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Can Drug Price Controls Help Patients Get a Better Deal? A SWOT Analysis 药品价格控制能否帮助患者获得更多优惠?SWOT 分析
Pub Date : 2023-11-13 DOI: 10.47836/mjmhs.19.6.30
Siti Norida Wahab, Muhammad Yazid Sahak
Introduction: Due to the increasing rate of drug prices and overall healthcare inflation, stakeholders from the pharmaceutical industry and non-governmental organisations (NGOs) are voicing their concerns about the possible reciprocal effects in the long run. Drug price controls (DPCs) regulation is crucial to ensure affordability and indirectly reduce congestion in public healthcare facilities. This study aims to identify the SWOT analysis of the DPCs in Malaysia and how it will impact the drug supply chain. Methods: The study adopted a subjective environmental scanning method and a SWOT analysis tool to examine the Malaysian pharmaceutical DPCs in the healthcare supply chain (HSC) ecosystem through both intrinsic and extrinsic perspectives. Results: The immediate effect of DPCs would be beneficial, especially to the patients and the government. Balancing the right amount of control and liberalization of the market is seen to be the biggest factor contributing to the policy’s effect on the drug supply chain. The main concern would be the long-term effect as mixed results are coming from a group of countries that had implemented a similar policy. Conclusion: Notwithstanding the qualitative methodology of the paper, the findings could provide a better understanding of the price of drugs in Malaysia’s HSC and serve as a foundation for future studies. This paper proposes a new way to diversify the DPCs economy by entering the HSC chain industry.
导言:由于药品价格和整体医疗保健通胀率不断上升,制药行业和非政府组织的利益相关者对长期可能产生的相互影响表示担忧。药品价格控制(DPCs)监管对于确保人们的负担能力和间接减少公共医疗设施的拥挤程度至关重要。本研究旨在确定马来西亚药品价格管制的 SWOT 分析,以及它将如何影响药品供应链。研究方法:本研究采用主观环境扫描法和 SWOT 分析工具,从内在和外在两个角度对医疗保健供应链(HSC)生态系统中的马来西亚药品 DPCs 进行研究。研究结果DPC 的直接效果是有益的,尤其是对患者和政府而言。平衡适度的控制和市场自由化被认为是该政策对药品供应链产生影响的最大因素。最令人担忧的是长期效果,因为从一些实施类似政策的国家得出的结果好坏参半。结论:尽管本文采用的是定性方法,但研究结果可以让我们更好地了解马来西亚 HSC 的药品价格,并为今后的研究奠定基础。本文提出了通过进入 HSC 连锁产业实现 DPCs 经济多样化的新途径。
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引用次数: 0
Knowledge, Attitude, and Practice of Sugar-Sweetened Beverage (SSB) Among University Students in Klang Valley, Malaysia 马来西亚巴生谷大学生对含糖饮料(SSB)的认识、态度和做法
Pub Date : 2023-11-13 DOI: 10.47836/mjmhs.19.6.25
K. Cheah, Pey Lyn Chua
Introduction: Excessive sugar consumption is a major global health concerns as it plays a significant role in the development of non-communicable diseases. Sugar-sweetened beverages (SSB) are a major source of added sugar in daily life that can lead to many health concerns. Understanding of the knowledge, attitudes, and practices (KAP) related to SSB intake is a key component of healthy beverage intake. Therefore, this study aimed to determine the prevalence of SSBs intake and the level of knowledge, attitude, and practice (KAP) of university students during the recovery phase of COVID-19 in 2022. Methods: This cross-sectional study involved 176 young adults aged 18-26 years old who completed a self-administered questionnaire. The questionnaire consisted of demographic and KAP data related to SSBs. Descriptive statistics were outlined, and a chi-square test was conducted to compare categorical variables. Results: Based on the frequency of beverage intake, sugar-sweetened coffee, or tea (39.8%) was the most frequently consumed SSB daily (at least once daily) while regular soft drink (52.3%) was the most consumed SSB among the participants on a weekly basis (≤6 times per week). Overall, the majority of university students had a positive attitude towards SSB intake (90.6%) but poor knowledge (51.7%) and poor practice (80.7%) levels. Gender and weight status were significantly related to the attitude and knowledge scores (p< 0.05). Conclusion: The prevalence of SSB intake among young adults should be addressed. Comprehensive education and intervention are vital to improving the knowledge and practice about proper SSB intake as part of healthy eating lifestyles.
