Introduction: Prevalence of active smokers in Malaysia is increasing despite availability of stop smoking clinics. Thus, practice of the healthcare professionals in providing smoking cessation intervention needs to be assessed. This study aimed to develop and validate a questionnaire to assess the knowledge, attitude and practice of medical doctors on national smoking cessation guidelines  and factors contributing to the score. Methods: The 26 items consists of mixture of                        true/false questions; strongly-agree/agree/don’tknow/disagree/strongly-disagree response; and always/frequent/seldom/never response were created based on domain of 5A’s (ask, assess, advice, assist, arrange) and 5R’s (relevant, risks, rewards, roadblocks, repetitions). The questionnaires were distributed to 141 medical doctors. Reliability was determined using Cronbach’s alpha for internal consistency while construct validity was assessed using factor analysis. Results: A high degree of internal consistency was observed for this 26 items (Cronbach’s alpha= 0.824). Subsequently, 2 items with poor inter-item correlations were removed. Factor analysis extracted 7 meaningful components from this remaining 24 items, in which 3 components with least items were deleted due to overlapping subscale with other components, leaving 4 meaningful components of (1st) practice ask, advice, assess and practice 5R’s, (2nd) practice of assist and arrange for those willing to quit, (3rd) knowledge and (4th) attitude. These final 17 items still demonstrate high internal consistency with Cronbach’s alpha of 0.832. Conclusions: This study indicates that this questionnaire is a reliable and valid tool to assess the knowledge, attitude and practice on stop smoking guidelines. Improvement can be made for attitude items in the future.

Introduction: Prevalence of active smokers in Malaysia is remaining high (22.8%) despite the wide availability of quit-smoking services. Rather than look at the patients’ factors alone, the possible negative factors from health care providers should also be explored. Therefore, knowledge, attitude and practice of the healthcare professional on smoking cessation intervention needs to be assessed, especially among the primary care doctors. This can be done during national conference gathering all doctors from Malaysia. Materials and Method: A crosssectional study was conducted among medical doctors attending First East Coast Symposium on Specialized Care at Primary Care Level at Grand DarulMakmur, Kuantan on 1st to 2nd December 2019, using validated questionnaire of Knowledge, Attitude and Practice of Medical Doctors on Smoking Cessation Guidelines; consisting 17 questions to determine the KAP score. The difference between the median KAP scores between age, gender, ethnicity, religion, profession, location of clinic, availability of specialist at clinic, numbers of smokers seen and presence of smoking cessation training were assessed using Independent sample T-test and One-way ANOVA. Results: A total of 131 primary care doctors involved in the study. Majority were female (80.9%), Malay (96.2%), medical officers (74.8%), government doctors (90%) and haven’t undergone any kind of smoking cessation training (65.5%). The higher KAP score were statistically associated (p < 0.05) with history of attending training program (mean 35.7 score) and in charge of quit smoking clinic (mean 35.4 score). No significant difference of score between government (mean 32.0 score) and private doctors (mean 29.9 score). Conclusions : Majority of the involved primary care doctors had low KAP score. Being a family medicine specialist, in charge in stop smoking clinic and have attended smoking cessation training program were significantly associated with high KAP score. Therefore, more smoking cessation training should be provided for doctors.

Introduction: Globally, depression is one of the serious problems reported among medical students. Various studies reported that the prevalence of depression among medical students was high due to multiple risk factors. Therefore, this study aimed to measure the prevalence of depression and its associated factors among medical students in International Islamic University Malaysia (IIUM). Materials and Methods: A cross-sectional study was conducted among 500 medical students in IIUM Kuantan. A validated self-reported questionnaire using Depression Anxiety Stress Score 21 was distributed during the second semester of the 2018/2019 session. Descriptive statistics were used to measure the prevalence of depression. Chi-square test, Fisher’s exact test, independent sample T-test, and multiple logistic regression were used to determine the association between risk factors and depression. Result: The prevalence of depression was 39% with 10.5% of them were having severe and extremely severe level of depression. Multiple logistic regression analysis showed regular physical activity (AOR=0.64, 95% CI: 0.42-0.98) and Tahajjud prayer practice (AOR: 0.76, 95% CI 0.66-0.88) are two protective factors against depression among medical students. Conclusion: About two out of every five IIUM medical students had depression. Regular physical activity and Tahajjud prayer practised may reduce the risk of depression and should be encouraged.

Introduction: The number of elderly diabetes patients is rising all over the world. Therefore, the quality of life of older people as well as the factors that influence it are aimed to be evaluated in this study. Method: A cross-sectional study was carried out on 269 senior diabetes patients from government health clinic in Kuantan, Pahang. Their sociodemographic information was gathered, and the Diabetes Quality of Life Instrument (DQoL) was used to assess their quality of life. The connection between DQoL domains and covariates was determined by Mann-Whitney U test and the Kruskal-Wallis test. Linear regression analysis was used to find the predictors. Results: : The majority of patients in the B40 groups had at least a primary level of education (52.2%) and a source of income (97.3%).The majority of the clinics (61.3 %) were located in rural areas and did not have a family medicine specialist on staff (77.7 %). The majority of the patients had uncontrolled diabetes (71.7%), uncontrolled blood pressure (63.2%), uncontrolled cholesterol levels (74.0%), and abnormal abdominal circumferences (84.8%). Clinic location, diabetes control status, and old age were statistically significant in predicting the quality of life. Conclusion: Despite the perception of a significant risk of problems, this study found that decreasing the HbA1c goal further improved the quality of life of older patients. Those clinic headed by family medicine specialist gave the highest degree of patient quality of life. As a result, additional primary care physicians should be trained, as well as local treatment measures.

Milk discharge from neonatal breast commonly occurs bilaterally. Majority of them are benign in nature. Those cases usually require conservative management and will resolve with time. It typically occurs within one month of age in which late-onset of galactorrhoea in toddlers is indeed a rare occasion. Thus, an abnormal cause needs to be ruled out. An 18-months-old child had persistent milky discharge from the left nipple for several days without underlying specific identified causes. This case highlights the occurrence of physiological milk discharge can still possibly occur at the age beyond one-year-old despite its absence in the initial months of life. The principle observation at primary care is still adequate in managing such cases unless high suspicion of alarming disease arises. This case proved a late onset of physiological galactorrhoea can still occur in the early toddler age group.