Displaying publications 1 - 20 of 39 in total

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  1. Adam BA
    Med J Malaysia, 1973 Mar;27(3):192-4.
    PMID: 4268922
    Matched MeSH terms: Acne Vulgaris/drug therapy
  2. Leelavathi, M., Mazlin, M.B., Adawiyah, J.
    Medicine & Health, 2013;8(1):0-0.
    MyJurnal
    Natural products are often perceived as safe due to the absence of artificial or chemical materials in its content. However, many are unaware that some of these compounds, albeit natural in existence, can cause harm. Cinnamon and lemon are two commonly used home remedies for acne. Both these naturally existing ingredients are capable of producing dermatitis upon contact with the human skin. The aim of this article is to create awareness among physicians that natural remedies are not free from harm hence, should look out for any possible untoward reactions that these products may cause. Physicians need to explore the possible use of homemade remedies to treat common or minor ailments during history taking as this information may not be given voluntarily. Early identification of the offending agent, adequate management and future avoidance could help prevent further episodes of contact dermatitis and its complications.
    Matched MeSH terms: Acne Vulgaris
  3. Abad-Casintahan F, Chow SK, Goh CL, Kubba R, Hayashi N, Noppakun N, et al.
    J Dermatol, 2016 Jul;43(7):826-8.
    PMID: 26813513 DOI: 10.1111/1346-8138.13263
    In patients with darker skin types (Fitzpatrick phototypes III-VI), acne is often accompanied by post-inflammatory hyperpigmentation (PIH). Further, acne-related pigmentation can pose a greater concern for the patient than the acne lesions. There has been little formal study of this acne-related PIH. Recently, the Asian Acne Board - an international group of dermatologists with interest in acne research - made a preliminary evaluation of the frequency and characteristics of PIH in seven Asian countries. A total of 324 sequential acne subjects were evaluated for the presence of PIH. The majority (80.2%) of subjects had mild to moderate acne and there were more females than males (63.0% vs 37.0%). In this population of patients consulting a dermatologist for acne, 58.2% (188/324) had PIH. The results also showed that pigmentation problems are often long lasting: at least 1 year for more than half of subjects and 5 years or longer in 22.3%. In accordance with our clinical experience, patients reported that PIH is quite bothersome, often as bothersome or more so than the acne itself and sometimes more problematic. Excoriation was commonly reported by patients, and may represent a modifiable risk factor that could potentially be improved by patient education.
    Matched MeSH terms: Acne Vulgaris/complications*; Acne Vulgaris/epidemiology
  4. Mohd Nor NH, Aziz Z
    J Dermatolog Treat, 2013 Oct;24(5):377-86.
    PMID: 22658322 DOI: 10.3109/09546634.2012.699179
    OBJECTIVE: Comparative trials of benzoyl peroxide (BPO) have yielded contradictory results on its effectiveness for acne vulgaris. The aim of the study was to synthesise the evidence for the effectiveness of BPO-containing topical products for facial acne vulgaris.
    DESIGN: Systematic review.
    METHODS: The Cochrane Central Register of Controlled trials, Cochrane Library, MEDLINE and other relevant databases were searched without publication date or language restriction.
    RESULTS: We identified 22 trials involving 2212 participants; 12 trials compared BPO as single agent while the other 10 trials compared BPO in combination products. All trials reported lesion count as the outcome measure but only five trials provided numerical data. However, pooling of data from these trials was inappropriate due to variations between trials in terms of acne severity, comparator used and trial duration. Overall the study quality was fair but most studies had some bias particularly in method of random generation and allocation concealment. Although the results provide some evidence that BPO reduces acne-lesion count, the available evidence is not robust enough for firm conclusions.
    CONCLUSIONS: There is no high quality evidence that topical BPO improves facial acne vulgaris, and further research is needed.
    Matched MeSH terms: Acne Vulgaris/drug therapy*
  5. Ismail NH, Manaf ZA, Azizan NZ
    BMC Dermatol., 2012;12:13.
    PMID: 22898209 DOI: 10.1186/1471-5945-12-13
    BACKGROUND: The role of dietary factors in the pathophysiology of acne vulgaris is highly controversial. Hence, the aim of this study was to determine the association between dietary factors and acne vulgaris among Malaysian young adults.
