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The incidence of pulmonary tuberculosis (PTB) can be reduced by preventing transmission with rapid and precise case detection and early treatment. The Gene-Xpert MTB/RIF assay is a useful tool for detecting Mycobacterium tuberculosis (MTB) with rifampicin resistance within approximately two hours by using a nucleic acid amplification technique. This study was designed to reduce the underdiagnosis of smear-negative pulmonary TB and to assess the clinical and radiological characteristics of PTB patients. This cross-sectional study included 235 participants who went to the Luyang primary health care clinic from September 2016 to June 2017. The demographic data were analyzed to investigate the association of patient gender, age group, and ethnicity by chi-square test. To assess the efficacy of the diagnostic test, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated. The area under the curve for sputum for both AFB and gene-Xpert was analyzed to compare their accuracy in diagnosing TB. In this study, TB was more common in males than in females. The majority (50.71%) of the cases belonged to the 25–44-year-old age group and the Bajau ethnicity (57.74%). Out of 50 pulmonary TB cases (smear-positive with AFB staining), 49 samples were positive according to the Gene-Xpert MTB/RIF assay and was confirmed by MTB culture. However, out of 185 smear-negative presumptive cases, 21 cases were positive by Gene-Xpert MTB/RIF assay in that a sample showed drug resistance, and these results were confirmed by MTB culture, showing resistance to isoniazid. In comparison to sputum for AFB, Gene-Xpert showed more sensitivity and specificity with almost complete accuracy. The additional 21 PTB cases detection from the presumptive cases by GeneXpert had significant impact compared to initial observation by the routine tests which overcame the diagnostic challenges and ambiguities. [ABSTRACT FROM AUTHOR]

Quantification of fungal populations in the environment is important for gaining a better understanding of various microbial processes. Recently, the development of real-time quantitative PCR (RTQ-PCR) has eliminated the variability associated with conventional quantitative PCR, thereby allowing the routine and reliable quantification of PCR products. Thus, in this present study, RTQ-PCR was used to quantify the fungal target DNA extracted by three commonly used DNA extraction protocols (bead mill homogenization, grinding in the presence of liquid nitrogen, and hot detergent SDS based enzymatic lysis combined with bead beating) to determine the suitability of the quantification of target DNA. For the purpose of this study, pure culture of Aspergillus fumigatus (model organism), sterilized soil seeded with a known amount of A. fumigatus (model soil system), and woodland and grassland soil samples (environmental samples) were chosen to extract DNA by the above three different protocols. The extracted DNA was then quantified by spectroscopy and a RTQ-PCR system. 18S rDNA specific universal fungal primers were used to quantify the target part and then amplification products were verified by agarose gel electrophoresis. Standard curves used for the quantification by RTQ-PCR revealed strong linear relationships (R2=0.9994 for the primer pair NS1 and NS2 and 0.9938 for the primer pair nu-SSU-0817 and nu-SSU-1196) with a higher amplification efficiency, e=0.983 for the primer pair NS1 and NS2 and 0.956 for the primer pair nu-SSU-0817 and nu-SSU-1196. Although for pure culture the hot detergent SDS based enzymatic lysis combined with bead beating method showed the highest target DNA copy number (1.5 × 109 copies/μl), for the model soil system and both environmental samples the bead beating method was found to be suitable on the basis of the high target DNA copy numbers (6.16 × 108 and 2.7 × 108 copies/μl for woodland and grassland, respectively), high DNA yield (6.4 μg/g and 1.8 μg/g of soil for woodland and grassland, respectively), and high recovery on the basis of the target DNA copy number (39.2%), suggesting an overall high extraction efficiency. [Copyright &y& Elsevier]

