Pusat Pengajian Sains Farmasi - Tesis

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Pharmacoeconomic Studies Of Breast Cancer Early Detection Programme In Malaysia
(2025-09)
Yeong, Siew Wei
The incidence of breast cancer continues to increase in malaysia, with 50.5% newly diagnosed at stages iii and iv. Various studies reported mixed outcomes of the cost-effectiveness of breast cancer early detection programmes among low- and middle-income countries. Our study aims to estimate the cost-effectiveness of breast cancer early detection programmes (bcedp) through a markov model for a malaysian population. The markov model was constructed following the transition from lower to advanced stages with death as the end stage, in a lifetime horizon. We compared clinical breast examination (cbe), mammography (mmg), and a combination of cbe and mmg to no programme for women aged 40 and older. This model was used to forecast the three programmes' lifetime costs and health outcomes from the payer's and societal perspectives. The sample size was initially calculated to be 268 for both the cost data and health outcomes of utilities, with an adjustment calculated due to the addition of data collection sites. Cost data were obtained from breast cancer patient profiles in hospital kuala lumpur, and a patient survey was conducted to obtain the utility data from a few hospitals. Sensitivity analysis was conducted to address the uncertainty in parameters. A willingness-to-pay (wtp) threshold of one gross domestic product at rm51,830 (1 usd = rm4.4497, 2023) was used in this study. Quality adjusted life years (qaly) gained were calculated by the quality of life, with the length of life gained as the health benefit of an intervention when compared to no exposure to bcedp
Evaluation Of Current Practices Of Antimicrobial Use Among Neonates And Children In Selected Hospitals Of Punjab, Pakistan
(2025-06)
Mustafa, Zia Ul
Excessive and inappropriate use of antibiotics are one of the principal drivers of antimicrobial resistance (amr) including children. Consequently, the judicious and optimal use of antibacterial agents is an urgent need under pediatric oriented antimicrobial stewardship program (asp). There are considerable concerns with current high levels of inappropriate antibiotic use across all sectors in pakistan and the subsequent implications for amr. However, more information is needed, especially following the covid-19 pandemic, to achieve future targets. Consequently, the objectives of the study were to ascertain the current practices of antimicrobial use among neonates and children across hospitals in punjab, pakistan, combined with the current knowledge of asps and their implementation among pediatricians, to provide future guidance to all key stakeholder groups in pakistan. The world health organization (who) developed a standardized methodology to ascertain current antibiotic prescribing practices in hospitalized settings named “point prevalence survey (pps)”, which was adopted for the pps studies in this phd. In the first phase of this study, a multicenter pps was conducted among leading children’s hospitals in the public sector in pakistan treating infants and children as well as in the children wards of fourteen tertiary care health settings in the largest province,
Evaluation Of Management, Treatment Outcomes, And In-Depth Analysis Of Pediatric Drug-Resistant Tuberculosis Patients In Punjab And Khyber Pakhtunkhwa, Pakistan
(2025-05)
Said, Muhammad Soaib
Drug-resistant tuberculosis (dr-tb), particularly multidrug-resistant (mdr) and extensively drug-resistant (xdr) tb, presents a significant public health challenge, especially in high-burden countries like pakistan. Managing pediatric dr- tb is complex, requiring a thorough understanding of treatment outcomes, drug resistance patterns, adverse drug reactions (adrs), and sputum culture conversion. This study aimed to assess risk factors associated with second-line drug (sld) resistance in pediatric dr-tb patients, evaluate treatment outcomes and unsuccessful treatment predictors, and analyze adr incidence and impact. Additionally, the study examined the rate and predictors of sputum culture conversion in mdr-tb patients. Conducted in two phases, the retrospective phase (2015–2021) analyzed data from programmatic management of drug-resistant tb (pmdt) sites, identifying key socio-demographic and clinical characteristics. Among 491 dr-tb patients, 52.5% were female, 60.5% were aged 5–14 years, and 51.9% resided in urban areas. Notably, 90.4% were underweight, and 99.4% were hiv-negative. Retreatment cases comprised 74.3%, and 70.3% had mdr-tb, with pulmonary involvement in 95.1%. Laboratory findings indicated high resistance to first-line drugs, including isoniazid (68.4%), rifampicin (61.7%, p=0.026), pyrazinamide (76.2%), and ethambutol (84.1%).
Evaluation Of Treatment Outcomes And Prognostic Factors In Managing Children With Steroid Sensitive Nephrotic Syndrome In Malaysia
(2025-05)
Mohamad, Khairunnisa
Steroid sensitive nephrotic syndrome (ssns) in children generally has a positive prognosis, yet a subset experiences frequent relapses or steroid dependent nephrotic syndrome (fr/sdns), posing management challenges. Steroids, mainly prednisolone, are the first-line treatment, with steroid sparing agents (ssas) reserved for ongoing relapses, steroid toxicity, or persistent steroid dependency. Despite evolving treatment protocols, studies on ssns management outcomes in malaysian children remain limited. Therefore, this study aimed to assess treatment outcomes and identify prognostic factors influencing fr/sdns development and the need for ssa. This retrospective multicentre cohort study followed 216 children with ssns for a median of 3.4 years (range 1.0–15.0). Among them, 58.8% developed fr/sdns, 27.3% had infrequent relapses, and 13.9% achieved sustained remission. The initial steroid protocol, either short or prolonged, did not influence fr/sdns risk (p=0.619). However, fr/sdns patients experienced earlier first relapses (median: 4.2 months, range: 1.0-37.7) and a higher incidence of steroid-related adverse effects (50.4%). A relapse within six months of diagnosis was strongly associated with fr/sdns development (adjusted odds ratio [aor] 7.04, 95% ci 3.53-14.02).
Formulation And Evaluation Of Liquid Crystalline Nanostructures For The Pulmonary Delivery Of Docetaxel
(2025-05)
Yousif, Ibrahim M. Abdulbaqi Almalla
Lung cancer is the leading cause of cancer-related deaths worldwide. Docetaxel (dtx) is a widely used chemotherapeutic agent; however, its poor solubility, low bioavailability, and high systemic toxicity limit its therapeutic efficacy. Conventional intravenous formulations utilise ethanol and surfactants such as polysorbate 80 (tween 80®), which cause severe adverse effects, including nephrotoxicity and hypersensitivity. This underscores the need for targeted drug delivery to enhance dtx efficacy while minimising systemic toxicity. Pulmonary delivery via lipid-based nanoparticles, particularly liquid crystalline nanostructures (lcns), presents a non-invasive and efficient approach with improved patient compliance. This study aimed to develop and characterise inhalable dtx-loaded lcns for pulmonary delivery, optimising anticancer efficacy while potentially reducing adverse effects. Lcns were prepared via extrusion, ensuring minimal dispersed phase loss and structural integrity. Small-angle x-ray scattering (saxs) confirmed cubic internal nanostructures, validating extrusion as a scalable fabrication method. A series of four full factorial experiments yielded 40 formulations, of which 11 met the selection criteria of highest lipid content, smallest particle size (ps), and a polydispersity index (pdi) < 0.25. Dtx was loaded at 2, 5, and 10 mg/ml, with 5 mg/ml identified as optimal.

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