Displaying publications 21 - 40 of 148 in total

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  1. Sainudeen S, Nair VS, Zarbah M, Abdulla AM, Najeeb CM, Ganapathy S
    J Pharm Bioallied Sci, 2020 Aug;12(Suppl 1):S423-S429.
    PMID: 33149499 DOI: 10.4103/jpbs.JPBS_127_20
    Aim: The purpose of this study was to evaluate the antimicrobial efficacy of Tylophora indica, Curcumin longa, and Phyllanthus amarus on Enterococcus faecalis biofilms formed on the tooth substrate. Sodium hypochlorite was used as a positive control. DMSO (dimethyl sulfoxide), the vehicle for the herbal extracts, was used as the negative control.

    Materials and Methods: Extracted human teeth were biomechanically prepared, vertically sectioned, placed in the tissue culture wells exposing the root canal surface to E. faecalis to form a biofilm. At the end of the third week, all groups were treated for 15 min with the test solutions and the control. The results were analyzed both quantitatively and qualitatively.

    Results: Statistical analysis was performed by using one-way analysis of variance and compared by the Mann-Whitney test using the Statistical Package for the Social Sciences (SPSS) software, version 20.0. The qualitative assay with the 3-week biofilm on the canal portion showed complete inhibition of bacterial growth for NaOCl, whereas samples treated with herbal solutions showed significant reduction of bacterial growth compared to control group, which showed 139.9 × 109 CFU/mL among the experimental herbal solutions groups. P. amarus has shown maximum bacterial count followed by C. longa and T. indica.

    Conclusion: NaOCl 5% showed maximum antibacterial activity against 3-week biofilm on tooth substrate. T. indica, P. amarus, and C. longa showed statistically significant antibacterial activity against 3-week biofilm. The use of herbal alternatives might prove to be advantageous considering the several undesirable characteristics of NaOCl.

  2. Natarajan P, Choudhury M, Seenivasan MK, Jeyapalan K, Natarajan S, Vaidhyanathan AK
    J Pharm Bioallied Sci, 2019 May;11(Suppl 2):S402-S406.
    PMID: 31198377 DOI: 10.4103/JPBS.JPBS_48_19
    Aim: This study evaluated the relationship between missing posterior teeth and body mass index with regard to age and socioeconomic state in a sample of the suburban south Indian population.

    Materials and Methods: The 500 individuals of both males and females aged 40 years and older with missing posterior teeth and not rehabilitated with any prosthesis were gone through a clinical history, intraoral examination, and anthropometric measurement to get information regarding age, sex, socioeconomic status, missing posterior teeth, and body mass index (BMI). Subjects were divided into five groups according to BMI (underweight > 18.5 kg/m2, normal weight 18.5-23 kg/m2, overweight 23-25 kg/m2, obese without surgery 25-32.5 kg/m2, obese with surgery < 32.5 kg/m2). Multivariate logistic regression was used to adjust data according to age, sex, number of missing posterior teeth, and socioeconomic status.

    Results: People with a higher number of tooth loss were more obese. Females with high tooth loss were found to be more obese than male. Low socioeconomic group obese female had significantly higher tooth loss than any other group. No significant relation between age and obesity was found with regard to tooth loss.

    Conclusion: The BMI and tooth loss are interrelated. Management of obesity and tooth loss can help to maintain the overall health status.

  3. Padmakumar V, Premkala Raveendran K, Abdulla AM, Ganapathy S, Sainudeen S, Nasim VS, et al.
    J Pharm Bioallied Sci, 2019 May;11(Suppl 2):S397-S401.
    PMID: 31198376 DOI: 10.4103/JPBS.JPBS_44_19
    Background: Mercury is a naturally occurring metal that exists in three forms: elemental (metallic), inorganic, and organic mercury. Amalgam, which is an alloy of inorganic mercury, is used as a restorative material in dentistry. Organic mercury gets ingested in the body mainly by the consumption of seafood. Mercury is also stated to cause various adverse health effects such as gastrointestinal disturbances, dermatitis, muscle weakness, and neurological disorders. In recent years, the use of amalgam has become a controversy stating the various adverse effects of mercury. Hence, the study was conducted to determine and compare the variation in levels of organic and inorganic mercury in fish-eating children before and after placement of amalgam restoration.

