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Aims Healthcare workers’ (HCWs) ability to recognize, classify and manage adverse reactions (ADR) is crucial to ensure patient safety. This study assessed HCWs’ awareness, knowledge, and practice on ADR. Methods This was a cross sectional online questionnaire case-based study, involving clinical HCWs at two tertiary hospitals. Results We recruited 321 respondents with 256 doctors, 58 nurses and seven medical assistants. HCWs with more than five years’ experience and dermatologists had better ADR knowledge. Three-quarter failed to recognize off-target nonimmune mediated non-steroidal anti-inflammatory drugs reactions. About 26% (n=84) could not recognize severe cutaneous adverse drug reactions (SCARs). In those who recognized SCARs, only 76.6% (n=177) will not re-introduce the implicated drugs. Knowledge in managing anaphylaxis and awareness in paradoxical drug-induced reaction was poor. About 18% (n=58) did not use adrenaline in anaphylaxis and 80% (n=259) were unfamiliar with the usefulness of tryptase in anaphylaxis. Nearly 52% were ignorant of succinylated gelatin solution as a hidden allergen. Nearly 90% (n=286) were unfamiliar with utilization of fresh frozen plasma in severe ACE-inhibitor induced angioedema. A significant proportion of respondents understood the reporting pathway for ADRs to medications and vaccines, respectively. Only up to 67.3% (n=216) understood the need to update ADR reporting when a new reaction occurred. Conclusion The overall HCWs knowledge and practice on ADRs is not satisfactory where they lacked awareness on many aspects of ADRs. These findings provide supportive evidence for the incorporation of ADR into the healthcare curricula and plan periodic programs to ensure patient safety.

Introduction The coronavirus disease 2019 (COVID-19) first emerged in December 2019 in Wuhan City, Hubei, China, following reports of several pneumonia cases with unknown aetiology agent.Roughly 19.5 million infections and more than 700,000 deaths have been reported worldwide by the early of August 2020. Remdesivir is a nucleotide analogue which inhibits viral RNA polymerase and consequently disrupts viral replication.This drug also has broad antiviral activities.Remdesivir has been demonstrated to possess prophylactic and therapeutic activity against MERS-CoV in a rhesus-macaque model with lower viral replication and lung damage and the eventual improved clinical symptoms. Objective This review aims to summarise and synthesise published data evaluating remdesivir and COVID-19. Our primary aim is the effect and safety of remdesivir among COVID-19 patients. Methods [Refer to Poster]. Results [Refer to Poster]. ConclusionWe found a paucity of high-quality clinical trials in relation to invitro, in-vivo and non-randomised studies, and so the quality of evidence to inform clinical practice is still not strong.The current evidence-base needs to be consolidated with the publication of more clinical trials with bigger cumulative samples, to the point where optimal information size is reached. Due to insufficient data, we are unable to determine further the applicability of the findings to all COVID patients, that is, adults and children. The high percentage of adverse effects in RCTs among adults and children need to be investigated further.

Introduction[Refer to Poster]. Methods[Refer to Poster]. Results[Refer to Poster]. ConclusionThere is so far no clear evidence that HCQ affects other outcomes with no data on adverse effects and animal-model outcomes. The certainty of the estimates for all outcomes (or the quality of evidence) were very low-to-moderate. More well-conducted RCTs are needed which should adhere to rigorous standards with clear documentation, to provide improvement in the overall certainty of evidence. There is lack of high-quality evidence that supports the efficacy and safety of HCQ and CQ for treatment of COVID-19.

OBJECTIVE The association between human leukocyte antigen (HLA)-B*58:01 and risk of allopurinol-induced severe cutaneous adverse reactions (AIS) was observed across different populations. We explore the association between HLA-B*58:01 and AIS risk in multiethnic Malaysian population. The HLA-B*58:01 risk for different AIS clinical phenotypes and ethnicity was determined. METHODS We performed a case-control association study by genotyping the HLA-B alleles of 55 patients with AIS [11 toxic epidermal necrolysis (TEN), 21 Steven Johnson syndrome (SJS) 22 drug reaction wit eosinophilia and systemic symptoms (DRESS) and one acute generalized exanthematous pustulosis (AGEP)] and 42 allopurinol-tolerant controls (ATC). RESULTS HLA-B*58:01 was positive in 89.1 and 14.3% of the AIS and ATC study groups [odds ratio (OR) = 49.0, 95% confidence interval (CI) = 14.6-164.4, P < 0.0001)], respectively. Our data showed that 93.8% of the AIS-SJS/TEN patients and 86.4% of the AIS-DRESS patients were HLA-B*58:01 positive (AIS-SJS/TEN, OR = 90, 95% CI = 16.9-470.1, P < 0.0001 and AIS-DRESS OR = 38, 95% CI = 8.5-169.2, P < 0.0001). Stratification by ethnicity and clinical phenotypes revealed a significant increased risk between HLA-B*58:01 and Chinese-AIS patients (OR = 137.5, 95% CI = 11.3-1680.2, P < 0.0001), in particular Chinese patients with AIS-SJS/TEN phenotype (100% HLA-B*58:01 positive). HLA-B*58:01 was positive in 90.9% Chinese AIS-DRESS (P < 0.0001). Highly significant associations of HLA-B*58:01 were observed in Malay AIS-SJS/TEN (OR = 78, 95% CI = 9.8-619.9, P < 0.0001) and Malay AIS-DRESS (OR = 54, 95% CI = 6.6-442.9, P < 0.0001). Although the number of Indian-AIS patients was relatively small (n = 2), both were HLA-B*58:01 positive. CONCLUSION Our data suggest strong associations between HLA-B*58:01 and AIS in Malaysian population with Chinese and Malays ethnicity. The strong association was also observed in three different clinical phenotypes of AIS, mainly the AIS-SJS/TEN.

