Publications

Antifungal Treatment of Mucormycosis Associated with COVID-19

    DOI: 10.52494/HUIV8341
    by Chia Siang Kow, Syed Imran Ahmed and Syed Shahzad Hasan.
    Vol. 7 No. 1 (2021): Malaysian Journal of Pharmacy / Published: June 30, 2021
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    Abstract

    Mucormycosis is an angioinvasive fungal infection due to fungi of the order Mucorales. The prognosis from mucormycosis can be poor despite early diagnosis and aggressive therapy. The systematic review and meta-analysis by Muthu and colleagues [1] investigated the rate of mortality in patients with pulmonary mucormycosis. While there had been a significant decrease in the mortality rate over time, the recent (2010-2020) rate of mortality is still substantial, in which about one in two patients (49.8%; 95% confidence interval 43.2% to 56.3%) with pulmonary mucormycosis died from the disease. Yet, patients originated from the lower-middle-income countries had a higher mortality rate, in which about three in four patients (71.5%; 95% confidence interval 58.7% to 84.3%) with pulmonary mucormycosis died from the disease. Indeed, there has been a recent surge in the occurrence of mucormycosis in lower-middle-income countries, especially in India. As raised by Szarpak [2], the increased incidence with a fairly severe course of mycormycosis was reported in patients with a history of coronavirus disease 2019 (COVID-19) and received systemic corticosteroid therapy.

    Utilization Pattern of Lipid Modifying Agents in An Outpatient Pharmacy Department of a Private Hospital in Malaysia

      DOI: 10.52494/LMJS6138
      by Xin Xuan Cha, Ching Siang Tan, Shashidharan Menon, H. Jaasminerjiit Kaur, Lee Kah Seng, Mohamed Mansor Manan and Shafeeq Mohd Faizal.
      Vol. 6 No. 1 (2020): Malaysian Journal of Pharmacy / Published: December 31, 2020
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      Abstract

      Introduction: Lipid-modifying drugs have been used to treat dyslipidemia as well as for the primary and secondary prevention of CVDs and stroke. Objectives: This study aims to describe the drug utilization pattern of lipid-modifying drugs in a private hospital. Method: A retrospective study was carried out in outpatient of the selected hospital. Patients were selected based on inclusion and exclusion criteria by using convenience sampling. Data were collected through KCIS by retrieving patients’ registration number. Defined daily dose (DDD) was calculated and compared to World Health Organization DDD. Medicine prices were also analysed. Results: A total of 180 patients’ record were analysed, 70% of them were male; 40.6% of the patients were from the age range of 50 to 59 years old; ethnicity breakdown was Malay (69.4%), Indian (18.3%) and Chinese (12.2%). Among all lipid-modifying drugs, utilization of statins was the highest as statins are the preferred line in the treatment of dyslipidemia. Innovator brands were more preferred where most of the lipid-modifying drugs used in the selected hospital are innovator brand drugs. In terms of cost, lipid-modifying drugs contributes to about 27% of the total cost of prescription in average. Conclusion: The utilization of all lipid-modifying drugs in the selected hospital was lower as compared to WHO DDD. As compared to combination therapy, monotherapy with atorvastatin was generally preferred in the selected hospital. The utilization of atorvastatin was found to be the highest in the OPD of the selected hospital.

      Folk Songs for Health Education: A Qualitative Exploratory Study among Public and Pharmacy Enforcement Officers

        DOI: 10.52494/HHPZ4168
        by Lee Kah Seng, Muthu Kumar Murugiah, Mohammad Aswady Adenan, Tahir Mehmood Kha, Chin Fen Neoh, Yaman Walid Kassab, Nur Akmar Taha and Zainol Akbar Zainal.
        Vol. 6 No. 1 (2020): Malaysian Journal of Pharmacy / Published: December 31, 2020
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        Abstract

        Dikir Farmasi (DF) is a new effort to expand and intensify the dissemination of information about the regulation of the legitimate use of drugs and cosmetics. This study was aimed to explore the opinions of Pharmacy Enforcement Division staff and the general public regarding the quality and impact of DF program as a health promotion tool in Malaysia. A qualitative study using semi-structured interviews and focus group discussions (FGDs) were conducted at the Pharmacy Enforcement Department and three health clinics located at the city of Kota Bharu, Malaysia. The interviews were audio recorded, translated and transcribed. Thematic analysis was performed to identify the themes and sub-themes of the transcripts. Ethical approval was obtained from Ministry of Health Malaysia. All respondents provided a written consent for participation. Nine pharmacy officers and 23 general public participated in this study. Five main themes emerged from the information gathered and analyzed: 1) language; 2) design; 3) content and delivery 4) costs and benefits and 5) prospect of DF. Certain weaknesses of DF have been raised and the health authorities could utilize this information for an improvement. Significant effort must be made to improve the publicity and dissemination of DF to ensure that it reaches the target population. Certain weaknesses of DF have been raised and the health authorities could utilize this information for an improvement. Significant effort must be made to improve the publicity and dissemination of DF to ensure that it reaches the target population.

