Introduction: : Hotel housekeepers are exposed to various ergonomic risks and there is a need to assess the physical risk factors for the work tasks performed. This study aims to determine the distribution of musculoskeletal symp- toms (MSS) and perform ergonomic risk assessment among hotel housekeepers working in budget hotels in District of Sepang, Selangor. Methods: A cross-sectional study was conducted among hotel housekeepers from 13 budget hotels around District of Sepang. Nordic questionnaire was used for the assessment of MSS. The overall risk level was determined by Workplace Ergonomic Risk Assessment (WERA) while Rapid Entire Body Assessment (REBA) was used to evaluate the whole body postural risks. Data obtained were entered into statistical program for further analysis according to objectives. Results: This study received 67.0% (n=40) response rate. In total, MSS was reported by 100% (n=40) of the participants in this study. Lower back is the most affected region (77.5%, n=31) and this was followed by heels (57.5, n=23) and shoulders (52.5%, n=21). WERA results showed that all housekeepers are found to be in medium action level of risk meanwhile REBA assessment reported scores that are categorised into medium, high and very high risk. This study suggests that there is the need for changes being implemented in daily work tasks performed. Conclusion: Hotel housekeepers were exposed to high body postural risk due to exposure to highly re- petitive movements and awkward posture while performing work tasks. Effective ergonomic intervention is needed for prevention of debilitating musculoskeletal disorders besides to increase work productivity.
Focal eventration involving the posterior segment of the
hemidiaphragm is a rare congenital anomaly. We report of a 10-
day-old infant who presented with significant respiratory
insufficiency and failure to show any responses to standard
treatment. The diagnosis of focal eventration of the diaphragm
was not anticipated until ultrasonographic examination revealed
the defect. Diaphragmatic plication resulted in complete
resolution of symptoms. A high level clinical awareness is
crucial as a relatively simple surgical procedure could avert long
term life-threatening complications.
With its high fibre content, okara has potentials to be used in bakery products, e.g. par-baked frozen bakery. This study aimed to develop frozen par-baked chapatti (Indian flat bread) through substitution of atta flour with okara flour. Six substitution treatments were applied. Samples were analysed for their physical characteristics, sensory acceptance and nutrient content. Up to 15 % substitution gave no significant effects on samples’ texture and colour. Furthermore, it almost tripled the sample’s fibre content without any detrimental effects on its sensory acceptance. Frozen storage up to eight weeks did not significantly affect samples’ characteristics, thus making this product fea- sible.
Background: Vertigo Symptom Scale (VSS) by Yardley et al. (1992) is one of the disease specific
questionnaires used widely in clinical settings. It is conducted in English and had been translated into six languages including Dutch, French, German, Spanish, Swedish, and Turkish. It has been acknowledged as a good subjective tool to determine the severity of balance disorders. Objective: To develop a valid Malay version of VSS (MVVSS) using appropriate translation methods and validation technique. Method: Forward and backward translation was performed by four professionals from different fields. The translated questionnaire was then assessed for its test reliability based on an experiment on 30 normal subjects. Further, to determine the cultural adaptation issues, the face validity of MVVSS was assessed from 32 normal subjects. They were asked to fill in the MVVSS questionnaire accordingly and give opinions regarding its language, understanding and overall format of questionnaire. Results: Final results of the translation process showed sufficient concurrence among the professionals involved. The reliability test among the normal subjects also showed a high Cronbach’s alpha value (0.90). The face validity method on 32 subjects (mean age of 29.9 ± 9.2 years) showed good feedbacks in terms of language, understanding and overall format of the MVVSS. Conclusion: The translation process was successful and the further validation showed an adequate face validity response. This suggests that our MVVSS has been culturally adapted and can be used in all Malay conversing patients.
