The influence of pharmacist-led collaborative care on clinical outcomes in type 2 diabetes mellitus: a multicenter randomized control trial

Background

Health care providers are mandated to deliver specialized care for the treatment and control of type 2 diabetes mellitus. In Malaysia, Diabetes Medication Therapy Adherence Clinics (DMTAC) in tertiary hospitals have designated pharmacists to administer these services.

Objective

To assess the effects of pharmacist-led interventions within DMTAC on the outcomes of patients with type 2 diabetes mellitus in two distinct hospitals in Kedah, Malaysia.

Methods

Patients with type 2 diabetes were randomly selected from the two hospitals included in this study. The study population was divided into two equal groups. The control group consisted of 200 patients receiving routine care from the hospitals. On the other hand, the intervention group included those patients with type 2 diabetes (200), who received separate counseling sessions from pharmacists in the DMTAC departments along with the usual treatment. The study lasted 1 year, during which both study groups participated in two distinct visits.

Results

Parametric data were analyzed by a paired t-test and one-way ANOVA, while non-parametric data were analyzed by a Chi-squared test using SPSS v24. A p < 0.05 was considered statistically significant. The study presented the results of a greater reduction in HBA1c levels in the intervention group compared to the control group, i.e., 3.59 and 2.17% (p < 0.001). Moreover, the Systolic and Diastolic values of BP were also significantly reduced in the intervention group, i.e., 9.29 mmHg/7.58 mmHg (p < 0.005). Furthermore, cholesterol levels were significantly improved in patients in the intervention group, i.e., 0.87 mmol/L (p < 0.001).

Conclusion

Based on the findings of the current study it has been proven that the involvement of pharmacists leads to improved control of diabetes mellitus. Therefore, it is recommended that the government initiate DMTAC services in both private and government hospitals and clinics throughout Malaysia. Furthermore, future studies should assess the impact of pharmacist interventions on other chronic conditions, including but not limited to asthma, arthritis, cancer, Alzheimer's disease, and dementia.

Shock absorption capability of corrugated ring yield mount subjected to high impact loading

Various types of mechanical energy-absorbing devices are known that operate by plastic deformation. The corrugated ring mount that is used in this study relates to a device that absorbs energy by plastic deformation. This energy-absorbing device has reduced volumetric proportions, simple in design, and therefore has small overall dimensions and can be mass-produced at low cost. This study aims to determine the shock absorption capability and efficiency of this mount against impact loading. For this, Finite Element Method Analysis (FEA) and experimentation are done. The FEA is done using the Explicit Dynamics (AutoDyn) module of ANSYS Workbench and for experimentation Drop Test Machine (DTM) is used. In this study impact load from low g up to 85 g is applied and a very close agreement is found between FEA and experimental results. There is just a 5-10% deviation between the findings. The results show that this mount is plastically deformed to absorb the impact energy with a maximum efficiency of 70%. It concludes that it is a reliable and safer shock energy device.

Knowledge, attitude, and perceptions about polycystic ovarian syndrome, and its determinants among Pakistani undergraduate students

OBJECTIVE

The aim of the study was to evaluate knowledge, attitude, perception, and assess the determinants of polycystic ovarian syndrome (PCOS) among undergraduate students.

METHODS

A cross-sectional study was conducted among female undergraduate students in Pakistan using a survey. The questionnaire was formulated in English language by a review of literature and expert consensus. The sampling approach was convenient, and survey was available as electronic as well as hardcopy. Data were analyzed using IBM SPSS v23. Descriptive statistics namely mean ([Formula: see text]), standard deviation (SD), or median ([Formula: see text]) and interquartile range (IQR) were used dependent upon data distribution. In addition, range (R) was also utilized to express the results. The logistic and linear regression analyses were also conducted. Study received ethical clearance from ethics committees.

RESULTS

A total of 646 responses were analyzed. The average PCOS knowledge score was 11.58 ± 4.99 (overall), 12.02 ± 4.73 (medical students), 9.36 ± 5.65 (non-medical students) (α = 0.861). 68.6% participants did not feel embarrassed while discussing PCOS in the society, but 67.3% never discussed it with a doctor. Lack of self-knowledge (31.6%) and shyness/reluctance (21.4%) were identified as barriers by most students. Further, obesity, irregular menstrual periods, family history, hirsutism and contraceptive use were observed to be determinants for having PCOS (AOR > 2, p<0.05). The disease knowledge score was higher for participants studying in medical college (β = 0.184), having menstrual periods < 5 days (β = 0.125), and with a family history (β = 0.121) (p<0.05).

CONCLUSION

The disease knowledge among undergraduates was inadequate. However, there is greater acknowledgement of PCOS as a problem for Pakistani women and barriers have been identified in the study. Conducting awareness campaigns within academic institutions which include promoting disease education, arranging talks, distributing merchandise with disease awareness signage, would greatly help in raising awareness of the disease and lowering stigma and hesitancy.

Evaluation of haematological, serum biochemical and oxidative stress parameters in cattle naturally infected with lumpy skin disease virus

Lumpy skin disease (LSD) is a vector-borne viral transboundary disease of cattle caused by the LSD virus (LSDV). Despite investigations on clinical and outbreak features of LSDV, information on disease pathogenesis and alternative changes in blood parameters are scarce. Keeping this in view, the current study was designed to determine haematological, serum biochemical, and oxidative stress parameters in naturally infected cattle with LSDV during the recent surge of outbreaks in Punjab, Pakistan. A total of 35 blood samples was collected from polymerase chain reaction-confirmed LSDV-infected cattle for assessment of all parameters. The haematological examination of blood samples showed a significant reduction (p < 0.05) in different variables of erythrogram and leucogram. On the other hand, differences between levels of various serum biochemical parameters with the significant increase in levels of alkaline phosphatase, serum alanine aminotransferase, aspartate aminotransferase, and blood urea nitrogen were observed in LSDV naturally infected cattle. Moreover, malondialdehyde levels for lipid peroxidation and nitrate concentration were markedly elevated whereas glutathione S-transferase fluorescent and serum superoxide dismutase enzymes showed a decrease in levels. The current study suggests that alternations in haematological and serum biochemical parameters following LSDV infection stimulate oxidative stress and such findings may be useful for early and rapid diagnosis and improvement in the treatment strategy of the disease.

