Introduction: Self-diagnose and obtaining various health products via the Internet were extremely risky practices as it may increase the risks of patient injury or even death. Objective: This study aims to explore the patterns of prescription medicines sale through e-marketplace (specifically: Shopee) in Malaysia as well as the associated factors. Method: Cross-sectional study secondary data of 983 Advertisement Screening Reports (reported from 1st January 2020 - 30th June 2020) in Johor State were collected. Descriptive statistics using frequency, percentages and/ bar charts using Microsoft Excel 2013 were used to report on the patterns of prescription medicines sale through e-marketplace (specifically: Shopee) in Malaysia based on types of prescription medicines that are being advertised, registration status of prescription medicine that are being advertised as well as frequently violated Malaysia’s law related to prescription medicine by sellers on Shopee. Factors associated were explored by Simple and Multiple Logistic Regressions using IBM SPSS Version 22. Results and Discussion: 796 out of 852 (93.4%) prescription medicines samples were not registered with the Drug Control Authority, Malaysia’s Health Ministry. Hormones (62.6%, while sex hormones which were anabolic steroids showed the highest frequency; 58.3%) were the highest prescription medicines sold through the e-marketplace in Malaysia, followed by antibiotics, clomiphene (fertility drug), sibutramine (slimming pill) and prostaglandin and its synthetic derivatives (abortion pill) denote 4.8%, 2.2%, 1.8%, 0.4% respectively. The unregistered prescription medicines were found to be the highest to violate Section 13(a) of Poison Act 1952 which include 766 samples. Multiple logistic regression tests indicate that sellers who violated Regulation 7(1)(a) of Control of Drug and Cosmetic Regulations 1984 (Adjusted OR: 728.63; 95%CI; 194.69, 2726.96%; p = 0.000) have higher chance to sell unregistered medicines through e-marketplace compared to those who violated Section 13 (a) of Poison Act 1952 (Adjusted OR: 0.012; 95%CI; 0.002, 0.058%; p = 0.000), and Section 4B of Malaysia Advertisement and Sale Act 1956 (Adjusted OR: 0.060; 95%CI; 0.014, 0.260%; p = 0.000). Conclusion: The findings in this study may give a brief idea for improving the current practice in order to curb the freely illegal prescription medicines sale through e-marketplace (specifically: Shopee) without the supervision of professionals.

Background: Paracetamol may be used as an antipyretic agent for the treatment of fever, as well as an analgesic in the treatment of mild to moderate pain post-vaccination in infants. The use of paracetamol during fever may be or may not be recommended since it may alter the natural human body immune response, although it may reduce fever and fussiness. Objectives: The aims of this study are to describe the effectiveness of breastfeeding in reducing pain and paracetamol in reducing fever and pain post infant vaccination. Methods: Data sources and study selection was conducted by electronic searching of six databases. Manual reference checks of all articles on paracetamol and breastfeeding post infant vaccination published in the English language between 1978 and 2017. Two levels of screening were used on 9614 citations, which include screening of abstracts and titles followed by full text screening. The data synthesis were tabulated into study characteristics, quality, and effects. Results: Systematic review of breastfeeding included three studies from 9614 database searches found significant benefit from breastfeeding in pain scores and the duration of crying, as well as behavioural changes. None of the studies stated the detriment of breastfeeding before, during, and after immunization. Systematic review of paracetamol effectiveness included four studies from 1177 database searches found significant benefit from prophylaxis paracetamol in fever, one study found significant benefit from prophylaxis paracetamol in fussiness, and one study’s results were found to be not significant. Two studies on evaluating the safety of prophylactic paracetamol in 2009 found that antibody responses to several antigens were significantly reduced, and the other study in 1988 found that antibody titres to DTP bacteria of placebo and PCM did not differ significantly. Conclusions: The relevancy of giving paracetamol post all types of vaccination may be questionable. Breastfeeding before, during, and after immunization are recommended for pain reduction and are proven effective. Further research is required in deciding if paracetamol is to be of rational use following infant immunization.

