buletin penyelidikan dan pembangunan (r&d)...

BULETIN PENYELIDIKAN DAN

PEMBANGUNAN (R&D) FARMASI NEGERI

SELANGOR JULAI-DISEMBER 2017

JAWATANKUASA R&D FARMASI SELANGOR 2017

ISI KANDUNGAN

SENARAI AHLI

JAWATANKUASA

1

PENCAPAIAN KAJIAN

R&D FARMASI

SELANGOR

JULAI— DISEMBER

2017

(PEMBENTANGAN DAN

PERSIDANGAN)

2-6

AKTIVITI DAN LATIHAN

JK R&D FARMASI

SELANGOR DAN

AKTIVITI R&D DI PTJ

JAN — JUN 2017

7-9

PROGRAM AKAN

DATANG

10

PENASIHAT

PN. AKMALYATUN KAMAL BT KAMARUDDIN

TIMBALAN PENGARAH

Cawangan A&P Farmasi BPF, JKN Se-

langor

PENGERUSI

PN. NORHALINA BT SULAIMAN

Pegawai Farmasi UF52

PKD Klang

SETIAUSAHA I

PN. SARAH DIYANA BT SHAFIE

Pegawai Farmasi UF48

Hosp Kajang

SETIAUSAHA II

PN HANIATI BT HASAN

Ketua Pen. Pengarah (A&P) UF52

BPF, Jabatan Kesihatan Negeri Selangor

JK KECIL SAINTIFIK

Aswani Yanti bt Baharuddin Peg.Farmasi UF52 Hosp Ampang

Dr. Wardati bt Mazlan Kepli Peg.Farmasi UF52 Hosp Serdang

Chong Pei Feng Peg.Farmasi UF48 Hosp Sg Buloh

Noorul Aimi bt Daud Peg.Farmasi UF48 Hosp Serdang

Josephine a/l Henry Basil Peg.Farmasi UF48 Hosp Shah Alam

Wan Nor Ashikin bt Wan Ibrahim Ketua Pen. Pengarah Kanan UF52 BPFJKNS

Ruwaida Nur bt Zainol Abidin Peg.Farmasi UF48 Hosp Serdang

Kong Su Shan Peg.Farmasi UF52 Hosp Ampang

Nur Kamalah bt Daud@Mahusain Peg.Farmasi UF52 PKD Hulu Langat

Mogana a/p Mathayena Peg.Farmasi UF44 Hosp Selayang

Puteri Juanita bt Zamri Peg.Farmasi UF48 Hosp Selayang

AHLI JAWATANKUASA R&D FARMASI SELANGOR 2017

JK KECIL LATIHAN

Asmahani bt Ramelan Peg.Farmasi UF52 HTAR

Wong Su Li Peg.Farmasi UF44 PKD Klang

Jaya Mania Rao a/l Ramadoo Peg.Farmasi UF44 Hosp Kuala Kubu Bharu

Teh Wen Yan Peg.Farmasi UF44 HTAJ

Silambarasu a/l Karuppiah Peg.Farmasi UF44 PKD Sabak Bernam

Yah Xin Yun Pen.Pengarah Kanan Farmasi UF44 BPFJKNS

Cindy Fow Peg.Farmasi UF44 Hosp Banting

Dinesh a/l Widiadharan Peg.Farmasi UF44 Hosp Sg Buloh

JK KECIL PENERBITAN

Sia Xin Ni Peg.Farmasi UF44 PKD Gombak

Noor Aini bt Zainal Abidin Peg.Farmasi UF44 Hosp Tanjung Karang

Hazwani bt Harith Peg.Farmasi UF44 Hosp Orang Asli Gombak

Sayeeda Zainab bt Hasnor Peg.Farmasi UF44 PKD Kuala Selangor

Nurul Syazwani bt Mohamad Peg.Farmasi UF44 PKD Kuala Langat

Muhamad Fahmi b Jamil Peg.Farmasi UF44 PKD Petaling

Hafizah bt Hassim Peg.Farmasi UF44 PKD Hulu Selangor

Norfaradila bt Mohamed Peg.Farmasi UF44 PKD Sepang

PENCAPAIAN KAJIAN R&D FARMASI SELANGOR

Ignatius L¹., T. J. Sen¹, W. F. Yen¹, Nor Idha Liana¹, Lina Hazwaniz¹, Dr Laila Kamaliah²

