countries. We have conducted an epidemiological survey on the prevalence of PAD in high-risk patients at an urban hospital in Malaysia. A total of 301 consecutive patients aged 32-90 years were recruited during their follow-up clinic visits for established cardiovascular disease, ischaemic stroke or diabetes mellitus > or = 5 years. All participants underwent ABI measurement and were subjected to the Edinburgh claudication questionnaire to assess leg symptoms. The prevalence of PAD in our high-risk population was 23%, of which only 27% were symptomatic with the classical intermittent claudication. All the patients with PAD were diagnosed at the time of the study. PAD was found in 33% of patients with pre-existent cardiovascular disease, 28% in patients with ischaemic stroke and 24% in diabetic patients. PAD was also highly prevalent among the younger patients. Our study has shown that PAD is highly prevalent among high-risk Malaysian patients and is not necessarily a disease of older age. Only 27% of these patients were symptomatic. All the subjects with PAD were diagnosed at the time of the study, which would suggest it is an unrecognised and underdiagnosed condition, even in patients with atherosclerotic risk factors.
  5. Ang QQ, Wing YK, He Y, Sulaiman AH, Chiu NY, Shen YC, et al.
    Int J Clin Pract, 2009 Jul;63(7):1041-9.
    PMID: 19570122 DOI: 10.1111/j.1742-1241.2009.02107.x
    Reports from non-Asian populations indicate that painful physical symptoms (PPS) are associated with poorer clinical and functional outcomes in major depressive disorder (MDD). The purpose of this study is to report comparative changes in disease severity, treatment patterns and quality of life observed in East Asian patients with MDD, with and without PPS, as assessed prospectively over a 3-month observation period.
  6. Anuar NA, Tey KWF, Ng SC, Teh AKH, Abdul Rahman MHF, Chong BP, et al.
    Int J Clin Pract, 2021 Mar;75(3):e13823.
    PMID: 33202073 DOI: 10.1111/ijcp.13823
    AIM: To retrospectively report the clinical outcomes of non-Hodgkin's Lymphoma (NHL) patients post high dose therapy (HDT) with autologous haematopoietic stem cell transplant (AHSCT) and determine whether upfront transplant, which is a first-line consolidative treatment with induction chemotherapy, would be a feasible modality in a resource-limited country.

    METHODS: The medical records for NHL patients who had undergone HDT followed by AHSCT from October 1997 to November 2016 from two hospitals in Klang Valley, Malaysia were obtained from the medical record database and analysed retrospectively through statistical analysis.

    RESULTS: A total of 148 patients were retrospectively identified post-AHSCT, where the majority of whom had B cell lymphoma (53.4%). Majority of patients (88.5%) were in complete remission before AHSCT. The overall survival (OS) and event-free survival (EFS) at 3 years were 68.9% and 60.8%, respectively. The major cause of death was disease progression at 73.9%, while transplant-related mortality was 15.2%, with a median follow-up period of 179.5 weeks.

    CONCLUSION: Our study illustrates the promising outcomes of HDT with AHSCT in NHL patients in a resource-limited country. We recommend larger studies to be conducted in the future with a longer duration of follow-up to validate our findings.