Introduction: Practice of dispensing paracetamol (PCM) in post infants’ vaccination remains debatable in Malaysia as the administration of PCM postvaccination in infants was found to cause the vaccine to be less effective, thus requiring appropriate regulation measures. Objective: This research aimed to investigate the prevalence of adverse events following immunization (AEFI) with/without PCM to be prescribed post infants’ vaccination in Malaysia (possible associated factors: age, types and stages of vaccination, concomitant vaccines and drugs, and/vitamins). Materials and Methods: A retrospective cross-sectional study was conducted from 2011 to 2017. The AEFI was extracted from Quests 2, 3, and 3+ System of National Pharmaceutical Regulatory Agency (NPRA). The population of vaccinated infants was obtained from the Ministry of Health (MOH) Malaysia official website. The AEFI data were further categorized into (i) AEFI with possibility for PCM to be prescribed, and (ii) AEFI with no possibility for PCM to be prescribed. The data were analyzed using Microsoft Excel 2013, Portland, USA simple and multiple logistic regression tests, Statistical Package for the Social Sciences (SPSS) software programme, version 22.0 (IBM), New York, USA. Result: Various AEFI cases (359 infants) were reported. DTaP/Hib/IPV and measles–mumps–rubella (MMR) showed higher prevalence of AEFI with/without PCM to be prescribed post infants’ vaccination cases per 100,000 population (2.07 and 2.21, respectively) than other types of vaccinations. DTaP/Hib/IPV (2 months) vaccination showed the highest value (3.00) among other age groups. Backward elimination presented DTaP/Hib/IPV (3–4 months) (95%CI; 0.231, 0.899%; P = 0.023) was the possible associated factor. Hepatitis B (1–5 months), DTaP/Hib/IPV (3–4 months), DTaP/Hib/IPV (5–12 months), concomitant vaccines as well as concomitant drugs and/ vitamins were the identified potential cofounders. Conclusion: Prescribing and dispensing of PCM post infants’ vaccination may be confined to DTaP/Hib/IPV (2–4 months) and 12 months MMR groups.

Pharmacists may play a crucial role in enhancing the primary care (PC) system by offering convenient patient care and leveraging their expertise to promote community health through pharmaceutical care and value-added services. Given the significant healthcare issue of Type 2 Diabetes Mellitus (T2DM) in Malaysia and other Asian countries, the associated treatment costs have become a global economic concern. The increasing prevalence of T2DM in Malaysia, particularly among older adults, is intensifying its clinical and economic impact on the country. To address this, the current study aims to evaluate the effectiveness of PC pharmacies using the Quality and Costs of Primary Care (QUALICOPC) Survey, which is widely used in Europe and other developed and developing countries. This research seeks to collect experience and value feedback from older adults with T2DM or their caregivers, and job satisfaction feedback from pharmacy staff. Additionally, the quality of life (QOL) of older adults with T2DM will be assessed among the patients who are respondents in this study. This study will use the adapted and validated QUALICOPC questionnaires that are in line with international standards and tailored to the Malaysian context. An expert panel, including the Pharmaceutical Services Division of the Ministry of Health (MOH) Malaysia and the Kulliyyah of Pharmacy at the International Islamic University Malaysia (IIUM), has been involved in the content validity of the adapted QUALICOPC questionnaires. The QUALICOPC questionnaires will be validated for the construct with a minimum of 38 samples for each client experience questionnaire, 30 samples for each value questionnaire, and 19 samples for the staff questionnaire. The survey will involve 192 samples from each group of T2DM older adults or caregivers and all corresponding public PC pharmacy staff. The QOL will be evaluated using the EuroQol (EQ) 5-dimensions 5-levels [EQ-5D-5L] and an EQ visual analog scale (EQ-VAS). The findings from this study will be valuable for informing the World Health Organization (WHO) and the Malaysian government in designing more effective health policies.

Objective: This study obtained information on Paracetamol (PCM) Dispensing Practice of Government Health Clinics (GHC) post infants’ vaccination in Malaysia as well as identify its possible factors. Methods: This descriptive cross-sectional retrospective study (with convenient sampling) using a data collection form (DCF) to collect data. The pharmacist who is the representative of the GHC filled the DCF. Potential risk factors were evaluated by Pearson chi-square tests (expected count<5 is<20%) for an independent sample. Results: A total number of 254 samples were collected all over Malaysia within the period of data collection, but only 248 that met inclusion criteria. The PCM dispensing practice of GHC in Malaysia for a total period of 3 y back (from 2015-2017), tend not to give PCM post immunization with respect to age of the upon vaccination and types of vaccination, conversely for gender. Trends of PCM dispensing practice were increasing for “Not Give PCM” with respect to gender, age of the baby upon vaccination, and types of vaccination from 2015 till 2017. The PCM dispensing practice had no association with no statistically significant value (p=0.804) on genders and a weak positive association with statistically significant value (p<0.05 each) on age of the baby (≤ 1year) upon vaccination and types of vaccination. Conclusion: Future research which may include the actual practice in which practices of prescribers or mother may be conducted in determining more accurate data on the giving PCM post infant’s vaccination.