A Qualitative And Quantitative Assessment Of Medicine Use Patterns And Practices Among General Public In The State Of Penang, Malaysia

Penggunaan ubat secara tidak rasional menjadi masalah global dalam kalangan negara maju dan negara yang sedang membangun. Penggunaan ubat-ubatan merupakan amalan biasa untuk kebanyakan orang dalam merawat masalah kesihatan mereka The irrational use of medicines is a global problem in developed and developing countries worldwide. The use of medicines is a common practice for many people to treat their health problem

Evaluation Of Knowledge, Attitude And Beliefs Regarding Medicines Among Primary Schoolchildren

The use of medicine for the treatment of health problems is a common practice among children. Most children are forming attitudes, beliefs and expectations about medicines through their past experience with medicines, through the parents or by observing family members taking medicines. Very few studies have been conducted about medicine knowledge among Malaysian children. This study aimed to evaluate knowledge, attitudes and beliefs about medicines among primary schoolchildren and identify those factors that may associate with their knowledge, attitudes and beliefs. A cross-sectional survey was conducted among schoolchildren from grades 5 and 6 in four primary schools in Penang Island. A convenience and purposive sampling methods were used to collect the data through a self-administered questionnaire to all schoolchildren and their parents

Synthesis of Complex Sugar Mycolates of Mycobacterium Tuberculosis

Mycobacteria are present in many environments and complex mixtures of sugar esters and mycolic acids are present in their cell wall structure. This complicated mixture is thought to be responsible for their high resistance to known antibiotics and chemotherapeutic treatments. Mycolic acids are high molecular weight α-alkyl-branched β-hydroxy long-chain fatty acids, have 60-90 carbon atoms, and various classes of mycolic acids are made by different species of mycobacteria. Sugar esters of mycolic acids associated with the cell wall of mycobacteria have very interesting toxic and immunological properties, and thus could be useful for the control and treatment of mycobacterial infections. The main objectives of this thesis will be discussed in three parts. The main target of the first part involved the first synthesis of a single enantiomer of the glycolipid di-mycolyl di-arabino glycerol (DMAG) (I), which has interesting toxicological and immunological properties. This was achieved by a successful synthesis of the glycan moiety of DMAG with the L-stereochemistry of the glycerol component, followed by the successful esterification of the glycan di-arabino glycerol with three normal fatty acids, a model mycolic acid, and five different mycolic acids. The NMR spectra of the synthetic isomer of the DMAG penta-acetate analogue, in the sugar region, matched very well those reported for the peracetate formed from the natural mixtures, confirming the stereochemistry of the arabinose units and establishing the absolute stereochemistry of the glycerol unit. An efficient route to prepare the DMAG glycan with excellent β-selectivity and in excellent yield was achieved. The second part entailed the first preparation of di-mycolyl tri-arabino glycerol (DMTAG) (II), which involved the synthesis of the donor moiety part according to literature methods with slight modifications, and the new arabino glycerol acceptor. The coupling of the donor and the acceptor to prepare the desired glycan was carried out using known coupling conditions. After the success in synthesising this tetra-saccharide, a model glycolipid was prepared through esterification with a normal fatty acid. Furthermore, a series of three DMTAG compounds were prepared, based on two common classes of mycolic acids. The final part of this project was the synthesis of glycerol mycolates (GroMM) (III), which have interesting adjuvant properties in vaccines, by coupling five common classes of synthetic mycolic acids with the S-glycerol stereoisomer. One model GroMM was prepared from a simple fatty acid. These compounds were prepared to study whether the stereochemistry of the glycerol component (R & S) has any effect on their biological activities. Initial studies of the biological activity of the synthetic DMAGs showed that some could be used to distinguish serum from cattle infected with bovine TB from uninfected cattle, and that they selectively activate THP-1 cells. In contrast, initial ELISA results with the synthetic GroMM showed little response to serum from patients with active TB

Letter to editor: Familiarisation of children with medicines and their sources of information

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Contribution Percentages of some Kinematical Variables of the Main Position in the Skills Performance Level of the Two-handed backhand Stroke for Tennis Players

يهدف البحث إلى التعرّف على نسب مساهمة بعض المتغيرات الكينماتيكية للوضع الرئيس في مستوى الأداء المهاري للضربة الخلفية بكلتا اليدين للاعبي التنس. افترض الباحث ونوجود نسب مساهمة لبعض المتغيرات الكينماتيكية في مستوى الأداء المهاري للضربة الخلفية بكلتا اليدين للاعبي التنس، وتكونت عينة البحث من(8) لاعبين من لاعبي التنس المتقدمين في محافظة نينوى، واستنتج الباحثون وجود نسب مساهمة معنوية لمتغيري (زاوية ميل الكتف، وارتفاع مركز ثقل كتلة الجسم) للوضع الرئيس في مستوى الأداء المهاري للضربة الخلفية بكلتا اليدين, وأوصى الباحثون بالتأكيد على مدربي التنس اعتماد المتغيرات الكينماتيكية التي أظهرت مساهمة معنوية لدورها في تطوير مهارة الضربة الخلفية بكلتا اليدين مع زيادة الاهتمام بالمتغيرات الكينماتيكية التي أفرزتها الدراسة.The study aimed to recognize the contribution  rates of  some Kinematical variables of   main position in the Skillful performance level of the two-handed  backhand stroke for tennis players, The researchers assumed that there are a contribution ratios of  some Kinematical variables of main position in the skillful performance level of the two-handed backhand stroke for tennis players, research sample was consisted of (8) senior players in Ninevah province, the researchers concluded that the Kinematical variables (shoulders angle, height of the BMC) in the main position had a significant contribution in the skillful performance level of the two-handed backhand stroke, the researchers recommend to emphasis on the tennis coaches to adopt mechanical variables, which showed a significant contribution to its role in the development  the two-handed backhand stroke skill and to Increase the interest in the Kinematical variables that  produced by the study. &nbsp

