bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors contributing to the prevalence of Malaria among Children under five years attending Health Care at Logoba Health Center III, Moyo District . A Cross- sectional Study.
Authors:   , Edebuga Emmanuel
Published: July 2022

Background: Malaria is an urgent public health priority, its costs of treatment trap families in a cycle of illness, suffering, and poverty, total funding for malaria control and elimination reached an estimated US$ 3billion, and contributions from the government of endemic countries amounted to US$ 900million, representing 31% of total funding (UNICEF, 2019). Methodology: The study design used was a descriptive cross-sectional study design using quantitative data that involved a sample size of 100 caretakers of 100 children below the age of five who attended health care at Logoba HCIII. A simple random sampling method allowed data to be collected on the prevalence of malaria and factors contributing to the Prevalence of Malaria simultaneously from 20th December 2021 to 07th January 2022. Result: The prevalence of malaria was high (35%) and the factors that were significant for the prevalence of malaria included; the caregiver’s knowledge of signs and symptoms like loss of appetite and loss of energy 01%, Socio-economic factors which were contributed by farming and farming related activities, 75% and environmental factor about the presence of garbage heaps 56%. Conclusion: In conclusion, the prevalence of malaria was high at 35% and it was contributed to caregiver’s knowledge about signs and symptoms of malaria, farming and related farming activities like water channels across the garden and farming near home, and garbage heaps around the homes. Recommendation: The study recommended more studies to be done in different areas and regions in the line, an effort to know and understand all signs and symptoms of malaria which are serious signs of severe malaria, sensitization by concerned authorities on how to avoid heap around the household as this is another suitable breeding sites for mosquitoes and sensitization by concerned authorities on safe farming and farm-related activities free for mosquitoes to hide and breed.
Factors contributing to the Early Sexual Debut among older Adolescents (15-19yrs) in Nyendo -Mukungwe Division Masaka District. A Cross-Sectional Study.
Authors:   , Namugerwa Peninah
Published: July 2022

Background: Early sexual debut is defined as having first sexual intercourse before age of 18 years and is associated with risks to sexual and reproductive health. It can be voluntary or coerced. Methodology: The study design was descriptive and cross-sectional. The study was aimed at obtaining the predictor outcome of the variables at the same time getting relevant data on the effect of religiosity and family financial background, peer pressure, and individual factors contributing to early sexual debut among older adolescents aged (15-19) years at Nyendo Mukungwe Division, Masaka district. Results: The majority of the respondents 95% had peer friends. This implies that most older adolescents have peer groups. This may be because of their peers on sex-related issues. This finding indicated that peer pressure was a great factor that led to increasing rates of early sexual debut among older adolescents (15-19) in Nyendo Mukungwe division, Masaka district probably because they got supportive news about how good is playing sex like feeling as If in heaven leaving its risks e.g. sexually transmitted infections. Conclusion: The majority of the respondents did not attend church or mosque regularly most of whom were not virgins making those who did not attend church or mosque regularly more involved in sex than their counterparts due to the missing of the teachings condemning playing sex like no sex before marriage, don’t commit adultery Recommendation. This goes to all medical persons, parents, teachers, religious leaders, political leaders, elders in communities, the government through education and health ministries, and anyone responsible in Nyendo Mukungwe division Masaka district to develop strategies aimed at reducing early sexual debut among adolescents which predisposes them to risks associated with playing sex e.g. sexually transmitted infections like HIV/AIDS, UTIs.
Factors associated with the prevalence of induced Abortions among Females of age 16 to 30 years at Busiu Center IV, Mbale District. A Cross-sectional Study.
Authors:   , Wanale Joshua
Published: July 2022

