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  1. Nguyen HTM, Nilsson S, Mueller AAR, Toms LM, Kennedy C, Langguth D, et al.
    Sci Total Environ, 2023 Apr 20;870:161749.
    PMID: 36690112 DOI: 10.1016/j.scitotenv.2023.161749
    Human biomonitoring programs of per- and polyfluoroalkyl substances (PFAS) have been conducted around the world to assess human exposure and health risk. Inquiry into population PFAS levels in a socioeconomically and geographically unique region such as the Pacific Island Papua New Guinea, may provide new insights into PFAS exposure pathways and sources. This study presented the first indication of PFAS exposure in the Papua New Guinea population. De-identified serum samples were pooled from surplus pathology serum samples collected between 2019 and 2020. A total of 11 PFAS were detected in the serum pools including 10 perfluoroalkyl acids (PFAA) and 9Cl-F53B (a perfluorooctane sulfonic acid - PFOS alternative). The observed PFAA profile was somewhat similar to that observed for general population data of other countries such as Australia, Malaysia, and Canada suggesting similar exposure sources and/or pathways. However, PFAS concentrations were consistently lower than concentrations in the serum measured in pools obtained from Australia. The detection of 9Cl-F53B in all pools was a new finding which might be related to exposure from locally industrial sources.
    Matched MeSH terms: Humans
  2. Galagoda GCS, Perera J, de Silva R, Wickramasinghe HT, Dasanayake D, Bravo L, et al.
    Hum Vaccin Immunother, 2023 Dec 31;19(1):2165360.
    PMID: 36655357 DOI: 10.1080/21645515.2023.2165360
    Aiming to further the Immunization Partners in Asia Pacific (IPAP)'s vision of a world where no one suffers from a vaccine preventable disease, the 8th Asian Vaccine Conference (ASVAC 2022) was held in Colombo, Sri Lanka and virtually from 15 to 18, September 2022 (www.asianvaccine.com). This conference followed those held in Siem Reap, Cambodia (2009), Manila, Philippines (2010), Jakarta, Indonesia (2011), Cebu, Philippines (2013), Hanoi, Vietnam (2015), Singapore (2017) and Naypyidaw and Yangon, Myanmar (2019). The ASVAC2022 themed "Immunization: in Era of Pandemics," commenced with the EPI Managers' Workshop, followed by pre-conference workshops and Vaccinology Masterclass, followed by the main conference featuring 5 plenary lectures, 6 partner-led symposia, free paper and poster presentations, and industry-supported lunch and evening sessions. There were over 1830 registered participants, with 112 attending in person and 998 virtually from 63 countries. The conference was organized by IPAP and hosted by the Vaccine and Infectious Disease Forum of Sri Lanka, Sri Lanka College of Pediatricians, Sri Lanka College of Microbiologists and College of General Practitioners of Sri Lanka, with the support of the Ministry of Health, Sri Lanka. The 9th ASVAC is scheduled to be held in Davao City, Philippines in late 2023.
    Matched MeSH terms: Humans
  3. Tang ASO, Ahmad Asnawi AW, Koh AZY, Chong SL, Liew PK, Selvaratnam V, et al.
    Am J Case Rep, 2023 Mar 08;24:e938868.
    PMID: 36882990 DOI: 10.12659/AJCR.938868
    BACKGROUND Plasma cell leukemia (PCL) is an aggressive form of plasma cell neoplasm. We report the first case of primary PCL successfully treated with upfront novel agents consisting of Venetoclax and daratumumab in combination with intensive chemotherapy and allogeneic transplantation. CASE REPORT A 59-year-old woman presented with epistaxis, gum bleeding, and blurred vision. On examination, she appeared pale, with multiple petechiae and hepatomegaly. Fundoscopy revealed retinal hemorrhages. Laboratory investigations revealed bicytopenia and leukocytosis, with mild coagulopathy and hypofibrinogenemia. Elevated globulin and calcium levels were also observed. Serum protein electrophoresis demonstrated IgG lambda paraproteinemia, with a serum-free light chain kappa-to-lambda ratio of 0.074. A skeletal survey revealed the presence of lytic lesions. Bone marrow investigations confirmed the presence of lambda-light-chain-restricted clonal plasma cells. FISH detected t(11;14) and 17p13.1 deletion. Therefore, a final diagnosis of primary PCL was made. The patient received 1 cycle of bortezomib, cyclophosphamide, and dexamethasone (VCD) and 5 cycles of Venetoclax-VCD, followed by an unsuccessful stem cell mobilization. One cycle of daratumumab in combination with bortezomib, lenalidomide, and dexamethasone (VRD) was then given. The patient achieved complete remission. She underwent allogeneic stem cell transplantation of an HLA-matched sibling donor. Post-transplant marrow assessment showed disease remission and absence of t(11;14) and 17p deletions. She was administered pamidronate and lenalidomide maintenance. She remained clinically well with a good performance status and no active graft-versus-host disease 18 months after transplant. CONCLUSIONS The success of our patient in achieving complete remission has highlighted the efficacy and safety of this novel therapy in the front-line management of PCL.
    Matched MeSH terms: Humans
  4. Vasantha Kumar P, Subramaniam P, Che Din N
    Asian J Psychiatr, 2021 Jun;60:102646.
    PMID: 33873045 DOI: 10.1016/j.ajp.2021.102646
    BACKGROUND: The effects of aging and its associated cognitive decline is particularly acute in Asia given the exponential growth of older adults as a proportion of the population as a whole. Many structured cognitive interventions have been proposed to prevent the cognitive decline typically seen in older age, but their utility as a viable means of achieving these goals is questionable.

