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It is with great pleasure and excitement that I extend acordial invitation to the esteemed members of themedical fraternity to the Academy of FamilyPhysicians of Malaysia (AFPM) Scientific Conference2024, slated to be held on the 26th and 27th of April.As the Organizing Chairperson, it is my privilege towelcome you to this momentous event dedicated tothe enhancement of primary care.Under the theme "Primary Care - For Each andEveryone", our conference will shine a spotlight onthe indispensable role played by primary careproviders from both the governmental and privatesectors. As custodians of comprehensive healthcare,these providers serve as the frontline ambassadors,ensuring accessible and quality healthcare forindividuals and communities alike.ForewordGreetings and warm regards,1Our primary objective for this conference is to deliver the latest updates and essentialinformation in the realm of primary care, encompassing vital discussions on artificial intelligenceand digitalisation. The landscape of healthcare is evolving rapidly, and our collective goal is toequip ourselves with the knowledge and tools required to adapt and excel in this dynamicenvironment. This year holds special significance for us as we commemorate the 50th anniversary of AFPM'sestablishment (1973-2023). We are also moving to our new building in Putrajaya in early 2024.In light of this milestone, we have elevated our traditional scientific meeting to a comprehensivescientific conference. This transformation mirrors our unwavering commitment to advancingmedical knowledge, fostering innovation, and fostering excellence in family medicine.The conference will serve as an invaluable platform for Continuous Medical Education (CME),offering participants the opportunity to access crucial updates vital to their professionalpractice. Moreover, the event will feature booth exhibitions showcasing the latestadvancements in medical technologies, devices, and pharmacological items, providingattendees with firsthand exposure to cutting-edge innovations.From The Chair's Desk

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2In conjunction with this momentous occasion, we are thrilled to announce a gala dinner tocelebrate AFPM's golden jubilee. We extend a heartfelt invitation to all past presidents andsignificant contributors to AFPM's success to join us in commemorating this remarkablemilestone.I extend my earnest invitation to healthcare professionals, academicians, researchers, andindustry experts to join us in this collaborative endeavour. Your participation and insights willundoubtedly enrich the discussions and contribute to the success of this conference.Together, let us embrace this opportunity to learn, share, and celebrate the achievements inprimary care at the AFPM Scientific Conference 2024. I eagerly await the gathering ofpassionate minds dedicated to shaping the future of family medicine.Let’s join us at the conference.Warm regards, Dr Hjh Norsiah Hj AliOrganizing Chairperson,Annual Scientific Conference 2024 (ASC2024)Academy of Family Physicians of Malaysia (AFPM)

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On behalf of the scientific committee, I warmly inviteyou to the Academy of Family Physicians AnnualScientific Meeting 2024.Our theme this year is, “Primary Care: For Eachand Everyone” which reflects our collectivecommitment to advancing knowledge, fosteringcollaboration, and addressing the challenges andopportunities in primary care for each individual inour community. This meeting will showcase currentand interesting topics to equip general practitionerswith the challenges of managing patients in primarycare. Attendees will have opportunities for thought-provoking discussions and forge connections thatwill undoubtedly contribute to the advancement ofour discipline.Dear Colleagues and Esteemed Guests,3 We have an exciting programme representing a diverse range of expertise and experiences inprimary care featuring current issues in managing different groups in the community. On eachday, we will have a plenary in line with the Health White Paper in prioritising primary care inMalaysia. Attendees can also gain knowledge from forums, case-based discussions, workshopsand poster sessions.As we embark on this intellectual journey together, I encourage you to embrace the spirit ofcollaboration and open dialogue. Take advantage of the networking opportunities, connectwith fellow colleagues, forge new collaborations, and strengthen existing partnerships. Ourcollective intelligence is a powerful force, and through the exchange of ideas, we have thepotential to inspire innovation and drive positive change. It is through these interactions that webuild a strong primary care community.We look forward to welcoming you to our meeting. See you there!Dr Siti Nurkamilla RamdzanScientific Chair,Annual Scientific Conference 2024 (ASC2024)Academy of Family Physicians of Malaysia (AFPM)Scientific Chair's Message

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AboutTitle: "Primary Care: For Each and Everyone"Abstract:The Annual Scientific Conference of 2024 is dedicated to exploring the pivotal role of primarycare in ensuring health equity and access for all individuals. Under the theme "Primary Care: ForEach and Everyone," this conference aims to delve into the multifaceted aspects of primaryhealthcare delivery, from preventive measures to chronic disease management, with a focus oninclusivity and patient-centred approaches.With the global healthcare landscape evolving rapidly, primary care is the cornerstone of arobust healthcare system that caters to the diverse needs of communities worldwide. Thisconference will bring together healthcare professionals, policymakers, researchers, andstakeholders to discuss innovative strategies, best practices, and emerging trends in primarycare.Key discussion topics will include advancements in telemedicine and digital healthtechnologies, integrating mental health services into primary care settings, addressing healthdisparities among underserved populations, promoting preventive care and healthy lifestylebehaviours, and optimizing the role of primary care in managing chronic conditions.Through engaging keynote presentations, interactive workshops, panel discussions, and postersessions, participants can exchange ideas, share experiences, and collaborate to shape thefuture of primary care delivery. Ultimately, the conference aims to inspire attendees tochampion a patient-centred approach to primary care that ensures equitable access to high-quality healthcare services for everyone in our communities.5

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CommitteeOrganising CommitteeDr Hjh Norsiah bt Hj Ali - ChairpersonDr Wong Ping FooDr Nur Aishah bt Abd LatiffDr Josephine Lum Lee ChinDr Lavneys Vijay A/P VijayanDr Noor Rawaida bt Abd LatipDr Saadatunnoor bt AmirrudinDr Siti Hawa bt AliasDr Haslina bt Mukhtar AajamerDr Nadiah Aminah bt AzizanDr Kalaivaani A/P VijanDr Musbahiyah bt Mat ZainalDr Rosmaliza bt KamaruddinDr Elvind Yip Hung Loong6Scientific CommitteeDr Siti Nurkamilla bt Ramdzan - ChairpersonAP Dr Ilham Ameera bt IsmailDr Isriyanti bt Mohd RafaeDr Sasikala Devi A/P AmirthalingamDr Fathima Begum bt Syed MohideenDr Hanifatiyah bt Ali

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SpeakersFormer Deputy Health Director (Primary Care)Family Health Development Division (BPKK)Ministry of Health, PutrajayaDr Mastura IsmailTopicSpearheading Non Communicable Diseases inPrimary CareObstetrics & Gynecology Specialist & Medical DirectorInternational Medical University (IMU)Prof. Dr Nazimah IdrisTopicAll about Hormones - Updates on PrescribingHormones in Primary CareHormone replacement therapy for womenFamily Medicine Specialist (Men’s Health)Universiti Sains Malaysia (USM)Prof. Dr Shaiful Bahari Ismail7TopicAll about Hormones - Updates on PrescribingHormones in Primary CareTestosterone deficiency in men

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Community Psychiatrist SpecialistMental Health & Psychiatry DepartmentHospital Tengku Jaafar, SerembanDr Siti Hazrah Selamat DinTopicManaging Mental Health in Primary Care: Case-BasedDiscussion Family Medicine Specialist (Sub in mental health)Ministry of HealthDr Zafferina ZulghaffarTopicManaging Mental Health in Primary Care: Case-Based Discussion Psychiatrist, Faculty of MedicineUniversiti Kebangsaan Malaysia (UKM)Prof. Dr Hatta SidiTopicHow Can I Address You? He, She And They?Acknowledging The Needs For Gender IdentityAnd The Management11

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ProgrammeRegistrationWelcome, all Committee Members, Speakers,and Participants.Time:0830-0900 Plenary Spearheading Non-Communicable Diseases InPrimary CareSpeakerDr Mastura IsmailTime:0900-0945Time:0945-103014Day 1: April 26, 2024 (Friday)Opening ceremony Ybhg Datuk Dr Muhammad Radzi Bin Abu HassanKetua Pengarah Kesihatan MalaysiaTime:0945-1030“All About Hormones”Updates On Prescribing Hormones In PrimaryCare:1) Hormone Replacement Therapy For Women2) Testosterone Deficiency In Men3) Growth Hormone In ChildrenSpeakersProfessor Dr Nazimah IdrisProfessor Dr Shaiful BahariAssoc. Prof. Dr Azriyanti Anuar ZainiTime:1045-1215

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Aesthetic Medicine in Primary CareSpeakerDr Usha HohTime:1215-1245Lunch Symposium: Management of COPD:What’s New in GOLD - Speaker: Dr Wan Jen LyeLunch break, Booth and Poster VisitTime:1245-1430Time:0945-103015Steroids Usage In Respiratory Conditions- To UseOr Not To Use?SpeakerDr Nurul Yaqeen Mohd EsaTime:1430-1500Procedures in Primary Care (Demonstration)- Implanon- Intraarticular injection- Removal of lumps and bumpsSpeakersDr Wan Hilya Munira MustaphaAssoc. Prof. Dr Anwar SuhaimiDr Kelvin Choo Siew PengTime:1500-1630

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Holistic Approach to Obesity ManagementSpeakerDr Mohamad 'Ariff Fahmi Ahmad ZawawiTime:1430-1500ForumProviding Primary Healthcare To The VulnerableGroups- Refugees- HomelessSpeakerDr Raja Ahmad ShaharulAssoc. Prof. Dr Nik Salida Suhaila Nik SalehDr Ng Shu HuiTime:1500-1600Time:0945-103019War and Calamities: Primary Care’s Role In DisasterManagementSpeakerColonel Dr Siti Salmiah AwangTime:1600-1630 Offering Lifestyle Medicine in Primary CareSpeaker: Dr Noor Mikraz Mohamad IsaPoster winner announcement and closingTime:1630-1730

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AcceptedResearch Abstracts20Introduction:Sexually Transmitted Infection (STI) screening is an important diagnostic tool for those withhigh-risk sexual behaviours regardless of being asymptomatic or symptomatic. Prevalence dataon STI in Malaysia is sparse, which curbs early intervention for specific targeted groups in thepopulation. This study aimed to ascertain the epidemiology of STI in private primary carecentre. Methods:A cross sectional study was conducted for a period of one year (May 2020 – May 2021) fromall patients visited to clinic for STI screening regardless of being symptomatic or asymptomatic. Results:There were 139 patients visited the clinic for STI screening [female 89/139 (64%); male 50/139(35.9%). 105 (75%) patients were asymptomatic and only 34 (25%) were symptomatic. 94(67%) patients were young adult, age from 20-29 years old. From the total screenings carriedout, 82 (58%) patients were positive for STI (single or multiple infections). Out of this positiveSTI cases, majority [52/82 (63%)] were young adult, age from 20-29 years old. 43 patients withsingle infection were young adult predominantly caused by C. trachomatis (n=18). There were39 patients with multiple infections (more than two STIs) predominantly from young adultgroup as well caused by HSV and C. trachomatis concomitantly (n=15). Conclusion:This study represent an urban epidemiological reviews on STI prevalence in private primary carecentre which may contribute to a better STI surveillance and intervention towards specifictargeted population including vast awareness and destigmatization strategy.Prevalence and Epidemiological Characteristics on Sexually Transmitted Infections:A One Year Cross Sectional Study from A Private Primary Care Centre.Ahmad RZ [1]U.n.i Klinik Taman Tun Dr Ismail, Kuala LumpurPoster ID 1

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21Introduction:Improving self-care practices among hypertensive patients have been shown to improve bloodpressure control and medication adherence. Video-based interventions (VBI) have been shownto increase a patient’s self-care practices among hypertensive patients. Furthermore, validatedVBI in the Malay language for patients in the primary care setting are scarce. The objectives ofthis study were to develop and validate a VBI series for hypertensive patients in the primarycare setting to improve their self-care practices.Methods:This study was conducted in three phases: (1) pre-production (2) production (3) postproductionphase. The pre-production phase involved designing the storyboard and scripts which thenunderwent content validation by a panel of experts and subsequently by hypertensive patients.Once the storyboards and scripts achieved acceptable consensus, the videos were thenrecorded (production phase). The post-production phase included video editing and facevalidation among hypertensive patients. Statistical analysis included calculation of item contentvalidation index (I-CVI) and item face validation index (I-FVI) in the content and face validationrespectively.Results:The storyboard and scripts for five videos were developed. The I-CVI of all videos was 1.0 aftertwo rounds of content validation among 6 content experts. I-CVI among 5 hypertensivepatients was 1.0 for all videos. Five videos were recorded and edited which then achieved an I-FVI of 1.0 during face validation among ten hypertensive patients. These videos are consideredcomprehensive compared to other VBI as the contents are mapped to the Information,Motivation and Behaviour (IMB) theory. Conclusion:A VBI series consisting of 5 videos was developed and validated to be used amonghypertensive patients in the Malaysian primary care setting to improve their self-care practicesand blood pressure control. Development and Psychometric Validation of a Video-Based Intervention (VBI) onSelf-Care Practices for Hypertensive Patients in The Malaysian Primary Care SettingRaja Ibrahim Raja Ismail [1,2], Nik Munirah Nik Mohd Nasir [1,2], Siti Fatimah Badlishah-Sham [1,2][1] Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA[2] Hospital Al-Sultan Abdullah (HASA), UiTM Puncak AlamPoster ID 2