导言:过量摄入糖分是全球主要的健康问题,因为它在非传染性疾病的发展中扮演着重要角色。含糖饮料(SSB)是日常生活中添加糖的主要来源,可导致许多健康问题。了解与摄入含糖饮料相关的知识、态度和做法(KAP)是健康饮料摄入的关键组成部分。因此,本研究旨在确定 2022 年 COVID-19 恢复阶段大学生摄入固态饮料的普遍程度以及其知识、态度和实践(KAP)水平。研究方法这项横断面研究涉及 176 名 18-26 岁的年轻人,他们填写了一份自填问卷。问卷包括与 SSB 相关的人口统计学和 KAP 数据。研究采用了描述性统计方法,并对分类变量进行了卡方检验。结果根据摄入饮料的频率,加糖咖啡或茶(39.8%)是每天(至少每天一次)摄入最多的固态饮料,而普通软饮料(52.3%)是参与者每周(每周不超过 6 次)摄入最多的固态饮料。总体而言,大多数大学生对摄入固态饮料持积极态度(90.6%),但知识水平(51.7%)和实践水平(80.7%)较差。性别和体重状况与态度和知识得分有明显关系(P< 0.05)。结论应解决青壮年普遍摄入 SSB 的问题。作为健康饮食生活方式的一部分,全面的教育和干预对于提高正确摄入固态饮料的知识和实践至关重要。
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引用次数: 0
In Vitro Investigation of Antioxidant and Antidiabetic Properties of Phenolic-Rich Extract from Stingless Bee Honey (Heterotrigona itama) 无刺蜂蜂蜜(Heterotrigona itama)富含酚类的提取物的抗氧化和抗糖尿病特性的体外研究
Pub Date : 2023-11-13 DOI: 10.47836/mjmhs.19.6.19
Mohamad Zulhafiz Shafiq Zulhilmi Cheng, N. Zawawi, D. Ooi, Kim Wei Chan, N. Ismail, Nur Akmal Ishak, N. Mohd. Esa
Introduction: The increase of Type 2 diabetes mellitus has prompted numerous research toward finding an alternative to manage the disease through the oxidant-antioxidant balance, mainly through bioactive compounds in natural products. This study explored the antioxidant and antidiabetic properties of phenolic-rich extract (PRE) from Stingless bee honey (SBH) (Heterotrigona itama) as therapeutic agent to restore the redox balance. Methods: The total phenolic content (TPC), total flavonoid content (TFC) and antioxidant assays of PRE and SBH, were determined to provide preliminary insight into the sample’s antioxidant properties, followed by high-performance liquid chromatography analysis of PRE. The antidiabetic potential of PRE and SBH were determined based on their inhibition against α-amylase and α-glucosidase enzymes. The cytotoxicity analysis of PRE was conducted on 3T3-L1 adipocytes and L6 muscle cells before the glucose uptake and cellular antioxidant analyses were performed on both cell lines, respectively. Results: PRE yielded higher TPC, TFC and antioxidant activities than SBH. The phytochemical profile of PRE comprises gallic acid, myricetin, kaempferol, epicatechin, chlorogenic acid, quercetin, syringic acid, and cinnamic acid. The results from carbohydrate enzymatic inhibitory assays collectively suggested that PRE exhibited more robust antidiabetic activities than SBH. PRE showed good glucose uptake stimulating and reactive oxygen species scavenging effects in those cell lines. Conclusion: Overall, PRE from SBH showed higher carbohydrate enzymatic inhibition, glucose uptake, and protection against intracellular oxidative stress, primarily due to its high antioxidant content and may serve as an alternative therapeutic agent for managing T2DM.