Pharmacy Department, Hospital Selayang

Anaesthesiology Department, Selayang Hospital

INTRODUCTION: HAP and VAP are the second most common causes of nosocomial infection in hospital and reported as the

highest mortality rate compared to other hospital acquired infection. Different regions have different rate of antimicrobial

resistance and pathological pattern. This might imply that available guidelines for the initial empirical treatment would not be able

to provide adequate coverage. This study aims to acquire and establish microbiological data of HAP/VAP in ICU settings,

Selayang Hospital.

METHODOLOGY: A retrospective observational study of ICU adult patients (age ≥ 18 years) in Hospital Selayang based on the

review and data extraction of the selected subjects’ electronic medical records system (EMR) from January to December 2015.

RESULTS: Out of 80 isolates, 78 were gram-negative pathogens and 2 were gram-positive pathogens. The results also revealed

total number of pneumonia which was 76. Most of the samples were from VAP. The most common pathogens are A. baumannii,

P. aeruginosa and K. pneumoniae which were associated with 51%, 20% and 11% of pneumonia, respectively. Among empirical

antibiotics started, carbapenems was the most frequent (42%), followed by cephalosporins (20%) and anti-pseudomonal

penicillins (19%). Empirical antibiotic did not provide adequate antimicrobial coverage in 65% of the non-MRO A. baumannii

isolates. In those isolates, 37.5% of the inadequacy was due to empirical use of cephalosporins and aminopenicillins. A.

baumannii were only found in late onset HAP/VA P whereas P. aeruginosa can be found equally in both early onset and late

onset.

CONCLUSIONS: We were able to precisely determine common pathogens and its susceptibility data. Guidelines completed with

local microbiological data provide better coverage compared to treatment based on the latter alone. We suggest the use of dual

therapy in late onset pneumonia without positive culture. Caution should be exercised when starting very broad spectrum

antibiotics as it can do more harm than good when used without careful considerations.

NMRR ID: NMRR-15-2440-25828

A RETROSPECTIVE STUDY ON LOCAL MICROBIOLOGICAL DATA IN INTENSIVE CARE

UNIT SETTING, HOSPITAL SELAYANG


L. S. Yan1, L. F. Y1., Zailin Junaida M. Z1., Nurul Iffah R1., Sreevidya Kumari K.1., Siti Maryam Z1., P. Vinci1, Mohammad Saiful

B1., Ghaneshwari R1., Dr B. B. Cheak1, Dr W. H. Seng1

Selayang Hospital

INTRODUCTION: There is limited evidence regarding the role of monitoring serum aminoglycosides and vancomycin

concentrations in peritoneal dialysis (PD) patients receiving these antibiotics in PD-related peritonitis.

METHODOLOGY: Data were collected from patients receiving PD in PD unit, Hospital Selayang who experienced PD-related

peritonitis between 1st January 2016 and 30th September 2016. We reported on the therapeutic drug monitoring of gentamicin,

amikacin and vancomycin levels from day 2 until completion of IP antibiotic therapy in PD patients.

RESULTS: Previous dosing regimen of IP gentamicin resulted toxic serum levels in 11%, 50%, 75% and 65% of patients on day

2, 4, 6 and 14 respectively. ISPD recommended dosage of IP gentamicin resulted toxic serum levels in 11%, 15%, 12% and 35%

of patients on day 2, 4, 6 and 14 respectively. Current dosing regimen of IP amikacin resulted in levels greater than 8 mg/L for

0%, 43%, 100% and 71% of patients on day 2, 4, 6 and 14 respectively; whereas IP vancomycin resulted in levels greater than 20

mg/L for 31%, 33%, 0% and 22% of patients on day 2, 4, 6 and 21 respectively.