Seroprevalence of Newcastle disease virus and avian influenza virus in poultry and captive wild birds in poultry-dense regions of Pakistan

Newcastle disease virus (NDV) and avian influenza virus (AIV) are causing contagious diseases in chickens and wild birds worldwide; however, there is a paucity of information on the current status of seropositivity of Newcastle and avian influenza diseases in chickens and wild birds of Pakistan. Therefore, the present study aimed to investigate the serological evidence of both diseases in commercial poultry (broiler, layer chickens), backyard poultry, and captive wild birds in poultry‑dense regions of Punjab, Pakistan. Enzyme‑linked immunosorbent (ELISA) and haemagglutination inhibition (HI) assays were performed for the determination of antibodies against NDV and AIV and their genotyping and subtyping, respectively. Overall, 47.5% and 67.4% seroprevalence of NDV and AIV, respectively, was observed in both poultry and wild birds. Based on bird's category, layer chickens had the highest seroprevalence of NDV (60.8%, 95% CI: 52.95‑68.22, OR: 0.71) followed by backyard poultry (56.8%, 95% CI: 47.92‑65.32, OR: 0.82), broilers (52.7%, 95% CI: 46.84‑58.64), pigeons (41.3%, 95% CI: 30.53‑52.81, OR: 1.59), peafowls (26.1%, 95% CI: 11.09‑48.69, OR: 3.16), ducks (23.8%, 95% CI: 12.59‑39.8, OR: 3.57), turkeys (16.7%, 95% CI: 4.41‑42.27, OR: 5.58), parrots (14.3%, 95% CI: 2.52‑43.85, OR: 6.70) and quails (2.3%, 95% CI: 0.2‑13.51, OR: 4.8). Comparatively, backyard chickens had the highest seroprevalence of AIV (78.8%, 95% CI: 70.64‑85.22, OR: 0.63) followed by ducks (73.8%, 95% CI: 57.68‑85.6, OR: 0.83), layers (73.5%, 95% CI: 65.98‑79.89, OR: 0.84), pigeons (72.5%, 95% CI: 61.2‑81.61, OR: 0.89), broilers (70.1%, 95% CI: 64.44‑75.29), turkeys (55.5%, 95% CI: 31.35‑77.6, OR: 1.87), peafowls (47.8%, 95% CI: 27.42‑68.9, OR: 2.56) and parrots (42.8%, 95% CI: 18.8‑70.3, OR: 3.1). Overall, 40.1%, 34.2%, 31.3%, and 25.1% sera were positive for H9 AIV, G‑VII NDV, H7 AIV, and G‑VI NDV, respectively. The current study revealed a widespread exposure to NDV and AIV in poultry and captive wild birds. Therefore, it is crucial to include captive wild birds in NDV and AIV surveillance programs to further strengthen disease control measures, particularly in endemic regions.

Semi Active Control of sinusoidal shock waveform on drop test machine (DTM) using non-linear dynamic model of hybrid wave generator (HWG) consisting of rubber and electroMagnet

Sinusoidal shock waveforms are the classical type of waveforms generated in Drop Test Machines (DTMs) using Rubber Wave Generators (RWGs). For different specifications of pulse, different RWGs are used, leading to the laborious work of replacing RWGs in DTMs. In this study, a novel technique is developed to predict a shock pulse of variable height and time using a Hybrid Wave Generator (HWG) that yields variable stiffness. This variable stiffness is a combination of the fixed stiffness of rubber and the variable stiffness of magnet. A mathematical nonlinear model has developed, consisting of a polynomial model of RWG and an integral approach of magnetic force. The designed HWG is capable enough to produce a strong magnetic force as a result of a high magnetic field generated in the solenoid. This magnetic force combines with rubber to give a variable stiffness effect. This way, a semi-active control of the stiffness and pulse shape is achieved. Two sets of HWGs are tested to study the control over the shock pulse. An average hybrid stiffness from 32 to 74 kN/m is observed by varying voltage from 0 to 1000 VDC, resulting in a change of height of pulse from 18 to 56 g (net change 38 g) and a change of shock pulse width from 17 to 12 ms (net change 5 ms). From experimental results, it is concluded that the developed technique gives satisfactory results for the control/prediction of variable shape shock pulse.

Infection Dynamics of Clostridium perfringens Fingerprinting in Buffalo and Cattle of Punjab Province, Pakistan

Clostridium perfringens produces core virulence factors that are responsible for causing hemorrhagic abomasitis and enterotoxemia making food, animals, and humans susceptible to its infection. In this study, C. perfringens was isolated from necropsied intestinal content of buffalo and cattle belonging to four major bovine-producing regions in the Punjab Province of Pakistan for the purpose offind out the genetic variation. Out of total 160 bovine samples (n: 160), thirty-three (n: 33) isolates of C. perfringens were obtained from buffalo (Bubales bubalis) and cattle (Bos indicus) that were further subjected to biochemical tests; 16S rRNA based identification and toxinotyping was done using PCR (Polymerase Chain Reaction) and PFGE (Pulse Field Gel Electrophoresis) pulsotypesfor genetic diversity. Occurrence of C. perfringens was found to be maximum in zone-IV (Bhakkar and Dera Ghazi Khan) according to the heatmap. Correlation was found to be significant and positive among the toxinotypes (α-toxin, and ε-toxin). Response surface methodology (RSM) via central composite design (CCD) and Box-Behnken design (BBD) demonstrated substantial frequency of C. perfringens based toxinotypes in all sampling zones. PFGE distinguished all isolates into 26 different pulsotypes using SmaI subtyping. Co-clustering analysis based on PFGE further decoded a diversegenetic relationship among the collected isolates. This study could help us to advance toward disease array of C. perfringens and its probable transmission and control. This study demonstrates PFGE patterns from Pakistan, and typing of C. perfringens by PFGE helps illustrate and mitigate the incidence of running pulsotypes.

Potential security and privacy issues in zero UI touchless technology

Touchless technology often called Zero User Interface (UI) has begun to permeate every aspect of our lives as its use became necessary for hygiene measures in public places. The evolution of touchless technology replacing touchscreen interaction started as a luxury concept to give a fancier look to digital interactions, but now it has gained real value as a health-oriented interaction method. Switching to a touchless interface reduces common touchpoints, which help to safeguard against the spread of pathogens. Although the evolution of touchless technology is not new, its use massively increased due to its inherent hygienic nature during the COVID-19 pandemic. However, this investment in a new form of digital interaction has several privacy and security issues that need attention, in order to allow for safe human-machine interaction to cope with security breaches and cyber-attacks to protect our credentials. This paper outlines the potential security and privacy issues concerning Zero UI adoption in various technologies that need to be considered if one wishes to adopt responsible technology practices with this technology.

