The global impact of the COVID-19 pandemic on the education of healthcare professionals, especially in low- and middle-income countries

The COVID-19 disaster has appreciably increased morbidity and mortality, as well as the delivery of healthcare, across countries exacerbated by the contagious nature of the virus.[1-4] Numerous public health measures were instigated across countries at the start of the pandemic to try and limit its spread without effective medicines and vaccines.[5,6] Introduced measures included lockdown activities, social distancing instructions, quarantining measures, wearing of personal protective equipment (PPEs), handwashing and sanitizers as well as the closure of borders.[5-8] Instigated measures also included the closure of universities appreciably affecting the education of healthcare professionals (HCPs), including physicians and pharmacists, across countries.[9-11] The extent of lockdown and other activities instigated during the early stages of the virus varied appreciably across countries leading to differences in observed morbidity and mortality rates.[12-15] For instance, comprehensive measures introduced early among several Asian countries including Korea, Malaysia, Taiwan, and Vietnam as well as among several African countries including Ghana, Malawi and Namibia, limited the number of deaths certainly when compared with Western European countries including Italy, Spain and the U

Demand of COVID-19 medicines without prescription among community pharmacies in Jodhpur, India : findings and implications

Background: COVID-19 pandemic led to increased self-medication of antimicrobials, vitamins, and immune boosters among the common people and consuming without prescription can lead to adverse consequences including antimicrobial resistance. Methods: A cross-sectional study was conducted on community pharmacies in Jodhpur, India. They were inquired regarding the prescription and increased sales (75% increase in vitamin C sales. Conclusion: There was an increase in the demand for COVID-19 medications without prescription. This study was unable to detect a significant increase in sales of antimicrobials, which is encouraging

Assessment of academic/non‑academic factors and extracurricular activities influencing performance of medical students of Faculty of Medicine, Universiti Sultan Zainal Abidin, Malaysia

Background: Physical and mental comfort is known to have a crucial influence on health and performance amongst medical students. Very often, medical students suffer from poor quality of life (QOL) related to the work‑life balance due to the lack of sleep, nutritional and dietary disorders and low physical activity, resulting in a negative impact on their academic performance. This study aims to determine the potential academic/non‑academic factors and extra‑curricular activities influencing the performance of medical students in Universiti Sultan Zainal Abidin (UniSZA). Materials and Methods: This was a cross‑sectional study conducted on medical students at the Faculty of Medicine, UniSZA, Terengganu, Malaysia. A sample size of 300 respondents were recruited from Year I to V medical students. The questionnaire was adopted, modified and validated from a similar study in Saudi Arabia. Results: Majority of the students enjoy medical education are self‑motivated, have a good command of English, non‑smokers and have a sufficient sleep. Conclusion: University medical students possess good QOL within the optimum educational environment

Tocilizumab in COVID-19: a study of adverse drug events reported in the WHO database

leading to pneumonitis with a poor prognosis. Tocilizumab, a type of humanized monoclonal antibody antagonizing interleukin-6 receptors, is currently utilized to treat COVID-19. The present study reviews tocilizumab adverse drug events (ADEs) reported in the World Health Organization (WHO) pharmacovigilance database. Research design and methods: All suspected ADEs associated with tocilizumab between April to August 2020 were analyzed based on COVID-19 patients’ demographic and clinical variables, and severity of involvement of organ system. Results: A total of 1005 ADEs were reported among 513 recipients. The majority of the ADEs (46.26%) were reported from 18–64 years, were males and reported spontaneously. Around 80%, 20%, and 64% were serious, fatal, and administered intravenously, respectively. ‘Injury, Poisoning, and Procedural Complications’ remain as highest (35%) among categorized ADEs. Neutropenia, hypofibrinogenemia were common hematological ADEs. The above 64 years was found to have significantly lower odds than of below 45 years. In comparison, those in the European Region have substantially higher odds compared to the Region of Americas. Conclusion: Neutropenia, superinfections, reactivation of latent infections, hepatitis, and cardiac abnormalities were common ADEs observed that necessitate proper monitoring and reporting

