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Background: Work-related stress is a significant issue among nurses globally, impacting their well-being and the quality of healthcare services. This study focuses on assessing the risks of work-related stress among nurses at King Fahad Hospital in Jeddah, Saudi Arabia. King Fahad Hospital was chosen for its status as one of the largest and busiest tertiary care hospitals in the region, representing the high-pressure healthcare environments typical of many Saudi hospitals, which are known to contribute to nurse stress due to heavy patient loads and long working hours. Objective: The primary objectives of this research were to estimate the risks of work-related stress hazards, explore the differences between demographics and workplace characteristics, and identify predictors of work-related stress among the nursing staff at King Fahad Hospital. Methods: A quantitative cross-sectional study was conducted, involving 262 registered nurses from non-critical wards at King Fahad Hospital. Data were collected using the Health and Safety Executive Management Standards Indicator Tool (HSE-IT), which measures potential stress hazards across seven dimensions: demands, control, manager support, peer support, relationships, role, and change. Statistical analyses, including the Mann-Whitney U test and logistic regression, were performed using SPSS to identify significant differences and predictors of work-related stress Results: The study revealed high levels of work-related stress among the nurses, with the highest risk factors being demand (Mean = 3.2, SD = 0.5) and role clarity (Mean = 3.7, SD = 0.8). Logistic regression analysis identified several significant predictors of work-related stress. Male nurses were 3.02 times more likely to experience stress related to job demands compared to female nurses (AOR = 3.02, 95% CI: 1.55–5.87, p = 0.001). Younger nurses (≤30 years) had 2.38 times higher odds of experiencing stress from job demands compared to older nurses (AOR = 2.38, 95% CI: 1.28–4.43, p = 0.006). Additionally, nurses with higher educational attainment (undergraduate or above) were 2.21 times more likely to report stress due to lack of job control compared to those with a diploma (AOR = 2.21, 95% CI: 1.14–4.27, p = 0.019). Nurses working longer hours (48 hours per week) had 3.14 times higher odds of experiencing stress related to peer support (AOR = 3.14, 95% CI: 1.68–5.87, p < 0.05), and shift workers were 5.17 times more likely to experience stress compared to those working fixed hours (AOR = 5.17, 95% CI: 2.14–10.82, p < 0.01). These findings suggest that targeted interventions are needed to support younger nurses, male nurses, and those working longer hours or shifts. Conclusions: The findings highlight the urgent need for targeted interventions to mitigate work-related stress among nurses at King Fahad Hospital. Broader implications extend beyond this hospital, as the challenges faced by nurses in Saudi Arabia are reflective of similar issues in other high-pressure healthcare environments globally. Addressing work-related stress through supportive policies, improved workplace relationships, clear role definitions, and organizational changes is crucial for enhancing nurse well-being and ensuring the delivery of high-quality patient care across the healthcare sector. Keywords: Work-related stress, nurses, healthcare, King Fahad Hospital, Saudi Arabia, HSE Management Standards, risk assessment, demographic predictors, workplace characteristics.