Predictors of Bleeding Risks and Episodes in Heart Patients

Objective: The aim of this study was to determine predictors of bleeding risks and episodes in heart patients. This study also determined the effect of demographic characteristics and comorbidities on the bleeding episodes in heart patients. Methods: A retrospective and observational study was done on a data collection form to obtain the required data. After adjusting confounders in logistic regression analysis model, (predicting likelihood of reporting bleeding risks and episodes), pure predictors of bleeding risks and episodes were determined. Descriptive and inferential statistics were applied using the Statistical Package for Social Sciences (SPSS) version 24.0. A p-value < 0.05 was considered statistically significant. Results: Overall, 220 patients’ data on data collection forms were collected in the study. Out of the total studied patients, around 56 were on warfarin, 47 on dabigatran, 67 on rivaroxaban and 50 on apixaban. In addition, age and presence of comorbidity were observed as the pure and strong predictors of bleeding risks and episodes among the studied patients. Conclusion: Age and presence of comorbidity were the pure and strong predictors of bleeding risks and episodes.

Coenzyme Q10 Supplements’ Knowledge among Cardiac Patients

Background: Most studies showed fair evidence on the benefits of Coenzyme Q10 supplements in improving cardiac functions and preventing cardiovascular diseases. This study aimed to assess knowledge of Coenzyme Q10 supplements among cardiac patients. Methods: This was a cross-sectional study and 134 patients were conveniently enrolled based on inclusion and exclusion criteria. This study was conducted using a self-administered questionnaire, derived from extensive literature reviews. Results: Study subjects were found to have not appropriate knowledge about Coenzyme Q10 supplements (mean knowledge score=1.8, SD=3.131). This study found strong positive correlation between the knowledge score and attitude score (r=0.776, p<0.05). Elderly and those earning higher incomes had statistically higher knowledge scores compared to others. Conclusion: The obtained knowledge towards Coenzyme Q10 supplements reflected the low pattern of use among cardiac patients. It also emphasized the role of healthcare providers to increase awareness about the benefits of Coenzyme Q10 supplements among cardiac patients as well as to educate them about its interaction with some drugs.

Psychometric Properties of PSS-10 among Atrial Fibrillation Patients

Objective: The objective of the current study was to assess the psychometric properties of Perceived Stress Scale 10 (PSS-10) among atrial fibrillation (AF) patients. Methodology: A cross-sectional study was performed among AF patients using the PSS-10. Sociodemographic and patients reported clinical data were collected. Descriptive and inferential statistics were applied using the Statistical Package for Social Sciences (SPSS) version 24.0. A p-value < 0.05 was considered statistically significant. Results: There were more male patients (n=165) than the female patients (n=111) in total of 276 studied patients. No major issues regarding internal consistency, factorial validity, convergent validity and floor and ceiling effect were observed. Conclusion: The present study confirmed the psychometric properties validation of PSS-10 among AF patients.

Effect of Sociodemographic Correlates on Quality of Life of Heart Failure Patients

Objective: This study aimed to determine effect of sociodemographic correlates on quality of life (QoL) in heart failure patients. Methods: A cross-sectional study using a newly developed and validated research tool and MLHF research tool, was conducted in heart failure patients. Data was collected by convenience sampling method. Descriptive, comparative, and inferential statistics were used by Statistical Package for the Social Sciences (SPSS) ver. 24 to determine the sociodemographic correlates of QoL in heart failure patients. Results: Out of total 177 studied patients, the majority of the studied heart failure patients were male 103 (58.2%) and the females were 74 (41.8%). The most of the studied heart failure patients were from > 60 years of age group 73 (41.2%). In Spearman’s correlation analysis, statistically non-significant (p >0.05), weak and positive associations were observed. The studied demographic variables like gender, age, marital status, educational level, monthly income, smoking, family history and weight were found to have positive correlation with patients overall QoL Conclusion: The study results concluded a weak but positive correlation between various studied demographic variables and QoL of the heart failure patients.

Attitude about Coenzyme Q10 Supplements among Cardiac Patients

Background: This study aimed to assess attitude of cardiac patients about Coenzyme Q10 supplements. Methods: A cross-sectional study using convenience sampling based on inclusion and exclusion criteria was conducted among cardiac patients. This study was conducted using a self-administered questionnaire, derived from extensive literature reviews. Results: Study subjects were found to have average attitude (n= 87, 64.9%) towards Coenzyme Q10 supplementations. This study found strong positive correlation between the knowledge score and attitude score (r=0.776, p<0.05). It was found that 7 (46.67%) of study subjects who consumed the Coenzyme Q10 supplements were recommended by friends and family. Conclusion: The attitude towards Coenzyme Q10 supplements reflected the low pattern of use, and emphasized the role of healthcare providers to increase awareness about the benefits of Coenzyme Q10 supplements among cardiac patients as well as to educate them about its interaction with some drugs.

Treatment Effectiveness of Biologic-DMARDs and their Impact on Disease Control among Rheumatoid Arthritis Patients

Objective: The study aimed to evaluate treatment effectiveness of biologic-DMARDs and their impact on overall disease control and management among rheumatoid arthritis patients being treated on biologic-DMARDs. Methods: The study was performed among RA patients and disease activity score (DAS) were calculated using DAS 28. Descriptive and inferential statistics were used to obtained the results. Descriptive and inferential statistics were applied using the Statistical Package for Social Sciences (SPSS) version 24.0. A p-value < 0.05 was considered statistically significant. Results: Different demographic characteristics were studied from the selected cohort of the RA patients. Around 89 of the studied patients were males and 64 were females. More than half of the patients were 60 years or above. Around 50% of the patients were diagnosed with RA five years or earlier. Among the studied RA patients, a significant therapy response was obtained which resulted in overall improvement in disease outcomes and showed treatment effectiveness among them. Conclusion: From the obtained results, it was concluded that all of the studied RA patients received optimum medication therapy with biologic-DMARDs and achieved significant therapy response which resulted in overall improvement in disease outcomes.

Psychometric Characteristics of Perceived Stress Scale – 10 (PSS-10) in Cardiovascular Patients

Objective: The objective of the current study was to assess the psychometric characteristics of Perceived Stress Scale 10 (PSS-10) in cardiovascular patients. Methodology: A cross-sectional study was performed in cardiovascular patients using the PSS-10. Sociodemographic and patients reported clinical data were collected. Descriptive and inferential statistics were applied using the Statistical Package for Social Sciences (SPSS) version 24.0. A p-value < 0.05 was considered statistically significant. Results: There were more male patients (n=212) than the female patients (n=150) in total of 362 studied patients. No major problems regarding internal consistency, factorial validity, convergent validity and floor and ceiling effect were observed. Conclusion: The present study confirmed the psychometric characteristics of PSS-10 in cardiovascular patients.