Tocilizumab in COVID-19: a study of adverse drug events reported in the WHO database

leading to pneumonitis with a poor prognosis. Tocilizumab, a type of humanized monoclonal antibody antagonizing interleukin-6 receptors, is currently utilized to treat COVID-19. The present study reviews tocilizumab adverse drug events (ADEs) reported in the World Health Organization (WHO) pharmacovigilance database. Research design and methods: All suspected ADEs associated with tocilizumab between April to August 2020 were analyzed based on COVID-19 patients’ demographic and clinical variables, and severity of involvement of organ system. Results: A total of 1005 ADEs were reported among 513 recipients. The majority of the ADEs (46.26%) were reported from 18–64 years, were males and reported spontaneously. Around 80%, 20%, and 64% were serious, fatal, and administered intravenously, respectively. ‘Injury, Poisoning, and Procedural Complications’ remain as highest (35%) among categorized ADEs. Neutropenia, hypofibrinogenemia were common hematological ADEs. The above 64 years was found to have significantly lower odds than of below 45 years. In comparison, those in the European Region have substantially higher odds compared to the Region of Americas. Conclusion: Neutropenia, superinfections, reactivation of latent infections, hepatitis, and cardiac abnormalities were common ADEs observed that necessitate proper monitoring and reporting

Detection of qnr genes and gyrA mutation to quinolone phenotypic resistance of UTI pathogens in Bangladesh and the implications

Background: Plasmid-mediated quinolone-resistant (PMQR) genes and mutations within the quinolone resistance determining regions (QRDRs) resulted in the advent of quinolone-resistant pathogenic microbes. This research was designed to assess the roles of three PMQR genes, qnrA, qnrB, and qnrS, and any mutation in the gyrA gene in the QRDR as a process of quinolone/fluoroquinolone resistance to urinary tract infection (UTI) bacteria in Bangladesh to guide future management of UTIs. Methods: Pathogens from UTIs were isolated and identified, and their phenotype antibiotic susceptibilities were tested for lomefloxacin, ofloxacin, ciprofloxacin, and nalidixic acid. Polymerase chain reaction (PCR) detected the qnrA, qnrB, and qnrS genes. PCR and sequencing were performed to evaluate any mutation within the QRDRs of the gyrA gene. Results: Of 100 UTI bacteria, phenotypic resistance was observed in 95.0%, 89.0%, 83.0%, and 71.0% against lomefloxacin, nalidixic acid, ofloxacin, and ciprofloxacin, respectively. PMQR genes qnrS, qnrA, and qnrB genes were found in 54.0%, 1.0%, and 4.0% of isolates, respectively. Sequencing the gyrA gene revealed single mutation (Ser-83 to Leu) and double mutations (Ser-83 to Leu and Asp-87 to Asn). PMQR genes showed a statistically nonsignificant association with phenotypic resistance. Conclusions: This study confirms the presence of QRDR mutations that were independent of PMQR genes. Consequently, high resistance against quinolones among uropathogens is evident, and their future use needs to be moderated

Antimicrobial prescribing confidence and knowledge regarding drug resistance : perception of medical students in Malaysia and the implications

Background: Worldwide, microbes are becoming more challenging by acquiring virulent skills to adapt and develop antimicrobial resistance (AMR). This is a concern as AMR increases morbidity, mortality, and costs. Consequently, physicians need to be trained on appropriate antimicrobial prescribing, starting as medical students. Objective: To evaluate medical students’ confidence in antimicrobial prescribing and AMR. Methods: Cross-sectional study assessing medical students’ knowledge, perception, and confidence in prescribing antimicrobials and AMR in a Malaysian University. A universal sampling method was used. Results: Most responding students believed that educational input regarding overall prescribing was sufficient. Regarding the principle of appropriate and accurate prescriptions, female medical students had less knowledge (odds ratio (OR) = 0.51; 95% confidence interval (CI) 0.25–0.99; p = 0.050). Year-IV and year-V medical students had more excellent knowledge than year-III students regarding confidence in potential antibiotic prescribing once qualified. Year-V students also showed an appreciably higher confidence in the broad principles of prescribing, including antibiotics for infectious diseases, compared to those in other years. Conclusion: Overall, medical students gain more knowledge and confidence regarding the potential prescribing of antimicrobials as their academic careers progress. This is important given concerns with the current excessive use of antimicrobials in Malaysia