To determine the extent of interference of co-extracted DNA contamination in the quantification of the tod gene transcript, two different concentrations of RNA (high, 500 ng/μl; low, 250 ng/μl) from a toluene-induced culture of Pseudomonas putida were treated with different amounts of DNase (2, 4, 6 and 8 U) and incubated for 30 and 60 min. The highly sensitive and reproducible TaqMan system was used to quantify the transcript of the tod gene, the tod gene in contaminating DNA and the 16S rRNA gene in DNase-treated RNA samples. For the high RNA concentration, the shorter incubation time (30 min) lowered the level of contaminating DNA as evidenced by the presence of 2.5 × 106 copies of the tod gene before treatment to 1.4 × 105 copies/μl (8 U), whereas, irrespective of the DNase units used, the longer incubation time (60 min) considerably lowered the level of DNA contamination (2.5 × 106 to 6.5 × 102 copies of the tod gene/μl). However, for the low RNA concentration, DNase treatment was found to be equally effective in lowering the level of contaminating DNA (106 to 102 copies of the tod gene/μ), irrespective of the incubation time and the amount of DNase used. Although the results of gel electrophoresis of conventional PCR amplification of the low RNA concentration revealed the absence of the target gene in contaminating DNA, the results of the TaqMan PCR indicated that a very low amount of contaminating DNA (less than 103 copies of the tod gene/μl) was still present in RNA samples, even after the DNase treatment. The number of copies of the tod gene transcript in RNA samples did not show any marked variation because of the DNase treatment. However, the proportion of contaminating DNA in RNA samples considerably decreased due to the treatment (0.01 to 0.000001). Furthermore, these results suggested that the extent of the removal of contaminating DNA from RNA samples depends on the concentration of RNA, the amount of DNase used and the incubation time. It is also suggested that the copies of the catabolic genes in contaminating DNA have to be quantified along with the target genes in RNA samples to have a more accurate quantification of the target genes for better understanding of their roles in many microbial processes. [Copyright &y& Elsevier]

Introduction: Role of nurses is very important in raising awareness, motivation level and increasing rate of organ donation subsequently. There are many studies on critical care nurses' roles and education affect organ donation. Methods: A narrative literature review article of published research. Twelve published articles from ten different countries were found using different renowned online search engines. Results: Knowledge about organ donation among nursing students almost all over the world is inadequate than expectation and requirement in respective country. Marlene R et al showed that scores on the knowledge, attitudes, and beliefs subscales were positively correlated with the number of requests for tissue and organs and consents obtained (0.76); and consents obtained for tissues and consents obtained for organs (0.72). Professional education was indicated in 43% of nurses surpassing family beliefs, religion and mass media. The cognitive part (knowledge) is directly depends on non-cognitive (Awareness and Attitude). Findings from almost all articles suggest the need of adding organ donation topic in the nursing and medical curriculum to prepare competent nurses and health care providers for future. Conclusion: This study suggests that there is a need to integrate organ donation aspects into the educational program to prepare nurses for their roles in organ and tissue procurement as well as awareness among policy makers in this regard for the well-being of our patients. [ABSTRACT FROM AUTHOR]

Introduction: Diabetic foot is an alarming complication of Diabetes Mellitus, results from neurological and vascular insufficiencies. If untreated, it may lead to amputation, resulting in a significant reduction in the quality of life and increase the risk of early death. Proper foot care with daily foot inspection and hygiene can prevent amputations. The objective of this study is to evaluate the knowledge, attitude, and practise of Diabetic foot care thus to establish the baseline reference for the effective foot care education and to propose an intervention method that is suitable for various cultural, religious and local circumstances. Methods: It was a cross-sectional survey conducted on diabetic patients who are seeking health care at HUMS Polyclinic, Kota Kinabalu, Sabah. A semi-structured Knowledge, Attitude and Practice validated questionnaire were used to get the information. Results: Around 93% of 30 diabetic patients knew that the self-examination was required but only 14 patients (46%)had the proper knowledge of foot care. Only 50% of respondent knew the correct way of cutting nails. 53% of the respondents were aware of proper foot-ware. The attitudes towards diabetic foot care, 96% were motivated to perform self-care. Although a high percentage of patients knew about diabetic foot care, but in practice the activities such as washing (100%), proper drying (83%), moisturizing (90%) and massaging (46%) were not executed together. Regarding nail cutting, only 33% practices proper technique and only 40% uses proper foot ware. Conclusions: Early detection and recognition of high-risk feet by patients and health care providers at regular intervals should be encouraged. It is essential to improve the awareness and practice of diabetic foot care daily by patients. Effective educational strategies should be established for both the health care providers and diabetic patients to create awareness for effective foot care. [ABSTRACT FROM AUTHOR]

