Journal of Pharmacy

Medical Cannabis Regulation in East and Southeast Asia: A Scoping Review and Policy Insights for Malaysia

2025-08-08T21:15:02+08:00

Introduction: A global shift towards legalising cannabis for therapeutic use has sparked significant debate in East and Southeast Asia, a region historically defined by stringent anti-narcotics laws. As nations navigate the tension between therapeutic evidence and public health concerns, regulatory responses have diverged, ranging from progressive legalisation to the continuation of strict prohibition. Methods: This scoping review examines the regulatory frameworks across Indonesia, Malaysia, Thailand, the Philippines, South Korea, Singapore, and Japan to identify divergent models, persistent challenges, and potential policy insights for Malaysia. Results: The findings reveal a fragmented landscape. Thailand is a regional outlier, having legalised medical cannabis through a controlled system integrating pharmaceutical and traditional medicine. Japan permits only cannabidiol products with negligible tetrahydrocannabinol. Conversely, countries like Indonesia, Singapore, and the Philippines maintain strict prohibition with severe penalties, despite ongoing debates and legislative proposals. This regulatory diversity highlights the tension between public health concerns, economic opportunities, and treaty obligations. For Malaysia, a cautious, incremental policy reform guided by scientific evidence is recommended. Conclusion: Adopting a regulated CBD-only framework could offer Malaysia a low-risk entry point, balancing therapeutic potential with strict controls. The study underscores the need for evidence-based strategies and stakeholder engagement to facilitate safe patient access while minimising risks of misuse.

Flavonoids as Antidiabetic Agents, Challenges and Future Directions

2025-08-08T21:10:39+08:00

Diabetes is a global health concern, affecting hundreds of millions of people worldwide. The number of adults living with diabetes has risen dramatically, from approximately 200 million in 1990 to nearly 589 million in 2024. Type 2 diabetes (T2DM) accounts for 90% of all cases. The incidence is increasing more rapidly in low- and middle-income countries than in high-income countries. By 2050, the number of people with diabetes is likely to reach over 853 million. Diabetes was the ninth leading cause of death globally in 2020, contributing to over 2 million deaths annually. In 2021, diabetes and kidney disease due to diabetes were responsible for more than 2 million deaths, and approximately 11% of cardiovascular deaths were associated with high blood glucose (International Diabetes Federation, 2025).

Pharmacy Students’ Views on the Inclusion of Immunisation Training in the Pharmacy Curriculum

2025-08-08T21:15:15+08:00

Introduction: Immunisation services are usually provided by healthcare workers who receive training in the field of immunisation. In Malaysia, limited exposure of pharmacy students in receiving immunisation training is partly due to lack involvement of pharmacists in immunisation programme. This study aimed to explore the insights of pharmacy students who received introductory training on the role of pharmacist in immunisation and the feasibility of introducing immunisation modules in the pharmacy curriculum.

Materials and method: Five focus group discussions (FGDs) were conducted with undergraduate final year pharmacy students who participated in an immunisation workshop. A guide was used to explore students’ experiences, challenges faced, learning perceived, perception, and suggestions for improvement from participants. Data were extracted from interview transcripts, sorted, and coded using Atlas.ti® version 9 and subjected to thematic analysis.

Results: There were four themes emerged from the FGDs: 1) Acquisition of new learning and skills, 2) Challenges in competency development, 3) Applicability of knowledge in practice, and 4) University initiatives on immunisation training.

Conclusion: Pharmacy students who received introductory training on the role of pharmacist in immunisation perceived its importance and suggested introducing immunisation modules into pharmacy curriculum.

Predictors Associated with Delayed Methotrexate Clearance among Patients with Haematological Malignancies