The impact of the COVID-19 pandemic on the education of medical, dental and non-medical healthcare professionals in Bangladesh : findings and connotation

Lockdown measures in response to the COVID-19 pandemic had an appreciable impact on the education of all medical, dental, and non-medical healthcare professional (HCP) students. These included the closure of universities necessitating a rapid move to e-learning and new approaches to practical’s. However initially, there was a lack of knowledge and expertise regarding e-learning approaches and the affordability of internet bundles and equipment. We initially con-ducted two pilot studies to assess such current challenges, replaced by a two-stage approach including a full investigation involving 32 private and public universities during the early stages of the pandemic followed by a later study assessing the current environment brought about by the forced changes. Top challenges at the start of the pandemic included a lack of familiarity with e-learning approaches, cost of the internet, lack of IT equipment and the quality of the classes. Universities offered support to staff and students to a varying degree to address identified challenges. Since then, e-learning approaches have widened the possibilities for teaching and learning at convenient times. However, challenges remain. In conclusion, there were considerable challenges at the start of them pandemic. Several key issues have been addressed with hybrid learning here to stay. Remaining challenges include a lack of ICT equipment. However, new innovations will continue

The Effect of Omega-3 Fatty Acids on Insulin Resistance

Insulin resistance is a critical pathophysiological process in the onset and advancement of type 2 diabetes mellitus. It is well-recognized that alterations in the metabolism of lipids and aberrant fat buildup effectively trigger the development of resistance to insulin. Adjusting one’s eating habits and managing weight appropriately are crucial for treating, controlling, and reducing the risk of T2DM because obesity and a lack of physical exercise are the primary factors responsible for the worldwide rise in T2DM. Omega-3 fatty acid is one of the polyunsaturated fatty acids (PUFA) that include long-chain omega-3 fatty acids such as eicosapentaenoic acid and docosahexaenoic acid, commonly found in fish oils. Omega-3 and omega-6 polyunsaturated fatty acids (PUFAs; 3 and 6 PUFAs) are essential for human health because they serve as metabolic precursors of eicosanoids, a class of signaling molecules that are essential for controlling a body’s inflammation. Since humans are unable to produce any of the omega-3 or omega-6 PUFAs, they both constitute imperative nutritional ingredients. Long-standing concerns about long-chain omega-3 fatty acids’ impact on diabetes management have been supported by experimental investigations that found significant increases in fasting glucose following omega-3 fatty acid supplementation and foods rich in PUFA and omega-3 fatty acid. Cellular explanations to explain the connection between inflammation and IR include mitochondrial dysfunction, endoplasmic reticulum (ER) stress, and oxidative stress. Modifications in the lipid composition of mitochondrial membranes and/or receptor-mediated signaling may be part of the mechanism behind the activation of mitochondrial fusion by fish oil/omega-3 PUFA. The exact molecular processes by which omega-3 PUFAs control mitochondrial activity to defend against IR are still unknown

Enhancing public health resilience in urban disaster settings: A study protocol on civil-military coordination in Malaysia

In Malaysia, the increasing frequency and severity of disasters emphasize the urgent need for enhancing disaster management. Given their significant impact on public health and healthcare, effective disaster management becomes a top priority. This study focuses on urban disasters and aims to identify health needs, assess multi-sectorial response gaps, and propose civil-military coordination mechanisms. To achieve this, a qualitative single-case approach will be employed, involving document reviews, in-depth interviews, and focus group discussions with representatives from key governmental agencies responsible for disaster management. The study will specifically concentrate on Kuala Lumpur, the densely populated and commercially active city. Thematic analysis will be used to systematize and verify the collected data, providing comprehensive insights into the current state of civil-military coordination in disaster response and management from stakeholders' perspectives. By examining their perceptions and experiences, the study will identify existing gaps and challenges in civil-military coordination. Ultimately, the findings will contribute to evidence-based policies and strategies aimed at improving disaster management coordination throughout Malaysia