Kingston Rajiah

A Clinical Study on Glucosamine Sulfate versus Combination of Glucosamine Sulfate and NSAIDs in Mild to Moderate Knee Osteoarthritis

Background. Glucosamine may be effective in treating and possibly slowing the progression of Osteoarthritis (OA). It is believed Glucosamine supplements may help to stop cartilage breakdown, build cartilage and decrease swelling. Objective. The objective of this study was glucosamine sulfate versus combination of glucosamine sulfate and Non-Steroidal anti-inflammatory drugs (NSAID) in mild to moderate knee osteoarthritis. Methods. Subjects were randomly recruited from Rheumatology outpatient department after a diagnosis of mild or moderate Osteoarthritis. Study tools like patient data collection form, Western Ontario McMaster Universities Arthritis index (WOMAC) of Osteoarthritis questionnaires and Visual Analog Scale (VAS) were used. Results. After 12 weeks, WOMAC total score the result showed that the significant mean difference between the group A and Group B treatment (P < 0.01), with a combination of GS and NSAIDs reducing VAS pain scores. Thus, it is found that Group B treatments over 4 and 12 weeks produced improved WOMAC and VAS grades. Conclusions. Study results may suggest that the Glucosamine Sulfate has a carryover effect like Disease modifying agents. Long-term treatment of Glucosamine Sulfate may reduce the dependence of NSAIDs usage and delay the disease progression. Thereby we can reduce the NSAIDs side effects and improve the patients quality of life.

Understanding of antibiotic use and resistance among final-year pharmacy and medical students: a pilot study.

INTRODUCTION This study is aimed to investigate the understanding of antibiotic use and antibiotic resistance and its correlate factors among final-year medical and pharmacy students at International Islamic University Malaysia (IIUM). METHODOLOGY This was a cross-sectional study. The study instrument was developed by extensive literature search and was subjected to face validity and content validity to medical and pharmacy academics. A pilot study was conducted to ascertain the reliability coefficient. Data was entered to SPSS version 17 and descriptive and inferential statistics were applied. RESULTS A total of 123 questionnaires were included in the study. Out of 123 respondents, 58.5% (n = 72) were final-year medical students, while 41.5% (n = 51) were final-year pharmacy students. The majority of the respondents showed adequate knowledge regarding the course contents related to antibiotics (n = 116; 94.3%). Almost all the respondents correctly reported the difference between bactericidal and bacteriostatic antibiotics. Only 15.4% (n = 19) and 27.6% (n = 34) of students were able to recognize Streptococcus pyogenes as non-pencillin resistant bacterium and Enterococcus as vancomycin-resistant bacterium, respectively. CONCLUSIONS The students showed good understanding regarding antibiotic resistance. In comparison to medical students, pharmacy students showed better understanding and more adequate knowledge, as the mean value for each domain was slightly higher for pharmacy students. Extensively improving the curriculum and educating healthcare professionals, especially physicians and pharmacists, right from the time of their educational training can inculcate a moral responsibility toward the judicious use of antibiotics, which can serve to eradicate antibiotic resistance.

Assessment of medication adherence in type-2 diabetes patients on poly pharmacy and the effect of patient counseling given to them in a multispecialty hospital

Introduction: The ability of physicians to recognize non-adherence is poor and interventions to improve adherence have had mixed results. Furthermore, successful interventions generally are substantially complex and costly. Poor adherence to medication regimens accounts for substantial worsening of disease; death and increased health care costs. The aim of this study is to assess the medication adherence in type-2 diabetes patients who are on polypharmacy and the effect of counseling provided for them in a multispecialty hospital. Materials and Methods: The study was carried out at Kovai Medical Center and Hospital; Coimbatore Tamil Nadu, India. This is a 500-bedded modernized, multi-specialty tertiary care hospital with full-fledged diabetic department. It caters to the needs of both out-patients and in-patients. An assessment was made on type-2 diabetic patients who are receiving more than 5 drugs for their co-morbidities were included in this study. A medication adherence questionnaire was prepared based on the literatures. The study was approved by the Kovai Medical Center and Hospital ethics committee. Results: Among 240 patients, 124 patients were adherent to medication whereas 116 patients were non-adherent. The non-adherent patients were giving verbal counseling in a private counseling room regarding medication adherence. Conclusions: Best way health professionals can tackle the adherence problem is through quality patient counseling as done in this study. With limited time most professionals have with a patient today this can be easier said than done. However, techniques such as the ask-educate-ask approach, the teach-back method and motivational interviewing can help ensure patient understanding of the counseling provided.