    METHODS: A case-control study was conducted among 44 acne vulgaris patients and 44 controls aged 18 to 30 years from October 2010 to January 2011. Comprehensive acne severity scale (CASS) was used to determine acne severity. A questionnaire comprising items enquiring into the respondent's family history and dietary patterns was distributed. Subjects were asked to record their food intake on two weekdays and one day on a weekend in a three day food diary. Anthropometric measurements including body weight, height and body fat percentage were taken. Acne severity was assessed by a dermatologist.
    RESULTS: Cases had a significantly higher dietary glycemic load (175 ± 35) compared to controls (122 ± 28) (p  0.05).
    CONCLUSIONS: Glycemic load diet and frequencies of milk and ice cream intake were positively associated with acne vulgaris.
    Matched MeSH terms: Acne Vulgaris/etiology*; Acne Vulgaris/physiopathology
  6. Hisham A, Mohamed Sukur S, Basiron N
    Australas J Dermatol, 2018 Nov;59(4):336-337.
    PMID: 29377074 DOI: 10.1111/ajd.12789
    Matched MeSH terms: Acne Vulgaris/drug therapy*
  7. Chew SS
    Family Practitioner, 1982;5:27-30.
    Matched MeSH terms: Acne Vulgaris
  8. Navedur Rehman, Chin Chwen Ch’ng, Thavin Kumar Mathana Sundram, Eugenie Sin Sing Tan, Chew Kek Lee, Chung Keat Tan3
    MyJurnal
    Introduction: Acne vulgaris is a chronic inflammatory dermatosis caused by Propionibacterium acnes. Clinicians are constantly attempting to discover the best antibiotic regimes in treating acne vulgaris. This study compares two regimens in terms of efficacy, tolerability, compliance and recurrence rate to make recommendation on which is the best regime. Methods: An open-labelled prospective randomized investigator-blinded interventional study was carried on moderate acne vulgaris patients. Patients were assigned to treatment arm at enrolment followed by fol- low-up and maintenance visits. Demographic data were collected at enrolment and questionnaire enquiring acne condition, general health and quality of life impairment were filled at every visit followed by blinded dermatologist assessment. Antibiotic tablets were provided based on assigned arm until follow-up 3. Results: 26 mild acne vulgaris patients aged 17 to 29 years were recruited. Physician assessment based on GAGS and photo assessment analysis showed an overall significant change (p0.05) were found between regimens. Similarly, patient self-perceived assessment and CADI assessment also showed overall significant changes (p
    Matched MeSH terms: Acne Vulgaris
  9. Khairani O, Zaiton S, Faridah MN
    Med J Malaysia, 2005 Jun;60(2):134-9.
    PMID: 16114152
    The aims of the study were to determine the prevalence of the common health problems namely acne, overweight, smoking and depressive symptoms among adolescents attending a primary healthcare clinic, whether they seek treatment for these problems and the reasons for not consulting health professionals. It was a clinic-based, crosssectional study. All adolescents aged 13 to 20 years who attended the clinic during the study period were included in the study. The respondents were given self-administered questionnaires and their weights were measured to assess if they had the above disorders. A total of 215 adolescents were included in the study. The proportion of adolescents who had acne were 70.7%, overweight 8.9%, smoking 41.9% and depressive symptoms 9.8%. Only 25% of those who had acne, 47% of those who were overweight, 9.5% who had depressive symptoms and none of those who smoked had ever sought treatment for these problems. The common reasons given for not consulting the health professionals were 'did not consider it as a problem', 'shy' and 'thought there was no treatment available'. The majority of the adolescents who attended the clinic did not consult health professionals the above common health problems. It is important to educate them on these disorders and encourage health-seeking behaviour in adolescents.
    Matched MeSH terms: Acne Vulgaris
  10. Goh CS
    Med J Malaysia, 1981 Jun;36(2):87-8.
    PMID: 6211594
    Matched MeSH terms: Acne Vulgaris/drug therapy*
  11. Zhang H, Liao W, Chao W, Chen Q, Zeng H, Wu C, et al.
    J Dermatol, 2008 Sep;35(9):555-61.