    Materials and Methods: Seventy-five subjects, 42 males (56%) and 35 females (44%) of age group ranging 7-13 years, living in South Canara district of Karnataka, India, were selected as a part of the study. Hair and urine samples were collected for estimation of organic and inorganic levels of mercury, respectively. Informed consent was collected from all the participating subjects.

    Results: On comparison between organic and inorganic mercury levels during the study period, the concentration of organic mercury in hair samples was greater irrespective of amalgam restorations present (1.172 and 0.085, respectively; P < 0.001).

    Conclusion: Thus inorganic levels of mercury do not seem to pose a threat as much as the organic levels observed in hair, which remain fairly constant for a longer period of time. Hence in a coastal region where this study was undertaken and fish being a staple food, the risk could probably be attributed to more of an organic toxicity than an inorganic one. Thus amalgam is relatively safe to be practiced and the controversy against it should be reevaluated.

  4. Kumar V, Goud EVSS, Turagam N, Mudrakola DP, Ealla KKR, Bhoopathi PH
    J Pharm Bioallied Sci, 2019 May;11(Suppl 2):S321-S324.
    PMID: 31198362 DOI: 10.4103/JPBS.JPBS_22_19
    Background: Dental anxiety is one of the prime reasons for discouraging children to receive dental treatment. Measurement of the dental anxiety is very useful to know the prevalence level among 6- to 12-year-old children. Thus, the aim of the study was to determine the dental anxiety among 6- to 12-year-old children using Modified Dental Anxiety Scale (MDAS) score.

    Materials and Methods: A total of 400 south Indian children in the age group of 6-12 years who had visited Dental College and Hospital were recruited in the study. Dental anxiety was measured before dental treatment using MDAS. Statistical analysis was performed using Wilcoxon signed rank test.

    Results: Of the 400 children, 240 (61.5%) had severe dental anxiety, 92 (23%) had mild anxiety, and 78 (17%) had no anxiety. Females had higher anxiety level compared to males. Many study subjects answered that local anesthesia (LA) injection was considered most fearful. Dental anxiety was highest in smaller age groups.

    Conclusion: In our research, high percentage of children had dental anxiety, so counseling before dental visits is very important to reduce the dental anxiety among these 6- to 12-year-old children.

  5. Shilpa M, Jain J, Shahid F, Gufran K, Sam G, Khan MS
    J Pharm Bioallied Sci, 2019 May;11(Suppl 2):S246-S251.
    PMID: 31198346 DOI: 10.4103/JPBS.JPBS_1_19
    Aim: The aim of this study was to evaluate and compare the efficacy of three types of plaque control methods among 13- to 35-year-old subjects receiving fixed orthodontic treatment in Coorg Institute of Dental Sciences, Virajpet, Coorg district, Karnataka, India.

    Materials and Methods: A total of 111 subjects who fulfilled the inclusion and exclusion criteria were randomly included in the study. The subjects were recalled after 1 month of the commencement of fixed orthodontic treatment for the recording of baseline data including plaque index (PI), gingival index (GI), and modified papillary bleeding index (MPBI). After recording of the baseline data, the subjects were randomly allocated into each of the intervention groups, i.e., group A (manual tooth brush), group B (powered tooth brush), and group C (manual tooth brush combined with mouthwash) by lottery method. Further, all the subjects were recalled after 1 and 2 months for recording the data.

    Results: Regarding plaque levels, it was seen that there was a highly statistically significant difference between the three groups (P = 0.001), with the manual tooth brush combined with chlorhexidine mouthwash group recording the lowest mean PI score of 0.5 ± 0.39. A comparison of the mean GI scores among the groups at the end of 2 months shows a highly statistically significant difference (P = 0.001). The mean MPBI scores at the end of 2 months were highly statistically significant among the three groups (P = 0.001), with the group C recording the lowest mean MPBI score of 0.3 ± 0.3.

    Conclusion: The powered tooth brush group subjects exhibited significantly lesser PI, GI, and MPBI scores than the manual tooth brush group at the end of 2 months, whereas the manual tooth brush combined with chlorhexidine mouth wash group subjects showed maximum improvement, having significantly lesser PI and GI scores than the powered tooth brush group.