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22Introduction:It is well known that cancer causes significant physical and emotional impairments not only toits sufferers but also to the caregivers. Caregivers are an important source of support for cancerpatients, but they often shoulder a high workload while providing care. The objective of thisstudy is to This research was carried out to investigate the resilience levels in caregivers ofpatients with cancer and its association with, the relationship between these levels of caregiverburden, religious coping, sociodemographic and clinical factorsMethods:This cross-sectional study was done from December 2021 to June 2022. Two hundred andthree participants were recruited from the oncology clinic and wards of Hospital Universiti SainsMalaysia (Hospital USM), Kelantan, Malaysia. The questionnaires used in this study were theConnor-Davidson Resilience Scale, Brief Religious Coping Questionnaire and Zarith BurdenInterview.Results:The result showed a mean score of resilience was 29.92 ± 4.89(range = 0–40), the caregiverburden score was 12.33 ± 9.77, (range = 0–88), positive religious coping (PRC) scores was 22.3± 4.14, (range = 7-28) and negative religious coping (NRC) scores was 8.75 ± 2.95 (range = 7-28). The findings showed that the patient's age [OR 0.04; 95%CI : (0.01, 0.09), p = 0.04] andnegative religious coping[OR -0.35, 95% CI (-0.52, -0.06); p = 0.02] were significantpredictors of caregiver resilience. Conclusion:Our study showed a high resilience score among the caregivers, and it also highlighted the roleof religion on resilience in the caregivers in our community. More studies need to be done onthe role of spirituality and its interaction with resilience, coping, and burden in caregivers. Resilience and Religious Coping in Caregivers of Patients with Cancer.Siti Nur Syakinah Md Sabdina [1], Lili Husniati Yaacob [1], Nani Draman [1] [1] Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu16150, Kelantan, MalaysiaPoster ID 3

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23Introduction:Analogies are powerful cognitive tools extensively employed in human reasoning, problem-solving, and learning. In medicine, analogies could serve as a valuable means of explainingintricate physiological, pathological, and pharmacological processes pertaining to challengingdiseases such as type II Diabetes Mellitus (T2DM) to patients. We have devised a consultationmodule intended for T2DM patients on insulin (A Practical Guide on Consulting The Type II DMPatients On Insulin In Primary Care), tailored for primary care physicians. This moduleincorporates a comprehensive consultation framework based on local clinical practiceguidelines, and it encompasses rapport building, history taking, diet and exercise advice, as wellas insulin use and intensification, employing the 'Garbage and Lorry' analogy as a unifyingthread for each topic addressed during the consultation, assisted by visual aids. Methods:This consultation module was piloted in Klinik Kesihatan Senawang, Negeri Sembilan. FromJanuary to June 2023, a total of 106 T2DM patients on insulin, with a mean age of 57 and amean latest HbA1c of 11.8%, were recruited for a specialized once-a-week clinic by referral fromMedical Officers. These patients were attended by two medical officers who had undergonetraining in the consultation module, and was seen every two months. Results:After 6 months, the subjects underwent a repeat HbA1c. Out of the 106 recruited patients, 31%(33/106) defaulted. The remaining 74 patients continued their participation, and 39% (29/74)experienced a mean reduction in HbA1c levels by 2.5% (equating to a mean percentagereduction of 20%) after the 6-month period.Conclusion:This consultation module, built upon a simple analogy that can be easily comprehended bypatients of diverse ages, races, and backgrounds, could emerge as a valuable tool for improvingdoctor-patient communication. It aids patient comprehension and engagement, and ultimatelyimproves outcomes for T2DM patients on insulin.Metaphoric Medicine: Analogies as a Possible Effective Consultation Tool inManaging Type 2 Diabetes Mellitus Patients on Insulin.M. Hanif Omar [1], Zainal F. Zakaria [2], W. Nusairi WMN [3], Muzawani M. [3][1] KKM [2] Klinik Kesihatan Seremban, KKM [3] Klinik Kesihatan Senawang, KKM Poster ID 4

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24Introduction:Time banking is a service exchange system where time is used as a currency. Time creditsearned for work can be exchanged for services. This study aims to identify the knowledge andattitude of Ipoh residents towards the use of time banks in the care of the elderly.Methods:Ipoh residents aged ≥18 years answered a pretested questionnaire on demographic data, healthstatus, knowledge and attitude towards time banking, via an online google form. Sample sizecalculated was 384. The knowledge scores were divided into poor, moderate and good.Attitude assessed using Likert scores (1-5), were grouped into poor, moderate to good(positive) attitude. Chi square test was used to analyze for any significant association (p value<0.05). Results:There were 386 respondents (males 44%, females 56%; aged 18-35 years (48%), 36-50 years(18%), >50 years (34%). The majority were Malays (70%), married (53%), living with family(72%) and college/university educated (80%), with 42% employed, 28% students and 19%retirees. Eleven percent had chronic health problems requiring constant assistance and 22%needed help with household chores. Eighty-one percent had no prior knowledge of timebanking and how it worked. The majority (72%) were interested to know more about timebanking; 64% agreed that time banking could help the elderly get free domestic services and60% were interested to participate if implemented (60%). Singles, college/university educated,students / those employed, those with no chronic health problems had more positive attitudetowards time banking (p-value<0.05). Conclusion:The majority of the respondents showed a positive attitude towards time banking in the care ofthe elderly but less than half felt that Malaysia was ready (43.5%) and safe (42%) for itsimplementation.Knowledge & Attitude of Ipoh Residents Towards Using "Time Bank" in the Care ofthe ElderlyAhmad Nabhan Abdul Kadir [1], Faiznur Mhd Ali [1], Farah Nabilah Ali [1], Farah Syamirah MohamadMydin [1], Muhammad Arees Mohamed Anwar [1], Muhammad Imtiyaz Wafi Nor Aizuddin [1], ChanSook Ching [1], Hussain Saadi [1][1] Community Based Department, Faculty of Medicine, Royal College of Medicine Perak, UniversitiKuala LumpurPoster ID 5

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25Introduction:Diabetes is a demanding chronic disease that not only affects physically but also mentally,particularly depression and anxiety. Those with diabetes and concomitant mental health distresshave been associated with poor glycemic control outcome and quality of life. Earlyidentification of mental health disorder and the characteristics of people living with diabeteswhom are at higher risk for mental health disorders may help to improve the management ofdiabetes. Thus, this study was conducted to determine the prevalence and its associatedfactors of depression, anxiety, and stress (DAS) among Type 2 diabetes mellitus (T2DM) adultsin selected government clinics in Melaka.Methods:A cross-sectional study was conducted among adults T2DM in six selected government healthclinics in Melaka from March to May 2022. Those with psychiatric disorders, pregnant orpostpartum 6 weeks were excluded. Systematic random sampling was used. Data collectioninclude primary data (DASS-21) and secondary data (clinical notes). Analysis used SPSS version28. Chi-square test, Mann–Whitney U test and logistic regression were used to measure theassociation.Results:450 participants were recruited in this study. Majority had normal mental health status. Theprevalence of DAS were 7.1%, 14.0% and 4.9% respectively. Males have 30% more risk ofsuffering from depression comparing to females (aOR 0.3, 95% CI 0.1-0.8). Those who adheredto diet control has double the risk of having anxiety (aOR 2.1, 95% CI 1.1-4.2). As for stress, therewere no significant association among all the variables. Conclusion:The prevalence of DAS in this study was low among T2DM adults. However, the fact that thereis still some prevalence of DAS especially anxiety showed that screening for mental health is stillessential when managing T2DM. Gender differences and adherence to diet control aspectsshould be considered when identifying those at risk for mental health disorders. Mental Health Status Among Adults’ Type 2 Diabetes Mellitus Attending SelectedGovernment Health Clinics in MelakaNor Atiqah [1], Abdul Rashid [2[, Alan Bong [3], Amalina Jalaludin [4], Mohd Zul Fahmi [5], RohaizaRoslan [6[, Vishales Eswari [6], Norsiah A [7], ChowSY [8][1] Klinik Kesihatan Ayer Keroh, Melaka[2] Klinik Kesihatan Rembia, Melaka[3] Klinik Kesihatan Ujong Pasir, Melaka [4] Klinik Kesihatan Ayer Molek, Melaka[5] Klinik Kesihatan Sri Tanjung, Melaka[6] Klinik Kesihatan Peringgit, Melaka[7] Klinik Kesihatan Masjid Tanah, Melaka[8] International Medical University Medical Clinic, Kuala LumpurPoster ID 7

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26Introduction:Overnutrition, low physical activity, high screen time and inadequate sleep contributes to the risein overweight and obesity. This study aims to explore how these factors affect the occurrenceof overweight in under-five children.Methods:An unmatched case-control study involving a total of 180 children (45 overweight/obesity children and135 with normal BMI) was conducted among attendees to eight health clinics in Kuantandistrict in 2023. An interviewer-guided questionnaire was used to gather the relevant data fromthe caregivers and data was analysed using the IBM SPSS Version 26.Results:The mean age was 29.4 + 12.1 months, with 53.3% of them were boys. Most were Malay(92.8%) came from B40 family group (74.4%). Children with excessive intake ofcarbohydrates food and milk (more than feeding recommendation) have more than three times(OR: 3.62 [95% CI 1.7-7.87]) and six times (OR: 6.43 [95% CI 2-20.7]) significant risk ofbecoming overweight respectively. Children with inadequate physical activity (<180 minutesper day) and excessive screen time (> 1 hour per day) have six times (OR: 6.04 [95% CI 1.67-21.81]) and nearly three times (OR: 2.76 [95% CI 1.28-5.93]) significantly higher risk ofbecoming overweight respectively. Lastly, children with inadequate sleep time (according toage recommendation) have more than three times higher risk of becoming overweight (OR:3.49 [95% CI 1.48-8.24]).
Conclusion:Caregivers and relevant authorities must play an active role in preventing childhood obesity throughreduction in sedentary behaviours and implementing healthy feeding and sleep practices amonginfants and young children.A Case Control Study on Risk of Overweight and Obesity among Under FiveChildren in KuantanNor Azam Kamaruzaman [1], Siti Shahirah Nadiah [1], Hafizah Pasi [2][1] Department of Family Medicine, Kulliyyah of Medicine, IIUM Kuantan, Pahang[2] Department of Community Medicine, IIUM Kuantan, PahangPoster ID 8

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27Introduction:Diabetes mellitus is one of the most serious worldwide public health issues, and Malaysia hasthe highest rate of diabetes in the Western Pacific region. The prevalence of Type 2 DiabetesMellitus (T2DM) has been increasing throughout the decades, especially among the youngerpopulation and 18.3% in 2019. This study aimed to identify the knowledge, attitude and risk oftype 2 diabetes mellitus and its association with sociodemographic characteristics amongundergraduate students of Universiti Tunku Abdul Rahman (UTAR).Methods:A cross-sectional study was conducted among undergraduate students in both Sungai Longand Kampar campuses of UTAR. A validated questionnaire were to explore the knowledge,attitude and risk of T2DM among the students . Data was analysed by using IBM-SPSS version27.Results:A total of 296 students participated in the study. The majority of the respondents fall under thecategory of moderate knowledge level, positive attitude and low-risk level of T2DM. There wasa significant association between ethnicity, faculty and family income with knowledge level. Thestudents from higher-income families and medical discipline demonstrated higher knowledgelevels. There was no significant association between any sociodemographic characteristics andattitude level. There was a significant association between ethnicity and risk level. There was astatistically significant positive linear relationship between knowledge and attitude. Conclusion:In conclusion, although the knowledge of T2DM among undergraduate university students wasmoderate, the attitudes were positive, and risk levels were low, interventions need to be takento improve the certain knowledge and attitude and reduce the risk level of type 2 diabetesmellitus. As the university is the main area of providing knowledge for the students, it wasrecommended to enhance campus- based health promotion campaign to reduce the risk ofT2DM among younger population.Knowledge, Attitude and Risk of Type 2 Diabetes Mellitus among UndergraduateStudents of Malaysia: A cross sectional studyYuen Zhong Hong [1], Celysce Fui Sze Kei [1], Clarence Ng Jun Cheng [1], Zoe Lee Shu Huey [1], KyeMon Min Swe [2], Hnin Pwint Phyu [1][1] M-Kandiah Faculty of Medicine and Health Sciences, UTAR[2] School of Medicine, Newcastle University Medicine MalaysiaPoster ID 9