Introduction: A unilateral enlarged tonsil always is a suspicion of carcinoma. Especially if it is with fungating ulcerative surface. Neoplasms in unilaterally enlarged tonsil include squamous cell carcinomas and lymphomas. Lymphomas in oropharynx are not common specially with fungating surface. Usually lymphomas in these areas are Non-Hodgkin's type. Case description: A 62-year-old woman was admitted in the tertiary level hospital of Kota Kinabalu, Sabah, with the complaint of sore throat, odynophagia and right neck swelling. She was treated as a case of acute tonsillitis by general practitioner without any noticeable improvement. Oral cavity examination revealed a hugely enlarged right tonsil with fungating ulcerative surface and almost obstructing the oropharynx. Trismus was seen which make the examination difficult. A non-tender right upper neck swelling was palpable. All baseline laboratory investigations were normal. A contrast-enhanced computed tomography (CECT) showed a heterogeneously enhancing mass at oropharynx compromising the airway, right supraclavicular lymphadenopathy. Histology of biopsy from right tonsillar mass showed High grade B-cell lymphoma. Chemotherapy was planned. First cycle of chemotherapy was administered, Patient was discharged home with the complete plan of chemotherapy. Conclusion: This patient was clinically suspicious of carcinoma of palatine tonsil. But later proven as high grade B-cell lymphoma. All unilateral enlarged tonsils are not always carcinoma. [ABSTRACT FROM AUTHOR]

Introduction: Obesity or overweight and its consequences are important public health problems globally resulting in a significant cause of morbidity such as hypertension, Diabetes Mellitus, hypercholesterolaemia, coronary artery disease, stroke, sleep apnoea, cancers and mortality which also render distressing financial burden on everyone. It is imperative to intervene in momentous strategies for early detection to prevent the weight-related epidemic. Methods: It was a health survey conducted in June 2019 to detect the prevalence of obesity and overweight problems and the resultant detrimental health conditions among the year 1 and year 2 medical students of the University Malaysia Sabah. The survey was done on 145 students aged between 19-23 years. The height, weight, BMI, waist circumference, blood pressure and capillary random blood glucose were measured. Pearson correlation and Chi-square tests were done to find an association between BMI and probable factors using SPSS. Results: The prevalence of obesity was 8.2%. High blood pressure was recorded in 23.45% participants where both systolic and diastolic blood pressure was high in 18.6%, only systolic blood pressure was high in 37.2% and only diastolic blood pressure was high in 28.3% among 145 students. There was no impaired glucose tolerance among the participants. There was a positive correlation between BMI and systolic (r=0.518, p<0.001) and diastolic (r=0.229, p<0.01) blood pressure despite age factor. There was also significant (Chi-square value=8.870, degree of freedom=1, p<0.01) association between obesity and high blood pressure. Conclusions: The findings of this study indicate that there was a significant association with obesity or overweight with hypertension. Healthy dietary behaviour and exercise should be encouraged. The ongoing monitoring of the population's health status remains crucially important for the prevention of hypertension, diabetes mellitus or other detrimental consequences. [ABSTRACT FROM AUTHOR]

