Blastocystis sp. has been considered as an opportunistic intestinal parasite particularly in immunocompromised patient. Recent findings of the predominance of Blastocystis subtypes infection in the clinical disease with its interaction with gut microbiota in the hosts will be discussed accordingly. A total of 57 eligible studies, published from 2010 to October 2020 from a broad search in electronic databases were accessed. The studies showed that bloating, abdominal pain and diarrhoea were among the common symptoms in Blastocystis sp. infection in the immunocompromised patients. However, asymptomatic and healthy individuals were also infected by the Blastocystis sp. with higher prevalence among healthy individuals. Specifically, Blastocystis sp. ST3 were most frequently discovered among immunocompromised patients (IBS, cancer, transplant, HIV/AIDS, dengue) followed by ST1 and ST2. Despite most studies suggesting that Blastocystis sp. promote a healthy gut, a few studies had suggested otherwise. Blastocystis sp. colonisation may modify the gut microbiota with the reduction of beneficial bacteria phyla such as Firmicutes and Bacteroides. Although there was a positive association between Blastocystis sp. subtypes and clinical diseases, more studies are needed. To understand the pathogenicity of Blastocystis sp., their interactions with the gut microbiota communities in humans are properly discussed.

Background: Leptospirosis cases are typically rodent-sourced. Domestic animals like cattle and dogs are also known to be carriers of Leptospira but are rarely implicated in human cases. Case Presentation: In this case, a parasitology researcher who dissected dogs presented with atypical leptospirosis which had high possibility to be canine-sourced. Conclusion: Leptospirosis must be suspected in febrile patients with canine bodily fluid exposure.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become one of the most disastrous health crises of the present world. The COVID-19 pandemic imposes unprecedented challenges for medical education globally. We describe how the pandemic has disrupted the medical education landscape from the students' perspectives and how medical students from a public higher institution adapted to the changes made to comply with the various government agencies' guidelines to contain the spread of COVID-19 while fulfilling the course requirements. The utilisation of numerous innovative online applications enabled the students to participate in numerous teaching and learning activities (TLA) with more flexible scheduling of the classes, participated in a series of online case-based discussions, clinical practice guideline (CPG) discussions, case presentations and objective structured clinical examination (OSCE) simulations. Students also joined TLAs conducted by other institutions both locally and abroad. In addition, students had collaborated among themselves and students from other institutions to conduct online peer-teaching activities. Perhaps, the main challenges for online classes were being unable to perform medical procedures and technical issues, commonly the poor internet connectivity. In regard to physical examinations, students performed it on members of their household instead of real patients. Learning medicine from a distance also gave us an opportunity to taste telemedicine which may be the future of medical practice. Students and academics should be adaptive, resourceful and resilient in facing these changes together. The institution needs to look at all stakeholders' perspectives to respond to the changes in the medical education landscape.