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28Introduction:Malaysia is currently witnessing a surge in the number of cases of type 2 diabetes (T2DM). Asubstantial proportion of Malaysians with diabetes are women. Implementing self-care is crucialto achieving optimum glycemic control and preventing women from mortality and morbidities.Individuals with diabetes require an effective coping strategy and good social support whenmanaging diabetes. Nevertheless, there is limited information on how these two aspectscorrelate with self-care, specifically in women with diabetes.Methods:A cross-sectional survey was conducted in Seremban Health Clinic from January to Mac 2023.A self-administered questionnaire in both English and Malay language was distributed. Thequestionnaire assessed sociodemographic characteristics, self-care activities using theSummary of Diabetes Self-care Activities scale, problem-focused coping from the Brief COPEand social support through the Multidimensional Scale of Perceived Social Support. Correlationanalysis was performed between social support, problem-focused coping and each self-caredomain.Results:A total of 414 women with T2DM were recruited for this study, but only 346 completed thequestionnaires. Majority are above 50 years old (86.4%), live with family or friends (94.8%) andhave a household income of less than RM5000 (70.8%). Approximately half are Indian (48.3%)and only attained a secondary level of education (51.7%). More than half are housewives(57.8%) and married (66.5%). Social support is significantly correlated with four domains of self-care: general diet (r=0.13, p=0.015), exercise (r=0.30, p<0.001), self-monitoring blood glucose(r=0.32, p<0.001) and footcare (r=0.26, p<0.001). Likewise, problem-focused coping has asignificant correlation with four domains of self-care: general diet (r=0.27, p<0.001), exercise(r=0.36, p<0.001), self-monitoring blood glucose (r=0.39, p<0.001) and footcare (r=0.30,p<0.001). Conclusion:Our findings highlighted that social support and problem-focused coping significantly correlatewith self-care. Future research is recommended to explore how these two aspects can influenceself-care in women with T2DM. Correlation Between Social Support, Problem-Focused Coping and Self-Care inWomen with Type 2 DiabetesSyahnaz Mohd Hashim [1,3], Ummi Azmira Ahmad Azam [1,4], Norfazilah Ahmad [2,3], Zuhra Hamzah[1,3][1] Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur,Malaysia.[2] Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, KualaLumpur, Malaysia.[3] Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, Malaysia [4] Masjid Tanah Health Clinic, Malacca, Ministry of Health, MalaysiaPoster ID 10

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29Introduction:Post-COVID conditions or PCC, describes the persistent or newly developed symptomsaffecting individuals, four weeks after a COVID-19 infection. This study focuses on PCCfollowing mild COVID-19, as this group of patients are often monitored at home during theiracute illness and are not routinely given a follow-up appointment for symptoms monitoring.Hence, their experiences are less known to us. Here, we explore the experiences and copingstrategies of patients traversing from mild COVID-19 to PCC in the Malaysian primary caresetting.Methods:Six women were selected through purposive sampling for in-depth interviews. Interviews werestructured using a topic guide guided by Mishel's Uncertainty in Illness Theory, Lazarus andFolkman's Coping Theory, and existing literatures. The interviews were audio-recorded andsubsequently transcribed verbatim. We used content thematic analysis to analyse the data.Results:Study participants reported various PCC symptoms that severely affected their daily life, andnarrated the coping strategies they employed to manage these repercussions. Our analysisidentified three overarching themes: 1) Deterioration from acute to chronic symptoms, 2)Navigating the uncharted territory, and 3) Being resilient to heal. In dealing with the challengesposed by PCC, our participants were steadfast in overcoming their struggles adopting variousstrategies to accommodate and mitigate the impacts of their PCC.Conclusion:These findings offer invaluable insights into the multifaceted challenges and adaptive strategiesamongst patients who developed PCC following a mild COVID-19 infection. This understandingis critical to equip primary care providers with the insight to approach these patients with acomprehensive, holistic management. Experiences and Coping Strategies amongst Patients with Post-COVID Conditions(PCC) at a Primary Care Centre. A qualitative studySalma Yasmin Mohd Yusuf [1], Izzuddin Ismail [1], Khasnur Abd Malek [1], Mazapuspavina Md-Yasin [1],Lina Lohshini Kanoo [1][1] Primary Care Medicine Department, Faculty of Medicine, Universiti Teknologi MARA (UiTM), 47000Sg Buloh, SelangorPoster ID 11

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30Introduction:Malaysian university students are vulnerable to poor mental health which could be due to manyfactors. This research aimed to determine the prevalence of depression and its factors amonguniversity students in the central region of Malaysia.Methods:This cross-sectional study was conducted between June and December 2019. The PatientHealth Questionnaire (PHQ-9) was used to determine depression. Inclusion criteria wereMalaysian students 18 years old and above and studying in selected universities in PeninsularMalaysia.The questionaires were in English and Bahasa Malaysia and consisted of sections onsociodemography, academic, psychosocial and psychological factors. Sample size wascalculated using cluster sampling.Ethics approval was obtained from the Ethics Committee for Research Involving HumanSubjects from Universiti Putra Malaysia (JKEUPM-2018-400), Ministry of Higher EducationMalaysia, and the Ethics Committee from the selected universities. Written consent wasobtained from students involved in this study.Data analysis was done using IBM Statistical Package for Social Sciences (SPSS) softwareversion 25, where data at p<0.05 was significant. The presence of depression was determinedat a cut-off point of ten and above (PHQ-9≥10). Results:The prevalence of depression was 35.5%, with 121 out of 341 students having a risk ofdepression. Poor sleep quality, having doubt about their future, and problems with otherstudents were factors significantly associated with depression (p<0.01). Conclusion:Depression can cause sleep disturbances, creating a negative impact to mental health amongstudents, whereas students with self-doubt regarding their future were found to have low self-esteem which can influence mental health, and students with low social support were shown tohave more likelihood in developing depression. Depression among university students warrantsattention and effective intervention. Factors found to be associated with depression should beaddressed and managed accordingly.Depression Among University Students in Central Region of Peninsular MalaysiaNadia Amira Rozali [1], Sherina Mohd Sidik [2], Mehrnoosh Akhtari [3][1] RCSI & UCD Malaysia Campus [2] Department of Psychiatry, UPM [3] Department of Public Health, Islamic Azad University, Tehran, IranPoster ID 12

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31Introduction:Gestational diabetes mellitus (GDM) has become a common medical condition in pregnancy.High levels of self-efficacy and self-care practices could lead to a reduction in the risk of short-term and long-term complications for both mother and offspring, but evidence on theassociation between self-efficacy and self-care activity levels with glycaemic control amongwomen with GDM is limited in Malaysia. This study aimed to assess self-efficacy and self-careactivity levels and to determine whether there is an association between socio-demographiccharacteristics, self-efficacy and self-care activity levels with poor glycaemic control amongwomen with GDM in Northern Terengganu.Methods: A cross-sectional study was conducted among 238 women with GDM in 11 health clinics inBesut and Setiu districts. Self-efficacy was assessed using the Malay Diabetes ManagementSelf-Efficacy Scale (DMSES-M), while self-care activity level was assessed using the MalaySummary of Diabetes Self-Care Activities Measure (SDSCA-M). Socio-demographiccharacteristics and blood sugar profiles were acquired from patients’ records. The mean for thethree latest fasting plasma glucose was calculated. A mean of >5.3 mmol/L was considered aspoor glycaemic control.Results:The prevalence of poor glycaemic control among women with GDM was 16.0%. The overallmean DMSES score was 8.15 ± 1.35 with the highest self-efficacy domain being ‘medication andfollow-up’ (8.83 ± 1.47) and the lowest domain being ‘eating plan’ (7.09 ± 1.45). The most self-care activity practised was the ‘specific diet restriction’ (4.77 ± 1.35), while the least self-careactivity practised was ‘blood sugar testing’ (0.46 ± 0.46). Multiple logistic regression showedthat not attending dietitian appointments (AOR=3.11, 95% CI: 1.52, 6.36) and self-efficacy foreating (AOR=0.783, 95% CI: 0.623, 0.983) were associated with poor glycaemic control. Conclusion:Behavioural counselling is important for women with GDM to become more confident and ableto self-manage their glycaemic control.Self-Efficacy and Self-Care Activity Levels and Glycaemic Control Among Womenwith Gestational Diabetes Mellitus: A Cross-Sectional Study in NorthernTerengganuMohd Adli Abd Khalim [1], Rohana Abdul Jalil [1], Surianti Sukeri [1], Mohd Hanief Ahmad [2], HafizuddinAwang [3][1] Department of Community Medicine, USM [2] Kuala Terengganu District Health Office, MOH[3] Besut District Health Office, MOHPoster ID 13

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32Introduction:Outbreaks of diarrhoea in children welfare homes are underreported and frequently gounnoticed in developing countries. The Kuala Kangsar District Health Office identified anoutbreak of acute gastroenteritis (AGE) in Rumah Kanak-Kanak Sultan Abdul Aziz (RKKSAA) on4/1/24. The outbreak began on 1/1/24 and ended on 16/1/24. Methods:A case-control study was conducted to identify the causes for this outbreak of AGE. Activecase investigation and case detection activities were carried out at the RKKSAA using the AcuteGastroenteritis Investigation/Outbreak Report Form [FWBD/KRM/BG/001 (Amendment2006)].Results:39 residents from 5 dormitories, and 3 staff members (27.5% of exposed individuals) wereaffected. Symptoms included diarrhoea in 37 cases (88.1%), vomiting in 28 cases (66.7%), andfever in one (2.4%). All 42 patients have made full recovery. 8 virology samples (100%) tested positive for Rotavirus, and 1 additionally tested positive forAdenovirus. 2 out of 12 bacteriology samples tested positive for E. coli. 4 environmentalsamples from Dormitory Mahsuri (DM) also tested positive for Rotavirus. Overcrowding at DM, which housed 25 children (aged 0-5 years) was the biggest risk factor forthis outbreak. None of these children had received the Rotavirus vaccination. The persistentpresence of 4 positive environmental samples for Rotavirus at day 9 indicated unsatisfactoryhygiene practices in DM, and ineffective disinfection process. 2 children whose bacteriology samples tested for E.coli were identified to have developmentalconcerns leading to coprophagia and inadequate hygiene. They were diagnosed with AutismSpectrum Disorder and enrolled for early intervention in Kuala Kangsar Health Clinic. Conclusion:The Rotavirus outbreak in RKKSAA highlighted the need for stringent measures in control andprevention of future outbreaks. Some measures undertaken include: health education, periodicdemonstration of disinfection process, Rotavirus supplementary vaccination, and routinedevelopmental assessment and intervention for these children. In conclusion, the infectious disease outbreak in this children welfare home underscores theimportance of proactive measures to protect the health and well-being of vulnerable children. An Infectious Disease Outbreak in A Children Welfare Home in Kuala KangsarDistrict: A Spotlight on Public and Primary Child Health ConcernsThenmoli Palaniyappan [1], Wan Nur Fazliyana Mohd Nashir [2][1] Klinik Kesihatan Kuala Kangsar, KKM[2] Kuala Kangsar District Health Office, KKMPoster ID 14