Introduction: The use of medicinal plants as a remedy and prevention of diseases based on practical skills, knowledge and therapies was passed down from one generation to the next. It was reported by WHO that, approximately a quarter of the modern drugs were derivatives of plants or herbs, used as traditional medicines. It has contributed greatly in the health care management as the main source of medicine for many of the rural population in Sabah. This preliminary study was carried out to observe the use of medicinal plants in different villages of Kudat and to know about the knowledge of the villagers related to possible side effects of these plants. Methods: It was a cross-sectional descriptive study which was carried out in different villages of Kudat, Sabah, Malaysia between August and September 2018. The data were obtained through interviewing the people in different villages by using semi- structured questionnaire. Descriptive statistics were used to present the data. Results: Among the 87 participants, 37.9% were male and 62.1% were female. Their mean age was 45.87 (±14.03) and they were mostly from Kadazan-Dusun (50.6%) and Rungus (42.5%). The highest level of education among the participants was SPM (20.7%). Roots, stems, leaves, flowers and fruits of 49 plant species were reported in the treatment of more than 30 types of health conditions. Anaemia, hypertension, diabetes, joint pain, hypercholesterolaemia, fever, asthma, malaria, vomiting and few acute illnesses are mentionable. Majority (71%) of the participants did not have any knowledge about possible side effects of the orally ingested or tropically applied medicinal plants. Conclusion: There should be thorough research on dosage, mechanism of action and possible side effects of the medicinal plants and the results of these researches should reach the users of these plants. [ABSTRACT FROM AUTHOR]

Introduction: The liver, the most important metabolic organ of the body, performs a wide variety of vital functions. Hepatic cell injury occurs by the activation of reactive oxygen species (ROS) that are generated by carbon tetrachloride (CCl4), xenobiotics, and other toxic substances through cytochrome P450-dependent steps resulting from the covalent bond formation with lipoproteins and nucleic acids. Observing the urgent state of hepatotoxic patients worldwide, different medicinal plants and their properties can be explored to combat such free radical damage to the liver. In vivo and in silico studies were designed and conducted to evaluate the antioxidant and hepatoprotective properties of Gynura procumbens in rats. Materials and methods: Gynura procumbens leaves were collected and extracted using 70% ethanol. The required chemicals CCl4, standard drug (silymarin), and blood serum analysis kits were stocked. The in vivo tests were performed in 140 healthy Wister albino rats of either sex under well-controlled parameters divided into 14 groups, strictly maintaining Institutional Animal Ethics Committee (IEAC) protocols. For the histopathology study, 10% buffered neutral formalin was used for organ preservation. Later the specimens were studied under a fluorescence microscope. In silico molecular docking and absorption, distribution, metabolism, excretion, and toxicity (ADMET) studies were performed, and the results were analyzed statistically. Results and discussion: Gynura procumbens partially negate the deleterious effect of carbon tetrachloride on normal weight gain in rats. The elevated level of serum glutamate pyruvate transaminase (SGPT), serum glutamate oxaloacetate transaminase (SGOT), alkaline phosphatase (ALP), creatinine, LDH, total cholesterol (TC), low-density lipoprotein (LDL), triglycerides (TG), malondialdehyde (MDA), deoxyribonucleic acid (DNA) fragmentation ranges, gamma-glutamyl transferase (γ-GT) in CCl4 treated groups were decreased by both standard drug silymarin and G. procumbens leaf extract. We have found significant & highly significant changes statistically for different doses, here p<0.05 & p<0.01, respectively. On the other hand, G. procumbens and silymarin displayed Statistically significant (p<0.05) and high significant(p<0.01) increased levels of HDL, CAT SOD (here p<0.05 & p<0.01 for different doses) when the treatment groups were compared with the disease control group. Because the therapeutic activity imparted by plants and drugs accelerates the movement of the disturbed pathophysiological state toward the healthy state. In the molecular docking analysis, G. procumbens phytoconstituents performed poorly against transforming growth factor-beta 1 (TGF-β1) compared to the control drug silymarin. In contrast, 26 phytoconstituents scored better than the control bezafibrate against peroxisome proliferator-activated receptor alpha (PPAR-α). The top scoring compounds for both macromolecules were observed to form stable complexes in the molecular dynamics simulations. Flavonoids and phenolic compounds performed better than other constituents in providing hepatoprotective activity. It can, thus, be inferred that the extract of G. procumbens showed good hepatoprotective properties in rats. [ABSTRACT FROM AUTHOR]

