UTILISATION OF THE WEB-BASED HOME ASSESSMENT TOOL AMONG PATIENTS WITH COVID-19 IN SELANGOR, MALAYSIA: AN OBSERVATIONAL STUDY Introduction: The COVID-19 pandemic has caused many countries to turn to web-based solutions. The Home Assessment Tool (HAT) is a web-based system using the MySejahtera application developed by the government. It serves as a communication platform for patients with COVID-19 to self-monitor their clinical symptoms and enables authorised healthcare personnel to access and manage collected data for clinical monitoring. Our study aimed to examine the utilisation of this internet-based tool among patients with COVID-19 in Selangor. Methods: This observational study analysed secondary data from the self-reported HAT within MySejahtera. It included all patients who were diagnosed with COVID-19 through molecular assays such as RT-PCR or RTK-Ag on 1–21 February 2021, aged ≥18 years and residing in Selangor. Patients who had documented their symptoms at least once in the HAT during the prescribed 10-day isolation period were classified as HAT users. Results: A total of 4438 patients were included, of whom 39.4% were HAT users, while 60.6% were non-HAT users. Logistic regression analysis revealed three significant factors associated with low utilisation of the HAT: absence of medical condition (odds ratio [OR]: 9.4; 95% confidence interval [CI]: 7.49–12.01), advanced age (OR: 1.35; 95% CI: 1.20–1.52) and non-Malaysian citizenship (OR: 3.4; 95% CI: 2.50–4.72). Conclusion: The utilisation of the HAT is low, which is associated with advanced age (≥65 years), absence of medical conditions and foreign nationality. It is imperative to develop inventive strategies tailored to address the unique needs of these particular demographics.

In this clinical challenge, we describe the case of a previously healthy 8-year-old girl who presented to a primary care clinic with fever, reduced oral intake and malaise on day 3 of her illness. Clinical examination revealed that she was tachypnoeic and tachycardic. An erythematous rash was found across the bridge of her nose and cheeks, and several painless ulcers were noted in the oral cavity. Blood investigation showed thrombocytopenia, while urinalysis revealed microscopic haematuria and proteinuria. Useful initial diagnostic imaging studies were discussed, including bedside ultrasound in the ambulatory care setting. It is imperative that primary care providers be vigilant when encountering cases like this.

Introduction: Microalbuminuria presents significant health risks for the progression of endstage renal-failure (ESRF) among type 2 diabetes mellitus (T2DM) patients. This study aims to determine the proportion and associated factors of microalbuminuria among T2DM patients in Kuala Selangor district, Malaysia. Methods: A retrospective cross-sectional study was conducted from December 2020 to February 2021 using secondary data from the National Diabetic Registry (NDR), Malaysia, and reviewed patients’ diabetic records for the year 2020. All T2DM patients aged ≥18 years who were registered with the NDR in 2020 and fulfilled the inclusion and exclusion criteria were included in the study. Descriptive statistics and multiple logistic regression analysis were performed. Data were analysed using SPSS version 26.0. A total of 343 samples were included in this study for the determination of the proportion of microalbuminuria and its associated factors. Results: Of 343 respondents, 34.4% had microalbuminuria. HbA1c >7.0% (AdjOR 2.19, 95% CI: 1.35, 3.55, p=0.001), HDL <1.04 mmol/L (AdjOR 2.44, 95% CI: 1.323, 4.52, p=0.004), dyslipidaemia (AdjOR 1.90, 95% CI: 1.03, 3.48, p=0.039), and peripheral neuropathy (AdjOR 3.01, 95% CI: 1.02, 8.93, p=0.047) were significantly associated with microalbuminuria. Conclusion Microalbuminuria is a modifiable risk factor in preventing the progression of ESRF among T2DM patients. Therefore, identification of factors associated with microalbuminuria among this high-risk group is important to facilitate early screening and prompt treatment to prevent progression of diabetic kidney disease to ESRF.
Diabetes Mellitus, Type 2 ; Glycated Hemoglobin

Superior vena cava (SVC) syndrome can be fatal if not discovered early. Most SVC syndrome presentations are related to malignancies; lung cancer in particular. The presentations may vary, depending on severity of SVC obstruction. We report a case of mild SVC syndrome of a 70-year-old gentleman who presented with a one-month history of intermittent plethora and facial puffiness. Computed tomography scan of the chest revealed superior mediastinal mass which may represent matted lymph nodes obstructing SVC with bilateral pleural and pericardial effusion. Biopsy of the mass was done, and non-small cell lung carcinoma was diagnosed. Clinical presentation, differential diagnoses and issues relating to SVC syndrome were discussed with the emphasis on early recognition of mild symptoms and prompt management.