https://ptsldigital.ukm.my/jspui/handle/123456789/388896 2026-04-20T17:30:47Z https://ptsldigital.ukm.my/jspui/handle/123456789/783009 Title: Improving medication procurement management in tertiary hospitals during a pandemic in Malaysia: a case study of COVID-19 Authors: Thanushiri Palani Velu (P114030) Abstract: The COVID-19 pandemic had a profound impact on healthcare systems globally, with an initial supply chain disruption rapidly escalating into a multifaceted crisis. Hospital pharmacists played a pivotal role in managing drug supply and distribution amid severe shortages, while simultaneously adapting to evolving clinical practices as new medications were introduced and others phased out. The first objective was to examine changes in medicine purchase patterns during the pandemic through a retrospective analysis conducted at a tertiary referral hospital in Malaysia. Two distinct periods were analyzed: pre-pandemic phase (January 2018 – December 2019) and pandemic phase (January 2020 – December 2021). Of the 266 medicines assessed, the majority (n=131; 49.2%) exhibited a decline in purchasing trends. However, demand for critical care medications surged, with procurement increases observed for cisatracurium besylate 2 mg/ml injection (1583.3%), vasopressin 20 IU/mL injection (796%), vitamin B and C injections (672.9%), and the oral antipsychotic olanzapine 5 mg (534.4%). Leveraging on these findings, the second objective employed a cross-sectional online survey design targeting hospital pharmacist to identify key barriers and facilitators affecting medicine availability, distribution, and pharmacists' roles during the pandemic. The questionnaire was developed through an extensive literature review, pre-tested, and validated by 25 hospital pharmacists before implementation. A total of 367 hospital pharmacists participated in the study. The most frequently reported barrier related to knowledge and skills was difficulty in analysing trends and usage patterns of COVID-19 medicines (n=183; 49.9%). The most pressing supply chain constraint was the global medicine shortage (n=314; 85.6%). Clinical challenges included the underway of clinical trials to identify effective treatments against COVID-19 (n=282; 76.8%), while the most significant departmental barrier was the challenge of predicting medicine usage based on previous purchasing data (n=262; 71.4%). Despite these obstacles, nearly all respondents (n=354; 96.5%) acknowledged that specialized training on COVID-19 treatments significantly enhanced their preparedness and response capabilities. Findings from the first two studies underscored the vulnerabilities in the pharmaceutical supply chain, highlighting the need to reassess hospital medicine procurement workflows. This led to the third study and objective, which aimed to design and validate an optimized procurement workflow to mitigate these challenges and strengthen facilitators. The third study consists of two key phases: (1) development of the workflow through expert consultation and (2) validation by clinical and procurement pharmacists using quantitative assessments. The proposed workflow introduces a structured, two-part approach that enhances collaboration with clinical teams to improve procurement accuracy while integrating thorough market research and strategic supplier selection. The workflow’s validity was confirmed after a single round of the Delphi method, achieving strong face validity (n=11, 96.4%) and high content validity (I-CVI ≥0.78, SCVI- Ave: 0.98, S-CVI-UA: 0.8). By streamlining procurement processes and addressing supply chain inefficiencies, this workflow seeks to improve medicine availability and distribution, particularly during health emergencies. 