Journal of Pharmacy (JOP)
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Measuring the Prevalence of Chronic Kidney Disease among Type 2 Diabetes Mellitus Patient in Hospital Jitra: A Population-Based Cohort Study
Get PDFIntroduction: Chronic kidney disease (CKD) develops in approximately 40% of patients with diabetes. The prevalence of CKD in Malaysia is 9.07% among adults. It is important to obtain accurate local data on CKD among patient with Type 2 Diabetes Mellitus (T2DM) patients to facilitate health-care planning including the review of health-care priorities, program activities, and allocation of resources. The objective of this study is to determine the prevalence of CKD among DM. We further explored the association between glycaemic control, eGFR and adverse outcomes (cardiovascular events, hospitalizations, and kidney failure) among these patients. Materials and method: This is a retrospective cohort study involving 91 DM patients who received treatment in Hospital Jitra, Kedah, Malaysia. Patients’ demographic data, comorbidities, history of hospital admission, medications, complication, and laboratory test results were retrieved from their medical record. Descriptive and inferential statistics have been used to analyse the data. Results: 60.4% of the patients were female and 85.7% Malay with mean age of 62.15 years old. Hypertension, hypercholesterolemia and heart disease were the most common comorbidities among them; 92.3%, 78.0%, and 23.1%, respectively. The prevalence of CKD among DM in Hospital Jitra was 38.46%. 20.9% of the patients experienced diabetic complications and 49.5% showed a progression of kidney disease. The results indicate a high percentage of poor glycaemic control among DM in Hospital Jitra; 69%-100% of the patients had HbA1c >7% at each visit and this is associated with CKD (P=0.042). Conclusion: The prevalence of CKD among DM patients at Hospital Jitra was 38.46%. Higher HbA1c was associated with CKD in adults with type DM, suggesting that improving glycaemic control may reduce the risk of CKD
The challenges of using Escherichia coli as a host in recombinant insulin production
Get PDFDiabetes mellitus is a metabolic disease characterised by elevation of blood glucose level which leads to serious damage to the blood vessels, eyes, heart, kidney, and nerves affecting about 830 million people worldwide. The most common diabetes is type 2 which usually happened in adults when the body becomes resistant to insulin, or the body does not produce enough insulin. Type 1 diabetes mellitus is dependent on insulin which required accessible and affordable insulin (Diabetes, 2025).
In Malaysia, the prevalence of diabetes mellitus (DM), depends on factors such as gender, age, and ethnicity, with women, the elderly, and the Indian community having the highest prevalence of DM. In the 103,063 participants that made up the study's sample, the combined prevalence of diabetes by gender in the population-based studies was 13.80% for men and 14.54% for women, while the combined prevalence of prediabetes was 11.40% for women and 10.98% for men (Akhtar et al., 2022). For age, from this study, it can be observed that the prevalence of diabetes showed a notable upward trend as people aged, rising from 3.16% in the 20–29 age group to 13.71% in the 30-45 age group, 25.66% in the 46–59 age group, and 33.45% in the 60 and older age group (Akhtar et al., 2022). Ethnicity and races can also affect the prevalence of DM. The subpopulation of Indian had the greatest prevalence of diabetes which is 25.10%, among all ethnic groups, followed by Malay with 15.25%, Chinese with 12.87%, Bumiputera with 8.62%, and others with 6.91%. The prevalence demands oral hypoglycaemic agents (OHAs) market size in Malaysia at USD282.22 million in 2025 with a CAGR of greater than 3% during forecast period (2025-2030). The drugs are mainly fall under the following segment: biguanides, alpha-glucosidase inhibitors, dopamine-d2 receptor agonists, sodium-glucose cotransport-2 (SGLT-2) inhibitor, dipeptidyl peptidase-4 (DPP-4) inhibitors, sulfonylureas, and meglitinides (Malaysia Oral Anti-Diabetic Drug Market Size | Mordor Intelligence, 2025)
Evaluating the Wound Healing Activity of Fabricated Stingless Bee Honey Hydrogels in an Animal Model