BACKGROUND: The COVID-19 pandemic significantly affected healthcare professionals, including community pharmacists in Malaysia, who faced increased workloads and emotional strain while continuing to provide essential services. However, limited research has been conducted on the health-related quality of life (HRQoL) of community pharmacists, particularly in the post-pandemic period. This study aims to assess the HRQoL of Malaysian community pharmacists to better understand the effects of the pandemic on their physical, mental, and social well-being. METHODS: A cross-sectional survey was conducted among 394 eligible community pharmacists in Malaysia, with 209 respondents completing the online questionnaire. The study utilized the RAND SF-36 for HRQoL assessment, the Fatigue Severity Scale (FSS) to evaluate fatigue, and the Epworth Sleepiness Scale (ESS) to assess daytime sleepiness. Data analysis was performed using SPSS, with t-tests, ANOVA, and multivariate regression applied to identify factors influencing HRQoL. Ethical approval was obtained, and informed consent was collected from all participants. RESULTS: Of the 209 pharmacists who participated, 46% were aged between 31-40 years, and 88% were female. Regarding HRQoL, 33.4% rated their health as "excellent" and 37.8% as "very good," while 20.1% reported their health had worsened compared to the previous year. A significant portion of participants (36.8%) reported limitations in physical activity, and half of them cut down on work hours. Emotional health issues impacted 52.6% of participants' performance, and 35.9% experienced health-related interference with social activities. Additionally, 67.5% reported severe fatigue, and 32.1% showed excessive daytime sleepiness. CONCLUSION: The findings reveal that HRQoL among Malaysian community pharmacists is significantly impacted by fatigue, emotional exhaustion, and physical strain. These challenges affect their overall well-being and productivity. The results highlight the urgent need for targeted interventions to improve the working conditions and support systems for pharmacists, aiming to enhance both their personal health and the quality of healthcare services they provide. KEYWORDS: Health-related quality of life, community pharmacists, COVID-19 pandemic, fatigue, daytime sleepiness, emotional exhaustion, Malaysia, post-pandemic well-being.

Utilisation of Non-Steroidal Anti-Inflammatory Drugs Among the Paediatric Patients of a Private Tertiary Care Hospital Introduction Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are widely prescribed, yet there is a lack of published research investigating their utilisation in the paediatrics population. This study aims to address this gap by examining the prescribing patterns of prescribers at a private tertiary hospital in Malaysia. Additionally, the study explores the actual and potential drug-related problems (DRPs) associated with NSAIDs use, based on all prescriptions collected during the study period. Methods This single-centred, ambi-directional cohort study was conducted at Sunway Medical Centre, Bandar Sunway from January to December 2024. The inclusion criteria included all prescriptions containing at least one NSAIDs, with the patients being less than 18 years old on the date of dispensing. The prescription data and patient progress notes were analysed for the indication for NSAIDs use. In addition to descriptive analysis, chi-squared tests were performed to examine relationships between NSAIDs use, the occurrence of DRPs, and patient demographics. Results There were no statistically significant differences in gender, race, age distribution, allergy status, and medical conditions among the study population with p-values more than 0.05. 93.26% of prescriptions were prescribed by the emergency, paediatrics and orthopaedic departments. Most NSAIDs were indicated for pain or fever relief, with aspirin specifically prescribed for conditions such as Kawasaki Disease or Systemic Lupus Erythematosus. Oral liquid formulations of NSAIDs (55.21%) were the most commonly prescribed due to their dosing convenience, palatability, and suitability for the younger children. Ibuprofen (58.69%) was the most frequently prescribed NSAID, followed by diclofenac (13.03%). As patient age increased, a broader range of NSAID options and formulations, including COX-2 inhibitors, were observed. Aspirin was prescribed mainly for patients under 5 years old, likely due to the prevalence of Kawasaki Disease in this age group. Paracetamol was the most common concomitant medication, consistent with its use for pain or fever relief. No severe adverse events associated with NSAIDs use were identified, indicating appropriate prescribing practices within this population. Dose-related potential DRPs were the most frequent type of DRP observed, occurring more often in patients between 6 to 11 years of age. Conclusion This study has identified the prescribing patterns and potential DRPs associated with NSAIDs use among the paediatric population of a private tertiary hospital. NSAIDs were predominantly prescribed for analgesic and antipyretic purposes. Future research could focus on investigating the knowledge, attitude, and perceptions of NSAIDs use among prescribers and pharmacy personnel. Such studies could provide insights into the practicality and challenges of prescribing medications for this young population. Keywords: Prescription, drug use, medications, prescriber, paediatric, analgesics.