Evidence of gut microbiota involvement in regulating glucose metabolism and type 2 diabetes mellitus (T2DM) progression is accumulating. The understanding of microbial dysbiosis and specific alterations of gut microbiota composition that occur during the early stages of glucose intolerance, unperturbed by anti-diabetic medications, is especially essential. Hence, this systematic review was conducted to summarise the existing evidence related to microbiota composition and diversity in individuals with prediabetes (preDM) and individuals newly diagnosed with T2DM (newDM) in comparison to individuals with normal glucose tolerance (nonDM). A systematic search of the PubMed, MEDLINE and CINAHL databases were conducted from inception to February 2021 supplemented with manual searches of the list of references. The primary keywords of “type 2 diabetes”, “prediabetes”, “newly-diagnosed” and “gut microbiota” were used. Observational studies that conducted analysis of the gut microbiota of respondents with preDM and newDM were included. The quality of the studies was assessed using the modified Newcastle-Ottawa scale by independent reviewers. A total of 18 studies (5,489 participants) were included. Low gut microbial diversity was generally observed in preDM and newDM when compared to nonDM. Differences in gut microbiota composition between the disease groups and nonDM were inconsistent across the included studies. Four out of the 18 studies found increased abundance of phylum Firmicutes along with decreased abundance of Bacteroidetes in newDM. At the genus/species levels, decreased abundance of Faecalibacterium prausnitzii, Roseburia, Dialister, Flavonifractor, Alistipes, Haemophilus and Akkermansia muciniphila and increased abundance of Lactobacillus, Streptococcus, Escherichia, Veillonella and Collinsella were observed in the disease groups in at least two studies. Lactobacillus was also found to positively correlate with fasting plasma glucose (FPG), HbA1c and/or homeostatic assessment of insulin resistance (HOMA-IR) in four studies. This renders a need for further investigations on the species/strain-specific role of endogenously present Lactobacillus in glucose regulation mechanism and T2DM disease progression. Differences in dietary intake caused significant variation in specific bacterial abundances. More studies are needed to establish more consistent associations, between clinical biomarkers or dietary intake and specific gut bacterial composition in prediabetes and early T2DM.

Introduction: Tropical herbs are used as a medicine long before the introduction of modern medicine, especially by traditional healers. However, its’ scientific benefits are not widely investigated. There is a belief that the use of traditional herbs potentially causing health deterioration due to its unknown mechanism of actions and interactions, and the nature of its unregulated processing as a health supplement. Parkia speciosa (local: petai) and Pithecellobium jiringa (local: jering) are two tropical herbs from the Leguminosae family that are widely used raw as salads with many perceived health benefits and harms. We reviewed both species, looking into scientific pieces of evidence supporting the belief. Methods: The databases of MEDLINE, PubMed, EBSCOhost, and Google Scholars were systematically searched for both in vitro and in vivo effects of both species with no language restriction. Data were extracted using standardised fashioned. Results: P speciosa has pharmacological properties including antioxidant and anti-inflammation. It has shown to have antibacterial properties and glucose-lowering activity. P jiringa contains known antioxidant metabolites such as flavonoids, phenolics and terpenoids. It also contains antiangiogenic properties with potential use in retinopathy, cancer, and Rheumatoid arthritis. However, both herbs have potentially harmful effects which include liver injuries. Large consumption of P jiringa leads to acute kidney injury. Conclusion: Consumption of both P speciosa and P jiringa has medicinal properties as well as health harm. If taken as a supplement, rigorous clinical trials are needed to delineate benefit vs harm effect of both herbs.

Healthy ageing is defined as the process of developing and maintaining the functional ability that enables wellbeing in older age individual. Through ageing, older people are exposed to the higher risks of having health illnesses. Skin health is important as it is the largest and most visible organ of the body and greatly influenced by environmental factors, hence considered as the indicator of ageing. Its appearance influences the individual mental status, social interaction, overall quality of life and especially women self-esteem which contributed to overall well-being. Living in the equator, Malaysians are exposed to a very high index of ultraviolet rays which can predispose to photo aging. However, the Asia region is blessed with varieties of herbal plants that contribute to the health and medicine of mankind for centuries. Its potential in treating different diseases, make scientists developed an interest in exploring the science and evidence behind it. Particularly in treating skin diseases, some of the herbs capability to adorn and improve skin appearance are well-established. Herbs have high potentiality due to primarily its' antioxidants activity. Antioxidants such as vitamins, flavonoid, phenolic acid and other active compounds play the main role in fighting against free radical species caused by the environmental insult. In this concept paper, we look for the works of literature of common herbs that can be found in Asia region to elaborate the properties of the herbs as anti-ageing such as photo protection, moisturizing, antioxidant which offer its benefits to the human against numerous negative effects of skin changes.