Impact of Clinical Characteristics on Quality of Life of Heart Failure Patients

Objective: This study aimed to determine impact of clinical characteristics on quality of life (QoL) in heart failure patients. Methods: A cross-sectional study using a newly developed and validated research tool and Minnesota Living with Heart Failure (MLHF) research tool, was conducted in heart failure patients. Data was collected by convenience sampling method. Descriptive, comparative, and inferential statistics were used by Statistical Package for the Social Sciences (SPSS) ver. 24 to determine the sociodemographic correlates of QoL in heart failure patients. Results: The majority of the studied heart failure patients were male 103 (58.2%) and the females were 74 (41.8%). The most of the studied heart failure patients were from > 60 years of age group 73 (41.2%). In Spearman’s correlation analysis, statistically non-significant (p >0.05), weak and positive associations were observed. The studied clinical variables like disease duration, total no. of comorbidities, types of comorbidities i.e., HPT, dyslipidemia, renal problems, Diabetes mellitus (DM) and others, hospital admissions, no. of current medications were found to have positive correlation with patients overall QoL. Conclusion: The study results concluded a weak but positive correlation between various studied clinical characteristics and QoL of the heart failure patients.

From luxury to necessity: Progress of touchless interaction technology

Touchless Technology is facilitating the move to Zero User Interface(UI) propelled by the COVID-19 pandemic which has accelerated the use of this technology due to hygiene requirements. Zero UI can be defined as a controlled interface that enables user interaction with technology through voice, gestures, hand interaction, eye tracking, and biometrics such as facial recognition and contactless fingerprints. Smart devices, IoT sensors, smart appliances, smart TVs, smart assistants and consumer robotics are predominant examples of devices in which Zero UI is becoming increasingly adopted. These control interfaces include natural interaction modes such as voice or gestures. Touchscreens and shared devices such as kiosks, self-service counters and interactive displays are present in our everyday lives. Each of these interactions however is a concern for consumers in a post-COVID-19 world where hygiene is of utmost importance. The one-stop solution to hygienic interactions includes touchless technology such as voice control, remote mobile screen take over, biometric, and gesture control as Zero User interfaces. With the breakthroughs in image recognition and natural language processing, powered by advanced computer vision and machine learning, "Zero UI" is becoming a new normal. This paper is focusing on the progress of the touchless interaction technology during the COVID-19 pandemic, which actually accelerated development in this concept and moved it from being a luxury to a life necessity.

Workplace bullying and turnover intentions of nurses: the multi-theoretic perspective of underlying mechanisms in higher-order moderated-serial-mediation model

PURPOSE

This study examines the relationship between workplace bullying (WPB) and the turnover intentions (TIs) of nurses, both directly and indirectly, i.e. through serial mediation of psychological contract violation (PCV) and poor employee wellbeing (EWB). And that with the moderating effect of servant leadership (SL) on its final path to TIs of nurses.

DESIGN/METHODOLOGY/APPROACH

A total of 285 nurses voluntarily participated in the survey through convenient sampling from 13 different district hospitals. The authors performed partial least squares structural equation modeling (PLS-SEM) to test the study's measurement and structural models.

FINDINGS

Overall, results indicated 62% prevalence rate of WPB and TIs of nurses had 67% variance explained by the exogenous factors. Workplace bullying was found to have direct as well as indirect relationship with TIs of nurses. For the latter, PCV and poor EWB were found to have partially mediated, both singly and serially. The moderating effect of SL on the serial mediation pathway was negative and significant.

ORIGINALITY/VALUE

Drawing on a tripartite theoretical perspective, this study illuminates the mechanism underlying WPB-TIs relationship with an advanced multivariate statistical technique in the nursing work setting in a developing country.

Concurrent validity of the Arabic version of General Medication Adherence Scale using two validated indirect adherences measures in Saudi patients with non-communicable diseases

Purpose

This study aimed to evaluate the concurrent validity of the Arabic version of the General Medication Adherence Scale (GMAS) using two validated scales namely Adherence to Refills and Medications Scale (ARMS) and Medication Adherence Rating Scale (MARS) in Saudi patients with non-communicable diseases.

Methods

A cross sectional study was conducted for 2 months in out-patient departments at a tertiary care hospital in Khobar, Saudi Arabia. The study collected data from patients with chronic illnesses through convenience sampling. Pearson correlation (ρ) was conducted to report concurrent validity of GMAS. A correlation coefficient value ≥ 0.5 with p-value < 0.01 was considered threshold for establishing concurrent validity. The study was approved by an ethics committee (IRB-2019–05-002).

Results

A total of 406 patients responded to the study. The average age was 42.4 ± 5.94 years, and most patients were females (53.7%), married (70%), graduates (65.3%), employed (39.9%) and, had a monthly family income > SAR 10,000, i.e., USD 2666.2 (56.4%). The mean adherence scores obtained from MARS, ARMS and GMAS were 7.09, 19.9, and 27.4. The correlation (ρ) between GMAS and MARS scores was 0.65, and between GMAS and ARMS scores was −0.79, p < 0.01 for both comparisons.

Conclusion

The concurrent validity of GMAS-AR was established in this study that would further substantiate psychometric properties of the scale in this population.

Getting Ratees to Accept Performance Feedback: A Relational Approach

This paper seeks to understand the association between ratees' relational justice perceptions and their feedback acceptance, both directly and through leader-member exchange (LMX). The paper also examines the moderated mediation effect of supervisory trust. The paper presents the findings of two studies. Study 1 utilized two data sets collected through an online survey from 280 part-time students working full-time (Sample 1) and 292 working professionals (Sample 2) in Pakistan. Study 2 utilized data collected from N = 167 students recruited for a scenario-based experiment that manipulated whether a manager was fair or unfair. Results revealed that relational justice positively predicted feedback acceptance in Studies 1 and 2. LMX positively mediated the above-mentioned relationship in both studies. As expected, supervisory trust negatively moderated the relational justice-feedback acceptance relationship in Study 2. The present study contributes to performance management theory and practice by illuminating that raters can stimulate performance partnership by employing a relational justice approach that increases the likelihood that employees accept performance feedback.