        Gamified Online Quizzes: Pharmacy Student Perceptions of Learning in an Undergraduate Medicinal Chemistry Course

          DOI: 10.52494/QAWJ8258
          by Aisyah Saad Abdul Rahim, Azidah Abu Ziden and Beow Keat Yap.
          Vol. 6 No. 1 (2020): Malaysian Journal of Pharmacy / Published: December 1, 2020
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          Abstract

          Introduction: In the context of pharmacy education worldwide and in Malaysia, the use of digital technologies to promote higher level thinking and discussions is seen as preparing the millennials as pharmacists in the 21st century. Together with leveraging on millennials’ penchant for mobile technology, gamified online quizzes as an assessment tool that help promote active and collaborative learning in a Medicinal Chemistry course have been used. Objectives: This study investigates students’ perception of the impact of gamified online quizzes on their learning in a Medicinal Chemistry course. Method: This study employs mix method research comprising descriptive analysis, content analysis from informal chats and researchers’ observation to gather the findings for the study. Three gamified online quizzes using Quizizz, were implemented outside classroom time, in place of traditional quizzes. Multiple attempts were allowed within a stipulated time. As interventions, post-quiz discussions were conducted during class time. Students completed an end-of-the-course survey. Results: Out of 63 respondents, more than 96% felt that the gamified online quizzes enhanced their learning as they learned from the instant feedback, their mistakes and post-quiz discussions. Overall student performance based on the percentage and accuracy of answering the quiz improved with time. Student qualitative comments on the survey, the course social media (closed group) and informal chats supported the findings from the descriptive data analysis of the study. Conclusions: From students’ perception, the gamified online quizzes were found to be enjoyable and effective in enhancing active, peer learning in an undergraduate medicinal chemistry course outside class time. For instructors, the online quiz served as an efficient tool for formative assessment in a large classroom setting, and could replace traditional classroom quizzes.

          The Need of Patient Education to Improve Medication Adherence Among Hypertensive Patients

            DOI: 10.52494/MOEL1486
            by Ching Siang Tan.
            Vol. 6 No. 1 (2020): Malaysian Journal of Pharmacy / Published: December 1, 2020
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            Abstract

            Essential medicines have become indispensable to maintain and to improve our lives and health. Latest literature again reiterated that inappropriate use of medicine is a global phenomenon in both developed and developing countries still prevail. Poor adherence is associated with negative clinical outcome of the disease. It is important to note that about 50% of treatment failures are due to poor medication adherence and this results in substantial morbidity and mortality. Patient’s belief and perception have been reported to influence medication adherence. Low rate of adherence was found strongly associated with patient’s belief across the studies with chronic diseases with hypertension, coronary heart disease, diabetes, asthma and renal disease. Exploring the health beliefs of patients is vital to improve adherence and thereby blood pressure among the patients with hypertension. Lack of knowledge about usage of medication and various misleading perceptions of hypertension management have resulted inappropriate use of medication especially medication adherence among community-dwelling patients with hypertension. Literatures classified non-adherence into primary and secondary. Primary non-adherence refers to medication is purposefully never filled or taken; Secondary non-adherence is defined as medication is not taken properly or continued as prescribed and further classified into intentionally and unintentionally. Patient education aims to train patient in the skill and self-management of their chronic disease by adapting to the treatment or lifestyle changes. Despite improving in patients’ skill and self-care by providing information about the treatment, patient education could enhance their empowerment and medication adherence. Patient education is a basic right of the patients and healthcare members have responsible to provide such information. However, the authenticity of the available information is yet to be verified. Therefore, healthcare professional could play a vital role here to educate their patients about the appropriate information.

