Introduction Several countries have started mass vaccination programs to halt the spread of the COVID-19 pandemic. With an R naught value of 2 to 3, about 70% of the population needs to be immunized to achieve herd immunity. This study aimed to investigate the reasons for acceptance or refusal of COVID-19 vaccines among the Malaysian population. Methodology An exploratory, descriptive qualitative design was performed. The cross-sectional survey used a non-probability convenient sampling technique to recruit the respondents, who were required to answer an open-ended question: Either "If you are willing to get the vaccine, please state your reason" or "If you are not willing to get vaccinated, please state your reason." The survey also included questions on demography such as age, gender, and place of residence. According to the Health Belief Model, the data was transcribed, translated, and analyzed: perceived susceptibility, perceived severity, perceived barrier, and cues for action. Results A total of 1091 respondents who completed the online survey comprised 685 (62.8%) females, 406 (37.2%) males, with a mean age of 38.16 (SD = 16.44). The majority (81.1%) were willing to get vaccinated. Thematic analysis showed that most respondents perceived that the vaccine is safe, effective, protective and will provide herd immunity. Barriers to vaccination include unknown long-term side effects, rapid vaccine production, inadequate information and concerns regarding halal status. Cues to vaccination included individual desire, social responsibility, economic concerns and wait-and-see behavior. Conclusions The public should be well informed about the vaccine, its efficacy, side effects, and halal status to increase vaccine acceptability and achieve herd immunity.

Introduction: Swimming pools pose significant public health risks due to chemical and microbiological contaminants. This study focuses on evaluating the prevalence of faecal coliform, Escherichia coli, and Pseudomonas aeruginosa, while also assessing physicochemical parameters in residential swimming pools located in Ampang, Selangor, Malaysia. Materials and methods: Water samples were collected 20cm below the pool surface, preserved in 500ml sterile containers, and transported to the laboratory in iceboxes. Physicochemical analyses, including pH and residual chlorine, were performed. Microbiological examination utilized standard multiple tube fermentation and membrane filtration techniques. Results: Thirty-three swimming pools participated in the study. Physicochemical parameters revealed a mean pH of 5.8±1.2 and residual chlorine of 1.2±1.24/L. Notably, 66.7% of tested pools exhibited pH levels outside the acceptable range (7.0 to 7.9), and 75.7% had residual chlorine values below the standard level (0-0.5mg/L). Microbial analysis indicated a prevalence of 24.2% for faecal coliform, 15.1% for E. coli, and 9.1% for P. aeruginosa. Conclusion: This study highlights prevalent issues in residential swimming pools, including low pH levels, insufficient residual chlorine, and the presence of microbial contaminants. The findings underscore the need for proactive measures to enhance water quality management in domestic pools, ensuring the safety of users. Ongoing vigilance and maintenance practices, particularly monitoring pH and chlorine concentrations, are crucial to mitigate potential health hazards associated with swimming pool water. Implementing stringent protocols and regular inspections by relevant authorities can contribute to maintaining optimal pool conditions and safeguarding public health.

Cupping therapy is defined as a therapeutic treatment using evacuated cups being placed to intact or scarified skin to withdraw blood and interstitial fluid filled with causative pathological substances. Clinical practice guideline is crucial to assist in decision making during patient care and promote standardized care which helps to increase quality and patient outcome. Adherence to cupping practice guideline was considered low at 5.3% in prior study (Mahat & Rahman, 2020). Hence, this study aimed to explore barriers of cupping practitioners’ adherence to Malaysian cupping practice guideline. This qualitative study involved three cupping practitioners who agreed to semi-structured interviews. Several barriers of practice guideline use were identified using thematic analysis. Among these are increased cost, lack of practice resources, lack of time, inadequate knowledge on the guideline, lack of agreement, and lack of feeling expectancy. Furthermore, being surrender or tawakkal is notified as a newly emerged barrier from the analysis. Specific measures addressing those should be disseminated and implemented, such as to streamline educational training in enhancing guideline familiarity. Besides, it is essential to have reminder systems such as notification pop-out, email, face-to face session and management chain to assist in guideline use

Background: Leptospirosis cases are typically rodent-sourced. Domestic animals like cattle and dogs are also known to be carriers of Leptospira but are rarely implicated in human cases. Case Presentation: In this case, a parasitology researcher who dissected dogs presented with atypical leptospirosis which had high possibility to be canine-sourced. Conclusion: Leptospirosis must be suspected in febrile patients with canine bodily fluid exposure.

