Background: In the treatment of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSIs), vancomycin stands as the prevalent therapeutic agent. Daptomycin remains an alternative antibiotic to treat MRSA BSIs in cases where vancomycin proves ineffective. However, studies have conflicted on whether daptomycin is more effective than vancomycin among patients with MRSA BSI. Objective: To compare the effectiveness of daptomycin and vancomycin for the prevention of mortality among adult patients with MRSA BSI. Methods: Systematic searches of databases were performed, including Embase, PubMed, Web of Science, and Cochrane Library. The Newcastle Ottawa Scale (NOS) and Revised Cochrane risk-of-bias tool for randomized trials (RoB 2) were used to assess the quality of individual observational and randomized control studies, respectively. Pooled odd ratios were calculated using random effects models. Results: Twenty studies were included based on a priori set inclusion and exclusion criteria. Daptomycin treatment was associated with non-significant lower mortality odds, compared to vancomycin treatment (OR = 0.81; 95% CI, 0.62, 1.06). Sub-analyses based on the time patients were switched from another anti-MRSA treatment to daptomycin demonstrated that switching to daptomycin within 3 or 5 days was significantly associated with 55% and 45% decreased odds of all-cause mortality, respectively. However, switching to daptomycin any time after five days of treatment was not significantly associated with lower odds of mortality. Stratified analysis based on vancomycin minimum inhibitory concentration (MIC) revealed that daptomycin treatment among patients infected with MRSA strains with MIC≥1 mg/L was significantly associated with 40% lower odds of mortality compared to vancomycin treatment. Conclusion: Compared with vancomycin, an early switch from vancomycin to daptomycin was significantly associated with lower odds of mortality. In contrast, switching to daptomycin at any time only showed a trend towards reduced mortality, with a non-significant association. Therefore, the efficacy of early daptomycin use over vancomycin against mortality among MRSA BSIs patients may add evidence to the existing literature in support of switching to daptomycin early over remaining on vancomycin. More randomized and prospective studies are needed to assess this association.

Introduction: Pharmacists are furnished with expert drug knowledge and have been considered as valuable resource of drug information, therefore, are well positioned to play a leading role in the application of pharmacogenomics (PG) in to clinical practice. This might prevent Chemotherapy related adverse events and improve patient outcomes, despite the ethical, privacy concerns and potential implications of lifelong genetic-data. Methods: This review is to evaluate and digest the various studies on Knowledge, Attitudes and Practice concerning pharmacogenomics among pharmacists and to suggest future research areas. 13 English published studies from 2004 to 2014 were selected. Studies involving Pharmacists of different area of practice and covering research from different continents were selected. Only studies onattitudes, knowledge and practice concerning pharmacogenetics among pharmacists from 2004 to 2014, and researcharticles published in English were selected. Non-research articles, studies done on general public; studies conducted among other healthcare professionals; studies on genetics of diseases or toxicogenetics were excluded. Results: Knowledge and practice regarding pharmacogenetics among pharmacists were poor despite good attitudes. There was knowledge advancement from 38% in 2005 to more than 50% in 2013 in some countries. Some barriers to adoption of pharmacogenomics into patient care and interventional recommendations were highlighted. Conclusion: there is an urgent call for additional training of Pharmacogenomics among pharmacists and to incorporate pharmacogenomics into curriculum of pharmacy schools. Pharmacists and future pharmacists should be trained on how to critically evaluate the use, efficacy, and safety of available pharmacogenetic testing. Key words: KAP, Pharmacogenomics, Pharmacogenetics, Pharmacists, Systematic Review.

