Cholera is a major infectious disease, affecting millions of lives annually. In endemic areas, implementation of vaccination strategy against cholera is vital. As the use of safer live vaccine that can induce protective immunity against Vibrio cholerae O139 infection is a promising approach for immunization, we have designed VCUSM21P, an oral cholera vaccine candidate, which has ctxA that encodes A subunit of ctx and mutated rtxA/C, ace and zot mutations. VCUSM21P was found not to disassemble the actin of HEp2 cells. It colonized the mice intestine approximately 1 log lower than that of the Wild Type (WT) strain obtained from Hospital Universiti Sains Malaysia. In the ileal loop assay, unlike WT challenge, 1×106 and 1×108 colony forming unit (CFU) of VCUSM21P was not reactogenic in non-immunized rabbits. Whereas, the reactogenicity caused by the WT in rabbits immunized with 1×1010 CFU of VCUSM21P was found to be reduced as evidenced by absence of fluid in loops administered with 1×102–1×107 CFU of WT. Oral immunization using 1×1010 CFU of VCUSM21P induced both IgA and IgG against Cholera Toxin (CT) and O139 lipopolysaccharides (LPS). The serum vibriocidal antibody titer had a peak rise of 2560 fold on week 4. Following Removable Intestinal Tie Adult Rabbit Diarrhoea (RITARD) experiment, the non-immunized rabbits were found not to be protected against lethal challenge with 1×109 CFU WT, but 100% of immunized rabbits survived the challenge. In the past eleven years, V. cholerae O139 induced cholera has not been observed. However, attenuated VCUSM21P vaccine could be used for vaccination program against potentially fatal endemic or emerging cholera caused by V. cholerae O139.

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An Objective Structured Clinical Examination (OSCE) is a tool of assessing the clinical school often used in the education system of the healthcare system. Traditional Oral Examination (TOE) is also a clinical examination where students are being tested by an examiner panel (1 or 2 members) on their clinical activities and knowledge. It is designed to objectively test competence in skills such as history taking, clinical examination, communication and clinical procedures. The Faculty of Medicine and Health Sciences of Universiti Malaysia Sabah (UMS) also use OSCE for assessing clinical students. The aim of this study was to compare the performance between the traditional oral examination (TOE) and OSCE among undergraduate medical students. Study populations were the 3rd year MBBS students of the Faculty of Medicine and Health Sciences of Universiti Malaysia Sabah (UMS). Number of students was 87. All students underwent traditional oral examination after finishing a 2 months module. The same students participated in the OSCE on the same day evening. Scores of each student were collected. Mean of the scores were calculated. P value was measured by Student’s t test to evaluate the significant difference between both the variables (traditional examination mean and OSCE mean) at 5% confidence interval (CI). P-value was 0.00015 in 5% confidence level in two tailed hypotheses. As the value was less than 0.05 so null hypothesis was rejected and alternate hypothesis was accepted. There was significant differenceBorneo Journal of Medical Sciences (2017) 11 (1): 3 - 104between the means of both the examinations. So it could be concluded that students’ performance was significantly better in the OSCE over the traditional oral examination.

Immunohistochemistry (IHC) is a laboratory technique that can be used by the pathologist to add value to the diagnosis. The basic principle of IHC involves using specific antibodies to go and get attached to specific antigens present on biological tissue and then visualizing the antigenantibody reaction thus identifying the cell type using its antigenic characteristics.The use of IHC in histopathological diagnosis can ensure a precise diagnosis thus helping the clinician to make appropriate therapeutic choices related to the management of common genital tract tumors. Cervix: IHC can help in differentiating reactive changes from cervical intraepithelial lesions. IHC can also improve the specificity of Pap smears while screening for squamous intraepithelial lesions. Corpus uteri: IHC has been used to identify cases of primary adenocarcinoma of the uterus metastasizing to the cervix and also to differentiate between type I and type II endometrial carcinoma. IHC can also be utilized to improve the positive predictive value of endometrial sampling to preoperatively diagnose uterine leiomyosarcomas. Ovary: One major problem faced by the clinician is the early intraoperative diagnosis of ovarian malignancy and IHC helps in obtaining an early and accurate diagnosis. Gestational trophoblastic diseases: The use of IHC techniques can help in accurate diagnosis of complete hydatidiform mole. Vulva: Coexistence of high-grade vulvar intraepithelial neoplasia or verrucous carcinoma of the vulva with condyloma acuminata, which is a benign condition, can be picked up using IHC and this is a big advantage to the clinician to plan a treatment protocol.Though IHC is an important tool, there are issues of standardization and reproducibility that need to be addressed. IHC is yet to evolve into a standalone method of laboratory diagnosis and must be used in conjunction with clinical assessment and histopathological findings.

In our previous study, complete protection was observed in rabbit immunized with 1 × 1010 CFU of live attenuated VCUSM21P vaccine against challenge with 1 × 109 CFU Vibrio cholerae O139. In the present study, we investigated whether the vaccines can effectively protect immunized animals from any pathologic changes using histological, immunohistochemical and ultrastructural techniques. Severe pathology is evident in wild type