    OBJECTIVES: To summarize and synthesize evidence on the utility and methodological quality of cognitive-based interventions on cognitive performance and associated secondary outcomes among healthy older adults in Asia, as well as novel, culture-specific components of cognitive interventions across the region.

    DATA SOURCES: The PubMed/Medline, Web of Science, Scopus, and ScienceDirect databases were searched through May 2020.

    ELIGIBILITY: Studies including individuals aged 60 years and above, who had no previous history of physical and/or mental illness. Few restrictions placed on intervention design, duration and mode of delivery, provided that participants were randomized to study conditions, and intervention included components addressing at least one cognitive domain.

    RESULTS: A total of 17 studies from six countries met the eligibility criteria and were included in the final review. Evidence from those studies indicated that cognitive interventions may be most effective when the design and aims were directed towards improvement in specific cognitive domains, but evidence regarding long-term effectiveness in preventing progression to clinical-level cognitive deficits is still unclear. Several studies highlighted culture-specific activities as components of their interventions, though these will need to be further outlined and standardized clearly in future research.

    Matched MeSH terms: Humans
  5. Owusu AFS, Abdullah A, Pinto GH, Bentum H, Moo JTN, Ayim M, et al.
    Community Health Equity Res Policy, 2023 Apr;43(3):329-338.
    PMID: 34102924 DOI: 10.1177/0272684X211022176
    In this study, we attempted to move beyond the skewed discussions on stigma to unravel other social consequences that are experienced by persons who have recovered from COVID-19. We conducted a documentary review of published news reports from 14 highly ranked news portals in Ghana and Malaysia (published between 1st January 2020 and 30th August 2020) that contained personal accounts from the recovered patients about their lived experiences with the virus and social consequences encountered after recovery. Narratives from the recovered patients were extracted and analyzed following the narrative thematic analysis procedure. Common themes identified from the narratives included: 1) Stigma impacting mental health, 2) Assault and abuse 3) Experiences of treatment. The findings show the need for interprofessional collaboration between social and health care professionals such as social workers, community health workers, medical practitioners and psychologists to prevent and address issues of abuse and other social consequences experienced by COVID-19 survivors.
    Matched MeSH terms: Humans
  6. Abdul Jalil NI, Tan SA, Ibharim NS, Musa AZ, Ang SH, Mangundjaya WL
    PMID: 36768122 DOI: 10.3390/ijerph20032758
    The emergence of coronavirus disease has impacted human lives, one of which is economic disruption. Many Malaysian organisations have devised various crisis-response techniques, such as downsizing, laying off, retrenching, and combining. As a result, the number of Malaysians working in precarious jobs, which are defined by unpredictable and uncertain situations, has indirectly increased, hence increasing job insecurity. Therefore, maintaining psychological health is essential to safeguarding the mental health of employees. In the current working landscape, job security and work-life balance have commonly been deemed necessary in contributing to well-being among employees. As a result, the purpose of this study was to examine how work-life balance influences the relationship between job insecurity and psychological well-being among Malaysian precarious workers. It also fills a gap in the research by explaining the causal association between job insecurity and psychological well-being among precarious workers, as previous well-being studies have largely focused on employees with secure jobs. There were 442 responders collected using purposive and snowball sampling methods, and they were requested to complete the Job Insecurity Scale (JIS), Work-Life Balance, and Well-Being Index Scale (WHO-5). Job instability was negatively connected with work-life balance and psychological well-being. On the other hand, work-life balance was found to be positively related to psychological well-being. This supports the notion that work-life balance is a significant mediator in the relationship between job insecurity and psychological well-being. These findings emphasise that Malaysian precarious workers with job security could enhance their psychological well-being by achieving work-life balance.
    Matched MeSH terms: Humans
  7. Subramaniam C, Johari J, Mashi MS, Mohamad R
    J Safety Res, 2023 Feb;84:117-128.
    PMID: 36868640 DOI: 10.1016/j.jsr.2022.10.013
    INTRODUCTION: This paper investigates the relationships among safety leadership, safety motivation, safety knowledge, and safety behavior in the setting of a tertiary hospital in Klang Valley, Malaysia.

