Incorporation of graphene oxide/titanium dioxide with different polymer materials and its effects on methylene blue dye rejection and antifouling ability.

Exposure of synthetic dye, such as methylene blue (MB), in water bodies led to a serious threat to living things because they are toxic and non-degradable. Amongst the introduced dye removal methods, membrane separation process can be considered a powerful technique for treating dye contamination. However, this method commonly suffered from drawbacks, such as short membrane lifetime, low permeability and selectivity. To overcome these issues, graphene oxide (GO) and titanium dioxide (TiO2) were used as additives to fabricate polyethersulfone (PES)- and polyvinylidene fluoride (PVDF)-based hybrid membranes via non-solvent-induced phase separation method. Prior to membrane fabrication, GO was synthesised via electrochemical exfoliation method assisted by customised triple-tail surfactant. The potential of PES- and PVDF-based hybrid membranes for wastewater treatment has been discussed widely. However, direct comparison between these two polymeric membranes is not critically discussed for MB dye separation application yet. Therefore, this study is aimed at evaluating the performance of different types of polymers (e.g. PES and PVDF) in terms of membrane morphology, properties, dye rejection and antifouling ability. Results showed that the incorporation of GO and TiO2 alters the morphology of the fabricated membranes and affects dye rejection further, as well as their antifouling performance. In contrast with pristine membrane, PES-GO/TiO2 and PVDF-GO/TiO2 possessed high hydrophilicity, as indicated by their low contact angle (67.38° and 62.12°, respectively). Based on this study, PVDF-GO/TiO2 showed higher porosity value (94.88%), permeability (87.32 L/m2hMPa) and MB rejection rate (92.63%), as well as flux recovery ratio value of > 100% as compared with others. Overall, the incorporation of GO and TiO2 with PVDF polymer are proven to be effective hybrid materials of membrane fabrication for dye rejection application in the near future. The polymer material's intrinsic properties can affect the attributes of the fabricated membrane.

Ionic Liquid-Based Green Emulsion Liquid Membrane for the Extraction of the Poorly Soluble Drug Ibuprofen.

Ibuprofen (Ibf) is a biologically active drug (BADs) and an emerging contaminant of concern (CECs) in aqueous streams. Due to its adverse effects upon aquatic organisms and humans, the removal and recovery of Ibf are essential. Usually, conventional solvents are employed for the separation and recovery of ibuprofen. Due to environmental limitations, alternative green extracting agents need to be explored. Ionic liquids (ILs), emerging and greener alternatives, can also serve this purpose. It is essential to explore ILs that are effective for recovering ibuprofen, among millions of ILs. The conductor-like screening model for real solvents (COSMO-RS) is an efficient tool that can be used to screen ILs specifically for ibuprofen extraction. The main objective of this work was to identify the best IL for the extraction of ibuprofen. A total of 152 different cation-anion combinations consisting of eight aromatic and non-aromatic cations and nineteen anions were screened. The evaluation was based upon activity coefficients, capacity, and selectivity values. Furthermore, the effect of alkyl chain length was studied. The results suggest that quaternary ammonium (cation) and sulfate (anion) have better extraction ability for ibuprofen than the other combinations tested. An ionic liquid-based green emulsion liquid membrane (ILGELM) was developed using the selected ionic liquid as the extractant, sunflower oil as the diluent, Span 80 as the surfactant, and NaOH as the stripping agent. Experimental verification was carried out using the ILGELM. The experimental results indicated that the predicted COSMO-RS and the experimental results were in good agreement. The proposed IL-based GELM is highly effective for the removal and recovery of ibuprofen.

A Clinical, Pathological, Epidemiological and Molecular Investigation of Recent Outbreaks of Peste des Petits Ruminants Virus in Domestic and Wild Small Ruminants in the Abu Dhabi Emirate, United Arab Emirates.

(1) Background: Peste des petits ruminants (PPR) is a highly contagious animal disease affecting small ruminants, leading to significant economic losses. There has been little published data on PPR virus (PPRV) infection in the United Arab Emirates (UAE); (2) Methods: four outbreaks reported in goats and Dama gazelle in 2021 were investigated using pathological and molecular testing; (3) Results: The infected animals showed symptoms of dyspnea, oculo-nasal secretions, cough, and diarrhea. Necropsy findings were almost similar in all examined animals and compliant to the classical forms of the disease. Phylogenetic analysis based on N gene and F gene partial sequences revealed a circulation of PPRV Asian lineage IV in the UAE, and these sequences clustered close to the sequences of PPRV from United Arab Emirates, Pakistan, Tajikistan and Iran; (4) Conclusions: PPRV Asian lineage IV is currently circulating in the UAE. To the best of our knowledge, this is a first study describing PPRV in domestic small ruminant in the UAE.