Get PDFIntroduction: Honey is a well-established treatment for wound healing and had been used for ages. However, there are limitations when it is directly applied to the wound such as inconsistent dosage and pain during dressing changes. The incorporation of honey into hydrogel could overcome these problems. The study is aimed at developing a suitable honey-based hydrogel formulation for wound healing application by using systematic experimental design from response surface methods (RSM). Methods: The hydrogel’s base was made from polyvinyl alcohol (PVA), polyethylene glycol (PEG), glycerol and agar. A two-level factorial design was selected to screen the factors followed by centred composite design for optimization. The characterizations of the optimized formulation were observed in term of hydrophilicity and rheological. The optimized formulation was further assessed in an in vivo wound healing study in New Zealand albino rabbits. Results: PEG and agar concentration was found to be the most important process variable based on the screening result. The optimised hydrogel has a good hydrophilicity ability and rheological property. In in vivo healing study, the healing in the honey incorporated hydrogel treated group was significantly faster than the no treatment group, as demonstrated in wound closure percentage and histological assessment. From the results, the wound in the honey hydrogel treatment group has entered the remodelling phase compared with the control group that was still in the proliferation phase. Conclusion: Based on all of these results, stingless bee honey incorporated hydrogel has a promising application as an efficient wound dressing
A Phytochemical Profiling and in vitro Antimicrobial Evaluation of Methanolic Extract and Fractions of Dicranopteris linearis Leaves
Get PDFIntroduction: Dicranopteris linearis, locally known as resam, has been recognized for its potential health benefits, primarily due to its rich phytochemical content. Traditionally used for medicinal purposes, the leaves are known to possess antioxidant and antimicrobial properties. This study aimed to screen the phytochemical composition and evaluate the antimicrobial activity of the methanolic extract of D. linearis leaves, with potential applications in the medicinal industry. Materials and Methods: The dried and ground leaves of D. linearis were macerated in 100% methanol to extract the phytochemicals. The extract was subjected to qualitative phytochemical profiling. Total Phenolic Content (TPC) was determined by the Folin-Ciocalteu method and Total Flavonoid Content (TFC) was measured using the AlCl? method. The methanol extract was fractionated by Vacuum Liquid Chromatography (VLC) with ethyl acetate (100%), ethyl acetate: methanol (5:5) and methanol (100%). Antimicrobial activity of the crude extract and fractions was assessed against Escherichia coli and Staphylococcus aureus using the disc diffusion assay and broth microdilution techniques. Results: Phytochemical profiling of the methanol extract revealed the presence of phenolic compounds, flavonoids, tannins, and saponins. The TPC and TFC assays showed that the methanolic extract contained 225.43 ± 4.16 mg GAE/g of phenolic compounds and 50.20 ± 4.78 mg QE/g of flavonoids. Fractionation of methanol extract was afforded three fractions, F1, F2 and F3. Antimicrobial testing demonstrated that the extract exhibited stronger activity against S. aureus (MIC = 1.563 mg/mL) compared to E. coli (MIC > 50 mg/mL). For the fraction, F1 exhibited both microbes with promising activity. Conclusions: The methanolic extract from D. linearis leaves contain bioactive phytochemicals with significant antioxidant and antimicrobial properties. These findings suggest that D. linearis may serve as a valuable source for the development of natural antimicrobial agents in the pharmaceutical industry
Students Perceptions, Satisfactions and Challenges on Problem-Based Learning (PBL): A Survey Study Among Final Year Pharmacy Students
Get PDFIntroduction: Problem-based learning (PBL) is being adopted more frequently in pharmacy education to enhance skills such as problem-solving, and self-directed learning. However, thorough research on pharmacy students’ perceptions and satisfaction towards PBL in Malaysia remains inconclusive. This study aims to explore students’ views, satisfaction, and obstacles regarding PBL in pharmacy education especially to improve critical thinking, interpersonal skills, and problem-solving skills. Method: A cross-sectional study using a validated closed and open-ended questionnaire consisting of 22 statements was distributed among 84 final-year pharmacy students. Results: Eighty-four final-year pharmacy students participated in this study. Findings revealed that the majority agreed with statements on benefits that PBL significantly contributed to their knowledge acquisition (100.0%), stimulated the exploration of basic scientific concepts (98.8%), and enhanced their understanding in selecting both pharmacological and non-pharmacological approaches in disease management (97.6%, 95.2% respectively). The consensus extended to the belief that PBL fostered interactions with peers (91.7%), improved problem-solving skills (95.2%) and enhanced interpersonal skills (95.2%). Students expressed confidence in their instructors’ clarity (92.9%) and clear answers to questions (90.5%). Most felt comfortable participating in discussions (69%), and nearly all students were satisfied with their group members’ cooperation (95.2%). Although, most findings highlight positive aspects of PBL, this study also identified three major challenges in PBL implementation, namely 1) insufficient time for PBL preparation, 2) lack of teamwork, and 3) difficulty in finding adequate reading materials. Conclusion: Overall, these findings highlight positive aspects of the PBL experience among respondents. Future research should consider diverse student populations, conduct longitudinal studies, and explore instructors’ perspectives