    METHOD: Underpinned by the self-efficacy theory, we argue that high-quality safety leadership enhances nurses' safety knowledge and motivation and subsequently, improves their safety behavior (safety compliance and safety participation). A total of 332 questionnaire responses were gathered and analyzed using SmartPLS Version 3.2.9, revealing the direct effect of safety leadership on both safety knowledge and safety motivation.

    RESULTS: Safety knowledge and safety motivation were found to directly and significantly predict nurses' safety behavior. Notably, safety knowledge and safety motivation were established as important mediators in the relationship between safety leadership and nurses' safety compliance and participation.

    PRACTICAL APPLICATIONS: The findings of this study offer key guidance for safety researchers and hospital practitioners in identifying mechanisms to enhance safety behavior among nurses.

    Matched MeSH terms: Humans
  8. Mathew R, Sathasivam HP, Mohamednor L, Yugaraj P
    BMC Oral Health, 2023 Mar 08;23(1):132.
    PMID: 36890517 DOI: 10.1186/s12903-023-02780-y
    BACKGROUND: Orthodontic treatment is a time-consuming and highly technique-sensitive clinical procedure. A patient's comprehension and compliance with oral hygiene instructions and appliance maintenance are critical to the success of orthodontic treatment. This study was performed to assess the knowledge, attitude and practice of patients seen at government orthodontic clinics in the Federal Territories of Kuala Lumpur and Putrajaya towards orthodontic treatment.

    METHODS: A validated, bilingual, self-administered questionnaire comprising fifteen questions across the domains of Knowledge, Attitude and Practice was used and responses were assessed with 3 responses; one correct, one incorrect and one reflecting uncertainty. 507 patients from five orthodontic centres participated in this study. Data was analysed using SPSS. Continuous data was summarised as mean and standard deviation or median and inter-quartile range, as appropriate. Categorical data was summarised as frequency and percentage, then univariable analysis was carried out with Pearson's chi-square test or Fisher's exact test, as appropriate.

    RESULTS: The mean age of respondents was 22.5 years (SD ± 2.8). A majority of respondents were female (64.1%) and from the lowest income bracket or B40 group (71%). Overall, for the knowledge domain, a majority of the respondents got all questions correct. 69.4% of patients were aware that incomplete treatment could lead to worsening of their malocclusion. 80.9% of respondents were aware of the need for a retainer upon completion of their orthodontic treatment. For the attitude section, 64.7% felt that they had to wait a very long time to see the orthodontist. In the Practice domain, the majority only got two of the five questions correct. Only 39.8% of respondents made an effort to alter dietary habits all of the time. In general, females and those with tertiary education fared better for all three domains.

    CONCLUSIONS: The orthodontic patients in the Federal Territories of Kuala Lumpur and Putrajaya possess good knowledge about their treatment however their attitude and orthodontic related practices need to be improved.

    Matched MeSH terms: Humans
  9. Goh LPW, Marbawi H, Goh SM, Bin Abdul Asis AK, Gansau JA
    J Infect Dev Ctries, 2023 Feb 28;17(2):139-146.
    PMID: 36897896 DOI: 10.3855/jidc.17135
    INTRODUCTION: Hospital-acquired infections (HAIs) have continually affected the quality of hospital care. Despite medical interventions by healthcare personnel and improved healthcare facilities, the rates of morbidity and mortality due to HAIs is increasing. However, a systematic review of HAIs is lacking. Therefore, this systematic review aims to determine the prevalence rate, types, as well as causes of HAIs in Southeast Asian countries.