Formation of a Nanorod-Assembled TiO2 Actinomorphic-Flower-like Microsphere Film via Ta Doping Using a Facile Solution Immersion Method for Humidity Sensing.

This study fabricated tantalum (Ta)-doped titanium dioxide with a unique nanorod-assembled actinomorphic-flower-like microsphere structured film. The Ta-doped TiO2 actinomorphic-flower-like microsphere (TAFM) was fabricated via the solution immersion method in a Schott bottle with a home-made improvised clamp. The samples were characterised using FESEM, HRTEM, XRD, Raman, XPS, and Hall effect measurements for their structural and electrical properties. Compared to the undoped sample, the rutile-phased TAFM sample had finer nanorods with an average 42 nm diameter assembled to form microsphere-like structures. It also had higher oxygen vacancy sites, electron concentration, and mobility. In addition, a reversed double-beam photoacoustic spectroscopy measurement was performed for TAFM, revealing that the sample had a high electron trap density of up to 2.5 µmolg-1. The TAFM showed promising results when employed as the resistive-type sensing film for a humidity sensor, with the highest sensor response of 53,909% obtained at 3 at.% Ta doping. Adding rGO to 3 at.% TAFM further improved the sensor response to 232,152%.

Adequacy of Empiric Antibiotics Therapy and Its Impact on Outcomes in Adult Critically Ill Sepsis Patients: A Review.

Sepsis is a medical emergency that involves a systemic immunological response due to an infection, resulting in the end-stage-organs malfunction and death. It is associated with high mortality rate despite a better understanding of the disease pathology and the mechanism involved. This review was designed to summarise the available evidences regarding the adequacy of the empiric antimicrobial therapy (EAMT), its predictors and its impact on the outcomes in intensive care unit (ICU) sepsis patients. Providing an adequate EAMT is considered one of the cornerstones of sepsis management as it has been found to be associated with better survival and is a good predictor for shorter ICU-length-of-stay. In contrast, inadequate EAMT in sepsis patients is associated with poor clinical outcomes including increased mortality and prolonged hospital stay. Evidence from this review suggest that it is important to identify determinants of inadequate EAMT to optimise the antimicrobial therapy provided to sepsis patients. Predictors of inadequate EAMT included co-morbidities (cancer), source and type of infection, higher Acute Physiology and Chronic Health Evaluation (APACHI-II) score and long hospital stay prior to the infection. As EAMT is considered as one of the effective treatment strategies to prevent sepsis associated death, healthcare providers should ensure the adequate antimicrobial therapy is provided for sepsis patients to improve and optimise their management.

Hydrophobicity and Biodegradability of Silane-Treated Nanocellulose in Biopolymer for High-Grade Packaging Applications.

The growing concern about pollution produced by plastic waste and the consequent environmental dangers has led to increased interest in replacing plastics with sustainable and biodegradable alternatives. Biopolymers such as seaweed have been examined for their film-forming characteristics to make edible films for packaging applications. This study aimed to prepare biopolymeric packaging films through a solvent-casting process using natural red seaweed (Kappaphycus alvarezii) and kenaf cellulose nanofiber (CNF), followed by film surface treatment using silane. The hydrophobic properties of the seaweed/CNF biopolymer were examined through water solubility (WS), moisture absorption capacity (MAC), water vapor permeability (WVP), and contact angle (CA) measurements. Fourier transform infra-red (FT-IR) film spectra clearly showed successful modification of the seaweed film (SF) by silane and the incorporation of kenaf CNF over the surface of the seaweed film. The wettability-related analysis showed positive results in determining the modified film's hydrophobicity properties. Film degradation analysis using the soil burial method showed a lower degradation rate for films with a higher CNF loading. Overall, the characterization results of the seaweed/CNF biopolymer film predicted hydrophobicity properties. The slow degradation rate was improved with surface modification using silane treatment and the incorporation of kenaf CNF filler with the seaweed matrix. As a result, we found that the seaweed/CNF biopolymer film could be used as high-grade packaging material in many potential applications.