Pharmacy students’ knowledge and perceptions about adverse drug reactions reporting and pharmacovigilance

Pharmacy students’ knowledge about adverse drug reaction reporting can impact their attitude towards patient care and issues on patient safety. The aim of this study was to investigate the knowledge and perception of pharmacy students about adverse drug reaction reporting and pharmacovigilance and to study their willingness to report. A cross-sectional study using a validated questionnaire was conducted among the university students. The demographic details of the respondents were studied. The number of female respondents was comparatively higher than the male respondents. There were no significant differences by gender regarding the knowledge on adverse drug reaction reporting and pharmacovigilance except with the knowledge of post-marketing surveillance for which male students appeared to be more knowledgeable than female students. The results showed that the pharmacy students had sufficient knowledge and there are significant differences in perception among the students on adverse drug reaction reporting.

Evaluation of the understanding of antibiotic resistance among Malaysian pharmacy students at public universities: An exploratory study

BACKGROUND Infectious diseases are a great threat to humankind, and antibiotics are a viable proposition to numerous pathologies. However, antibiotic resistance is a global concern. Therefore, the aims of this survey were to explore the understanding and attitudes of pharmacy students regarding antibiotic use and resistance. METHODS This is a cross-sectional study conducted on final-year undergraduate pharmacy students from 5 public universities. A validated, self-administered questionnaire written in English was used to collect data. It was made up of six domains and forty-five questions. Raosoft software was used to determine the minimum required sample size. Descriptive and inferential data analyses were carried out using SPSS version 20 software. RESULTS Out of 346 students, only 59.5% showed a strong understanding of antibiotic usage, while 84.4% of students demonstrated a good level of understanding regarding the issue of antibiotic resistance. However, only 34.1% of students demonstrated a positive attitude toward this issue. CONCLUSION This survey reveals that final-year pharmacy students at Malaysian public universities have a relatively good understanding of antibiotic resistance. However, their attitudes did not strongly correlate to their knowledge.

Study of Drug Utilization Pattern for Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Patients Attending a Government Hospital in Kerala, India

Objective: Drug utilization studies are powerful exploratory tools to ascertain the role of drugs in society. This study was conducted to establish the drug utilization pattern and the common adverse drug reactions for the treatment of acute exacerbation of chronic obstructive pulmonary disease (COPD) in one of the government hospitals in Kerala, India. Methods: This was a prospective observational study aimed at recognizing the drug utilization pattern for the treatment of acute exacerbation of COPD for 7-day under nonexperimental settings. All information significant to the study was collected from the case records and discussions conducted with the inpatients and bystanders during ward rounds, with the support of a physician. Moreover, daily follow-ups were conducted to assemble data on amendment in therapy, add-on therapy, and clinical improvement until the patient was discharged from the hospital or to an upper limit of 7-day, whichever is earlier. Results: All the patients in this study received combination therapy. Among the inhalational β-agonists, salbutamol accounted for 74% use. Parenteral steroids were used in 78% of the patients and all of them received hydrocortisone. Steroid inhalers were used only in 25% of the patients. Anticholinergics were used in 77.5% of patients. Antibiotics were used in 86.7% patients. The main adverse effects noted were dry mouth (15%) and bad taste (10%) and these adverse effects were highly correlated with the use of anticholinergics (P < 0.05). Conclusions: Despite the use of drugs according to the availability and physicians preference, it was found in the analysis that majority were in accordance with Global Initiative for Chronic Obstructive Lung Disease criteria recommendations.