  7. Ariffin H, Navaratnam P, Lin HP
    Int J Clin Pract, 2002 May;56(4):237-40.
    PMID: 12074201
    We prospectively studied the type, frequency and outcome of infections in 513 patients with 762 consecutive episodes of febrile neutropenia (FN) over a five-year period between 1995 and 1999 in a single paediatric oncology unit. The findings were then compared with a similar study carried out in our unit between 1990 and 1994. The types of bacterial isolates and sensitivity patterns were also studied to identify trends and to gauge the suitability of antibiotics chosen for empirical therapy. Bacteraemia was documented in 35.4% of FN episodes, although 70% of patients did not have an obvious site of sepsis. The majority of isolates (61.9%) were gram-negative bacteria, a consistent finding throughout the study period. Resistance to ceftazidime, amikacin and imipenem among gram-negative bacteria was 26.3%, 21.2% and 0.7%, respectively. Methicillin resistance among gram-positive bacteria was 26.3%, while no vancomycin-resistant bacteria were encountered. There were 36 sepsis-related deaths. Factors associated with a fatal outome were prolonged capillary refill time, hypotension, fever above 39 degrees C and pneumonia. Rapid neutrophil recovery was associated with a good prognosis. A change to our current choice of empirical antibiotics for FN, comprising ceftazidime/ceftriaxone and amikacin appears necessary because of the relatively high resistance rates found.
  8. Ayittey FK, Chiwero NB, Dhar BK, Tettey EL, Saptoro A
    Int J Clin Pract, 2021 Dec;75(12):e15012.
    PMID: 34806816 DOI: 10.1111/ijcp.15012
    Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected millions of people around the world, with most cases recorded among adults. The cases reported among children have been acknowledged to be minimal in comparison to adults. Nevertheless, coronavirus disease 2019 (COVID-19) has been reported to affect children of all ages, including newborns. The symptoms among children have also been identified to be similar to those observed among adults, although paediatric patients have been noted to display a spectrum of clinical features ranging from asymptomatic to moderate symptoms. Despite ample publications on the ongoing pandemic, the literature is only replete with guidelines on treating SARS-CoV-2 infection among older people. In this narrative review, comprehensive updates on the infection in children have been discussed. The latest information on the spread of the disease among children around the world, the clinical features observed among the paediatric population, as well as recommended pharmaceutical treatments of COVID-19 among this special group of patients have been covered. Further, expert consensus statements regarding the management of this highly contagious disease among pregnant women and neonates have been discussed. It is believed that this comprehensive review will provide updated information on the epidemiology and clinical features of the ongoing pandemic among paediatric patients. Additionally, the guidelines for handling SARS-CoV-2 among pregnant women and children, as reviewed in this article, are anticipated to be useful to frontline clinicians battling this fatal disease around the globe.
  9. Balasingam M
    Int J Clin Pract, 2017 Sep;71(9).
    PMID: 28851081 DOI: 10.1111/ijcp.12989
    This is a medical kitty hawk moment. Drones are pilotless aircrafts that were initially used exclusively by the military but are now also used for various scientific purposes, public safety, and in commercial industries. The healthcare industry in particular can benefit from their technical capabilities and ease of use. Common drone applications in medicine include the provision disaster assessments when other means of access are severely restricted; delivering aid packages, medicines, vaccines, blood and other medical supplies to remote areas; providing safe transport of disease test samples and test kits in areas with high contagion; and potential for providing rapid access to automated external defibrillators for patients in cardiac arrest. Drones are also showing early potential to benefit geriatric medicine by providing mobility assistance to elderly populations using robot-like technology. Looking further to the future, drones with diagnostic imaging capabilities may have a role in assessing health in remote communities using telemedicine technology. The Federal Aviation Administration (FAA) in the United States and the European Aviation Safety Agency (EASA) in the European Union are some examples of legislative bodies with regulatory authority over drone usage. These agencies oversee all technical, safety, security and administrative issues related to drones. It is important that drones continue to meet or exceed the requirements specified in each of these regulatory areas. The FAA is challenged with keeping pace legislatively with the rapid advances in drone technology. This relative lag has been perceived as slowing the proliferation of drone use. Despite these regulatory limitations, drones are showing significant potential for transforming healthcare and medicine in the 21st century.
  10. Chan CM, Ahmad WA
    Int J Clin Pract, 2012 Jan;66(1):16-20.
    PMID: 22171901 DOI: 10.1111/j.1742-1241.2011.02831.x
    Aims: There is limited study on patient-centred attitudes with regards to the patient–physician relationship in physicians. The objective of this study was to examine and compare physician attitudes toward patient-centredness in four different medical settings.
    Methods: The present study utilised a cross-sectional survey design and purposive sampling to recruit physicians from a single academic medical centre via face-to-face interviews. Patient-centred attitudes of physicians specialising in surgery, oncology, obstetrics and gynaecology and primary care