Predictors Associated with Delayed Methotrexate Clearance among Patients with Haematological Malignancies
Get PDFIntroduction: High dose methotrexate is commonly utilised in haematological malignancies; however, the prevalence of delayed clearance is not well-defined. The study aimed to determine the prevalence of delayed clearance of methotrexate, to analyse correlation between rate of methotrexate infusions and its concentrations, and to identify the predictors associated with delayed clearance. Method: A crosssectional study was conducted among adult patients with haematological malignancies who received high-dose methotrexate. Spearman’s correlation was utilised to analyse correlation between the rates of methotrexate infusions with its concentrations at 48 and 72 hours. Multiple logistic regression was used to identify factors associated with delayed clearance. Results: A total of 63 patients with 159 methotrexate infusions were included, with a mean age of 42.2 years (±18.06) and a median body mass index of 23.36 kg/m2 (19.91-26.14). Delayed methotrexate clearance was observed in 29 (46%) patients, which affected 41 (25.6%) methotrexate infusions. A poor negative correlation was found between the rate of methotrexate infusion and 48-hour concentration (r=-0.206, p=0.009). Older age (odds ratio (OR) 1.06, 95% confidence interval (CI) 1.03-1.10, p<0.001) and dose of methotrexate >3000 mg/m2 (OR 3.33, 95% CI 6.45-120.88, p<0.001) were identified as the predictors of delayed methotrexate clearance. Conclusion: Almost half of the patients experienced delayed methotrexate clearance. A slower rate of infusion was found to correlate with higher 48-hour concentrations. Older age and higher doses of methotrexate were identified as predictors for delayed clearance. Prospective study is needed with larger sample size to ensure generalisability of the outcomes
Solid-State Modification Strategies for Alpha-Mangostin Solubility Enhancement: A Review on Recent Progress
Get PDFIntroduction: Enhancing the therapeutic efficacy of active pharmaceutical ingredients requires addressing the persistent challenge of improving their solubility. Alpha-mangostin (AM), a promising natural compound with various pharmacological properties, faces significant limitations due to its low aqueous solubility. This review focuses on evaluating solid-state modification (SSM) techniques developed to enhance AM solubility. It aims to identify the most effective SSM approaches, analyse their advantages, and provide insights for future research directions in addressing solubility challenges for poorly water-soluble compounds. Methods: This review article is based on a comprehensive analysis of the literature from databases like Scopus, Google Scholar, ScienceDirect, Springer, and PubChem, covering studies published in the past 15 years. Keywords such as "solubility," "alpha-mangostin," and "solubility improvement" were utilised, with a focus on scientific articles and reviews. Results: Several strategies, such as nanoparticle technology, particle size reduction, amorphous formation, and solid dispersion, have been used to enhance AM solubility. Solid dispersion with polyvinylpyrrolidone achieved the highest solubility (2743 ?g/mL), while the AM-chitosan-oleic acid complex using nanotechnology improved AM solubility to 160 ?g/mL, an 800-fold increase from 0.2 ?g/mL. Conclusion: The reviewed methods have significantly enhanced the aqueous solubility of AM, with solid dispersion and nanotechnology showing the most promising results. These findings highlight the potential of solubility enhancement strategies to optimise AM’s pharmaceutical applications and provide a framework for improving the bioavailability of other poorly water-soluble compounds. Future research should explore alternative methods, such as co-crystallisation and advanced nanotechnologies, to further enhance solubility and formulation efficiency
The Role of Fall Risk-Increasing Drugs in Prevalence of Fall and its Associated Factors