导言:随着 2 型糖尿病患者的增加,许多人开始研究如何通过氧化-抗氧化平衡(主要是通过天然产品中的生物活性化合物)来控制这种疾病。本研究探讨了无刺蜜蜂蜂蜜(SBH)(Heterotrigona itama)中富含酚类的提取物(PRE)作为恢复氧化还原平衡治疗剂的抗氧化和抗糖尿病特性。研究方法测定无刺蜂蜂蜜(PRE)和无刺蜂蜂蜜(SBH)的总酚含量(TPC)、总黄酮含量(TFC)和抗氧化测定,以初步了解样品的抗氧化特性,然后对无刺蜂蜂蜜(PRE)进行高效液相色谱分析。根据 PRE 和 SBH 对 α 淀粉酶和 α 葡萄糖苷酶的抑制作用,确定了它们的抗糖尿病潜力。在分别对 3T3-L1 脂肪细胞和 L6 肌肉细胞进行葡萄糖摄取和细胞抗氧化分析之前,对 PRE 进行了细胞毒性分析。结果显示PRE 产生的 TPC、TFC 和抗氧化活性均高于 SBH。PRE 的植物化学成分包括没食子酸、杨梅素、山柰酚、表儿茶素、绿原酸、槲皮素、丁香酸和肉桂酸。碳水化合物酶抑制实验的综合结果表明,PRE 比 SBH 具有更强的抗糖尿病活性。在这些细胞系中,PRE 表现出良好的葡萄糖摄取刺激作用和活性氧清除作用。结论总体而言,SBH 的 PRE 对碳水化合物酶抑制、葡萄糖摄取和细胞内氧化应激的保护作用更强,这主要归功于其较高的抗氧化剂含量,可作为治疗 T2DM 的替代药物。
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引用次数: 0
Indicators of Nurse Leadership in Disaster Management: A Qualitative study 护士在灾害管理中的领导力指标:定性研究
Pub Date : 2023-11-13 DOI: 10.47836/mjmhs.19.6.9
Y. N. Fithriyyah, S. Alim, Sri Warsini, Dr. Sri Setiyarini, Ariani A.P Pertiwi
Introduction: Nurses play critical roles in disaster management and are required to demonstrate leadership by dealing with disaster events effectively. This study aimed to identify the nurse leadership indicators at each phase of disaster management. Methods: A qualitative descriptive study was conducted in two phases between November 2017 -January 2018 at two regional hospitals and one central hospital in Yogyakarta. The first phase involved semi-structured in-depth interviews with seven emergency nurses, and the second was a focus group discussions with five nurses’ managers or lecturers. Participants were selected using a purposive sampling technique. Data Analyze used a modified version framework method. Results: We found 49 indicators of nurse leadership in disaster management. We grouped indicators into two major groups: common indicators (27 indicators) and specific indicators (22 indicators). Four themes were obtained according to the disaster management phases: nurse leadership in the mitigation phase, the preparedness phase, the response phase, and the recovery/rehabilitation phase. Each theme contains three main sub-themes (3Cs): character, competence, and the central role of the leader. Conclusion: Using the International Council of Nurses (ICN) framework’s disaster phase as a conceptual basis, 49 nurse leadership indicators were identified as potential information for future items candidates of the instrument for measuring nurse leadership in disaster management.