Effect of Pharmacist-Led Intervention on Progression of Diabetic Complications at Two Tertiary Care Hospitals of Malaysia

Background and Objective

Diabetes mellitus is a chronic disease which can lead to different complications in patients if not treated properly. An appropriate intervention from health care providers is needed to stop and decrease the progression of diabetic complication in diabetic patients. This study aimed to measure the effect of pharmacist intervention on improvement in sign and symptoms and progression of diabetic complications in diabetic patients.

Methodology

Diabetic patients were randomly selected and divided into two groups from two tertiary care hospitals. Control group contained those 200 patients who were receiving usual treatment from hospitals. In contrast, the intervention group included those 200 patients who were receiving conventional treatment from hospitals together with separate counselling sessions with pharmacists from Diabetes Medication Therapy Adherence Clinic departments. The study continued for 1 year and two follow-up visits for both groups. A prevalidated data collection form was used to measure the improvement in sign and symptoms and progression of diabetic complication in diabetic patients. Statistical Package for the Social Sciences (SPSS) version 24 was used to analyze the data.

Results

The average hemoglobin A1c (HbA1c) values decreased up to 1.43% in the control group and 2.82% in the intervention group. The intervention group showed significant improvement in HbA1c between groups (P < 0.05). The results of univariate and multivariate regression analysis showed that a statistically significant (P < 0.001) improvement was observed in all the predictors of diabetic complications among in the intervention group when compared with the control group.

Conclusion

Statistically significant reduction in the sign and symptoms of diabetic complications was observed in the intervention group at the end of 1 year. The progression of diabetic neuropathy was significantly reduced in the pharmacist intervention group.

Use of Medicinal Plants for Respiratory Diseases in Bahawalpur, Pakistan

The most common ethnomedicinal plants being effective in respiratory disorders were studied for the first time in Bahawalpur District. The herbal medication represents a low-cost treatment for the local community. There is a need for documenting the traditional uses of plants for further investigation of bioactive compounds. Using a qualitative approach, the ethnobotanical data was collected from the district of Bahawalpur, Pakistan, from February 2018 to February 2020 through semistructured interviews with the local people and traditional healers. The quantitative analysis included use value, informant consensus factor, family importance value, and relative frequency citation. A total of 20 indigenous plants belonging to 17 families were documented from 185 informants. These plants were claimed to be used for the treatment of 10 respiratory ailments. The plant habit, part of the plant used, and mode of preparation were standardized for authentication. The herbs are the most used life form (55%), while trees and shrubs are also used. Leaves dominate with high use value (47.62%) followed by fruit, stem, flower, and other parts of plants. For the preparation of traditional remedies, decoction (76.19%) and extract (71.43%) are common preparation methods. However, other methods of paste infusion, powder juice, and ash are used to a lower extent. The plants with higher use value are Glycyrrhiza glabra, Acacia arabica, and Mentha piperita; these have significant potential therapeutic activity for respiratory disease. The ethnomedicinal importance of plants against respiratory diseases used by the local population (traditional healers) is the commercial availability of the herbal product. It is a first-time study in this area to fill the gap between traditional practices and synthetic medicine to screen out the phytochemical and pharmacological properties of plants that have a highly futuristic use value to develop antibiotic drug with least side effects by using sustainable methods.

Occurrence and Toxicogenetic Profiling of Clostridium perfringens in Buffalo and Cattle: An Update from Pakistan

Clostridium perfringens is a Gram-positive bacterium that possess seven toxinotypes (A, B, C, D, E, F, and G) that are responsible for the production of six major toxins, i.e., α, β, ε, ι, CPE, and NetB. The aim of this study is to find out the occurrence of toxinotypes in buffalo and cattle of Punjab province in Pakistan and their corresponding toxin-encoding genes from the isolated toxinotypes. To accomplish this aim, six districts in Punjab province were selected (i.e., Lahore, Sahiwal, Cheecha Watni, Bhakkar, Dera Ghazi Khan, and Bahawalpur) and a total of 240 buffalo and 240 cattle were selected for the collection of samples. From isolation and molecular analysis (16S rRNA), it was observed that out of seven toxinotypes (A–G), two toxinotypes (A and D) were found at most, whereas other toxinotypes, i.e., B, C, E, F, and G, were not found. The most frequently occurring toxinotype was type A (buffalo: 149/240; cattle: 157/240) whereas type D (buffalo: 8/240 cattle: 7/240) was found to occur the least. Genes encoding toxinotypes A and D were cpa and etx, respectively, whereas genes encoding other toxinotypes were not observed. The occurrence of isolated toxinotypes was studied using response surface methodology, which suggested a considerable occurrence of the isolated toxinotypes (A and D) in both buffalo and cattle. Association between type A and type D was found to be significant among the isolated toxinotypes in both buffalo and cattle (p ≤ 0.05). Correlation was also found to be positive and significant between type A and type D. C. perfringens exhibits a range of toxinotypes that can be diagnosed via genotyping, which is more reliable than classical toxinotyping.

Knowledge of the Use of Herbal Medicines among Community Pharmacists and Reporting Their Adverse Drug Reactions

Introduction:

Community pharmacist’s knowledge about the uses of herbal medicines and its adverse drug reactions reporting can contribute in better therapeutic outcomes and patient safety. Objectives: To evaluate community pharmacists’ knowledge about the use of herbal medicines and its adverse drug reactions reporting in Kedah state, Malaysia.

Methods:

A cross-sectional, questionnaire-based study was conducted among 103 pharmacists from 74 different community pharmacies to assess their knowledge about the use of herbal medicines and its adverse drug reaction reporting by using a pre-validate knowledge questionnaire consisting of 12 questions related to it. The pharmacists’ responses were measured at a 3-point Likert scale (Poor=1, Moderate=2, and Good=3) and data was entered in SPSS version 22. The minimum and maximum possible scores for knowledge questionnaires were 12 and 36 respectively. Quantitative data was analyzed by using One Way ANOVA and Paired t-test whereas Chi-square and Fisher exact test were used for qualitative data analysis. A p-value of less than 0.05 was considered statistically significant for all the analyses.

Results:

About 92% of the pharmacist had good knowledge regarding the use of herbal medicines and its adverse drug reaction reporting with a mean knowledge score of 32.88±3.16. One-way ANOVA determined a significant difference of employment setting (p<0.043) and years of experience (<0.008) with mean knowledge scores of Pharmacists. Pharmacists’ knowledge was significantly associated with their years of experience with the Chi-square test.

Conclusion:

Pharmacists exhibit good knowledge regarding the use of herbal medicines and its adverse drug reaction reporting. However, with an increasing trend of herbal medicine use and its adverse drug reaction reporting it recalls the empowerment of experienced pharmacists with training programs in this area for better clinical outcomes.