Vegetable Oil-Ionic Liquid-Based Emulsion Liquid Membrane for the Removal of Lactic Acid from Aqueous Streams: Emulsion Size, Membrane Breakage, and Stability Study.

In this study, we present a highly stable vegetable oil ionic liquid (IL)-based emulsion liquid membrane (VOILELM) for the removal of lactic acid from water streams. The system developed as a part of this work comprises a non-ionic surfactant Span 80, sodium hydroxide as an internal stripping agent, sunflower canola oil as a green diluent, and IL-tetramethylammonium acetate [TMAm][Ac]-as a carrier. VOILELM stability was evaluated in terms of breakage, emulsion diameter, and standalone stability. The effect of various parameters, namely, concentration of the surfactant, concentration of the internal stripping agent, concentration of the carrier, phase ratio, homogenizer speed, and homogenization time, on the VOILELM stability was studied. The results revealed that VOILELM was highly stable, with 1.34% minimum breakage, 1.16 µm emulsion diameter, and 131 min standalone stability. The optimal process parameters were 0.1 wt % Span 80, 0.1 M NaOH, 0.3 wt % IL, 0.25 phase ratio, 5000 rpm homogenizer speed, and 5 min homogenization time. At these optimized conditions, 96.08% lactic acid extraction efficiency was achieved. Thus, a highly effective VOILELM was developed, with minimal breakage and emulsion diameter and maximum stability.

Evaluating Different TiO2 Nanoflower-Based Composites for Humidity Detection.

Unique three-dimensional (3D) titanium dioxide (TiO2) nanoflowers (TFNA) have shown great potential for humidity sensing applications, due to their large surface area-to-volume ratio and high hydrophilicity. The formation of a composite with other materials could further enhance the performance of this material. In this work, the effect of different types of composites on the performance of a TNFA-based humidity sensor was examined. NiO, ZnO, rGO, and PVDF have been explored as possible composite pairing candidates with TiO2 nanoflowers, which were prepared via a modified solution immersion method. The properties of the composites were examined using field emission electron spectroscopy (FESEM), X-ray diffractometry (XRD), transmission electron microscopy (TEM), X-ray photoelectron spectroscopy (XPS), current-voltage (I-V) analysis, Hall effect measurement, and contact angle measurement. The performance of the humidity sensor was assessed using a humidity sensor measurement system inside a humidity-controlled chamber. Based on the result, the combination of TiO2 with rGO produced the highest sensor response at 39,590%. The achievement is attributed to the increase in the electrical conductivity, hydrophilicity, and specific surface area of the composite.

Correction: Rare disease in Malaysia: Challenges and solutions.

[This corrects the article DOI: 10.1371/journal.pone.0230850.].

Barriers and facilitators to pharmacovigilance activities in Pakistan: A healthcare professionals-based survey.

The timely reporting of adverse drug reactions (ADRs) could improve pharmacovigilance (PV) in a healthcare system. However, in almost all healthcare systems barriers exist that lead to the underreporting of ADRs. The objective of this study was to identify the barriers and facilitators regarding PV activities from the point of view of healthcare professionals (HCPs) in Lahore, Pakistan. A cross-sectional questionnaire-based survey was conducted between September 2018 to January 2019. The data was collected through convenience sampling of physicians, pharmacists, and nurses at tertiary care public hospitals in Lahore. A total of 384 questionnaires were distributed, and 346 HCPs responded to the survey. Over 62% percent of physicians and 54.8% of nurses agreed that they did not know how to report an ADR in their workplace. About 43.2% of pharmacists and 40.1% of nurses disagreed that they were not aware of the need for ADR reporting. Furthermore, 41.6% of nurses identified a lack of financial reimbursement and 51.8% highlighted a lack of support from a colleague as a reason that could lead to the underreporting of ADR. The majority of participants, including 69.6% physicians, 48.6% pharmacists, and 55.3% nurses identified the lack of knowledge about the existence of a national PV centre. Extra time for ADR reporting, incentives, continuous medical education, reminders, and availability of an online ADR reporting system was classed as the facilitators and were agreed upon by the majority of HCPs.

A guide to designing graphene-philic surfactants.