Background: Induced abortion is defined as a procedure done to end pregnancy [ACOG], and most induced abortions are done in the first 12 weeks of pregnancy. Methodology: The study was cross-sectional in design. This is so because it yields results in a short time. A simple random sampling technique was used to select 60 respondents who participated in the study. Results: The majority 35(58%) of the respondents were Bagisu and the least 4(7%) were Bagwere. Most 33(55%) of the respondents had attained secondary 12(40%) of the respondents had attained primary level, 9(15%) attained tertiary level and the least 6(10%) had attained none. The majority (43)72% of the respondents were in the age range of 16-26 years due to fact that this is the reproductive age group, still attending school, more sexually active, and are exposed to sexual and reproduction information and articles; of which most are not married having fear to sustain pregnancy and the least (17) 28% were 30-44 years as most of them are married thus with no fear for sustaining the pregnancy once they conceived. Conclusion: The study showed that most women of reproductive age had some knowledge of induced abortion but a few knew about safe induced abortion and the majority knew at least one method of induced abortion. Recommendations: This study highlighted the need for policymakers and health administrators to implement measures that would increase the knowledge of people on safe induced abortion including legal rights.
Prevalence and factors associated with Anemia among Pregnant Women attending Antenatal Care at Mpigi Health Centre IV. A Cross-sectional study.
Authors:   , Mpaulo Stephen
Published: July 2022

Background: Anemia continues to be a challenging condition and a common condition among many mothers attending antenatal clinics in many hospitals in Uganda. The aim was to ascertain the proportion and factors associated with anemia among pregnant women in Mpigi Health Center IV which serves as a District hospital in Mpigi District. Methodology: A cross-sectional study was done in which both qualitative and quantitative research designs were used. 100 respondents were chosen to take part in the study. The data was collected between December 2021 and January 2022 Results: The study found that the prevalence of Anemia was low. It showed that about 24% and those that presented with mild anemia were 75%. The major risk factors included multiparity, multi gravidity, helminths infections, low standards of living, and poor diet among others. Recommendation: After a study, the researcher recommends continuous health education to mothers on the dangers of anemia and its prevention. This could be done majorly during antennal care sessions, continuous deworming during antenatal visits would help to reduce the anemia which is due to infestation with helminth infections. Conclusion: Having a well-balanced diet would be good advice as it would greatly reduce the risk of contracting anemia, especially iron-deficiency anemia. This would also require a multisectoral approach were nutritionists, health workers, and the community would be put together to reduce or eliminate anemia in the community among pregnant women.
Factors associated with under Nutrition among Children less than five years in Iganga General Hospital, Iganga District. A Cross-sectional Study.
Authors:   , Nakimuli Agatha
Published: July 2022

Introduction Malnutrition refers to a state of either undernutrition or overnutrition. Undernutrition manifests as wasting or low weight for height (acute malnutrition), stunting or low height for age (chronic malnutrition), underweight or low weight for age, and mineral and vitamin deficiencies or excessiveness. Objectives: The main objective of the study was to determine the factors associated with undernutrition among children less than five years in Iganga Hospital The specific objectives were to determine the socio-demographic factors such as residence, and age, identify the economic factors such as mother’s occupation, and to determine the knowledge of parents/caregivers on factors associated with undernutrition among children less five years in Iganga Hospital in Iganga district Methodology: A Cross-sectional Study design was used, using both qualitative and quantitative approaches in Iganga General Hospital. The researcher conveniently sampled 100 respondents from 5th January 2022 to 11th January 2022. Data collection was by using self-administered questionnaires which were filled and later analyzed using tables, graphs, and pie charts. Results: Out of the 100 respondents, the majority; 73(73%) resided in rural areas while 27(27%) resided in urban areas. The majority; 68(68%) knew that diarrheal diseases lead to undernutrition. The majority; 95(95%) knew how to encourage the child to eat while 5(5%) did not know. Majority;80(80%) of the children’s mothers’ occupation was agricultural work while 9(9%) had formal employment. Conclusion: The majority (82%) reported that residence influenced the child's nutrition status. The majority (74%) of the participants had average knowledge about undernutrition Recommendation: Channels of communication like televisions, and radios should be intensely used by health workers with the help of the ministry of health to spread the message about undernutrition, factors associated with it, and nutrition services available so that the incidences of delayed seeking of treatment and severe forms of the disease are reduced.
Associated Factors of Hepatitis B Infection among Pregnant Women attending Antenatal Clinic in Kitagata Hospital, Sheema District. A Cross-sectional Study.
Authors:   , Areebahona Edgar
Published: July 2022

