Benzodiazepines Refusal During Dispensing Process Among Patients Diagnosed With Depression or Schizophrenia in Malaysia

@#Introduction: Benzodiazepines (BZDs) are commonly prescribed to psychiatric patients. However, there have been few studies evaluating BZD refusal among patients with psychiatric disorders during the dispensing process. Thus, this study aimed to determine 1) the factors associated with BZD refusal during the dispensing process and to determine 2) the association between BZD refusal and psychiatric medication adherence among patients diagnosed with depression or schizophrenia. Method: This study was conducted at the Specialist Clinic Pharmacy, Jerantut Hospital, Malaysia, from May 2018 to June 2018. BZD refusal status was determined after the dispensing process, and general information on BZD was determined using a questionnaire developed by the researchers. Medication adherence was assessed using the Malaysian Medication Adherence Scale (MALMAS). Results: Overall, 75 patients with psychiatric disorders participate in the study. Participants had been on BZD treatment for a mean of 32.8± 21.6 months. The BZD refusal rate was 38.7%. BZD refusal was significantly associated with several factors. A one-year increase in age resulted in increased odds of BZD refusal by 1.16 times (95% CI 1.05-1.27). Other factors were male gender (OR,9.14; 95% CI, 1.17-71.27), being single (OR,15.07; 95% CI, 1.12-184.28), the diagnosis of schizophrenia (OR,13.45; 95% CI, 1.75-10.33) and not having history of illicit drug use (OR,20.63; 95% CI, 2.49-171.0). Medication adherence was not associated with BZD refusal. Conclusion: BZD refusal was significantly associated with demographic factors such as increased age, male gender and being single and diagnosis factors namely schizophrenia diagnosis and not having history of illicit substance use. Thus, the need for BZD in these groups of patients should be reviewed regularly.

research note on outbreak of infectious bursal disease [IBD] in Saudi Arabia

During spring 1991, a severe outbreak of infectious bursal disease [IBD] in the Eastern Province of Saudi Arabia was investigated. The mortality rate recorded was very high and reached 26.49%. The affected chicken flocks were 35 days old and were vaccinated against IBD virus at 15 and 30 days old. Large swelling in some cases accompanied with haemorrhages, were observed in the bursa of Fabricius of the affected chickens. Kidneys were oedematous and showed signs of nephrosis. Pathological and histopathological examinations of affected organs were described. The etiological agent was isolated in embryonated chicken eggs and subsequently identified by agar gel precipitation test and fluorescent antibody technique. A recommendation of close monitoring and further investigation of these virulent cases of field IBD viruses has been suggested