导言:护士在灾害管理中发挥着关键作用,需要通过有效处理灾害事件来展现领导力。本研究旨在确定灾害管理各阶段的护士领导力指标。研究方法在 2017 年 11 月至 2018 年 1 月期间,在日惹的两家地区医院和一家中心医院分两个阶段进行了定性描述性研究。第一阶段是对七名急诊护士进行半结构化深度访谈,第二阶段是对五名护士管理者或讲师进行焦点小组讨论。参与者的选择采用了目的性抽样技术。数据分析采用修正版框架法。结果:我们发现了 49 个护士在灾害管理中的领导力指标。我们将指标分为两大类:普通指标(27 个指标)和特殊指标(22 个指标)。根据灾害管理阶段,我们得出了四个主题:减灾阶段、备灾阶段、应对阶段和恢复/重建阶段的护士领导力。每个主题包含三个主要次主题(3C):性格、能力和领导者的核心作用。结论以国际护士理事会(ICN)框架的灾难阶段为概念基础,确定了 49 个护士领导力指标,作为未来衡量灾难管理中护士领导力的工具候选项目的潜在信息。
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引用次数: 0
The Discovery of Putative Small Molecules via Ligand-based Pharmacophore Modelling Targeting Human Tau Protein for an Effective Treatment of Parkinson’s Disease 通过配体药理模型发现靶向人类 Tau 蛋白的假定小分子,从而有效治疗帕金森病
Pub Date : 2023-11-13 DOI: 10.47836/mjmhs.19.6.12
Y. Najib, Y. Ayipo, Waleed Abdullah Ahmad Alananzeh, Mustapha Muhammed, M. Mordi
Introduction: The human tau protein is a key protein involved in various neurodegenerative disease (NDs) including Parkinson’s disease (PD). The protein has high tendency to aggregate into oligomers, subsequently generating insoluble mass in the brain. Symptoms of PD include tremor, bradykinesia, rigidity, and postural instability. Currently drugs for PD treatment are only symptom-targeted while effective therapeutic treatment remains a challenge. The objective of this study is to identify novel promising anti-PD drugs using computational techniques. Method: ligand-based (LB) receptor modelling was conducted using LigandScout, validated and subjected to Glide XP docking, virtual screening, ADMET, and molecular dynamics predictions. Results: The adopted LB modelling generated pharmacophoric features of 5 hydrogen bond donors, 1 aromatic rings, and 7 hydrogen bond acceptors. The validation result indicated GH score of 0.73 and EF of 36.30 as validation protocols, probing it to be an ideal model. Using 3D query of the modelling a total of 192 compounds were retrieved from interbioscreen database containing 70,436 natural compounds. Interestingly, ligands 1, 2, 3, 4 and 5 orderly indicated higher binding affinities to the receptor with Glide XP docking of -7.451, -7.368, -7.101, -6.878, and -6.789 compared to a clinical drug Anle138b with -4.552 kcal/mol respectively. Furthermore, molecular dynamics and pkCSM pharmacokinetics demonstrated ligands 1, 2, & 4 having better stability and low toxicity profiles compared to the reference. Conclusion: In summary, the study pave way for discovery of small molecules that could be recommended as adjuvant /single candidate as ant-PD candidates upon further translational study.
简介人类 tau 蛋白是与包括帕金森病(PD)在内的多种神经退行性疾病(NDs)有关的一种关键蛋白。这种蛋白质极易聚集成低聚物,随后在大脑中产生不溶性物质。帕金森病的症状包括震颤、运动迟缓、僵硬和姿势不稳。目前,治疗帕金森氏症的药物仅针对症状,而有效的治疗方法仍是一项挑战。本研究的目的是利用计算技术找出有前景的新型抗帕金森病药物。方法:使用 LigandScout 进行基于配体(LB)的受体建模、验证并进行 Glide XP 对接、虚拟筛选、ADMET 和分子动力学预测。结果:所采用的 LB 建模生成了 5 个氢键供体、1 个芳香环和 7 个氢键受体的药效特征。验证结果表明,作为验证协议,GH 得分为 0.73,EF 为 36.30,这表明它是一个理想的模型。通过建模的三维查询,从包含 70,436 种天然化合物的 interbioscreen 数据库中共检索到 192 种化合物。有趣的是,配体 1、2、3、4 和 5 与受体的结合亲和力分别为-7.451、-7.368、-7.101、-6.878 和 -6.789,而临床药物 Anle138b 的结合亲和力为-4.552 kcal/mol。此外,分子动力学和 pkCSM 药代动力学表明,与参考药物相比,配体 1、2 和 4 具有更好的稳定性和低毒性。结论总之,这项研究为发现小分子化合物铺平了道路,这些小分子化合物可在进一步的转化研究中被推荐用作抗多发性骨髓瘤候选药物的辅助剂/单个候选药物。
