Mutations of transporter genes associated with drug resistance in Plasmodium Falciparum isolates from rural area of Sabah

The successful use of chloroquine(CQ) through the decades finally resulted in CQ resistant(CQR) Plasmodium falciparum. These drug resistant parasites led to high fatality in humans. CQR P. falciparum strains were spread through the world from Colombia and Cambodia-Thailand border within these decades. The ATP-binding cassette (ABC) protein plays the major role in drug resistance in P. falciparum. Antimalarial drug resistance was associated with single nucleotide polymorphisms (SNPs) in genes encoding ABC proteins. Three genes which are well studied include pfcrt (Plasmodium falciparum CQ-resistance transporter) pfmdr 1 (Plasmodium falciparum multidrug resistance 1) and pfmrp 1 (Plasmodium falcipi!rum multidrug resistance protein 1) genes. All pfcrt alleles in CQR parasites consistently include mutations for K76T and A220S accompanied by changes in two to six other mutations. Pfcrt K76T SNP is the major molecular determinant of CQR P. falciparum strains. N86Y marker of pfmdr 1 gene and K76T marker of pfcrtgene were prevalent in CQR isolates. Another SNP which is well studied and highly prevalent in pfmdr 1 gene is Y184F. Five SNPs, two SNPs and 1 SNP in pfcrt, pfmdr 1 and pfmrp 1 genes respectively were studied by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) and PCR-DNA sequencing methods in the current study. SVMNT and CVIET haplotypes of pfcrt gene were circulating in rural areas of Sabah. The results indicate that the drug resistant markers in drug resistant P. falciparum isolates from rural Sabah were supposed to be pfcrt 76T, 220S and pfmdr 1 84Y. Finally, we have succeeded to identify the molecular markers for CQR Plasmodlum falclparum for the rural areas of Sabah

Premenstrual syndrome among female medical students of Univerisiti Malaysia Sabah

The premenstrual syndrome (PMS) is particularly common in the younger age groups, posing a significant public health problem among young girls. It was noted that, among the female students, PMS was a frequent reason for seeking care at the in-house health clinics of Universiti Malaysia Sabah (UMS). The Faculty of Medicine and Health Sciences (FPSK) took an initiative to explore this problem as the health and quality of life of students are the major concerns of UMS. A cross-sectional study was conducted with 211 female medical students of FPSK to determine the prevalence of premenstrual syndrome (PMS) and to investigate its associated factors. American College of Obstetrics and Gynaecology (ACOG) PMS-criteria-based questionnaires were used. The mean age of students under study was 20.94±0.92 and 51.65% responded to have experienced PMS. Among the somatic symptoms, 70.6% of the studied females complained of breast tenderness, 62. 4% of abdominal bloating, 39.4% of headache and 2.8% of swelling of extremities. Common behavioural symptoms were irritability (80.7%), angry outbursts (66.1%), depression (57.8%), anxiety (53.2%), social withdrawal (31.2%), and confusion (24.8%). Among the reported symptoms; headache, confusion, irritability, social withdrawal, anxiety and swelling of extremities were significantly associated with PMS. However, the relationships between PMS and disturbances in students’ daily physical and mental activities were not statistically significant. As the prevalence estimated by this study was quite high, in-depth studies on PMS of female UMS students need to be conducted

The study oil road traffic injuries (RTL) in Kudat, Sabah State, Malaysia

With rapid urbanization of rural areas in Sabah, road traffic injuries are gaining higher ranks among the top priority hospital admissions. According to 2006 data, road traffic injuries and related cases ranked third and accounted for 7.75% of all hospital admissions in 10 Government Hospitals. The problem is considered to be in a rising trend as the number of motor vehicles used by the rural population is escalating. A retrospective case reviews of all cases of road traffic injuries, who sought treatment during January to December 2008, was conducted at the district hospitals of Kudat and Kota Marudu. Review of medical records was made and demographic data like age, sex and the relevant data such as type of road users, time of accident, type of vehicle , sites and type of wound as well as type of injury sustained were retrospectively collected. A total of 203 road traffic injuries were covered. Out of which, 68% were male. The highest percentage (30%) was found in the age group of 21-30 years. Passengers formed the major group of people affected by road traffic injuries. Nearly one fourth was noted to be suffering from severe bone injuries while more than one third of cases required referral to Queen Elizebeth hospital, Kota Kinabalu. Common sites of injury were head, face and limbs. According to 2004 statistics, the population in Kudat was 76046 within 1287.2sqkm while Kota Marudu has 70051 population within the area of 19170 sq km. It was estimated that 14 road traffic injuries cases to every 10,000 population occurred in year 2008, in these areas. Associated mortality at the time of accident was more than 4%. The study revealed the magnitude of road traffic injuries in terms of morbidity and mortality. The extent of injuries and the nature of bony involvements indicated the burden of road traffic injuries on medical and health care system. Thus the findings of this study would provide baseline data for the hospital planners and administrators to plan ahead for emergency measures as well as appropriate care of road traffic injuries in the area

Intestinal Parasites among school children (7 to 12 years) in rural areas of Kudat District Sabah Malaysia

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Unrecorded alcohol and alcohol-related harm in rural Sabah, Malaysia: a socio-economically deprived region with expensive beer and cheap local spirits