Get PDFIntroduction: The World Health Organization defines a fall as "an event where a person comes to rest inadvertently on the ground or another lower level”. Among numerous risk factors, medication use stands out as one of the most highly modifiable risk factors for falls in adults. Medications associated with an increased fall risk have been termed Fall Risk–Increasing Drugs (FRIDs). This study aimed to determine the prevalence of falls among patients at Hospital Baling and its associated factors. Methods: A cross-sectional study was conducted by examining patients' history of falls and medication records for those admitted to the ward from 1st January to 30th June 2023. Systematic random sampling was used, and multiple logistic regression was performed to determine the risk factors for falls. Types of FRIDs were extracted from the Comprehensive Falls Risk Assessment Instrument (FRAI) and scored based on prescribed medications. Results: A total of 200 medical records were examined. The prevalence of falls among patients was 10.5% whereby the mean FRAI score was 2.32. Patients using diuretics were 81% less likely to experience falls (adjusted OR = 0.19, 95% CI [0.04, 0.94], p = 0.038), while each additional comorbidity increased the odds of falling by 2.2 times (adjusted OR = 2.20, 95% CI [1.38, 3.51], p = 0.001). Conclusion: FRIDs, except for diuretics, did not show any significant association with falls. However, thorough medication review by pharmacists remains essential, despite FRIDs showing little to no difference in increasing risk of falls
Sweet Potato Peel Pectin's Potential as a Suspending Agent in Pharmaceutical Formulations: The Effect of Extraction Technique
Get PDFIntroduction: Sweet potato (Ipomoea batatas L. Lam) represents an essential underutilised crop globally. The ubiquitous hydrocolloid, pectin, with versatile pharmaceutical and cosmetic applications has been reported to be abundant in the peels. This study thus examined the impact of acid (citric acid) and alkaline (sodium hydroxide) extraction procedures on the suitability of pectin extracted from sweet potato peels as a biocompatible and economical alternative pharmaceutical suspending agent. Methods: Conventional acid and alkaline extraction procedures were utilised in sweet potato pectin extraction followed by characterisation and phytochemical evaluation. The proximate composition, FTIR spectra, secondary metabolites and degree of esterification were determined. Additionally, different concentrations (1% and 2%) of the pectins were utilised in formulating paracetamol suspensions using acacia gum as the reference and assessed for pharmaceutical quality. Results: Secondary metabolites were present in all pectins while the yield was 9.04±0.07 and 7.24±0.25 respectively for the acid and alkaline extraction methods. Quality and high methoxyl pectins with significant differences (p<0.05) in all characterisation parameters (Equivalent weight=1666.67 and 1250mg/mol; methoxyl content=16.43 and 9.57% respectively) except for ash content (3.12 and 2.95 % respectively) were obtained. FTIR highlighted characteristic functional groups in pectin. Both pectin suspensions demonstrated good however, variable significant differences (p<0.05) in flow rates, re-dispersibility, sedimentation rates, and volumes compared to acacia gum. The pH remained mildly acidic (<7) with no physical instabilities. Conclusion: The alkaline pectin exhibited a better-suspending property than the acid pectin extract. Nevertheless, they both can be utilised as an alternative to acacia gum as a suspending agent
Circadian Variation of Zinc, Copper, Selenium, and Bromine in Human Milk
Get PDFIntroduction: Human milk undergoes dynamic modifications throughout lactation to optimally meet the dietary and immunological requirements of the growing infant, with variations of its composition also occurring throughout the day. Circadian variation in some bioactive components helps the development of the biological clock by passing on chronobiological information from mother to infant. This study aimed to identify the circadian variation of zinc, copper, selenium, and bromine in human milk during the postpartum period. Methods: Human milk samples were collected from a postpartum mother who was taking zinc and copper supplements. Milk samples were analysed using inductively coupled plasma mass spectrometry. Data on zinc, copper, selenium, and bromine concentrations were analysed using Microsoft Excel 2021 and reported descriptively to determine circadian variation. Results: The concentration of all four trace elements declined throughout the six months postpartum period with consistent fluctuations for bromine. Zinc, copper, and bromine possess the most similar circadian variation throughout the day with a ‘V’ shaped pattern, but selenium showed inconsistent circadian pattern over the first six months postpartum. The ‘V’ shaped pattern generally disappeared in the fourth, fifth, and sixth months. Conclusion: Circadian rhythms for zinc, copper, selenium, and bromine varied during the first six months postpartum. This may indicate a functional circadian clock regulating infants’ biological development. Future studies should explore the factors influencing the development of fully functional circadian rhythmicity in infants