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Background. The CYP2C19*2 allele may be associated with a reduced antiplatelet effect for clopidogrel. Here, we assessed whether CYP2C19*2 alleles correlate with clopidogrel responsiveness following the administration of clopidogrel in healthy Malaysian volunteers. Methods. Ninety volunteers were genotyped for CYP2C19*2 and CYP2C19*3 alleles. Forty-five of 90 volunteers were included in the clopidogrel response studies and triaged into three genotypes, namely, CYP2C19*1/*1 (n = 17) CYP2C19*1/*2 (n = 21) and CYP2C19*2/*2 (n = 17). All subjects received 300 mg of clopidogrel, and platelet reactivity was assessed after a four-hour loading utilizing the VerifyNow-P2Y12 assay. Platelet activity was reported using P2Y12 reaction units (PRUs), and nonresponder status was prespecified at PRU = 230. Results. Following clopidogrel intake, CYP2C19*2/*2 carriers had a significantly higher mean PRU compared to the CYP2C19*1/*2 and CYP2C19*1/*1 (291.0 ± 62.1 versus 232.5 ± 81.4 versus 147.4 ± 87.2 PRU, P < 0.0001) carriers. Almost half of the participants (46.7%) were found to be nonresponders (3 were CYP2C19*1/*1, 11 were CYP2C19*1/*2, and 7 were CYP2C19*2/*2). Conclusion. In healthy Malaysian volunteers, CYP2C19*2 allele was associated with a decrease in platelet responsiveness to clopidogrel. However, clopidogrel nonresponders can be found not only in the carriers of CYP2C19*2/*2, but also in the carriers of CYP2C19*1/*2 and CYP2C19*1/*1. The present paper demonstrated that genotype information does not correlate with clopidogrel response, and genotyping may represent a less robust approach compared to platelet activity testing in guiding clopidogrel therapy. [ABSTRACT FROM AUTHOR]

Aim: To determine the occurrence, factors and outcome of missed nursing care from the perspective of Malaysian nurses. Background: Missed nursing care is an important issue in the global health care sector. However, little is known on the extent of missed nursing care in the Malaysian context and its contributing factors. Methods: A cross‐sectional design was adopted for data collection using the MISSCARE Survey instrument. Participants comprised 364 nurses from medical and surgical wards of a large teaching hospital. Data were analysed using descriptive, binomial logistic and hierarchical regression analyses. Results: The overall occurrence of missed nursing care was 1.88 (on a scale of 1.00–5.00), which differed across 24 nursing care elements. Basic nursing care and communication‐related care were the most frequently missed elements. Types of ward and labour resources were identified as contributing factors to missed nursing care (p <.001). No significant association was found between missed nursing care and nurses' intention to leave (p >.05). Conclusion: The occurrence of missed nursing care was noted to be low. Implications for Nursing Management: Practical strategies such as an acuity‐based staffing system, close monitoring of rendered care and strengthening of teamwork are recommended to minimize missed nursing care. [ABSTRACT FROM AUTHOR]