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33Introduction:Hypertension is a prevalent medical condition affecting over 1.28 billion adults worldwide, withhalf undiagnosed. In Malaysia, hypertension is the leading cause of death and contributes todisability-adjusted life years. Home Blood Pressure Monitoring (HBPM) is important inmanaging hypertension. However, implementing HBPM faces challenges due to inadequatetraining and knowledge among healthcare providers (HCPs). About 98% of doctorsrecommend HBPM but lack skills for accurate monitoring, leading to incorrect readings andineffective treatment. This study aims to fill the gap in associated factors of HBPM instructionmethods among primary HCPs for better blood pressure control.Methods:An English questionnaire from the Obara et al. study was translated into Malay and pilot-testedwith a 10% sample size to ensure clarity by two subject matter experts (SME). Forward andbackward translations to ensure accuracy. Following translation, the questionnaire underwentpilot testing in the first two weeks of January 2024 to assess the clarity of meaning andappropriateness of language. The HCPs who met the inclusion criteria were invited toparticipate. Results:The translated scales showed excellent reliability (Cronbach’s Alpha =.97), with no alterationsmade. Among the 30 respondents, consisting of Family Medicine Specialists (n=3, 10%),Medical Officers (n=12, 40%), Jururawat Masyarakat (n=3, 13.3%), Staff Nurses (n=9, 30%),Pharmacists (n=1, 2%), and Medical assistant (n=1, 3.3%). Among respondents, most hadattended hypertension management courses (76.6%) and managed a high proportion ofhypertensive patients weekly (56%). All HCPs recommended HBPM to their patients, but only60% demonstrated high recognition. About 6.6% of HCPs have optimal practice of HBPMinstruction methods, and 17% correctly identified the reference values. No significantassociations were found in this study.Conclusion:The HBPM Practice Questionnaire in the Malay version is a reliable tool. Although most HCPsrecognise and recommend HBPM, many have inadequate knowledge of HBPM instructionmethods.Questionnaire Translation and Its Result: Factors Associated with the Practice ofHome Blood Pressure Monitoring Among Healthcare Providers in all PutrajayaPublic Healthcare ClinicsNoor Faridzatul Ain Mohd Noor [1], Aneesa Abdul Rashid [1], Muhamad Fikri Shazlan Saad [2][1] Department of Family Medicine, Faculty of Medicine and Medical Sciences, Universiti Putra Malaysia,Selangor, Malaysia.[2] Department of Human Anatomy and Physiology, Faculty of Medicine and Health Sciences, UniversitiPutra Malaysia, Selangor, MalaysiaPoster ID 15

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34Introduction:Metabolic-associated fatty liver disease (MAFLD) is an increasing healthcare burden inMalaysia. Point-of-care transient elastography like FibroScan© is a convenient and affordabletool to detect and measure fatty liver and fibrosis in primary care settings. This pointprevalence survey from two primary care centres in Malaysia offers insights into thedemographic distribution and degree of fatty liver and fibrosis among primary care patients.Methods:Two primary care centres that partner with Angsana Health utilized FibroScan©, after trainingby the manufacturer Echosens©. A retrospective analysis was conducted with 202 patientswho had undergone FibroScan between April 2023 and January 2024. Deidentified andaggregated information was collected: gender, age, controlled attenuation parameter (CAP)and liver stiffness measurement (LSM) values to evaluate the degree of fatty liver and degree offibrosis, respectively. Results:There were 56.9% (n=117) males and 43.1% (n=87) females categorized into six age groups: 18-30 (n=26), 31-40 (n=51), 41-50 (n=38), 51-60 (n=37), 61-70 (n=37), and 71 and above (n=13).The survey reveals a significant prevalence of fatty liver disease, with 35.6% (n=72) of patientsexhibiting a high degree (>66%) of fatty liver. Amongst patients with a high degree of fatty liver,65% were associated with risk factors for fatty liver disease. The prevalence of patients who mayhave advanced fibrosis (LSM 10 and above) is 9.4% (n=19). While fatty liver is highly prevalent,the prevalence of severe liver fibrosis is infrequent within this primary care cohort. Conclusion:FIbroScan© is a realistic tool in clinic-GP settings, not just hospital-specialist settings. Thefindings underscore the importance of early detection, administering proactive lifestylemodifications, and making early referrals to hepatologists. The high prevalence of fatty liverdisease suggests a need for targeted interventions for those at higher risk, emphasizing thesignificance of continued surveillance and early intervention in primary care settings.Transient Elastography in Primary Care: Findings from a Point Prevalence Survey inTwo Primary Care Clinics in MalaysiaLee Pei San [1], Afifah Abdul Shukor [2], Kohila Devan A/L Murugan [3], Lee Shen-Han [4] [1] Klinik LS Family Ipoh Garden, Ipoh [2] Department of Internal Medicine, Hospital Sultanah Bahiyah [3] Poliklinik Optimal Health, Semenyih[4] Department of Otorhinolaryngology-Head & Neck Surgery, Hospital Universiti Sains Malaysia[5] Angsana HealthPoster ID 16

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35Introduction:Perceived food environment may influence the food choice of diabetic patients and affect theirglycaemic control. This study aimed to determine the associated factors of glycaemic controlparticularly related to the perceived food environment among diabetic patients in KualaTerengganu capital city. Methods:The data was collected among diabetic patients at a health clinic in Kuala Terengganu using thePerceived Nutrition Environment Measure Survey (NEMS-P) questionnaire from United Statewhich had been translated, culturally adapted and underwent content and face validity by theexperts and potential respondents and was analysed using simple logistic regression via SPSSversion 26. HbA1C of 6.5% was regarded as good glycaemic control in this study.Results:In simple logistic regression analysis, we found that increasing in age have protective factoragainst poorly control diabetes while those having higher body mass index (BMI) have 10.7%higher chances of having poorly control diabetes. Some perceived food environment factorssuch as having microwave (instant cook appliance) and wholemeal bread at home was found tolower the chance of having poor glycaemic control by 12.7% and 14.4% respectively althoughnot statistically significant. Other perceived food environment such as eating outside foodincrease the chances of poor glycaemic control by 89.8% although not statistically significant. Conclusion:These results showed that higher BMI can be associated with poor glycaemic control in personswith diabetes while increasing in age was found to be a protective factor. Availability of cookingappliance and healthy food at home can be protective factors while eating outside increasedthe chance of having poor glycaemic control although not statistically significant. Perceived Food Environment Among Diabetic Patients in East Coast Peninsular ofMalaysiaAhmad Syaify Berahim [1], Rohana Abdul Jalil [1], Najib Majdi Yaacob [1], Ruslina Yeop [2] [1] Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, KubangKerian, 16150 Kota Bharu, Kelantan[2] Kuala Terengganu District Health Office, 21100 Kuala Terengganu, TerengganuPoster ID 17

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36Introduction:Iron deficiency is the commonest cause of anemia in pregnancy. In Kota Bharu, the prevalenceof anaemia in pregnancy in 2021 until 2023 approximately was 25%. This study aims to describethe characteristic of antenatal mother who received Intravenous iron Venofer and to examinethe efficacy of intravenous iron used.Methods:We conducted a retrospective cohort study from January 2022 till June 2023 to all pregnantwomen who made booking at all antenatal health clinics in Kota Bharu’s Health District Officeand who had completed the prescribed course of Intravenous iron Venofer. The calculatedsample size was 125. The patient's antenatal booklets were examined and recorded in theproforma.Results:Majority of the participants were between 20 to 45 years old, Malay and married. 59% of theparticipants had education level till secondary school and 31% till tertiary education level. 50%of the participants were housewife. 85% of the respondents received parenteral iron at 3rdtrimester of pregnancy. 81% of them had mild anaemia and 19% had moderate anaemia. 86% ofthem had serum ferritin less than 30 ug/L. The mean haemoglobin level in non-iron deficientgroup (serum ferritin more than 30 ug/L) after given parenteral iron at 2nd, 4th, 6th and 8thweek were 9.91 g/L, 10.42 g/L, 10.69 g/L and 10.4 g/L respectively. While in iron deficientgroup (serum ferritin less than 30ug/L) at 2nd, 4th, 6th and 8th week were 10.3 g/L, 10.94 g/L,11.23 g/L and 11.4 g/L respectively. Conclusion:In our study, we observed iron deficient group responds well compared to non-iron deficientgroup. The peak rise in Haemoglobin level is between 6th to 8th week post parenteral Irongiven. Hence, timely screening, diagnosis and correct intervention is needed for improvementof iron store and haemoglobin level in the antenatal mother. Study of Intravenous Iron Venofer in The Treatment of Anaemia in Pregnancy inKota Bharu, Kelantan.Muhammad Faiz Bin Che Yaacob [1], Zalani Binti Zakaria [2], Rosmah Binti Ismail [3], Norazizah BintiHassan [4], Marzilah Binti Mohamad [5], Siti Sarah Binti Mansor [2], Narulkhana Binti Abdullah [6],Zurina Binti Hasan [7][1] Klinik Kesihatan Bandar Kota Bharu, Jalan Hospital, 15586 Kota Bharu[2] Klinik Kesihatan Cempaka, Jalan Panji, Kota Bharu[3] Klinik Kesihatan Kubang Kerian, Jalan Istana Mahkota,Kota Bharu, 16150 Kota Bharu[4] Klinik Kesihatan Penambang, Jalan Pantai Cahaya Bulan, Kg. Penambang, 15350 Kota Bharu[5] Klinik Kesihatan Peringat, Jalan Melor, 16400 Kota Bharu[6] Klinik Kesihatan Mulong, Jalan Kuala Krai- Kota Bharu[7] Klinik Kesihatan Pintu Geng, Jalan Pintu Geng, Kota BharuPoster ID 18

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37Introduction:The COVID-19 pandemic spurred intensive investigations into various facets of the microbes-host interaction. The human microbiota, comprising trillions of microorganisms inhabitingdiverse niches like the gut, upper and lower respiratory tract, plays a crucial role in maintaininghost homeostasis and modulating immune responses. This study reviewed studies thatinvestigated the relationship between human microbiota and COVID-19, to shed light on thecompositional changes within these microbial communities during infection. Methods:Keywords ‘microbiota’, ‘microbiome’ and ‘COVID-19 infection’ were used to search thePubMed, Scopus and EBSCOHost databases. The search identified a total of 707 papers: 24papers (PubMed), 628 papers (Scopus) and 55 papers (EBSCOHost), which were narrowed to50 papers based on the titles screened. A total of 16 original full papers were obtained andreviewed. Results:The healthy gut microbiota composed mainly of phyla Firmicutes and Bacteroidetes, followedby Verrucomicrobia and Actinobacteria. Common genera of microbiota in the upper respiratorytract include Staphylococcus spp., Propionibacterium spp., Corynebacterium spp., Moraxellaspp., Dolosigranulum spp., Haemophilus spp., Streptococcus spp., Neisseria spp., Rothia spp.,Veillonella spp., Prevotella spp., and Leptotrichia spp. The main phyla identified in healthy lungsare Bacteroidetes, Firmicutes, Proteobacteria, Fusobacteria, and Actinobacteria. Most of thestudies showed that microbiota diversity was significantly reduced in COVID-19 patientscompared to healthy controls. The angiotensin-converting enzyme 2 (ACE2) serves as themajor receptor for SARS-CoV-2 entry. ACE2 also proved to be a modulator of the gutmicrobiota. Findings propose an association between ACE2 dysfunction and gut microbiotadysbiosis.Conclusion:This scoping review shows that the pathophysiology aspects of the COVID-19 disease aretightly linked to the microbiota. Dysbiosis of the microbiota is seen in COVID-19. Increasing theadvantageous microorganisms in the host's microbiota and reducing the opportunisticpathogens may prevent an inflammatory environment. This is essential to prevent complicationsof COVID-19 like acute respiratory distress syndrome.Unravelling Host Microbiota Shifts in COVID-19: A Scoping ReviewNormaisarah Aman Shah [1], Siva Gowri Pathmanathan [2], Fathima Begum Syed Mohideen [3][1] Faculty of Medicine and Health Sciences, USIM[2] Family Medicine Unit, Department of Primary Health Care, Faculty of Medicine and Health Sciences,USIM[3] Department of Medical Sciences, Faculty of Medicine and Health Sciences, USIMPoster ID 19

