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there is an increasing demand of Infrastructure roads due to increase in road traffic and related issues in safety. Roads are the dominant mode of transportation in India. Roads carry almost 85 percent of the country’s passenger traffic and more than 62 percent of its freight traffic Due to improvement in transportation network, reduction in transportation costs, such as reduction in travel time, decrease in vehicle operations cost, increased safety and reduction in the level of air and noise pollution. In addition to reduction is transportation cost, it also increases comfort to passenger and enhancing land value. Widening of road is mostly the case followed for the increasing demand. However, nowadays, for catering the needs of increasing traffic demand, Greenfield alignment is also as an option. Hence, there are advantages and disadvantages in both the alignments. This study involves for comparing and analyzing a NH 160A highway section between Ghoti to Trimbakeshwar for a length of 14.3 km. This paper compares the pros and cons of both alignments, costing of both the alignments, Geometry of both alignments; problems/issues like encroachment, forest area, Utilities in both alignments. In this study, the optimal alignment has been arrived by bringing all the issues to a common platform with a grading system. Further, different scenarios considered based on the requirement of a Client by doing Sensitivity analysis for various cases.

Background: Metformin has been added in the Malaysian clinical practice guideline (CPG) as one of the first-line options in the management of gestational diabetes mellitus (GDM); however, the uptake on this practice among healthcare professionals is unknown. Objective: The objective of the study is to determine the awareness, attitude, and practice and their predictors on the use of metformin for GDM among healthcare professionals in Malaysia. Materials and Methods: This was a multicenter, cross-sectional study in three tertiary hospitals in Malaysia. Medical doctors and pharmacists working in several departments were invited to participate in a survey using self-administered questionnaires. Results: From 350 questionnaires distributed, 225 were completed by medical doctors (43.1%), pharmacists (40.4%), and specialists (7.5%). Less than 30% of them were aware on the option of using metformin as one of the first-line agents in GDM. Education level, department, and profession were found to be associated with the awareness level (P = 0.016, P = 0.004, and P = 0.001, respectively). 70.2% of the respondents showed a positive attitude toward metformin use in GDM. Only 64 (28.4%) of the respondents have prescribed/dispensed metformin for GDM before, although more than half will consider doing so in the future. Having postgraduate qualifications increased the likelihood of having a good awareness (odds ratio [OR]: 2.44, 95% confidence interval [CI] 1.23–4.85) and to consider prescribing/dispensing metformin for GDM patients (OR: 2.27, 95% CI 1.08–4.78). Conclusion: Despite a positive attitude toward metformin use in GDM among healthcare professionals in Malaysia, their awareness level on this practice was low as they currently prefer the use of insulin over metformin.

Purpose: There is a wide range of use of complementary and alternative medicine (CAM), which has increased drastically and affected treatments overall. The knowledge and practice of Chinese herbal medicine among the general population is considered as positive. Literature shows that the effectiveness and acceptance of alternative therapies is still debatable among the general population. Materials and Methods: Study design was cross-sectional, in which sociodemographic data of respondents were collected through a validated questionnaire; results were analyzed by using validated data collection tool. The results were concluded on the basis of good, moderate, and poor response, which was evaluated through data analysis by the Statistical Package for the Social Sciences (SPSS) software, version 20.0. A P < 0.05 was considered as statistically significant. Results: Respondents were 182 (44.4%) males and 228 (55.6%) females; better knowledge was recognized among the females (P < 0.001) with mean knowledge of 15.55 ± 2.7. Chinese population had good knowledge with statistically strong correlation with mean knowledge of 15.63 (P = 0.006). Likewise, Buddhism was reported to have good knowledge among all the religions. Rural population was underlined with lesser family income and they showed good practice and understanding (P = 0.006). Comparatively positive attitude was noticed among the females (P < 0.001) with mean attitude of 15.55 ± 2.7. The highest level of education in this study was postgraduate, which showed 77.1% good attitude. Postgraduate participants were having varied results with standard deviation of ±6.23. Statistically highly significant association was seen between the religion and attitude of respondents with the P < 0.001. Chinese medicine is widely used, but religious difference was found among the races. Similar difference was found in knowledge and practice among the population of rural side and low family income compared to urban population with higher income and access to allopathic medicine. Conclusions: Despite having better practice among the Malaysian population, still the knowledge needs to be disseminated among the population for the overall use of traditional Chinese medicine with safety to improve health and quality of life in Malaysia.

