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Although infections of the outer eye commonly occur, there are few antibiotics available for local, topical treatment. Several bacterial strains have become established that are resistant to chloramphenicol, one of the widely used antibiotics; additionally, topical use of this antibiotic has been associated with rare, but serious side effects. Ofloxacin, a synthetic fluorinated quinolone, is a new antibiotic that may be useful against topical external eye infections. A randomized clinical trial was undertaken to compare the safety and effectiveness of ofloxacin with that of chloramphenicol in treating suspected bacterial eye infection in 167 patients. The rate of clinical and microbiological improvement of 84 of the 167 patients who had culture-proven bacterial infection was also studied. The most common diagnosis was conjunctivitis (63 percent); other diagnoses included blepharoconjunctivitis (inflammation of the eyelid and conjunctiva), keratoconjunctivitis (inflammation of the cornea and conjunctiva) and blepharitis (inflammation of the eyelid). There was no significant difference between the treatment groups in rate of clinical improvement. All the patients with proven bacterial infection improved clinically after ofloxacin treatment; 93 percent of those treated with chloramphenicol improved clinically. Both antibiotics had similar rates of microbiological improvement, and patients tolerated both drugs well. One of 83 patients (1 percent) treated with ofloxacin and four of 84 patients (4 percent) treated with chloramphenicol experienced adverse reactions that might have been due to the medications. The authors note that in comparing these two drugs the side effects of both must be considered. Ofloxacin has few side effects, whereas the risks associated with chloramphenicol have prompted some authors to suggest its use only when other antibiotics have not been successful. (Consumer Summary produced by Reliance Medical Information, Inc.)

Background/aims: The management of lower eyelid retraction can be challenging, and established techniques to correct it are not always successful. Previous reports have suggested a role for the ultrathin high density porous polyethylene lower eyelid spacer (Medpor LES) in such patients. The authors report the experience of three surgeons implanting Medpor LES over 1 year, and ascertain whether such implants are a safe and effective alternative to autogenous spacers. Methods: A prospective, interventional, non-comparative case series of consecutive patients. Surgical indications for Medpor LES were noted. Preoperative and postoperative lower marginal reflex distance (L-MRD), vertical palpebral aperture (PA), lagophthalmos, and scleral show inferior to the limbus (LSS) were recorded, together with major and minor complications. Results: 32 patients (35 eyelids) had a Medpor LES inserted, 22/32 under local anaesthetic, and nine with adjunctive procedures. Mean follow up was 22 months (range 15-28 months). The Medpor LES was effective in reducing the palpebral aperture (p < 0.001) and lagophthalmos (p =0.04) and raising the lower eyelid height by reducing both L-MRD (p = 0.006) and ISS (p < 0.001). However there were major complications in 7/32 patients and minor complications in 8/32, most requiring further surgery. Final outcome was good in 24/35 eyelids and satisfactory in 5/35. Conclusions: Despite a good or satisfactory final outcome in the majority of patients, the value of this technique is limited by complications, and should be reserved for those unsuitable for safer techniques. [ABSTRACT FROM AUTHOR]

Autism and ADHD are related to brain abnormality. Many studies show that scalp acupuncture is effective in treating neurological problems related to autism and ADHD. New study has found impairments in white matter in the main neural pathway connecting the right and left hemispheres of the brain in children with both autism and ADHD. The more we learn and know about brain functions, the more we can incorporate this knowledge into our clinical practice of scalp acupuncture. Needling scalp acupuncture on children with autistic and ADHD patients is very different from doing it with adult patients. This paper shares our clinical experiences and techniques on how to practice scalp acupuncture using various scalp acupuncture systems and the Neoh Scalp acupuncture system on autistic and ADHD patients.

