When the dietary supplement users were asked why they did not disclose their dietary supplement consumption, the most frequently cited reason was "the doctors never asked" (49.6%). Other reasons were "no possibility to tell the doctor considered nutritional supplements irrelevant" (12.0%) and "the doctors had no knowledge of herbal remedies" (6.8%).
Jackey Suen
Several possible mechanisms may
How does a structured lifestyle intervention programme contribute to the management of
It is important to identify individuals at risk for DM (i.e., those with prediabetes or early onset diabetes) and to initiate a structured lifestyle intervention program early (i.e., delivered through a combination of exercise, MNT, and behavioral therapy) to reduce the risk to reduce diabetes. prediabetes that develops into diabetes.
Could you please share with us the common challenges to implementing a structured
In Malaysia, only 16.4% of patients with T2DM adhere to the dietary regimen provided by their
An update on medical nutrition therapy for type 2 diabetes
T2DM in Malaysia: Current
- The Malaysian transcultural diabetes-specific nutrition algorithm (tDNA) recommends MNT
- How does a meal replacement programme complement the dietary regimen of patients
- The findings of a recently published study highlighted the benefits of MI in the management
- What are the challenges to implementing MI in Malaysia?
Findings from a recently published study highlighted the benefits of MI in the management highlighted the benefits of MI in the management of T2DM.6 Can you describe how MI can promote better self-adherence to MNT. Several studies have also evaluated the effectiveness of MI in reducing substance abuse and smoking cessation.9,10. MI learning in the workshop should be supplemented through daily practice to further improve counseling skills.
However, it is important to note that many aspects of MI can be included in one visit with only a small increase in time.
Motivational interviewing approach to diet counselling
The Malaysian Transcultural Dietary Algorithm for Diabetes (tDNA) recommends the MNT Dietary Algorithm (tDNA) recommends MNT as a key component of glycemic control in the treatment of T2DM. MNT is defined as "nutritional diagnostic, therapeutic and counseling services for purposes provided by a registered dietitian or nutritionist for the purpose of diabetes management."7 Current Malaysian clinical practice guidelines for type 2 diabetes, in addition to facilitating glycemic control, recommend the use of MNT for achieving and maintaining blood glucose levels, blood pressure, and lipid profiles as close to normal as possible safely.8 All individuals with prediabetes or diabetes, especially those with newly diagnosed diabetes or those with an A1C level of approximately 8 .%, would benefit significantly from MNT. The diabetes-specific formula is used as a meal replacement with a fixed calorie and nutrient content designed to achieve the recommended caloric intake for patients with T2DM (kcal/day).
MI is a patient-centered approach to counseling designed to elicit and strengthen motivation for behavior change based on a perspective of patient empowerment through exploration and resolution of ambivalence.
Slow digested carbohydrate results in slow release of
Cholesterol free
Omega 3 & Omega 6
Steady energy release for proven blood glucose control as Glucerna ® contains
This phase III, double-blind trial included 829 pregnant women who were randomized to a single dose of 2 g oral azithromycin (n=414) or placebo (n=415) during labor. Mothers and infants were assessed for nasopharyngeal carriage of bacteria within 4 weeks postpartum. Overall, a lower incidence of purulent bacterial conjunctivitis was observed in infants in the azithromycin arm compared with the placebo arm (1.2%).
There was also a lower incidence of bacterial conjunctivitis associated with gram-positive bacteria such as Staphylococcus aureus and Streptococcus pneumoniae in infants whose mothers were given azithromycin.
Azithromycin may reduce bacterial conjunctivitis in infants
A single dose of oral azithromycin during labor was associated with a reduced risk of neonatal bacterial conjunctivitis, according to a recent study. All neonates received tetracycline eye ointment as part of the standard of care before discharge. Eye samples were collected from infants who had evidence of conjunctivitis within 8 weeks of birth.
Among all 843 infants (n=419 in the azithromycin arm and n=424 in the placebo arm), 40 infants were diagnosed with purulent bacterial conjunctivitis at 8-week follow-up.
Tristan Manalac
Prenatal acetaminophen may up risk of language delays in girls
Jairia Dela Cruz
Empagliflozin improves clinical outcomes in T2D patients with CVD, CKD
Rachel Soon
You were attached with the British Antarctic Survey
How did that happen?
What were some of your findings?
By MDR bacteria, do you mean things like MRSA
Hope from a grain of soil: pharmacist
Could you describe the pro- cess of drug discovery in the
Where does your expertise as a pharmacist come in?
Are all the students working under you in the pharmacy
The prevalence of acute pain leading to the use of analgesics approaches 100% in the general population, and pharmacists are a crucial first point of contact for patients on their journey to better pain management.1 Noting that pharmacists need to be more aware of their GlaxoSmithKline Consumer Healthcare, an evolving role as a community pharmacist, partnered with MIMS Education to host a workshop that served as a platform for robust knowledge sharing.
Know the difference: Arthritis versus arthrosis
The 2013 Malaysian Clinical Practice Guidelines (CPG) on the Management of Osteoarthritis and the National Institute for Health and Care Excellence (NICE) guidelines advocate identifying and modifying osteoarthritis risk factors to prevent the disease and its progression. The Malaysian CPG emphasizes different pharmacological options, recommending the choice of analgesic according to the severity of pain and the pathophysiology of the underlying disease.9 Paracetamol is the first-line pharmacological treatment for painful symptomatic OA.9,10 In patients with non-inflammatory OA, paracetamol provides effective analgesia compared with placebo, all and paracetamol formulations are well tolerated and safe at the appropriate recommended dose.9. The Malaysian CPG found that ER formulations of paracetamol achieve significant pain reduction and improvement in physical function compared to placebo.9.
