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Baharudin Abdullah,1 Kar Chai Koh,2 Mohazmi Mohamed,3 Vincent Eng Soon Tan,4 Nurashikin Mohammad,5 Zamberi Sekawi,6 Petrick Periyasamy,7 Anitha Ramadas,8 Martin Duerden9 1School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia; 2Kepong Baru Polyclinic, Kuala Lumpur, Malaysia; 3Department of Primary Care Medicine, Universiti Malaya Medical Centre, Kuala Lumpur, Malaysia; 4KPJ Klang Specialist Centre, Klang, Selangor, Malaysia; 5KPJ Ampang Puteri Specialist Hospital, Selangor, Malaysia; 6Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia; 7Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; 8Department of Pharmacy, Hospital Kuala Lumpur, Ministry of Health, Kuala Lumpur, Malaysia; 9Centre for Medical Education, Cardiff University, Cardiff, UKCorrespondence: Baharudin Abdullah, Department of Otorhinolaryngology – Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia, Tel +6097676416, Email profbaha@gmail.comIntroduction: Using antibiotics in the treatment of acute sore throats has been linked with antimicrobial resistance (AMR) and needs to be addressed. The consensus sought to improve diagnostic accuracy, decrease unwarranted antibiotic prescriptions and enhance patient outcomes.Methods: A multidisciplinary panel of nine experts reviewed published literature and discussed current practices in managing sore throat. Ten evidence-based statements on sore throat and AMR, diagnostic accuracy and antibiotic prescribing, and symptomatic therapy were developed. A modified Delphi exercise was then carried out. A consensus was reached if at least 70% of the group agreed with the statement.Results: All 10 statements for managing acute sore throat achieved consensus. The major concern of AMR caused by improper antibiotic prescribing, particularly in cases of viral sore throat, was recognized. This underscores the need for improved diagnostic tools, such as the McIsaac score, to reduce needless antibiotic prescriptions. To improve patient satisfaction, effective pain management using non-antibiotic alternatives such as paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), and flurbiprofen throat lozenges was recommended. Pain and inflammation can be adequately managed with low-dose NSAIDs. The potential benefits of topical NSAIDs were acknowledged for their milder safety profile than oral formulations.Conclusion: A consensus was achieved on the use of a clinical diagnostic tool, prudent use of antibiotics, and symptomatic therapy in acute sore throat management. The McIsaac score and point-of-care testing (POCT) for the presence of group A beta-hemolytic Streptococcus (GABHS) can aid in the decision-making process for antibiotic use, reducing needless prescriptions. The mainstay of therapy is symptomatic treatment, which includes the use of NSAIDs.Keywords: antibiotic, antimicrobial resistance, diagnosis, sore throat, symptomatic treatment

Sara Soheili,1 Sobhan Ghafourian,2 Zamberi Sekawi,1 Vasantha Kumari Neela,1 Nourkhoda Sadeghifard,2 Morovat Taherikalani,2 Afra Khosravi,2 Ramliza Ramli,3 Rukman Awang Hamat11Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health sciences, Universiti Putra Malaysia, Serdang, Malaysia; 2Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran; 3Department of Medical Microbiology and Immunology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaakob Latif, Bandar Tun Razak, Kuala Lumpur, Malaysia Abstract: The toxin–antitoxin (TA) system is a regulatory system where two sets of genes encode the toxin and its corresponding antitoxin. In this study, the prevalence of TA systems in independently isolated clinical isolates of Enterococcus faecium and Enterococcus faecalis was determined, the dominant TA system was identified, different virulence genes in E. faecium and E. faecalis were surveyed, the level of expression of the virulence and TA genes in normal and stress conditions was determined, and finally their associations with the TA genes were defined. Remarkably, the analysis demonstrated higBA and mazEF in all clinical isolates, and their locations were on chromosomes and plasmids, respectively. On the other hand, a quantitative analysis of TA and virulence genes revealed that the expression level in both genes is different under normal and stress conditions. The results obtained by anti-mazF peptide nucleic acids demonstrated that the expression level of virulence genes had decreased. These findings demonstrate an association between TA systems and virulence factors. The mazEF on the plasmids and the higBA TA genes on the chromosomes of all E. faecium and E. faecalis strains were dominant. Additionally, there was a decrease in the expression of virulence genes in the presence of anti-mazF peptide nucleic acids. Therefore, it is suggested that mazEF TA systems are potent and sensitive targets in all E. faecium and E. faecalis strains.Keywords: Enterococcus faecium, Enterococcus faecalis, toxin–antitoxin system, virulence genes, peptide nucleic acids

