The role of pharmacists in the management of AKI patients: what recent studies added to our knowledge?

Introduction: Acute kidney injury (AKI) is a complex syndrome requiring special management. It also complicates the prognosis of many hospitalized patients. Some essential yet nephrotoxic medications and the use of certain procedures that may alter renal hemodynamics further complicate the management of AKI patients. Fortunately, as part of the renal care team, pharmacists can have a significant role in the multidisciplinary approach used to optimize renal patients’ health-related quality of life by delivering safe and effective pharmaceutical care. Objective: The present review aims to explore pharmacists’ contributions to the management of patients with AKI as well as their influence on improving renal patients’ care. Methods: An online search was performed in the databases PubMed, Scopus, and ScienceDirect for relevant articles published in English between 1 January 2015 and 31 December 2021. Review articles, books, guidelines, websites, and conference proceedings were excluded. Results: Only 12 articles out of 51 initially gathered met the eligibility criteria for this review. The three main roles that pharmacists play in the management of AKI patients are patients’ education, collaborating with other renal care practitioners, and identifying and solving drug-related problems (DRPs). The latter task span includes medication reconciliation, dosage adjustments, and identifying adverse drug reactions. Conclusion: In view of the complexity of the AKI course, trained pharmacists, as members of the renal care team, can play a pivotal role in managing AKI patients and minimizing their medications burden. This can positively impact the overall renal care process as well as the patient’s outcome. Further studies can provide more support to the importance of pharmacists’ role in managing AKI

Increased risk of osteoporosis in depressive patients with eractile dysfunction: a cross-sectional study from Malaysia

Background: Depression imposes numerous changes on depressive men, promoting for low bone mineral density (BMD) and erectile dysfunction (ED), yet no published data on exploring the possible association between these two disorders among depressive men. We therefore investigated whether low BMD is associated with ED among depressive men and highlighted the possible mutual underlying factors that might give rise to these two disorders in this specific group of patients. Materials and Methods: In this cross-sectional study, 119 depressive men were recruited and their sociodemographic and clinical characteristics were obtained. Erectile function was evaluated using the 5-item International Index of Erectile Function. All patients received a calcaneal BMD scanning. Chi-square test was conducted to determine if a significant association exists between ED and low BMD. Results: Of the study participants, ninety patients reported ED, while 29 patients reported no ED. Within the ED group, there was a significantly higher proportion of patients with low BMD compared to the non-ED group (85.6% vs. 62.1%, P = 0.006). In addition, among younger participants (i.e., aged < 50 years old), the difference in T-score between ED patients (Md =-2.2, n = 41) and non-ED patients (Md =-1.3, n = 20) was significant (P = 0.001); but held no significance among older participants. Conclusions: While our findings are considered prefatory, we reported that low BMD was significantly associated with ED in depressive men and that only among young depressive patients, BMD was significantly lower in ED patients compared to non-ED patients. More research investigating these findings and the possible underlying mechanisms for such association are warranted

Prescribing patterns of antidepressants among depressive men in Malaysia: A survey

Objective: In recent studies on the prescribing pattern of antidepressants, selective serotonin reuptake inhibitors (SSRIs) were the most prescribed antidepressants in many countries. Yet, little reports investigated depressive populations for antidepressants prescribing in Malaysia. Therefore, this study aimed to explore the pattern of prescribed antidepressants in a Malaysian group of depressive patients throughout their years of depression. Method: A cross-sectional study was conducted on 119 adult male depressive outpatients who were recruited from three psychiatric centers. Patients’ age and duration of depression were recorded, as well as their current and past antidepressants prescribed. Results: Of the study participants, 107 patients (89.9%) were currently antidepressant-treated. Mean age of patients was 49.9 (SD=11.0), while mean duration of depression was 7.8 years (SD=6.1). Markedly, SSRIs were the most currently prescribed antidepressants (72.9%), followed by tricyclic antidepressants (TCAs; 10.3%). Moreover, SSRIs predominated the prescribed antidepressants over the years of depression. Additionally, there was an increase in the share of SSRIs prescribing during these years in the expenses of other antidepressants, especially TCAs, whose prescription share fell from 34.1%, in the years preceding 2005, to only 10.3% in the current time. Conclusion: In sum, this study findings concur several reports from various countries, in which SSRI were the most frequent prescribed antidepressants and their prescribing was increasing over nearly the last 10 years. Further research is advocated to explore these findings in larger depression populations