Background: The study assessed the associated factors of hepatitis B infection among pregnant women attending antenatal clinic in Kitagata hospital, Sheema district, and specifically sought to find out the prevalence, the knowledge, and the risk factors of hepatitis B infection among pregnant women attending antenatal clinic in Kitagata hospital, Sheema district. Methodology: The study used a cross-sectional study design while employing a quantitative data collection approach where a pretested questionnaire designed based on the specific objectives was used to collect data from 100 respondents following the informed consent of the participant. Results: The prevalence of Hepatitis B among Pregnant Women attending Antenatal Clinic in Kitagata Hospital, Sheema District is 4.0%. The majority (51%) of the respondents were between 20-25 years, (53%) were cohabiting, (42%) had attained secondary education, (50%) were Catholic, (52%) were unemployed, (90%) had a gestation period of 7-9 months,(40%) were Banyankole and (4.0%) were positive of hepatitis B virus. Majority (63%) had ever heard about Hepatitis B infection (57.1%) heard about it from a health worker, (55%) knew Hepatitis B could be found in the blood, (60%) understood Hepatitis B, (55%) knew the transmission routes of Hepatitis B, (80%) knew that Hepatitis B vaccine exists, (93%) had not been vaccinated and (75%) did not know the symptoms. Conclusion: The prevalence of hepatitis B infection among pregnant women was high whereas the knowledge regarding hepatitis B infection was moderate and the predisposing factors to hepatitis B infection were majorly having two sexual partners and having a tooth extraction. Recommendation: I recommend the provision of mandatory free screening and vaccination services by the government to the pregnant mothers since it will help in discovering the number of cases hence scaling up the type of care and treatment needed.
Nutrition status among Children under 5 years in Ibalikoma Village Apac District. A Cross-sectional Study.
Authors:   , Odot Rebecca
Published: July 2022

Abstract The study was conducted in Ibalikoma Village Apac District to assess the factors influencing the nutritional status of children under 5 years. Objectives The objectives of the study were to assess the level of knowledge, practice, and maternal-related factors influencing nutrition status among children under 5 years in Ibalikoma village Apac district. Methodology The study design was a descriptive cross-sectional study where data was collected using self-administered questionnaires given by 100 respondents using random sampling. Results Results showed that the majority 69(69%) knew that a child should be breastfed on demand. majority 85(85 %) knew that a child should spend at least 6 months on exclusive breastfeeding before initiating them on other feeds. About care taker’s practices, majority 56(56%) of the caregivers had stopped breastfeeding their children Conclusion The study established that the majority of the respondents had knowledge about exclusive breastfeeding and complementary feeding However most of the mothers did not put all the knowledge into practice due to lack of resources and citing unfavorable environments to apply what they knew. The nature of the work of caretakers, their level of education, and their economic status had a great influence on the applicability of the required nutrition practices. Recommendations There is a need for increased sensitization and awareness campaigns by the government of Uganda through the ministry of health specifically about the practical ways which suit the lifestyle in rural areas that can help improve the nutritional status among children under 5 in rural areas.
Let op: deze controleverklaring valt buiten AFM-toezicht
Authors: Bosman Tjibbe , van der Kuip Merel , Janssen Wim
Published: July 2022

