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@#Non-pharmaceutical interventions (NPIs) as a means of prevention during the COVID-19 pandemic have gained increasing attention. NPIs are important to reduce infectious diseases and flatten the curve of infection. However, data or literature on the effectiveness of NPIs is scarce. In this review, we aim to investigate the effectiveness of NPIs in the community based on previous literature. A literature search was conducted on seven databases (OVID, EBSCOHOST, WOS, SCOPUS, TRIP, JSTOR, and PUBMED) using the PICO method which yielded 208 articles from 12th March to 1st April 2020. A PRISMA flow diagram and extraction tables were used to analyze the final 14 eligible articles spanning nine countries. There were nine articles on human surveillance, two on patient and contact management, two on community restrictions, and one article discussing the combination of NPIs (quarantine, closure of facilities, and transit site surveillance). With the use of NPIs, there was a significant reduction of infection episodes among the target population. There has been an increasing demand for scientific evidence on NPIs during the COVID-19 pandemic, and present policy recommendations rely heavily on expert judgement. Randomized trials are required to obtain better evidence for these interventions. However, this review will help experts create feasible and widely acceptable policies and protocols for mitigation plans in the absence of definitive evidence.
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Background: Dengue fever is endemic in Malaysia and continues to be a public health concern. Selangor was the top hit and there is a paucity of information on knowledge, attitudes, and practices (KAP) of Bandar Baru Bangi residents regarding dengue infection. Therefore, the objective of this study is to describe dengue related knowledge, attitudes and practices (KAP) of residents of Bandar Baru Bangi.Methods: A cross-sectional questionnaire survey of 152 residents from Section 3 and Section 8, Bandar Baru Bangi attending the dengue awareness events was conducted. The information on socio-demographic characteristics of the participants and their knowledge, attitude and practice on dengue fever was collected using a structured questionnaire.Results: The results showed that the residents only 52% had sufficient knowledge about the dengue vectors, signs, symptoms, and modes of transmission. However, approximately all the respondents considered dengue as serious but preventable disease to which they are vulnerable to. Television/radio was the predominant sources of information about dengue fever. Knowledge on dengue is associated with prevention practice. But the self-efficacy has a significant impact between the owner and tenant house (p=0.010, p<0.05). Female has higher self-efficacy compare to male.Conclusions: As conclusion, findings suggest that despite the residents of Bandar Baru Bangi have moderate knowledge level about dengue fever nevertheless; they still adopted the preventive measures suggested by the guidelines from Ministry of Health. Therefore, health program planners and practitioners need to identify why the dengue fever still rampant among the population.
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@#Sharps injury imposed a major threat towards safety and health among healthcare workers (HCWs). Many studies in Malaysia concentrated on prevalence of needle stick injury (NSI), however the prevalence of sharps injury among HCWs based on local guideline was still scarce in Malaysia. This information gap leads us to conduct this study. Our study aimed to determine the prevalence of sharps injury among HCWs in Hospital Melaka and to describe the factors among staff with sharps injury. This cross-sectional study was conducted in Hospital Melaka, Malaysia. 165 reported cases from 2013-2015 were reviewed and secondary data extracted. Data was analyzed using IBM SPSS version 20. Among reported sharps injury cases in this study, 65 (39.4%) were male, while 100 (60.6%) were female. The mean age was 27.41 (SD: 6.06). More than half of the reported sharps injury occurred among doctor, 113 (68.5%) specifically House Officer; 89 (53.9%) followed by paramedic, 26 (15.8%) and others, 26 (15.8%). Mostly occurred in ward, 114 (69.1%). The device which accounted for most of sharps injury cases was hypodermic needle, 67 (40.6%). Many of the sharps injury cases occurred while withdrawing needle from patient, 26 (15.9%). Prevalence of sharps injury among HCWs in this study was 0.8% in year 2013, 1.1% in year 2014 and 0.5% in year 2015. Nearly half from the total number of reported sharps injury cases among HCWs in Hospital Melaka were from Medical Department, 71 (43%). Recommended measures include usage of Safety-engineered devices (SEDs) and emphasize on standard precaution.