Introduction: Zika virus infection is caused by flavivirus virus and spread by Aedes mosquitoes. Since first reported in 1947, it spread to various countries especially in the equatorial region including Malaysia. The infection is non-fatal to an adult. However, the major risk of its infection is towards unborn baby when the mother is infected. The vertical transmission to the foetus possess various risks include the teratogenic effect that may lead to elective abortion. Thus, the objectives of this review are to discover about Zika virus and its effect on pregnant women and to evaluate Islamic perspective about elective abortion of Zika virus-infected women. Methods: This review was done through reviewing evidence from the journals, books and reports. The data were reviewed thematically according to the objectives. Results: Studies shown that Zika virus may cause miscarriage, preterm birth, microcephaly and other malformation known as Congenital Zika syndrome. This leads to a demand for elective abortion which raised Islamic ethical issue if it is permissible. In Islam, abortion is extremely prohibited once the foetus reached 120-day of conception unless it causes harm to the mother’s life. But, if the foetus age is less than 120-day, abortion is permissible when the pregnancy affects the mother’s health. Abortion due to foetal microcephaly and congenital malformation is prohibited. Conclusion: Effort must be taken to prevent the spread of Zika virus to reduce the need for an elective abortion through an education Muslim community regarding elective abortion.

Malaysia is categorized as an intermediate tuberculosis (TB) burden country by World Health Organisation. This cause great challenge as an occupational hazard for healthcare providers (HCPs) in Malaysia, as they received two- to three-fold greater risk of contracting TB than the general population. This cross-sectional questionnaire study aimed to assess HCPs' knowledge, attitude, practice, and stigma (KAPS) towards TB in Hospital Sultan Haji Ahmad Shah, Temerloh. A pilot-tested questionnaire was designed based on the WHO recommendation for KAPS study in TB. A survey was carried out between September 2018 and February 2019. Data were analyzed using SPSS version 25.The majority of respondents have moderate knowledge (75%) and practice (93%) on tuberculosis whilst scored lower on attitude (49%). Average self-perceived stigma was observed (67%) with higher sympathy (73%). Overall knowledge and practice on tuberculosis among HCPs in HOSHAS was good with some misconceptions about disease transmission. However, more works needed to improve the attitude and stigma towards TB, as it may affect health services delivery towards TB patients.

Possessing, processing and distributing marijuana or cannabis is illegal in many countries, especially Malaysia. Individuals guilty of that act may face imprisonment and even a death sentence even though cannabis oil and its derivative in the medical field have become more prevalent and have been legalised in many countries and recently in Thailand, a Malaysian neighbour. The Malaysian government is also evaluating and detailing the users and will have its final stand by 2022. Various studies proved marijuana to be beneficial for specific medical conditions. Thus, this paper aims to explore the current evidence of the use of medical marijuana from medical, legal and Islamic law views. The literature search was conducted online using various platforms such as google scholar, Pubmed, ScienceDirect, Medline EBSCO host and DOAJ. The search term includes "medical marijuana", "cannabis oils", "cannabis law", "Medical Marijuana Law", "cannabis"," marijuana legal", and "Islamic perspective". The content further discusses the medical perspective of marijuana, including its pharmacology, potential benefits and risks. In addition, the legal and Islamic views on medical marijuana, especially regarding the medical marijuana laws and Islamic rulings on marijuana use, will also be discussed.