    PMID: 18837699 DOI: 10.1111/j.1346-8138.2008.00523.x
    Sebaceous gland diseases are a group of common dermatological diseases with multiple causes. To date, a systematic report of the risk factors for sebaceous gland diseases in adolescents has not been published. The aim of this study was to assess the prevalence and risk factors for certain sebaceous gland diseases (seborrhea, seborrheic dermatitis, acne, androgenetic alopecia and rosacea) and their relationship to gastrointestinal dysfunction in adolescents. From August-October, 2002-2005, a questionnaire survey was carried out to obtain epidemiological data about sebaceous gland diseases. Using random cluster sampling, 13 215 Han adolescents aged 12-20 years were recruited from four countries or districts (Macau; Guangzhou, China; Malaysia; and Indonesia). The statistical software SPSS ver. 13.0 was used to analyze the data. The prevalence of seborrhea, seborrheic dermatitis, acne, androgenetic alopecia and rosacea was 28.27%, 10.17%, 51.03%, 1.65% and 0.97%, respectively. Based on multivariate logistic regression analysis, the risk factors for sebaceous gland diseases included: age; duration of local residency; halitosis; gastric reflux; abdominal bloating; constipation; sweet food; spicy food; family history of acne; late night sleeping on a daily basis; excessive axillary, body and facial hair; excessive periareolar hair; and anxiety. There was a statistically significant difference in the prevalence of gastrointestinal symptoms (halitosis; gastric reflux; abdominal bloating; constipation) between patients with and without sebaceous gland diseases (chi(2) = 150.743; P = 0.000). Gastrointestinal dysfunction is an important risk factor for diseases of the sebaceous glands and is correlated with their occurrence and development.
    Matched MeSH terms: Acne Vulgaris*
  12. Khaing MS, Parash MTH, Shimmi SC, Kabir S, Chodanakar NC, Subramaniam P, et al.
    MyJurnal
    ABSTRACTS FOR THE 1ST INTERNATIONAL BORNEO HEALTHCARE AND PUBLIC HEALTH CONFERENCE AND 4TH BORNEO TROPICAL MEDICINE AND INFECTIOUS DISEASE CONGRESS. New Frontiers in Health: Expecting the Unexpected; Held at the Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia; On 3rd-5th September 2019
    Introduction: Since January 2010, the UMS Polyclinic, situated at Riverside Plaza, Kingfisher Park, Kota Kinabalu, Sabah, provided general medical consultation as well as specialist consultations comprising of Internal Medicine, Endocrinology (Diabetes and related problems), Dermatology, Rheumatology, Cardiology including ECG and ECHO services, Orthopedic, Ophthalmology, ENT (Ear, Nose and Throat), Obstetrics and Gynecology, Pediatrics and Psychiatry. The purpose of this study was to look into the Dermatology consultations provided by the UMS Polyclinic in order to improve health care services, by reporting on the demographic characteristics of the patients with reference to the provisional diagnosis and management offered, as well as referrals to tertiary health care centers for further managements. Methods: It was a retrospective, descriptive study which included 76 patients who visited the Dermatology Specialist Clinic at UMS Polyclinic from January to December 2018.
    Results: The 76 patients comprised of 50 males and 26 female patients with the age ranged from 2 years to 86 years, with 5 children (under the age of 12 years).The catchment population of the patients were mainly from Universiti Malaysia Sabah, Kingfisher, and also from wide areas of Kota Kinabalu with a few from Kudat,Tamparuli, Telipok, Keningau, Kinarut and Beaufort, etc. The consultations comprised of 19 varieties of dermatological problems to which were given appropraite management. The period of the year 2018 under study showed highest attendance in February with 21 patients (27.6%) followed by 13 patients (17.1%) in October with December showing 11 patients (14.5% ).
    Conclusion: A total of 32 varieties of Dermatological problems were found among the 76 patients consulted. Acne Vulgaris was found to be the highest variant with 12 cases(15.7%) with Seborrhoeic Dermatitis seen as 5 cases (6.5%) followed by 4 cases (5.2%) each of Contact Dermatitis, Allergy/Hypersensitivity, Photosensitive Dermatitis, and Vitiligo. Certain patients had to be referred to Dermatology Department at Hospital Queen Elizabeth for further management, like for skin biopsy, and also for Electro-cautery machine, Phototherapy, and Laser, as we are still waiting for few equipments.
    Matched MeSH terms: Acne Vulgaris
  13. Ismail MT
    Malays J Reprod Health, 1994 Jun;12(1):43-8.