Introduction: The world has been badly affected by the spread of a novel virus known as Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) that was first reported in Wuhan, China back in December 2019. As the virus is transmitted through aerosol, respiratory droplets and close contact, hand hygiene and wearing mask are the most important preventive measures for COVID-19. Studies showed hand hygiene intervention improved compliances. This paper discussed the development of a hand hygiene intervention module, validation, usability and effectiveness reports. Methods: This study involved 5 stages; need analysis, module development, validation, usability and effectiveness studies. Need analysis and module development were carried out through brainstorming and literature search. The content was evaluated by three experts, whereas the usability was screened by four preschool teachers. The effectiveness of knowledge transfer was evaluated via pre and post intervention surveys. Results: The hand hygiene educational module received valuable comments from the content expert and the end-users (teachers). Knowledge score related to COVID-19 transmission, prevention and hand hygiene moments among pre-school children were significantly increased after the intervention. Conclusion: This module can be used to improve teaching method related to COVID-19 and hand hygiene. The ‘learn and play’ approach may increase excitement, thus make learning process enjoyable and memorable.

Coronavirus diseases 2019 (COVID-19) have become a major pandemic and a gruesome burden worldwide. The infection is easily spread through respiratory droplets from infected individuals during coughing, sneezing or talking. People in their vicinity, within 1-meter distance, can get infected by breathing contaminated air and touching the contaminated surfaces or hands. WHO encouraged the use of facemasks in the community, together with regular hand washing with soap and social distancing to prevent the transmission of COVID-19. However, with the many types of facemasks available in the markets, it remains debatable as to which ones are the most effective in curbing the transmission of the disease. This paper reviews available literature on the types of face masks, their effectiveness in filtering droplets and the advantages and disadvantages of using disposable and fabric masks. As found out, the most superior mask is the N95 type, with a filtration rate of 95% of 0.3 micron particles. However, for respiratory droplets, which particle size is from 5 to 10 microns, a surgical mask is adequate with a filtration rate of 90% of 3 micron particles. Due to disposal and cost concerns, surgical masks are recommended to be used only by health care workers. Three-layer cotton masks offer almost the same filtration rate as surgical mask and are recommended by WHO to be used in the community to prevent the transmission of COVID-19. Surgical masks and 3-layered cotton masks are effective in preventing droplet transmission from infected to healthy individuals. To prevent COVID-19, the public should be reminded continuously on the proper use and disposal of masks, regular hand washing and physical distancing.

Background: Gargling had been reported to have significant roles in the prevention and treatment of respiratory tract infections. The purpose of this study was to assess the ability of regular gargling to eliminate SARS-CoV-2 in the oropharynx and nasopharynx. Methodology: This pilot, open labeled, randomized, parallel study compared the effect of 30 seconds, 3 times/day gargling using 1% povidone-iodine (PVP-I), essential oils and tap water on SARS-CoV-2 viral clearance among COVID-19 patients in a tertiary hospital in Kuala Lumpur. Progress was monitored by day 4,6 and 12 PCR (Ct value), gargling and symptoms diary as well as clinical observations. Results: Five confirmed Stage 1 COVID-19 patients were recruited for each arm. The age range was from 22 to 56 years old. The majority were males. Two respondents had co-morbidities, which were asthma and obesity. Viral clearance was achieved at day 6 in 100%, 80%, 20% and 0% for 1% PVP-I, essential oils, tap water and control group respectively. Analysis of 1% PVP-I group versus control group showed significant p-value for comparison of PCR results on Day 4, Day 6 and Day 12. Conclusions: This preliminary study showed that gargling with 1% PVP-I and essential oils show great potential to be part of the treatment and management of Stage 1 COVID-19. Larger studies are required to ascertain the benefit of gargling for different stages of COVID-19 patients. This study was registered in clinicaltrial.gov (NCT04410159).

Background: Absenteeism amongst pre-school children is often due to illnesses such as hand, foot, and mouth disease, acute gastroenteritis, cold and fu, which are easily spread amongst them. This is because of weak immunity and lack of knowledge on proper hand hygiene. This quasi-experimental study assessed the efcacy of an intervention consisting of a hand hygiene education programme, along with digital tools in bringing about a change in behaviour and health conditions amongst preschool children in Klang Valley, Malaysia. Methods: A total of 377 school children, male and female, aged 5–6 years old, participated and were assigned to either the intervention or a control group. During the 2 months intervention period, children in the test group were trained on proper hand hygiene practices and techniques with the aid of the interactive android-based tablets. The numbers of absent days of all the children were recorded for 2 months before the intervention and during the intervention. Results: In the test group, there was a 25% increase in the total number of absent days from the pre-intervention period to the intervention period, a much lesser increment observed as compared to that of control group in which the increase was much higher at 89%. Results: showed a signifcant diference (P<0·05) between the absenteeism rates for the test and control group during the intervention period. Conclusion: These results suggest that proper education and intervention increase hand hygiene compliance, which may help decrease school absenteeism due to illness; however, a longer study duration may be necessary to evaluate the beneft further.