Background: Since its emergence, COVID-19 has affected more than one million people with over 100,000 deaths globally as of early April 2020. In this review, we evaluated the efficacy and safety of hydroxychloroquine and chloroquine on patients with COVID-19. Methods: PubMed, CENTRAL, Google Scholar, Chinese Clinical Trial Registry and Trial Registers: ISRCTN; UMIN-CTR (Japan's Trial Register); and the WHO portal up were searched for the in vitro and in vivo studies of hydroxychloroquine and chloroquine.Results: Moderate-certainty evidence from a single published RCT to-date showed that after a five-days treatment, patients on hydroxychloroquine may have shorter symptom duration compared to the control group, including fever (MD-1.0 day (95% CI -1.48, -0.52), cough (MD -1.1 day (95% CI -1.63, -0.57) and higher likelihood of having improved chest CT appearance (RR 1.47 (95% CI 1.02, 2.11), no clear differences was observed in the risk of progressing to severe illness and risk of adverse effects. A single non-randomized study showed marked decreased in the number with positive viral load at day 6, but due to several flaws in the study, the certainty of evidence for the outcome was very low.Conclusion: Despite the evidence on possible effects of hydroxychloroquine and chloroquine, given the paucity of available evidence especially in relation to the number on-going RCTs, conclusion on the effectiveness and safety of hydroxychloroquine cannot yet be made.

IntroductionWorld Health Organization (WHO) defines mental health as an identification of individual potential state of well-being, coping with life’s normal stresses, working productively and fruitfully, and able to make community contribution. ObjectiveThis study aims to identify gaps in mental health research globally and in Malaysia, serving to guide a national project on health research priorities setting. Methods[Refer to Report]. ResultsSystematic searches retrieved 43,282 records, yielding 2890 eligible studies. Using the reference lists of included studies, an additional 216 eligible records were retrieved, yielding a total of 3106 studies. A total of 189 studies were retrieved for full text and 27 studies were included.Most of the studies concentrated on the effectiveness of interventions, epidemiology and biomedical research. Only 5 studies were concerned with rehabilitation and complication. ConclusionThis study provided a mapping of evidence used to identify, prioritize, and display gaps or priorities in mental health research. Through this exercise, a need is identified for increased research on rehabilitation and complications of various mental health conditions.

Substance use disorder (SUD) has both social and public health problems with a substantial burden to society. SUD is a type of mental illness and has been described as a chronic relapsing disease. Treatments for SUD may include among others, psychosocial rehabilitation as a provision to comprehensive treatment to address the social and behavioral issues. These psychosocial components can address the issues of morality, spirituality, and religion. Religion and spirituality are believed to support SUD clients in the reduction of drug use, other associated high-risk behaviors, and criminal issues. In promoting treatment retention, it is important to reduce the drug use, maintain abstinence, and influence the self-esteem and coping ability of SUD clients. Hence, this review was conducted to determine the effects of psychosocial and spiritual support towards clients with substance abuse problem. We had followed the framework from Arksey and O’Malley’s scoping review in identifying published studies from specific databases to be included in this review. A total of 8560 articles from various databases were screened. After removing duplicates, two authors independently screened 244 titles and abstracts. A total of eighteen articles were included in the final review. Out of eighteen studies, seventeen studies found that psychosocial support and spiritual needs have positive effect among substance abuse clients. Psychosocial and spiritual supports are beneficial among SUD clients due to various potential factors, such as religious reasons, personal beliefs or philosophical reasons, safety concerns, and a desire for improvements from substance abuse.

Cervical cancer is the most common malignant cancer of the female reproductive organs worldwide. Currently, cervical cancer can be prevented by vaccination and detected at an early stage via various screening methods. Malaysia, as a developing country faces a heavy disease burden of cervical cancer as it is the second most common cancer among Malaysian women. This population based study was carried out to fulfil the primary aim of determining the survival rates of Malaysian women with cervical cancer and associated factors. Data were obtained from two different sources namely, the Malaysian National Cancer Registry (MNCR) and National Health Informatics Centre (NHIC) from 1st January 2000 to 31st December 2005. Kaplan Meier analyses were conducted to identify the overall survival rates and median survival time. Differences in survival among different ethnic and age group were compared using the log-rank test. A total of 5,859 patients were included. The median survival time for cervical cancer in this study was 65.8 months and the 5-year survival rate was 71.1%. The overall observed survival rates at 1, 3 and 5 years were 94.1%, 79.3% and 71.1% respectively. The log-rank test finding also showed that there were significant differences in the 5-year survival rate among different ethnic groups. Malays had the lowest survival rate of 59.2% followed by Indians (69.5%) and Chinese (73.8%). The overall 5-year survival rate among patients with cervical cancer in Malaysia is relatively good. Age and ethnic groups remain as significant determining factors for cervical cancer survival rate.