During the pandemic, diagnosis of COVID-19 infection must be excluded in patients presenting with respiratory features, especially in the area where the incidence was high. This case report highlights a man who came with respiratory infection symptoms and the chest radiograph suspicious of COVID-19 pneumonia; however, his swab test for RT-PCR was negative for COVID-19. Later he was found to have a positive anti-HIV antibody and developed advanced HIV infection by multiple opportunistic infections. A 45-year-old man presented with chronic cough and dyspnea for three months which worsened five days before the presentation. It was associated with diarrhoea, dysphagia, weight loss, left lower limb weakness, with bowel and urinary incontinence. Chest auscultation revealed generalized crepitations. The first chest radiograph showed bilateral reticular opacities extending to the lung peripheries when the suspected diagnosis of COVID-19 pneumonia was made. The nasopharynx swab for RT-PCR for COVID-19 was negative, and the sputum was positive for Pneumocystis jirovecii. The contrast-enhanced CT (CECT) brain revealed changes consistent with brain abscess. The cerebrospinal fluid (CSF) examination was consistent with cryptococcal infection. He was initially treated in the Severe Acute Respiratory Infection (SARI) ward because of the initial impression of COVID-19. He was tested positive for Human Immunodeficiency Virus (HIV) rapid test and PCR, RPR and TPHA for syphilis. He was diagnosed with Pneumocystis jirovecii pneumonia, cryptococcal meningitis, brain abscess, oral and oesophageal candidiasis and syphilis. He was treated with co-trimoxazole, Amphotericin B, flucytosine, fluconazole, penicillin G and Nystatin. He initially improved upon treatment but later succumbed to his illnesses. Given the current situation of COVID-19, any patient with acute respiratory symptoms must be tested to rule out COVID-19 pneumonia. However, in a newly diagnosed advanced HIV patient presented with respiratory infection symptoms and extrapulmonary symptoms, opportunistic infections should be excluded along with COVID-19.

Volten VR4® capsules containing herb extract of Kaempferia parviflora has been claimed to reduce blood glucose in patients with diabetes. This preliminary study is conducted to evaluate the efficacy of Volten VR4® on healthy individuals and type-2 diabetes mellitus volunteers. The extracts of 400 mg capsules of Kaempferia parviflora (KP) were used to measure the blood glucose level of 2-hour postprandial. The healthy group consists of 15 young adults aged 20-30 with no history of serious diseases, while the diabetic group includes 12 individuals aged 35-75 diagnosed with type-2 diabetes mellitus. Data were validated through the Willcoxon and Friedman test statistics and error distribution. The investigation was continued to trace the capsules contents of elements using inductively coupled plasma optical emission spectrometry (ICP-OES) techniques. It has been shown that KP reducing blood sugar levels has been associated with flavonoids and methoxyflavones components. The result specifically showed that consuming VR4® capsules can significantly reduce blood glucose, either at the state of fasting or postprandially. In the study the content of mineral and heavy metal elements in VR4® capsules has been evaluated. Volten VR4® Kaempferia parviflora extract is safe to be consumed at a single dose of 400 mg. The study also has shown that the participants are free from adverse reactions and hypoglycaemia.

The term ‘Islamic medicine’ is controversial. Some denied modern medicine as Islamic practice as its origin from the Western. They believe Islamic medical practices follow the Prophetic Medicine (‘Al-Tibb al-nabawī’) which is the advice and practices of the Prophet Muhammed (pbuh) regarding sickness and treatment. This review is to enlighten practitioners regarding the concept of Islamic medicine and the view of modern medicine from the Islamic perspective.These literature reviews were carried out by collecting evidence from books, reports and the electronic databases (Google Scholars, Medline, PUBMED and EBSCOhost). According to the majority of Islamic and medicine scholars, the concept of Islamic medicine does not contradict the concept of modern medicine. The major differences was the basic paradigms, concept values and procedure conform to the Quran, Sunnah and tawhid to Allah. Islamic medicine is universal, flexible, and allows for growth and development. There is misconception the term Islamic Medical practice came from the Arabic civilization from the time of the Prophet (pbuh). Modern medicine on the other hand was a journey of knowledge by all civilizations including Ancient Egyptian, Greek and Medieval Islamic during the legacy of Prophet Muhammad pbuh. Further steps are needed to abolish misconceptions in Islamic medicine and to instil awareness among Muslim patients seeking medical treatment. Science and knowledge from ancient civilization, along with research in the modern day setting gives rise to modern medicine. Understanding the origin of modern medicine will deliberately highlight parts of the Islamic way of practicing medicine.