Peripheral vestibular disorder (PVD) is serious and common. Clinically, giving an accurate diagnosis of PVD can be challenging. Vestibular evoked myogenic potential (VEMP) is an objective test to evaluate the integrity of vestibular organs, particularly saccule and/or inferior vestibular nerve. This study was performed to determine the sensitivity and specificity of VEMP using different stimuli. Fourty normal and 65 PVD subjects who fulfilled the inclusion criteria were recruited. While sitting comfortably, VEMP waveforms were recorded with active electrode on sternocleidomastoid muscle and negative electrode on upper forehead. Tone bursts (500, 750 and 1000 Hz) were delivered via headphones at 90 dBnHL and 5/s presentation rate. VEMP parameters for each stimulus (amplitude and latency of P1 and N1 peak) were analyzed accordingly. Receiver operating characteristic (ROC) was performed to determine the sensitivity and specificity of VEMP at different test frequencies. N1 amplitude of 750 Hz stimulus produced the most ideal sensitivity (65% on right and 63% on left) and specificity (83% on right and 78% on left). The importance of using a few tone bursts in VEMP test in order to minimize the false negative in cases might be encountered in clinics as the certain tone burst had inadequate sensitivity in detecting PVD cases. The 750 Hz stimulus produced the most ideal VEMP with adequate values of sensitivity and specificity, at least in this study.
Introduction: Globally, HIV/AIDS has been a growing global threat and one of the major public health challenges. In Malaysia, the number of PLWH is continued to increase year by year. What is of alarming concern is that the prejudices related to HIV/AIDS still exist within the community. Stigma and discrimination towards people living with HIV have been widely documented. It has extended their impact into the workplace and this hinders HIV pre- vention efforts and indirectly affected the national developmentprocesses. The aim of this study was to determine the knowledge of HIV/AIDS and the attitude of PLWHA among students in Universiti Malaysia Sabah. Methods: This is a cross-sectional study with convenience sampling techniques used. Data were collected among the 300 medical students and non-medical students. Self-administered questionnaires were distributed and comprise of; socio-de- mographic characteristics, items assessing knowledge of HIV/AIDS and attitudes towards PLWHA. Results: The majority of respondents were female (74%) who had never encountered PLWH (76%). The mean score of knowl- edge and attitudes were 4.04±1.12 and 27.18±4.0, respectively. Year 1 male students were found to have more comprehensive knowledge of HIV/AIDS. They were also having a more positive attitude toward PLWH as compared to female students. Conclusion: Stigma and discrimination associated with HIV/AIDS are the most challenges issues- experienced by people suffering from the disease and it has been recognized. It is regarded as a serious threat to the fundamental rights of all infected people who are affected by or associated with this disease. This study highlights the need for better education programs on HIV/AIDS at the undergraduate level in order to increase knowledge of HIV/ AIDS andshape the positive attitude toward PLWH.
Introduction: Cardiovascular disease (CVD) is a group of disease which are related to the heart and its circulations. The main modifiable risk factors of the CVD disease are hypertension, hyperglycemia and obesity. This study aims to evaluate the knowledge, awareness and practice on cardiovascular disease risk factors among Gombak community in Kuala Lumpur. Methods: This was a cross-sectional study using self-administered questionnaire and anthropomet- ric measurement among 388 subjects in Gombak District, Kuala Lumpur. Descriptive data analysis and multivariate binary logistic regression were carried to identify demographic and factors associated. Results: The prevalence of the risk factors was high among study subjects, including obesity (24.2%), hypertension (42.3%) and hyperglycemia (26.8%). More than half (64.4%) of the study subjects having at least one of the risk factor. The multivariate binary logistic model factor illustrated that compare to Malays, Chinese were 37% less likely to have obesity (CPR=0.67; 95% Cl: 0.26-1.69). Gombak district community are more likely to have the knowledge on the CVD risk factor but lack of awareness and poor in practicing the prevention action. The Indian ethnic group was less likely to be aware (APR: 0.33, Cl: 0.05-2.31) and others bumiputera ethnic group were less likely to prevent (APR: 0.58, CI: 0.20-1.65) the risk of CVD. The Chinese ethnic less likely to have the knowledge (APR: 0.88, Cl: 0.35-2.22). Conclusion: Gom- bak community was more likely to have the knowledge but less likely to be aware and lack of practice of prevention of the risk factors of CVD.
