Vol. 9 No. 2 (2023): Malaysian Journal of Pharmacy


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Published: 31 December 2023

In this issue:

Review Articles

  • Review The Effects of Intermittent Fasting on Cardiovascular Health of Prediabetes and Type 2 Diabetes Mellitus Patients: A Systematic Review

Original Research Articles

  • Deferoxamine injection practice assessment and common administration errors among adult thalassaemia patients
  • Knowledge, Practices & Attitudes towards Adverse Drug Reaction Reporting among Public Healthcare Professionals in West Pahang
  • Antibiofilm Activities of Activated Carbon Film Wound Dressing

Supplementary

  • Proceedings of MPS-National Pharmacists Convention 2023, Pharmacists in The Evolving Integrated Healthcare Landscape: Navigating Change and Driving Quality In Primary Care
  • Proceedings of Penang Pharmacists Convention 2023, Advancements in Pharmacy Practice

The Effects of Intermittent Fasting on Cardiovascular Health of Prediabetes and Type 2 Diabetes Mellitus (T2DM) Patients: A Systematic Review

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    Abstract

    Background: Type 2 diabetes mellitus and prediabetes are showing an increasing number of cases and are predicted to keep increasing over the years. Both conditions have a 2-3-fold increased risk of developing cardiovascular diseases. Intermittent fasting is one of the forms of dietary intervention being practiced in preventing and managing these conditions and their associated complications. There are many reported benefits of intermittent fasting for health, but no specific studies discussed regarding the effect of this practice on cardiovascular health of these patients. Objective: This study is aiming to systematically review the benefits of intermittent fasting on cardiovascular health of these groups of patients. Methods: This systematic review followed the guideline of PRISMA and was registered at PROSPERO with the registration number of CRD42022378349. A systematic literature search was conducted in PubMed, Scopus, Cochrane Library, Google Scholar and by using snowball technique. The articles retrieved were independently screened by two authors against the eligibility criteria in stages of title, abstract and full text. The risk of bias in the included studies were assessed independently by two authors using the Joanna Briggs Institute critical appraisal checklist. Data from all the included articles were extracted using a predetermined template. Results: Twelve studies were included in this study. Six studies recorded low risk of bias while the other six studies had moderate risk of bias. Three studies recorded significant reduction for both systolic and diastolic blood pressure, and 3 studies showed significant improvement in the lipid profiles at the end of intervention. Conclusion: Intermittent fasting is beneficial for cardiovascular health of prediabetes and type 2 diabetes mellitus patients mainly by improving both systolic and diastolic blood pressure and the lipid profiles. Randomized controlled trials that investigate specifically the benefits of this practice on the cardiovascular health of these populations are needed to confirm the findings.

    Deferoxamine injection practice assessment and common administration errors among adult thalassaemia patients

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      Abstract

      Background: Thalassaemia is a hereditary blood disorder characterised by defective globin chains, which results in haemolysis and impaired erythropoiesis. Routine blood transfusion is required, which may lead to iron overload in a long run. Deferoxamine (DFO) provides effective iron chelation in thalassaemia patients, however, challenges were faced among patients, especially in ensuring proper drug administration techniques. Objective: The study aim is to describe the current DFO administration practice, common administration errors, patient compliance towards iron chelation therapy and to identify factors associated with serum ferritin levels. Methods: A cross-sectional study among adult thalassaemia patients was done from January 2019 until November 2020. Patients were assessed for DFO injection practices and compliances. A DFO score was used to assess steps of dilution and administration of DFO, categorised as good (score 75-100%), satisfactory (score 60-74%), and fail (score <60%). Compliance was assessed using a validated 7-questions survey; a score of less than 27 marks dictated non-compliance. A multivariate linear regression was used to identify factors associated with high serum ferritin level (>1000 µg/L). Results: Twenty-four patients were included in the study. For administration practice, 79.2% were able to administer independently. Abdomen was the most favoured injection site and most patients administered DFO at night. Although 75% of the patients had a good DFO score, DFO administration errors persist. The compliance rate was low (29.2%), and majority reported more than 4 times per month of missed doses. Working status (4664.13, 95% CI 1609.41-7718.86, p=0.005) and frequent missed dose (1152.39, 95% CI 382.18-1922.6, p=0.005) were identified as factors associated with serum ferritin level, controlling for other factors. Conclusion: DFO administration errors persist among thalassaemia patients. Patients who are working and non-compliant were identified to be associated with high serum ferritin level. Effective counselling method may be needed to properly educate patients on DFO administration and improve patients’ compliance.