            Welcome Letter for Malaysian Journal of Pharmacy New Editorial Board

              DOI: 10.52494/UPHS9437
              by Chan Siok Yee and Long Chiau Ming.
              Vol. 6 No. 1 (2020): Malaysian Journal of Pharmacy / Published: December 1, 2020
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              Abstract

              Malaysian Journal of Pharmacy (MJP) since its launch in 2001, upholds the essence of knowledge and experience dissemination of regional pharmaceutical related research and sciences. With Dr Yew Su Fong as the founding Editor in Chief, a few journal issues were published and in year 2008 the torch was passed on to the successor, Professor Dr Mohd Baidi Bahari. Under the helm of Prof Baidi, valuable research findings by respective hospitals in Malaysia were published, some disseminated in the form of conference proceeding and abstract. Gradually, MJP has become a keystone to showcase the research findings of fellow pharmacists especially in the hospital setting which provide publications that are both informative and impactful, highlighting matters that of high value to the profession. In recent years, the journal’s management and structure grow and improve, along with its appointment of the journal’s immediate past Editor in Chief, Associate Professor Dr Asrul Asrul Akmal Shafie that strengthened the workflow of the journal.

              In term of operation, the way forward for MJP is to keep abreast with the latest trend and technology advancement. Web-based automated submission system, digital object identifier (DOI), citation tracking are the crucial features to be implemented o encourage article submission to MJP. Given a chance to lead MJP, we would like to take a moment to introduce the revamped structure of our editorial board. The newly assembled board comprises of registered pharmacist from different disciplines of pharmacy whom either a well cited researcher or highly experienced practising pharmacist. To name a few, Professor Habibah A Wahab, Dean of School of Pharmaceutical Sciences of Universiti Sains Malaysia (USM), Professor Mohd Cairul Iqbal Mohd Amin, Deputy Director of Ministry of Higher of Education, Professor Wong Ting Wui and Associate Professor Dr Asrul Asrul Akmal Shafie who are among the high cited researchers in their research field. Advisors are included in the structure of our editorial board who are entrusted to advise the Board on strategic planning and progress of the journal. Advisors included in the team include Emeritus Professor Yuen Kah Hay and Emeritus, Professor Dr Paraidathathu Thomas, former Editor in Chief Professor Dr Mohd Baidi Bahari, international renown researcher Dr Sheng Qi and Associate Professor Alberto Berardi. This local and international advisory team is in the interest of transparency, good governance and render the decision-making process to independent scrutiny. Besides, the Board serves on the principle of autonomy and impartiality, to ensure the article published in this MJP is of high quality and non- bias. As far as the journal is concerned, the editorial board of MJP have the right to reject manuscript that is deemed not appropriate or unqualified without influence, fear, or favour.

              MJP is a peer-reviewed publication with an aim to publish content covers all aspects of pharmacist in Malaysia and beyond. It solicits manuscripts across different areas as long as it brings benefit to the growth of pharmacy profession as a whole. The scope of the journal includes research performed clinically, community, lab-based, social administrative based, Pharmacy Education as well as industrial related. Relevant contents from academicians, pharmacy student (final year projects), pharmaceutical industrial research, as well as the mandatory research by provisionally registered pharmacy (PRP) are also welcome. Special Issue may also be considered for current hot topic. We envisage that MJP will serve as a platform to educate, motivate and help the author as well as readers to better serve as a pharmacist.

              The impact of implementing WMTAC towards anticoagulation treatment in Dungun Hospital

                DOI: 10.52494/ORUR4745
                by AN Alias, SF Ali, W Yusoff, NAS Yahaya, NH Abdul Karim and SA Fadzillah.
                Vol. 5 No. 1 (2019): Malaysian Journal of Pharmacy / Published: December 1, 2019
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                Abstract

                Objective: The main objective of this study is to compare patients’ outcome in anticoagulation treatment before and after Warfarin Medication Therapy Adherence Clinic (WMTAC). The study compares the cost of INR test between usual care (UC) and WMTAC. The study also determines factors affecting International Normalized Ratio (INR) level among WMTAC patients.

                Methods: A retrospective study involving WMTAC patients was conducted by trained pharmacists at Dungun Hospital. Patients were reviewed by UC for 4 months and continuously followed up by WMTAC for another 4 months were included in this study. Patients who passed away, transferred out and defaulted were excluded from the study. The data were derived from Patient Medical Record and recorded in Warfarin Data Collection Form for analyze.

                Results: The time in therapeutic range (TTR) was 73.46% for WMTAC and 45.58% for UC (p<0.001). The expanded TTR for WMTAC was 90.37% and 61.88% for UC (p<0.001). The percentage of time INR level <1.5 were 0.57% for WMTAC patients and 7.92% for UC patients, while 5.28% UC patients had INR level > 5. The total reagent costs of INR test were MYR 341.04 for WMTAC and MYR 519.40 for UC. The known factors affecting INR level in WMTAC patients were diet (55%), missed dose (36%) and drug interaction (9%).

                Conclusion: According to this study, the WMTAC implementation significantly improved anticoagulation treatment. Besides that, it also beneficial for our reagent cost expenses.