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@#The trend of choosing natural birth at home without proper supervision is gaining more attention and popularity in Malaysia. This is partly due to wrong beliefs of modern medical care. It prompts the need to explore further into other myths and wrong beliefs present in communities around the world surrounding pregnancy and childbirth that may lead to harmful consequences. A total of 25 literatures were selected and reviewed. The most reported wrong belief is the eating behaviour such as avoiding certain nutritious fruits besides eating saffron to produce fairer skinned babies which in fact contains high doses of saffron that may lead to miscarriage. The most worrying myth however, is that unregulated birth attendants such as doulas have the necessary knowledge and skills to manage complications in labour which may well end up in perinatal or even maternal death. Other myths suggested that modern medical care such as vaginal examinations and baby’s heart monitoring in labour as unnecessary. A well-enforced health education programme by well-trained healthcare personnel besides sufficient number of antenatal care visits are needed to overcome these myths, wrong beliefs and practices. In conclusion, potential harmful beliefs and practices in pregnancy and childbirth are still abound in today’s communities, not just in least developed and developing countries but also in developed countries. Women and children are two very vulnerable groups, therefore debunking myths and eliminating harmful practices should be one of a healthcare provider priority especially those in the primary care settings as they are the closest to the community.
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Prolonged mechanical ventilation among cardiac surgery patient has been found to be correlated with negative clinical outcome and increased healthcare resources utilization. Prolonged mechanical ventilation (PMV) was defined as the accumulative duration of 24 hours or more of postoperative endotracheal intubation starting from transfer of the patient to cardiac ICU. This study is aimed to identify the risk factors preoperative, intra operative and postoperative for prolonged ventilation among cardiac patients in AL-Thawra Modern General Hospital (TMGH). Observational study design was conducted during a two-month period (from 1 August 2014 to 30 September 2014). It was among 70 patients who were admitted to cardiac surgery intensive care unit in Al-Thawra Modern General Hospital and selected by convenient sampling. The soci-demographic characteristic and clinical patient data were collected using short questionnaire developed by researcher. All patients had the same anesthetic and postoperative management. Statistical analysis was performed with SPSS version 20 and using bivariate analysis and multivariate logistic regression. The p-value of < 0.05 was found to be statistically significant. Incidence of prolonged mechanical ventilator post cardiac surgery was 37.1% (26/70) through bivariate analysis, multivariate logistic regression. Low Ejection fraction of Left Ventricle was inversely related to mechanical ventilation time (AOR= 0.872) with 95% confidence interval [0.790 - 0.963], hemodynamic instability were associated with prolonged mechanical ventilation time (AOR=16.35) with 95% confidence interval [2.558 - 104.556]. Low ejection fraction of Left Ventricle and Hemodynamic Instability post operation were identified risk factors for prolonged mechanical ventilation post cardiac surgery.
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The main purpose of the early introduction of Clinical Skills Learning [CSL] to pre-clinical years is to allow medical students to gain experience in clinical examination skills, basic medical procedures, history-taking and clinical communication. The objective of this study was to determine the effectiveness of the early teaching of clinical skills in preparing medical students for their clinical years. A validated questionnaire assessing the value of CSL on students in their first clinical year was distributed to 3rd year medical students. The questionnaire consisted of 8 items with a five-point Likert scale and one open-ended question. The response rate to the questionnaire was approximately 62%. Nearly 97 [70.8%] students suggested that CSL was a favourable teaching strategy. A high percentage of students [90.5%] agreed that CSL was a useful pre-clinical module to prepare them for their clinical years. The students gave positive feedback on the teaching of history-taking and physical examination, exposure to the hospital environment and acquisition of communication skills with supervisors and patients. No student perceived the CSL module as poor. Early CSL was well-perceived by students in preparing them for their clinical years. CSL is a vital part of the pre-clinical curriculum and should be further enriched with frequent hospital visits to enhance students' confidence level and performance when interacting with patients during their clinical years