2026-02-27T00:00:00Z https://ptsldigital.ukm.my/jspui/handle/123456789/783008 Title: Isu-isu berkaitan pengurusan ubat-ubatan dalam kalangan orang yang hidup dengan HIV dan komorbiditi berkaitan usia Authors: Chew Yeong Tai (P110957) Abstract: Wabak jangkitan Human Immunodeficiency Virus (HIV) kekal sebagai isu kesihatan global. Terapi antiretroviral (ART) telah mengubah jangkitan HIV menjadi penyakit kronik yang boleh dirawati, meningkatkan jangka hayat orang yang hidup dengan HIV/AIDS (ODHA). Namun, peningkatan usia populasi ODHA menimbulkan cabaran baharu termasuk beban komorbiditi berkaitan usia dan pengurusan ubat yang kompleks. Keperluan untuk mengurus pelbagai ubat untuk HIV dan komorbiditi berkaitan usia, ditambah pula dengan cabaran sosial dan psikologi, meningkatkan risiko kepatuhan dan interaksi ubat, yang berpotensi menjejaskan kejayaan rawatan HIV. Namun demikian, masih terdapat jurang yang ketara dalam pemahaman tentang keperluan khusus warga tua ODHA dengan komorbiditi berkaitan usia yang menjejaskan pengurusan ubatubatan dan kesejahteraan keseluruhan mereka. Kajian ini bertujuan untuk menyiasat isu-isu berkaitan pengurusan ubat dalam kalangan warga tua ODHA dengan komorbiditi berkaitan usia. Kajian ini dijalankan dalam dua fasa yang berbeza, iaitu kuantitatif dan kualitatif. Dalam fasa kuantitatif pertama yang melibatkan 250 warga tua ODHA di sebuah hospital awam tertiari, didapati bahawa 84.4% daripada peserta mempunyai sekurang-kurangnya satu komorbiditi berkaitan usia, dengan dislipidemia (67.2%) dan hipertensi (46.4%) paling lazim. Walaupun dengan bilangan jenis ubat yang tinggi, dengan purata lima jenis atau lebih, serta jumlah pil harian kumulatif sebanyak 6.30 pil, sebahagian besar (91.2%) warga tua ODHA mencapai kepatuhan optimum terhadap ART, dengan viral suppression yang tinggi. Bilangan komorbiditi, jenis ubat, dan tempoh rawatan adalah peramal signifikan beban pil. Selain itu, bilangan komorbiditi yang lebih tinggi dikaitkan dengan peningkatan kemungkinan polifarmasi. Dalam fasa kualitatif seterusnya, temubual separa berstruktur dijalankan dengan 18 warga tua ODHA. Kajian ini mengenalpasti tiga tema utama iaitu kepentingan kepatuhan kepada ubat, cabaran berkaitan pengurusan ubat-ubatan, dan strategi penyesuaian dalam pengurusan ubat-ubatan. Walaupun peserta umumnya mempunyai pandangan positif terhadap ubat-ubatan, cabaran emosi dan sosial yang berkaitan dengan penyakit HIV memberi kesan terhadap pengurusan ubat-ubatan. Kajian ini menegaskan bahawa walaupun prevalens komorbiditi berkaitan usia, polifarmasi, dan beban pil adalah tinggi dalam kalangan warga tua ODHA, kepatuhan terhadap ART masih tinggi. Namun demikian, peserta melaporkan pelbagai cabaran dalam pengurusan ubat. Oleh itu, perkhidmatan penjagaan kesihatan bersepadu, saringan kesihatan berkala, pengurusan emosi, dan sokongan social adalah penting bagi mengoptimumkan pengurusan ubat-ubatan serta kualiti hidup warga tua ODHA 2025-11-26T00:00:00Z https://ptsldigital.ukm.my/jspui/handle/123456789/783007 Title: Green synthesis of silver nanoparticle- embedded cellulose nanofibers from mushroom biomass for antibacterial hydrogel applications Authors: Charzen Mae A. Kinoan (P121113) Abstract: Underutilized agricultural wastes such as spent mushroom substrate (SMS) offers a significant potential for the development of sustainable biomedical materials. In this study, cellulose nanofibrils (CNFs) were successfully isolated from SMS via a chemomechanical process, while the aqueous extract of SMS (WESMS) was utilized as a green reducing agent for the in-situ synthesis and loading of silver nanoparticles (AgNPs) onto TEMPO-oxidized CNFs (AgNP/ToCNF). ATR-FTIR confirmed the chemical structure of the isolated cellulose, while UV-Vis spectroscopy (λmax = 424 nm) verified successful AgNP synthesis and incorporation. The hybrid nanomaterial exhibited fibril diameters ranging from 273.5–318.5 nm and AgNP sizes averaging 34.04 ± 7.39 nm. Antimicrobial evaluation against Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli using agar diffusion, broth microdilution, time-kill, and membrane leakage assays revealed potent antibacterial activity. AgNP/ToCNF showed MIC₉₀ values of 250 μg/mL for S. aureus and 125 μg/mL for P. aeruginosa and E. coli, while free AgNPs demonstrated lower MIC₉₀ values (62.5–31.25 μg/mL). Despite this, AgNP/ToCNF retained strong bactericidal activity with improved safety as determined by LDH assays that showed minimal cytotoxicity to human dermal fibroblasts at ≤500 μg/mL, in contrast to >67% cytotoxicity was observed from the free AgNPs. The nanocomposite was incorporated into a citric acid–crosslinked hydrogel, which exhibited solid-like rheological properties and high swelling capacity (~1000%), ideal for moist wound environments. Furthermore, the wound scratch assay demonstrated significantly enhanced fibroblast migration in the presence of the crosslinked hydrogel, supporting its potential to accelerate wound healing. Altogether, this study demonstrates the successful upcycling of SMS into a cytocompatible, multifunctional AgNP/ToCNF-based hydrogel with antimicrobial and wound-healing properties, underscoring its potential as a sustainable and effective material for advanced wound dressings. 