Aims: Bacterial pathogens such as Pseudomonas aeruginosa and Burkholderia pseudomallei are intrinsically resistant to many classes of antibiotics. This is not only due to the poor permeability of their outer membrane but also because of expression of multiple efflux pumps. A promising strategy to minimize the efflux of drugs by these pumps is the use of efflux pump inhibitors (EPIs). In this study, the potential of caffeic acid derivatives as EPIs in P. aeruginosa and B. pseudomallei were evaluated. Methodology and results: The potential of caffeic acid and its derivatives, i.e. chlorogenic acid, caffeic acid phenethyl ester (CAPE) and caffeic acid phenethyl amide (CAPA) to act as EPIs in P. aeruginosa and B. pseudomallei were assessed using the ethidium bromide (EtBr) accumulation and minimum inhibitory concentration (MIC) validation assays. Among the four test compounds, CAPE was found to significantly increased intracellular accumulation of EtBr in both P. aeruginosa and B. pseudomallei. An increase of 21.4% and 16.8% in cell fluorescence, over a 5-min time frame was observed in P. aeruginosa and B. pseudomallei respectively. Combination of CAPE with kanamycin significantly reduced MICs of this aminoglycoside by a factor of 8-fold in P. aeruginosa and 2-fold in B. pseudomallei. Combination of CAPE with gentamicin also led to a reduction of 4-fold MIC value of this antibiotic in B. pseudomallei. Conclusion, significance and impact of study: The in-vitro results suggest that CAPE has the potential to act as an EPI in P. aeruginosa and B. pseudomallei, thus improving the efficacy of aminoglycosides as antimicrobial agents.

Introduction: Outbreak of vaccine preventable disease still persists despite good coverage of immunization in Malaysia. Health literacy on childhood immunization is one of essential factor for the outbreak to happen. Thus, this study determined the predictors of health literacy on childhood immunization among antenatal mother in Seremban, Negeri Sembilan. Methodology: A cross sectional study was conducted among 424 antenatal women using a cluster sampling approach. Antenatal women who were Malaysian and not illiterate were chosen in this study. A self-administered, validated and pretested questionnaire was used to collect data on sociodemographic, socio economic, awareness on immunization, utilization of health care services and health literacy on childhood immunization. The data was analyzed using SPSS version 22.0. Chi Square test was used in bivariate analysis and multiple logistic regression was used to determine the predictors of inadequate health literacy on childhood immunization. Result: Out of 362 respondents, 81.2% were inadequate health literacy. The predictors were maternal education (AOR= 2.608, 95% CI 1.477-4.604), parity (AOR= 1.067, 95% CI 1.103-3.876), residential area (AOR= 2.344, 95% CI 1.184-4.641) and utilization of government hospital (AOR= 2.344, 95% CI 1.184-4.641). Conclusion: Accessibility of health education with regard to immunization need to be strengthen among primigravida, low education and those staying in rural area. In addition, health education also needs to emphasize on the individual that is employed and low economic status with underutilization of government hospital. A simplified education material with interesting pictures and using visual aids help illiterate people for better understanding.

Introduction: Pap smear screening may increase the quality of women’s health through early detection of cervical cancer thus providing a better prognosis for women with cervical cancer. While the benefit of Pap smear screening is well documented, the screening uptake among Malaysian women in general was unsatisfactory with only 47.3% being screened. This study aimed to determine the prevalence of Pap smear uptake and its associated factors among Orang Asli women who lives in rural areas in Selangor. Methods: A cross sectional study was conducted in Hulu Langat and Kuala Langat districts from April to July 2017. Through cluster sampling, five Orang Asli settlements in the two districts were chosen. All women in the selected village aged between 18 to 65 years were invited to participate and interviewed using a structured, pretested questionnaire. Data were analysed using SPSS Version 22. Univariate and bivariate analysis were conducted to identify factors associated with Pap smear uptake among the participants. All hypotheses tests were two-sided and level of significance was set at 0.05. Results: Out of the 147 respondents, 114 (77.6%) had undergone Pap smear for at least once in the past. Women aged more than 35 years (p=0.013) were shown to be significantly more likely to take Pap smear compared to women who were 35 years old and less. There were significant associations between marital status (p<0.001), knowledge (p<0.001), attitude (p<0.001) and use of oral contraceptive (p=0.001) with Pap smear uptake. Conclusion: This study showed a high prevalence of Pap smear uptake among Orang Asli women in Selangor.