BACKGROUND Antimicrobial resistance (AMR) is a critical global health challenge, necessitating widespread antimicrobial stewardship (AMS) across all healthcare sectors, including community pharmacies. Community pharmacists (CPs) play a key role in AMS by ensuring responsible antimicrobial dispensing, educating patients, and collaborating with prescribers. However, barriers such as limited training, unclear professional roles, and regulatory challenges hinder AMS implementation. This study aims to assess the extent of AMS application among CPs in Malaysia, identify key facilitators and barriers to AMS implementation, and evaluate the perception of AMS among CPs nationwide. Ultimately, our research can help to design a suitable AMS programme for CPs in Malaysia. METHODS A nationwide cross-sectional survey was conducted among 401 registered CPs across Malaysia, selected through convenience sampling. A structured, self-administered questionnaire assessed perceived AMS awareness, antimicrobial dispensing practices, and implementation barriers. The survey was distributed via a Google survey link and disseminated through Whatsapp. Data were analysed and statistical analyses were performed using SPSS (version 28). Descriptive statistics summarised responses, while the Mann–Whitney U and Kruskal–Wallis tests examined associations between demographic factors and AMS-related attitudes, practices, and barriers. Dunn’s post hoc test with Bonferroni correction was pplied for multiple comparisons (p = 0.050). RESULTS Among 401 respondents, 89.0% adhered to prescription regulations, 66.8% consulted national guidelines, and 97.3% educated patients on unnecessary antibiotic use. Collaboration with prescribers was common, with 97.0% encouraging physician consultations. CPs emphasised patient education, with 93.0% raising AMR awareness and 97.8% reinforcing full-course completion. Facilitators included ethical commitment, with 81.0% ensuring valid prescriptions and 89.0% prioritising patient safety over revenue. Barriers included AMS training gaps (28.7%), unclear AMS roles (31.2%), and logistical constraints (29.4%). CPs with 3–10 years of experience were more proactive in AMS, while hospital-trained CPs had greater perceived AMS awareness. CONCLUSION This study underscores the crucial role of CPs in AMS, with strong adherence to AMS principles. However, gaps in training, role clarity, and structured protocols remain. Addressing these barriers through targeted training, clear guidelines, and CP-GP collaboration will enhance AMS application, empowering CPs to combat AMR effectively in community settings. Keywords AMR; Antimicrobial Resistance; AMS; Antimicrobial Stewardship; Community Pharmacists

Introduction: Malaysia has implemented various tobacco control measures to reduce smoking prevalence and its associated health risks. Despite the implementation of anti-smoking programs, high rates of smoking still exist, requiring innovative approaches. The exclusion of the Generational End Game policy and nicotine liquid from the Poison List has sparked debate. Hence, the study aimed to analyze the public's support and opinion for tobacco control strategies in Malaysia. Methods: The mixed-method study was conducted nationwide through an online survey using Rakuten Insight with a representative sample of 1000 adult Malaysians to assess their support for the current and new policies on tobacco control. Semi-structured interviews were done among nine samples to gather qualitative data about their opinion on the implementation of these policies. Result: Most of the participants supported all 15 tobacco control strategies. Support was higher among those who do not smoke and use tobacco products. By multiple linear regression, Malay (B=-3.7408, 95% CI –5.468, -1.949, p<0.001), primary educational level (B=-4.185, 95%CI –5.911, -2.459, p<0.001) and knowledge score (B=0.916, 95% CI 0.696, 1.137, p<0.001) were the factors that significantly associated with the support. Qualitative findings showed that most participants agreed with tobacco control policies. They disagreed with the removal of nicotine liquid from the Poison List. The major challenge was the lack of enforcement. They suggested stricter enforcement, public education, and monitoring of contraband cigarettes as possible solutions. Conclusion: There is strong public support for tobacco control strategies in Malaysia. A well-structured implementation is needed to curb the growing number of smokers in the country. Keywords: Support, Tobacco, Policy, Cigarette, E-cigarette, HTPs, Smoker, Nonsmoker