This paper presents the results of a measured data-based mass flow and balance study in UluPandan Water Reclamation Plant (WRP), the second largest municipal wastewater treatment plant in Singapore. The results are benchmarked against the Strass wastewater treatment plant in Austria, which has achieved energy self-efficiency. The gaps between the two plants have been identified and areas for process improvement in UluPandan WRP, especially those related to energy efficiency, have been proposed. This case study demonstrates that mass flow and balance is an effective tool in improving process performance and the energy efficiency of a municipal wastewater treatment plant.

Dikir Farmasi (DF) is a new effort to expand and intensify the dissemination of information about the regulation of the legitimate use of drugs and cosmetics. This study was aimed to explore the opinions of Pharmacy Enforcement Division staff and the general public regarding the quality and impact of DF program as a health promotion tool in Malaysia. A qualitative study using semistructured interviews and focus group discussions (FGDs) were conducted at the Pharmacy Enforcement Department and three health clinics located at the city of Kota Bharu, Malaysia. The interviews were audio recorded, translated and transcribed. Thematic analysis was performed to identify the themes and sub-themes of the transcripts. Ethical approval was obtained from Ministry of Health Malaysia. All respondents provided a written consent for participation. Nine pharmacy officers and 23 general public participated in this study. Five main themes emerged from the information gathered and analyzed: 1) language; 2) design; 3) content and delivery 4) costs and benefits and 5) prospect of DF. Certain weaknesses of DF have been raised and the health authorities could utilize this information for an improvement. Significant effort must be made to improve the publicity and dissemination of DF to ensure that it reaches the target population. Certain weaknesses of DF have been raised and the health authorities could utilize this information for an improvement. Significant effort must be made to improve the publicity and dissemination of DF to ensure that it reaches the target population.

Introduction: Lipid-modifying drugs have been used to treat dyslipidemia as well as for the primary and secondary prevention of CVDs and stroke. Objectives: This study aims to describe the drug utilization pattern of lipid-modifying drugs in a private hospital. Method: A retrospective study was carried out in outpatient of the selected hospital. Patients were selected based on inclusion and exclusion criteria by using convenience sampling. Data were collected through KCIS by retrieving patients' registration number. Defined daily dose (DDD) was calculated and compared to World Health Organization DDD. Medicine prices were also analysed. Results: A total of 180 patients' record were analysed, 70% of them were male; 40.6% of the patients were from the age range of 50 to 59 years old; ethnicity breakdown was Malay (69.4%), Indian (18.3%) and Chinese (12.2%). Among all lipid-modifying drugs, utilization of statins was the highest as statins are the preferred line in the treatment of dyslipidemia. Innovator brands were more preferred where most of the lipidmodifying drugs used in the selected hospital are innovator brand drugs. In terms of cost, lipidmodifying drugs contributes to about 27% of the total cost of prescription in average. Conclusion:The utilization of all lipid-modifying drugs in the selected hospital was lower as compared to WHO DDD. As compared to combination therapy, monotherapy with atorvastatin was generally preferred in the selected hospital. The utilization of atorvastatin was found to be the highest in the OPD of the selected hospital.

Introduction Widespread over-prescription of proton pump inhibitors (PPIs) without an appropriate indication has financial and potentially adverse clinical consequences.