Introduction: Food safety remains a critical public health concern, particularly among school children, as evidenced by escalating instances of foodborne illnesses globally. Despite various efforts, there is a need to assess and enhance knowledge about food safety practices among secondary school students. This study aims to assess the food safety knowledge of secondary school students in the East Coast of Malaysia. Methods: A cross-sectional study was conducted at a secondary school in Kelantan, East Coast, Malaysia. Data were collected through a self-administered questionnaire involving 82 students aged 13 to 17 years. The questionnaire covered socio-demographic information, food safety knowledge, and hygiene practices. Statistical analysis was performed using SPSS, employing descriptive statistics. Results: The study revealed varying levels of food safety knowledge among students. While many demonstrated awareness of certain practices, gaps existed, particularly in recognizing symptoms of food poisoning. Fast food restaurants were identified as the most common locations for students. The majority recognized preventive measures but exhibited misconceptions in certain areas, emphasizing the importance of comprehensive education. The findings highlight the critical role of students as both consumers and potential future food handlers. The study aligns with global concerns regarding foodborne illnesses, highlighting the imperative for systematic and targeted food safety education for this age group and stressing the significance of promptly recognizing and addressing symptoms of foodpoisoning. Conclusion: The results provide valuable insights for public health practitioners, educators, and policymakers to develop effective strategies for preventing foodborne illnesses in schools and promoting a culture of food safety.

Introduction: The rapid mutation rate of influenza virus results in recurring outbreaks, affecting vulnerable age groups. Although teenagers are not a priority group for the vaccine, they are at risk of getting influenza, especially if they live in dormitories, where an outbreak could easily occur due to close proximity. This study aimed to evaluate the knowledge, attitudes and practices towards influenza vaccination among teenagers aged 13-17 from a boarding school in Negeri Sembilan, Malaysia. Materials and Methods: This survey was done using an online questionnaire distributed via a Google form to randomly selected students in a boarding school. The questionnaire consisted of questions regarding knowledge, attitude and practices of influenza and vaccination. Results: The 260 respondents revealed that they primarily obtained influenza information from social media and personal connections. Majority had good knowledge, while just over 50% showed good attitude and practice. There was no significant association between sociodemographic and knowledge status, but a significant relationship between attitude and gender was found. Conclusions: Malaysian teenagers possess a good understanding of influenza but often confuse it with the common cold. Improved public education on influenza and infection control, particularly in congested areas, is required to reduce the rate of infection and increase vaccination uptake.

Human health has been jeopardized due to a lack of understanding about proper hand washing techniques. Because of their underdeveloped immune systems, preschool children are more vulnerable to infectious infections. Hand hygiene inhibits the spread of infectious illnesses. The purpose of this study was to develop a better understanding of pre-school children’s hand hygiene knowledge and behavior on the current situation of COVID-19. A total of 232 children aged 5 and 6 years old from 10 pre-schools in the Sepang region of Selangor, Malaysia, were chosen for this study. A questionnaire containing socio-demographic information, knowledge, and hand hygiene behavior was distributed. A completed hand hygiene education programme, including a video on correct hand washing technique, was presented to the test group. The results were statistically examined using descriptive analysis and an independent t-test. More than 90% of the participants displayed effective hand washing technique. Hand hygiene routine practice was much superior (p < 0.05) in the test group. Indeed, further progress should be made through targeted health education initiatives emphasizing the importance of hand hygiene in health.

"Honey is healing for man" is mentioned in the Holy Quran (Surah An-Nahl 16:69). Honey has many therapeutic properties such as anti-acteria, anti-inflammatory, anti-oxidant, immune booster, and cell growth stimulator. It also promotes wound healing. Diabetic patients are at increased risk of having infection over the foot (diabetic foot) due to presence of peripheral neuropathy and peripheral vascular disease. Management of diabetic foot revolves around surgery and wound dressing. Wound healing in diabetic patient is unpredictable. Delayed wound-healing results in higher chance of secondary infection. This paper illustrates the therapeutic properties of honey in relation to management of diabetic foot. Studies showed that honey reduces inflammation and kills bacteria thus accelerates wound healing. Honey confers less side effect compare to other chemical medicine such as antibiotics. It also soothes the pain, non-irritating, gives no secondary reactions and its allergy is rare. It is a cost-effective method of dressing that can be used in underdeveloped countries. This paper was prepared for Special Study of Module, Year 4 Medical Student, Faculty of Medicine and Health Science, Universiti Sains Islam Malaysia.