CONCLUSION: This study demonstrated that drug accumulation occurs with repeated dosing of IP aminoglycosides and

vancomycin. Therapeutic drug monitoring and dosage adjustment are essential to minimize the risk of toxicity. This study will be

continued further to ascertain whether current regimen of IP aminoglycosides and vancomycin adopted results in toxic serum

levels and hence nephrotoxicity after prolonged course of therapy.

NMRR ID: NMRR-15-2189-28501

THERAPEUTIC DRUG MONITORING OF INTRAPERITONEAL AMINOGLYCOSIDES

AND VANCOMYCIN IN PERITONEAL DIALYSIS PATIENTS WITH PERITONITIS AND

THEIR EFFECT ON RESIDUAL RENAL FUNCTION

SELANGOR RESEARCH WEEK 2017


A. Alias, K.Y. Lee, A. Palaniappan, S. Ramaniganthan, K.V. Karuppannan

Pharmacy Department, Hospital Tengku Ampuan Rahimah, Klang

INTRODUCTION: Highly active anti-retroviral therapy (HAART) is a combination of multiple antiretroviral drugs from

different antiretroviral classes required to suppress the virus replication, thus increase the immunological response. In

Malaysia, the agents used for first line treatment include combination of nucleoside reverse transcriptase inhibitor (NRTI)

and non-nucleoside reverse transcriptase inhibitor (NNRTI).

OBJECTIVES: The purpose of this study is to evaluate the factors affecting virological & immunological response and the

incidence of virological failure in association to adherence among HAART naïve patient.

METHOD: The retrospective observational case control study was conducted in RVD Clinic of HTAR, Klang. The total of

130 samples was included. All information was collected analyzed statistically using logistic regression and chi-square test.

RESULTS: As a result, it shown that age, adherence, combination of HAART regimen and NNRTI were the factors that

significantly affect the immunological response (P = 0.03, 0.001, 0.02 & <0.001 respectively). However there is no

significant result with virological response. The level of adherence also was significantly highly associated with faster onset

of virological, immunological response (P<0.05). The higher the score, the more adhere to medication, the faster onset of

virological & immunological response and the less likely to develop virological failure (P<0.001). There were some other

factors that we unable to analyze as time constrain.

CONCLUSION: We believe that our study would initiate an expansion to other study in other centre that allowing

comparison to be made.

ID No.: NMRR-15-235-23954

EVALUATON OF FACTORS AFFECTING VIROLOGICAL AND IMMUNOLOGICAL

RESPONSES OF NEVIRAPINE- AND EFAVIRENZ- BASED HIGHLY ACTIVE

ANTIRETROVIRAL THERAPY REGIMENS IN RETROVIRAL DISEASE NAIVE PATIENTS

Best Oral Presenter


2nd Prize Poster Category

DEVELOPMENT OF WARFARIN APP TO IMPROVE TIME IN THERAPEUTIC RANGE AND REDUCE INCIDENCE OF OVER- AND UNDER-WARFARINIZATION

Shahir Anuar S., Tharshini S., Noor Aini Z. A., Raja Azman R. I.

Pharmacy Department, Hospital Tanjong Karang

INTRODUCTION: The Time in Therapeutic Range(TTR) for warfarin in Hospital Tanjong Karang(HTK) was 46.99%, far

below the target set by WHO (>60%). Moreover, the percentage of under-warfarinization, which puts patients at a higher

risk for thromboembolic events such as stroke was 42.26%. Over-warfarinization, a state where patients are at higher risk

for bleeding events, was 20.08%. These findings are primarily attributed to inaccurate warfarin dosage.