Muhammad Abdul Hadi,1 Chin Fen Neoh,2 Rosdi M Zin,3 Mahmoud E Elrggal,4 Ejaz Cheema4 1School of Healthcare, Faculty of Medicine and Health, University of Leeds, Leeds, UK; 2Collaborative Drug Discovery Research Group, Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam, Salangor, 3Pharmacy Department, Malacca Hospital, Malacca, Malaysia; 4Faculty of Pharmacy, Umm-Al-Qura University, Makkah, Saudi Arabia Abstract: Globally, adverse drug reactions (ADRs), one of the leading causes of morbidity and mortality, will continue to pose a threat to public health as long as drugs are being used to treat various ailments. Prompt ADR reporting is crucial in ensuring drug safety. The aim of this narrative review was to highlight the role of pharmacists in pharmacovigilance and to identify barriers and facilitators toward ADR reporting documented in the literature. The perspective of pharmacy students on pharmacovigilance and ADR reporting has also been discussed with an aim to highlight the need to improve content related to ADR reporting and pharmacovigilance in undergraduate pharmacy curriculum. Globally, although the role of pharmacists within national pharmacovigilance systems varies, it is very well recognized. In general, pharmacists acknowledge that ADR reporting is part of their professional responsibility and have a positive attitude toward reporting ADRs. However, current research evidence suggests that there are still critical knowledge gaps with regard to ADR reporting among pharmacists, especially in countries where the role of pharmacists within the health care system is limited. These knowledge gaps can be fulfilled through continuous professional development programs and reinforcing theoretical and practical knowledge in undergraduate pharmacy curriculums. Without adequately identifying and fulfilling training needs of pharmacists and other health care professionals, the efficiency of national pharmacovigilance systems is unlikely to improve which may compromise patient’s safety. Keywords: pharmacist, adverse drug reaction, pharmacovigilance, patient safety

Chee Fai Sui,1 Long Chiau Ming,2,3 Chin Fen Neoh,2,4 Baharudin Ibrahim1 1School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, 2Faculty of Pharmacy, Universiti Teknologi MARA, 3Brain Degeneration and Therapeutics Group, 4Collaborative Drug Discovery Research (CDDR) Group, Pharmaceutical and Life Sciences (PLS) Community of Research (CoRe), UiTM, Selangor, Malaysia Background: This study utilized a validated combination of a COPD Population Screener (COPD-PS) questionnaire and a handheld spirometric device as a screening tool for patients at high risk of COPD, such as smokers. The study aimed to investigate and pilot the feasibility and application of this combined assessment, which we termed the “VitalQPlus”, as a screening tool for the early detection of COPD, especially in primary care settings. Methods: This was a cross-sectional study screening potentially undiagnosed COPD patients using a validated five-item COPD-PS questionnaire together with a handheld spirometric device. Patients were recruited from selected Malaysian government primary care health centers. Results: Of the total of 83 final participants, only 24.1% (20/83) were recruited from Perak and Penang (peninsular Malaysia) compared to 75.9% (63/83) from Sabah (Borneo region). Our dual assessment approach identified 8.4% of the surveyed patients as having potentially undiagnosed COPD. When only the Vitalograph COPD-6 screening tool was used, 15.8% of patients were detected with a forced expiratory volume in 1 second/forced expiratory volume in 6 seconds (FEV1/FEV6) ratio at

Objective: This study aimed to explore hypertensive patients’ perspectives on quality use of medication and issues related to hypertension management at the community level in Malaysia. Methods: Focus groups discussion was employed in this qualitative study. A total of 17 hypertensive patients were purposively recruited. Three focus group discussions with semi-structured interview were carried out at Flat Desa Wawasan, Penang. All the conversations were audio recorded, transcribed verbatim and thematically analysed. Results: Three major themes were developed, including medication adherence among hypertensive patients, self-management of hypertension and patients’ knowledge towards hypertension. Poor medication adherence was found and different strategies were taken to overcome the barriers towards adherence. Use of herbal and traditional therapies was perceived as alternative method in controlling blood pressure instead of taking antihypertensive medication. The participants were found to have poor knowledge on side effect and mechanism of action of hypertensive medication. Conclusions: The misconception about the side effect of antihypertensive medication has led to poor adherence among the participants. Lack of knowledge on targeted blood pressure level has led to poor blood pressure monitoring among the participants. Health awareness program and counselling from health care professional should be advocated among the hypertensive patients in addressing the above gaps.