    (N = 78) were compared on the Patient–Practitioner Orientation Scale (PPOS) using an independent one-way analysis of variance (ANOVA). The four medical
    specialties comprised the four levels, with role orientation (patient-centred orientation vs. doctor-centred orientation) as the dependent measure.
    Results: A significant level of difference (p < 0.001) was found between the four specialisations:
    oncologists were found to have the highest level of patient-centeredness, followed by obstetricians & gynaecologists and primary care physicians, with surgeons being the least patient-centred among specialisations sampled.
    Conclusion: These data are the first from the South-East Asian region to demonstrate differences in
    physician attitudes between medical specialties. Our findings prompt further investigation and confirmation as to whether physicians with particular attitudinal traits are attracted to any particular specialties of medicine, or if physician attitudes are acquired through professional experience and training. In addition, this study offers better insight into the attitudinal differences of physician between medical specialities.
    Questionnaire: Patient–Practitioner Orientation Scale; PPOS
  11. Chee KH, Azman W
    Int J Clin Pract, 2009 May;63(5):722-5.
    PMID: 18028390
    Peripartum cardiomyopathy (PPCM) is an uncommon form of congestive heart failure, afflicting obstetric patients around the time of delivery. The epidemiology of PPCM is infrequently reported. To the best of our knowledge, there has been no report from Asia.
  12. Chee KH, Siaw FS, Chan CG, Chong WP, Imran ZA, Haizal HK, et al.
    Int J Clin Pract, 2005 Jun;59(6):628-31.
    PMID: 15924588
    This single centre study was designed to demonstrate feasibility, safety and efficacy of the Vivant Z stent (PFM AG, Cologne, Germany). Patients with de novo lesion were recruited. Coronary angioplasty was performed with either direct stenting or after balloon predilatation. Repeated angiogram was performed 6 months later or earlier if clinically indicated. Between January to June 2003, a total of 50 patients were recruited (mean age 55.8 +/- 9 years). A total of 52 lesions were stented successfully. Mean reference diameter was 2.77 mm (+/-0.59 SD, range 2.05-4.39 mm) with mean target lesion stenosis of 65.5% (+/-11.6 SD, range 50.1-93.3%). Forty-six lesions (88.5%) were American College of Cardiologist/American Heart Association class B/C types. Direct stenting was performed in 18 (34.6%) lesions. Mean stent diameter was 3.18 mm (+/-0.41 SD, range 2.5-4 mm), and mean stent length was 14.86 mm (+/-2.72 SD, range 9-18 mm). The procedure was complicated in only one case which involved the loss of side branch with no clinical sequelae. All treated lesions achieved Thrombolysis In Myocardial Infarction 3 flow. Mean residual diameter stenosis was 12.2% (+/-7.55 SD, range 0-22.6%) with acute gain of 1.72 mm (+/-0.50 SD, range 0.5-2.8). At 6 months, there was no major adverse cardiovascular event. Repeated angiography after 6 months showed a restenosis rate of 17% (defined as >50% diameter restenosis). Mean late loss was 0.96 mm (+/-0.48 SD) with loss index of 0.61 (+/-0.38 SD). The restenosis rate of those lesions less than 3.0 mm in diameter was 22.2% compared with 6.25% in those lesions more than 3.0 mm in diameter. The Vivant Z stent was shown to be safe and efficacious with low restenosis rate in de novo coronary artery lesion.
  13. Dhanjal TS, Lal M, Haynes R, Lip G
    Int J Clin Pract, 2001 Dec;55(10):665-8.
    PMID: 11777289
    Indo-Asians in the UK are at an increased risk of coronary artery disease (CAD); this may be a reflection of their cardiovascular risk factor profile as well as of a more sedentary lifestyle. We hypothesised that Indo-Asians in Malaysia and the UK may exhibit a similar cardiovascular risk factor and physical activity profile, which would be more adverse compared with caucasians. We studied 70 consecutive Indo-Asian patients admitted to hospitals in Kuala Lumpur, Malaysia (n=42; 35 males; mean age 60.6 years, SD 11.8); and Birmingham, England (n=28; 20 males; mean age 60.8 years, SD 12.9). Both groups of Indo-Asian patients were compared with 20 caucasian patients (13 males; mean age 62.7 years, SD 9.4) admitted with myocardial infarction from Birmingham. There was a higher prevalence of diabetes among Indo-Asians in both countries than among caucasians (p=0.0225). By contrast, caucasians had a higher prevalence of hypercholesterolaemia (p=0.0113), peripheral vascular disease (p=0.0008), regular alcohol consumption (p<0.0001) and family history of CAD (p=0.0041). There were no significant differences in mean age, body mass index or blood pressures. There was a significantly lower leisure activity score (p=0.001) and total physical activity score (p=0.003) among Indo-Asians in both countries than among caucasians. This survey has demonstrated differences in cardiovascular risk factors among Indo-Asian and caucasian patients. The high prevalence of diabetes, as well as the lower physical activity and sedentary lifestyles among Indo-Asians, in both Malaysia and the UK, may in part contribute to the high incidence of CAD in this ethnic group.
  14. Hasan SS, Burud IAS, Kow CS, Rasheed MK, Chan KSC, Tay PK, et al.
    Int J Clin Pract, 2021 Mar;75(3):e13714.
    PMID: 32949074 DOI: 10.1111/ijcp.13714
    BACKGROUND: Older individuals are seemingly having more medical conditions, which predispose them to a greater risk of polypharmacy. Potentially inappropriate medications (PIMs), including those having anticholinergic and sedative properties, are common in their prescriptions, often associated with functional decline and negative health outcomes. Thus, this study reports proportions of inappropriate drugs and drug burden exposures and its correlation with patient-reported outcomes (PROs) among cognitively intact older adults admitted to a ward or visiting the outpatient clinic at a tertiary care hospital in Malaysia.