  6. Elenjikal MJ, Latheef AA, Kader MAM, Ganapathy S, Mohamed AB, Sainudeen SS, et al.
    J Pharm Bioallied Sci, 2019 May;11(Suppl 2):S450-S456.
    PMID: 31198386 DOI: 10.4103/JPBS.JPBS_75_19
    Background: Root resorption is the loss of dental hard tissues as a result of clastic activities. It might be broadly classified into external or internal resorption by the location of the resorption in relation to the root surface. the various techniques used these days for filling internal resorption include warm condensation, vertical condensation, core techniques, thermoplasticized gutta-percha, warm vertical compaction, and cold lateral condensation.

    Objectives: The aims and objectives of this study were to compare the quality of root fillings in artificially created internal resorption cavities filled with warm vertical compaction, lateral condensation, Obtura II along with System B, E and Q plus along with System B, and Thermafil, and to calculate the percentage of gutta-percha, sealer, and voids using an ImageJ software.

    Results: Results between the warm vertical compaction (group I), lateral condensation (group II), Obtura II with System B (group III), E and Q plus with System B (group IV), and Thermafil (group V), group III showed the highest percentage of gutta-percha plus sealer and gutta-percha, and least number of voids, which was statistically significant (P < 0.000).

    Conclusion: It can be concluded that Obtura II along with System B was found to be the most suitable obturation technique for the management of teeth exhibiting internal resorption. Thermafil was found to give the poorest obturation quality when used to fill the teeth with internal resorption. Similarly, lateral condensation technique was observed to show maximum sealer and hence was not ideal for the management of internal resorptive cavities.

  7. Mathews A, Azad AK, Abbas SA, Bin Che Rose FZ, Helal Uddin ABM
    J Pharm Bioallied Sci, 2018 12 21;10(4):226-231.
    PMID: 30568380 DOI: 10.4103/JPBS.JPBS_80_18
    Background: In Malaysia, community pharmacies play an important and vital role in both urban and rural areas with approximately 30% of 12,000 registered pharmacists with annual retention certificate practicing in community pharmacies. The main objective of this study was to find the perception of respondents on the value and necessity of pharmacists.

    Materials and Methods: The questionnaire was divided into two sections: the first section assessed the visits to community pharmacies, purpose, interaction with pharmacy staffs, professional fee, and improvements to pharmacy practices; the second section evaluated the characteristics of respondents including an e-consent form. Data were analyzed using the Statistical Package for the Social Sciences software (version 11.5).

    Results: The highest number of respondents (66.1%) consulted with the pharmacists for cough and cold, 33.1% for gastric and stomach ailments, and 28.9% for diarrhea and constipation. Only 34% of cases were handled by the pharmacists, whereas 52.1% by the sales assistant. Approximately 88.5% showed satisfaction with the counseling provided. A total of 46.3% did not know whom they dealt with, whereas 51.2% wanted personal attention of the pharmacists instead of the sales assistants. However, 66.9% of respondents preferred to a private consultation room. Records of only 32.2% of respondents were secured by the pharmacies, whereas 42.1% showed interest to pay a professional fee. Moreover, 83.3% agreed the fee of RM5 only, whereas 20.8% agreed to RM10. Among the respondents, majority agreed to pay a fee willingly, but approximately 30% stayed neutral.

    Conclusion: There is a need for the community pharmacists to play vital roles firsthand at the front desk to serve the patients professionally instead of handing over the responsibilities to the sales assistant.

  8. Mitha S, ElNaem MH, Chandran J, Rajah NP, Fam TY, Babar MG, et al.
    J Pharm Bioallied Sci, 2018 12 21;10(4):216-225.
    PMID: 30568379 DOI: 10.4103/JPBS.JPBS_296_16
    Background and Objectives: Various devices have been used to maintain oral hygiene. These include toothbrush and toothpaste, mouthwash, dental floss, miswak, and toothpick. This study attempts to investigate the use of various oral cleaning devices and their perceived benefits among Malaysians.

    Methods: A quantitative cross-sectional study conducted in two different cities of Malaysia. A convenience sampling approach was adopted. A total of 787 participants agreed to participate in the current research. A validated questionnaire translated into national language was used for data collection.

    Statistical Analysis Used: Data analysis was performed using Statistical Package for Social Sciences version 20.