HYPOTHESIS: As compared to common aliphatic surfactants, increasing the number of pendant or incorporated aromatic groups in a surfactant is expected to offer significant enhancement in the affinity for graphene surfaces. The basis for enhanced graphene-philicity of aromatic surfactants is that they can develop appreciable π - π interactions with graphene. Furthermore, charged (anionic) surfactants are expected to confer electrostatic stabilization on surfactant-graphene composites. Hence, it is expected that anionic aromatic surfactants combine these two properties for effective stabilization of graphene dispersions in water. EXPERIMENTAL: The properties of two custom made graphene-compatible surfactants carrying two and three aromatic moieties in the hydrophobic tails, namely DC3Ph2 (sodium 1,4-dioxo-1,4-bis(3-phenylpropoxy)butane-2-sulfonate) and TC3Ph3 (sodium 1,5-dioxo-1,5-bis(3-phenylpropoxy)-3-((3-phenylpropoxy)carbonyl) pentane-2-sulfonate) were compared with other common ionic commercial surfactants. Air-water (a/w) surface tension measurements were used to assess the surfactant adsorption and interfacial packing in the absence and presence of graphene. The surfactant coverage index for graphene (Ф) was calculated using surfactant headgroup areas derived from a/w surface tension data, chain volumes, and molecular fragment volumes from literature. FINDINGS: Increasing the number of aromatic groups and tails per surfactant was shown to increase the ability of surfactants to pack and fill space, as expressed by Ф. Comparison between the values of Ф for surfactants of different chain structure and architecture showed that the affinity for graphene increased with Ф. Hence, there is an implicit link between surfactant-graphene compatibility and the identity, chemical composition and architecture of the surfactant chains.

Barriers to scaling up hepatitis C treatment in Malaysia: a qualitative study with key stakeholders.

BACKGROUND: While the availability of generic direct-acting antivirals (DAAs) opens the door for large-scale treatment, the care for people living with hepatitis C virus (HCV) in Malaysia is shifting toward a tripartite partnership between the public health system, correctional settings and civil society organizations (CSOs). This study aimed to explore the barriers to scaling up HCV treatment in Malaysia from the perspective of key stakeholders. METHODS: Eighteen focus-group discussions (FGDs) were conducted with 180 individuals, who actively engaged in coordinating, executing or supporting the implementation of the national strategic plan for HCV. An analytical framework was adapted to guide the data collection and thematic analysis. It covered four key aspects of HCV treatment: geographical accessibility, availability, affordability and acceptability. RESULTS: Movement restrictions in times of coronavirus disease 2019 (COVID-19) outbreaks and being marginalized translated into barriers to treatment access in people living with HCV. Barriers to treatment initiation in health and correctional settings included limited staffing and capacity; disruption in material supply; silos mentality and unintegrated systems; logistical challenges for laboratory tests; and insufficient knowledge of care providers. Although no-cost health services were in place, concerns over transportation costs and productivity loss also continued to suppress the treatment uptake. Limited disease awareness, along with the disease-related stigma, further lowered the treatment acceptability. CONCLUSIONS: This study disclosed a series of supply- and demand-side barriers to expanding the treatment coverage among people living with HCV in Malaysia. The findings call for strengthening inter-organizational collaborations to overcome the barriers.

Extraction and Isolation of Cellulose Nanofibers from Carpet Wastes Using Supercritical Carbon Dioxide Approach.

Cellulose nanofibers (CNFs) are the most advanced bio-nanomaterial utilized in various applications due to their unique physical and structural properties, renewability, biodegradability, and biocompatibility. It has been isolated from diverse sources including plants as well as textile wastes using different isolation techniques, such as acid hydrolysis, high-intensity ultrasonication, and steam explosion process. Here, we planned to extract and isolate CNFs from carpet wastes using a supercritical carbon dioxide (Sc.CO2) treatment approach. The mechanism of defibrillation and defragmentation caused by Sc.CO2 treatment was also explained. The morphological analysis of bleached fibers showed that Sc.CO2 treatment induced several longitudinal fractions along with each fiber due to the supercritical condition of temperature and pressure. Such conditions removed th fiber's impurities and produced more fragile fibers compared to untreated samples. The particle size analysis and Transmission Electron Microscopes (TEM) confirm the effect of Sc.CO2 treatment. The average fiber length and diameter of Sc.CO2 treated CNFs were 53.72 and 7.14 nm, respectively. In comparison, untreated samples had longer fiber length and diameter (302.87 and 97.93 nm). The Sc.CO2-treated CNFs also had significantly higher thermal stability by more than 27% and zeta potential value of -38.9± 5.1 mV, compared to untreated CNFs (-33.1 ± 3.0 mV). The vibrational band frequency and chemical composition analysis data confirm the presence of cellulose function groups without any contamination with lignin and hemicellulose. The Sc.CO2 treatment method is a green approach for enhancing the isolation yield of CNFs from carpet wastes and produce better quality nanocellulose for advanced applications.