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38Introduction:The domiciliary service comprises of medical and rehabilitation services done at the home ofpatients to ensure uninterrupted care upon early discharge from hospital. It renders support tothe family members in training the caregiver and reduces readmission by providing qualitymedical care at home and in the community. OBJECTIVE: To explore the barriers of domiciliaryservices at Hospital Seberang Jaya (HSJ), PenangMethods:A total of 53 respondents (34 trained nurses, 5 matrons, 8 sisters, 4 occupational therapists and2 physiotherapists) involved in domiciliary care from the medical, surgical, orthopedic andpediatric wards of HSJ were interviewed using a semi-structured questionnaire as a guide. Theinterviews were done in homogenous focus groups or as individual interviews, which were,audio recorded, transcribed and thematically analyzed using NVivo 12 Plus. Results:Health System Barriers (inadequacy in; manpower, support services, public domiciliarydissemination, basic ward equipment, ward staff orientation on domiciliary, prolong bedoccupancy, ineffective domiciliary team with no remedial measures).Health Professionals Barriers; Concerning doctors (bias selection of cases, default inresponsibilities and weekend discharges). Concerning nurses (lacking initiatives, compromisenursing tasks and facing intimidating factors). Concerning other allied health respondents(facing language barrier, poor comprehension and non-committal of caretakers to attendcoaching sessions).Patient and Caregiver Barriers ;(Incompetent caregiver, locale inconvenience especially whendecant, non-conducive home to receive home visits, misconception on nursing role in wardslightened when caretaker takes over, lacking self-confidence to learn and financial issues) werealso noted. Encompassing all barriers were lack of continual monitoring, supervision, knowledgeupdates and default communication within and with health centers.Conclusion:Overcoming barriers in health system, health professionals, patients and caregivers will catapulttowards excellent domiciliary services at HSJ. Barriers Of Domiciliary Care Services at Hospital Seberang Jaya: A QualitativeStudy on The Views of The Healthcare ProfessionalsMarshall DS [1], PY Lee [2], Abdul Malik NS [1], Looi Irene [1][1] Hospital Seberang Jaya, Penang, Malaysia [2] Universiti Malaya, Kuala Lumpur, MalaysiaPoster ID 20

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39Introduction:This audit was performed to evaluate the standard of practice in the management of patientswith warfarin in a primary care clinic.Methods:Data of patients on warfarin who attended the INR clinic from July 2022 to June 2023 wereretrieved. Those who were on regular follow-up with at least 3 traceable readings in theelectronic medical record were included, except for those who were less than 18 years old,pregnant and those who were transferred to other facilities. The audit criteria were set based onthe 2nd edition of the Malaysian CPG on Anticoagulation Medication Adherence Clinic (AC-MTAC). The standards were set with reference to CPG and latest published standards of care.Results:A total of 75 medical records were included in this audit. For process of care, 10 out 22 criteria(first visit record) and 5 out of criteria (follow-up visits) did not meet the standards. Theseinclude: (a) a referral letter/form for every new patient referred to the INR clinic (87.5%) and (b)documentation of: warfarin initiation date (56.2%), duration of INR treatment (18.75%), patient’scurrent warfarin dose (93.75%). and (c) assessment of: compliance (87.5%), signs andsymptoms of thromboembolism (93.75%), drug interaction (87.5%), alcohol status (18.75%),nicotine intake (43.75%), advice on safety netting (93.8%), missed doses (98.67%), assessmentfor changes in medication intake (98.67%), assessment for alcohol intake (33.33%), assessmentfor nicotine intake (70.67%), and assessment for signs and symptoms of thromboembolism(98.67%). Outcomes in the INR clinic were measured in terms of the presence of complications(thromboembolic or bleeding events) and the time in the therapeutic range (TTR). Conclusion:Overall, 19 out of 51 criteria did not meet the standard of management of patients on warfarinset for this audit. The problems and issues have been identified and strategies have beenformulated to address them.Warfarin Management in A Primary Care Clinic: A Clinical AuditNur Khadijah Johari [1,2], Siti Anisah Jamaludin [1,2], Nurfaten Hamimah Abdul Hamid [1,2], Mohd HafisZul Arif Awang [1,2], Nordini Asri [1,2], Abdul Khaliq Abdul Jalil [1,2], Mohd Ashraf Mohamad Rafee [1,2],Nur Zawani Md Nawawi [1,2], Lina Lohshini Kanoo [1,2], Hayatul Najaa Miptah [1,2][1] Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selangor,Malaysia. [2] Hospital Al-Sultan Abdullah (HASA), UiTM Puncak Alam, Selangor, MalaysiaPoster ID 21

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40Introduction:Measles remains a significant public health challenge globally, including in Malaysia, despite theavailability of effective vaccines. Traditional studies often focus solely on individual factors andoverlook the contextual factors that influence disease transmission dynamics. This study aimedto explore the determinants of measles incidence in Malaysia by employing a mixed-effectmodeling approach that incorporates contextual factors at the district level.Methods:This study was conducted utilizing data from e-measles database by Ministry of HealthMalaysia, which provided information on the number of reported cases by districts.Additionally, data on vaccination coverage were obtained from Health Informatics Centre.Contextual factors such as median household income, population density, healthcareinfrastructure, and local governance were derived from Department of Statistics Malaysia(DOSM). Ecological data including relative humidity, temperature, and PM10 were sourcedfrom Department of Environment (DOE). A negative-binomial mixed effect model wasemployed for data analysis using R software, interpreting model results to identify significantdeterminants of measles incidence.Results:A total of 3850 confirmed measles cases reported from 2018 to 2022. The trend of measlesincidence exhibited a substantial decline from 2018 to 2021, followed by a slight increase in2022. We found that median household income (Incidence Rate Ratio [IRR] 1.02, 95%Confidence Interval [CI] 1.01 – 1.03) and number of health clinics and rural clinics (IRR 1.02,95% CI 1.01 – 1.04) were positively associated with measles incidence. Conversely, temperature(IRR 0.85, 95% CI 0.74 – 0.99) and the year of observation (IRR 0.51, 95% CI 0.47 – 0.56) werenegatively associated with measles incidence.Conclusion:This study highlights the significance of contextual factors in measles transmission. Relevantauthorities can develop targeted interventions tailored to the specific needs and challenges ofdifferent communities in Malaysia with consideration of contextual factors for a more effectivedisease prevention and control, ultimately reducing the burden of measles.Determinants of Measles Incidence in Malaysia: A Mixed-Effect Modeling ApproachMohd Rujhan Hadfi Mat Daud [1], Nor Azwany Yaacob [1], Wan Nor Arifin Wan Mansor [2], JamiatulAida Md Sani [3], Wan Abdul Hannan Wan Ibadullah [3][1] Department of Community Medicine, USM [2] Unit of Biostatistics and Research Methodology, USM [3] Disease Control Division, MOH MalaysiaPoster ID 22

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41Introduction:The COVID-19 pandemic has largely affected accessibility to healthcare services, particularly onthe timeliness of healthcare services delivered to the population. Defaulter rate is one of theproxy indicators recommended to monitor timeliness. This study assessed and compared thedefaulter rate of services in primary care clinics during the pandemic and pre-COVID-19 period. Methods:This longitudinal study utilised data from the Ministry of Health administrative routine databaseand Tele-Primary Care (TPC) system, available from 78 health clinics throughout the country.Data on number of defaulters and total attendances for three services; outpatient, antenatal andchild health from January 2019 to December 2020 were extracted, with date prior to January2020 defined as pre-COVID-19. The monthly defaulter rates of respective months in 2019 and2020 were compared using paired t-tests via SPSS version 26.Results:During COVID-19, the defaulter rates ranged from 0.033-0.123 for OPD as compared to 0.032-0.042 in 2019. The rate varied from 0.093-0.138 during the pandemic for antenatal, whereas in2019, it was between 0.099-0.116. As for child health, the rate ranged from 0.062-0.184 duringCOVID-19 as compared to 0.066-0.080 in 2019. Comparing 2020 and 2019, higher defaulterrates for outpatient and child health services were seen during March, April, and June 2020(p<0.05). No significant differences were seen for antenatal services throughout the months,although the rate was highest in March 2020. Conclusion:Defaulter rates were significantly higher during the second wave of COVID-19 in outpatient andchild health services, whilst antenatal care services appeared unchanged. This study providesvaluable insights into the effect of a pandemic on the timeliness of primary care services,specifically in TPC clinics. Strategies to maintain timeliness of healthcare services during futuredisease outbreaks should consider more vulnerable services to ensure healthcare access ismaintained across all services. Defaulter Rate During the Covid-19: A Longitudinal Study of Tele-Primary Care(TPC) Clinic Roslina Supadi [1], Izzatur Rahmi Mohd Ujang [1], Samsiah Awang [1], Divya Nair Narayanan [1],Khalidah Maruan [1], Normaizira Hamidi [1], Mariyah Mohamad [1], Nor Ezdiani Mohamed [1], NurhayatiShaharuddin [1], Nur Wahida Zulkifli [2][1] Institute for Health Systems Research, National Institutes of Health, Ministry of Health, Selangor,Malaysia[2] Faculty of Pharmacy, University Technologi MARA, SelangorPoster ID 23

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42Introduction:Youths are typically at their peak of exploring new things including sexual risk behaviour (SRB)which often results in multiple reproductive health problems, complications and death. Thisstudy aims to determine the prevalence and association between multi-system factors and SRBamong local youths studying in higher education institutions.Methods:A cross-sectional online survey was conducted on 28 higher education institutions which wereselected using stratified random sampling. Participants were recruited using the conveniencesampling method. The questionnaire consisted of participants’ socio-demographiccharacteristics, academic background, substance abuse, childhood abuse, religiosity,knowledge on sexuality, attitude on pre-marital sex, parents’ parenting behaviour, peerinfluence and sexual risk behaviour was used. Descriptive statistics were computed for allvariables. The association between variables were measured using logistic regression analysis.The level of significance was set at p<0. 05. Results:1172 respondents were recruited in this study. The prevalence of SRB among the students was84 (7.2%) with a mean score of 0.07 ± 0.26. Mean age of participants was 20.16 ± 1.66. Age,smoking or vaping history, alcohol use, non-organized religious activity (NORA), father care andpeer pressure were found to be significantly associated with SRB. Conclusion:The prevalence of SRB among Malaysian youths was 7.2%. Those factors required furtherexploration and are relevant in the preventive strategies of SRB. Preventive plans must be madeparallel to the needs of the local youths as this generation represents the future of the country. Sexual Risk Behaviour Among Malaysian Youth – A Nationwide Cross-SectionalStudyFadzilah Mohamad [1], Syifa' Mohd Azlan [1], Khairatul Nainey Kamaruddin [2], NuramirahShibraumalisi [2], Sharifah Najwa Syed Mohamad [3], Rahima Dahlan [4], Irmi Zarina Ismail [1],Nurainul Hana Shamsuddin [1], Kadir Shahar [5][1] Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia[2] Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA [3] Department of Primary Health Care, Universiti Sains Islam Malaysia[4] Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia[5] Department of Community Health, Faculty of Medicine and Health Sciences, Universiti PutraMalaysiaPoster ID 24

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43Introduction:Acknowledging the intricate interplay among biological, psychological, and social factors isimperative in comprehending masculinity norms. The CMNI represents a pivotal instrument forsuch exploration. Thus, this study aims to translate the original English version into the Malaycontext, validate and determine psychometric properties through confirmatory factor analysis(CFA), and assess reliability.Methods:The translation process followed seven stages with content validation assigned to six expertpanels and face validation by ten selected raters. A cross-sectional study was conductedamong 438 male personnel and postgraduate students who work and/or study at the HospitalUniversiti Sains Malaysia (HUSM) and Health Campus, Universiti Sains Malaysia (USM).Consented respondents either completed forms manually or online.Results:I-CVI values were acceptable; 0.83 to 1.00. Even S-CVI/UA values of 0.67 for five factors,below the threshold, but their S-CVI/Ave exceeded 0.94. The overall S-CVI/UA and S-CVI/Avewere between 0.83 to 0.97. I-FVI values were acceptable; 0.9 to 1.00. Even S-FVI/UA valuesfor five factors were 0.67, yet S-FVI/Ave exceeded 0.97. The overall S-FVI/UA and S-FVI/Avewere 0.83 and 0.98, respectively. Model 9 emerged as the best-fit model; SRMR = 0.052,RMSEA (90% CI) = 0.042 (0.036, 0.049), CFI = 0.931, TLI = 0.911, and factor loadingexceeded (0.324 to 0.952). Three factors with low Raykov’s rho were identified; winning(0.475), violence (0.431), and self-reliance (0.270). The uncorrected item-total correlations (I-TC) indicated most items above 0.80 upper limits (ranging from 0.639 to 0.895), however, thecorrected coefficients (CI-TC) were < 0.75 and > 0.20 except items X25 and X26, 0.171respectively (ranging from 0.171 and 0.719). Regardless, the mean inter-item correlations wereall acceptable (ranging from 0.171 to 0.581).Conclusion:The Malay version of the CMNI-30 provided a valid and fairly reliable questionnaire to measuremasculinity norms among male personnel and postgraduate students. Translation, Validation, and Reliability Assessment of the Malay version of theConformity to Masculine Norms Inventory (CMNI-30) Questionnaire: A Studyamong Male Personnel and Postgraduate Students at Hospital Universiti SainsMalaysia and Health Campus, Universiti Sains MalaysiaMuhammad Iqbal Haji Mukhti [1], Mohd Ismail Ibrahim [1], Najib Majdi Yaacob [2], Tengku Alina TengkuIsmail [1][1] Department of Community Medicine, School of Medical Sciences, Health Campus, USM[2] Unit of Biostatistics and Research Methodology, School of Medical Sciences, Health Campus, USMPoster ID 25