The association of socioeconomic status with positive mental well-being and mental health seeking attitude among undergraduate students: a cross-sectional study

Introduction: The future of our healthcare services highly depends on the current generation of health science students since they are the ones who will work in the healthcare setting. Ensuring their mental well-being is the utmost priority so that they can offer top-tier quality care and services to people in need. Thus, this study aimed to explore the prevalence of mental well-being and mental help-seeking attitude among undergraduate health science students and the impact of socioeconomic status (SES) towards both variables. Materials and method: A cross-sectional study was conducted via online survey among undergraduate health science students from six different kulliyyahs (N=364) at International Islamic University Malaysia, Kuantan Campus. The survey contained three main parts. The first part focused on the sociodemographic and socioeconomic status, the second part assessed participants’ mental well-being using the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) and the third part used the General Mental Help-seeking Attitude Scale (MHSAS) to analyse students’ mental help seeking attitude. Data were analysed using Statistical Package for the Social Sciences version 29.0. Descriptive analysis and inferential analysis were run to address the research objectives, which include independent sample t-test, one-way analysis of variance (ANOVA), Chi-Square, Pearson correlation and linear regression. Results: Only 7.1% of the students have positive mental well-being while about 44.8% scored positive mental help-seeking attitude. There were no significant differences between the mental well-being of students with all socioeconomic characteristics (p > 0.05). Additionally, One-way ANOVA tests showed a significant association between students’ year of study and mental help-seeking attitude (p = 0.029). Furthermore, Pearson correlation and linear regression tests revealed that both WEMWBS score and MHSAS score showed a positive correlation (p < 0.01). Conclusion: Future study is essential to find out the contributing factors, prevention and intervention that can be done to help the student in need

Self-medication practice among final year students of a governmental university: a comparison between medical and non-medical students

ntroduction: Self-medication is defined as any usage of the medications without having any proper diagnosis, consultation and prescription from a healthcare practitioner. Objective: This study aimed to determine the prevalence and pattern of selfmedication among undergraduate final year students, and to compare the prevalence and pattern of self-medication between medical and non-medical final year students. Method: A cross-sectional study was conducted among final year students (4 medical programmes and 1 non-medical programme) from International Islamic University Malaysia, Kuantan Campus. A pre-validated questionnaire was distributed to 300 students in October 2016. Chi-square test was used to compare between medical and non-medical students. Results: 225 medical and 63 non-medical students (science programme students) answered the questionnaire. The mean age was 23.23 0.733 years. More than half of the participants (61%) practiced self-medication with no significant difference between medical and nonmedical students (60.9% Vs 61.9%; P = 0.884). The most common reasons of selfmedication in both groups was “a previous experience with similar problem”; with fever being the most self-treated condition followed by flu/cold. The majority of both groups (89.9%; 92.1%) acknowledged the necessity of consulting a certified medical practitioner before taking any medications. However, only 69.3% of the non-medical students believed that selfmedication could be harmful compared with 89.3% of the medical students (P < 0.001). Conclusion: The prevalence of self-medication practice among medical and nonmedical students was high and there was also a lack of awareness about its harm among non-medical students

Knowledge, attitude, and practice of medical and health sciences students in IIUM Kuantan regarding human papilloma virus vaccination

Introduction: Human Papilloma Virus (HPV) is the major causal agent for the fourth most frequent cancer in women which is cervical cancer. HPV vaccine is already available as the primary prophylactic method for cervical cancer. The objective of this study was to assess the level of knowledge, attitude and practice regarding HPV and its vaccination among medical and health sciences students in the International Islamic University Malaysia (IIUM). Materials and Methods: This study was conducted from November until December 2017. Pretested and validated questionnaire was distributed among third-year students from the faculties of medicine, dentistry, pharmacy, and allied health sciences. Results: The results showed that the level of knowledge was good for medicine and dentistry students while poor for pharmacy and allied health sciences students. Medicine students showed the highest level of knowledge compared to other faculties (p=0.000016). The majority of students had a positive attitude towards HPV vaccination. A small percentage of students were fully vaccinated (13.65%, 37) with no significant difference between different faculties. Conclusion: In conclusion, the levels of knowledge and attitude of the respondents were high and positive, respectively. More awareness, healthcare programs, and campaigns should be run at the campus