A Cross-Sectional Assessment of Urinary Tract Infections Among Geriatric Patients: Prevalence, Medication Regimen Complexity, and Factors Associated With Treatment Outcomes.

Background: Urinary tract infections (UTIs) are the second most prevalent infection among the elderly population. Hence, the current study aimed to evaluate the prevalence of UTIs among older adults, medication regimen complexity, and the factors associated with the treatment outcomes of elderly patients infected with UTIs. Methods: A retrospective cross-sectional study was conducted at the Department of Urology, Hospital Pulau Pinang, Malaysia. The patients ≥65 years of age were included in the present study with a confirmed diagnosis of UTIs from 2014 to 2018 (5 years). Results: A total of 460 patients met the inclusion criteria and were included in the present study. Cystitis (37.6%) was the most prevalent UTI among the study population followed by asymptomatic bacteriuria (ASB) (31.9%), pyelonephritis (13.9%), urosepsis (10.2%), and prostatitis (6.4%). Unasyn (ampicillin and sulbactam) was used to treat the UTIs followed by Bactrim (trimethoprim/sulfamethoxazole), and ciprofloxacin. The factors associated with the treatment outcomes of UTIs were gender (odd ratio [OR] = 1.628; p = 0.018), polypharmacy (OR = 0.647; p = 0.033), and presence of other comorbidities (OR = 2.004; p = 0.002) among the study population. Conclusion: Cystitis is the most common UTI observed in older adults. Gender, the burden of polypharmacy, and the presence of comorbidities are the factors that directly affect the treatment outcomes of UTIs among the study population.

Validation of newly developed culturally specific diabetes self-management education and support program for Iraqi type 2 diabetes mellitus patients.

BACKGROUND: Diabetes self-management (DSM) is the cornerstone in diabetes mellitus (DM) management. Unfortunately, the practice of DSM by Iraqi type 2 DM (T2DM) patients is poor that mainly resulted from their poor knowledge about the required DSM behaviors. This lack of knowledge may be attributed to the lack of DSM education and support (DSMES) program in Iraq. Thus, this study was conducted with aim of developing and validating a culturally specific DSMES program for Iraqi T2DM patients. MATERIALS AND METHODS: The development and validation of the DSMES program was done according to the Hilda Taba model. Content validity of the program was done by a panel of 6 health-care experts in management of Iraqi DM patients. Face validity was confirmed by conducting a pilot study for six adults with uncontrolled T2DM at the National Diabetes Center, Baghdad, Iraq. Both the experts and patients were asked to evaluate the developed program in regard to its contents, design, and supporting material (booklet). The evaluation was done by filling in a questionnaire that based on a 5-point scale. Items with a score ≥4 by <70% of the experts and patients were subjected to revision and further assessment. RESULTS: No total disagreement for any item was expressed by all participants (experts and patients). Content and face validity was ensured through obtaining a positive feedback from all participants at which all items about the program had scores of ≥4 by at least 75% of participants. CONCLUSION: The developed culturally based DSMES program is highly suitable for educating Iraqi T2DM patients.

Validation of the Arabic Version of General Medication Adherence Scale (GMAS) in Sudanese Patients with Diabetes Mellitus.

OBJECTIVE: The aim of this study was to validate the Arabic version of General Medication Adherence Scale (GMAS) in Sudanese patients with type 2 diabetes mellitus (T2DM). METHODS: A 3-month cross-sectional study was conducted among patients with T2DM at Al-Daraja Health Center, located in Wad Medani, Sudan. A convenient sample of patients was selected, and the study sample size was calculated using the item response ratio. Factorial, known group, and construct validities were determined. Internal consistency and reliability were also determined. RESULTS: Responses were provided by 500 patients. The average medication adherence score was 30 (median 31). The normed fit index (NFI) was 0.950, the comparative fit index (CFI) was 0.963, the incremental fit index (IFI) was 0.963, and the root-mean-square error of approximation (RMSEA) was 0.071. The results from these fit indices indicated a good model. Factorial, known group and construct validities were all established. A significant association was found between adherence score and age (P = 0.03) since a larger proportion of older patients were found to have high adherence compared to patients in other age groups. The reliability (α) of the questionnaire was 0.834. CONCLUSION: The Arabic version of GMAS was validated in Sudanese patients with T2DM making it a suitable scale to be used in this population.