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44Introduction:Elderly population is increasing globally. Disability is common among elderly resulting fromphysiological changes and morbidities. Inability to manage their daily activities due to disabilitywill affect the quality of life of the elderly and their family. This study is to assess the domain andthe level of disability and its association with sociodemographic factors, living arrangement andmorbidities.Methods:A cross-sectional study was carried out in ten residential areas in Bukit Baru, Melaka. A total of432 elderlies were conveniently selected and interviewed using World Health OrganizationDisability Assessment Survey 2.0 questionnaires to assess 6 disability domains that areCognitive disability, Mobile disability, Self-care disability, Social impairment, Life activitiesdisability and Participation disability. The disability domain and level were analyzed to assess itsassociation with sociodemographic factors, living arrangement and number of morbidities.Results:The commonest disability was Participation followed by Mobility and Cognitive disability.Highest disability score was Participation, followed by Mobility and Life-activities. There weresignificant association between age, marital status, and number of morbidities and all disabilitydomains (p <.05). Age, marital status, and number of morbidities were also significantlyassociated with level of disabilities (p <.05). Gender and living arrangement were notsignificantly associated with disabilities. Conclusion:This study showed that disability was relatively common among elderly living in Bukit Baru,Melaka, however majority were mild. The commonest disability was Participation. Age, maritalstatus, and number of morbidities were the determinants of disabilities.Disability Domain and Its Determinants Among Elderly in Bukit Baru, Melaka,Malaysia.Nur Farhana binti Mohammed Noor [1], Sabaridah binti Ismail [1][1] No. 3, Jalan Greentown, Faculty of Medicine, Universiti Kuala Lumpur Royal College of MedicinePerakPoster ID 26

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45Introduction:Obesity is a chronic disease influenced by various risk factors which requires a holistic approachfor intervention. In view of this, the assessment of patients’ knowledge, attitude and perceptiontowards obesity is important to identify modifiable behavioural factors. This study aimed toreview the knowledge, attitude and perceptions of patients attending a university-basedmultidisciplinary weight management clinic as part of patients’ personalized treatment plan.Methods:This is a cross-sectional study involving all participants who attended the weight managementclinic program from March 2016 until December 2023. Sociodemographic and clinical historydata was collected using a standardized clinic proforma. Knowledge, attitude, and perceptionon obesity was assessed using an adapted questionnaire from Simkhada et al (2011) using a 10-point Likert scale with 1 ‘Not Agree’ and 10 ‘Agree’. Descriptive data were analyzed using SPSS28.Results:A total of 204 patients were included in the study. Majority were male (51%), Malay ethnicity(95.6%) and had tertiary level of education (70.1%). The mean baseline weight was 119.62 kg(SD=±30.91) and body mass index (BMI) was 44.61 kg/m2 (SD=±10.09). Overall knowledge onobesity among participants was good (Mean score 57.4 ± 7.33, total score = 70). For theattitude and perception, majority of the participants did not agree with the perception thatobesity is the symbol of richness and prosperity, and obese people are untidy. However,majority perceived that obese people should not expect to live normal lives and that peoplewho are overweight tend to be lazier than those with normal BMI. Conclusion:The participants had good knowledge obesity; however, the results are mixed for the attitudeand perception on obesity. Negative attitudes and perception could deter obese patients fromachieving their treatment target. Patient education and awareness is important to cultivatepositive attitude and perception on obesity.Knowledge, Attitude and Perceptions of Patients Attending A University-BasedMultidisciplinary Weight Management Clinic For ObesityNik Munirah Nik Mohd Nasir [1,2], Khairatul Nainey Kamaruddin [1,2], Mazapuspavina Md Yasin [1,2],Khasnur Abd Malek [1,2], Zahirah Tharek [1,2], Lina Lohshini Kanoo [1,2][1] Primary Care Medicine Department, Faculty of Medicine, Universiti Teknologi MARA, 47000 SungaiBuloh, Selangor, Malaysia[2] Hospital Al Sultan Abdullah (HASA), Universiti Teknologi MARA, 42300 Puncak Alam, Selangor,MalaysiaPoster ID 27

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46Introduction:Antimicrobial resistance (AMR) is a problem caused by overuse of antibiotics, leading toincreased mortality, morbidity, hospital stays, and expenses. This audit aims to evaluateantibiotic prescribing practices for acute pharyngitis, urinary tract infection (UTI), and skin andsoft tissue infections (SSTI) in UiTM Primary Care Clinics in order to identify potential targetareas for quality improvement.Methods:This is a retrospective clinical audit conducted among all patients who were diagnosed withacute pharyngitis, UTI and SSTI requiring antibiotics in UiTM Primary Care Clinic Sungai Bulohand Selayang. The duration of the audit was one year starting from 01/06/2021 until31/05/2022. A total of 307 patients were included from the universal sampling from theelectronic medical record. Audit proforma was adapted from antimicrobial stewardship (AMS)protocol. The appropriateness of antibiotics usage was based on the accuracy of diagnosis,indication of antibiotics, correct usage (dose, frequency, duration) according to the NationalAntibiotic Guideline (NAG 2019).Results:Proportion of patients with acute pharyngitis, UTI, SSTI with the recommended antibiotic,dosage, frequency, and duration as per NAG 2019 with documented diagnosis and indicationwas 28.3% (n=87). Wrong antibiotic selection was the most common reason for theinappropriateness of antibiotic prescribing for UTI and SSTI in this clinical audit (54.4% and 64%respectively). For acute pharyngitis, wrong indication for antibiotic was the most encounteredreason (69%).Conclusion:Adherence and appropriateness of antibiotic prescription were low at UiTM Primary CareClinics, hence there is a need to take measures to improve appropriateness of antibiotic usage.Appropriateness of Antibiotic Prescription for Acute Pharyngitis, Urinary TractInfection and Skin and Soft Tissue Infection in a Public Primary Care Clinic.Syameme Padzel [1], Eza Azfarina Kamal Baharin [1], Nursakinahsharifah Abdul Halim [1], Salwa Rosli[1], Sharifah Idayu Sayid Abdullah [1], Hayatul Najaa Miptah [1], Khairatul Nainey Kamaruddin [1][1] Department of Primary Care Medicine, Faculty of Medicine, University Teknologi MARA, MalaysiaPoster ID 37

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47Introduction:Background: Back pain (BP) affected 619 million people globally in 2020, and the number ofcases is projected to increase up to 843 million cases by 2050, largely driven by populationexpansion and ageing. In older adults presenting with musculoskeletal pain, the percentage ofthose pain suffering from back pain is between 36 to 70% as the prevalence of osteoarthritis,disc degeneration, osteoporosis and spinal stenosis increase with age.TRE: TRE is a dietary approach that restricts all caloric intake within a consistent interval of lessthan 12 hours per day without caloric reduction. TRE decreases markers of oxidative stress andinflammation. TRE plays a beneficial role in the management of inflammatory musculoskeletalrelated BP as a cardinal feature of inflammation is pain. Current treatment: Management of chronic BP usually requires multidisciplinary interventions.The primary form of pharmacotherapy are oral/topical analgesics, oral supplementation(glucosamine/ chondroitin/ piascledine), and intra-articular steroid or hyaluronic acid injections.For non-pharmacological intervention, physiotherapy coupled with weight reduction has beenproven to be an effective treatment for BP. Definitive surgical procedures have also beenemployed with positive results.Problem: In the elderly (>65 years of age), the pain coincides with other complex health issues renderingthem unsuitable or high-risk candidates for current interventions hence limiting treatmentoptions. Age-related decline in kidney function also limits the use of non-steroidal anti-inflammatories.Methods: We aim to synthesize current available evidence to study the interplay between TRE and BP asa promising component in a holistic pain management strategy in the Primary care setting.Goals: This review intends to explore the potential efficacy TRE as a non-pharmacological modality formanaging BP in this population. Timed-restricted Eating as a Management Modality for Back Pain in Elderly Patientswith Multiple Comorbidities: A Review of the EvidenceHaslina Mukhtar Aajamer [1], Faridah Mohd Zin [1][1] Department of Primary Care, IMS, MSU Poster ID 38

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Case ReportAbstractPOSTER ID: 2848Background:Cutis Verticis Gyrata is a benign disorder of the scalp characterized by convoluted folds anddeep furrows which resemble cerebral sulci and gyri. It is also known as paquidermia verticisgyrata, cutis verticis plicata, and “bulldog” scalp syndrome. Cutis Verticis Gyrata can be primaryor secondary. Primary is idiopathic, meaning the cause is unknown, and it usually occurs duringadolescence or early adulthood. Secondary is associated with underlying diseases such as scalpinflammatory diseases, tumors, or genetic syndromes.Case presentation:We report here a case of a 28-year-old lady, primigravida, with antenatally iron deficiencyanemia, newly diagnosed Hepatitis B Infection in pregnancy, and Gestational Diabetes Mellituson diet control. The patient presented with a thickening of skin on her forehead withcerebriform convoluted folds and furrows during 24 weeks of pregnancy. She was seen by thedermatology team too and treated as Cutis Verticis Gyrata in Pregnancy secondary to hormonalchanges. No active intervention for the dermatology side. Subsequently, the symptomsresolved postpartum.Conclusion: In summary, this is a case report of Cutis Verticis Gyrata, which spontaneously developed andresolved due to hormonal changes during pregnancy. The present case may reveal theexistence of a new pregnancy-related syndrome that may present with transient Cutis VerticisGyrata, elevated androgens, and empty sella.Cutis Verticis Gyrata Related to Pregnancy: A Case Report Muhammad Ashrul Affiq Bin Abd Halim [1], Farah Hazwani Binti Mohd Jaffar [1] [1] Klinik Kesihatan Telipok, Sabah

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POSTER ID: 2949Background:Syphilis is a treatable sexually transmitted disease that remains a global health concern as 7.1million new infections were reported in 2020 (WHO, 2021). The interplay between syphilis andHIV introduces a complex dynamic, as studies reveal syphilis's potential to facilitate HIVtransmission, elevate viral load, and impede immune response (Wu et al., 2021). Thecoexistence of HIV and syphilis may lead to heightened risks of neurosyphilis, ocular syphilis,and treatment failure (Tang et al., 2022).Case presentation:A 32-year-old male with newly diagnosed HIV with a nadir CD4 count of 170, was referred forantiretroviral drug (ARD) initiation after a private hospital admission for Pneumocystispneumonia. Despite unprotected heterosexual activities five years prior, he displayed nosymptoms of syphilis and denied prior treatment. Initial screening revealed negative rapidplasma reagin (RPR) but positive Treponema pallidum hemagglutination assay (TPHA). Thesubsequent RPR test was 1:2 at 2 weeks post ARD. He was treated as latent syphilis and his RPRat 1st month was 1:2 and was non-reactive at 3rd month post-treatment. Our patient, respondedwell to ARD treatment, achieving viral load suppression at six months. The patient's compromised immune response may contribute to the initial RPR false-negativeresult (Devi, 2014). This case prompts reconsideration of screening protocols in Malaysia, wherenon-treponemal test is the primary screening tool (Baba & Ngadiman, 2015).Conclusion:Acknowledging the potential for false negatives, we advocate for repeat RPR post-ARDtreatment initiation or consideration of TPHA for early syphilis diagnosis. This case serves as acall to action for refining diagnostic protocols and enhancing syphilis management in thecontext of HIV co-infection.Unravelling Diagnostic Dilemmas: A Tale of Deceptive Silence – False Negative RPRin an Untreated HIV CaseNur Aishah Abdul Latiff [1], Fauzia Majid [1], Tiang Koi Ng [2][1] Klinik Kesihatan Seremban 2, Seremban, Negeri Sembilan[2] Infectious Disease Unit, Internal Medicine, Hospital Tunku Jaafar, Seremban, Negeri Sembilan