2025-08-08T21:15:13+08:00

Introduction: High dose methotrexate is commonly utilised in haematological malignancies; however, the prevalence of delayed clearance is not well-defined. The study aimed to determine the prevalence of delayed clearance of methotrexate, to analyse correlation between rate of methotrexate infusions and its concentrations, and to identify the predictors associated with delayed clearance. Method: A crosssectional study was conducted among adult patients with haematological malignancies who received high-dose methotrexate. Spearman’s correlation was utilised to analyse correlation between the rates of methotrexate infusions with its concentrations at 48 and 72 hours. Multiple logistic regression was used to identify factors associated with delayed clearance. Results: A total of 63 patients with 159 methotrexate infusions were included, with a mean age of 42.2 years (±18.06) and a median body mass index of 23.36 kg/m2 (19.91-26.14). Delayed methotrexate clearance was observed in 29 (46%) patients, which affected 41 (25.6%) methotrexate infusions. A poor negative correlation was found between the rate of methotrexate infusion and 48-hour concentration (r=-0.206, p=0.009). Older age (odds ratio (OR) 1.06, 95% confidence interval (CI) 1.03-1.10, p<0.001) and dose of methotrexate >3000 mg/m2 (OR 3.33, 95% CI 6.45-120.88, p<0.001) were identified as the predictors of delayed methotrexate clearance. Conclusion: Almost half of the patients experienced delayed methotrexate clearance. A slower rate of infusion was found to correlate with higher 48-hour concentrations. Older age and higher doses of methotrexate were identified as predictors for delayed clearance. Prospective study is needed with larger sample size to ensure generalisability of the outcomes.

Formulation and evaluation of topical gels containing Phyllanthus muellerianus leaf extract using various gelling agents

2025-08-08T21:15:11+08:00

Introduction: The high expense of current pharmaceuticals used to treat wounds, as well as some of their adverse effects, has spurred the quest for alternatives, particularly those derived from natural sources that have minimum side effects, less microbial susceptibility and are less expensive. Phyllanthus muellerianus leaf extract incorporated in creams and ointments greatly decreased wound closure time and increased epithelialization at the wound site. This study aims to formulate and evaluate a gel made from P. muellerianus. Methods: Leaves of P. muellerianus were extracted using water. Phytochemical screening for tannins, flavonoids, alkaloids and reducing sugars was performed on the extract. The water extract was used to formulate twenty gels with varying gelling agents. Physicochemical analysis, toxicity, wound healing and stability studies were performed on the gels. Results: The extraction of P. muellerianus leaves yielded 13.1 %w/w. Only tannins, glycosides, saponins, sterols and triterpenoids were present. P. muellerianus gels (1 %w/v) were formulated with five different concentrations of each of four different gelling agents. The gels had satisfactory physicochemical properties, and the microbial load and drug content were within the acceptable range for herbal formulations. There was no indication of chemical interactions between the extract, polymer, and other excipients in Fourier transform infrared spectroscopy investigations. There were no significant changes in the pH, spreadability, viscosity and drug content of the gels throughout the stability assay period. Dermal toxicity studies revealed that the P. muellerianus gels were not toxic to the skin (acute and repeated dose dermal toxicity tests). Wounds treated with formulations A4 and C5 showed significantly decreased wound area from the fifth day to day 15 post-injury compared to the positive and negative control groups, with an increased rate of re-epithelialization, fibroblast proliferation, collagen deposition and neovascularization. Conclusion: Ultimately, P. muellerianus gels (A4 and C5) showed tremendous wound healing activity, stability and safety.

The Role of Fall Risk-Increasing Drugs in Prevalence of Fall and its Associated Factors

2025-08-08T21:15:09+08:00

Introduction: The World Health Organization defines a fall as "an event where a person comes to rest inadvertently on the ground or another lower level”. Among numerous risk factors, medication use stands out as one of the most highly modifiable risk factors for falls in adults. Medications associated with an increased fall risk have been termed Fall Risk–Increasing Drugs (FRIDs). This study aimed to determine the prevalence of falls among patients at Hospital Baling and its associated factors. Methods: A cross-sectional study was conducted by examining patients' history of falls and medication records for those admitted to the ward from 1st January to 30th June 2023. Systematic random sampling was used, and multiple logistic regression was performed to determine the risk factors for falls. Types of FRIDs were extracted from the Comprehensive Falls Risk Assessment Instrument (FRAI) and scored based on prescribed medications. Results: A total of 200 medical records were examined. The prevalence of falls among patients was 10.5% whereby the mean FRAI score was 2.32. Patients using diuretics were 81% less likely to experience falls (adjusted OR = 0.19, 95% CI [0.04, 0.94], p = 0.038), while each additional comorbidity increased the odds of falling by 2.2 times (adjusted OR = 2.20, 95% CI [1.38, 3.51], p = 0.001). Conclusion: FRIDs, except for diuretics, did not show any significant association with falls. However, thorough medication review by pharmacists remains essential, despite FRIDs showing little to no difference in increasing risk of falls.