                Knowledge Level of Government Healthcare Personnel in Labuan towards Registered Product and Notified Cosmetic

                  DOI: 10.52494/AHIE4209
                  by ZS Sujata Tan.
                  Vol. 5 No. 1 (2019): Malaysian Journal of Pharmacy / Published: December 1, 2019
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                  Abstract

                  Introduction: All pharmaceutical products in Malaysia must be registered with the Drug Control Authority (DCA) whereas cosmetics must be notified with the National Pharmaceutical Regulatory Agency (NPRA). Availability of unregistered products and unnotified cosmetics in the market are longstanding issues affecting public safety and health. It is vital that all government healthcare personnel (GHP) as the front liners are equipped with the knowledge to properly advise the public on this issue.

                  Objective: This study aims to determine the level of knowledge towards registered products and notified cosmetics among various groups of GHP under the Ministry of Health facilities in Labuan.

                  Methods: This was a cross-sectional study performed from August to November 2017 using a validated 12 question questionnaire. Respondents were divided into 4 groups (doctors/dentist, pharmacist, nurse, allied healthcare professional) and results between the groups were analysed using Chi-square analysis. Respondent’s knowledge was given score and those who scored 9 marks and above were considered to have good knowledge. Those who scored 8 marks and below were considered to have poor knowledge.

                  Results: Only 40.2% Pharmacists have the highest score of good knowledge on registered products and notified cosmetics at 81.8% (n=18). The level of good knowledge among allied health professionals (AHP) stood at 42.9% (n=21), 36.4% of nurses (n=43) and 20% of doctors (n=6). However in total, only 40.2% (n=88) of the study population had good knowledge.

                  Conclusion: The level of knowledge towards registered products and notified cosmetics among doctors, pharmacist, nurses and allied health professional in Labuan is poor as only 40.2% have good knowledge. This study shows a significant association between the levels of knowledge among GHP varies between groups of profession. Pharmacist group has the highest score in knowledge in this study and thus should be another reference for the general public and patients when it comes to health-related matters. Further re-education should be conducted to improve the knowledge of GHPs in Labuan with regards to this subject.

                  Stability of Extemporaneously Compounded Chloral Hydrate Oral Solution

                    DOI: 10.52494/JDPF8319
                    by Freeda Siew Yuin Thean, Chan LT, Lucy Yeoh and Yeap PC.
                    Vol. 4 No. 1 (2018): Malaysian Journal of Pharmacy / Published: July 25, 2018
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                    Abstract

                    The objective of this study is to look into the stability of Chloral Hydrate 40 mg per ml formulated as oral solution in X-temp Oral Suspension System in order to select proper storage conditions and establish beyond-use date. X-temp is a novel oral, flavoured sugar-free extemporaneous compounding vehicle to assist in the preparation of extemporaneous dosage forms.

                    The compounded solution of 40 mg/ml was prepared by dissolving chloral hydrate powder in X-temp vehicle. The solution was then packed in amber HDPE containers, and were stored at refrigeration 5 ± 3°C and room temperature 30°C. Physical, chemical and microbiological parameters were evaluated at predetermined time-points up to 180 days. Samples were tested using a validated stability–indicating assay. Chloral hydrate concentration was assayed by high-performance liquid chromatography (HPLC).

                    The stability results indicated that the solution remained unchanged in visual appearance or pH at both refrigeration and room temperature for up to 180 days. The HPLC results showed that all the stability studies maintained 90 – 100% of initial drug concentration. There was no substantial changes in the microbiological stability.

                    Chloral hydrate solution prepared in X-temp Oral Suspension System was stable for up to 180 days when stored at room temperature and refrigeration conditions. These results demonstrated that X-temp is a suitable vehicle for extemporaneous compounding for chloral hydrate.

                    Management of Mild Valproic Acid Toxicity with Hemodialysis – A Case Report

                      DOI: 10.52494/TUCS1692
                      by Chow NK and Heng LM.
                      Vol. 4 No. 1 (2018): Malaysian Journal of Pharmacy / Published: July 25, 2018
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                      Abstract

                      The management of Valproic Acid (VPA) toxicity is mainly supportive treatment. Invasive management such as hemodialysis (HD) and hemoperfusion were only used in isolated cases where patient is highly VPA toxic, which results in coma. We described a case of mild VPA toxicity (VPA serum concentration 326.42mcg/mL), where the patient was successfully treated with two hours of low-flux HD with no complication. While the guideline of indication of HD in VPA toxicity has yet to be published, low-flux HD can be an effective treatment in cases of mild VPA toxicity, if other supportive measures failed or not available.