    Results: About 302 respondents were in the age range of 18 - 25 years old (38.4%). There were marginally more females (55.7%) than males (44.3%). Although 99.9% of the participants used a toothbrush, a significant majority (n = 590, 75%) used more than a single device to maintain their oral hygiene. Only 311 respondents knew that toothpicks were inappropriate to use to remove food between teeth and gums, while a majority (n = 592, 75.2%) did not realize that some mouthwashes can stain the teeth. Less than half (42.1%) knew that improper use of miswak might harm the teeth.

    Conclusions: Although their oral hygiene behaviors are relatively at a higher level, their perceived oral health benefits did not compare well.

  9. Ismail NFF, Neoh CF, Lean QY, Abdullah AH, Lim SM, Ramasamy K, et al.
    J Pharm Bioallied Sci, 2018 12 21;10(4):199-207.
    PMID: 30568377 DOI: 10.4103/JPBS.JPBS_33_18
    Aims: Facial candling is one of the traditional treatments that is claimed to be able to help in curing or reducing various allergy and inflammation conditions such as allergic rhinitis. We aimed to explore the perceptions of participants with allergic rhinitis toward their disease conditions and facial candling treatment.

    Materials and Methods: The study used a qualitative exploratory design, comprising 12 in-depth interviews. A semi-structured topic guide was used to explore all relevant aspects of the topic, which were audio recorded, transcribed verbatim. All the interviews were conducted in a few beauty salons in purposively selected city areas in the state of Kedah, Malaysia.

    Results: Of the 12 patients, seven (58%) reported a positive experience of facial candling treatment, with improvement in the condition of their allergic rhinitis. Specific themes about the experience of facial candling treatment that were identified within the transcript data included knowledge about facial candling, options for disease treatment, effectiveness of facial candling, sources of information, comparison, application of treatment, treatment budget, and safety. The major strength lies in the fact that reasons for using facial candling were uncovered from the perspectives of people with allergic rhinitis through the in-depth interviews.

    Conclusions: The motives of these participants for using facial candling are mainly due to cultural influence and its low cost of treatment. There were mixed responses from the participants about the usefulness of facial candling. Most of the respondents had not assessed the safety of prolonged use of facial candling and regarded it as a safe procedure as this has been practiced for generations.

  10. Siddiqui MJ, Saleh MSM, Basharuddin SNBB, Zamri SHB, Mohd Najib MHB, Che Ibrahim MZB, et al.
    J Pharm Bioallied Sci, 2018 12 21;10(4):173-180.
    PMID: 30568374 DOI: 10.4103/JPBS.JPBS_83_18
    Saffron, Crocus sativus (Iridaceae), is a perennial herb, which earned its popularity as both medicine and spice. It is an inhabitant of different mountainous regions of Asia Minor to Greece, Western Asia, Egypt, and India. The benefits of saffron as an antidepressant are well-documented. Almost 150 volatile and nonvolatile compounds are obtained from the chemical analysis of this plant. Fewer than 50 constituents elucidated and identified so far showed phytochemical characteristics. The major bioactive compounds identified are safranal, crocin, and picrocrocin, which are responsible for its aroma as well as its bitter taste. This review is an attempt to encompass the methods of analysis and pharmacodynamic and pharmacokinetic properties of saffron followed by its efficacious and safe potential.
  11. Mohd Yusof AM, Rahman NAA, Haque M
    J Pharm Bioallied Sci, 2018 12 21;10(4):232-239.
    PMID: 30568381 DOI: 10.4103/JPBS.JPBS_141_18
    Background: Food poisoning (FP) commonly occurs because of consuming contaminated food, which can be fatal. Many people are not aware of the dangers of FP. Thus, the purpose of this study is to analyze the knowledge, attitude, and practice (KAP) of FP among dietetic students (DS) and food handlers (FH) in a public university in Malaysia.

    Materials and Methods: A cross-sectional study was designed, and a self-administered questionnaire was distributed to 106 respondents. The survey comprised four sections including sociodemographic, knowledge, attitude, and practice.