INTRODUCTION Virus particles in respiratory droplets and aerosols generated during medical/dental procedures are a potential source of SARS-CoV-2 cross infection. In the dental setting, oral decontamination could be an important adjunct to personal protective equipment and is recommended by a number of national COVID-19 guidance documents for dental settings. AIM To assess the in vitro virucidal activity of an oral povidone iodine (PVP-I) product against SARS-CoV-2. MATERIAL AND METHODS BETADINE gargle and mouthwash (1% PVP-I) was tested against SARS-CoV-2 virus under both clean and dirty conditions using a suspension assay based on EN14476 methodology. Virucidal activity of the product, undiluted and at 1:2 dilution, was tested at contact times of 15, 30 and 60 seconds. Viral titres were calculated using the Spearman-Kärber method and reported as median tissue culture infectious dose (TCID50/ml). RESULTS The undiluted product achieved >5 log10 reduction in viral titres compared to the control at 15, 30 and 60 seconds under both clean and dirty conditions. At a twofold dilution (0.5% PVP-I), the test product demonstrated >4 log10 kill at 15 seconds and >5 log10 kill at 30 and 60 seconds in both clean and dirty conditions. CONCLUSION PVP-I gargle and mouthwash product, undiluted and at 1:2 dilution, demonstrated potent and rapid virucidal activity (≥4 log10 reduction of viral titre) in 15 seconds against SARS-CoV-2 in vitro. The PVP-I gargle and mouthwash product is widely available and could be readily integrated into infection control measures during dental treatment including pre-procedural oral decontamination.

Background: COVID-19 is an emerging infectious disease caused by a novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). In Malaysia, first few cases of COVID-19 were detected in January 2020, among Chinese nationals and the cases keep increasing day by day. Methods: This self-administered web based cross sectional study using Google forms was conducted among 400 Malaysian adults to explore their level of knowledge, attitude and practice towards COVID-19, as well as factors associated with the variables. Descriptive and binary logistic regression were performed using SPSS version 22. Results: Knowledge and practice among Malaysian adults towards COVID-19 were low. Gender (p = 0.030, OR:0.616, 95% CI 0.398-0.955) and occupation (p = 0.002, OR:2.489, 95% CI 1.485-4.172) were found as significant predictors of practice towards COVID-19. Conclusions: In conclusion, proper mass public health messages should be conducted by the higher authorities to improve knowledge and practice towards COVID-19.

Malaysian government started the Movement Control Order (MCO) on 18th March 2020, as one of the initiatives to prevent the more massive outbreak of COVID-19. Recent statistics showed a rapid rise in the numbers of positive COVID-19 patients. However, the statistics on COVID-19 patients being discharged showed that the higher authority was very committed in managing COVID-19 crisis. This online study was conducted among 1,543 Malaysian adults using a validated questionnaire to explore more ϑindings on the Malaysian’s Knowledge, Attitude and Practice (KAP) level towards COVID19 prevention during the MCO period. Descriptive study and binary logistic regression were performed using SPSS version 22. This study showed that the majority of respondents have good KAP level regarding COVID-19 prevention. WhatsApp and Telegram were the primary sources of information used by the respondents. Education level was the main predictor for knowledge (OR: 2.083, CI: 1.605-2.702), attitude (OR:1.854, Ci; 1.42-2.42) and practice (OR: 1.745, CI; 1.326-2.096) regarding COVID-19 prevention (p<0.001). Knowledge (OR; 1.636, CI: 1.302-2.054) and practice (OR;2.328, CI: 1.858- 2.916) were predictors of attitude regarding COVID-19 prevention (p<0.001). In conclusion, total adherence to the Movement Control Order (MCO) along with public health interventions focusing on behavioral change may play vital roles in breaking the chain of infection.

Hand hygiene is one of the effective measures to prevent infectious diseases such as hand, foot and mouth disease and COVID-19. Parents involvement as the child's first educator in establishing the child's sanitary behavior are crucial in nurturing good hand hygiene habit. This study aimed to assess parents' knowledge, attitudes, and practice on hand hygiene in relation to childcare during the endemic phase of COVID-19. This cross-sectional study involved parents of pre-school children from the Sepang district of Selangor, Malaysia. The parents were given a set of pre-tested, self-administered questionnaires about their knowledge, attitude, and practice of personal hand hygiene, hand hygiene practice while caring for children, and diseases caused by inadequate hand hygiene. A total of 179 parents, mostly (62%) were mothers with mean age of 37.55 (SD 21.2) involved in this study. The parents had good knowledge (99.4%), good attitude (92.7%) and good (100%) hand hygiene practice. Good attitude was significantly associated with good practice. Good knowledge, attitude, and practice on hand hygiene among parents might be due to repetitive information about the importance of hand hygiene during the COVID-19 pandemic. Efforts should be made to ensure teachers, children and parents are continuously being educated and reminded about hand hygiene not only during COVID-19.