    METHODS: This cross-sectional study included data from 344 older (173 inpatients and 171 outpatients) patients, aged 60 years and above, through validated questionnaires. Medication appropriateness was assessed via Medication Appropriateness Index (MAI) tool, whereas Beers and Screening Tool of Older Person's Potentially Inappropriate Prescribing (STOPP) criteria were used to evaluate PIMs and potentially inappropriate prescribing (PIP), respectively. The Drug Burden Index (DBI) and polypharmacy, as well as PROs, included Groningen Frailty Indicator (GFI), Katz Index of Independence in Activities of Daily Living (Katz ADL) and Older People's Quality of Life (OPQOL) were also evaluated.

    RESULTS: Overall, inpatients received significantly higher medications (6.90 ± 2.70 vs 4.49 ± 3.20) than outpatients. A significantly higher proportion of inpatients received at least one PIM (65% vs 57%) or PIP (57.4% vs 17.0%) and higher mean MAI score (1.76 ± 1.08 and 1.10 ± 0.34) and DBI score (2.67 ± 1.28 vs 1.49 ± 1.17) than outpatients. Inpatients had significantly higher total OPQOL (118.53 vs 79.95) and GFI score (5.44 vs 3.78) than outpatients. We only found significant correlations between GFI and DBI and total OPQOL and the number of PIMs.

    CONCLUSIONS: Proportions of PIMs and DBI exposure were significantly higher in an inpatient setting. No significant correlations between exposures to inappropriate medications or drug burden and PROs were observed.