Stingless Bee Honey Stick Deodorant: Formulation, Antioxidant and Antimicrobial Activities

2025-03-19T12:41:02+08:00

Introduction: Deodorant often contain ingredients like aluminium salts, triclosan, fragrances, propylene glycol, and parabens that are usually associated with skin irritation and other health conditions. This study addresses the problem by formulating and characterising a natural deodorant that was free from these ingredients by using stingless bee honey (SBH) as an antibacterial and antioxidant ingredient. SBH, recognised for its efficacy in inhibiting the proliferation of odour-producing bacteria like Staphylococcus sp, was integrated into a stick deodorant formulation owing to its significant benefits. Methods: The evaluation of SBH began with testing its antioxidant activity, including total phenolic content (TPC), total flavonoid content (TFC) and DPPH assay. Thereafter, the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were determined. Based on the MIC value, an SBH-stick deodorant was formulated and then characterised based on its pH, softening point, antimicrobial study by using well diffusion method and stability study (30 °C ± 2 °C /75% RH ± 5%) for two weeks. Results: The TPC and TFC in this study were 57.99 ± 0.38 mg GAE/100g and 0.132 ± 0.04 mg QE/mL, respectively. Meanwhile, the DPPH scavenging activity was 66.78 ± 0.45%. The result showed that 20% w/w and 50% w/w of SBH were needed as MIC and MBC, respectively. The formulated stick deodorant was reported to have suitable pH, softening point and exhibit its antibacterial activity towards Staphyloccoccus aureus after being formulated as deodorant. It was also stable during the two weeks of storage. Conclusion: The SBH stick deodorant was successfully formulated and demonstrated potential antibacterial activity against Staphylococcus aureus, a known body-odour causing bacteria. These findings highlight the potential application of SBH as a natural antibacterial agent in personal care products, offering a promising alternative to synthetic deodorants.

Green Synthesis of Silver Nanoparticles Using Aidia densiflora Leaf Extract: Characterisation and Bioactivities

2025-08-08T21:15:07+08:00

Introduction: Plant-mediated green synthesis of nanoparticles has become a promising option in green nanotechnology because it is simple, cost-effective, eco-friendly, and biologically effective. This study focused on the synthesis and characterisation of silver nanoparticles (AgNPs) using Aidia densiflora leaf extract, as well as the evaluation of their antimicrobial and cytotoxic activities. Methods: AgNPs were synthesised with A. densiflora leaf extract and their formation was confirmed using an ultraviolet–visible (UV–Vis) spectrophotometer. Liquid chromatography-mass spectrometry quadrupole time-of-flight was utilised for phytochemical profiling. The synthesised AgNPs were characterised using a zetasizer and zeta potential analyser, scanning electron microscopy-energy dispersive X-ray, Fourier Transform Infrared, X-ray diffraction (XRD), and thermogravimetric analysis. Antimicrobial activity of AD-AgNPs was tested against six microorganisms using the disc diffusion method, while cytotoxicity against MCF-7 human breast cancer cells was evaluated via MTT assay. Results: AgNP formation was confirmed by XRD and UV–Vis analysis, with absorbance peaks at 399–424 nm. Optimal synthesis was achieved using 10 mM AgNO? at 60°C and pH 7. SEM showed spherical-like nanoparticles averaging 96.06 nm with significant aggregation. The zeta potential was –35.6 mV, and XRD indicated a face-centred cubic structure with a crystalline size of 6.94 nm. AD-AgNPs showed no antimicrobial activity and low cytotoxicity. Conclusion: A. densiflora leaf extract can be used to synthesise AgNPs, however, further optimisation is required for better nanoparticle stabilisation and improvement of bioactivities.

Optimisation of Supercritical Fluid Extraction for Fatty Acids from Benincasa hispida Seed Oil: A Response Surface Approach

