Health-related quality of life of dialysis patients during early COVID-19 lockdowns: a snapshot from a public hospital in Malaysia.

Background: End-stage renal disease is the last stage of chronic kidney disease and can affect the quality of life (QOL) of dialysis patients. The aim of this study was to assess the quality of life and examine its determinants. Methods: A cross-sectional survey involving patients on dialysis in a tertiary hospital was conducted from July 2020 to September 2020. Demographic data were collected using a predesigned questionnaire. QOL was measured using the 36-item KDQOL questionnaire, and statistical analysis was carried out using SPSS version 25. Results: Of the 108 patients, 59 were men and 49 were women, and the mean age was 48.15 ± 15.4 years. The results showed that there was no significant difference in the mean score of all components of health-related quality of life in different types of dialysis. The demographic data, which included age, gender, ethnicity, marital status, education level, occupation, and monthly income, did not significantly affect the QOL of dialysis patients. Patients with a dialysis duration of more than 5 years had a better QOL compared to other groups. Laboratory parameters such as low albumin and low hemoglobin showed a significant correlation with the health-related quality of life of dialysis patients. Conclusion: The quality of life among patients on dialysis was impaired, especially in terms of burden of the kidney disease. Hypoalbuminemia and anemia were the two factors that influenced QOL.

Prevention and Treatment of Monkeypox: A Systematic Review of Preclinical Studies.

The outbreak of monkeypox, coupled with the onslaught of the COVID-19 pandemic is a critical communicable disease. This study aimed to systematically identify and review research done on preclinical studies focusing on the potential monkeypox treatment and immunization. The presented juxtaposition of efficacy of potential treatments and vaccination that had been tested in preclinical trials could serve as a useful primer of monkeypox virus. The literature identified using key terms such as monkeypox virus or management or vaccine stringed using Boolean operators was systematically reviewed. Pubmed, SCOPUS, Cochrane, and preprint databases were used, and screening was performed in accordance with PRISMA guidelines. A total of 467 results from registered databases and 116 from grey literature databases were screened. Of these results, 72 studies from registered databases and three grey literature studies underwent full-text screening for eligibility. In this systematic review, a total of 27 articles were eligible according to the inclusion criteria and were used. Tecovirimat, known as TPOXX or ST-246, is an antiviral drug indicated for smallpox infection whereas brincidofovir inhibits the viral DNA polymerase after incorporation into viral DNA. The ability of tecovirimat in providing protection to poxvirus-challenged animals from death had been demonstrated in a number of animal studies. Non-inferior with regard to immunogenicity was reported for the live smallpox/monkeypox vaccine compared with a single dose of a licensed live smallpox vaccine. The trial involving the live vaccine showed a geometric mean titre of vaccinia-neutralizing antibodies post two weeks of the second dose of the live smallpox/monkeypox vaccine. Of note, up to the third generation of smallpox vaccines-particularly JYNNEOS and Lc16m8-have been developed as preventive measures for MPXV infection and these vaccines had been demonstrated to have improved safety compared to the earlier generations.

Resilience among Malaysian Community Pharmacists and General Medical Practitioners Using the 10-Item Connor-Davidson Resilience Scale (CD-RISC): The First National Survey.

With the growing importance of the healthcare sector, resilience has become a fundamental personal quality that healthcare professionals need to cultivate to cope with adverse events in daily work. Distress in the workplace cannot only impact the well-being of healthcare professionals but also negatively affect the capability to care effectively for others. This study was conducted to determine the score and level of resilience among private primary healthcare professionals and their relationships with independent variables. Sets of questionnaires on resilience based on the Connor-Davidson resilience scale-10 (CD-RISC-10) were completed by 164 general practitioners (GPs) and 87 community pharmacists (CPs). Inferential analysis was used to assess the difference, correlation, association, and predictor among dependent and independent variables. The validity and reliability of the study instrument were assessed using Modern Test Theory (MTT) and Classical Test Theory (CTT). The majority of GPs and CPs possessed the lowest resilience level. There were significant differences between CD-RISC-10 with gender, age, and years of experience in GPs as well as overall. Significant associations were found between CD-RISC-10 with all independent variables, except for the highest education level in GPs and overall. This study revealed significant correlations between independent variables with CD-RISC-10 in GPs and overall. However, there were nonsignificant differences, associations, and correlations among CPs between all independent variables and CD-RISC-10. Gender was the predictor of CD-RISC-10 in GPs, while age and years of experience were the predictors of CD-RISC-10 in GPs and overall. There was no predictor of independent variables for CPs. In multinomial logistics regression, years of experience and gender were the significant predictors of CD-RISC-10 among GPs. The CD-RISC-10 instrument had good validity and reliability. Overall, healthcare professionals showed a low level of resilience. This emphasized the need to cultivate and build resilience, as it is a desirable, important element when working in harsh and unprecedented healthcare settings.

Knowledge, Attitude and Practice towards the Use of Over-the-Counter Medicines: An Online Survey among Bruneian Adults amid the COVID-19 Pandemic

Globally, self-medication has increased, where 25% of adults use OTC medicines. This research is intended to assess the knowledge, attitude and practice regarding OTC medicines among adults in Brunei Darussalam. An online cross-sectional survey was performed using a questionnaire adapted from similar research conducted among students in Brunei Darussalam. A total of 364 responses were collected, where the median age of the study participants was 23 years. The mean knowledge score was 7.3 out of 9, with most respondents (77.7%) having good knowledge of OTC medicines. Almost all (92.9%) showed a positive attitude towards OTC use. A statistically significant difference (p ≤0.05) was observed in attitude scores between age groups and education levels. Most of the study participants (88.2%) have practiced self-medication with OTC medicines, mainly due to their easy accessibility (79.4%). A small number practiced improper habits, such as consuming more than the recommended dose (6.0%) and not checking the expiry date (0.5%). The practice of self-medicating with OTC medicines can be advantageous when patients fully know the medications and nature of their disease. Knowledge of proper OTC medicine use among adults in Brunei Darussalam is essential to avoid improper user practices and potential health hazards associated with the misuse of medications.

The potential roles of pharmacy medication sales data to augment the syndromic surveillance system in response to COVID-19 and preparedness for other future infectious disease outbreaks in Indonesia.

BACKGROUND: Indonesia faces a continuous threat from communicable disease outbreaks. The current COVID-19 outbreak, the previous one of SARS, and many other infectious outbreaks encountered in the country warn of the need to develop comprehensive early warning systems to enable timely health responses in the long run. In this article, we argue that over the counter medication sales data at community pharmacies in Indonesia can potentially augment and increase the detection power of the current syndromic surveillance system, particularly in dealing with COVID-19 and other future infectious disease outbreaks in the country. MAIN BODY: This article discusses the experience of other countries in employing pharmacy medication sales data to serve as potential syndromic surveillance platform and contribute to pandemic responses. We argue why it is worth considering utilising medication sales data from pharmacies in Indonesia to support the current surveillance system which enables the provision of early warnings of disease outbreaks. We then discuss the potential challenges of operationalising these data and suggest a way forward for the development and implementation of the syndromic surveillance system at community pharmacy settings in Indonesia. CONCLUSION: While there are several challenges in developing a workable system in Indonesia that need to be addressed, introducing a syndromic surveillance system using pharmacy-setting medication sales data is worth investigating in the country.