Introduction: Tissue-engineered oral mucosa (TEOM) is increasingly being used to model oral mucosal diseases and to assess drug toxicity. Current TEOM models are constructed using normal oral fibroblasts (NOF) contained within a hydrogel matrix with normal oral keratinocytes (NOK) cultured on top. NOK are not commercially available and suffer from donor-to-donor variability. Therefore, oral mucosal models based on immortalised keratinocytes may offer advantages over NOK-based models. The objective of this study was to construct and characterise the TEOM developed using TERT2-immortalised oral keratinocyte (FNB6) cells and validate its similarity to normal oral muco-sal tissue. Methods: TEOM were constructed by culturing FNB6 cells on top of a NOF-populated collagen type-1 hydrogel in tissue culture transwell inserts cultured at an air-to-liquid interface and collected at 14 day. TEOM were subjected to morphological (H&E and PAS), ultrastructural (TEM) and immunohistological (Ki-67, cytokeratin 14 and E-cadherin) analysis. Results: Histologically TEOM mimicked native oral mucosa displaying a stratified epithelium, fibroblast-containing connective tissue and basement membrane. Furthermore, TEM confirmed the presence of des-mosomes and hemi-desmosomes in the epithelium. IHC revealed expression of differentiation markers (cytokeratin 14), proliferation (Ki-67), cell adhesion (E-cadherin). Conclusion: FNB6 mucosal models able to mimic native oral mucosa structure. It has potential for drug delivery and toxicity evaluation, and replacing models based on NOK where access to primary cells is limited.
Introduction: Currently, organoid technology provides a useful tool for modelling human organ development and pathologies in vitro. Salivary gland (SG) organoids developed from mice SG cells display self-organizing properties closely mimic the native organ. Thus, this study would like to investigate the potential of this organoid system to de-velop a human salivary gland in vitro. Methods: Organoids were developed from biopsy samples of normal human sublingual gland tissue. Cells were isolated and cultured in Matrigel at an Air Liquid Interface (ALI) for up to 14 days in an enriched media supplementing with Wnt-3A, R-spondin1, EGF, and FGF2. Specific differentiation factors like TGFβ, BMP, and LIMK inhibitors were added to enriched media for further differentiation studies. Haematoxylin and eosin-stained sections of the cultures were used to visualise growth. RT-PCR, immunohistochemistry and immunoflu-orescence were used to determine the differential expression of cell-specific markers. Results: Human SG organoids developed when the cells were grown in Matrigel at ALI in a defined culture system. The addition of TGFβ inhibitor and all the inhibitors (TGFβ, BMP and LIMK) to the culture media affected SG organoids development by displaying distinct characteristics that closely resemble native glands and expressed specific cell-type markers; BPIFA2, AQP5, CK5 and E-cadherin. The inhibition of BMP signalling demonstrated SG organoids growth more into ductal-like struc-tures and expressed ductal cell marker, CK7. While LIM kinase inhibition signalling showed significantly higher of amylase activity assay. Conclusion: This study certainly offers valuable insight into determining the optimal culture conditions for developing human SG organoids.
