CLINICAL OUTCOMES OF THE PILOT PROJECT NEPHROLOGY LIAISON CLINIC IN A PRIMARY CARE CLINIC: A RETROSPECTIVE OBSERVATIONAL STUDY Introduction: The pilot project Nephrology Liaison Clinic, initiated in 2019 at Klinik Kesihatan Sentul, integrates nephrology services into primary care. Managed by primary care physicians with periodic nephrologist input, this project aims to enhance early intervention and reduce tertiary care burdens. Methods: In this retrospective study, the clinical outcomes of patients enrolled from 2019 to 2021 were analysed. Patients with chronic kidney disease stage G3 or stage G4/G5 declining hospital referral and those with persistent proteinuria were included. Patients who were lost to follow-up, deceased or transferred to other clinics were excluded. Data analysis included descriptive statistics, the chi-square test, Fisher’s exact test and McNemar test. Results: A total of 73 patients were included. After 1 year, 45 (61.6%) remained under primary care, while 28 (38.4%) required tertiary referral, predominantly for renal replacement therapy preparation. Among the primary care patients, 71.1% (32/45) either had maintained or slowed estimated glomerular filtration rate decline. Ten patients had their HbA1c improved from >8% to <8% (p = 0.002), and 13 more patients were initiated on sodium–glucose cotransporter-2 inhibitors compared to baseline (p < 0.001). Conclusion: This study demonstrates the feasibility of nephrology liaison clinics in stabilising renal function and improving metabolic parameters within primary care settings. The findings highlight the potential of shared-care models in resource-limited settings. However, challenges remain in ensuring adequate human resources and improving access to renoprotective medications. Larger-scale, longterm studies are warranted to validate the long-term benefits and wider applicability of this integrated approach.

PRIMARY CARE DOCTORS’ PRACTICES IN MANAGING MENOPAUSAL SYMPTOMS AND VIEWS ON PATIENT CLINICAL CONDITIONS INFLUENCING THEIR DECISION TO OFFER MENOPAUSE HORMONE THERAPY: A CROSS-SECTIONAL STUDY Introduction: Menopausal symptoms, such as vasomotor disturbances, mood changes and atrophic vaginitis, significantly affect women’s quality of life. This study aimed to examine how primary care doctors (PCDs) manage these symptoms and the clinical conditions influencing their decision to offer menopause hormone therapy (MHT), bridging gaps between guidelines and real-world practices. Methods: A cross-sectional study was conducted from June to October 2022 among PCDs in public health clinics in Selangor, Kuala Lumpur and Putrajaya. An online survey was distributed to 1301 PCDs, achieving a 42.9% response rate (559 respondents). Data were analysed descriptively. Results: Lifestyle modifications were the most common recommendation (98.4%), while complementary treatments were widely recommended (54.8%). MHT was discussed by 83.5% of the PCDs but directly prescribed by only 0.9%, with 66.0% referring patients to tertiary care. MHT was primarily offered for vasomotor symptoms (80.5%) and mood disorders (56.7%) but less commonly for non-communicable diseases such as hypertension (14.1%) and diabetes mellitus (25.2%). It was withheld in cases of breast cancer (91.9%) or venous thromboembolism (86.0%), with breast cancer concerns being a major barrier (75.3%). Conclusion: Lifestyle modifications and complementary treatments were common practice options. MHT discussions were frequent, but prescription was limited due to patient concerns and comorbidities. Targeted updates to guidelines and tools can support healthcare professionals in counselling, risk assessment and effective management of menopausal symptoms.

Objective: This case report highlights a case of young male referred for psychiatric evaluation due to paraphilic disorder. This 27-year old single male working as an assistant accountantwas noted to have voyeuristic behaviour andpresented with depressive symptoms since his teenage age. He has poor coping whenever he experiences stress in life. He started to watch pornographic videosand subsequently get involved by peeping pre-pubescent’s undergarments. These activities are followed by a compulsive behavioursuch as masturbation to gratify his sexual arousal. Results: The patient undergone several psychotherapy sessions, and medical report was furnished for the court's purpose. Our assessment revealed that he was suffering from a lifetime major depressive disorder,and he was prescribed with Tablet Sertraline 50mg/daily.He also has premature ejaculation, severe in nature. He regretted his voyeuristic urge and psychotherapyfocused on how to channel his sexual needs. Conclusion: Mood disorder is seen in paraphilic disorder and has to be dealt with in order to establish good management care.

Cooperative learning is one of the active learning techniques. There are three commonly recognized types of cooperative learning groups, namely informal cooperative learning (ICL), formal cooperative learning and cooperative base groups. There is no study been done on ICL which relate to radiology teaching. The results of this study will provide evidence to support either traditional lecture (TL) or ICL is a more suitable teaching method for radiology teaching. This study was aimed to compare students’ attitude and preference towards TL versus ICL in radiology teaching. This interventional study had been conducted among 52 third year Bachelor of Medicine and Bachelor of Surgery (MBBS) students at Universiti Sultan Zainal Abidin. They underwent both TL and ICL methods during eleven radiology lectures in classroom setting from September 2013 until July 2014. Subsequently, multiple items questionnaires regarding students’ attitude and preferences towards TL and ICL were administered. These questionnaires had undergone validation process and revealed excellent internal consistency with Cronbach’s Alpha of 0.90, 0.92 and 0.88 respectively. The mean total attitude score towards informal cooperative learning was (90.90) (SD: 11.73) significantly higher than the score for traditional lecture 85.46 (SD: 11.82) (p= 0.012). Students showed preference in ICL significantly in six domains. These domains were active involvement in the class, promotion of good rapport among classmates, getting an opportunity to help others, facilitation of understanding difficult materials, improvement of communication skills, opportunity for training to be a good leader and follower, and opportunity for enabling to participate in sharing information, making decision and problem solving. ICL method is recommended in radiology teaching because students demonstrated better students’ attitude and preferences in the learning sessions as compared to TL.