Volgens de AFM-Monitor werden er in 2019 circa 19.333 wettelijke controleverklaringen in Nederland afgegeven, maar welke organisaties deze controleverklaringen voor welke verantwoordingen ontvangen en of deze gegevens publiekelijk beschikbaar zijn, is tot nu toe niet structureel in kaart gebracht. Tegelijkertijd is er steeds meer behoefte aan informatie over de kwaliteit van accountantscontrole voor de markt als geheel. Voor jaarrekeninggebruikers, beleidsmakers en andere belanghebbenden is het niet altijd duidelijk welke accountantscontroles onder de Wet toezicht accountantsorganisaties (Wta) en daarmee onder het AFM-toezicht vallen. In dit beschrijvende artikel schatten wij de aantallen Wta-controles en of deze publiekelijk beschikbaar zijn. Van de wettelijke controles zijn 18.311 verklaringen (95%) publiekelijk beschikbaar via verschillende bronnen, zoals de Kamer van Koophandel.
Key Risk Indicators reloaded
Authors: van den Brink Gerrit Jan , Leipoldt Marc
Published: July 2022

Although Key Risk Indicators have been a staple for Operational Risk Management reports in financial institutions for years now, they are rarely drivers for action and their relevance is waning. The authors argue that, for Key Risk Indicators to become more relevant, they should be recast as predominantly business (first line of defence) driven and made practical rather than theoretical. After describing the current state of Key Risk Indicators and the future for such indicators in case no action is taken, an ideal situation is outlined and five recommendations are presented that serve as practical steps towards that ideal state.
Peran Media Sosial Dalam Peningkatan Jaringan Pasar
Authors: Zuhrinal M. Nawawi Gita Aulyia Utami,
Published: July 2022

Tujuan dari penelitian ini guna mengetahui peran media sosial dalam pengkatan jaringan pasar dengan studi kasus pada warung makanan (UKM) di Kec. Sawit Seberang. Metode penelitian yang digunakan adalah metode kualitatif dengan pendekatan deskriptif dan jenis data yang dikumpulkan adalah data primer yang diperoleh melalui wawancara mendalam ke informan. Dari hasil penelitian diperoleh bahwa peran media sosial dalam peningkatan jaringan pasar sangat membantu dalam memasarkan hasil produk makanan pada warung makanan (UKM) Kec. Sawit Seberang serta meningkatkan jumlah penjualan.
Finance function : leveraging a source of competitive advantage for selected South African companies in KwaZulu-Natal
Authors:   , Shewell Patricia Maureen
Published: July 2022

As a result of current business trends, South African companies are being forced to examine changes in the finance function. The purpose of this research is to establish and examine the paradigm shift in the finance functions of selected South African companies in KwaZulu-Natal, and to develop a measuring tool to determine the degree to which these functions are evolving to be more in line with a value adding paradigm. A mixed methods approach was used in this study, with qualitative analysis supported by some quantitative analysis. A case study approach was adopted, and non-probability sampling using the purposive method was applied to select eleven respondents. The data was gathered by means of both a questionnaire and follow up interviews. The data has been analysed using a combination of both descriptive and inferential statistics, and qualitative analysis. It was found that the majority of respondents were not measuring the cost of, nor were they focused on reducing the resources allocated to the finance function. In addition, the major portion of finance function resources remain focused on the accounting processing roles of the finance function. However, an increasing emphasis on the decision support and strategy formulation roles was discovered. A measuring tool was developed and applied to the finance functions of respondents. This brought the researcher to the conclusion that the finance functions of respondents could not be confirmed as value adding business units. It was recommended that finance function resources be mapped according to the various roles identified. The measuring tool could then be applied to reveal potential areas of change that would result in the finance function transforming into a value adding business unit. Future research into an appropriate finance function performance measurement system, and the impact on the training of accountants of the changing finance function paradigm, was identified.
Tourist service quality management in the ecotourism accomodation sector of KwaZulu-Natal
Authors:   , Naidoo Krishna Murthi
Published: July 2022