2026-02-06T00:00:00Z https://ptsldigital.ukm.my/jspui/handle/123456789/783006 Title: Physicochemical analysis of Malaysian Sacha Inchi (Plukenetia volubilis L.) seed oil and its lipid-modulating effects with proteomic profiling Authors: Mariam Fardush (P133811) Abstract: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a highly prevalent metabolic liver disorder characterized by excessive hepatic lipid accumulation in the context of cardiometabolic dysfunction, for which conventional treatments remain limited by modest efficacy, side effects, and poor adherence, thereby driving interest in plant-derived nutraceuticals as safer, multi-targeted therapeutic alternatives. Sacha Inchi (Plukenetia volubilis L.), native to the Amazon and increasingly cultivated in Malaysia, has gained attention due to its reported antioxidant, anti-inflammatory, hypoglycaemic, and anti-hyperlipidaemic effects. These effects are largely attributed to its ω3 rich fatty acid composition and antioxidant constituents. Previous in vitro and in vivo studies have reported improvements in lipid-related outcomes following Sacha Inchi oil (SIO) supplementation, supporting its relevance to metabolic disorders such as MASLD. Despite increasing cultivation and use, the mechanistic basis for SIO mediated hepatic lipid modulation remains insufficiently verified, limiting its scientific validation as a nutraceutical for MASLD. In particular, how SIO influences lipid-metabolizing pathways at the proteome level in hepatic models like HepG2 cells remains underexplored. This study evaluated the physicochemical properties and lipidmodulating effects of Malaysian SIO in oleic acid (OA)-induced HepG2 cells using physicochemical analysis, lipid accumulation assays, and LC-MS/MS based proteomics for protein identification processed in Proteome Discoverer, followed by pathway mapping and enrichment using DAVID (KEGG) and MetaboAnalyst. Three SIO types, including Peruvian commercial, Malaysian commercial, and lab-extracted oil, were investigated by Fatty Acid Methyl Ester analysis. Lab SIO had the highest ω3 (52.89%) and ω6 (36.23%), with an ω3/ω6 ratio of 1.46, compositionally similar to the Peruvian oil. In contrast, Malaysian commercial oil h ad l ow ω 3 a nd a n imbalanced ratio, reflecting compositional differences. Based on these findings, the Lab oil was selected for further bioactivity analysis due to its favorable fatty acid profile. Moreover, the physicochemical characterization of the Lab SIO confirmed its high quality, with a refractive index of 1.4739, an acid value of 1.10 mg KOH/g, and a peroxide value of 2.82 mEq/kg, indicating minimal oxidation and suitability for biological assays. In the lipid accumulation assays, Lab SIO reduced OA-induced lipid accumulation in a concentration-dependent manner based on Oil Red O staining. Proteomics and pathway analyses revealed that Lab SIO significantly modulated the expression of key differentially expressed proteins, including VDAC3, ALDH9A1, SOD2, GSTK1, and ACAT1, which were linked to four highly enriched lipid-related pathways. Fatty acid degradation exhibited the highest fold enrichment (48-fold, p<0.001), followed by peroxisome (24.85-fold), ferroptosis (24.56-fold), and fat digestion and absorption (23.99-fold), all showing statistical significance (p<0.05). These findings suggested that SIO modulated lipid metabolism through several key lipid-related pathways, highlighting its potential as a therapeutic agent for regulating metabolism and promoting liver health. Further in vivo and clinical studies are needed to validate its therapeutic potential. Keywords: Sacha Inchi; Plukenetia volubilis; HepG2 cells; proteomics; lipid metabolism; MASLD 2025-12-31T00:00:00Z