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POSTER ID: 3050Background:Gallbladder cancer is a rare disease with ASR of 1.2 cases per 100,000 population of the world.In Malaysia, it has 5-year prevalence (all ages) of 0.22 cases per 100,000 population. It is veryaggressive with a 5-year survival rate of 19%. Paraneoplastic Leukemoid Reaction (PLR) iscommonly present in solid tumors, especially lung cancer but rarely reported in case ofgallbladder cancer.Case presentation:A 79-year-old man presented with recurrent right hypochondriac abdominal pain for one monthwith on and off fever. He was feverish with a 2x2cm tender mass below his liver margin withpositive Murphy’s sign. Bedside abdominal ultrasound revealed an enlarged gallbladder masswith multiple liver masses. His full blood count showed leukocytosis (WCC: 34 x10^9) andmacrocytic anemia. He was then referred to a tertiary hospital for sepsis secondary to acutecholecystitis.Subsequently, his blood investigations revealed CA19-9 >24,000 IU/mL, AFP: 3.99 IU/mL withsevere transaminitis. CECT liver 4-phase showed enhancing mass at gallbladder wall withmultiple enhancing mass in the liver and a cystic lesion at segment 6 liver compressed thebiliary system causing mild biliary tract dilatation.The diagnosis of advanced gallbladder carcinoma with liver metastasis with dilated bilateralintrahepatic duct was made and he was referred to hepatobiliary team for ERCP and bilateralmetallic stenting. The patient then passed away two weeks after the procedure.Conclusion:Gallbladder cancer is a rare disease with a high mortality rate due to delay in diagnosis. It israrely presented with paraneoplastic leukemoid reaction.Rare Presentation of Paraneoplastic Leukemoid Reaction in Gallbladder CarcinomaLeong Siew Fai [1][1] Klinik Kesihatan Lawin, KKM

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POSTER ID: 3151Background:Syphilis is an evolving sexually - transmitted infection which appears in different distinguishableclinical stages: Primary, Secondary, Latent and Tertiary Syphilis. Secondary syphilis is a formsystemic manifestation which is characterized by vast features. Psoriasiform syphilis is a rareand atypical form of secondary syphilis which imitates psoriasis. Here, we highlighted a case ofpsoriasiform syphilis with diagnostic challenges in primary care.Case presentation:A 36-year-old homosexual man with underlying Human Immunodeficiency Virus (HIV) infectionon ART and Psoriasis came to the HIV clinic appointment with complaints of generalized patchythick red silvery skin scales for 3 months. He had a history of treated late latent syphilis in 2021with final Venereal Disease Research Laboratory (VDRL) test result of 1:2. He had regularunprotected sexual intercourse with a male sexual partner for 3 months. He had visited adermatology clinic and was treated as psoriasis flare up with phototherapy for 30 cycles.However, the skin condition is not improving, and it is leaving burn marks. VDRL test screeningwas done, and the result was 1:64. He was treated as secondary syphilis with 3 doses ofintramuscular Benzathine Penicillin 2.4 million units in 3 weeks. His symptoms were resolved in5 days of treatment. Subsequent VDRL titre result was 1:8 after 3 months.Discussion:The polymorphism of skin lesions in secondary syphilis is undoubtedly challenging. Psoriasiformsyphilis has been described in old dermatology literatures as syphilide psoriasiforme or psoriasissyphilitique. While modern literature reported most cases psoriasiform syphilis as palmoplantarpsoriasis. Most of the cases, syphilis diagnosis was missed and treated as psoriasis. Conclusion:Improperly treat psoriasiform syphilis as psoriasis flare with immunosuppressive drugs couldpotentially worsen the infection. Thus, clinicians should always be aware of psoriasiform syphiliswith high index of suspicion to unmask the diagnosis. Unmasking The Psoriasiform Syphilis as Secondary ReinfectionNur Nadja Azman [1], Ahmad Ramdan Zainordin [2][1] Klinik Kesihatan Kajang, KKM[2] U.n.i Klinik Taman Tun Dr Ismail, Kuala Lumpur

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POSTER ID: 3252Background:Gestational Trophoblastic Diseases (GTD) encompasses a spectrum of pregnancy relateddisorders attributed to abnormal placental trophoblastic proliferation. This includes completeand partial hydatidiform mole (molar pregnancy). Any form of GTD typically produces markedlyelevated serum human chorionic gonadotropin (β-hCG), giving us a positive Urine PregnancyTest (UPT). However, there is an exception in some rare cases whereby the UPT turns out to befalsely negative due to the “high-dose hook effect” of the β-hCG.Case presentation:The main aim is to identify a patient presenting with molar pregnancy in Primary Care despite anegative UPT test. As we are well-versed, any woman in child-bearing age who presents withabdominal pain and per vaginal bleed, besides a complete physical and pelvic examination, UPTis mandatory. If the UPT is positive, this is followed by Pelvic Ultrasound. This patient, however,had a negative UPT and due to high index of suspicion, the Pelvic Ultrasound was done.Fortunately, the Ultrasound did show a typical snow-storm appearance of the abnormaltrophoblastic cells enabling us to reach a diagnosis and manage the patient correctly. Hence itis extremely crucial for us to understand that the abnormally elevated hCG level present in urineexerts a “high dose hook effect”.Conclusion:The diagnosis of Molar Pregnancy was initially missed here. The false-negative UPT due to the“high dose hook effect” was indeed an eye-opener. So, whenever we have a high index ofsuspicion, sonographic evaluation is mandatory to be performed for accurate diagnosis. Onlythen will there be prompt gynecologic consultation followed by definitive operative treatment.High Dose Hook Effect of Molar Pregnancy - Identified in Primary CareVenotha Ganasan [1] [1] Klinik Kesihatan Kampung Gajah, Pejabat Kesihatan Daerah Perak Tengah, Perak, KKM

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POSTER ID: 3353Background:To describe a case report of Vogt-Koyanagi-Harada Syndrome (VKH) that mimicked thepresentation of Acute closed-angle glaucoma (ACAG).Case presentation:A 31-year-old lady presented with acute onset of eye redness, blurry vision, eye pain, andphotophobia for a week associated with severe headaches. She has no fever, nausea, or neckstiffness and no history of eye surgery or trauma. An ocular examination revealed signs of ciliaryinjection in both eyes, bilateral pupil reactive 3mm, visual acuity right eye 6/60 and left eye6/18. She was referred to an ophthalmologist as acute angle-closure glaucoma. Fundoscopyshowed bilateral swollen optic discs with multiple exudative retinal detachments. Theapplanation tonometry normal intraocular pressure. Blood investigations reveal normal fullblood count, erythrocyte sedimentation rate not raised, negative antinuclear antibody, andVDRL not reactive. A CT brain with contrast was performed due to bilateral disc swelling, but noabnormalities were found.She was admitted and treated with IV methylprednisolone followed by tapering oralprednisolone. Treatment aimed to alleviate symptoms, preserve eyesight by addressing ciliaryspasm, inflammation, adhesiolysis, macular edema, and choroiditis. Follow-up showedimproved vision in both eyes, resolution of retinal detachment, and reduced disc swelling.Conclusion:VKH disease can mimic ACAG. Thus, primary care physicians play a role at the forefront ofpatient care for prompt recognition of uncommon causes of painless loss of vision for earlytreatment.A Clinical Case Report: Vogt-Koyanagi-Harada SyndromeHazwani Mohamed Padzir [1], Siti Suhaila Mohd Yusoff [2], Salziyan Badrin [2], Sakinah Zakariah [3][1] Klinik Kesihatan Segambut, Wilayah Persekutuan Kuala Lumpur,Malaysia[2] Department of Family Medicine, Universiti Sains Malaysia[3] Department of Opthalmology, Hospital Raja Perempuan Zainab II, Kelantan, Malaysia

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POSTER ID: 3454Background:Scrub typhus, caused by Orientia tsutsugamushi, manifests as an acute febrile illness with aspectrum of symptoms, making timely diagnosis challenging.Case presentation:This case involves an 8-year-old patient initially presenting with fever, myalgia, and respiratorysymptoms resembling acute tonsillopharyngitis. Despite initial treatment, the clinical conditionworsened, prompting further investigation. Crucially, a physical examination revealed an eschar,a key diagnostic indicator. Laboratory analyses confirmed thrombocytopenia, elevated liverenzymes, and a positive PCR result for scrub typhus. The delayed recognition of the diseasewas attributed to overlapping symptoms with common febrile illnesses and initial misdiagnoses.This delay led to severe complications, notably septic shock and bilateral pleural effusion,emphasizing the gravity associated with delayed diagnosis.Conclusion:The case underscores the importance of considering scrub typhus in patients with fever,especially when symptoms mimic other common febrile diseases. The presence of an escharshould raise suspicion and prompt appropriate diagnostic tests. Early diagnosis andadministration of the right antibiotics, like doxycycline, is crucial to prevent complications suchas septic shock and pleural effusion, highlighting the need for heightened awareness amonghealthcare providers to mitigate the impact of this potentially life-threatening disease.Revealing the Delayed Identification of Scrub Typhus in An Eight-Year-Old Girl: ACase ReportSyarifah Nur Hanisah Tuan Simbak [1], Lingess Muniandy [1], Amirul Akmal Sohor [1][1] Pejabat Kesihatan Batu Pahat, Johor

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POSTER ID: 3555Background:Hydrops fetalis is characterised by the excessive interstitial fluid collection in multiplecompartments of a fetus. The prognosis of hydrops fetalis depends on several factors includingits cause and amount of edema presence.Case presentation:This case report illustrated an antenatal case who was diagnosed with hydrops fetalis with cystichygroma at 15 weeks of pregnancy. Antenatal ultrasound findings demonstrated multicysticappearance at the back of fetal neck, generalised anasarca and increased amniotic fluid. Uponreferral to Maternal Fetal Medicine Specialist, the patient was advised for termination ofpregnancy. Examination of the aborted fetus revealed a cystic structure extendingposterolaterally along the neck associated with ascites and fetal edema.Conclusion:Antenatal scans at primary care clinics may detect fetal anomalies including hydrops fetalis.Genetic evaluation of the fetus and parents is recommended to establish the cause of hydropsfetalis. Termination of pregnancy is considered if it is diagnosed early with poor prognosticfeatures.Hydrops Fetalis with Cystic Hygroma: A Case Report Dr Heng Miao Ching [1][1] Klinik Kesihatan Pendang, Jalan Sungai Tiang, 06700 Pendang, Kedah

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Acknowledgement Ms Patricia Mary A/P Arockiasamy General ManagerMs Kalaivaanni A/P Narainan R Administrative Academic ExecutiveMr Marthandavar A/L Appannah Administrative ExecutiveMs Vekneswary A/P Gopiraj Administrative ExecutiveAdminDepartmentMr Ts. Saufi Bin Omar IT ManagerMr Afdal Bin Diyaudin IT ExecutiveMs Sharifah Hanim Binti Ruslan Software EngineerITDepartmentMs Radiah Binti Sadarudin Senior Accounts ManagerMs Siti Atiah Binti Saineh Accounts ExecutiveMs Nadia Binti Ahmad Accounts ExecutiveMs Syerra Syaferra Binti Muhammad Accounts AssistantMr Muhammad Aziz Fitri Bin Zulkifli Accounts AssistantAccountDepartmentMs Nirmla Devi A/P S Haridas Course ManagerMr Thillainathan A/L Mariyappen Course CoordinatorMr Muhamad Zulkhalid Bin Md Isa Course CoordinatorMs Ezzah Dalilah Binti Zaid Ahmad Khan Course CoordinatorCourseDepartment56

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SponsorshipsPFIZER (Malaysia) Sdn BhdAbout PfizerGood health is vital to all of us, and finding sustainable solutions to the most pressing globalhealth care challenges of our world cannot wait.Good health is vital to all of us, and finding sustainable solutions to the most pressing globalhealth care challenges of our world cannot wait. That's why we at Pfizer are committed toapplying science and our global resources to improve health and well-being at every stage oflife. We strive to provide access to safe, effective and affordable medicines and related healthcare services to the people who need them.Every day, Pfizer colleagues work across developed and emerging markets to advancewellness, prevention, treatments and cures that challenge the most feared diseases of our time.Consistent with our responsibility as one of the world's premier innovative biopharmaceuticalcompanies, we collaborate with health care providers, governments and local communities tosupport and expand access to reliable, affordable health care around the world. For more than170 years Pfizer has worked to make a difference for all who rely on us.Our Visual IdentityEncoded within a successful logo is a company’s DNA—its history, its future.Pfizer has become much more than a pharmaceutical company. Our new logo signals this shiftfrom commerce to science. We’ve unlocked the pill form to reveal the core of what we do: adouble helix spiralling upward.The logo is constructed of two interlocking forms. Their unity reflects our passion anddedication to the science behind our innovations and to the wellbeing of our patients.Located in: The HorizonAddress: Wisma Averis Tower 2, 8, Jalan Kerinchi, Bangsar South, 59200 Kuala Lumpur,Wilayah Persekutuan Kuala Lumpur Phone: 03-2281 6000www.pfizer.com.my/010257