      Knowledge, Practices & Attitudes Towards Adverse Drug Reaction Reporting among Public Healthcare Professionals in West Pahang

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        Abstract

        Background: The World Health Organization identifies adverse drug reactions (ADRs) as unintentional and harmful reactions to drugs, which are among the leading causes of death in many nations. ADR under-reporting is a threat to pharmacovigilance. Objective: The objectives of this study were to evaluate the knowledge, practices & attitudes towards ADR reporting among public healthcare professionals and to determine factors that lead to underreporting of ADR in public health facilities (hospitals and clinics) in West Pahang, Malaysia. Methods: This was a cross-sectional, questionnaire-based observational study conducted in 2021 with respondents consisting of healthcare professionals from all hospitals and health clinics in West Pahang. Data was collected from March 2021 to April 2021 via a validated questionnaire. Results: A total of 400 questionnaires were distributed and 344 healthcare professionals took part in the study, with an 86% response rate. The majority of survey respondents selected positive responses in the area of knowledge and attitude, but not in the area of practice for ADR reporting. It was found that 95.3% of respondents had good knowledge, 11% had good practices and 52% had good attitudes towards ADR reporting. Over half of respondents (53.2%) believed that it is nearly impossible to conclude that a drug is the cause of a particular adverse event. Fifty percent of respondents believed they would be held accountable for the ADR which occurred once they reported it. The majority of the respondents (68%) thought that really serious ADRs were already documented when the drugs were marketed. Conclusion: The majority of healthcare professionals in West Pahang showed good knowledge and attitude, but poor practice in ADR reporting. Insecurity, fear of admitting harm, complacency, and ignorance were the discouraging factors that led to the underreporting of ADR among healthcare professionals from West Pahang.

        Antibiofilm Activity of Activated Carbon Film Wound Dressing

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          Abstract

          Background: Biofilm is a structured community of bacterial cells enclosed in a self-produced matrix containing 80% extracellular polymeric substances (EPS). When biofilms are present on the wound surface, they impair optimal penetration of antimicrobials resulting in delayed healing. Chronic wounds are likely to be impacted since the wound may be moist and purulent which are conducive for biofilm growth. Objective: To develop and characterise hydrogel films containing AC at various concentrations and to study the antibiofilm activities of the produced films through in vitro approach on two common biofilm strains, Staphylococcus aureus, and Pseudomonas aeruginosa. Methods: An approach was suggested in this study by utilising the high adsorptive capacity of activated carbon (AC) loaded into PVP/CMC hydrogel film wound dressing to disrupt and inhibit the biofilms present on the wound surface. Results: The results obtained showed that the developed hydrogel films containing AC at different concentrations (0.1%, 0.5%, 1.0%, 1.5% and 2.0%) provided a balanced moist environment to the wound surface with adequate swelling properties. Characterisation of the AC films also showed satisfactory mechanical properties indicating the films were durable and flexible, thus suitable for wound application. Antibiofilm study was conducted via XTT assay by treating biofilms of two common bacterial strains, Staphylococcus aureus and Pseudomonas aeruginosa with the AC hydrogel films. Findings showed AC exerted antibiofilm activity by inhibiting more than 50% of biofilm growth on P. aeruginosa biofilm, with AC 0.5% achieving the highest biofilm inhibition (62.41±8.48%). However, there was lack of evidence to support AC hydrogel films in inhibiting biofilm produced by S. aureus because there was no significant difference (p<0.05) in biofilm inhibition when compared to AC 0%. Conclusion: Although AC hydrogel films showed promising results on P. aeruginosa biofilm inhibition, its application in wound dressing as antibiofilm agent may be limited especially on multispecies biofilm due to its lack of activity towards S. aureus. Further investigations are required to assess antibiofilm activity of AC hydrogel films on other bacterial strains and its mechanism of biofilm inhibition.

          Proceedings Of MPS-National Pharmacists Convention 2023

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            Abstract

            28th-30th July 2023 Venue: Dorsett Grand Hotel, Subang JayaTheme: Pharmacists In The Evolving Integrated Healthcare Landscaope: Navigating Change And Driving Quality In Primary Care Editors… Read More »Proceedings Of MPS-National Pharmacists Convention 2023

            PROCEEDINGS of Penang Pharmacists Convention 2023 23rd-24h September 2023

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              Abstract

              23rd-24h September 2023 Venue: Setia SPICE Convention Center, Penang. Theme: Advancements in Pharmacy Practice Editors CONTENTS RESEARCH PRESENTATIONS P01Exploring Supplement Usage Among Older Adults in… Read More »PROCEEDINGS of Penang Pharmacists Convention 2023 23rd-24h September 2023