    PMID: 12320338
    PIP: Marvelon, a monophasic oral contraceptive (OC) containing 30 mcg of ethinyl estradiol and 150 mcg of desogestrel, has been available to Malaysian women through the national family planning program since 1982. To assess the safety, effectiveness, and side effects associated with this OC, 247 women who requested the pill were enrolled in a multicenter prospective study that included follow-up after the first, third, and sixth cycles of use. 81% of participants had never used any form of contraception before Marvelon. 194 women (79%) completed the 6-month study. There were no pregnancies recorded. Although women reported a slightly increased incidence of nausea, breast tenderness, and headache in the first treatment cycle, these side effects had abated by the end of the third cycle. After six cycles, mean body weight had decreased by an average of 0.4 kg. Both systolic and diastolic blood pressure were unaffected. An unexpected finding was a decrease in the severity of acne with continuous use of Marvelon. Although both spotting and breakthrough bleeding increased slightly in the first two cycles, irregular bleeding returned to pretreatment levels by the third cycle. The length of the withdrawal bleed in the pill-free week was reduced. The incidence of irregular bleeding and other side effects was substantially lower in this sample of Malaysian women than in Asian and Caucasian Marvelon users surveyed in other studies.
    Matched MeSH terms: Acne Vulgaris*
  14. Ismail R
    Med J Malaysia, 1987 Jun;42(2):124-6.
    PMID: 2971861
    Acne is one of the most common disorders affecting mankind. Although acne does not cause death, it however produces a lot of discomfort, disfigurement and psychological trauma, particularly in teenagers. Acne vulgaris is a chronic condition involving the pilosebaceous unit of the skin. It is characterised by the presence of comedones, inflammatory papules, pustules or cysts, and eventually by scarring. The end result of acne varies from hyperpigmentation, slight pitting, to extremely disfiguring scars that may develop into keloids. Acne fulminans is a rare disorder and is characterised by sudden explosive appearance of highly inflammatory, tender, crusted, ulcerated lesions involving the back, chest and face. It is one of the most scarring acute dermatologic disorders of young people. A case of acne fulminans in a young female who developed haemolysis due to dapsone is reported here.
    Matched MeSH terms: Acne Vulgaris/drug therapy*
  15. Ramli R, Malik AS, Hani AF, Jamil A
    Skin Res Technol, 2012 Feb;18(1):1-14.
    PMID: 21605170 DOI: 10.1111/j.1600-0846.2011.00542.x
    INTRODUCTION: This paper presents a comprehensive review of acne grading and measurement. Acne is a chronic disorder of the pilosebaceous units, with excess sebum production, follicular epidermal hyperproliferation, inflammation and Propionibacterium acnes activity. Most patients are affected with acne vulgaris, which is the prevalent type of acne. Acne vulgaris consists of comedones (whitehead and blackhead), papules, pustules, nodules and cysts.
    OBJECTIVES: To review and identify the issues for acne vulgaris grading and computational assessment methods. To determine the future direction for addressing the identified issues.
    METHODS: There are two main methods of assessment for acne severity grading, namely, lesion counting and comparison of patient with a photographic standard. For the computational assessment method, the emphasis is on computational imaging techniques.
    RESULTS: Current acne grading methods are very time consuming and tedious. Generally, they rely on approximation for counting lesions and hence the assessment is quite subjective, with both inter and intra-observer variability. It is important to accurately assess acne grade to evaluate its severity as this influences treatment selection and assessment of response to therapy. This will further help in better disease management and more efficacious treatment.
    CONCLUSION: Semi-automated or automated methods based on computational imaging techniques should be devised for acne grade assessment.
    Matched MeSH terms: Acne Vulgaris/classification*; Acne Vulgaris/diagnosis*
  16. Gunter NV, Teh SS, Lim YM, Mah SH
    Front Pharmacol, 2020;11:594202.