One option to consider is bilayer ER tablets (Panadol Extend®; GlaxoSmith-Kline), which contains 665 mg of paracetamol with a unique dual-release profile indicated for pain associated with OA.
Nonpharmacological and pharmacological options in the management of OA
Gan noted that a common misconception among community pharmacists is that "clinical pharmacy" only takes place in the hospital. Pharmacists play a key role in improving the management of chronic diseases such as OA in society. OA is a prevalent condition in Malaysia and pharmacists play an important role in minimizing OA-related pain in the community through the recommendation of appropriate non-pharmacological and pharmacological interventions.
To improve patient care and outcomes, pharmacists must remain continuously attuned to the needs of their patients while delivering high-quality healthcare services.
Shifting viewpoints: Evolving roles of the
PHARMACISTS AS AN INTERVENTIONIST, NOT A PHARMACIST The main roles of a 'classic' community pharmacist include processing prescriptions, monitoring drug use, providing advice on traditional and complementary medicines, as well as the temporary preparation of medicines, such as set out. by the World Health Organization.10 In Malaysia, community pharmacists provide most of these services except for extemporaneous dispensing, due to existing regulations that complicate such practices.11. Specific emphasis should be placed on providing value-added services – such as clinical pharmacy services – to improve patient care and satisfaction. Clinical pharmacy is a health science discipline in which pharmacists provide patient care that optimizes medication therapy, promotes healthy living, and advocates disease prevention.
In practice, clinical pharmacy takes place daily in an environment where pharmacists collect the patient's medical history and collect information that will help them give good health advice.
The opinions expressed in this publication are not necessarily those of the editor, publisher or sponsors. No part of this publication may be reproduced by any process in any language without the written permission of the publisher. Community pharmacists are easily accessible to the general public and their pharmacies have longer opening hours, which improves patient access to medication.11 As the main point of contact for patients, community pharmacists are able to closely monitor the progress of the patient's disease and to intervene when necessary.14 Patient education is one of the main areas for community pharmacists.
Patient empowerment involves counseling patients to improve their health literacy, which requires time and commitment from the pharmacist.
PANADOL EXTEND: TOUGH ON JOINT PAIN, 1,2 NOT ON YOUR PATIENTS 3,4
Managing gastroesophageal reflux
Introduction
Symptoms
Dr Renukha Sellappans
CPD point every month!
These symptoms are often aggravated by activities such as lying down, bending forward or eating a meal rich in fat. The atypical symptoms include chronic cough, asthma-like symptoms, recurrent sore throat and laryngitis.4 Chest pain is another common manifestation of GERD where 50% of those with chest pain and a normal electrocardiogram have BUOO.8 Other atypical symptoms of GERD include in dyspepsia, epigastric pain, nausea, bloating and belching which may be indicative of BUOO but may overlap with other conditions such as peptic ulcer disease and Helicobacter pylori infections.4.
Diagnosis
Pharmacological treatment
It should be used on demand or as intermittent therapy at the lowest effective dose.4 The following sections will further discuss the different classes of pharmacological agents in terms of their specific characteristics and their role in the treatment of GERD. Antacids play a role in the treatment of GERD by neutralizing stomach acid and increasing intragastric pH. The use of PPIs in the treatment of GERD should not be hindered by concerns about fracture risk, except in patients with an established risk of hip fracture.4,12 Osteoporosis patients can be initiated on PPIs for the treatment of GERD at the lowest possible age. the most effective dose and duration.4 Patients should be advised to consume adequate amounts of calcium and vitamin D, and to have a bone mineral density screening if they are at risk for low bone mass.4 Weight-bearing exercises may also help. 4.
Promotility agents play a role in the treatment of GERD through their action on the cholinergic mechanism to facilitate gastric emptying.
Non-pharmacological treat- ment
Therefore, prescribers should consider temporarily switching to ranitidine if necessary.4 Alternatively, there have been some suggestions to withhold the PPI dose for 2 days before and after administration of methotrexate to avoid interactions between medicines. 4. In addition, metoclopramide is a dopamine agonist with multiple daily dosing and is associated with side effects such as dizziness, fatigue, somnolence, extrapyramidal symptoms, and hyperprolactinemia, which limits its clinical use in the treatment of GERD.4.
Surgical therapy
However, it is not recommended in patients who do not respond to PPI therapy. Obese patients considering surgical therapy for GERD should be considered for bariatric surgery.
Role of pharmacists in the management of GERD
Wong Lee Fung
Pharmacists reaching out to the indigenous people
Recognizing the need, MPS Penang remains committed to continuing this medical outreach program for the orang asli communities in the future to bring about real improvement in their health, provide proper nutrition and create health awareness among them. The orang asli recognize the prevailing need for medical care and so several tribes who had walked for hours from their settlements deep into the jungle were already on site to meet the health team upon their arrival. MPS Penang was recently recognized and awarded the second prize for the Best Community Project in the Asian Region for 2017 by the Asian Young Pharmacists Group (AYPG).
In March 2017, the medical outreach project received support in the form of cash, medicine and efforts from other Penang pharmacists as well as from several pharmaceutical companies and distributors.
SUBSCRIPTION FORM
Location: Petaling Jaya, Selangor Information: Hannah/Secretariat, Malaysian Community Pharmacists Guild Tel Email: [email protected]. To notify us of any events of interest to pharmacists, please submit details to [email protected].
Topical nonsteroidal anti-inflammatory drugs in the management of acute
Earn Y CPD Cr our
INTRODUCING NEW MODULE