    METHODOLOGY: A systematic literature search was conducted on PubMed, Cochrane library, World Health Organization database-Index Medicus for South-East Asia Region (WHO-IMSEAR), and Google Scholar databases. The search period was from 1st January 1990 until 12th May 2022. The prevalence of HAIs and subgroups were calculated using MetaXL software.

    RESULTS: The database search retrieved 3879 non-duplicate articles. After applying exclusion criteria, 31 articles with a total number of 47666 subjects were included and a total of 7658 cases of HAIs were recorded. The overall prevalence of HAIs in Southeast Asia was 21.6 % (95% CI: 15.5 - 29.1%) with heterogeneity statistics of I2 = 100%. Indonesia had the highest prevalence rate of 30.4% whereas Singapore had the lowest prevalence rate at 8.4%.

    CONCLUSIONS: This study revealed that the overall prevalence of HAIs was relatively high and the prevalence rate of each country was associated with socioeconomic status. Measures should be taken to examine and control the rates of HAIs in countries with high HAI prevalence.

    Matched MeSH terms: Humans
  10. Pandit PS, Anthony SJ, Goldstein T, Olival KJ, Doyle MM, Gardner NR, et al.
    Commun Biol, 2022 Aug 19;5(1):844.
    PMID: 35986178 DOI: 10.1038/s42003-022-03797-9
    Host-virus associations have co-evolved under ecological and evolutionary selection pressures that shape cross-species transmission and spillover to humans. Observed virus-host associations provide relevant context for newly discovered wildlife viruses to assess knowledge gaps in host-range and estimate pathways for potential human infection. Using models to predict virus-host networks, we predicted the likelihood of humans as hosts for 513 newly discovered viruses detected by large-scale wildlife surveillance at high-risk animal-human interfaces in Africa, Asia, and Latin America. Predictions indicated that novel coronaviruses are likely to infect a greater number of host species than viruses from other families. Our models further characterize novel viruses through prioritization scores and directly inform surveillance targets to identify host ranges for newly discovered viruses.
    Matched MeSH terms: Humans
  11. Khan S, Thambiah S, Khoo YH
    Violence Against Women, 2023 Mar;29(3-4):431-452.
    PMID: 35938226 DOI: 10.1177/10778012221092468
    This article uses the narratives of survivors of honor killing to show that women's agency is the reason for life threats because it undermines masculine domination. The findings show that life threats are made against women engaging in behaviors not aligned to cultural norms as perceived by male members of their family, to escape shame and gossip, and it is a manifestation of men losing control over women. These survivors of honor-based violence have undermined masculine domination by acting in unanticipated ways and by fleeing to a shelter home in the face of overwhelming cultural sanctions and structural inequalities.
    Matched MeSH terms: Humans
  12. Ang PS, Yeo SL, Koran L
    Dementia (London), 2023 Apr;22(3):628-645.
    PMID: 36764831 DOI: 10.1177/14713012231155979
    INTRODUCTION: This study examines the underlying visual communication strategies found in existing images of dementia in the public domain. By delineating how experiences of dementia are visualized and their consequent social interpretations, we aim to inform and advocate for a dementia-inclusive visual communication, that is, visual depictions that cultivate and represent a dementia-inclusive society.

    METHODS: The visuals were analyzed by employing the Visual Discourses of Disability (ViDD) framework that juxtaposes the "perspectivizing-personizing" cline with the "enabling-disabling" continuum. The data studied comprise a total of 432 images sourced from three domains, namely (1) The Star, a Malaysian mainstream English newspaper (2012-2021); (2) Alzheimer's Disease Foundation Malaysia (ADFM) website (2019-2021); and (3) the Ministry of Health Malaysia (2019-2021) website. Findings from the visual analyses were corroborated by four representatives of ADFM in a group interview.