Shuaibu A Hudu,1,2 Yasmin A Malik,3 Mohd Taib Niazlin,1 Nabil S Harmal,1,4 Ariza Adnan,5 Ahmed S Alshrari,1 Zamberi Sekawi1 1Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia; 2Department of Pathology and Medical Microbiology, College of Health Sciences, Usmanu Danfodiyo University Sokoto, Sokoto State, Nigeria; 3Department of Clinical Science, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Selangor, Malaysia; 4Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen; 5Cluster of Laboratory Medical Sciences, Faculty of Medicine Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia Objectives: This study aimed to evaluate the level of hepatitis B immunity among undergraduate students 23 years after commencement of the nationwide hepatitis B childhood immunization program in Malaysia. Methods: A total of 402 serum samples obtained from volunteer undergraduate students were screened for the presence of hepatitis B surface antibodies using qualitative ELISA. Results: Results showed that 62.7% of volunteers had protective anti-hepatitis B surface antigens (≥10 IU/L), of whom 67.9% received three doses of the vaccine. The estimated post-vaccination immunity was found to be at least 20 years, indicating persistent immunity against hepatitis B and a significant association (P < 0.05) with duration of vaccination. Anamnestic response 1 month post-hepatitis B booster was 94.0% and highly significant (P < 0.01). Isolated anti-hepatitis B core antigen (anti-HBc) prevalence was found to be 5.0%, all having had a positive anamnestic response. Conclusion: Immunity after primary vaccination with hepatitis B recombinant vaccine persists for at least 20 years post-vaccination, with significant association with the number of vaccinations. Furthermore, the presence of anamnestic response to booster vaccine indicates long-lasting immunity despite decreasing antibody levels; therefore, the need for hepatitis B vaccine boosters may not be of significant benefit after complete infant vaccination. Keywords: hepatitis B vaccination, persistent immunity, anamnestic response, booster vaccination

Problem statement: Plant antioxidants are natural plant products that inhibit the adverse effects of the Reactive Oxygen Species (ROS) produced in plants. Thus, antioxidants enable plants to survive. Depending on this principle, human beings started using some plants' parts to cure from diseases many centuries ago, even before the discovery of microbes or disclosing the etiology of many human diseases. Shed light on the importance of diet and natural products that have proved of great health impact on human traditionally and scientifically, disclosing the central role of natural antioxidants in this matter. Moreover, this review tried to give an overview on the research has so far done in Asian countries particularly in the field of natural antioxidants during the period 2000-2008. Therefore, the aim of this review is to present a comprehensive index for the antioxidant property of herbs and plants that have been traditionally used as well as experimentally proved beneficial in these countries. Approach: We had compared Asian and other nation's diet in the popularity of the traditional medicine and the type of daily meal in respect to their antioxidants contents and valuable health promoting effects. Many literatures had been collected using online search engines and the main library of University Putra Malaysia. The gathered data had been arranged alphabetically in a table depending on the plant's scientific name, common name, the used part(s) and the family name. Results: The research had shown that there were seventy-six plants with proved antioxidant activity which had been well studied by Asian scientists in the chosen period of time. Conclusion: The antioxidant components of the natural products constitute the major source of human health promotion and maintenance. The nature is still the perfect source for health promotion and for the supplementation of safe drugs. Great attention is mandatory from all the scientists around the world to explore many underestimated plants with highly effective antioxidant activity. Key words: Dietary supplements, herbs, medicinal food, natural products, spice, INTRODUCTION Since antiquity, man has used plants to treat common infectious diseases and some of these traditional medicines are still included as part of the habitual treatment of various maladies [...]

Most food poisoning outbreaks are caused by consumers' poor knowledge, attitude, perception, and behaviour in relation to food safety. A valid and reliable tool is thus needed to measure these factors among the consumers. A total of 79 respondents participated in this pilot survey using convenient sampling, and participants self-completed the questionnaire given. Item analysis was conducted to determine the difficulty and discrimination indices of 40 items involved in knowledge construction. Construct validity and reliability were performed on 33 items which measured attitudes, preventive practices, and perceptions. Item analysis showed that more than 80% of respondents answered 19 items correctly. The discrimination index revealed that 16 items scored below 0.20. The Average Variance Extraction for all latent constructs, namely attitude, practice, and perception met acceptable threshold values of 0.527, 0.517, and 0.535, respectively. The Fornell-Larcker criterion suggested that three latent constructs were acceptable for discriminant validity. The internal consistency and reliability for all scaled items in each construct were good, with Cronbach's alpha values of more than 0.7 (0.820, 0.809, and 0.799 for attitude, practice, and perception, respectively). In conclusion, the present work indicated that the knowledge, attitude, practice, and perception (KAP2) questionnaire used could be a valid and reliable measure to evaluate consumer's knowledge, attitude, preventive practice, and perception on food poisoning. [ABSTRACT FROM AUTHOR]