Asian Pacific Journal of Tropical Medicine

4-11

Authors: Ni Wayan Anantika Riani, I Gde Raka Widiana, Yenny Kandarini

Objective: To investigate the difference in serum ferritin levels between deceased and surviving regular hemodialysis patients with COVID-19. Methods: We conducted a systematic search across four databases following the PRISMA statement guidelines. Studies reporting ferritin levels and mortality of regular hemodialysis patients with COVID-19 were included. Employing the random-effects model, we performed a meta-analysis to determine the mean difference in serum ferritin levels between the studied groups, along with their corresponding 95% confidence intervals. The meta-analysis was carried out using Review Manager 5.4 and Stata 16. Results: A total of 1 013 patients from seven studies were included in this study. Our meta-analysis showed higher mean serum ferritin in the deceased compared to surviving regular hemodialysis patients with COVID-19, with a mean difference of 449.43 ng/mL [95% CI (244.07, 654.80), P<0.000 1; I2=58%, P=0.003]. Conclusions: Our study found a higher mean of serum ferritin levels in the deceased compared to surviving regular hemodialysis patients with COVID-19.

21-29

Authors: Ahlam Sundus, Renukha Sellappans, Tan Maw Pin

Objective: To explore existing practices and challenges in the delivery of geriatric home medication review (HMR). The study was part of a larger study aimed to offer solution to expand the range of geriatric HMR. Methods: This study employed qualitative exploratory design through semi-structured individual in-depth interviews with the public pharmacists involved in the delivery of geriatric HMR at public hospitals. The purpose of the interviews was to explore challenges faced by them in the delivery of geriatric HMR. Results: Based on the emerging themes from the qualitative data, the study reveals that geriatric HMR in Malaysia is integrated as part of multidisciplinary home care visits, encompassing a diverse patient population with various healthcare needs. However, it faces challenges such as the lack of outcome monitoring, formal training, and workforce constraints. Despite these hurdles, there is a pressing need for the expansion of this service to better serve the community, and collaboration with community pharmacists holds potential to broaden its scope. Ultimately, the findings suggest that pharmacistled HMR is both warranted and feasible within the Malaysian healthcare context. In order to optimize medicine-use among older people living in the community, approaches for expanding geriatric HMR services in Malaysia must be developed. Conclusions: This study holds profound implications as it attempts to illuminate policy makers in developing countries, enabling them to formulate effective HMR plans. By considering the challenges highlighted within this research, policy makers can design a comprehensive HMR service that caters adeptly to the healthcare needs of the mass population.

39-42

Authors: Hekmatollah Khoubfekr, Mohammad Jokar, Vahid Rahmanian, Hasan Blouch, Mohammad Reza Shirzadi, Rouzbeh Bashar

Rationale: Rabies is a zoonotic disease with a high mortality, primarily transmitted through the bite of infected mammals, particularly dogs and cats. Despite being a well-known disease since ancient times, it continues to cause a significant number of human deaths worldwide, with approximately 65 000 fatalities reported annually. Patient concerns: We present two fatal cases of rabies in a 12-yearold immigrant boy and a 7-year-old boy. The first case was subject to a 24-hour delay in receiving appropriate medical attention and rabies preventive measures due to the lack of awareness among emergency hospital staff, leading to the administration of wound dressing only. The second case received timely rabies immunoglobulin administration; however, there was a 4-day delay in administering the fourth dose of the rabies vaccine, despite presenting evident symptoms of rabies. Diagnosis: Postmortem examination of brain samples from both patients confirmed the presence of rabies virus. Interventions: Post-exposure prophylaxis for rabies. Outcomes: Both patients were admitted to the hospital after the manifestation of rabies-related symptoms, with the 12-year-old child seeking medical care 47 days after the animal bite and the 7-year-old child seeking medical care 58 days after the exposure. Finally, the first patient died after 27 days and the second patient died after 40 days of hospitalization. Lessons: There is an urgent need for heightened awareness and education among both healthcare professionals and the public regarding the urgency of seeking immediate medical attention after potential rabies exposure. Timely recognition and initiation of postexposure prophylaxis are pivotal in preventing the progression of the disease. Strengthening surveillance and reporting systems, coupled with continuous training for healthcare professionals, can contribute to early detection and management of rabies cases.

45-46

Authors: Sheikh Mohd Saleem, Shah Sumaya Jan

None.