Introduction: The present study aimed to determine the prevalence of hypertension and itsassociation with nutritional status (body mass index, body fat percentage, and visceral fat) amongstudents in a public university in Sarawak, Malaysia.Methods: This was a cross-sectional study among undergraduate students aged 18 years old andabove. Anthropometric measurements, such as weight, height, body composition, and bloodpressure measurements, were collected. Hypertension was defined as equal or more than 140/90mmHg. Statistical analyses were done using IBM SPSS version 20.Results: A total of 354 respondents participated in the study. Mean age for the respondents was21 years (SD 1.18 years). About 40% of the respondents were overweight or obese. Prevalence ofhypertension was 8.2%. Mean systolic blood pressure was 119.1mmHg (SD14.36mmHg), and themean diastolic blood pressure was 72.6mmHg (SD 9.73mmHg). There is a significant associationbetween male gender (odds ratio =3.519, 95% CI is 1.886-6.566), body fat percentage (odds ratio=1.944, 95% CI is 1.050-3.601), visceral fat (odds ratio = 2.830, 95% CI is 1.346-5.951), andfamily history of hypertension (odds ratio= 2.366, 95% CI is 1.334-4.194) and hypertension.Conclusion: The prevalence of hypertension was less than 10% and is associated with malegender, body composition, and family history of hypertension.

Introduction: Cervical cancer ranks as the second most frequent cancer among women inMalaysia. Although a cervical screening program has been introduced since 1960s and isprovided free of charge in all government health facilities, the coverage and adherence rate torecommendation among Malaysian women remains low.Objectives: To determine the proportion of non-adherence to Pap smear screening guidelines andits associated factors among women attending a health clinic in Malaysia.Method: A cross sectional study involving 316 women aged 20 to 65 years who had undergonea Pap smear. Universal sampling method was applied to select participants among womenwho attended the selected health clinic from January 2013 to May 2013. A self-administeredquestionnaire was used to obtain the socio-demographic characteristics, socio-health data andperceptions about cervical cancer and Pap smear screening. The data was analysed using descriptivestatistics and multiple logistic regression.Result: The proportion of non-adherence to Pap smear screening was 90.5%. Age, marital status,duration of marriage, education level, employment, household income and number of children were notsignificantly associated with non-adherence. Perceived severity, perceived susceptibility, perceived benefit,perceived barrier and cues to action did not show significant association with non-adherence to Papsmear screening.Conclusion: Non-adherence to Pap smear screening was high among Malaysian women. Measuresshould be taken to increase Pap smear screening coverage in our country. Other factors beyondHealth Belief Model that influence Pap smear screening practice among Malaysian women shouldbe explored.

Background: Chronic low back pain (CLBP) is a common and often difficult to treat conditionin the primary care setting. Research involving in-depth exploration on the views and experiencesfaced by primary care doctors in managing patients with CLBP in Malaysia is limited.Objective: To explore the primary care practitioners’ views and experiences in managing patientswith CLBP.Study design: A qualitative approach was employed using focus group discussions (FGD) at anacademic primary care clinic in Kuala Lumpur, Malaysia. Twenty-three primary care doctorswere purposively selected. Data were collected through audio-recorded interviews, which weretranscribed verbatim and checked for accuracy. Data saturation was reached by the third FGD. Anadditional FGD was included to ensure completeness. A thematic approach using the one sheet ofpaper (OSOP) method was used to analyse the data.Results: Participants view managing patients with CLBP as challenging. This is mainly due to thedifficulty in balancing the doctors’ expectations with the patients’ perceived expectations duringconsultation. Barriers identified include lack of awareness and conflicting views regarding theusefulness of the local clinical practice guideline (CPG) in clinical practice. Other barriers includetime constraints and perceived lack of support from multidisciplinary teams in managing thesepatients.Conclusion: Managing patients with CLBP is still a challenge for Malaysian primary care doctors.Any intervention should target identified barriers to improve the management of patients with CLBP.

Introduction: A foreign body (FB) in the upper aerodigestive tract is a fairly common encounter.Fish bones are the commonest FB seen in adults. The commonest presentation is odynophagia.Usually, the patient will point at the level of FB on the neck to indicate the location.Methods: Clinical report.Results: This case report describes a large FB in an adult with underlying infantile cerebral palsy.Besides dysphagia, it was associated with drooling of saliva and pain in the throat region.Conclusion: FB ingestion with complete obstruction of the oesophagus is an emergency. It maycause total dysphagia as the passage of food is completely blocked.