  15. Hooi PY, Yong CM, Cheong I
    Int J Clin Pract, 2001 May;55(4):272-4.
    PMID: 11406914
    A prospective study was conducted to determine the proportion of patients who received an antibiotic within 12 hours of admission to the medical wards. During the four-week study, 234 patients were admitted to medical wards from casualty; 68 patients (29%) received an antibiotic. The survey indicated that antibiotics were inappropriate in 22-65% of those treated. This study also shows that as many as 67% of patients who received intravenous antibiotics could have been equally well treated with oral preparations.
  16. Jamaleddin Surani SA, Budiman M, Azman M, Abdul Rahman R
    Int J Clin Pract, 2022;2022:4090444.
    PMID: 36458263 DOI: 10.1155/2022/4090444
    INTRODUCTION: Although uncommon, local anaesthetic systemic toxicity (LAST) may impose fatal risk to the patients. We investigated the awareness of LAST and knowledge on local anaesthetics among our postgraduate trainees.

    MATERIALS AND METHODS: A total of 134 postgraduate trainees from the departments of general surgery (Surgical), orthopaedic surgery (Ortho), otorhinolaryngology (ENT), obstetrics and gynaecology (OBGYN), as well as anaesthesiology and intensive care (Anaesth) were recruited. A validated questionnaire was used to assess awareness and knowledge. All participants attended a medical-education session and completed the questionnaire as preassessment and postassessment. Data were analysed, and comparisons between disciplines were conducted.

    RESULTS: The trainees' awareness of LAST was overall poor at preassessment which improved almost 6-folds at postassessment. Surprisingly, only 20 (45.5%) participants from the anaesthesiology group had awareness of LAST at preassessment, and none of the participants were from surgical, orthopaedic, and obstetrics and gynaecology departments. Preassessment scores were significantly higher in the anaesth group as compared to all other groups; with a difference in the average score for Anaesth vs Surgical of 3.46 (95%, CI:2.17, 4.74), Anaesth vs Ortho of 3.64 (95%, CI:2.64, 4.64), Anaesth vs ENT of 3.43 (95%, CI:2.20, 4.67), and Anaesth vs OBGYN of 6.93 (95%, CI:5.64, 8.21). However, there was no significant difference of awareness scores between all participants at postassessment scores.

    CONCLUSION: The overall level of awareness was poor. However, the implementation of an education session significantly improved the knowledge and awareness across all disciplines.

  17. Ji L, Pranoto A, Andag-Silva A, Deerochanawong C, Van Phuoc D, Tan KCB, et al.
    Int J Clin Pract, 2021 Jan 22.
    PMID: 33480067 DOI: 10.1111/ijcp.14019
    Prediabetes and diabetes burden become the strong challenge in the Western Pacific region. Prediabetes with impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and the mixed status (IFG + IGT) are considered as risk factors for the development of diabetes. Effective early intervention for prediabetes can significantly delay the progression of the onset of diabetes, even if reverse blood glucose to normal. Increasing evidence shows that without targeted intervention, the progression from prediabetes to diabetes occurs more frequently in Asians compared with Caucasians. Consequently, it is essential to timely detect the populations at higher risk and effectively implement intervention and management to prevent diabetes. Significant evidence also supports the effectiveness of adjusting lifestyle in combination with medication to delay the onset of diabetes. A working group of Western Pacific expertise in diabetes conducted to develop evidence-based consensus recommendations to guide the management of patients with prediabetes. These consensual recommendations are intended to provide a clear and concise approach to the management of individuals with prediabetes.
  18. Kan CH, Lee SK, Low CS, Velusamy SS, Cheong I
    Int J Clin Pract, 2000 Dec;54(10):645-6.
    PMID: 11221275
    A cross-sectional study was conducted on 160 Malaysian patients to validate the usefulness of the Siriraj Stroke Score (SSS) for differentiating intracerebral haemorrhage and infarction following acute strokes. Our results indicate that the score lacks sensitivity and specificity. It should thus not be used in epidemiological studies to determine stroke types in a community. More importantly, in the absence of information from neuroimaging of the brain, it cannot be used safely by physicians to assess the need or otherwise of thrombolytic and/or anticoagulant therapy after an acute stroke.
  19. Kandasamy G, Sivanandy P, Almaghaslah D, Khobrani M, Chinnadhurai M, Vasudevan R, et al.
    Int J Clin Pract, 2020 Nov;74(11):e13599.
    PMID: 32593188 DOI: 10.1111/ijcp.13599
    BACKGROUND: Resistance to antibiotics causes negative impact on health of the patients. Antibiotic resistance is the major global concern that has to be nullified for the better health outcome. The knowledge on antibiotics is very essential for the students who undertake pharmacy and health science courses. Hence a study was aimed to assess the level of knowledge, attitude, perception and practice on antibiotics usage among the pharmacy students of King Khalid University, KSA.

