Risk Perception and Emergency Preparedness Against Flood Affected Participants From the Primary Health Care Centre, Malaysia: A Comparison Between Genders

@#Introduction: Flooding has become a major natural disaster in Malaysia in recent decades. There may be a gender difference in many aspects related to flood response and practice. This study aimed to examine the gender gap in knowledge, attitudes, and practice of flood preparedness in Malaysia. Method: This cross-sectional study was conducted among patients attending the primary care clinic at Universiti Sains Malaysia health campus, Kelantan. A validated questionnaire was used for data collection. Results: 328 subjects were recruited, 56.1% of them were females. The female respondents were younger than the males (36 vs. 41 years old). However, females have better knowledge, and practice on flood preparedness compared to male respondents. Among those, women were more aware of the local emergency plan than males (p=0.01). More female respondents kept their vaccination and personal medical records in a waterproof container or sealed plastic bag during past and future flood preparations (3-5 day supply of non-perishable food) than male respondents (p<0.05). In addition, with the practice of keeping a one-week supply of medication, and having their medical records in a waterproof container along with a first-aid kit (p=0.001). For future flood preparation, more women would filter the cloudy water through clean clothes for boiling (p=0.035). The determinants of good preparedness for future floods for female were older-age (p=0.001), blue-collar (p=0.043); whereas male were lower household income (p=0.014), being blue collar (0.014) and white collar (0.039) compared with student/retiree based on multivariate logistic regression. Conclusion: Our study reported that the determinants of good preparedness for future floods were older-age, blue-collar and having a lower-household income.

A life-threatening condition—ruptured ectopic pregnancy with negative urine pregnancy test: A case report

@#Ectopic pregnancy is an extra-uterine pregnancy and is a potentially life-threatening condition that can lead to death from intra-peritoneal hemorrhage. This case reports a rare occurrence of ruptured tubal pregnancy in which the patient presented early with abdominal pain and a negative urine pregnancy test but subsequently presented again with evidence of intra-peritoneal hemorrhage. A negative urine pregnancy test is often used to rule out pregnancy, but it is not 100% sensitive. Complete assessment is critical in this important diagnosis in order to plan for the appropriate emergency management.

A Prevalence Study of Pharyngitis and Its Associated Factors Among Adults With a Sore Throat in Three Primary Clinics in Selangor, Malaysia

@#Introduction: Since pharyngitis in adults is one of the most common infectious diseases seen in general practitioner consultations in Malaysia, data on pharyngitis among adults concerning to its prevalence, socio-demographic, risk factors and clinical manifestations is very much lacking. This study aims to determine the prevalence of pharyngitis among adults in Sepang, Selangor, Malaysia from 2016 to 2017 and its associated demographic and risk factors. Methods: We conducted a cross-sectional study on 215 adult patients with a sore throat as the main symptom and who did not receive any antibiotic treatment within two weeks at three Malaysian primary care clinics. The researchers assessed the participants’ clinical manifestations and collected throat swabs for culture to determine the presence of group A streptococcus (GAS). Data on demographic characteristics, clinical manifestation and throat swab culture results were analyzed using chi-square test and multivariate logistic regression. Results: Pharyngitis was diagnosed in 130/215 (65%) adults with a sore throat. Only six isolates (2.8%) were identified as GAS. The overall mean age ± S.D was 36.43 ± 15.7. The majority of the participants were in the age group of 18-28 years. There were 42.3% males and 57.7% females; most participants were Malay 62.8%, followed by 30.2% Indian, 5.1% Chinese, and 1.9% other ethnicities. The most common symptom among the participants was cough 196 (91.2%), followed by rhinorrhea 161 (74.8%), tonsillar swelling or exudates 68 (31.6%), inflamed or reddish of pharynx 62 (28.8%), swollen anterior cervical lymph nodes 50 (23.3%), and fever ≥37.5°C 28 (13.0%). Conclusion: Besides, there was no significant association between pharyngitis and the demographic variables; the current findings emphasized that inflamed or reddish pharynx, tonsillar swelling or exudates were among the factors associated with pharyngitis.

Efforts on Reducing Dietary Salt Intake and its Associated Factors Among Medical Students in Universiti Putra Malaysia

@#Introduction: Increased dietary salt intake can cause retention of fluid and subsequently an increase in blood pressure. Excessive salt consumption is one of the main causes of hypertension. This study aims to determine efforts done by medical students to reduce dietary salt intake and its associated factors in Universiti Putra Malaysia (UPM). Methods: This is a cross-sectional study. A self-administered questionnaire looking into efforts to reduce dietary salt intake adapted from the WHO STEPS questionnaire was used. There were six efforts altogether which were; limiting consumption of processed food; looking into sodium contents on food labels; purchasing low salt or sodium alternatives; avoid eating out; using spices when cooking; and doing things specifically to control salt consumption. Other factors in this questionnaire are on socio-demographic, practice of salt consumption, awareness, perception, attitude of dietary salt intake. Results: A total of 362 respondents participated. The majority had good awareness on salt intake (98.1%). A larger proportion of females significantly made the effort to buy low salt alternatives (p=0.003) and avoided eating out (p=0.048). On salt consumption practice, there were a bigger proportion of those that rarely ate processed food, that avoided eating out (p=0.08), bought low salt/sodium alternatives (p<0.001), looked at the sodium contents on labels (p=0.027) and limited the consumption of processed food (p<0.001). Conclusion: There are significant associations between the female gender and practice of eating processed food with efforts to decrease salt intake. More studies are recommended to look into assisting efforts to reduce salt consumption.