Introduction: Vector surveillance in high-rise buildings is important to predict and monitor the presence of vectors regarding their abundance and distribution. In this study, the infestation profile of Aedes aegypti and Aedes albopic- tus species in different environmental settings were investigated. Methods: Four high-rise apartments in four differ- ent localities were selected for ovitrap surveillance. Fifty ovitraps were placed in semi indoor and outdoor settings. Results: A total of 507 (42.8%) from ovitraps showed the presence of the Aedes species larvae. Out of these, 170 (33.5%) of the positive ovitraps were those placed in semi indoor and 337 (66.5%) in outdoor. Of the total 16,613 Aedes larvae found, 4,130 (24.9%) were from semi indoor, and 12,483 (75.1%) from outdoor. In terms of distri- bution, Ae. albopictus was predominantly found in outdoor environments (POI=87.5%; MLT=36.45 larvae). Ae. aegypti was also found in outdoor environments (POI=14.89%; MLT=8.26 larvae). There was a significant difference in POI for both Ae. aegypti and Ae. albopictus in the two different environments but no significant difference was observed in MLT, indicating that the density of the Aedes species in both environments was well distributed. Con- clusion: In this study, the patterns of Aedes habitat in high-rise apartments were observed. This study has shown an invasion and adaptation of Aedes mosquitoes into the ecosystems of high-rise buildings. It can be concluded that housing designs and the condition of the surrounding environment affects the infestation profile and the distribution of Aedes mosquitoes.
Vector surveillance in high-rise buildings is important to predict and monitor the presence of vectors regarding their abundance and distribution. In this study, the infestation profile of Aedes aegypti and Aedes albopictus species in different environmental settings were investigated. Methods: Four high-rise apartments in four different localities were selected for ovitrap surveillance. Fifty ovitraps were placed in semi indoor and outdoor settings. Results: A total of 507 (42.8%) from ovitraps showed the presence of the Aedes species larvae. Out of these, 170 (33.5%) of the positive ovitraps were those placed in semi indoor and 337 (66.5%) in outdoor. Of the total 16,613 Aedes larvae found, 4,130 (24.9%) were from semi indoor, and 12,483 (75.1%) from outdoor. In terms of distribution, Ae. albopictus was predominantly found in outdoor environments (POI=87.5%; MLT=36.45 larvae). Ae. aegypti was also found in outdoor environments (POI=14.89%; MLT=8.26 larvae). There was a significant difference in POI for both Ae. aegypti and Ae. albopictus in the two different environments but no significant difference was observed in MLT, indicating that the density of the Aedes species in both environments was well distributed. Conclusion: In this study, the patterns of Aedes habitat in high-rise apartments were observed. This study has shown an invasion and adaptation of Aedes mosquitoes into the ecosystems of high-rise buildings. It can be concluded that housing designs and the condition of the surrounding environment affects the infestation profile and the distribution of Aedes mosquitoes.
Neurodegeneration resulting from pathogen invasion or tissue damage has been associated with
activation of microglia, and exacerbated by the release of neurotoxic mediators such as pro-inflammatory cytokines,
chemokines and reactive oxygen species. Activation of microglia stimulated by lipopolysaccharide is mediated in
part by GSK-3 signaling molecule. Induced IL-10 expression via GSK-3 inhibition is noteworthy since IL-10 has been
remarkably shown to suppress inflammation. Objectives: We aimed to inactivate microglia through inhibition of
GSK-3 signaling and to determine its effects on the production of pro- and anti-inflammatory mediators. Methods:
LPS-stimulated BV-2 cells were treated with a GSK-3 inhibitor (LiCl, NP12, SB216763 or CHIR99021). Inhibition
of GSK-3 was determined by the phosphorylation status of GSK-3β. The effects of GSK-3 inhibition on microglial
inflammatory response were investigated by examining various mediators and CD200R marker. Production of nitric
oxide (NO), glutamate and pro- and anti-inflammatory cytokines were measured using flow cytometry, Griess assay,
glutamate assay and Cytometric Bead Array (CBA) respectively. Results: GSK-3β signaling in LPS-stimulated microglia
was blocked by GSK-3 inhibitor through increased phosphorylation at Serine 9 residue. GSK-3 inhibitors had also
led to reducing in microglia activity via increased expression of CD200R. Inhibition of GSK-3 also diminished
inflammatory mediators such as nitric oxide (NO), glutamate, pro-inflammatory cytokines (TNF-α and IL-6) and
chemokine, MCP-1. Reduction of pro-inflammatory mediators by GSK-3 inhibitor was coincided with increased
IL-10 production. Conclusions: Suppression of microglia-mediated inflammatory response was facilitated by GSK-3
inhibition with associated increased in IL-10 production.
