Introduction: The study’s objective was to validate a Malay language translated questionnaire on end-of-life care to be used among nurses practicing in critical care areas. Methods: The English language questionnaire underwent forward and backward translations by four experts. The translated Malay language questionnaire was pilot tested on 30 subjects and revised accordingly. The validation of the revised questionnaire was carried out on 250 nurses. The reliability of the translated questionnaire was checked. Cronbach alpha value of at least 0.70 suggests adequate internal consistency. The validity of the questionnaire was explored using Confirmatory Factor Analysis (CFA) and model fit tests were run to achieve fit test specific cut off values. The CFAs were run repeatedly with iterative item reductions until acceptable goodness of fit for the model was achieved. Results: All domains of the translated questionnaire showed reasonable to excellent reliability (Cronbach Alpha 0.687 to 0.922). Multiple CFAs were run and 13 out of 46 items were excluded, and the final model fit improved substantially with the indices were within the acceptable threshold of good or reasonably fit, cut off values are in brackets [Chi-Square statistics 1.635 (≤ 2.0), Root Mean Square Error of Approximation 0.050 (< 0.05), Standardised Root Mean Square Residual 0.059 (≤ 0.08), Comparative Fit Index 0.911 (0.90-0.94), Tucker Lewis Index 0.900 (0.90-0.94), Akaike Information Criteria 13024, Bayesian Information Criteria 13334]. Conclusion: The psychometric properties of the final model indicated the Malay language translated questionnaire is reliable and valid to investigate nurses’ perspective and involvement in end-of-life care.

Pharmacotherapeutics are being repurposed and used as off-label at various stages of COVID-19 infection. Clinical trials are being initiated or are ongoing to investigate the effectiveness and safety of these pharmacotherapeutics. This review article outlines the current pharmacotherapeutics and the controversies surrounding their use. The pharmacotherapeutics that were discussed are hydroxychloroquine, favipiravir, lopinavir/ritonavir, remdesivir, interferons, tocilizumab, and steroids. We also discussed the special consideration for pharmacotherapeutics in COVID-19 infection. No pharmacotherapeutics have been found to be effective and approved for the treatment of COVID-19 infection. However, there are clinical trials that have eliminated the possibilities of use of some pharmacotherapeutics while others had shown promising preliminary results of its use

Introduction: Pulmonary aspiration of gastric contents is a potentially life threatening complication of general anaesthesia especially in high risk patients undergoing emergency anaesthesia. Classically,ranitidine has been used to reduce gastric pH and volume. Esomeprazole, the S-isomer of omeprazole, is a newer generation proton pump inhibitor whose effect on gastric pH and volume in emergency surgeries has not been determined. Materials and Methods: This was a prospective, randomised, double blind study to compare the effect of intravenous esomeprazole and ranitidine on gastric pH and volume in patients undergoing emergency appendicectomy. Following induction of anaesthesia, seventy patients of American Society of Anesthesiologists physical status I or II had their gastric contents aspirated via a nasogastric tube. They were then randomised to receive either intravenous esomeprazole 40 mg or intravenous ranitidine 50 mg. A second aspiration of gastric contents was done three hours later. The pH and volume of gastric contents of both aspirations were recorded. Results: Both intravenous esomeprazole and ranitidine significantly reduced the gastric fluid acidity (p=0.001) and volume (p=0.001). There were no significant differences measured between the two groups in terms of gastric fluid pH (p=0.86) and gastric fluid volume (p=0.14) after administration of study drugs. Conclusion Esomeprazole and ranitidine given intravenously were both comparable in reducing the volume and acidity of gastric secretions in patients undergoing emergency appendicectomy.