There is extensive focus on the practical performance of ecotourism in respect of environmentally invasive activities and the satisfaction of ecotourists in South Africa. Therefore, the purpose of the study was to evaluate the impact of quality management practices on service quality in the accommodation sector serving ecotourism destinations in KwaZulu-Natal. The study was conducted at 58 hotels within a 50 kilometre proximity to ecotourism development regions of KwaZulu-Natal province. Two separate self-administered questionnaires were designed for the hotel managers and for their guests. A quantitative approach and a census of 58 managers were conducted and the guest response of 587 was obtained using convenience sampling. The results revealed that there are mismatches in guests’ actual experience on the variables of interest for customer service quality and the importance they attach to each variable. The experience-importance findings show that most guests rated their experiences above the importance they attach to those experiences. Little attention has been paid to hotel service quality research pertaining specifically to quality-related performance. This study fills this gap by identifying congruent hotel service quality attributes and relating these to management performance by analysing the importance of these attributes for hotel-guests seeking experiences of the natural environment. The results of the study offer measures for ecotourism service quality enhancement for the ecotourists experience at the hotels and a starting point for hotel managers to optimise the service quality growth and development while protecting the resources on which they are based. Quality function deployment has emerged as a significant tool to guide hotel managers in ecotourism destinations to attain planned levels of guest service quality and formulate a well-informed and systematic framework that will advance strategies for service quality enhancement.
The effectiveness of an induction programme for newly appointed staff at Coastal KZN FET College
Authors:   , Mabaso Calvin Mzwenhlanhla
Published: July 2022

The research project focussed on the effectiveness of an induction programme for newly appointed staff at Coastal KZN FET College in Kwa-Zulu Natal. The main aim of the study was to investigate the perceptions of educators with regard to the effectiveness of the induction programme for newly appointed lecturers. The key findings of the research were that newly appointed lecturers experienced various problems. The study also explored experiences faced by newly appointed lecturers at Coastal KZN FET College. The challenges arise from the lack of an effective induction programme. These problems resulted in poor productivity among newly appointed lecturers. The empirical component underpinned the review and analysis of the effectiveness of an induction programme for newly-appointed lecturers as they adjust to their entry into the teaching profession. The study also investigated the high turnover (lecturer attrition) among newly appointed lecturers as well as the possible solutions which can be implemented. The survey method was used to administer the questionnaire to all 45 target respondents using the personal method. The study adopted the quantitative research method with precoded close ended questions. The personal method was used to administer the questionnaire to all 45 target respondent and in this way a high response rate of 100% was obtained. An important finding in this regard was that the induction programme was not evaluated and improved frequently. The induction programme should ensure that new lecturers are treated with dignity and are allowed the opportunity to display their strengths and the knowledge they bring to their new College by implementing an effective induction programme. Arising out of the empirical analysis the researcher has recommended and developed a set of guidelines which could be used in developing an effective induction programme for the Coastal FET College in Kwa-Zulu Natal. The study concludes with directions for future research to expand on the body of knowledge in this field.
Assessment of plant needs for food elements using feedback principles
Authors: Savich Vitaliy , Naumov Vladimir , Tazin Ivan , Efimov Oleg , Sedykh Vladimir
Published: July 2022

The paper shows the prospects for assessing the need of plants in nutrition elements using feedback principles: by photosynthesis activity during the introduction of N, P, K, Ca into the suspension of soils, by the activity of chloroplasts, by the content of positively and negatively charged complex compounds in plants, by the composition of transpiration products from plants, by the absorption of elements by plants from a nutrient solution after preliminary cultivation on a soil suspension. Thus, when zinc was added to the suspension of soils, the photosynthesis activity of the rose varied from 12.9± 0.9 to 15.2± 0.2 mmol/m2 per second, which indicates a lack of Zn in the soil for the development of biotest. Keywords: ASSESMENT, NPK DEFICIT, PLANTS, SOIL
Effect of heavy metal pollution on the total number of bacteria in the soils of the Central Caucasus and the Caucasus
Authors:   Southern Federal University, Moshenko Darya , Kuzina Anna , Kolesnikov Sergey , Nevedomaya Elena , Ter-Misakyants Tigran , Kazeev Kamil
Published: July 2022