Background: Occupational Violence is prevalent among healthcare workers, including pharmacists, and poses a big threat to their job satisfaction, safety, and social wellbeing. Objective: This study seeks to assess the incidents and factors associated with occupational violence towards pharmacists in Nigeria. Methods: A cross-sectional study was conducted among pharmacists practicing in Nigeria, using an online survey (Google FormTM). Occupational violence was assessed using a validated questionnaire. The survey was conducted and reported based on the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). Participants were recruited by sharing the survey link via social media platforms including WhatsApp, Facebook, LinkedIn, and Twitter. Results: A total of 263 respondents returned the online questionnaire, with a completion rate of 99.2%. The prevalence of occupational violence was 92.7% (95% CI, 90 to 96). Violent events occurred among 48.7% of pharmacists with at least six years of experience, and 68.4% of hospital pharmacists. The commonly reported factors associated with the violence include long waiting times in the pharmacy (36.5%), refusal to fulfil aggressor’s demands (22.1%), and counseling/poor communication (21.7%). Events related to verbal abuse were reported among 95% of the participants. The prevalence of violence was significantly higher among hospital pharmacists, compared with those practicing in administration/regulatory, and in community pharmacies (chi-square=10.213 (2); p=0.006). Similarly, physical aggression was higher among hospital pharmacists (chi-square=10.646 (2), p = 0.005). Conclusions: The prevalence of occupational violence towards pharmacists practicing in Nigeria appeared to be high. Major factors associated with the violence were refusal to fulfil aggressors’ demands and frustrations due to long waiting times at pharmacy. Recommended strategies to slowdown the incidences of violence were improved pharmacists’ workforce, interprofessional harmony, and penalties against perpetrators.

Objectives: The objectives of this study were to assess the general public views and familiarity toward electronic cigarette (e-cigarette) in Kuantan, Malaysia. Methodology: A total of 277 Kuantan people were involved in this study. The questionnaire was distributed at random in shops, businesses, and public places in Kuantan. Statistical analysis was performed using SPSS (version 17.0). Results: From 400 participants, a total number of 277 (160, 57.7% men and 117, 42.4% women) respondents completed the questionnaire. The mean age was 26.89 ± 9.8 years old. The majority of the study participants were male (57.7%), Malay (83.8%), Muslims (83.8%), singles (69%), and employed (75.8%), with about 83 (29.9%) of the respondents were smokers. The prevalence of e-cigarettes smokers was found to be only 1.4% (n = 4). About one-third of the respondents (n = 72, 26%) have tried e-cigarette before. Job status was significantly associated with smoking e-cigarette among the population (P = 0.02). Main factors for a person to start e-cigarette smoking were curiosity (37.5%) and cheaper price (40.8%). Majority of respondents agreed that e-cigarette would not affect health as normal cigarette, and that variety of flavors contribute to better enjoyment (51.6% and 66.7%, respectively). Conclusion: The results of the current study demonstrate that the prevalence of e-cigarettes smoking and its popularity, familiarity, and knowledge are still insufficient among Kuantan population. Further studies should be done to tackle this problem before it getting worse.

The round-the-clock demands of healthcare services, coupled with the shortage of healthcare providers in many parts of the world, have made shiftwork widespread among healthcare workers. Understanding how to mitigate unfavourable effects of shiftwork on well-being is essential to improve health promotion, to prevent disease prevention, and to increase quality of life. This comprehensive review aims to present evidence linking shiftwork with cardiovascular diseases and cancers among healthcare workers. Several studies have demonstrated evidence indicating the relationship between long-term exposure to shiftwork tempo and a higher risk of cardiovascular diseases. Health workers are increasingly witnesing unfavourable effects of shiftwork on their health state. Shiftwork disturbs circadian rhythm and cardiopulmonary processes, leading to adverse health outcomes. Increasing prevalence of shiftwork in healthcare industries due to population expansion and public health threat of cancers call for investigation towards a better understanding of the underlying mechanism of shiftwork-induced diseases. The shift work period has been considered in different studies using various criteria, resulting in inconsistent definition of measurement criteria leading to misclassification of the study population. There is a need for a more considerable and holistic effort towards standardization of shiftwork definition and conduct an assessment to establish a more conveniently appliacable framework for intervention strategies.