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A Patient-Focused CompanyAt Menarini Asia-Pacific, we are dedicated to invigorating lives. Driven by a firm belief thatgood health empowers people to unlock their full potential, we serve over 13 key markets in theregion to enhance healthcare and uplift the lives of people and communities.Menarini Asia-Pacific is a wholly owned subsidiary of the Menarini Group − an Italianpharmaceutical company with more than 135 years of history that thrives with the highest levelof trust. Today, Menarini operates in the highest level of compliance and integrity. Uniting thestrengths of our global resources with local customer insights, we equip hospitals andhealthcare providers with the best medical innovations and leverage our omni-channelmarketing and distribution strategy.Armed with strong commercial capabilities and a flexible business and partnering model, wesupport customers in a diverse range of therapeutic areas by providing access to health andwellness solutions. The agility of our in-country teams allows us to harness synergies acrossrelevant channels and develop customised go-to-market models. This helps improve the healthof underserved patients.Our unsurpassed in-market expertise and commitment to delivering value, from R&D throughto manufacturing, regulatory approvals and commercialisation – means we are there forcustomers, partners and patients for the long term, every step of the way.Corporate office in Petaling JayaLocated in: Paradigm MallAddress: B-18-2, Level 18, The Ascent Paradigm, No.1, Jalan SS7/26A, 47301 Petaling Jaya,SelangorPhone: 03-7985 7000https://menariniapac.com/en.htmlA.MENARINI Singapore Pte Ltd58

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What we doDiscovering, developing and deliveringFor more than 100 years, we have been translating the unmet medical needs of people livingwith a serious chronic disease into innovative medicines and delivery systems, like our insulinpens. Our treatments today are benefiting millions of people living with diabetes, obesity, and rareblood and endocrine diseases. From our labs to our factory floors, we are discovering and developing innovative biologicalmedicines and making them accessible to patients throughout the world.Who we areWe are a global healthcare company founded in 1923 and headquartered just outsideCopenhagen, Denmark.Our purpose is to drive change to defeat serious chronic diseases built upon our heritage indiabetes. We do so by pioneering scientific breakthroughs, expanding access to our medicinesand working to prevent and ultimately cure the diseases we treat.We employ more than 65,000 people in 80 offices around the world, and market our productsin 170 countries.Novo Nordisk Pharma Malaysia OfficeNovo Nordisk Pharma (Malaysia) Sdn. Bhd. (240770-W)Menara 1 Sentrum, Level 16No. 201 Jalan Tun Sambanthan,50470 Kuala Lumpur, MalaysiaTel: +60 3 2265 7300 (switchboard)Email: customerservicemy@novonordisk.comhttps://www.novonordisk.my/Novo Nordisk Pharma (M)59

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Address: SUITE 803, BLOCK F, Phileo DamansaraI, 9, Jalan 16/11, Pusat Perdagangan PhileoDamansara, 46350 Petaling Jaya, SelangorPhone: 03-7958 8373UNAM Pharmaceuticals (M) Sdn BhdBoehringer Ingelheim in MalaysiaSuite 15-5 Level 15, Wisma UOA Damansara IINo 6 Jalan Changkat Semantan, DamansaraHeight, 50490 Kuala LumpurPhone +60/3/2092 0088 Fax +60/3/2095 2818https://www.boehringer-ingelheim.com/Boehringer Ingelheim Sdn Bhd.60Malaysia (Headquarters)Pharm-D Sdn.Bhd.No. 8B, Jalan 1/137C, Bedford Business Park,Off Jalan Kelang Lama, 58000 Kuala Lumpur,Malaysia.Phone: +603-7770 7918info@pharmd.com.my (General Inquiry)hr@pharmdhs.com (Job Application)https://pharmd.com.my/Pharm-D Sdn Bhd CIMED Healthcare Sdn Bhd Address: 6, Jln Eco Perindustrian 1/3A, EcoPerindustrian 5, 42300 Puncak Alam, SelangorPhone: 03-5871 1094www.innoasia.com.myInno Asia Distribution Sdn BhdC-6-1 & C-6-3A LOBBY C,Melawati Corporate Centre,Lot 29242, Jalan Bandar Melawati,Taman Melawati, 53100 Kuala Lumpur, Malaysiacare@cimedhealthcare.com(+603) 4101 0668 (+6011) 5881 6368 - WhatsAppOnlyhttps://cimedhealthcare.com/Lot 50, 52, 54 Jalan Puteri 5/18, Bandar Puteri,47100 Puchong, SelangorNo 26, Jalan Industri PBP 3, Taman PerindustrianPuchong, 47100 Puchong Selangor, Malaysia+6010-668 9209+603-8068 9209info@eikonms.comEikon Medical Solutions Sdn Bhd

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MalaysiaIDS Medical Systems (M) Sdn. Bhd.8 Jalan Pensyarah U1/28, Hicom GlenmarieIndustrial Park, 40150, Shah Alam, Selangor,MalaysiaPhone: +603 5022 5225Email: moc.demsdi@ofnisymFax: +603 5022 5335https://www.idsmed.com/my-en/team.htmlIDSMED (GE)61Zuellig Pharma Sdn Bhd (MDD Facility)Address: 6 Jalan Tiang U8/92 Section U8 BukitJelutong, Jalan Tiang U8/91, U 8, 40150 ShahAlam, SelangorPhone: 03-5566 2288https://www.zuelligpharma.com/Zuellig Pharma Sdn BhdUnit No. 1-8, Level 1, Plaza Menjalara, No. 1,Jalan Menjalara Idaman, Bandar Menjalara,Kepong, 52200 Kuala Lumpur, Malaysia.+6012 691 9219info@smithmeyerlab.comhttps://www.smithmeyerlab.com DMS MedHealth PLTPJ HEADQUARTERB-3A-07, Dataran 32, No.2, Jalan 19/1, 46300 Petaling Jaya, Selangor Darul Ehsan.TEL: 603 7958 1077FAX: 603 7960 7530 Emailenquiry@hoepharma.com.myhttps://www.hoepharma.com.myHOE Pharmaceuticals Sdn BhdAddress: No. 3, Jalan Nirwana 35, Taman Nirwana,68000 Ampang, SelangorPhone: 03-9282 9527https://metamedical.com.myMeta Medical Sdn Bhd

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27-02, Level 27, Imazium,No. 8, Jalan SS 21/37, Damansara Uptown,47400 Petaling Jaya,Selangor Darul Ehsan, Malaysia.Tel : +603 7988 7000Abbott Nutrition Careline - 1800-88-6233Email: wecare@abbott.comhttps://www.my.abbott/Abbott Laboratories (M) Sdn BhdSuites 8.01 & 9.01, Level 8 & 9, The Gardens SouthTower, Mid Valley City, Lingkaran Syed Putra,59200 Kuala LumpurTel: +603 2298 1688Careline at: 1800 38 1038https://www.danone.com/id-cards/malaysia.htmlDanone Specialized Nutrition (Malaysia)Sdn Bhd62Merck Sdn BhdMenara Sunway Annexe,Jalan Lagoon Timur, Bandar Sunway Level 3Petaling Jaya, Selangor Darul Ehsan, 46150, alaysiaPhone: +60374943688Email: info.my@merckgroup.comhttps://www.merckgroup.com/en/worldwide/merck-in-malaysia.htmliNova Pharmaceuticals (S'pore) Pte. Ltd.(M'sia Branch)6F-2A, 6th Floor, Tower 4 @ The PFCC,Jalan Puteri 1/2, Bandar Puteri, 47100 Puchong,Selangor, MalaysiaP: (+603) 8600 3900F: (+603) 8600 3901https://inovapharma.com/iNova PharmaceuticalsAddress: No 39, 1st Floor, Jalan PJU 1a/16, TamanPerindustrian Jaya, 47301 Petaling Jaya, SelangorPhone: 03-7842 8641https://teephamedical.com.myTeepham Medical Sdn Bhd4th Floor, Pantai Hospital Ampang,Jalan Perubatan 1, 55100, Pandan Indah,Kuala Lumpur, Malaysia.Phone: +603 4297 9911Fax: +603 4296 5901Email: info@premierintegratedlabs.com.myhttps://www.premierintegratedlabs.com.my/Premier Integrated Labs Sdn. Bhd

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15-03 & 15-04, Level 15, Imazium,No. 8, Jalan SS 21/37, Damansara Uptown,47400, Petaling Jaya, Selangor, Malaysia.Tel: 603-7733 8005Email:enquirymy@viatris.comhttps://www.viatris.my/Viatris Sdn Bhd63The Bousteador, Level 12,No. 10, Jalan PJU 7/6, Mutiara Damansara,47800 Petaling Jaya, Selangor Darul Ehsan,Malaysia.Phone: 03-7624 3888Email: contactazmedical.astrazeneca.com https://www.astrazeneca.my/Astrazeneca Sdn. Bhd.3A-3 Level 3A Block ADataran PHB Saujana Resort, Seksyen U2 40150Shah Alam, Selangor MalaysiaPhone: 1 800 880 601 General Line: 03 7844 0815Email: customerservicemalaysia@convatec.comhttps://www.convatec.com.my/Convatec Malaysia Sdn BhdAddress: Business Park, 350(A) Jalan S2 B8Uptown Avenue, Seremban 2, 70300, NegeriSembilanPhone: 06-603 0334Email: customercare@southerncrescent.com.mySouthern Crescent Sdn. BhdAddress: No . 3A, 1 & 2, Jalan Putra 4,Taman Kajang Putra, 43000 Kajang,SelangorPhone: 03-9078 3030https://kliniksalam.com/Salam Alliance Sdn. Bhd.No. 48G, Petaling Utama Avenue,Jalan PJS 1/50, Taman PetalingUtama, 46150 Petaling Jaya, Selangor Call: +603 77823016/+603 77833016Whatsapp: +6012 5553016email: sales@ihbhealthcare.comhttps://ihbhealthcare.com/IHB Healthcare Sdn BhdAddress: B.6-1, No, Wisma Sejarah,Level 6, 230, Jln Tun Razak, WilayahPersekutuan, 50400 Kuala LumpurPhone: 03-2681 2232Email: msqh@msqh.com.myhttp://www.msqh.com.my/web/index.php/en/Malaysian Society for Quality inHealth (MSQH)

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64No 4-1, First Floor, Jalan KS 1,Kepayang Sentral, Taman BukitKepayang 70200 SerembanNegeri Sembilan.Email: primaryeyegp@gmail.comPRIMARY EYE GPNo. 37-2, Jalan Wangsa Delima 2A,Seksyen 5, Pusat Bandar WangsaMaju, 53300 Kuala Lumpur,MALAYSIA.Phone: +603 4144 4711Email: info@ie-direct.comhttps://ie-direct.com/IE Direct Sdn. BhdFOMEMA Sdn. Bhd.Address: Lot 49 & 51, Jalan KampungPandan, Maluri, 55100 Kuala Lumpur,Wilayah Persekutuan Kuala LumpurTelephone:+603-5523 8662Email:sales@fomemapharma.com.myhttps://www.fomemapharma.com.my/Fomema Pharmaceuticals Sdn BhdAddress: 25-02, Level 25, Imazium, 8, JalanSS21/37, Damansara Utama, 47400 PetalingJaya, SelangorPhone: 03-7726 3866https://www.serviermalaysia.com/Servier Malaysia Sdn BhdMedical equipment supplier in PuchongLocated in: Gaia Science (M) Sdn Bhd -Scientific & Laboratory EquipmentAddress: No. 60, Jalan Puteri 5/5,Bandar Puteri, 47100 Puchong,Selangor, MalaysiaPhone:Office: +6017 467 2889Fax: +603 8065 3889Email:info@gaiahealth.com.myhttps://gaiahealth.com.my/Gaia Health Sdn Bhd

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