Evaluation and Optimization of Antibiotics Resistance Profile against Clostridium perfringens from Buffalo and Cattle in Pakistan

Clostridium perfringens is a serious threat to successful bovine farming. It causes severe damage to the buffalo and cattle health causing a drastic reduction in milk and meat production. In Pakistan, C. perfringens is a constant threat, and for its management, antibiotics are mostly used. Most bovine farmers use a single antibiotic to suppress the bacterial infection which in turn, increases the antimicrobial resistance (AMR) against the particular antibiotic. To reduce the resistance, the administration of multiple antibiotics in their standard doses at different times can be a possible remedy to manage the AMR and reduce their viability. This study aims to evaluate the effect of 11 commonly used antibiotics at their standard concentrations for inhibiting 33 strains of C. perfringens from five districts of Punjab province in Pakistan. Based on the zone of inhibition, ciprofloxacin, ampicillin, and cefotaxime (CAC) at their standard concentrations effectively inhibited the bacterium. These antibiotics showed appropriate significance statistically, i.e., correlation, Chi-square test, and cluster analysis. Optimization of these antibiotics using response surface methodology (RSM) revealed that the selected antibiotics from medium to high range not only reduce the bacterial propagation but also their population up to a considerable extent. Hence, the health of milk- and meat-producing large animals could be improved, which will be cost-effective and less harmful to the animal, human health, and the environment. Moreover, optimized administration of the selected antibiotics would reduce the impact of drug-resistant superbugs.

Molecular epidemiology of Coxiella Brunetii in small ruminants in Punjab, Pakistan: a novel reporting analytical cross sectional study

Coxiella burnetii, an intracellular zoonotic bacterium, causes query (Q) fever in ruminants. Its role has never been elucidated in small ruminants from Pakistan. The current study is designed to (a) determine the prevalence of coxiellosis in small ruminants, (b) evaluate the association of various potential risk factors and biomarkers in the occurrence of Coxiella burnetii, (c) and determine phylogeny and genetic variability of its various isolates identified during the study. For this purpose, 320 blood samples from sheep (n = 160) and goats (n = 160) were collected from 9 Union Councils of district Kasur, Punjab, and processed for DNA extraction. C. burnetii was confirmed by amplification of IS1111 transposase gene with an amplicon size of 294 bp. The results showed that the overall positive percentage of C. burnetii is 36.87% (sheep: 46.9% and goats: 30%). The phylogenetic tree was also constructed which described the possible origin of this pathogen from environment. Besides, after translation into amino acid, the resultant alignment showed several unique changes at position numbers 18 and 27 in the isolates from goats and at 27 and 66 from those of sheep. These mutations can have major impact on the infectious characteristics of this pathogen. Furthermore, different potential risk factors and clinical biomarkers like age, tick infestation, abortion, mastitis, and infertility were also studied and found that these are significantly (p < 0.05) associated with the occurrence of coxiellosis. It is concluded from the study that C. burnetii is endemic in small ruminants in Punjab, Pakistan. The outcomes of this study are alarming for scientific community as well as for policy makers because coxiellosis is an emerging threat to both humans and animals in this region due to its interspecies transmission ability.

Knowledge, Attitude, and Practice about Mental Health Challenges among Healthcare Students of a Private University

OBJECTIVE

The objective of this study was to evaluate the knowledge, attitude, and practice of healthcare students (Medicine, Pharmacy, and Dentistry) in a private university about mental health challenges (MHC).

MATERIALS AND METHODS

A research cross-sectional observational was conducted to evaluate the knowledge, attitude, and practice of students towards MHC at a private university in Malaysia. A validated questionnaire was distributed to 284 students studying in three different selected faculties, namely the Faculty of Medicine, Pharmacy, and Dentistry. The Statistical Package for Social Science (SPSS) Version 24.0 was used to analyze the data.

RESULTS

Upon evaluation of knowledge, male students were having less-adequate knowledge than females (P = 0.006). Malay students were having adequate knowledge than other races about MHC. Faculty of Medicine was having adequate knowledge than other faculties (P ≤ 0.001). Regarding attitude, the Faculty of Pharmacy students had the highest positive attitudes (P = 0.001). Final year students were having a more positive attitude than pre-final year students. For the evaluation of practice, the Faculty of Dentistry students had the lowest practice compared with other faculties.

CONCLUSION

In conclusion, overall, good knowledge was seen among the students of the private medical university about MHC. The medical students had adequate knowledge when compared with other faculties in the university.

University Students’ Awareness about Oral Health and Hygiene

Objective: The objective of the study was to evaluate the awareness of university students about oral health and hygiene in a university in Malaysia. Methods: A cross-sectional study was conducted among the students of four different faculties (pharmacy, medical, biotechnology and business) in a university in Malaysia with the help of pre-validated research questionnaire.  The Statistical Package for Social Science (SPSS) Version 24.0 was used to analyze and present the data. Results: The final response gathered was 324 from four faculties. The pharmacy faculty students had better knowledge as compared to the other faculties. The female students had better knowledge of oral health hygiene as compared to males. Final year students reported more appropriate knowledge as compared to pre-final year students. Conclusion: Overall appropriate knowledge was observed among the four studied faculties of the university. The present study concluded that pharmacy students had more appropriate knowledge of oral health and hygiene than the other faculty students.

Amyotrophic Lateral Sclerosis Knowledge among University Students

Objective: The objective of the study was to evaluate the knowledge of ALS among students in a university in Malaysia. Methods: A cross-sectional and observational study was performed among the students of three different healthcare provider faculties (Medical, Pharmacy and Dental) in a university with the help of pre-validated research questionnaire. The Statistical Package for Social Science (SPSS) Version 24.0 was used to analyze and present the data. Results: A total of 268 university students from three faculties participated in the current study. The medical faculty students and final year students had more appropriate knowledge towards the ALS. Conclusion: Overall appropriate knowledge was observed among the studied faculty students. The present study concluded that medical students had adequate knowledge of ALS than the other two faculty students.

University Students’ Attitude towards Amyotrophic Lateral Sclerosis

Objective: The objective of the study was to evaluate the attitude of university students towards Amyotrophic Lateral Sclerosis (ALS) in a medical university. Methods: A cross-sectional study was performed among the students of three different faculties (Medical, Pharmacy and Dental) in a medical university in Malaysia using a self-prepared and pre-validated research tool. The Statistical Package for Social Science (SPSS) Version 24.0 was used to analyze and present the data. Results: A total of 268 students from three faculties participated in the present study. The faculty of pharmacy students and male students had more positive attitude towards ALS. The positive attitude was more among the non-hostellers than the hostellers. Conclusion: Overall positive attitude was observed among the three health care provider faculty students. The present study concluded that pharmacy students had a more positive attitude towards ALS than the other two faculty students.