Studies have been carried out to determine the total number of bacteria contaminated with heavy metals (lead, chromium, nickel, copper) for the main soils of the Central Caucasus and the Caucasus. The dependence of the toxic effect of heavy metals on the total number of bacteria on the type of pollutant was obtained: Cr > Cu ≥ Pb ≥ Ni. It has been established that the number of bacteria in the soils of the Central Caucasus and the Caucasus varies significantly in resistance to heavy metal contamination (soils are located as their resistance decreases): mountain meadow turf > mountain meadow chernozem > leached chernozem ≥ ordinary chernozem = typical chernozem (mountain) ≥ podzolized chernozem = mountain meadow sod-peat ≥ sod-carbonate ≥ mountain meadow-steppe = dark gray forest > brown forest slightly unsaturated. Keywords: NUMBER OF BACTERIA, SOIL POLLUTION, NICKEL, LEAD, CHROMIUM, COPPER, CENTRAL CAUCASUS, CAUCASUS, STABILITY, BIO-DIAGNOSTICS
Mortalidad y egresos hospitalarios por enfermedad renal crónica de causas no tradicionales
Authors: Rivera-Chavarría Ana , Méndez-Chacón Ericka
Published: July 2022

Objetivo: describir las tendencias del diagnóstico primario de defunción, el diagnóstico de egreso hospitalario así como los años de vida potencialmente perdidos de pacientes con enfermedad renal crónica compatible con enfermedad renal crónica de causas no tradicionales según datos registrados en bases de acceso público en el país entre 2014 y 2019.Métodos: se efectuó un estudio longitudinal descriptivo de la información sobre defunciones y egresos hospitalarios registrada en bases de datos de acceso público sobre el diagnóstico primario de enfermedad renal crónica compatible con enfermedad renal crónica de causas no tradicionales. Con los resultados obtenidos se calcularon porcentajes y frecuencias absolutas y relativas de la mortalidad y los egresos hospitalarios. Las tasas de mortalidad general, específica y ajustada fueron calculadas por el método directo. Además, se estimaron, por provincia y sexo, los años de vida potencialmente perdidos en el país.Resultados: en Costa Rica, entre 2014 y 2019, se registraron 2548 muertes y 1893 egresos hospitalarios relacionados con la Enfermedad Renal Crónica de Causas no tradicionales. Se encontró que las tasas de mortalidad ajustadas fueron elevadas para las provincias de Guanacaste y Limón en comparación con las tasas nacionales y con respecto a las de otras provincias. En la provincia de Guanacaste, además, la tendencia de egresos resultó elevada. Adicionalmente, se detectó que los años de vida potencialmente perdidos evidenciaron un incremento progresivo y constante en el país, predominantemente en el sexo masculino y en la provincia de Guanacaste. Se reportaron trece defunciones de personas menores de veinte años de edad.Conclusión: la actualización de los datos en las tendencias de mortalidad ha permitido identificar que las provincias de Guanacaste y Limón presentan tasas ajustadas superiores a la media nacional, así como menores edades promedio de defunción según el resto de las provincias. Las defunciones y egresos hospitalarios en personas menores de veinte años de edad sugieren daño renal temprano y no relacionado con enfermedad ocupacional. La mortalidad y los años de vida potencialmente perdidos proporcionan información sobre la carga de enfermedad en la población del país. Se debe agregar que la codificación específica para vigilar la patología estaba escasamente registrada en el periodo de estudio.
Ciencia básica y sus aplicaciones: tres hitos en el siglo XX Con especial referencia a la Hidratación Oral
Authors: De Céspedes Carlos
Published: July 2022

Tras el descubrimiento de que el transporte del sodio y el transporte de la glucosa están acoplados en el intestino delgado, de manera que la glucosa acelera la absorción de soluto y agua, destacó la hidratación oral junto con otros hitos del siglo XX como el desarrollo de la penicilina y los cultivos virales que anteceden la vacuna contra la poliomielitis; este artículo de opinión se refiere a la participación de Costa Rica en el exitoso desarrollo de un estudio de investigación aplicada sobre un problema prioritario de Salud: la hidratación oral en las diarreas provocadas por virus.
Recommendations and tips for passing the key feature problem examination
Authors: Kwa Siew Kim , Tan Chow Wei , Ng Aik Chiew , Sheikh Mobarak Sheikh Mohd Amin , Selamat Hairel Anuar
Published: July 2022