Intravenous (IV) infusion of medical fluid is a very common procedure used as part of medical procedure treatment. It is also the best alternative medical administration route when medical administration through orally is impossible. The most common use of VAD is the short Peripheral IV Catheter (PIVC) or recognized as IV Cannula. In spite of that, even with experience used of PIVC in medical practice nowadays the rate of IV access failure is very high which is up to 69%. Intensive research studies shows the dislodgement case is one of the major contributions of PIVC failure. For some reason only a fewer cases are reported to the administration. This article seeks the awareness and risk factor regarding to the prevailing IV access failure using the PIVC. This manuscript reviewed the statistical data of PIVC dislodgement, significant of dislodgement, dislodgment cases among pediatric, medical staff factor related to PIVC dislodgement and alternative of securement device. This manuscript also discussed the needs of new securement device in order to reduce the percentage of PIVC dislodgement from occurs.
Cancer pain is a complex experience and is one of the most common and distressing symptom of breast cancer which affects patients’ functioning in daily activities, their quality of life (QOL), and mood. Yet, there is a great lack of data on breast cancer and pain in Malaysia.
Methods: A cross-sectional study using the Breast Cancer Patient Version of Quality of Life (QOL) Instrument (translated into Malay) and Depression Anxiety and Stress Scale (DASS) were conducted on 87 female breast cancer patients to investigate the impact of pain interference level on their quality of life and depressive level.
Results: The patients were divided into 4 groups based on their rating of how pain and aches have been a problem to them (i.e not a problem [n=18 (20.7%)], mild[n=29 (33.3%)], moderate [n=18 (20.7%)] and severe [n=22(25.3%). Pain and aches ware reported to be the most severe interference problems in QOL physical domain by patients (mean=5.8, SD=2.8), followed by fatigue (mean=6.0, SD=3.1) and sleep changes (mean=6.2, SD=3.5). Patients who reported that pain and aches had severely affected them showed significantly lower score on many aspects of quality of life (Fs > 5, p < 0.005; p < 0.0001) and patients reported pain was not a problem at all demonstrated highest score on all aspects of QOL. Patients with most severe pain interference level showed highest depressive score [F (3, 84) =3, p < 0.05].
Conclusion: The study underscores the impact of pain interference on patients’ quality of life and depressive level. The pain assessment deserves significant attention and therefore a comprehensive biopsychosocial assessment of pain to rule out any related underlying issues is warranted in the management of breast cancer to ensure appropriate intervention given to the patients.
Introduction: Hajj is a unique religious mass gathering among Muslims hosted by Kingdom of Saudi Arabia (KSA) annually. It is a fifth pillar that is compulsory to be carried among muslim. Infections due to Neisseria meningitidis, Streptococcus Pneumoniae and Influenza virus are very high among Hajj pilgrims in KSA. Study shows knowledge and attitude towards vaccine preventable disease and vaccination which is very important for the prevention of these infectious diseases. This study aims to determine knowledge and attitude among the prospective Malaysian hajj pilgrims on vaccine preventable disease and vaccination. Method: A cross sectional study was conducted among prospective hajj pilgrims in June 2019. Self-administered questionnaires were given to the respondents through simple random sampling. The socio-demographic characteristics were described using descriptive analysis. Chi-square test was used to analyse the association between the socio-demographic and Malaysian hajj pilgrims’ knowledge and attitude towards the vaccine preventable diseases and vaccination. Results: A total of 135 respondents were recruited in the study. There were statistically significant associations between the knowledge and the highest education level (p=0.01), and also between the knowledge and the occupation (p=0.02) on vaccine preventable disease and vaccination. Conclusion: There is a lack of knowledge among the Malaysian hajj pilgrims about these vaccine preventable diseases and vaccination, especially those who have lower education level and also unemployed. Tabung Haji are highly advised to focus on these group and prepare a special course that focused on these vaccine preventable diseases so that Malaysian Hajj pilgrims will be protected.