    Results: Total percentage scores for KAP for FH were 86.06%, 32.40%, and 19.91%, respectively, whereas the KAP scores for DS were 89.36%, 34.26%, and 19.94%, respectively. This study revealed that the respondents had good knowledge but poor attitude and practice toward FP. Total mean percentage of KAP scores for DS was higher than FH. Besides, no significant difference was observed in KAP toward FP across different genders, age, education, and income levels among FH. However, for DS, significant difference (p = 0.008) was observed in knowledge toward FP between genders. Significant association (p = 0.048) was also reported in practice toward FP with age among DS. This study also found a significant association between knowledge and attitude (p = 0.032) and knowledge and practice (p = 0.017) toward FP among FH.

    Conclusion: Nevertheless, among DS, no significant association was observed between knowledge, attitude and practice toward FP. The findings may help them to plan effective methods to promote better understanding about FP and improving their knowledge and awareness.

  12. Alwan IA, Awadh AI, Tangiisuran B, Khan HRM, Yahaya N, Majid MI
    J Pharm Bioallied Sci, 2020 10 08;12(4):475-481.
    PMID: 33679096 DOI: 10.4103/jpbs.JPBS_340_19
    Background and Purpose: The wide availability of medications has led to an increased exposure of humans to the possibility of poisoning. An unavoidable effect due to the availability of these medications has also led to a rising increment in the number of poisoning cases. All drugs, especially when administered in large doses or overextended periods, can initiate a toxic condition. Therefore, the objective of this study was to examine nationwide, the patterns attributed to poisoning, and to describe the sociodemographic, and geographic distribution of poisoning, by identifying the category of substances implicated in these cases.

    Data Sources and Methods: A retrospective study based on telephone calls reported on poisoning caused by pharmaceutical products undertaken by the National Poisoning Centre (NPC) in Penang (Malaysia) was used as the basis of this study covering the period between 2010 and 2015. The study included the mode and type of poisoning, exposure routes as well as the incidence locations.

    Results: A total of 10,998 cases were examined, finding that females represented 5,899 cases (53.6%) being intoxicated more frequently compared to the number of males, 3,839 (34.9%). The age group of poisoning cases ranged between 20 and 29 years representing 2,579 (23.4%) of reported cases. The common mode of poisoning was attributed to suicide 5,203 (47.3%) from among the 10,998 cases and the highest poisoning agents reported were from the psychiatric group of pharmaceutical products of 2,287 (21%).

    Conclusion and Implications: These findings indicate a rising trend of suicidal poisoning attempts between 2013 and 2015, which emphasizes the need for more stringent and effective enforcement protocols to limit the rising incidence of poisoning. As such, analyzing the trends in poisoning in a particular zone periodically could help health policy-makers to develop management policies and prevention strategies.

  13. Hayati F, Chabib L, Fauzi IS, Awaluddin R, Sumayya, Faizah WS, et al.
    J Pharm Bioallied Sci, 2020 10 08;12(4):457-461.
    PMID: 33679093 DOI: 10.4103/jpbs.JPBS_297_19
    Introduction: Pegagan is a traditional medicinal plant with three major bioactive properties, triterpenoid, steroids, and saponin. It has the properties of antioxidant, antistress, and wound healing. Pegagan extract is prepared in self-nanoemulsifying drug delivery systems (SNEDDS) to overcome the problem of low water-solubility level.

    Objectives: This study aimed to observe the effect of pegagan ethanolic extract SNEDDS on the development of zebrafish embryos.

    Materials and Methods: This study used 12 sets of zebrafish embryos presented in five sets of extract SNEDDS with different concentrations, that is, 20, 10, 5, 2.5, and 1.25 μg, five sets of SNEDDS without extract with different concentrations, that is, 20, 10, 5, 2.5, and 1.25 μg, a set of positive control (3.4-DCA 4 mg/L) with one control set (diluted with water), and a negative control (SNEDDS without extract). The procedure was conducted for 96 h with observations every 24 h. The parameters observed were embryonic coagulation, formation of somites, detachment of tail bud from the yolk, and abnormality of embryo.

    Results: The results showed that in 96 h the 20ppm concentration caused 100% mortality. Embryo abnormality appeared as coagulation of embryo, somite malformation, and abnormal tail.

    Discussion: There is a correlation between the concentration of SNEDDS and the incidence of embryo coagulation. The malformation in the group of pegagan extract SNEDDS is characterized by cardiac edema, somite malformation, and abnormal tail.

    Conclusion: Pegagan ethanolic extract SNEDDS of 20ppm can inhibit the development of zebrafish embryos.