OBJECTIVES: a) To increase average TTR; b) To increase percentage of patients with TTR>60%; c)To reduce percentage

of under-warfarinization and over-warfarinization

METHOD: Our study is a retrospective, observational, cohort study using universal sampling of all patients enrolled in INR

Clinic of HTK, 6 months prior to and after intervention. The strategy is to create a smartphone application to aid healthcare

providers in determining accurate dosages for warfarin. ‘Warfarin Dosing HTK’ is a smartphone application currently

accessible to android users only. The application comprises of three sections; a calculator to calculate warfarin dosage

adjustment, a warfarin-food interaction database, and also a warfarin-drug interaction database.

RESULTS: The average TTR showed an increase of 13.19%, up to 60.18% which achieves the target set by WHO.

Percentage of patients with TTR >60% increased by 15.7%. Both under-warfarinization and over-warfarinization were

reduced by 12% and 3.46% respectively.

CONCLUSION: The app has been proven to improve the management of warfarin patients. Incidence of bleeding and

thromboembolic may be reduced. Results may be replicated if app is used elsewhere. At present, it has been downloaded

more than 10 000 by users from more than 100 countries.


PENYERTAAN PERSIDANGAN YANG LAIN;

1. Hosp. Ampang

Role of intravenous glutamine in haematology patients with chemotherapy induced

oral mucositis

2. PKD Sepang

Prospective observational study of iron preparation presciribing pattern of antena-

tal women attedn the mother and child clinic in Sepang

3. Hosp. Selayang

Peritoneal Dialysis-Related Peritonitis Caused by Achromobactor Denitricants.

Case Report and Review of the Literature

Warfarin Anticoagulation & Outcomes in Petiens with Atrial Fibrillation : A Ret-

rospective Study in Different Types of Ministry Health Treatment Protocol

SELANGOR RESEARCH WEEK 2017 14-16 OGOS 2017

HOSPITAL SELAYANG

17th ASIAN CONFERENCE ON CLINICAL PHARMACY (ACCP) 27-31 JULAI 2017

YOGYAKARTA, INDONESIA

1. Hosp. Tengku Ampuan Rahimah (HTAR)

Evaluaton of Virological and Immunological responses of Nevi-

rapine- and Efavirenz- Based Highly Active Antiretroviral Therapy

Regimens in Retroviral Disease Naive Patients

Evaluation on Effect of Hemodialysis in Vancomycin Level

among End Stage Renal Failure Patients

2. Hosp. Sg. Buloh

A Retrospective Review; Oral Indomethacin vs Oral Paracetamol

for PDA in Neonates

A Review of Guidelines and Evidence Basedbin Managing Sus-

pected Early Onset Neonatal Sepsis

AKTIVITI JK R&D FARMASI SELANGOR JUL—DEC 2017

Mesyuarat JK R&D Bil 2/2017

19 JULAI 2017

03 OGOS 2017

Sesi Pembentangan Kertas Cadangan Penyelidikan Sesi 02/2017 - Tarikh: 3 Ogos 2017 - Para Juri: Pn Asmahani Ramelan, Pn Lee Jian Lynn,

Cik Nor Mazni Bt Mohamad Tamyes, Pn Aliza Alias, Cik Geetha Ng Poh Lee, Pn Adilah Mohd Fazli, Pn SIti Mahanim

03 OGOS 2017

Mesyuarat R&D Jabatan Farmasi, HTAR Klang Agenda:

1) Taklimat 'Introduction to Clinical Research' oleh Pn Lee Jian Lynn

2) Sesi perbincangan Principle Investigator ber-sama penyelidik baru

Penceramah: Pn Lee Jian Lynn

06 DISEMBER

Sesi Pembentangan Kertas Cadangan Penyelidikan Sesi 03/2017 - Tarikh: 6 Disember 2017 - Para Juri: Pn Lee Jian Lynn, Pn Aliza Alias, Pn Siti

Mahanim, Pn Tan Shirlyn

14 DISEMBER

Mesyuarat JK Kecil Penerbitan, JK R&D BIL 2/2017

12-14 SEPTEMBER

Bengkel R&D Farmasi JKNS 2017 - Tempat: PPAS Shah Alam - Penceramah: Assoc Prof Dr Moy