Introduction: This study aimed to compare the nutritional characteristics and clinical outcomes among critically ill patients with diabetes (DM) and without diabetes (WDM). Methods: Mechanically ventilated, critically ill patients who were admitted into the intensive care unit (ICU) within 48 hours and remained in ICU 72 hours were prospec- tively recruited and followed for up to 12 days. They were stratified to DM or WDM, depending on their diabetes status at ICU admission and comparison were made for nutritional characteristics and clinical outcomes including 60-day mortality. Results: A total of 154 patients were included with 73 (47.4%) DM patients. In comparison to WDM, patients with DM were older, more severely ill, had higher nutritional risk and body mass index, presented with a higher blood glucose level, and required more insulin. DM was fed relatively earlier but had lower energy adequacy. They experienced more frequent EN interruption. Both groups had comparable ICU and hospital stay, ventilation support duration and mortality. In multivariable logistic regression, no association was found between diabetes status and for ICU and hospital mortality. However, There was a trend towards an increase in 60-day mor- tality in DM patients (Odds Ratio: 2.220, 95% Confidence Interval: 0.764-6.452; p=0.143). Conclusion: Critically ill patients with DM had higher nutritional risks, were fed relatively earlier, but with frequent EN interruption leading to lower energy adequacy than patients WDM. Diabetes status does not affect clinical outcomes.
Carpanenamase-producing Enterobacteriaceae (CPE) has emerged as a threat to hospitalized patients. Phenotypic test such as Modified hodge test was less sensitive and specific especially to detect blaNDM-1 which is the most predominant genotype in this region. Nucleic acid amplification technology offers improved specificity and sensitivity. Failed amplification due to the presence of inhibitors is a limitation. In this study, we tried to use previous method described by Villumseen et al with some modification using another DNA extraction kit. Methods: Ten mls of sterile whole blood taken from nearly expired blood bag from blood bank was spiked with 200 μl of 0.5mcFarland bacterial suspension from thirty-six confirmed isolates of blaNDM-1 carbapenamase-producing Klebsiella pneumoniae in an aerobic Bactec Plus and incubated until the growth was detected. The blood specimen was subjected to DNA extraction method using Macherey-Nachel, Nucleospin® Blood QuickPure followed with multiplex PCR. Results: Out of the 36 isolates, 12 isolates revealed blaNDM-1 , 9 isolates revealed blaNDM-1 and blaOXA-48, 7 isolates revealed blaNDM-1, blaVIM and blaKPC genotypes that were amplified at cycle threshold of less than 30. Another 8 isolates could not pick up any genotypes possibly due to pipetting error as all the internal control were amplified. Eight true negative gram negative isolates underwent same procedure and none amplified at a cycle threshold less than 30. Conclusion: This modified method was proved to give a high yield of CPE genotypes with the cycle threshold was set at less than or equal to 30 and able to overcome the presence of PCR inhibitors.
Introduction: Good indoor air quality (IAQ) is important for workers’ well-being whilst simultaneously optimize work productivity and job performance of the workers in an office. This study aims to determine the association between the sick building syndrome (SBS) in relation to the personal factors, indoor office environment and indoor air pollutants at an academic institution in Malaysia. Methods: A total of 342 office workers; made up of 188 (55%) female and 154 male (45%), from 14 different office buildings; made up of administrative, faculties, centers, institutes and school, participated in this study. A self-administered questionnaire was used to determine symptoms related to SBS. Real time readings of IAQ parameters were conducted three times daily for 15 minutes /sampling point. Results: Results showed higher prevalence of the SBS symptoms generally among women; diagnosed asthma was positively associated with mucosal symptoms; current smoking was significantly associated with skin symptoms; and centralized air conditioning system, the use of photocopiers, printers or fax machines for more than 1 hour per day and installation of a new carpet in the office environment were significant risk factors of SBS. After adjusting for de- mographic characteristics, formaldehyde, ultrafine particle and total volatile organic compounds were significantly associated with mucosal symptoms. Conclusion: Demographic characteristics, indoor office environment and indoor air pollutants were significant risk factors of SBS among workers in this study. It is highly recommended to maintain good housekeeping and to isolate printers and photocopier machines from the main workplace since both were sources of particulates.
