The world population of older people is on the rise with improved health services. With longevity, older people are at increased risk of chronic non-communicable diseases (NCDs), which are also leading causes of death among older people. Screening through case finding in primary care would allow early identification of NCDs and its risk factors, which could lead to the reduction of related complications as well as mortality. However, direct evidence for screening older people is lacking and the decision to screen for diseases should be made based on comorbidity, functional status and life expectancy, and has to be individualised.

This is a case of a 65 year old lady who presented with Cushing’s syndrome secondary to ingestion of a complementary and alternative medicine that has been adulterated with exogenous glucocorticoids. In a clinical consultation, it is important to include assessment of complementary and alternative medicine use for a comprehensive care.

Three urban public primary schools in the district of Petaling, Selangor were surveyed for obesity amongst the schoolchildren and factors related to it. The prevalence of obesity amongst primary schoolchildren, with the mean age of 8.91 years was 9.5%. In addition, it was more prevalent among the boys (p<0.05) as compared to the girls. However, there was no difference with regards to ethnicity, being breastfed, physical activity, time spent watching television or fast food intake in relation to obesity among these primary schoolchildren. A larger community study is required to determine if other specific factors and dietary energy intake are associated with obesity amongst primary schoolchildren, especially in rural or less urbanised regions.

Introduction: The incidence of diabetes mellitus (DM) is increasing globally and it is associated with significant morbidity and mortality. The importance of a better quality of diabetes care is increasingly acknowledged. Objective: This clinical audit was conducted to assess the quality of care given to type 2 DM patients in public primary care clinics. Methods: A clinical audit was conducted in two selected urban public primary care clinics, between April and June of 2005. The indicators and criteria of quality care were based on the current Malaysian clinical practice guidelines for type 2 DM. A structured pro forma was used to collect data. Results: A total of 396 medical records of patients with type 2 DM were included in this audit. Most of the patients had measurements of fasting blood glucose and blood pressure recorded in more than 90% of the visits over the previous one year.Twenty-seven percent of the patients had glycosylated haemoglobin (HbA1c) done every 6 months with a mean of 8.3%. Only 15.6% had HbA1c values less than 6.5%. Fifty percent had blood pressure controlled at 130/80 mmHg and below; and 13.0% had low density lipoprotein cholesterol values of 2.6mmol/L or less. The majority of the patients were overweight or obese. Conclusions: The quality of diabetes care in this study was found to be suboptimal. There is a gap between guidelines and clinical practice. Certain measures to improve the quality of diabetes care need to be implemented with more rigour

Introduction: Hypertension is highly prevalent in the older people. Chronic disease care is a major burden in the public primary care clinics in Malaysia. Good blood pressure (BP) control is needed to reduce the morbidity and mortality of cardiovascular disease (CVD). This study aimed to determine the status of BP control and its associated factors among older people with hypertension in public primary care clinics. Materials and methods: A cross-sectional study on hypertensive patients aged 18 years and above was conducted in six public primary care clinics in Federal Territory, Malaysia. A total of 1107 patients were selected via systematic random sampling. Data from 441 (39.8%) patients aged 60 years and more were used in this analysis. BP control was determined from the average of two BP readings measured twice at an interval of 5 min. For patients without diabetes, poor BP control was defined as BP of ≥140/90 mm Hg and ≥150/90 for the patients aged 80 years and more. For patients with diabetes, poor control was defined as BP of ≥140/80 mm Hg. Results: A total of 51.7% (𝑛 = 228) of older patients had poor BP control. The factors associated with BP control were education level (p = 0.003), presence of comorbidities (p = 0.015), number of antihypertensive agents (p = 0.001) and number of total medications used (p = 0.002). Patients with lower education (less than secondary education) (OR = 1.7, p = 0.008) and the use of three or more antihypertensive agents (OR = 2.0, p = 0.020) were associated with poor BP control. Conclusion: Among older people with hypertension, those having lower education level, or using three or more antihypertensive agents would require more attention on their BP control.