The beta2-adrenergic receptor gene polymorphism is a major determinant of bronchodilator response to albuterol. Future pharmacodynamic studies of beta2-agonists should include determination of 02-adrenergic receptor genotype.

BackgroundThere is substantial evidence to support the association between tuberculosis (TB) and tobacco smoking and that the smoking-related immunological abnormalities in TB are reversible within six weeks of cessation. Therefore, connecting TB and tobacco cessation interventions may produce significant benefits and positively impact TB treatment outcomes. However, no study has extensively documented the evidence of benefits of such integration. SCIDOTS Project is a study from the context of a developing nation aimed to determine this.MethodsAn integrated TB-tobacco intervention was provided by trained TB directly observed therapy short-course (DOTS) providers at five chest clinics in Malaysia. The study was a prospective non-randomized controlled intervention using quasi-experimental design. Using Transtheoretical Model approach, 120 eligible participants who were current smokers at the time of TB diagnosis were assigned to either of two treatment groups: conventional TB DOTS plus smoking cessation intervention (integrated intervention or SCIDOTS group) or conventional TB DOTS alone (comparison or DOTS group). At baseline, newly diagnosed TB patients considering quitting smoking within the next 30 days were placed in the integrated intervention group, while those who were contemplating quitting were assigned to the comparison group. Eleven sessions of individualized cognitive behavioral therapy with or without nicotine replacement therapy were provided to each participant in the integrated intervention group. The impacts of the novel approach on biochemically validated smoking cessation and TB treatment outcomes were measured periodically as appropriate.ResultsA linear effect on both 7-day point prevalence abstinence and continuous abstinence was observed over time in the intervention group. At the end of 6 months, patients who received the integrated intervention had significantly higher rate of success in quitting smoking when compared with those who received the conventional TB treatment alone (77.5% vs. 8.7%; p < 0.001). Furthermore, at the end of TB treatment (6 months or later), there were significantly higher rates of treatment default (15.2% vs. 2.5%; p = 0.019) and treatment failure (6.5% vs. 0%; p = 0.019) in the DOTS group than in the SCIDOTS group.ConclusionThis study provides evidence that connecting TB-tobacco treatment strategy is significant among TB patients who are smokers. The findings suggest that the integrated approach may be beneficial and confer advantages on short-term outcomes and possibly on future lung health of TB patients who quit smoking. This study may have important implications on health policy and clinical practice related to TB management among tobacco users.

Objectives. To assess bachelor of pharmacy students' overall perception and acceptance of an objective structured clinical examination (OSCE), a new method of clinical competence assessment in pharmacy undergraduate curriculum at our Faculty, and to explore its strengths and weaknesses through feedback. Methods. A cross-sectional survey was conducted via a validated 49-item questionnaire, administered immediately after all students completed the examination. The questionnaire comprised of questions to evaluate the content and structure of the examination, perception of OSCE validity and reliability, and rating of OSCE in relation to other assessment methods. Open-ended follow-up questions were included to generate qualitative data. Results. Over 80% of the students found the OSCE to be helpful in highlighting areas of weaknesses in their clinical competencies. Seventy-eight percent agreed that it was comprehensive and 66% believed it was fair. About 46% felt that the 15 minutes allocated per station was inadequate. Most importantly, about half of the students raised concerns that personality, ethnicity, and/or gender, as well as interpatient and interassessor variability were potential sources of bias that could affect their scores. However, an overwhelming proportion of the students (90%) agreed that the OSCE provided a useful and practical learning experience. Conclusions. Students' perceptions and acceptance of the new method of assessment were positive. The survey further highlighted for future refinement the strengths and weaknesses associated with the development and implementation of an OSCE in the International Islamic University Malaysia's pharmacy curriculum.

No abstract