    RESULTS: There is a predominance of stigmatized images, constructing dementia as a loss and deficit, thus depicting individuals in distanced suffering. Generic representations of people through stock images, a unique focus on the hands, representations of brain degeneration through abstractions and missing puzzle pieces are also prevalent. Despite these, the interview data confirmed that the perspectivizing aspect may be necessary to educate the public on what dementia entails. While personizing images that depict personhood and actual persons living with dementia are ideal, the use of stock images may be necessary if there is a need to maintain confidentiality and observe sensitivities. Similarly, images with positive emotions are encouraged but disabling ones are equally important to reflect reality and inculcate empathy.

    CONCLUSION: When capturing, selecting and publishing images of dementia, organizations should deliberate on different visual elements which evoke empowerment, advocacy, handicapping and othering implications as outlined in the ViDD framework. Any decision should only be made after considering the purposes of publications and implications such images have on the intended audiences.

    Matched MeSH terms: Humans
  13. Gul MU, Kamarul Azman MH, Kadir KA, Shah JA, Hussen S
    Comput Intell Neurosci, 2023;2023:8162325.
    PMID: 36909967 DOI: 10.1155/2023/8162325
    Atrial flutter (AFL) is a common arrhythmia with two significant mechanisms, namely, focal (FAFL) and macroreentry (MAFL). Discrimination of the AFL mechanism through noninvasive techniques can improve radiofrequency ablation efficacy. This study aims to differentiate the AFL mechanism using a 12-lead surface electrocardiogram. P-P interval series variability is hypothesized to be different in FAFL and MAFL and may be useful for discrimination. 12-lead ECG signals were collected from 46 patients with known AFL mechanisms. Features for a proposed classifier are extracted through descriptive statistics of the interval series. On the other hand, the class ratio of MAFL and FAFL was 41 : 5, respectively, which was highly imbalanced. To resolve this, different data augmentation techniques (SMOTE, modified-SMOTE, and smoothed-bootstrap) have been applied on the interval series to generate synthetic interval series and minimize imbalance. Modification is introduced in the classic SMOTE technique (modified-SMOTE) to properly produce data samples from the original distribution. The characteristics of modified-SMOTE are found closer to the original dataset than the other two techniques based on the four validation criteria. The performance of the proposed model has been evaluated by three linear classifiers, namely, linear discriminant analysis (LDA), logistic regression (LOG), and support vector machine (SVM). Filter and wrapper methods have been used for selecting relevant features. The best average performance was achieved at 400% augmentation of the FAFL interval series (90.24% sensitivity, 49.50% specificity, and 76.88% accuracy) in the LOG classifier. The variation of consecutive P-wave intervals has been shown as an effective concept that differentiates FAFL from MAFL through the 12-lead surface ECG.
    Matched MeSH terms: Humans
  14. Manzoor SR, Mohd-Isa WN, Dollmat KS
    F1000Res, 2021;10:1106.
    PMID: 35646326 DOI: 10.12688/f1000research.73311.2
    Background: The Covid-19 pandemic has resulted in an abrupt but accelerated shift to e-learning worldwide. Education in a post-pandemic world has to amalgamate the advantages of e-learning with important pedagogical goals associated with in-person teaching. Although various advanced technologies are present at our fingertips today, we are still unable to use their full potential in teaching and learning. In this regard, mobile VR technology is both cost-efficient, versatile and engaging for students. Developing countries have more smartphone users than developed countries, implying that developing countries, like Malaysia, should utilize mobile or cellphones more significantly. With that in mind, we propose here a pre-protocol to investigate learner motivation and levels of engagement for e-learning with smartphone-integrated VR, based on their VARK (Visual, Auditory, Read/Write, Kinesthetic) learning styles. Proposed methodology: This study intends to look into students from the same age group under the K-12 (particularly grade 9-12) belonging to STEM curriculum. The Google Cardboard VR set will be used as the prime technology for its affordability, easy build feature and variety of available vendors. A mixed-method (survey and activity log/tracking) for data collection is suggested to find the degree of engagement and motivation of the learners' learning in the mobile VR-assisted e-learning context. The students will be taught a topic using the mobile VR and then be assessed through simple classroom quizzes to assess how well they grasped the concept. The data collected through activity logs (while teaching the topic in mobile VR) and questionnaires will be mapped to each individual learner and organized in a data repository. Further visualization, analysis and investigation will be performed using Smart PLS, Python or R language. Conclusions: The study aims to provide context for smartphone and software companies to develop technologies that could facilitate learner motivation and engagement during the post-pandemic state.
    Matched MeSH terms: Humans
  15. Ang MP, Yeoh SL, Lim CH, Foo SL, Wong YW, Ch'ng GS
    Br J Haematol, 2022 Dec;199(5):765-767.
    PMID: 36237120 DOI: 10.1111/bjh.18481
    Matched MeSH terms: Humans
  16. Boonhok R, Sangkanu S, Phumjan S, Jongboonjua R, Sangnopparat N, Kwankaew P, et al.
    PeerJ, 2022;10:e13657.
    PMID: 35811814 DOI: 10.7717/peerj.13657
    BACKGROUND: Curcumin is an active compound derived from turmeric, Curcuma longa, and is known for its benefits to human health. The amoebicidal activity of curcumin against Acanthamoeba triangularis was recently discovered. However, a physiological change of intracellular pathways related to A. triangularis encystation mechanism, including autophagy in the surviving amoeba after curcumin treatment, has never been reported. This study aims to investigate the effect of curcumin on the survival of A. triangularis under nutrient starvation and nutrient-rich condition, as well as to evaluate the A. triangularis encystation and a physiological change of Acanthamoeba autophagy at the mRNA level.