Background: The study was focused on evaluating cytotoxic and antimicrobial activities of Erythrina suberosa (Roxb.) bark through in vitro pharmacological screening. Materials and Methods: The bark was extracted using different solvents, for example, dichloromethane, ethyl acetate, methanol, and aqueous for obtaining the organic fractions. These organic fractions were then evaluated for their cytotoxic and antimicrobial activity compared with the standard. Cefixime was used as the standard for antibacterial assay, whereas clotrimazole was used as the standard for antifungal activities. Bacterial strains used were Staphylococcus aureus and methicillin-resistant S. aureus (MRSA), whereas for antifungal activities Candida albicans, Candida parapsilosis, and Candida krusei strains were used. Results: The organic fractions obtained were evaluated for their cytotoxic and antimicrobial activities. In cytotoxic assay (Brine shrimp lethality assay), dichloromethane fraction was the most potent with LD50 of 47.63, whereas aqueous, methanol, and ethyl acetate fractions showed LD50 of 121.74, 422.2, and 201.96, respectively. Similarly, for antibacterial assay, dichloromethane fraction showed 32.2mm zone of inhibition against MRSA in comparison with standard cefixime (zone of inhibition, 30.5mm). A minimal zone of inhibition with crude saponins (13.1 and 12.2mm) was observed against C. albicans in comparison to standard (cefixime) with a zone of inhibition of 28.5mm. No prominent results were observed against C. parapsilosis and C. krusei strains. Conclusion: The study was based on the plant from Indo-Pak origin, and it has shown some prominent cytotoxic and antibacterial activities. Although the results of this study have provided a basic idea about the efficacy of plant extract, still more explanatory and high-scale studies can be beneficial for elaborating the cytotoxic and antimicrobial activities of this plant.

Background Extra-pulmonary tuberculosis (EPTB) represents about 14% of all cases of tuberculosis (TB) in Malaysia. The aims of the study include evaluation of socio-demographic factors, clinical manifestations, co-morbidities among patients with Tuberculous Lymphadenitis and their treatment outcomes.Methods The retrospective study was conducted from 2006 to 2008. Data on socio-demographic along with histopathological results were collected. Signs and symptoms were also recorded from TB registers, treatment cards and TB medical personal files using standard data collection tool. Among multiple variables significant factors identified by univariate analysis, were included in multivariate logistic regression to estimate the odds ratios (ORs) with the 95% confidence intervals (CIs). The statistically significant p value was considered as < 0.05.Results There were 348 (57%) males and on the other hand 262 (43%) females which shows almost equal incidence rate of Lymphadenitis in both genders. Mean age was found as 34.3 ± 14.6 years were majorly reported with positive diagnosis. 196 (32.1%) Malay was found with Tuberculous lymphadenitis followed by Chinese population of 148 (24.3%). Geographically from 386 (63.3%) urban population were found positive for lymphadenitis and over 224 (36.7%) of rural region. treatment outcome was observed 444 (72.8%) with successful treatment. WHO states the types of treatment failures and accordingly 85 (13.9%) patients were continued with the therapy that can be due to non-compliance or relapse of Tb. Among unsuccessful outcomes 194 patients of age group 26 -35 years, 65 (33.5%) were reported and 38 (29.7%) patients out of 128 between 16 – 25 years. Blood results showed erythrocyte sedimentation rate greater than 10 in 280 (45.9%) patients. Therefore, among 280 there were 115 (41.1%) patients found to have unsuccessful treatment showing strong association with p-value of

Prior-to the COVID-19 outbreak, undergraduate PharmCare II Clerkship activities consisted of two phases. The first phase requires pharmacy students to clerk infectious disease and endocrine-related cases of patients admitted into wards at a teaching hospital, whilst in the second phase, the students are required to present the clerked cases in front of their group members with a thorough assessment by lecturers at Universiti Sains Malaysia. Due to sudden outbreak of COVID-19, presentations at hospitals and face-to-face learning were no longer feasible; therefore an online methodology was executed. Each student was assigned a real completed case clerked by a previous Master’s in Clinical Pharmacy graduate. The students then critically evaluated any pharmaceutical care issues (PCIs) in each of the cases, recorded a video presentation for assessment by the lecturers and discussed each case with other group members in a synchronous online session via web-conferencing software.

