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.

Introduction: Parasitic worm infection is a global affliction with significant disease burden. The disease however is endemic in the tropics where poverty stricken communities live in substandard living conditions. In Malaysia, the infection is largely limited to Orang Asli (aborigine) and rural communities across the country where prevalence may reach up to 90%. Objective: This study investigates the parasitic worm infection in an aboriginal primary school closely located to Cyberjaya, the modern IT capital of Malaysia. Materials and Methods: 42 pupils from Bukit Cheeding primary school participated in this study and were screened for hel- minth infection by faecal sample examination using Kato-Katz technique. Result: The overall prevalence of soil-transmitted helminth (STH) infection was 59.5%. Majority of pupils were infected with Trichuris trichiura and Ascaris lumbricoides and double infection with Trichuris and Ascaris constituted 16.6% prevalence. None of the pupils were infected with hookworm. The infection rate amongst the males (66.7%) seemed to be higher than the females (46.7%). The mean worm burden for Ascaris lumbricoides was 2495.6 ± 1709 while for Trichuris trichiura was 1093.1 ± 433. Conclusion: Despite the rising affluence in Malaysia's Klang Valley, minority communities such as the aborigine who live side by side to modernity are still plagued with soil-transmitted helminth infection. More efforts are needed to address this problem.

Dengue fever is endemic in tropical urban developing regions worldwide. Thrombocytopenia is an important clinical feature which may result in bleeding. However, there is no specific treatment for Dengue-induced thrombocytopenia. Carica papaya leaves (CPL) is a popular remedy in South East Asia to treat Dengue-induced thrombocytopenia. Development of CPL into pharmaceutical therapeutic agents is not forthcoming due to lack of rigorous scientific evidence and unknown mechanism of action. This study investigated the role of thrombopoietin (TPO) and interleukin (IL-6) in the thrombocytosis effect of CPL in vivo. These experiments were conducted using busulfan-induced thrombocytopenic rats. Treatment of aqueous and methanol extracts of CPL at 600mg/kg were administered orally for 7 consecutive days and serum platelet count was determined intermittently until day 15. At the end of experiments, serum Thrombopoietin (TPO) and IL-6 levels were determined by ELISA. Both aqueous and methanol extracts of CPL significantly increased platelet count compared to the control groups (x2 (2) = 25.373, P = 0.00). Investigations into the mechanism of thrombocytosis showed that TPO and IL-6 levels were increased compared to controls but was not statistically significant (H (3) = 5.339 P = 0.149) (H (3) = 4.412 P = 0.220) respectively. This study is the first to document the thrombocytosis effect of both aqueous and methanol CPL extracts in a rodent model system. Our findings showed that aqueous extract of CPL demonstrated an increase of TPO and IL-6 levels. We suggested that the possible mechanism could be linked with the upregulation of major thrombopoietic cytokines such as TPO and IL-6