Natural cellulose, a sustainable bioresource, is highly abundant in nature. Cellulosic materials, particularly those that explore and employ such materials for industrial use, have recently attracted significant global attention in the field of material science because of the unique properties of cellulose. The hydroxyl groups enable the formation of intra- and inter-molecular hydrogen bonding and the arrangement of cellulose chains in a highly ordered crystalline zone, with the remaining disordered structure referred to as an amorphous region. The crystalline areas of cellulose are well-known as cellulose nanocrystals (CNCs). In the present study, we extracted CNCs from pure cellulose isolated from waste jute fibers by sulfuric acid hydrolysis, followed by characterization. Pure cellulose was isolated from jute fibers by treating with sodium hydroxide (20% w/w) and anthraquinone (0.5%) solution at 170 °C for 2 h, followed by bleaching with chlorine dioxide and hydrogen peroxide solution. CNCs were isolated from pure cellulose by treating with different concentrations (58% to 62%) of sulfuric acid at different time intervals (20 min to 45 min). The FTIR study of the CNCs reveals no peak at 1738 cm−1, which confirms the absence of hemicellulose in the samples. The CNCs obtained after 45 min of acid hydrolysis are rod-shaped, having an average length of 800 ± 100 nm and width of 55 ± 10 nm, with a high crystallinity index (90%). Zeta potential significantly increased due to the attachment of SO42− ions on the surface of CNC from −1.0 mV to about −30 mV, with the increment of the reaction time from 20 min to 45 min, which proved the higher stability of CNC suspension. Crystallinity increased from 80% to 90% when the reaction time was increased from 20 to 45 min, respectively, while a crystallite size from 2.705 to 4.56 nm was obtained with an increment of the acid concentration. Acid hydrolysis enhanced crystallinity but attenuated the temperature corresponding to major decomposition (Tmax) at 260 °C and the beginning of degradation (Ti) at 200 °C due to the attachment of SO42− ions on the surface, which decreased the thermal stability of CNC. The second degradation at 360 °C indicated the stable crystal structure of CNC. The endothermic peak at 255 °C in the DTA study provided evidence of sulfated nanocrystal decomposition and the recrystallization of cellulose I to cellulose II, the most stable structure among the other four celluloses. The proposed easy-to-reproduce method can successfully and efficiently produce CNCs from waste jute fibers in a straightforward way. [ABSTRACT FROM AUTHOR]

Cancer has been one of the most dominant causes of mortality globally over the last few decades. In cancer treatment, the selective targeting of tumor cells is indispensable, making it a better replacement for conventional chemotherapies by diminishing their adverse side effects. While designing a drug to be delivered selectively in the target organ, the drug development scientists should focus on various factors such as the type of cancer they are dealing with according to which drug, targeting moieties, and pharmaceutical carriers should be targeted. All published articles have been collected regarding cancer and drug-targeting approaches from well reputed databases including MEDLINE, Embase, Cochrane Library, CENTRAL and ClinicalTrials.gov, Science Direct, PubMed, Scopus, Wiley, and Springer. The articles published between January 2010 and December 2020 were considered. Due to the existence of various mechanisms, it is challenging to choose which one is appropriate for a specific case. Moreover, a combination of more than one approach is often utilized to achieve optimal drug effects. In this review, we have summarized and highlighted central mechanisms of how the targeted drug delivery system works in the specific diseased microenvironment, along with the strategies to make an approach more effective. We have also included some pictorial illustrations to have a precise idea about different types of drug targeting. The core contribution of this work includes providing a cancer drug development scientist with a broad preliminary idea to choose the appropriate approach among the various targeted drug delivery mechanisms. Also, the study will contribute to improving anticancer treatment approaches by providing a pathway for lesser side effects observed in conventional chemotherapeutic techniques. [ABSTRACT FROM AUTHOR]