Fabrication and application of composite adsorbents made by one-pot electrochemical exfoliation of graphite in surfactant ionic liquid/nanocellulose mixtures.

Previously, surfactant-assisted exfoliated graphene oxide (sEGO) formed with the triple-chain surfactant TC14 (sodium 1,4-bis(neopentyloxy)-3-(neopentylcarbonyl)-1,4-dioxobutane-2-sulfonate) was applied in wastewater treatment. The extent of dye-removal and the adsorption capacity of the sEGO formed with this triple-chain surfactant outperformed those of two other systems, namely, the di-chain version of TC14 (AOT14; sodium 1,2-bis-(2,2-dimethyl-propoxycarbonyl)-ethanesulfonate) and the single-chain surfactant sodium n-dodecylsulfate. In the present study, to further optimise the surfactant chemical structure, the sodium ion of TC14 was substituted with 1-butyl-3-methyl-imidazolium (BMIM) generating surfactant ionic liquids (SAILs; 1-butyl-3-imidazolium 1,4-bis(neopentyloxy)-3-(neopentyloxycarbonyl)-1,4-dioxobutane-2-sulfonate), hereafter denoted as BMIM-TC14. This SAIL, together with nanofibrillated kenaf cellulose (NFC), was used to electrochemically exfoliate graphite, yielding BMIM-TC14 sEGO/NFC composites. These highly hydrophobic polymer composites were then used for the removal of methylene blue (MB) from aqueous solution. 1H NMR spectroscopy was used to elucidate the structure of the synthesised SAILs. The morphologies of the resulting nanocomposites were investigated using Raman spectroscopy, field-emission scanning electron microscopy, and high-resolution transmission electron microscopy. Analysis using small-angle neutron scattering was performed to examine the aggregation behaviour of sEGO and custom-made SAILs. Zeta potential, surface tension, and dynamic light-scattering measurements were used to study the aqueous properties and colloidal stability of the suspension. Amongst the surfactants tested, BMIM-TC14 sEGO/NFC exhibited the highest MB adsorption ability, achieving 99% dye removal under optimum conditions. These results highlight the importance of modifying the hydrophilic moieties of amphiphilic compounds to improve the performance of sEGO/NFC composites as effective adsorbents for wastewater treatment.

Community Pharmacists' Awareness toward Their Roles in Healthcare and Interaction with General Practitioners: A Cross-Sectional Study.

INTRODUCTION: There is a paucity of data on the extended role of community pharmacists (CP) in Malaysia. This study is aimed to evaluate CPs awareness toward their roles in healthcare and interaction with general practitioners (GPs). MATERIALS AND METHODS: A cross-sectional design using a validated questionnaire was conducted nationwide among randomly selected Malaysian CPs. The questionnaire consisted of consisted of 32 questions with three sections. The Cronbach's alpha measure for the scale on awareness was 0.494 and 0.724 for the interaction between CPs and GPs. Descriptive statistics were reported. The Chi-square test, Mann-Whitney test, Kruskal-Wallis test, and post hoc analyses were applied at the alpha level of 0.05. RESULTS: Of the 127 CPs who filled out the responses, 57.5% (n = 73) mentioned that they rarely or never interacted with GPs. Many CPs (n = 106, 83.5%) were aware of their role in providing patient education, and 109 (85.8%) indicated that they could suggest nonprescription medicines to patients, whereas 88 respondents (69.3%) were aware that they could suggest alternative medicines. A total of 117 respondents (92.1%) indicated their willingness to perform selected screening tests and identify and prevent prescription errors. A considerable number of CPs (n = 76, 59.8%) were aware of their ability to design and regulate prescribed regimens, and 89 (70.1%) showed their willingness to monitor these regimens. The total average score of the CPs' awareness toward their roles in providing healthcare for the 16 activities/items and the value of the interaction mean score was 12.00 (±2.92), with a median score of 12.00 (interquartile range: 9.5-14.5). CONCLUSIONS: Malaysian CPs are fully aware of their role in providing healthcare and pharmaceutical care. Though the majority of them were willing to provide extended services, they are often unable to perform these roles due to the lack of interprofessional collaboration, lack of time, and absence of remuneration for their extended services. Training programs, practice guidelines, and professional service fee may encourage CPs to perform more extended services.