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引用次数: 0
C-reactive Protein, Albumin, Urea, CRP/Albumin Ratio, and Urea/Albumin Ratio: A Retrospective Evaluation in COVID-19 Patients C反应蛋白、白蛋白、尿素、CRP/白蛋白比值和尿素/白蛋白比值:对 COVID-19 患者的回顾性评估
Pub Date : 2023-10-13 DOI: 10.47836/mjmhs.19.6.22
Nor Amirah Mohammad Nazri, W. N. Wan Azman, Norsyuhadah Musa, Tuan Salwani Tuan Ismail, Azian Harun, Najib Majdi bin Yaacob, S. Sulong, Sirajudeen K.N.S., Mahaya Che Mat, Hani Ajrina Zulkeflee, Siti Sarah Mustapa
Introduction: C-reactive protein (CRP), urea, albumin, CRP/albumin ratio (CAR) and urea/albumin ratio (UAR) could be valuable biomarkers for determining the severity of illness in patients with COVID-19. This study aimed to determine the association between these markers and disease severity in COVID-19 patients on admission and days five to seven after admission. Methods: This retrospective study includes 153 adult COVID-19 patients admitted to Hospital Raja Perempuan Zainab II and Hospital Ampang from January 2021 to December 2021. Patients’ serum CRP, urea, albumin and creatinine levels were recorded on admission and on days five to seven after admission. The patients were categorised based on the Annex 2e guidelines published by the Ministry of Health, Malaysia and further classified as mild to moderate disease (stages 1-3) and severe to critical illness (stages 4-5). Results: On admission, urea, creatinine, CRP, UAR and CAR were significantly higher in the severe to critical group (p<0.001). The optimal cut-off value for the UAR was 0.16; the area under the curve (AUC) was 0.760, and sensitivity and specificity were 63.6% and 85.7%, respectively. The AUC of the CAR was 0.752, with 54.2% sensitivity and 91.4% specificity at an optimal cut-off value of 1.63. In severe to critical COVID-19 patients, albumin levels decreased significantly on days five to seven after admission, while urea levels remained significantly higher in this group (p<0.001, p<0.05, respectively). Conclusion: CRP, urea, albumin, CAR and UAR are promising biomarkers for predicting the severity of disease in COVID-19 patients.
导言:C反应蛋白(CRP)、尿素、白蛋白、CRP/白蛋白比值(CAR)和尿素/白蛋白比值(UAR)是判断COVID-19患者病情严重程度的重要生物标志物。本研究旨在确定 COVID-19 患者入院时和入院后 5-7 天内这些标志物与疾病严重程度之间的关系。研究方法这项回顾性研究包括 2021 年 1 月至 2021 年 12 月期间在 Raja Perempuan Zainab II 医院和安邦医院住院的 153 名 COVID-19 成人患者。研究记录了患者入院时和入院后第 5-7 天的血清 CRP、尿素、白蛋白和肌酐水平。根据马来西亚卫生部发布的附件 2e 指南对患者进行分类,并进一步分为轻度至中度疾病(1-3 期)和重度至危重疾病(4-5 期)。结果:入院时,重症至危重病组的尿素、肌酐、CRP、UAR和CAR明显较高(P<0.001)。UAR 的最佳临界值为 0.16;曲线下面积(AUC)为 0.760,灵敏度和特异度分别为 63.6% 和 85.7%。最佳临界值为 1.63 时,CAR 的 AUC 为 0.752,灵敏度为 54.2%,特异度为 91.4%。在 COVID-19 重症和危重症患者中,白蛋白水平在入院后第 5 至 7 天显著下降,而尿素水平在该组中仍显著较高(分别为 p<0.001、p<0.05)。结论CRP、尿素、白蛋白、CAR和UAR是预测COVID-19患者病情严重程度的理想生物标志物。
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引用次数: 0
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November 2023
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