Cancer has been one of the most dominant causes of mortality globally over the last few decades. In cancer treatment, the selective targeting of tumor cells is indispensable, making it a better replacement for conventional chemotherapies by diminishing their adverse side effects. While designing a drug to be delivered selectively in the target organ, the drug development scientists should focus on various factors such as the type of cancer they are dealing with according to which drug, targeting moieties, and pharmaceutical carriers should be targeted. All published articles have been collected regarding cancer and drug-targeting approaches from well reputed databases including MEDLINE, Embase, Cochrane Library, CENTRAL and ClinicalTrials.gov, Science Direct, PubMed, Scopus, Wiley, and Springer. The articles published between January 2010 and December 2020 were considered. Due to the existence of various mechanisms, it is challenging to choose which one is appropriate for a specific case. Moreover, a combination of more than one approach is often utilized to achieve optimal drug effects. In this review, we have summarized and highlighted central mechanisms of how the targeted drug delivery system works in the specific diseased microenvironment, along with the strategies to make an approach more effective. We have also included some pictorial illustrations to have a precise idea about different types of drug targeting. The core contribution of this work includes providing a cancer drug development scientist with a broad preliminary idea to choose the appropriate approach among the various targeted drug delivery mechanisms. Also, the study will contribute to improving anticancer treatment approaches by providing a pathway for lesser side effects observed in conventional chemotherapeutic techniques. [ABSTRACT FROM AUTHOR]

Cancer has been one of the most dominant causes of mortality globally over the last few decades. In cancer treatment, the selective targeting of tumor cells is indispensable, making it a better replacement for conventional chemotherapies by diminishing their adverse side effects. While designing a drug to be delivered selectively in the target organ, the drug development scientists should focus on various factors such as the type of cancer they are dealing with according to which drug, targeting moieties, and pharmaceutical carriers should be targeted. All published articles have been collected regarding cancer and drug-targeting approaches from well reputed databases including MEDLINE, Embase, Cochrane Library, CENTRAL and ClinicalTrials.gov, Science Direct, PubMed, Scopus, Wiley, and Springer. The articles published between January 2010 and December 2020 were considered. Due to the existence of various mechanisms, it is challenging to choose which one is appropriate for a specific case. Moreover, a combination of more than one approach is often utilized to achieve optimal drug effects. In this review, we have summarized and highlighted central mechanisms of how the targeted drug delivery system works in the specific diseased microenvironment, along with the strategies to make an approach more effective. We have also included some pictorial illustrations to have a precise idea about different types of drug targeting. The core contribution of this work includes providing a cancer drug development scientist with a broad preliminary idea to choose the appropriate approach among the various targeted drug delivery mechanisms. Also, the study will contribute to improving anticancer treatment approaches by providing a pathway for lesser side effects observed in conventional chemotherapeutic techniques. [ABSTRACT FROM AUTHOR]