Use of Traditional Chinese Medicine in Malaysia: A Knowledge and Practice Study among General Population toward Complementary and Alternative Medicine in Relation to Health and Quality of Life in Malaysia

Purpose:

There is a wide range of use of complementary and alternative medicine (CAM), which has increased drastically and affected treatments overall. The knowledge and practice of Chinese herbal medicine among the general population is considered as positive. Literature shows that the effectiveness and acceptance of alternative therapies is still debatable among the general population.

Materials and Methods:

Study design was cross-sectional, in which sociodemographic data of respondents were collected through a validated questionnaire; results were analyzed by using validated data collection tool. The results were concluded on the basis of good, moderate, and poor response, which was evaluated through data analysis by the Statistical Package for the Social Sciences (SPSS) software, version 20.0. A P < 0.05 was considered as statistically significant.

Results:

Respondents were 182 (44.4%) males and 228 (55.6%) females; better knowledge was recognized among the females (P < 0.001) with mean knowledge of 15.55 ± 2.7. Chinese population had good knowledge with statistically strong correlation with mean knowledge of 15.63 (P = 0.006). Likewise, Buddhism was reported to have good knowledge among all the religions. Rural population was underlined with lesser family income and they showed good practice and understanding (P = 0.006). Comparatively positive attitude was noticed among the females (P < 0.001) with mean attitude of 15.55 ± 2.7. The highest level of education in this study was postgraduate, which showed 77.1% good attitude. Postgraduate participants were having varied results with standard deviation of ±6.23. Statistically highly significant association was seen between the religion and attitude of respondents with the P < 0.001. Chinese medicine is widely used, but religious difference was found among the races. Similar difference was found in knowledge and practice among the population of rural side and low family income compared to urban population with higher income and access to allopathic medicine.

Conclusions:

Despite having better practice among the Malaysian population, still the knowledge needs to be disseminated among the population for the overall use of traditional Chinese medicine with safety to improve health and quality of life in Malaysia.

Impact of Pharmacist-led Educational Intervention on Predictors of Diabetic Foot at Two Different Hospitals of Malaysia

Objective:

Diabetes mellitus (DM) is a chronic metabolic disorder that can initiate organ damage inside the body if not treated appropriately. Apart from tight glycemic control, a suitable educational intervention is also needed from health-care providers to stop or decrease the progression of organ damage in diabetic patients. This study intended to measure the impact of pharmacist-led educational intervention on improvement in predictors of diabetic foot in two different hospitals in Malaysia.

Materials and Methods:

In two tertiary care selected hospitals, the included diabetic patients were randomly divided into two study arms. In the control group, 200 patients who were receiving usual treatment from hospitals were included. However, in the intervention group, those 200 patients who were receiving usual treatment along with counseling sessions from pharmacists under the Diabetes Medication Therapy Adherence Clinic (DMTAC) program were included. The study continued for 1 year, and there were four follow-up visits for both study arms. A prevalidated data collection form was used to measure the improvement in predictors of diabetic foot in included patients. Data were analyzed by using the Statistical Package for the Social Sciences (SPSS) software program, version 24.0.

Results:

With the average decrease of 1.97% of HbA1c values in the control group and 3.43% in the intervention group, the univariate and multivariate analysis showed a statistically significant difference between both of the study arms in the improvement of predictors belonging to the diabetic foot (P < 0.05). The proportion of patients without any signs and symptoms of the diabetic foot in the intervention group was 91.7%, which increased from 42.3% at baseline (P < 0.05). However, this proportion in the control group was 76.9% at the fourth follow-up, from 48.3% at baseline (P < 0.05).

Conclusion:

A statistically significant reduction in the signs and symptoms of diabetic foot was observed in the intervention group at the end of 1 year. The progression of diabetic foot was significantly decreased in the pharmacist intervention group.

University Students’ Perception of Japanese Encephalitis

Objective: The objective of the study was to evaluate the perception of Japanese Encephalitis (JE) among future healthcare providers in a university in Malaysia. Methods: A cross-sectional and observational study was conducted among the students of three different healthcare provider faculties in a university in Malaysia with the help of pre-validated research tool. The Statistical Package for Social Science (SPSS) Version 24.0 was used to enter and analyze the data. Results: Overall, 252 respondents from three different health care faculties participated in the current study. The dental faculty students had better perception as compared to the other two faculties. The female students had a better perception of JE as compared to the students who were living in hostels. Conclusion: Overall appropriate perception was observed in the three health care provider faculty students. The present study concluded that dental and pharmacy students had a better perception of JE than medical students.

Japanese Encephalitis Knowledge among University Students

Objective: The objective of the study was to evaluate the knowledge of future healthcare providers about Japanese Encephalitis in a university in Malaysia. Methods: A cross-sectional study was conducted among the students of three different healthcare provider faculties in a university in Malaysia with the help of pre-validated research questionnaire. The Statistical Package for Social Science (SPSS) Version 24.0 was utilized to analyze and present the data. Results: Overall, 252 respondents from three different health care faculties participated in the current study. The medical faculty students had better knowledge as compared   to the other two faculties. The students living in their houses with their families had  better knowledge about Japanese Encephalitis as compared to the students who were living in hostels. Conclusion: Overall appropriate knowledge was observed among the three health care provider faculty students. The present study concluded that medical students had more adequate knowledge of Japanese Encephalitis than the other two faculty students.

University Students’ Perception of Ebola Virus Disease

Objective: The present study was conducted to appraise future healthcare providers' perceptions in medical, dental, and pharmacy students on Ebola virus disease (EVD) in university in Malaysia. Methodology: A cross-sectional observational study was conducted between healthcare students from the medical pharmacy and dental faculties using a self-developed and pre-validated research tool. A stratified convenient sampling technique was used to calculate the sample size. SPSS version 24 was used for data analysis. Results: A total of 273 future healthcare providers from the medical pharmacy and dental faculty participated in the current study.  The medical and pharmacy student shows move appropriate perception as compared to the dental students. Gender does not have any significant impact on future health care providers on Ebola virus disease. Conclusion: The present study concluded varied reactions from the future health care providers regarding the perception of EVD in a university in Malaysia.