    MATERIALS AND METHODS: A prospective online questionnaire based survey was carried out among the pharmacy students about knowledge, attitude perception and practice of antibiotics using 5-point "Likert scale" and true/false responses. The responses range from strongly agree to strongly disagree, and always to never were recorded. The data were analysed by using simple descriptive statistics.

    RESULTS: Out of 300 students approached 212 responded and the response rate was found to be 71%. In this study, most (95%) of the students were aware of the emerging problem of antibiotic resistance due to inappropriate use of antibiotics. Majority (89%) of the students agreed the inappropriate use of antibiotics can increase the overall cost of treatment. However, over half of the (54%) students were not aware of the antibiotic resistance that may be a nation-wide problem of Kingdom of Saudi Arabia. The net positive response (NPR) and net other response (NOR) of all items in perception on antibiotics received more or less equal responses.

    CONCLUSION: The knowledge of antibiotics usage among the students are considerably good compared with previous studies. However, the attitude, perception and practice on antibiotics usage among the pharmacy students are very poor. It alarms the need of appropriate education to enlighten antibiotic awareness for the better disease prevention and health outcomes for the benefit of patient community.

  20. Kandasamy G, Sivanandy P, Almaghaslah D, Almanasef M, Vasudevan R, Chinnadhurai M, et al.
    Int J Clin Pract, 2021 Sep;75(9):e14489.
    PMID: 34115424 DOI: 10.1111/ijcp.14489
    BACKGROUND: The substantial and increasing use of medications escalating the risk of harm globally. The serious medication errors in hospital and community settings resulting from patient injury and death. Hence, a cross-sectional study was aimed to analyse the prescribing and dispensing errors in the outpatient departments of a south Indian hospital.

    MATERIALS AND METHODS: A prospective cross-sectional study was carried out to evaluate the prescribing, and dispensing errors in outpatients who seek patient counseling at the tertiary care multispecialty hospital. The data were collected from various sources such as patient's prescriptions and dispensing records from the pharmacy.

    RESULTS: A total of 500 prescriptions were screened and identified 65.60% of prescriptions with at least any one type of medication errors. Out of 328 prescriptions, 96.04% were handwritten and 3.96% were computerised prescriptions. Among the 328 prescriptions with medication errors, 32.62% noticed prescribing errors, 37.80% with dispensing errors, and 29.58% with both prescribing and dispensing errors. Out of these 328 prescriptions, 74.09% prescriptions were found to have polypharmacy.

    DISCUSSION: Medication errors are serious problems in healthcare and can be a source of significant morbidity and mortality in healthcare settings. The present study showed that dispensing errors were the most common among the types of medication errors, in these particularly wrong directions were the most common types of errors.

    CONCLUSION: This study concludes that the overall prevalence of medication errors was around 80%, but there were no life-threatening events observed. A clinical pharmacist can play a major role in this situation appears to be a strong intervention and early detection and prevention of medication errors and thus can improve the quality of care to the patients.

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