Lemierre’s syndrome is a systemic complication commonly caused by oropharyngeal infection byFusobacterium species, which manifests itself as an internal jugular vein thrombosis formation.It is a rare occurrence nowadays with the availability of broad spectrum antibiotics for treatment.Most cases in the literature presented with a life-threatening condition. We are reporting a case ofLemierre’s syndrome that presented with persistent neck pain and swelling, initially diagnosed ascervical lymphadenitis.

Glomus tympanicum is a tumour classified under the group glomus tumours, and is also knownas paragangliomas. It is thought to commonly occur in women in the fifth to sixth decades of life.Here, we report a case of a 77-year-old lady with multiple co-morbids and a diagnosis of glomustympanicum presenting to us. Her symptoms included pulsatile tinnitus, and reduced hearing,and the management of the case was done with consideration for her underlying multiple comorbidities.This paper also describes the best modality of treatment for this patient with regardto her background history. The treatment goal was to improve her quality of life and control thedisease.

Introduction: Nicotine cravings and withdrawal symptoms are associated with higher rates ofrelapse. It has been shown that combining behavioral therapy and pharmacotherapy leads to ahigher long-term abstinence rate in those who quit smoking. Al-Quran recitation has been provento reduce anxiety among athletes before tournaments and pulse and heart rates among patientsawaiting cardiac operations. As most of the patients who wish to stop smoking experience highanxietystates, we postulate that Al-Quran recitation will also able to reduce craving among smokersattempting to quit smoking.Methods: Fifty smokers from an outpatient clinic were randomly assigned to control andintervention groups. They were taught different ways of coping with smoking urges, i.e., counselingusing the 12’M’ method (control group) versus Al-Quran recitation (intervention group). Theymet for four consecutive weeks of counselling and to fill out a withdrawal scale. Carbon monoxide(CO) levels were tested at baseline and at week 4. At week 12, the number of cigarettes smoked wasmeasured again. The decrease in the number of cigarettes considered to be clinically significant forthe calculation of sample size was based on expert opinionResults: The reduction in the number of cigarettes smoked was 7 cigarettes in the counsellinggroup and 9 cigarettes in Al-Quran recitation group over 12 weeks duration. There was astatistically significant difference in the number of cigarettes smoked between the groups. Therewas also a statistically significant difference in the change in cravings between the groups at week 4(p-value= 0.005). However, the difference in the changes in CO levels between the two groups wasnot statistically significant.Conclusion: Al-Quran recitation produced a statistically significant reduction in the numberof cigarettes smoked at week 12 and a significant change in cravings at week 4 among smokersattempting to quit. Difference in smoking abstinence rates was not measured in this study.

Foreign body aspiration is commonly described in infants and children. However, recently, a newhigh-risk group was identified among young women, especially those from the Muslim populationwho wear the traditional hair scarf. This is due to the habit of holding the scarf pin in between thelips to free hands to adjust the scarf more easily. Talking, laughing, or coughing while fixing thescarf may result in inadvertent inhalation of the pin into the tracheobronchial tree. We present acase of scarf pin inhalation and the challenges encountered in managing this patient during thesuccessful removal of the pin via flexible bronchoscopy under fluoroscopy guidance. This particularcase was technically challenging for us as the sharp tip of the needle was pointing upward andpiercing the bronchial mucosa.

Objective: The objective of this paper was to determine the prevalence of overactive bladder syndrome (OABS) and its risk factors among patients with other gynaecological problems. Methods: This study was conducted on women aged more than 18 years who attended the gynaecology clinic for various diagnoses other than urinary problems at a tertiary hospital in Negeri Sembilan, Malaysia, for a period of 6 months. Data on patient’s profile, symptoms and risk factors for overactive bladder (OAB) were prospectively collected using a structured questionnaire adapted from ICIQ (international consultation on incontinence questionnaire). Exclusion criteria included patients with confirmed diagnosis of stress incontinence or OAB, neurological impairment, gynaecological malignancy and those with a previous history of pelvic radiation. Chi-square test and logistic regression test were used in the statistical analysis. We presented the odds ratio (OR) and 95% confidence interval for each of the OAB symptoms with p-value of 0.05. Results: The prevalence of OAB among the patients (n = 573) in this study was 19.1%. History of giving births to macrosomic babies and presence of utero-vaginal prolapse (UVP) were shown to be significantly associated with OAB in the multivariate analysis. Other factors were advanced age, high parity and menopausal for more than 5 years. More than half of the patients with the symptoms of OAB did not seek treatment, as they did not think it is necessary. Conclusion: It is found that the prevalence of OAB is similar with many other studies conducted elsewhere. It was found to be multifactorial, but was highly significantly related with the presence of UVP, especially cystocoele and history of giving births to macrosomic babies.