    METHODS: In this study, A. triangularis amoebas were treated with a sublethal dose of curcumin under nutrient starvation and nutrient-rich condition and the surviving amoebas was investigated. Cysts formation and vacuolization were examined by microscopy and transcriptional expression of autophagy-related genes and other encystation-related genes were evaluated by real-time PCR.

    RESULTS: A. triangularis cysts were formed under nutrient starvation. However, in the presence of the autophagy inhibitor, 3-methyladenine (3-MA), the percentage of cysts was significantly reduced. Interestingly, in the presence of curcumin, most of the parasites remained in the trophozoite stage in both the starvation and nutrient-rich condition. In vacuolization analysis, the percentage of amoebas with enlarged vacuole was increased upon starvation. However, the percentage was significantly declined in the presence of curcumin and 3-MA. Molecular analysis of A. triangularis autophagy-related (ATG) genes showed that the mRNA expression of the ATG genes, ATG3, ATG8b, ATG12, ATG16, under the starvation with curcumin was at a basal level along the treatment. The results were similar to those of the curcumin-treated amoebas under a nutrient-rich condition, except AcATG16 which increased later. On the other hand, mRNA expression of encystation-related genes, cellulose synthase and serine proteinase, remained unchanged during the first 18 h, but significantly increased at 24 h post treatment.

    CONCLUSION: Curcumin inhibits cyst formation in surviving trophozoites, which may result from its effect on mRNA expression of key Acanthamoeba ATG-related genes. However, further investigation into the mechanism of curcumin in A. triangularis trophozoites arrest and its association with autophagy or other encystation-related pathways is needed to support the future use of curcumin.

    Matched MeSH terms: Humans
  17. Abu Bakar SA, Syed Mohamed Shahruddin SNS, Ismail N, Wan Md Adnan WAH
    PeerJ, 2022;10:e13694.
    PMID: 35935256 DOI: 10.7717/peerj.13694
    The estimation of biological age (BA) is an important asymptomatic measure that can be used to understand the physical changes and the aging process of a living being. Factors that contribute towards profiling the human biological age can be diverse. Therefore, this study focuses on developing a BA model for patients with Chronic Kidney Disease (CKD). The procedure commences with the selection of significant biomarkers using a correlation test. Appropriate weighting is then assigned to each selected biomarker using the indexing method to produce a BA index. The BA index is matched to the age variation within the sample to acquire additional terms for the chronological age leading ultimately to the estimated BA. From a sample of 190 patients (133 trained data and 57 testing data) obtained from the University of Malaya Medical Centre (UMMC), Malaysia, the intensity of the BA is found to be between three to nine years from the chronological age. Visual observations further validate the high similarities between the training and testing data sets.
    Matched MeSH terms: Humans
  18. Mohd Sani N, Aziz Z, Kamarulzaman A
    BioDrugs, 2023 Jan;37(1):109-120.
    PMID: 36571697 DOI: 10.1007/s40259-022-00571-5
    BACKGROUND: With the increasing availability biosimilars, the role of pharmacists as drug information specialists has expanded to include promoting biosimilar acceptance among prescribers.

