Background: We aimed to investigate the efficacy of ascorbic acid and acetylsalicylic acid among type II diabetes mellitus patients using metformin (only) for diabetes management therapy. Method: A 12-month single blinded multicenter randomized control trial was designed to investigate the measured variables [Glycated Hemoglobin (HbA1c), Renal function, Albumin Creatinine Ratio (ACR) etc.]. The trial was randomized into 2 experimental parallel arms (ascorbic acid vs acetylsalicylic acid) were blinded with study supplements in combination with metformin and findings were compared to control arm with metformin alone and blinded with placebo. Withdrawal criteria was defined to maintain the equity and balance in the participants in the whole trial. Finding: Patients with metformin and ascorbic acid (parallel arm I) was twice more likely to reduce HbA1c than metformin alone (control arm) in a year (OR 2.31 (95% CI 1.87–4.42) p < 0.001). Also Parallel arm I was ten times more likely to reduced risk factors contributing to long-term diabetes complications than participants of arm II in a year (OR 10.38 (95% CI 6.91–15.77) p < 0.001). In contrast, parallel arm II patients were seven times more effective to reduce the risk of expected CVD development in 10 years than arm I (OR 7.54 (95% CI 3.76–10.32) p < 0.001). Conclusions: The trial concluded that ascorbic acid with metformin is more effective against reducing risks for diabetes related long-term complications (including ACR). TRIAL details Registration No: NTR-6100, Registry Name: Netherlands Trial Registry, URL: http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=6100, Date of Registration: 20th October, 2016, Date of first Enrollment: 1 November, 2015.

In recent times the basic understanding, perceptions and CAM use among undergraduate health sciences students have become a topic of interest. This study was aimed to investigate the understanding, perceptions and self-use of CAM among pharmacy students in Malaysia.

Ensuring drug safety among the patients is the main domain of pharmacovigilance activities worldwide. A pharmacovigilance system was established in the United Arab Emirates (UAE) in 2008. Research evidence reflects that the current system is lacking in active participation from patients, and also, the inadequate role of healthcare professionals is anticipated. In this context, it is pertinent to know the general public’s understandings and their patterns of safe use of medication, which are unexplored areas in Dubai, UAE. The current study aimed to explore the public views, attitudes, and experiences toward medication safety, and to explore key factors enhancing the safe use of medications among the public in Dubai. This study adopted a qualitative approach and face-to-face, 14 in-depth interviews with public individuals, selected purposively using the snowball sampling technique. The interviews were conducted in different places in Dubai recorded and transcribed verbatim and thematically analyzed for data analysis. Reporting of adverse drug reaction was not well-known among all the participants. Public views towards safe use of medicines were limited to the side effects of the consumed medicines only, and to a lesser extent to the inappropriate indication and dosage. Most of the participants mentioned that gaining knowledge about the side effects of the prescribed drug was the main reason for reading the patient information leaflet. Quite a few participants have experienced side effects while consuming their medicines and they were unsure of how to deal with the situation. The current research also reflected the lack of proper communication between pharmacists and physicians in managing drug safety issues. Conclusively, the current research revealed gaps in public views regarding medication’s safety, which consequently may impact their attitudes during the course of medication use. Efforts need to be strengthened to enhance positive views and attitudes of the public towards medication safety and ADR reporting in the UAE.

Practicing evidence based medicine (EBM) is a professional need for the future clinical pharmacist in UAE and around the world. An attempt was made to evaluate pharmacy student's knowledge, attitude and proficiency in the practice of EBM. A within-subject study design with pre and post survey and skill test were conducted using case based practice of EBM through a validated questionnaire. The results were tabulated and there was a statistically significant increase in pharmacy students' perceived ability to go through steps of EBM, namely: formulating PICO questions (95.3%), searching for evidence (97%), appraising the evidence (81%), understanding statistics (78.1%), and applying evidence at point of care (81.2%). In this study, workshops and (Problem Based Learning) PBLs were used as a module of EBM teaching and practices, which has been shown to be an effective educational method in terms of improving students' skills, knowledge and attitude toward EBM. Incorporating hands on experience, PBLs will become an impetus for developing EBM skills and critical appraisal of research evidence alongside routine clinical practice. This integration would constitute the cornerstone in lifting EBM in UAE up to the needed standards and would enable pharmacy students to become efficient pharmacists that rely on evidence in their health practice.

We aimed to evaluate and determine the effect of diabetes mellitus (DM) on overall survival (OS) and cancer-specific survival (CSS) in early stage cervical cancer (CC) patients. Patients with primary cervical cancer and newly diagnosed were selected from ten different cancer specialist hospitals of Malaysia. Patients’ demographic and clinical data were obtained for the prognostic analysis. Kaplan-Meier method was used to estimate patients’ survival time (CSS and OS) with DM status and values were compared using the log-rank test. A total of 19,785 newly diagnosed CC patients were registered during 2010–2016, among them only 16,946 (85.6%) with primary CC tumor. There was no difference in treatment modality between DM and non-DM patients. However intergroup assessment showed that type 2DM have significantly higher rate of mortality in both overall mortality (28.3%) and CC-specific (11.7%) as compared to Type 1DM (17.3%; 5.5%) and non DM patients (12.7%; 9.1%) (p < 0.001). Within group assessments showed that Type 2DM patients have better quality of life (mean 7.13 ± 3.67) (p < 0.001) and less distress levels (mean 2.41 ± 0.63) (p < 0.011) as compared to type1 DM (meant 10.54 ± 2.11; 3.19 ± 1.07). This study concluded that T2DM prognostic effect still remained after adjusting demographic and clinical parameters. Type 1 diabetes mellitus showed better OS and CSS then type2 DM.

Background/Aim: Diabetes mellitus (DM) is a considerable systemic metabolic disorder to exhibit various metabolic and cardiovascular disorders, mainly hyperglycemia. Our study aims to evaluate oxidative stress markers in DM patients and to determine the clinical correlates affecting the investigational parameters. Methodology: To evaluate oxidative stress, the following parameters were included: tri-glycerides(TG), total cholesterol, low density lipoprotein cholesterol(LDL), oxidized LDL cholesterol(Ox LDL), superoxide dismutase(SOD), glutathione peroxidase(GSH-Px) and plasminogen activator inhibitor(PAI) which were measured at single observation point. Patient clinical and demographic data were taken from registered medication profiles from the Outpatient Department. Results: The diabetic subjects have significantly high measured values of endocrine(p<0.01), metabolic(p<0.01) and antioxidant parameters(p<0.05), and have significant higher values of TG(3.69±1.27 vs 1.79±0.84 mmol/L, p< 0.01), Ox LDL(85.37±19.1 vs 77.11±26.64 mmol/L, p<0.05) and SOD enzyme activity(918.78 ± 145.39 vs 880.08±149.52 U/g Hb, p<0.05) compared to the controls. A significant negative correlation was found between Ox LDL and HbA1c(r = -0.6782, p < 0.001) among diabetic subjects. Elevated Ox-LDL, SOD and GSH-Px are associated with the diabetic patients. However, oxidative stress threshold values also showed high oxidative activity markers among controls. Clinical variables showed predictive information on oxidative activity among diabetes patients.