Introduction: Coronavirus Disease 2019, or better known as the COVID-19, has caused a global pandemic and high deathrate worldwide. Following the rapid increase of COVID-19 cases in Malaysia, the government had enforced Movement Control Order (MCO) started from 18 March 2020 and the restrictions were conducted and reviewed in several phases. The MCO also involved schools closure and commencement of online learning. This study aimed to identify the level of knowledge, attitudes and practices regarding COVID-19 among students in selected boarding schools in Malaysia. Methodology: This cross-sectional study was done in July to September 2020 using a set of questionnaire that was distributed via Google form. The questionnaire consisted of demographic data, knowledge, attitude and practice regarding COVID-19. The data was analysed using the Statistical Package for the Social Science 22. Results: A total of 365 students participated in this study. The respondents comprised of 54.2% female and 45.8% male students. The study found that they have moderate knowledge on COVID-19 while their attitude and practice were high. The study found a significant association between the knowledge and practice scores and between the attitude and practice scores of the respondents. [r = 0.389, p < 0.05] regarding COVID-19 However, there was no significant association between the knowledge and attitude scores. Conclusions: This study concluded that students' practice regarding COVID-19 was influenced by their attitude on health care to prevent COVID-19 infection. Therefore, changing their attitude and increasing the students knowledge are necessary to improve their practices regarding COVID-19 preventive measures.

Introduction: Foodborne diseases have caused a significant morbidity and mortality around the world. Food safety is an increasingly important public health issue since years ago until now. Food handlers have a major role in the prevention of food poisoning during food production and distribution. However, food contamination by food handlers could occur and leading to foodborne diseases if they lack knowledge and neglect of their personal hygiene on food handling practices in their premises. This study was aimed to assess the level knowledge, attitude and practices among food handlers in Kuala Lumpur. Methods: A cross sectional study was carried out on 30 food handlers. The information consisting of demographic, knowledge, attitude and practices on personal hygiene was collected using self-administered questionnaire. Results :Overall results showed that the majority of the food handlers had a good knowledge, attitude and practices on personal hygiene. Analyzed data obtained stated that mean score for knowledge is 2.84±0.10 out of total 3 respectively, attitude is 4.38±0.25 and practices is 4.37±0.68 out of total 5 respectively. Discussion :This study revealed that, although food handlers personal hygiene knowledge, attitude and practices were good, some of the hygiene aspects need to be emphasized. However, more effort is needed such as continuous education and food safety training should be provided periodically and frequently in order to minimize foodborne hazards

Introduction: Infections spread easily among children in nurseries due to overcrowding and their natural intimacy. Contact transmission is preventable through proper hand hygiene and good sanitation. This is a pilot study that evaluated knowledge, attitudes and practice (KAP) of hand hygiene among parents. Further study will focus on KAP among parents and caregivers in nurseries and its association with Staphylococcus aureus nasal carriage. Methods :This cross-sectional study involved 30 university support staff who sent their children to nurseries. Participants were given questionnaires consisting statements related to personal hand hygiene, hand hygiene practices during the care of children and infection related to poor hand hygiene. Results :The mean score for knowledge of hand hygiene was 2.71 ±0.257 out of 3. Meanwhile, the mean score for attitude and practice of hand hygiene were 4.59 ±0.395 out of 5 and 4.54 ±0.362 out of 5 respectively. Discussions: Overall results showed that the majority of parents had a good understanding of hand hygiene. However more effort is needed to ensure good hand hygiene technique is taught as early as in nurseries and practiced in the community. This is very important for prevention of communicable diseases in the community

Long COVID-19 is a constellation of symptoms following a confirmed COVID-19 acute infection. SARS-CoV-2 infection does not only give rise to respiratory problems but also other non-respiratory conditions. The symptoms and duration may vary among the patients and its treatment is based on the clinical presentation. Long COVID-19 among mildly infected patients was scarcely studied and reported, therefore we present a previously healthy, stage 2 COVID-19 patient who experiences prolonged symptoms of cough, chest pain, including anxiety and limited physical activities months after the first COVID-19 symptoms.