    PMID: 33424605 DOI: 10.3389/fphar.2020.594202
    The pathogenesis of skin inflammatory diseases such as atopic dermatitis, acne, psoriasis, and skin cancers generally involve the generation of oxidative stress and chronic inflammation. Exposure of the skin to external aggressors such as ultraviolet (UV) radiation and xenobiotics induces the generation of reactive oxygen species (ROS) which subsequently activates immune responses and causes immunological aberrations. Hence, antioxidant and anti-inflammatory agents were considered to be potential compounds to treat skin inflammatory diseases. A prime example of such compounds is xanthone (xanthene-9-one), a class of natural compounds that possess a wide range of biological activities including antioxidant, anti-inflammatory, antimicrobial, cytotoxic, and chemotherapeutic effects. Many studies reported various mechanisms of action by xanthones for the treatment of skin inflammatory diseases. These mechanisms of action commonly involve the modulation of various pro-inflammatory cytokines such as interleukin (IL)-1β, IL-6, IL-8, and tumor necrosis factor α (TNF-α), as well as anti-inflammatory cytokines such as IL-10. Other mechanisms of action include the regulation of NF-κB and MAPK signaling pathways, besides immune cell recruitment via modulation of chemokines, activation, and infiltration. Moreover, disease-specific activity contributed by xanthones, such as antibacterial action against Propionibacterium acnes and Staphylococcus epidermidis for acne treatment, and numerous cytotoxic mechanisms involving pro-apoptotic and anti-metastatic effects for skin cancer treatment have been extensively elucidated. Furthermore, xanthones have been reported to modulate pathways responsible for mediating oxidative stress and inflammation such as PPAR, nuclear factor erythroid 2-related factor and prostaglandin cascades. These pathways were also implicated in skin inflammatory diseases. Xanthones including the prenylated α-mangostin (2) and γ-mangostin (3), glucosylated mangiferin (4) and the caged xanthone gambogic acid (8) are potential lead compounds to be further developed into pharmaceutical agents for the treatment of skin inflammatory diseases. Future studies on the structure-activity relationships, molecular mechanisms, and applications of xanthones for the treatment of skin inflammatory diseases are thus highly recommended.
    Matched MeSH terms: Acne Vulgaris
  17. Leelavathi M, Tan HC, Puah JWD, Apipi M, Sohami AE, Mahat NF
    Medicine & Health, 2015;10(1):1-9.
    MyJurnal
    Acne can affect personal appearance and impair quality of life. A cross sectional study, over a period of 12 months was conducted among medical students at Universiti Kebangsaan Malaysia to evaluate the disability, self management and help-seeking behaviour of medical students for acne. A total of 361 students were selected using stratified cluster random sampling. Acne was graded using the Comprehensive Acne Severity Score (CASS) while acne disability was assessed using the Cardiff Acne Disability Index (CADI). Acne self management and helpseeking behaviour was assessed using the acne management questionnaire. Mean CADI score was 3.35 + 2.39, with mostly mild (83.8%, n=206) and moderate (14.6%, n=36) levels of impairment. Female students and those from the nonMalay ethnic group demonstrated higher disability (3.76 + 2.24, p=0.006 and 3.79 + 2.59, p=0.018, respectively). Although the majority of students (87.4%, n=215) knew that acne can be treated, they preferred to discuss their acne problems with friends (54.1%, n=133) rather than consulting a physician (9.3%, n=23). Most of them also practiced non-evidence based measures for their acne. The results of the present study shows that young adults tend to have mild grades of acne severity and disability. However, efforts are needed to enhance their knowledge on evidence based management of acne and modify their help seeking behavior. This would help reduce complications such as permanent scars and improve quality of life, as acne is a treatable dermatological disorder.
    Keywords: acne vulgaris, medical, disability, quality of life, students, severity, self care
    Matched MeSH terms: Acne Vulgaris
  18. Al-Talib H, Al-Khateeb A, Hameed A, Murugaiah C
    An Bras Dermatol, 2017 5 26;92(2):212-216.