Epidemiology and antibiogram of common mastitis-causing bacteria in Beetal goats

Background and Aim:

Mastitis has been identified as the most prevalent and economically imperative disease among dairy animals. Thus, understanding its common bacterial pathogens and risk factors is necessary to improve udder health at herd, region, or country level. However, scientific research on caprine mastitis, especially on Beetal breed, has remained to be insufficient in Pakistan. Therefore, this study aimed to evaluate the epidemiology and antibiogram assay of common mastitis-causing bacterial agents, that is, Staphylococcus, Streptococcus, and Escherichia coli, in dairy goats.

Materials and Methods:

In total, 500 Beetal goats, irrespective of age and those that were not treated with any kind of antimicrobial agents during the past 120 h, were screened using California Mastitis Test in Pattoki, Kasur District, whereas epidemiological factors were recorded. The milk samples of mastitic goats were then collected and processed using standard methods. Each sample was primarily cultured on nutrient agar. Using a specific medium, each bacterial colony was separated using several streak methods. Six antibiotic disks belonging to different antibiotic groups were used for antibiogram profiling of bacterial isolates. Chi-square test was used to assess the association of baseline characteristics and mastitis occurrence. Meanwhile, multivariable logistic regression (p<0.001) was utilized to determine the risk factors associated with positive and negative dichotomous outcome of mastitis.

Results:

The results revealed that the overall prevalence of goat mastitis was 309 (61.8%), in which 260 (52%) and 49 (9.8%) cases were positive for subclinical mastitis (SCM) and clinical mastitis (CM), respectively. Streptococcus and E. coli were found to be the predominant isolates causing SCM and CM, respectively (p<0.001). It was observed that amoxicillin+clavulanic acid was highly sensitive to isolates of Staphylococcus and Streptococcus and ceftiofur sodium to isolates of Streptococcus and E. coli., while enrofloxacin was found to be sensitive to isolates of Streptococcus and E. coli. Risk factors such as herd structure, deworming, vaccination, presence of ticks, use of teat dip and mineral supplements, feeding type, age, parity, housing, blood in the milk, milk leakage, milk taste, and milk yield were found to have the strongest association with mastitis occurrence, while ease of milking has moderate association.

Conclusion:

In the area examined, cases of SCM were found to be higher compared with that of CM, and ceftiofur sodium has been identified as the preferred treatment in both clinical and subclinical forms of caprine mastitis in Beetal goats. Risk factors for mastitis that was identified in this study can form the basis for the creation of an udder health control program specific for dairy goats. We hope our findings could raise awareness of the risk factors and treatment approaches for common mastitis-causing bacterial agents.

Perception among Future Healthcare Providers about Treatment and Management of ALS

Objective: The objective of the study was to determine the perception of future healthcare providers regarding Amyotrophic Lateral Sclerosis (ALS) in a private medical university. Methods: A cross-sectional study was conducted using a convenience sampling method. A self-developed and pre-validated tool was used to collect data from students studying in three health care faculties of a university in Malaysia. The Statistical Package for Social Science (SPSS) Version 24.0 was used to analyze the data. Results: A total of 268 healthcare students from three faculties (medical, pharmacy and dental) participated in the current study More female students 183 (68.3%) participated than the male students 85 (31.7%) in current study. Conclusion: Overall appropriate perception was observed among the studied future healthcare providers. The present study concluded that pharmacy students had more positive perception regarding ALS than the rest of the participants.

Future Healthcare Providers’ Knowledge about Ebola Virus Disease: A Private University Students’ Perspective

Objective: The objective of the study was to determine the knowledge of future healthcare providers regarding the Ebola virus disease (EVD) in a private university. Methods: A cross-sectional study was conducted using a convenience sampling method. A self-developed and pre-validated tool was used to collect data from students studying in three health care faculties of a university in Malaysia. The Statistical Package for Social Science (SPSS) Version 24.0 was used to analyze the data. Results: More female students 170 (62.3%) participated in the present study than the male students 103 (37.7%), out of a total of 273 studied students. The majority of the final year students had an adequate knowledge towards EVD than the pre-final year students. Conclusion: Overall appropriate and good knowledge was observed among the studied future healthcare providers. The present study concluded that pharmacy students had better knowledge regarding EVD than the rest of the studied students.

Attitude of Future Health Care Providers Regarding Treatment and Management of Mental Health Disorders

Objective: The objective of the study was to determine the attitude of future health care providers regarding the treatment and management of mental health disorders (MHDs). Methods: A cross-sectional study was conducted using a convenience sampling method. A self-developed and pre-validated tool was used to collect data from students studying in three health care faculties of a university in Malaysia. The Statistical Package for Social Science (SPSS) Version 24.0 was used to analyze the data. Results: Out of the total study participants, males were 104 (36.6%) and females were 180 (63.4%) in the study. For the race variable the Malays students were 7 (2.5%), Chinese students 212 (74.6%), Indians students 60 (21.2%), and others 5 (1.7%). Conclusion: Overall positive attitude was observed among the studied cohort of future health care providers.

Evaluation of Good Oral Practices among Students: A Cross-Sectional Study

Objective: The objective of the study was to determine the good oral practices (GOP) among university students. Materials and Methods: A cross-sectional study was conducted using a convenience sampling method. A self-developed and pre-validated tool was used to collect data from students studying at a university in Malaysia. The Statistical Package for Social Science (SPSS) Version 24.0 was used to analyze the data. Results: A total of 324 respondents had participated in the study. The respondents were from four different faculties; pharmacy 118 (36.4%), medicine 81 (25.0%), business 67 (20.6%), and biotechnology 58 (18.0%). Conclusion: The final year students had more good practices towards good oral practices. The unmarried students also had more good practices towards oral health.

Attitude of Healthcare Students towards Japanese Encephalitis

Objective: To assess the attitude of healthcare students regarding Japanese Encephalitis (JE) in a medical university. Methods: A descriptive cross-sectional study was conducted using a convenience sampling method. A self-developed and pre-validated tool was used to collect data from students studying in three healthcare faculties of a university in Malaysia. The Statistical Package for Social Science (SPSS) Version 24.0 was used to analyze the data. The level of significance was alpha of 5% (0.05). Results: Of the total of 252 studied student, more female students 177 (70.2%) participated in the present study than the male students 75 (29.8%).. The majority of the final years’ students had a positive attitude than the pre-final year students, with female students of the university had a more positive attitude (77.4%) as compared to the male students (69.3%) when the question was asked about the personal role in the management of JE is essential Conclusion: Overall positive attitude was observed among the studied healthcare students.  The present study concluded that pharmacy students had a more positive attitude than the two other faculties students i.e. dentistry and medicine regarding JE.