  14. Hamid N, Muhamad R, Kueh YC, Zahari Z, Mohamad Nor N, Abdullah N, et al.
    J Pharm Bioallied Sci, 2020 10 08;12(4):444-448.
    PMID: 33679091 DOI: 10.4103/jpbs.JPBS_265_19
    Background: In Malaysia, the problem of marital distress is fast becoming an important public health concern. A major shortcoming is inadequate marital evaluation. There are, however, very few localized instruments for married women in Malaysia. The objective of this study was to translate the original version of the Revised Dyadic Adjustment Scale (RDAS) and to evaluate for its psychometric properties. Multiple aspects of validity and reliability were also assessed.

    Materials and Methods: The questionnaire was first translated into the Malay language (RDAS-M). In this cross-sectional study, healthy married Malay women in Kota Bharu, Kelantan, were recruited from January to April 2018. Participants were asked to complete the RDAS-M that consists of three domains, that is, dyadic consensus, dyadic satisfaction, and dyadic cohesion with a total of 14 items. The concept, content, and construct validity using exploratory factor analysis (EFA) and reliability of the RDAS-M were assessed.

    Results: Of the 164 recruited participants, 150 consented to participate. The mean age of the participants was 34.1 years (standard deviation [SD], 9.5 years), ranging from 20 to 57 years. All 14 items were considered comprehensible by more than 95% of the subjects. Based on EFA, total variance extracted was 69.08%, and the original three factors were retained. The Malay version of the RDAS was valid based on factor loadings for dyadic consensus, dyadic satisfaction, and dyadic cohesion, which ranged from 0.64 to 0.80, 0.79 to 0.98, and 0.37 to 0.78, respectively. The internal consistency was good with coefficient α of 0.87 for dyadic consensus, 0.93 for dyadic satisfaction, and 0.78 for dyadic cohesion.

    Conclusions: The Malay version of the RDAS is easy to understand, and is a reliable and valid instrument for married women. It is also comparable with the original version of the RDAS in terms of structure and psychometric properties.

  15. Tahir M, Upadhyay DK, Iqbal MZ, Rajan S, Iqbal MS, Albassam AA
    J Pharm Bioallied Sci, 2020 10 08;12(4):436-443.
    PMID: 33679090 DOI: 10.4103/jpbs.JPBS_263_20
    Introduction: Community pharmacist's knowledge about the uses of herbal medicines and its adverse drug reactions reporting can contribute in better therapeutic outcomes and patient safety. Objectives: To evaluate community pharmacists' knowledge about the use of herbal medicines and its adverse drug reactions reporting in Kedah state, Malaysia.

    Methods: A cross-sectional, questionnaire-based study was conducted among 103 pharmacists from 74 different community pharmacies to assess their knowledge about the use of herbal medicines and its adverse drug reaction reporting by using a pre-validate knowledge questionnaire consisting of 12 questions related to it. The pharmacists' responses were measured at a 3-point Likert scale (Poor=1, Moderate=2, and Good=3) and data was entered in SPSS version 22. The minimum and maximum possible scores for knowledge questionnaires were 12 and 36 respectively. Quantitative data was analyzed by using One Way ANOVA and Paired t-test whereas Chi-square and Fisher exact test were used for qualitative data analysis. A p-value of less than 0.05 was considered statistically significant for all the analyses.

    Results: About 92% of the pharmacist had good knowledge regarding the use of herbal medicines and its adverse drug reaction reporting with a mean knowledge score of 32.88±3.16. One-way ANOVA determined a significant difference of employment setting (p<0.043) and years of experience (<0.008) with mean knowledge scores of Pharmacists. Pharmacists' knowledge was significantly associated with their years of experience with the Chi-square test.

    Conclusion: Pharmacists exhibit good knowledge regarding the use of herbal medicines and its adverse drug reaction reporting. However, with an increasing trend of herbal medicine use and its adverse drug reaction reporting it recalls the empowerment of experienced pharmacists with training programs in this area for better clinical outcomes.