To investigate recorded and unrecorded alcohol and the relation to alcohol-related harm in a region with high taxation, economic deprivation and cultural use of alcohol. Methods: Two participants per household were systematically sampled from 12 different villages chosen using stratified random sampling in the North of Sabah, Malaysia. Participants were asked about each type and amount of drink consumed; price paid, whether tax was paid, number of days sick in the last year and whether they had experienced various health problems. A brief screen for mental disorders (PHQ) and an alcohol disorder screening test (AUDIT) were completed. Village heads were also interviewed about alcohol-related problems at village level. Results: 470 people were interviewed. The most commonly drunk beverages were beer and Montoku (a local distilled beverage), which had average prices of RM3.85 and RM0.48 per standard drink respectively. Montoku was more likely to be drunk by problem drinkers. Only 3.1% of alcohol drunk was believed by respondents to be taxed. Men with an AUDIT score of more than 15 were more likely to have had a sick day in the last year and have a female household member with symptoms of mental disorder on PHQ. Conclusions: Change in the taxation structure needs to be considered to reduce alcohol-related harm. Most alcohol consumed in rural Sabah is smuggled or informal. The low price of local spirits is likely to be contributing to alcohol-related harm. Differential effects on minority populations need to be considered when designing alcohol policy

Antenatal care practice and pregnancy out come at Sikuati area, Kudat, Sabah

Antenatal (AN) care is vital for all pregnant women and for reduction of maternal mortality and morbidity. AN care knowledge and specific AN care practices are some of the crucial components of what determines effective AN care. In developing nations, the health of pregnant women can be even more sensitive to these factors. Objectives of this study was to assess the antenatal ( AN) care practice and pregnancy outcome of ever-married women aged 18 to 49 years old having at least one pregnancy experience, residing in kampongs of Sikuati area, Kudat between March to December 2015. Cross–sectional descriptive study, non-probability convenient sampling method was used and 150 eligible participants were interviewed through face to face by trained interviewers using a semi- structured questionnaire and their knowledge of AN care, their AN care practices and outcomes and complications of their pregnancies were recorded. 99% of all the women received AN care, and 64% of the women received essential AN care practice (AN visit of minimum 4 times). The study revealed that overall knowledge amongst the women with good knowledge was 48% and low knowledge was 52%. Despite this, it was found that low knowledge of AN care was associated with essential AN care practice. Additionally, AN care practices, assessed through timing of first AN care visit and frequency of visits, was not significantly associated with pregnancy complications. Despite these results, outcomes were good and all complications were properly and successfully addressed. This may reflect the effectiveness of current programs in place promoting importance of AN care and delivery practices. Maintenance of current programs with targeted interventions to address low knowledge level and the low level of compliance with essential AN care completed are recommended

Preferred modalities for learning anatomy: medical students’ opinion

Learning anatomy is the basic and essential component of medical study when students start to learn in medical career. Since five hundred years ago, the human cadaver has been used as the silent mentor for students in learning anatomy. Later, pre-dissected specimens were used in addition to hands-on dissection of human cadaver. Current advances promote the use of anatomical models as well as plastinated specimens. This study focused on analyzing the preference of students towards different learning modalities available for anatomy teaching. It was conducted on first year medical students at the Faculty of Medicine and Health Sciences, University Malaysia Sabah (FPSK, UMS). A total of 76 students (27 males and 49 females) participated in this study. Out of 76 students, 57 (75%) students preferred using human cadaver for anatomy learning. Four students (5.3%) opted for plastinated specimen while 15 students (19.7%) chose the plastic model. Knowledge gained in learning Anatomy was said to be easier from cadaver (67.1%), followed by plastinated specimen (35.5%) and plastic models (52.6%). In the present study, 97.4% responded that plastic model was easier to apply their knowledge in objective structured practical examinations. The present study found that using cadaver was still favoured by medical students. Further studies are required to determine the preference between hands-on cadaveric dissections versus pre-dissected specimens

Antenatal care practice and pregnancy out come at Kudat area,Sabah,Northern Borneo

Women have been fulfilling their reproductive responsibility of propagating human race, many have died and many more faced death in the process of delivering babies, but this can be prevented by taking appropriated antenatal care, clean and safe delivery and essential obstetric care. Antenatal care is the first phase to be encountered once a woman has conceived. The objective of the study was to assess the antenatal (AN) care practice and pregnancy outcome of ever-married women aged 18 to 49 years old having at least one pregnancy experience, residing in kampongs of Kudat area, Sabah, East Malaysia, Northern Borneo from December 2015 to October 2016. Crosssectional analytical study, non-probability convenient sampling method was used and 300 eligible participants were interviewed face to face by trained interviewer using pretested questionnaire. 99.3% of all the women received AN care, and 97% of the women received AN care practice (AN visit of 4 times and above). Mean AN visit was 9 times. The study revealed that overall knowledge amongst the women with good knowledge was 47.2% and low knowledge was 52.8%. Additionally, there was significant association between education and knowledge, income and knowledge, AN care practices and knowledge. But there was no significant association between AN practice and complication. Despite these results, outcomes were good and all complications were properly and successfully addressed. This may reflect the effectiveness of current national maternal health programs

A training module to empower marginalised Northern Borneo islanders for tuberculosis control

Empowering marginalised urban islanders with limited heatlh accessibility for controlling pulmonary tuberculosis (PTB) requires a specific training module. Developing a training module for knowledge transfer to empower these marginalised islanders in high PTB occurrence region can be adapted based on IMCI framework. Structuring knowledge and skills for PTB control is based on the National Strategic Plan for Tuberculosis Control 2016-2020 and the Integrated Management of Childhood Illness (IMCI) framework is adapted for developing the training module. A total of five knowledge and skills were structured: 1) PTB disease and diagnosis, 2) PTB treatment, 3) preventive PTB measures, 4) prevention of malnutrion, and 5) psychosocial discrimination. The IMCI framework was adapted in 3 ways: 1) identifying signs and symptoms of PTB, 2) emphasising 5 steps: assess, diagnose, treat, counsel and detect, as the integrated management, and 3) counseling on BCG immunisation, malnutrition, environmental modifications and stigma on PTB