    PMID: 28538881 DOI: 10.1590/abd1806-4841.20175273
    Acne vulgaris is an extremely common condition affecting the pilosebaceous unit of the skin and characterized by presence of comedones, papules, pustules, nodules, cysts, which might result in permanent scars. Acne vulgaris commonly involve adolescents and young age groups. Active acne vulgaris is usually associated with several complications like hyper or hypopigmentation, scar formation and skin disfigurement. Previous studies have targeted the efficiency and safety of local and systemic agents in the treatment of active acne vulgaris. Superficial chemical peeling is a skin-wounding procedure which might cause some potentially undesirable adverse events. This study was conducted to review the efficacy and safety of superficial chemical peeling in the treatment of active acne vulgaris. It is a structured review of an earlier seven articles meeting the inclusion and exclusion criteria. The clinical assessments were based on pretreatment and post-treatment comparisons and the role of superficial chemical peeling in reduction of papules, pustules and comedones in active acne vulgaris. This study showed that almost all patients tolerated well the chemical peeling procedures despite a mild discomfort, burning, irritation and erythema have been reported; also the incidence of major adverse events was very low and easily manageable. In conclusion, chemical peeling with glycolic acid is a well-tolerated and safe treatment modality in active acne vulgaris while salicylic acid peels is a more convenient for treatment of darker skin patients and it showed significant and earlier improvement than glycolic acid.
    Matched MeSH terms: Acne Vulgaris/therapy*
  19. Deena Clare Thomas, Arlene C T, Emilia E, Noor Syaffa Shawani Y X H
    MyJurnal
    Introduction: Rooted form the ancient times, having a white and a delicate skin has been a dream of all women as it is perceived as a perfect beauty. Due to this high desideratum, the global beauty industry had taken an advantage to this target group promising an instant white skin for as early as three days. Global industry analysts (GIA) pre- dicted that this year 2020 the global market for skin lighteners will reach $23 billion. Despite the effectiveness of using skin-lightening, some had reported of having adverse effect including dermatological as well as neurological. Methods: This is a quantitative study using descriptive analysis approach to all nursing students in Sabah. The type of sampling is using snowball sampling methods. A questionnaire was developed and distributed to all nursing colleges in Sabah. Results: A total of 161 nursing students responded. Based on this study, most of students start are using cos- metic product in the age of15years old. Using an open-ended question, the top three cosmetic products containing skin-lightening ingredients use by students are Safi(27.9%), Garnier (25.5%)and Simple(16.1.%). Majority experience acne (47.5%) and skin irritation (18.8%)after using cosmetic products containing skin-lightening ingredients while 36.6% did not experience any skin problem. It is about80% concern about safety when choosing skin care contain skin-lightening ingredients,76.9% will make an effort to read leaflet provided prior to purchasing, 69.4% aware about the list of dangerous ingredients in choosing skin care contain skin-lightening ingredients, 78.1% aware about its side effect. Conclusion: The outcome of this preliminary study lead to the conclusion that nursing students in Sa- bah are aware that using a cosmetic product contain skin-lightening ingredient is harmful for them.
    Matched MeSH terms: Acne Vulgaris
  20. Sathishkumar P, Preethi J, Vijayan R, Mohd Yusoff AR, Ameen F, Suresh S, et al.
    PMID: 27541567 DOI: 10.1016/j.jphotobiol.2016.08.005
    In this present investigation, AgNPs were green synthesised using Coriandrum sativum leaf extract. The physicochemical properties of AgNPs were characterised using UV-visible spectrophotometer, field emission scanning microscopy/energy dispersive X-ray (FESEM/EDX), Fourier transformed infrared spectroscopy (FT-IR), X-ray diffraction (XRD) and Brunauer-Emmett-Teller (BET) analysis. Further, in vitro anti-acne, anti-dandruff and anti-breast cancer efficacy of green synthesised AgNPs were assessed against Propionibacterium acnes MTCC 1951, Malassezia furfur MTCC 1374 and human breast adenocarcinoma (MCF-7) cell line, respectively. The flavonoids present in the plant extract were responsible for the AgNPs synthesis. The green synthesised nanoparticles size was found to be ≈37nm. The BET analysis result shows that the surface area of the synthesised AgNPs was found to be 33.72m(2)g(-1). The minimal inhibitory concentration (MIC) of AgNPs for acne causative agent P. acnes and dandruff causative agent M. furfur was found to be at 3.1 and 25μgmL(-1), respectively. The half maximal inhibitory concentration (IC50) value of the AgNPs for MCF-7 cells was calculated as 30.5μgmL(-1) and complete inhibition was observed at a concentration of 100μgmL(-1). Finally, our results proved that green synthesised AgNPs using C. sativum have great potential in biomedical applications such as anti-acne, anti-dandruff and anti-breast cancer treatment.
    Matched MeSH terms: Acne Vulgaris/drug therapy*; Acne Vulgaris/microbiology
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