Background: This study aimed to evaluate the phytochemicals screening of Erythrina suberosa (Roxb) bark and to analyze the enzymatic activities of its various organic fractions. Materials and Methods: Crude methanolic fraction of E. suberosa (Roxb) bark and its respective fractions were screened for the presence of different phytochemicals with different reagents. On the basis of increasing order of polarity, different organic solvents were used to obtain different fractions. Enzymatic studies were performed on crude methanolic extract of the plant. All the assays were performed under standard in vitro conditions. Results: The phytochemical analysis shows the presence of alkaloids, phenols, triterpenoids, phytosterols, and flavonoids. Phenolic compounds and flavonoids are the major constituents of the plant. In anticholinesterase assay, the percent inhibition of standard drug (eserine) was 91.27 ± 1.17 and the half maximal inhibitory concentration (IC50) was 0.04 ± 0.0001. For α-glucosidase inhibition, the IC50 value for Dichloromethane fraction was 8.45 ± 0.13, for Methanol fraction it was 64.24 ± 0.15, and for aqueous fraction it was 42.62 ± 0.17 as compared with standard IC50 that is 37.42 (acarbose). Furthermore, results show that all fractions have potential against anti-urease enzyme, but DCM fraction of crude aqueous extract has significant IC50 value (45.26 ± 0.13) than other fractions. Conclusion: Keeping in view all the results, it is evident that the plant can be used in future for formulating effective drugs against many ailments. Secondary metabolites and their derivatives possess different biological activities, for example, .g. flavonoids in cancer, asthma, and Alzheimer. Furthermore, the extracts of this plant can be used in their crude form, which is an addition to the complementary and alternative treatment strategies.

Purpose: The demand of complementary and alternative medicine (CAM) has increased drastically over the past few decades. The perceptions about CAMs among general population are positive. However, the literature highlights that effectiveness and acceptance of alternative therapies among the general population is still a subject of debate. Materials and Methods: This is a cross-sectional study and the response along with demographic details was collected through a validated questionnaire; the results were analyzed by using a validated data collection tool. The results were concluded based on good, moderate, and poor responses, which were evaluated through data analysis by using the Statistical Package for the Social Sciences software version 20.0., SPSS Inc., Chicago, III, USA. A value of P < 0.05 was considered statistically significant. Results: In total, 182 (44.4%) of male and 228 (55.6%) of female respondents were selected for this study. Studies showed that a greater knowledge level was observed among female respondents (15.55 ± 2.7, P < 0.001). The selected Chinese population had relatively good knowledge (i.e., 15.63, P = 0.006). People practicing Buddhism had also good knowledge. Rural population had lesser family income and showed a good practice pattern and understanding (P = 0.006). The positive attitude was identified among women ( P < 0.001) with a mean score of 15.55 ± 2.7. Postgraduate participants were found to have diverse results with SD ± 6.23, and 77.1% had a good attitude. A statistically significant association was observed between religion and attitude of respondents (P < 0.001). Conclusion: Although a better practice was noticed in Malaysian population, more awareness is required and knowledge should be disseminated among the population to improve the overall health and quality of life in Malaysia.

Background: This study aimed to evaluate the phytochemicals screening of Erythrina suberosa (Roxb) bark and to analyze the enzymatic activities of its various organic fractions. Materials and Methods: Crude methanolic fraction of E. suberosa (Roxb) bark and its respective fractions were screened for the presence of different phytochemicals with different reagents. On the basis of increasing order of polarity, different organic solvents were used to obtain different fractions. Enzymatic studies were performed on crude methanolic extract of the plant. All the assays were performed under standard in vitro conditions. Results: The phytochemical analysis shows the presence of alkaloids, phenols, triterpenoids, phytosterols, and flavonoids. Phenolic compounds and flavonoids are the major constituents of the plant. In anticholinesterase assay, the percent inhibition of standard drug (eserine) was 91.27 ± 1.17 and the half maximal inhibitory concentration (IC50) was 0.04 ± 0.0001. For α-glucosidase inhibition, the IC50 value for Dichloromethane fraction was 8.45 ± 0.13, for Methanol fraction it was 64.24 ± 0.15, and for aqueous fraction it was 42.62 ± 0.17 as compared with standard IC50 that is 37.42 (acarbose). Furthermore, results show that all fractions have potential against anti-urease enzyme, but DCM fraction of crude aqueous extract has significant IC50 value (45.26 ± 0.13) than other fractions. Conclusion: Keeping in view all the results, it is evident that the plant can be used in future for formulating effective drugs against many ailments. Secondary metabolites and their derivatives possess different biological activities, for example, .g. flavonoids in cancer, asthma, and Alzheimer. Furthermore, the extracts of this plant can be used in their crude form, which is an addition to the complementary and alternative treatment strategies.