    OBJECTIVES: Our study aimed to determine Malaysian hospital pharmacists' perspectives on biosimilars and to identify factors influencing the successful promotion of biosimilars to prescribers.

    METHODS: This was a cross-sectional, web-based survey of hospital pharmacists across Malaysia. Multivariate logistic regression analysis was used to identify factors associated with pharmacists successfully promoting biosimilar use.

    RESULTS: Of the 913 responses, over 60% of pharmacists believed that patients may safely be switched from the originator product to a biosimilar and would have the same clinical outcome. Many lacked training in biosimilars (62.8%); yet most (80.6%) perceived pharmacists to play a critical role in promoting biosimilar prescribing. Multivariate logistic regression analysis showed that the strongest factor associated with pharmacists' successful promotion of biosimilars to prescribers was having confidence (odds ratio [OR], 3.33; 95% confidence interval [CI] 2.10-5.26). Respondents who had prior experience handling biosimilars were more likely to be successful in promoting biosimilar use than those without (OR, 1.76; 95% CI 1.16-2.66). The pharmacists' top perceived barrier to promote biosimilars in clinical practice was efficacy concerns.

    CONCLUSION: Although Malaysian pharmacists are in favour of biosimilars, they lack training to promote biosimilar use. Among the factors associated with successful promotion of biosimilars to prescribers are pharmacist confidence, their previous experience handling biosimilars, and prior biosimilar training.

    Matched MeSH terms: Humans
  19. Prinz JC, Choon SE, Griffiths CEM, Merola JF, Morita A, Ashcroft DM, et al.
    J Eur Acad Dermatol Venereol, 2023 Feb;37(2):256-273.
    PMID: 36331364 DOI: 10.1111/jdv.18720
    Generalized pustular psoriasis (GPP) is a rare auto-inflammatory skin disease characterised by acute episodes of sterile pustule formation. Diagnosis and treatment of the disease have historically been complicated by a lack of awareness, and no consistent global definition or clinical coding standards. Now acknowledged as a distinct clinical entity with a recognised genetic component, GPP can take a serious and life-threatening course due to systemic inflammatory complications and its association with various comorbidities. As with other rare diseases, there are significant challenges to understanding the epidemiology of GPP, notably a small patient population, non-standardised study methodologies and ethnic differences in its presentation. A clearer understanding of GPP is therefore required for clinicians to better manage patients with this rare condition. In this review article, we present an overview of the available data on GPP prevalence estimates in key demographics and report the frequency of genetic mutations associated with the disease. We detail the incidence of known comorbidities and summarise the data on mortality and assigned causes of death. Lastly, we discuss the various factors that impact the collection, interpretation and comparison of these data.
    Matched MeSH terms: Humans
  20. Elnaem MH, Mosaad M, Abdelaziz DH, Mansour NO, Usman A, Elrggal ME, et al.
    Int J Environ Res Public Health, 2022 Nov 06;19(21).
    PMID: 36361453 DOI: 10.3390/ijerph192114571
    Controlling hypertension (HTN) remains a challenge, as it is affected by various factors in different settings. This study aimed to describe the disparities in the prevalence and barriers to hypertension control across countries of various income categories. Three scholarly databases-ScienceDirect, PubMed, and Google Scholar-were systematically examined using predefined search terms to identify potentially relevant studies. Original research articles published in English between 2011 and 2022 that reported the prevalence and barriers to HTN control were included. A total of 33 studies were included in this systematic review. Twenty-three studies were conducted in low and middle-income countries (LMIC), and ten studies were from high-income countries (HIC). The prevalence of hypertension control in the LMIC and HIC studies ranged from (3.8% to 50.4%) to (36.3% to 69.6%), respectively. Concerning barriers to hypertension control, patient-related barriers were the most frequently reported (n = 20), followed by medication adherence barriers (n = 10), lifestyle-related barriers (n = 8), barriers related to the affordability and accessibility of care (n = 8), awareness-related barriers (n = 7), and, finally, barriers related to prescribed pharmacotherapy (n = 6). A combination of more than one category of barriers was frequently encountered, with 59 barriers reported overall across the 33 studies. This work reported disparities in hypertension control and barriers across studies conducted in LMIC and HIC. Recognizing the multifactorial nature of the barriers to hypertension control, particularly in LMIC, is crucial in designing and implementing customized interventions.
    Matched MeSH terms: Humans
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