  16. Dellemin NA, Zahari Z, Ahmad Hassali MA, Abdul Rashid S
    J Pharm Bioallied Sci, 2020 10 08;12(4):428-435.
    PMID: 33679089 DOI: 10.4103/jpbs.JPBS_247_19
    Introduction: National Pharmaceutical Regulatory Agency, Ministry of Health Malaysia has received 1018 adverse drug reaction reports related to paracetamol with 1972 adverse events from the year 2000 to February 2015. Serious skin reactions including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis, and acute generalized exanthematous pustulosis may develop as a result of allergic reactions of paracetamol. This study aimed to develop and validate a questionnaire regarding Knowledge, Attitude, and Perception towards Allergic Reactions of Paracetamol (KAP-ARP) among the general population.

    Materials and Methods: Content and face validity of the KAP-ARP were determined by four experts and 20 respondents, respectively. A questionnaire with 36 items, consisting of 16 Knowledge, 9 Attitude, and 11 Perception items, was distributed to 177 respondents. Exploratory factor analysis (EFA) was performed for construct validity. Cronbach's alpha was used to determine the reliability of the questionnaire.

    Results: EFA constructed 13 Knowledge, 8 Attitude, and 8 Perception items. The final KAP-ARP questionnaire is reliable based on its internal consistency reliability (Knowledge: α = 0.78; Attitude: α = 0.63; Perception: α = 0.70).

    Conclusion: A valid and reliable questionnaire that is useful for measuring KAP-ARP among the general population has been developed.

  17. Shirazi OU, Ab Rahman NS, Zin CS
    J Pharm Bioallied Sci, 2020 10 08;12(4):369-380.
    PMID: 33679082 DOI: 10.4103/jpbs.JPBS_311_19
    The overuse of antibiotics has led to various healthcare problems such as the emergence of resistance in infectious microbes and mortality due to antibiotic resistant healthcare associated infections (HAIs). An antimicrobial stewardship (AMS) program is the set of interventions used worldwide to enhance the rational use of antibiotics especially for the hospitalized patients. This review aimed to describe the characteristics of the implemented AMS programs in various hospitals of the world mainly focusing on the interventions and patients outcomes. The literature about AMS program was searched through various databases such as PubMed, Google Scholar, Science Direct, Cochran Library, Ovid (Medline), Web of Science and Scopus. In this review the literature pertaining to the AMS programs for hospitalized patients is sorted on the basis of various interventions that are categorized as formulary restriction (pre-authorization), guideline development, clinical pathway development, educative interventions and prospective audit. Moreover a clear emphasis is laid on the patient outcomes obtained as a result of these interventions namely the infection control, drop in readmission rate, mortality control, resistance control and the control of an overall cost of antibiotic treatment obtained mainly by curbing the overuse of antibiotics within the hospital wards. AMS program is an efficient strategy of pharmacovigilance to rationalize the antimicrobial practice for hospitalized patients as it prevents the misuse of antibiotics, which ultimately retards the health threatening effects of various antibiotics.
  18. Wasli NS, Ridzwan IE, Azzubaidi MS, Kasmuri AR, Ahmed QU, Ming LC, et al.
    J Pharm Bioallied Sci, 2020 Nov;12(Suppl 2):S826-S830.
    PMID: 33828384 DOI: 10.4103/jpbs.JPBS_379_19
    Introduction: κ-opioid receptor (KOPr) system has been linked to relapse to many substances, especially opioids. Positive responses were recently reported in morphine and methamphetamine (polydrug)-dependent mice treated with buprenorphine and naltrexone, a functional κ antagonist.

    Objectives: This study aimed to determine the specific brain region that is responsive to KOPr treatment following polydrug dependence.

    Materials and Methods: The polydrug-dependent mice model was developed using conditioned place preference (CPP) method. Following successful withdrawal phase, the mice were treated with 0.3 mg/kg buprenorphine and 1.0 mg/kg naltrexone. Four brain regions (hippocampus, prefrontal cortex, amygdala, and striatum) were investigated using immunohistochemistry technique. This is to quantify the changes in KOPr expression in each major brain region that was primarily involved in addiction neurocircuits of many substances. Unpaired Student's t test was used to analyze all results, where P < 0.05 is considered significant.

    Results: The results showed that treatment with buprenorphine and naltrexone successfully attenuated relapse in 60% of mice (n = 14). A significant upregulation of KOPr was detected in striatum at the end of post-withdrawal phase (P < 0.01, n = 12). This treatment successfully suppressed KOPr in striatum (P < 0.001, n = 12), which supports the positive results seen in the CPP setting. No significant changes were observed in other brain regions studied.