Foong Ming, Faculty of Medicine, UM

AKTIVITI DAN LATIHAN JK R&D FARMASI SELANGOR JUL—DEC 2017

Lokasi ;

Perbadanan Perpustakaan Awam Selangor

Tarikh ;

12-14 September 2017

Penceramah Jemputan ;

Assoc Prof Dr Moy Foong Ming,

Fakulti of Medicine, UM

Objektif;

1. Mendedahkan dan meningkatkan

kemahiran dalam membuat

pembentangan projek penyelidikan

& pembangunan

2. Memantau perkembangan dan

kualiti kajian-kajian saintifik yang

dijalankan dan dijalankan di

peringkat PTJ

3. Menyediakan platform bagi

pembentangan kajian-kajian yang

sedang dijalankan dan yang telah

selesai supaya boleh dibuat

BENGKEL R&D FARMASI JKNS 2017

AKTIVITI DAN LATIHAN JK R&D FARMASI SELANGOR JUL—DEC 2017

Hospital Kajang

Aktiviti R&D : Bengkel Penulisan Manuskrip dan Publication

- Tarikh:30-31/10/2017

- Penceramah: En. Chan Huan Keat, Pegawai Farmasi U48, Pusat

Penyelidikan Klinikal (CRC) Hospital Sultanah Bahiyah

Hospital Selayang

Aktiviti R&D : Basic Study Design Workshop

- Tarikh: 13/2/2017

- Penceramah: Puteri Juanita, Nurah Zainal Abidin, Lee Chee Ming

Aktiviti R&D : Research Proposal Presentation Day

- Tarikh: 21/3/2017

- Penceramah: Nurakmal Baharum (CRC) ,Nadiah Sa’at (CRC),

Dr Neoh Chin Fen

Aktiviti R&D : Statistical Analysis Clinic Day (CRC) Session 1

- Tarikh: 30/5/2017

- Penceramah: Nadiah Sa’at (CRC), Tassha Hilda Adnan (CRC)

Aktiviti R&D : Statistical Analysis Clinic Day (CRC) Session 2

- Tarikh: 4/7/2017

- Penceramah: Nadiah Sa’at (CRC), Tassha Hilda Adnan (CRC)

Aktiviti R&D : Annual Presentation Day

- Tarikh: 18/11/2017

Hospital Sungai Buloh

Aktiviti R&D : Meeting for Research Updates with CRC HSgB

- Tarikh: 13/10/2017

- Penceramah: Nicholas Hing Yee Liang (CRC HSgB)

Hospital Tengku Ampuan Rahimah (HTAR)

Aktiviti R&D : Sesi Pembentangan Kertas Cadangan Penyelidikan

02/2017

- Tarikh:3/8/2017

Aktiviti R&D :Mesyuarat Penyelidikan & Pembentangan Jabatan Far-

masi, HTAR

- Tarikh: 3/8/2017

- Penceramah: Lee Jian Lynn

Aktiviti R&D : Sesi Pembentangan Kertas Cadangan Penyelidikan

03/2017

PROGRAM AKAN DATANG

Tarikh: 4 April 2017 & 7 Ogos 2017

Tempat : Perbadanan Perpustakaan Awam Selangor,

Seksyen 13 Shah Alam

Klinik Mentor - Mentee 2018

Tarikh : 27 - 28 Jun 2018

Tempat: Concorde Hotel, Shah Alam

International Conference on Pharmacy Practice 2018

Tarikh : 14 Mei 2018

Tempat : Wisma MBSA, Shah Alam

Bengkel Research & Oral Presentation 2018

Tarikh : 19 - 21 September 2018

Tempat: Wisma MBSA, Shah Alam

Mini Conference R&D 2018

Tarikh : 9 - 11 Julai 2018

Tempat: Royale Chulan Hotel, Seremban

National Pharmacy R&D Conference 2018

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