Knowledge, attitude and practice of medical and health sciences students in IIUM Kuantan regarding human papilloma virus vaccination

Introduction: Human Papilloma Virus (HPV) is the major causal agent for fourth most frequent cancer in women which is cervical cancer. HPV vaccine is already available as the primary prophylactic method for cervical cancer. The objective of this study is to assess the level of knowledge, attitude and practice regarding HPV and its vaccination among medical and health sciences students in the International Islamic University Malaysia (IIUM). Materials and Methods: This study was conducted from November until December 2017. Pre-tested and validated questionnaire was distributed among third year students from faculties of medicine, dentistry, pharmacy and allied health sciences. Results: The results shows that total knowledge of students was good for medicine and dentistry student while poor for pharmacy and allied health sciences students. Medicine students showed the highest level of knowledge compared to other faculties (p=0.000016). The majority of students has a positive attitude towards HPV vaccination. Conclusion: In conclusion, the levels of knowledge and attitude of the respondents were high and positive, respectively. Small percentage of students are fully vaccinated (13.65%, 37) with no significant difference between different faculties. More awareness, healthcare programs and campaigns should be run at the campus

Evaluation of the impact of COVID-19 pandemic on hospital-acquired infections in a tertiary hospital in Malaysia

Background: Infection prevention measures are the gold standard for preventing the spread of hospital-acquired infections (HAIs). COVID-19 pandemic caused major disruptions in infection prevention measures, and this has implications on the rate of HAIs. This study assessed the impact of COVID-19 pandemic on the rate and the types of HAIs at Sultan Ahmed Shah Hospital. Method: This is a retrospective cohort study that compared the rate of HAIs from April to October 2019 (pre COVID period) and April to October 2020 (during COVID period). Data was collected through the review of patients’ electronic medical records. Results: There were a total of 578 patients included in the selected wards during the pre- and during the pandemic. Thirty-nine episodes (12.1%) of HAIs were report in the pre COVID period and 29 (11.3%) during COVID-19. In both periods, hospital-acquired pneumonia (HAP) was the most frequent HAI among the patients. There was a rise in catheter-associated bloodstream infections (CLABSI) (0.8%) and ventilator associated pneumonia (VAP) (1.1%) during the COVID-19 period. The most common bacteria were methicillin-resistant Staphylococcus aureus (MRSA) (28.2%) and Enterococcus faecalis (17.9%) in the Pre COVID-19 period, and Pseudomonas aeruginosa (27.6%) and Stenotrophomonas maltophilia (6.9%) during COVID-19. Conclusion: Our research concluded that the rates of HAIs during the COVID-19 pandemic were not significantly impacted by the improved in-hospital infection prevention efforts to control the pandemic. There is need for further efforts to promote adherence to preventive practices

Determination of zinc, copper, selenium, and manganese in human milk using acid digestion by ICP-MS and its application in biological trace element monitoring.

Introduction: Human milk contains essential trace elements which support healthy development of infants. Previous studies have reported various analytical methods using different instruments to measure trace elements in human milk. This study aimed to determine the trace element concentration in human milk using a validated acid digestion method and its application in biomonitoring. Methods: Human milk samples were collected from three postpartum mothers and prepared using acid digestion method. All samples were analysed using ICP-MS and all validation parameters were measured. Results: Four trace elements which were zinc, copper, manganese and selenium were found to have good linearity (r² > 0.99), limit of detection in µg/L (0.06, 0.0001, 0.005, 0.00003, respectively) and limit of quantification in µg/L (0.18,0.0003, 0.02, 0.0001, respectively). The accuracy (83.4 – 112.7%), inter-day, and intra-day repeatability were within the acceptable limit. The method application on one case study showed the median levels of zinc, copper and selenium in human milk gradually decreased during the early six months, whereas manganese remained stable. Positive significant correlations were observed for most of the elements (r > 0.40, p < 0.001) except for copper-manganese. Conclusion: Acid digestion method is sensitive, accurate and precise to analyse and quantify zinc, copper, manganese and selenium concentrations in human milk simultaneously by ICP-MS. It can be applied in future studies to monitor trace elements concentration in human milk in future studies with larger sample size