Introduction: Dengue virus (DENV), Zika virus (ZIKV) and Chikungunya virus (CHIKV) are Arboviruses that are transmitted by the same vector, Aedes aegypti. Dengue has become a global problem since the Second World War and is common in more than 110 countries. In Malaysia, dengue is a major disease burden as total economic costs to the country as a result of dengue is close to RM1.05 billion in 2010 and estimated to rise to 1.3 billion by 2020. Apart from Dengue, Zika and Chikungunya are the other important mosquito borne diseases in Malaysia. The aim of this study was to develop a multiplex real-time assay for simultaneous detection of DENV, ZIKV and CHIKV in clinical specimens. Methods: The published singleplex protocols were used with key modifications to implement a triplex assay. A one-step multiplex real-time RT-PCR assay was developed that can simultaneously detect RNA of DENV, ZIKV and CHIKV with good performance for a routine diagnostic use. The assay was evaluated for inter- and intra-reproducibility by mean CT value. The diagnostic sensitivity was tested with 135 archived samples which had been defined positive or negative by routine singleplex assays. Whole blood, plasma and urines were used in this study. Results: Intra- and inter-reproducibility and sensitivity varied from 0.10% to 4.73% and from 0.45% to 5.98% for each virus respectively. The specificity of detection was 100%. The multiplex real-time RT-PCR assay showed concordance with test results performed by routine singleplex assays. No cross reaction was observed for any of the clinical samples. Conclusion: The development of a rapid, sensitive and specific molecular assay for DENV, ZIKV and CHIKV infections will produce a greater diagnostic capacity in our laboratory. This multiplex approach is cost effective and robust with the concurrent detection of 3 viruses of public health concern.
Introduction: Adherence towards childhood immunization (completeness and timeliness), with consideration of age-dependent-seroconversion, is the basis for children protection. Despite high global and national immunization coverage, vaccine preventable diseases’ are rising. This study aimed to determine adherence (completeness and timeliness) towards different vaccines of childhood immunization and associated factors among mothers of under five children. Methods: Cross-sectional study design was conducted at a health clinic in Seremban. Total of 320 mothers of under five children attending child health clinic selected via systematic random sampling. Data collection was via validated self-administered questionnaires and proforma, analysed using SPSS version 22. Associations between categorical variables determined by chi-square tests. Results: Consented respondents were 314; resulting in response rate of 98.1%. Adherence (completeness) was 98.09% but only 56.5% - 97.1% of respondents adhered in terms of timeliness. Types of transportation was significantly associated with adherence (completeness), p=0.041. Employment status was significantly associated with adherence (timeliness) towards BCG (p=0.008), Hepatitis B dose one (p=0.018) and dose two (p=0.040) vaccines. Education level was significantly associated with adherence (timeliness) towards DTaP/IPV/HiB dose four (p=0.019). Maternal age and usage of government clinic were significantly associated with adherence (timeliness) of MMR dose one, p=0.030 and p=0.017 respectively. Conclusion: Adherence (completeness) was high but varying adherence towards vaccine timeliness. Transportation types associated with completeness. Employment status associated with BCG, first and second doses of Hepatitis B vaccines’ timeliness. Education level associated with fourth dose of DTaP/IPV/HiB. Maternal age and usage of government clinic associated with timeliness of first dose MMR.