https://ptsldigital.ukm.my/jspui/handle/123456789/388896 2026-06-09T00:10:52Z 2026-06-09T00:10:52Z Yu, Na https://ptsldigital.ukm.my/jspui/handle/123456789/783202 2026-06-08T12:22:46Z 2026-04-15T00:00:00Z

Title: Intestinal-retaining fluid gel formulations for oral medication delivery in post-stroke dysphagia management Authors: Yu, Na Abstract: Patients with post-stroke dysphagia (PSD) face crucial challenges in taking oral medications due to swallowing difficulties, particularly with long-term secondary prevention medications. Current countermeasures relying on modification of existing formulations with thickened liquids carry potential hazards including bioavailability alterations and unsatisfactory safety profiles. Despite the obvious unfavorable impact, there is limited awareness and few effective solutions. Herein, an integrated patientcentered pharmaceutical framework to address critical oral medication challenges in PSD patients was established. A cross-sectional survey revealed that among Chinese stroke patients with stroke duration less than 5 years, 42.7% reported PSD. Among PSD participants, 40.2% frequently had difficulty swallowing pills, 37.1% regularly crushed solid oral dosage forms (SODFs), and 23.5% often coughed when taking SODFs, with 87.4% expressing need for PSD-specific formulations prioritizing safe and easy swallowing and reduced medication frequency. Driven by these patient-centered needs, a swallowing dynamics-inspired oleogel-in-hydrogel Pickering emulsion fluid gel was proposed as a versatile oral delivery system. With the dual structure of high acyl gellan gum (HAG) fluid gel and whey protein isolate (WPI) stabilized oleogel-in-hydrogel Pickering emulsion gel, the novel system demonstrated rheological properties wellmatched with swallowing dynamics, lower shear yield stress, better shear flowability, and superior extensional capabilities, alongside versatile loading potential for both hydrophilic and lipophilic substances. The customization capability of this biphasic fluid gel was further explored, confirming that microstructure and rheological properties could be tailored by adjusting HAG content and process mixing rate, enabling customization for different dysphagia severity levels referencing η50 based on NDD thickened fluid classification standards, with shear, extensional rheological capabilities and digestion rate aligning with expectations from mild to severe dysphagia. A patient self-controlled swallowing sensory evaluation study further validated significant improvements in swallowing experience across PSD cohorts with mild to severe dysphagia. Collectively, this work bridges patient-centered evidence with advanced pharmaceutical engineering, resolving swallowing challenges in long-term secondary prevention drug administration and establishing a transformative platform for PSD-specific oral drug delivery.

2026-04-15T00:00:00Z Thanushiri Palani Velu https://ptsldigital.ukm.my/jspui/handle/123456789/783009 2026-06-08T12:21:44Z 2026-02-27T00:00:00Z

Title: Improving medication procurement management in tertiary hospitals during a pandemic in Malaysia: a case study of COVID-19 Authors: Thanushiri Palani Velu 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 Chew Yeong Tai https://ptsldigital.ukm.my/jspui/handle/123456789/783008 2026-06-08T12:22:38Z 2025-11-26T00:00:00Z

Title: Isu-isu berkaitan pengurusan ubat-ubatan dalam kalangan orang yang hidup dengan HIV dan komorbiditi berkaitan usia Authors: Chew Yeong Tai 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 Charzen Mae A. Kinoan https://ptsldigital.ukm.my/jspui/handle/123456789/783007 2026-06-08T12:23:15Z 2026-02-06T00:00:00Z

Title: Green synthesis of silver nanoparticle- embedded cellulose nanofibers from mushroom biomass for antibacterial hydrogel applications Authors: Charzen Mae A. Kinoan 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