Background. Diabetes mellitus is one of the most notable health dilemmas. Analyzing plants for new antidiabetic remedies has become an impressive territory for life science researchers. Gynura procumbens has long been used to treat diabetes. Thus, we strived to ascertain the hypoglycemic potentiality of extract of leaves of G. procumbens by in vivo and in silico approaches. Methods. Fresh leaves of G. procumbens were collected and shade-dried to prepare ethanolic extracts to evaluate pharmacological parameters. Diabetes was induced in rats via injecting alloxan through the intraperitoneal route at a dose of 150 mg/kg body weight. Humalyzer 3000 was used to perform a biochemical assay of collected samples from rats. Anti-hyperglycemic activity study along with overdose toxicity test was performed. The pharmacological activity of this plant was also evaluated through a molecular docking study. This in silico study investigated the binding affinity of natural ligands from G. procumbens against glycoside hydrolase enzymes. Results. We detected a peak plasma concentration of G. procumbens at 3 hours 45 minutes that is roughly similar to the peak plasma concentration of metformin. Again, in OGTT and anti-hyperglycemic tests, it has been ascertained that both plant extract and metformin can exert significant P < 0.05 and highly significant P < 0.01 hypoglycemic activity in a dose-dependent manner. Metformin exhibited better therapeutic efficacy than that of plant extract, but it possessed null statistical significance. Also, our safety profile expressed that, similar to metformin, the plant extract can restore the disturbed pathological state in a dose-oriented approach with a wide safety margin. In silico study also validated the potentialities of natural constituents of G. procumbens. Conclusion. This study suggested that G. procumbens can be considered as potential antidiabetic plant. Robust and meticulous investigation regarding plant chemistry and pharmacology in the future may bring about a new dimension that will aid in discovering antidiabetic drugs from this plant in the diabetes management system. [ABSTRACT FROM AUTHOR]

Introduction: The National Centre for Complementary and Alternative Medicine (NCCAM) defines complementary and alternative medicine (CAM) as a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine. Many types of CAM practices, and they may be grouped into categories such as natural products, mind-body, and body-based practices. A broad collection of own-care and practitioner-based practices, (CAM) has been a major stream health care to meet the primary health care needs of people for centuries. A good proportion of the world's population, even in developed countries, continue to depend on CAM. This study aimed to find out the knowledge, attitude, and responses among nursing students of Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Malaysia. Methods: This cross-sectional study was carried out between June 2015 and June 2016. One hundred and eight (108) nursing studentsparticipated by simple random sampling. After taking informed consents, data were collected by structured questionnaire. The first section of survey data contained demographic profille. The second, third and fourth sections of the survey instrument consisted of the items assessing the knowledge of, interest in, and attitudes toward CAM. The last section consisted items to assess the attitude towards the teaching-and-learning in the curriculum. Descriptive statistics were used to present the data. Results: Out of 108 students, there were 19 males and 89 females. Knowledge did not have any relation (p>0.05) to response towards CAM but both positive and negative attitude was significantly (p<0.001) related to the response. Conclusion: Changes in the attitude will increase the use of CAM as complementary to the modern medicine. This attitude change requires extensive scientific studies regarding usefulness, side effects, and mechanism of actions of CAM. [ABSTRACT FROM AUTHOR]

Introduction: Since January 2010, the UMS Polyclinic, situated at Riverside Plaza, Kingfisher Park, Kota Kinabalu, Sabah, provided general medical consultation as well as specialist consultations comprising of Internal Medicine, Endocrinology (Diabetes and related problems), Dermatology, Rheumatology, Cardiology including ECG and ECHO services, Orthopedic, Ophthalmology, ENT (Ear, Nose and Throat), Obstetrics and Gynecology, Pediatrics and Psychiatry. The purpose of this study was to look into the Dermatology consultations provided by the UMS Polyclinic in order to improve health care services, by reporting on the demographic characteristics of the patients with reference to the provisional diagnosis and management offered, as well as referrals to tertiary health care centers for further managements. Methods: It was a retrospective, descriptive study which included 76 patients who visited the Dermatology Specialist Clinic at UMS Polyclinic from January to December 2018. Results: The 76 patients comprised of 50 males and 26 female patients with the age ranged from 2 years to 86 years, with 5 children (under the age of 12 years).The catchment population of the patients were mainly from Universiti Malaysia Sabah, Kingfisher, and also from wide areas of Kota Kinabalu with a few from Kudat,Tamparuli, Telipok, Keningau,Kinarut and Beaufort, etc. The consultations comprised of 19 varieties of dermatological problems to which were given appropraite management. The period of the year 2018 under study showed highest attendance in February with 21 patients (27.6%) followed by 13 patients (17.1%) in October with December showing 11 patients (14.5%). Conclusion: A total of 32 varieties of Dermatological problems were found among the 76 patients consulted. Acne Vulgaris was found to be the highest variant with 12 cases(15.7%) with Seborrhoeic Dermatitis seen as 5 cases (6.5%) followed by 4 cases (5.2%) each of Contact Dermatitis, Allergy/Hypersensitivity,Photosensitive Dermatitis, and Vitiligo. Certain patients had to be referred to Dermatology Department at Hospital Queen Elizabeth for further management, like for skin biopsy, and also for Electro-cautery machine, Phototherapy, and Laser, as we are still waiting for few equipments. [ABSTRACT FROM AUTHOR]