An assessment of pharmacy students’ knowledge, attitude, and practice toward oral health: An exploratory study

Background: Community pharmacies are now frequently being visited by customers/patients to seek oral advice. Malaysian community pharmacists are also found to be experiencing an increased demand of oral health advices by their visiting customers. Aims/Objectives: The aim of the study was to explore the knowledge, attitude, and practice of the final year Bachelor of Pharmacy students in a private university toward oral health, as these students will be the future pharmacists. Materials and Methods: This cross-sectional study was carried out among final year undergraduate pharmacy students by using self-administered questionnaire. It was conducted as a classroom survey. Raosoft software was used to determine the minimum required sample size. Results: The demographic distribution of the respondents was separated into gender, ethnicity, and state of origin. Over 83.8% of the participants were females, with Chinese ethnicity dominating (78.4%) compared to others, and the distribution showed 11 different states of origin. Conclusions: This research finding shows that pharmacy students have positive attitude toward oral health despite having poor knowledge and mediocre practice principles regarding oral health.

Standard setting in OSCEs: a borderline approach.

The evaluation of clinical skills and competencies is a high‐stakes process carrying significant consequences for the candidate. Hence, it is mandatory to have a robust method to justify the pass score in order to maintain a valid and reliable objective structured clinical examination (OSCE). The aim was to trial the borderline approach using the two‐domain global rating scale for standard setting in the OSCE.

Evaluation of patient safety culture among Malaysian retail pharmacists: results of a self-reported survey

Background Patient safety is a major public health issue, and the knowledge, skills, and experience of health professionals are very much essential for improving patient safety. Patient safety and medication error are very much associated. Pharmacists play a significant role in patient safety. The function of pharmacists in the medication use process is very different from medical and nursing colleagues. Medication dispensing accuracy is a vital element to ensure the safety and quality of medication use. Objective To evaluate the attitude and perception of the pharmacist toward patient safety in retail pharmacies setup in Malaysia. Methods A Pharmacy Survey on Patient Safety Culture questionnaire was used to assess patient safety culture, developed by the Agency for Healthcare Research and Quality, and the convenience sampling method was adopted. Results The overall positive response rate ranged from 31.20% to 87.43%, and the average positive response rate was found to be 67%. Among all the eleven domains pertaining to patient safety culture, the scores of “staff training and skills” were less. Communication openness, and patient counseling are common, but not practiced regularly in the Malaysian retail pharmacy setup compared with those in USA. The overall perception of patient safety of an acceptable level in the current retail pharmacy setup. Conclusion The study revealed that staff training, skills, communication in patient counseling, and communication across shifts and about mistakes are less in current retail pharmacy setup. The overall perception of patient safety should be improved by educating the pharmacists about the significance and essential of patient safety.

Suitability of the RIPLS and IEPS for Discriminating Attitude Differences towards Interprofessional Education among Students of Healthcare Profession

Background. Interprofessional education provides students of healthcare programme an opportunity to collaborate with students from other disciplines and help them to get a training prior to entering the healthcare workforce. This study may help to select a suitable tool to discriminate attitude differences of healthcare professional students towards interprofessional education. Methods. A study, which was cross-sectional, was conducted at a private university in Malaysia to explore the two scales (RIPLS and IEPS) and their psychometric properties. Study participants comprised students from four different professions with at least one exposure or no previous exposure to IPE. Results. Both the scales (RIPLS and IEPS) have their own ability to detect differences in students’ attitude towards IPE in their own way. However, the IEPS scale was able to detect differences within the gender, professions (both junior and senior students), and prior exposure to IPE. Conclusions. This study revealed that though both scales can be used to follow the impact of IPE in curricula, IEPS scale is more suitable than RIPLS to discriminate attitude differences among healthcare students. Educators may develop various strategies to observe students’ behaviours and perceptions qualitatively and conduct longitudinal study to assess the outcomes of including IPE in curricula.