    Conclusion: The hyperactivity of striatum suggests that the affected brain region following KOPr antagonist treatment is the region that primarily controls the drug rewarding activity, in which nucleus accumbens is located. This indicates that manipulation of KOPr system is one of the potential targets to treat morphine- or methamphetamine-dependence problem.

  19. Ramlan AR, Mohamed Nazar NI, Tumian A, Ab Rahman NS, Mohamad D, Abdul Talib MS, et al.
    J Pharm Bioallied Sci, 2020 Nov;12(Suppl 2):S810-S815.
    PMID: 33828381 DOI: 10.4103/jpbs.JPBS_3_20
    Introduction: Methadone maintenance therapy (MMT) program helped to improve access to antiretroviral therapy (ART) among people who inject drugs (PWID) with human immunodeficiency virus (HIV). However, the time to treatment initiation (TTI) and outcomes of ART intervention in this population have scarcely been analyzed.

    Objectives: The aim of this study was to analyze the TTI and outcomes of ART among MMT clients in primary health-care centers in Kuantan, Pahang.

    Materials and Methods: This was a retrospective evaluation of MMT clients from 2006 to 2019. The TTI was calculated from the day of MMT enrolment to ART initiation. The trends of CD4 counts and viral loads were descriptively evaluated. Cox proportional hazard model was used to analyze the survival and treatment retention rate.

    Results: A total of 67 MMT clients from six primary health-care centers were HIV-positive, of which 37 clients were started on ART. The mean TTI of ART was 27 months. The clients who were given ART had a mean CD4 count of 119 cells/mm3 at baseline and increased to 219 cells/mm3 after 6 months of ART. Only two patients (5.4%) in the ART subgroup had an unsuppressed viral load. The initiation of ART had reduced the risk of death by 72.8% (hazard ratio = 0.27, P = 0.024), and they are 13.1 times more likely to remain in treatment (P < 0.01).

    Conclusion: The TTI of ART was delayed in this population. MMT clients who were given ART have better CD4 and viral load outcomes, helped reduced death risk and showed higher retention rates in MMT program.

  20. Rozali MA, Abd Rahman NS, Sulaiman H, Abd Rahman AN, Atiya N, Wan Mat WR, et al.
    J Pharm Bioallied Sci, 2020 Nov;12(Suppl 2):S804-S809.
    PMID: 33828380 DOI: 10.4103/jpbs.JPBS_266_19
    Introduction: Approach to managing infection in the intensive care unit (ICU) often varies between institutions and not many readily adapt to available local guidelines despite it was constructed to suite local clinical scenario. Malaysia already has two published guidelines on managing infection in the ICU but data on its compliance are largely unknown.

    Objectives: A cross-sectional survey was carried out and sent to a total of 868 specialists working primarily in the ICU. The aim of this study was to explore knowledge, perception, and the antibiotic prescribing practice among specialists and advanced trainees in Malaysian ICU.

    Materials and Methods: A cross-sectional survey was used, consisted of three sections: knowledge, perception, and antibiotic prescribing practice in ICU. Three case vignettes on hospital-acquired pneumonia (HAP), infected necrotizing pancreatitis (INP), and catheter-related bloodstream infection (CRBSI) were used to explore antibiotic prescribing practice.

    Results: A total of 868 eligible subjects were approached with 104 responded to the survey. Three hundred eighty-nine antibiotics were chosen from seven different classes in the case vignettes. All respondents acknowledged the importance of pharmacokinetic/pharmacodynamic (PK/PD) in antibiotic optimization and majority (97.2%) perceived that current dosing is inadequate to achieve optimal PK/PD target in ICU patients. Majority (85.6%) believed that antibiotic dose should be streamlined to the organisms' minimum inhibitory concentration (MIC). In terms of knowledge, only 64.4% provided the correct correlations between antibiotics and their respective PK/PD targets. Compliance rates in terms of antibiotic choices were at 79.8%, 77.8%, and 27.9% for HAI, INP, and CRBSI, respectively.

    Conclusion: Malaysian physicians are receptive to use PK/PD approach to optimize antibiotic dosing in ICU patients. Nonetheless, there are still gaps in the knowledge of antibiotic PK/PD as well as its application in the critically ill, especially for β-lactams.

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