The role of social media in primary care

@#Online activities have become the norm. From searching for new information to conducting business meetings, social media’s role in daily life continues to grow in prominence. It is estimated that the majority of the population uses social media, and users include doctors and other healthcare professionals. It is critical for primary care doctors to note how social media can substantially influence one’s healthcare behaviour and decision making. Because primary care doctors are usually the first line of contact for patients, they are the most easily accessible and most instrumental in using social media to steer the public toward proper information on healthcare.

Effects of Social support and Self-efficacy of Glucose Control Among Malaysian Type 2 Diabetes Mellitus Patients in Primary Care

@#Diabetic control depends partially on self-management. Diabetes self-care is reported to be a strong predictor of glycemic control in Type 2 Diabetes Mellitus (T2DM) patients. Factors contributing to better self-care include self-efficacy and social support. We aim to determine effects of these factors on glucose control in T2DM patients in a primary care clinic. Methods: This study utilised data from a bigger study looking into factors affecting social support and self-efficacy and their correlation in T2DM patients. This study was done among 329 T2DM patients attending a primary care clinic in Selangor, Malaysia between November 2013- January 2014. Systematic random sampling was used. Instruments used were the MOS Social Support Survey and the Diabetic Management Self Efficacy Scale (DMSES). Patients’ socio-demographic data and glucose monitoring records were obtained. The association between social support and self-efficacy with blood glucose control was determined using logistic regression. Results: The mean age of the respondents is 54.6 (+11.2), mostly female (55.3%) and Malay ethnicity (63.5%). Being older and retired were predictors for good glucose control (OR=1.05,p=0.01 and OR=2.2,p=0.023) respectively. There is also significant correlations between number of close friends/relatives with social support and self-efficacy (r=0.162,p=0.030 and r=0.190,p=0.01) respectively. The correlation of social support and self-efficacy with HbA1c levels are r= -0.044(p=0.426) and r= -0.08(p= 0.744) respectively. Conclusion: There were no correlations between social support and self-efficacy with the level of HbA1c among patients with T2DM in this study. We found older aged and retired patients to have better HbA1c levels.

Topical corticosteroids in clinical practice

@#Topical corticosteroids are common medications prescribed for skin problems encountered in the primary care or dermatology clinic settings. As skin conditions comprise of around 20% of cases seen in primary care, this article written to guide readers, especially non-dermatologists on the appropriate potency of topical corticosteroids to be chosen for skin problems of patients and to list the side effects both local and systemic

A Presentation of Penile Siliconoma in Primary Care after a Dubious Implant Injection: A Case Report

Abstract@#Cases of penile siliconoma are unusual and less commonly present to medical practitioners. The siliconoma is a subsequence of injecting high viscous solution into the penis; commonly sillicone with the aim to enhance its size and performance. This case will look at a patient who developed penile siliconoma after a dubious penile implant injection gone wrong. It will also look at what surgical options are available to the unfortunate patients to ease their suffering. Physician should have a high index of suspicion on the use of such substances to enhance sexual performances in patients presenting with atypical penile swelling.

Social support, self-efficacy and their correlation among patients with Type 2 Diabetes Mellitus: A primary care perspective

Introduction: Social support and self-efficacy are factorsthat influence patients’ health behaviour. However, therelationship between these two factors among patients withType 2 Diabetes Mellitus (T2DM) has not been adequatelyexplored. This study aims to report social support and selfefficacy of Malaysian T2DM patients, and their correlations.Methods: This cross-sectional questionnaire study involved329 patients with T2DM who received their follow up at apublic primary care clinic. Patients were selected viasystematic random sampling. Patients self-completedlocally adapted versions of the Medical Outcomes Study(MOS) Social Support Survey and Diabetic Management SelfEfficacy Scale (DMSES). The scores of both tools wereanalysed to determine the association and correlationbetween social support and self-efficacy.Results: The mean score for overall social support was72.7±21.40 score range (0-100). “Affectionate support” wasrated the highest averaged mean score at 78.31±23.71 (scorerange: 0-100). The mean DMSES score was 147.6±35.5(score range :0-200), of which “medications” subscale wasrated the highest with averaged mean scores 9.07±1.67(score range: 0-10). Overall social support and self-efficacywere found to be weakly correlated (r=0.197, p<0.001).However, all subscales of social support were moderatelycorrelated with “medications” subscale of self-efficacy.Conclusion: Social support is significantly associated withpatients’ self-efficacy in handling their own medications.

Breastfeeding Practice, Support, and Self- Efficacy Among working Mothers in a Rural Health Clinic in Selangor

@#Introduction: In first six months of life, breastfeeding is the recommended form of feeding by the World Health Organisation for the growing child. To enable the working mother to continue this noble practice, adequate workplace breastfeeding support and self- efficacy is needed.This study aims to determine the prevalence of breastfeeding among working mothers of children aged three months to two years and factors associated with breastfeeding practice including workplace support and mother’s self-efficacy. Method: This is a cross sectional questionnaire study carried out in a rural Health Clinic in Selangor using socio-demographic data, Workplace Breastfeeding Support Scale (WBSS), and the Breastfeeding Self-Efficacy Scale Short Form (BSES-SF). This study was conducted for a period of three months from April to June 2015. The respondents were employed Malaysian mothers of healthy infants aged three months to two years. A total of 84 participants were involved in the study. Data analysis was done with SPSS 22.Results: The prevalence of breastfeeding among working mothers were high at 97.6%. We found significant association of breastfeeding practice with workplace breastfeeding support (p=0.005) and self-efficacy (p= 0.017). We also noted a significant correlation between breastfeeding workplace support and breast feeding self-efficacy (r= 0.40, p <0.01). Age, religion, ethnicity, educational level and place of employment were found to be not associated with breastfeeding practices.Conclusion: This study highlights the importance of workplace support and self-efficacy with workplace breastfeeding practices. Policymakers and stakeholders should provide a conducive and supportive environment to enhance breastfeeding among working mothers.