Introduction: Tropical phagedenic ulcer is a skin disease caused by a cocktail of bacteria. This painful ulcer forms over the lower limbs. It is also associated with necrotic slough and foul-smelling discharge that eventually lead to amputation and permanent disabilities. Tropical phagedenic ulcer in Malaysia has not been given much attention. In light of this situation, this research was conducted to assess the knowledge, attitude and practice regarding tropical phagedenic ulcer among the public in Shah Alam, Selangor. Methods: The total respondents were 384, consisting of 164 males and 220 females who were randomly selected. Data were obtained qualitatively through structured questionnaires and analysed using the chi-square test to study the association between the dependent variables and demographic factors. Results: The collected data showed that the respondents (67.2%) had poor knowledge of trop- ical phagedenic ulcer; merely 65.4% considered it to be a health problem, whereas 29.7% believed it is contagious. Also, the data revealed an association between age (χ2=13.587, p =0.004), marital status (χ2=15.435, p=0.001), time spent in community (χ2=6.438, p=0.04) and knowledge of the local name of tropical phagedenic ulcer. About 74.7% of the respondents did not know the cause of tropical phagedenic ulcer. Only 22.1% of the respondents had encoun- tered tropical phagedenic ulcer patients and an association was found between the variable with gender (χ2=4.672, p =0.031), age (χ2=24.134, p =0.000) and marital status (χ2=17.143, p =0.001). Conclusion: This study reveals mis- conceptions about the aetiology and transmission of tropical phagedenic ulcer which greatly influence the attitude of community members towards tropical phagedenic ulcer patients.
Biological activities of crude methanolic extracts from leaves, barks, twigs and roots of Enicosanthellum pulchrum were investigated in four bioassays. The antioxidant, 2,2-Diphenyl-1-picrylhydrazyl (DPPH) scavenging assay showed that bark and twig extracts showed high inhibitory activity with 60 and 56% inhibition at 1 mg/mL and IC50 values of 0.43 ± 0.04 and 0.64 ± 0.05 mg/mL, respectively. The bark and root extracts showed greater reducing power (FRAP) than several standard drugs used in the bioassay. Methanolic extracts of leaves, twigs and roots displayed strong cytotoxicity to breast cancer cell line (MCF-7), myelomonocytic leukaemia cell line (WEHI-3) and ovarian cancer cell line (CAOV-3); the IC50 of the leaf extract were 7.8 ± 0.85 μg/mL (MCF-7) and 9.0 ± 0.13 μg/mL (WEHI-3), while those for the twig and root extracts were 13.9 ± 0.35 and 7.3 ± 0.98 μg/mL (CAOV-3), respectively. In the antimicrobial assays, the extracts were tested against ten bacterial strains and two fungal strains. Bark and twig extracts displayed high inhibitory activity to Bacillus subtilis with 13.3 ± 0.57 and 12.0 ± 0.01 mm inhibition, respectively. In addition, the twig extract displayed better minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) compared with the bark extract (MIC 0.5 and 1.0 mg/mL, MBC 1.0 and 2.0 mg/mL, respectively). For antifungal activity, all extracts showed inhibition on Candida albicans but not on Aspergillus niger. The obtained results suggested that this plant may possibly contain bioactive compounds in the active extracts.