2025-08-08T21:15:04+08:00

Introduction: The goal of this study was the optimisation of the process parameters for the extraction of Benincasa hispida seed extract using the supercritical carbon dioxide. Methods: Response surface methodology was carried out using the design expert software with the implementation of process parameters including the temperature (40°C – 70°C), pressure (100 bar – 400 bar) and supercritical carbon dioxide flow rate (2 g/min – 10 g/min) in this study due to their significant impact towards the oil yield and the polyunsaturated fatty acids. Results: The optimised parameter for this supercritical fluid model is 70°C, 247 bar and 7 g/min while 0.36 bar and 40 °C has been chosen from previous studies as the optimised parameter for Soxhlet extraction. The oil yield (33% from Soxhlet extract and 9.67% from supercritical fluid extract) obtained was quite similar with previous studies, however, the polyunsaturated fatty acids obtained throughout this optimisation were much higher indicating that this study provided better output of the polyunsaturated fatty acids obtained from the seed oil. Moreover, the polyunsaturated fatty acids contents were also compared between the extract obtained from the conventional Soxhlet extraction versus novel supercritical fluid extraction techniques. Conclusion: The result shows the polyunsaturated fatty acids in the supercritical fluid extraction were significantly higher than the Soxhlet extraction due to the advantages and suitability of the polyunsaturated fatty acids extraction using the supercritical fluid extraction method.

Evaluating the Wound Healing Activity of Fabricated Stingless Bee Honey Hydrogels in an Animal Model

2025-08-08T21:14:59+08:00

Introduction: Honey is a well-established treatment for wound healing and had been used for ages. However, there are limitations when it is directly applied to the wound such as inconsistent dosage and pain during dressing changes. The incorporation of honey into hydrogel could overcome these problems. The study is aimed at developing a suitable honey-based hydrogel formulation for wound healing application by using systematic experimental design from response surface methods (RSM). Methods: The hydrogel’s base was made from polyvinyl alcohol (PVA), polyethylene glycol (PEG), glycerol and agar. A two-level factorial design was selected to screen the factors followed by centred composite design for optimization. The characterizations of the optimized formulation were observed in term of hydrophilicity and rheological. The optimized formulation was further assessed in an in vivo wound healing study in New Zealand albino rabbits. Results: PEG and agar concentration was found to be the most important process variable based on the screening result. The optimised hydrogel has a good hydrophilicity ability and rheological property. In in vivo healing study, the healing in the honey incorporated hydrogel treated group was significantly faster than the no treatment group, as demonstrated in wound closure percentage and histological assessment. From the results, the wound in the honey hydrogel treatment group has entered the remodelling phase compared with the control group that was still in the proliferation phase. Conclusion: Based on all of these results, stingless bee honey incorporated hydrogel has a promising application as an efficient wound dressing.

A Phytochemical Profiling and in vitro Antimicrobial Evaluation of Methanolic Extract and Fractions of Dicranopteris linearis Leaves

2025-08-08T21:14:57+08:00

Introduction: Dicranopteris linearis, locally known as resam, has been recognized for its potential health benefits, primarily due to its rich phytochemical content. Traditionally used for medicinal purposes, the leaves are known to possess antioxidant and antimicrobial properties. This study aimed to screen the phytochemical composition and evaluate the antimicrobial activity of the methanolic extract of D. linearis leaves, with potential applications in the medicinal industry. Materials and Methods: The dried and ground leaves of D. linearis were macerated in 100% methanol to extract the phytochemicals. The extract was subjected to qualitative phytochemical profiling. Total Phenolic Content (TPC) was determined by the Folin-Ciocalteu method and Total Flavonoid Content (TFC) was measured using the AlCl? method. The methanol extract was fractionated by Vacuum Liquid Chromatography (VLC) with ethyl acetate (100%), ethyl acetate: methanol (5:5) and methanol (100%). Antimicrobial activity of the crude extract and fractions was assessed against Escherichia coli and Staphylococcus aureus using the disc diffusion assay and broth microdilution techniques. Results: Phytochemical profiling of the methanol extract revealed the presence of phenolic compounds, flavonoids, tannins, and saponins. The TPC and TFC assays showed that the methanolic extract contained 225.43 ± 4.16 mg GAE/g of phenolic compounds and 50.20 ± 4.78 mg QE/g of flavonoids. Fractionation of methanol extract was afforded three fractions, F1, F2 and F3. Antimicrobial testing demonstrated that the extract exhibited stronger activity against S. aureus (MIC = 1.563 mg/mL) compared to E. coli (MIC > 50 mg/mL). For the fraction, F1 exhibited both microbes with promising activity. Conclusions: The methanolic extract from D. linearis leaves contain bioactive phytochemicals with significant antioxidant and antimicrobial properties. These findings suggest that D. linearis may serve as a valuable source for the development of natural antimicrobial agents in the pharmaceutical industry.