Introduction: Ascariasis is a parasitic infection, which commonly affects immunocompromised patients. Most patients remained asymptomatic during the early larval migration stage and respond well with conventional anti-helminthic drugs. Previous literature had reported symptomatic Ascaris infection mimicking bacterial pneumonia and the typical eosinophilia found in Loeffler syndrome was absent in patients on corticosteroids. Thus, a high index of suspicion for ascariasis is needed for immunosuppressed patients presented with infection. We present here a case of severe ascariasis infection in a systemic lupus erythematosus patient. Case description: A 16-year-old boy presented with fever, generalized maculopapular rash associated with neutropenia and thrombocytopenia. He was treated initially as Dengue Fever initially. However his symptoms did not resolve at even day 14 of admission. On further assessment, we were convinced he has SLE based upon presence of malar rash, oral ulcers, urinary proteinuria, persistent leucopenia, thrombocytopenia with low complements and ANA positive. He was promptly started on IV hydrocortisone. He showed a good progress in the first few days. On day 5 of admission, he coughed out a round worm which later identified as Ascarisis lumbricoides. He was started on Albendazole. Unfortunately he developed hemoptysis and respiratory compromisation where he required intubation. Post intubation he went into cardiac arrest, which required CPR. Following that event, his condition further deteriorated with multi organ failure. He succumbed to his illness three days later. Conclusion: Immunocompromised patients are prone to opportunistic infections including parasitic infections. we present here a case of ascariasis in an SLE patient who unfortunately succumbed to the illness. Due to the variable clinical symptoms that mimic other infections, screening for parasitic infections needs to be considered especially if the patients do not respond to antibiotics and routine treatments. [ABSTRACT FROM AUTHOR]

Introduction: Tuberculosis (TB) is the ninth leading cause of mortality in the world while it is the most prevalent infection which is ranked abolve HIV/AIDS. In Malaysia, tuberculosis is still a public health problem. Sabah State on Malaysian Borneo had 20-30% of total TB cases of the country. In Sabah, case notification rate of almost 200 per 100,000 population was still present in the last 10 years. Hotspots are defined as TB notification rate more than 100/100.000 in a district or TB notification rate more than 100/100,000 in the squatters' area. In this study, cycle threshold (ct) values in GeneXpertMTB/RIF (Xpert) were tried to be correlated with growth in Mycobacterim growth indicator tubes (MGIT) by measurement of time to detection (TTD). Methods: Sputum samples from six hotspots of Kota Kinabalu were studied by Xpert as well as MGIT culture after processing of sputum samples. The correlation between Mean ct value of Xpert and TTD in MGIT was analysed by using IBM SPSS Statistic 25 and the statistical test used was Pearson Correlation test. Results: The results of Xpert indicated 35 of 204 sputum samples were positive whereas only one sample was rifampicin resistant. The mean ct values were very low, low and medium in all the hotspots with sputum from one hotspot showed medium ct values predominantly. The sputum from remaining hotspots showed mainly very low and low ct values. MGIT results showed no growth in five samples with two very low, two low and one medium mean ct values. Conclusion: The finding indicated that there were correlations between mean ct values of Xpert and TTD in MGIT with a few exceptions. [ABSTRACT FROM AUTHOR]