Incidence and Risk Factors of Surgical Site Infection Among Patients Undergoing Cesarean Section

Background: Wound infections constitute a significant problem in surgical procedures. In cesarean sections (CS), this is particularly important as a wound infection not only results in increased morbidity but also has far-reaching implications by way of pelvic organ disease, disturbance of the bonding process between mother and baby in the puerperium, and a longer hospital stay with its inherent problems. Objective: This study was conducted with the aim to determine the incidence and risk factor associated with surgical site infection (SSI) following cesarean section. Methodology: A retrospective cross-sectional study was conducted for 400 women undergoing cesarean section procedures during an 18-month period from January 2013 to June 2014 at Hospital Pulau Pinang, Malaysia. Patients’ socio-demographic, clinical data and incidence of SSI following the CS were noted using a standardized data collection form. SPSS v 21 was used for data analysis. Resu lts : In total, 18.8% of the study participants developed SSI. Multivariate logistic regression analysis identified the following: higher body mass index (≥30 kg/m2) (odds ratio [OR]: 0.555; 95% confidence interval [CI] = 0.313-0.985, P = .044), increase in the blood loss during surgery (≥500 mL) (OR: 0.757; 95% CI = 0.423-1.354, P = .034), prolonged hospital stay (≥4 days) (OR: 0.439; 95% CI = 0.260-0.740, P = .002), spinal anesthesia (OR: 1.543; 95% CI = 1.230-1.937, P = .021), breech baby presentation (OR:2.927 95% CI = 1.020-8.400, P = .046), and intrathecal analgesia (OR:1.567; 95% CI = 1.246-1.970, P = .001) had statistically significant association with incidence of SSI. Conclusions: Surgical site infections are common among women undergoing CS at Hospital Pulau Pinang. Special attention and enhanced clinical management of patients with identified risk factors for developing SSI may decrease its incidence

Gabapentin for chronic pelvic pain in women (GaPP2):a multicentre, randomised, double-blind, placebo-controlled trial

BackgroundChronic pelvic pain affects 2–24% of women worldwide and evidence for medical treatments is scarce. Gabapentin is effective in treating some chronic pain conditions. We aimed to measure the efficacy and safety of gabapentin in women with chronic pelvic pain and no obvious pelvic pathology.MethodsWe performed a multicentre, randomised, double-blind, placebo-controlled randomised trial in 39 UK hospital centres. Eligible participants were women with chronic pelvic pain (with or without dysmenorrhoea or dyspareunia) of at least 3 months duration. Inclusion criteria were 18–50 years of age, use or willingness to use contraception to avoid pregnancy, and no obvious pelvic pathology at laparoscopy, which must have taken place at least 2 weeks before consent but less than 36 months previously. Participants were randomly assigned in a 1:1 ratio to receive gabapentin (titrated to a maximum dose of 2700 mg daily) or matching placebo for 16 weeks. The online randomisation system minimised allocations by presence or absence of dysmenorrhoea, psychological distress, current use of hormonal contraceptives, and hospital centre. The appearance, route, and administration of the assigned intervention were identical in both groups. Patients, clinicians, and research staff were unaware of the trial group assignments throughout the trial. Participants were unmasked once they had provided all outcome data at week 16–17, or sooner if a serious adverse event requiring knowledge of the study drug occurred. The dual primary outcome measures were worst and average pain scores assessed separately on a numerical rating scale in weeks 13–16 after randomisation, in the intention-to-treat population. Self-reported adverse events were assessed according to intention-to-treat principles. This trial is registered with the ISRCTN registry, ISCRTN77451762.FindingsParticipants were screened between Nov 30, 2015, and March 6, 2019, and 306 were randomly assigned (153 to gabapentin and 153 to placebo). There were no significant between-group differences in both worst and average numerical rating scale (NRS) pain scores at 13–16 weeks after randomisation. The mean worst NRS pain score was 7·1 (standard deviation [SD] 2·6) in the gabapentin group and 7·4 (SD 2·2) in the placebo group. Mean change from baseline was −1·4 (SD 2·3) in the gabapentin group and −1·2 (SD 2·1) in the placebo group (adjusted mean difference −0·20 [97·5% CI −0·81 to 0·42]; p=0·47). The mean average NRS pain score was 4·3 (SD 2·3) in the gabapentin group and 4·5 (SD 2·2) in the placebo group. Mean change from baseline was −1·1 (SD 2·0) in the gabapentin group and −0·9 (SD 1·8) in the placebo group (adjusted mean difference −0·18 [97·5% CI −0·71 to 0·35]; p=0·45). More women had a serious adverse event in the gabapentin group than in the placebo group (10 [7%] of 153 in the gabapentin group compared with 3 [2%] of 153 in the placebo group; p=0·04). Dizziness, drowsiness, and visual disturbances were more common in the gabapentin group.InterpretationThis study was adequately powered, but treatment with gabapentin did not result in significantly lower pain scores in women with chronic pelvic pain, and was associated with higher rates of side-effects than placebo. Given the increasing reports of abuse and evidence of potential harms associated with gabapentin use, it is important that clinicians consider alternative treatment options to off-label gabapentin for the management of chronic pelvic pain and no obvious pelvic pathology.FundingNational Institute for Health Research