The Key Feature Problem (KFP), is part of the Conjoint MAFP/FRACGP exit examination for Family Medicine specialisation in Malaysia. KFP tests candidates’ skills in clinical reasoning and decision making. Over the years, KFP has been the cause of most of the failures in the Part 1 theory examination. This paper aims to highlight common errors committed by candidates and provide recommendations and practical examination technique tips on how to mitigate these errors. A summary of the 26 KFP cases used in the 2020 Conjoint KFP examination demonstrates the breadth and types of cases. From the feedback reports collated from eight assessors involved in this exam, we determined that although inadequate knowledge is probably the main contributor to failure, other easily correctible mistakes made by candidates further aggravate the situation. Common errors include offering more answers than requested, giving duplicate or incomplete answers, and writing answers out of context to the case scenario. The paper concludes with recommendations and sources for effective learning, and provides 12 examination technique tips. The tips include time management, reading carefully through the case, and checking that the answers are congruent with the questions asked.
Unilateral sudden sensorineural hearing loss in post-COVID-19 patients: Case report
Authors: Wong Meng Yee , Tang Wei Shuong , Zakaria @ Azidin Zahirrudin
Published: July 2022

Sudden sensorineural hearing loss (SSNHL) is an otologic emergency. Sensorineural hearing loss needs to be distinguished from conductive when patients present with sudden hearing loss at the primary care level. Prompt diagnosis of sensorineural hearing loss with pure tone audiometry and immediate treatment by an otolaryngologist can improve the hearing outcome. To date, few case reports exist about SSNHL among post-COVID-19 patients, and none were reported in Malaysia. Here, we present two cases of SSNHL in patients after COVID-19 infection. We wish to highlight the association of SSNHL following COVID-19 infection for timely referral towards better audiology outcomes. Permanent hearing loss will lead to another negative impact on the long-term quality of life of COVID-19 patients.
Case report of chronic cough in primary care: a diagnostic challenge and lessons to learn
Authors: Azmi Nurul Husna , A.Bakar Anifah , Md Aris Mohd Aznan , Sharman Khamis@Roslee Norhayaty
Published: July 2022

Cough is one of the most common complaints seen at the outpatient primary health clinic. While the most common aetiologies of chronic cough are asthma, chronic obstructive pulmonary disease, postnasal drip, gastroesophageal reflux disease, drug-induced, and tuberculosis, we often overlook that chronic cough, especially in a young female, can be the initial presenting complaint of an autoimmune disease. In this case report, we present a case of 35-year-old woman with no known prior medical illness who presented with chronic cough for 1 year with no other symptoms initially; but later in the disease course, the patient complained of multiple, symmetrical small joint pain, which led us to the diagnosis of seronegative rheumatoid arthritis.
Tennis racket sign in pulmonary tuberculosis: A case report
Authors: Ng Kian Seng , Lau Calvin Koh Sii , Ngu Ping Hoe
Published: July 2022

We report a case of ‘tennis racket sign’ in the chest radiograph of a patient with pulmonary tuberculosis (PTB). This graphic but relatively unknown sign helped us pinpoint the diagnosis. Our patient, a 24-year-old male migrant worker, presented with a five-month history of a racking cough with expectoration of blood-streaked sputum. No antecedent fever existed, but he had a concomitant loss of appetite and weight. He was seen in three different primary care facilities, and three chest radiographs were performed. These radiographs were reported as normal, with no overt evidence of pulmonary infection. Antibiotics were not useful. We believed that the history and our finding of scattered, fine crepitations in both upper zones of the lungs warranted a repeat chest radiograph. This demonstrated shadowing that we recognised as the tennis racket sign. We told the patient that the radiological shadow pointed to the diagnosis of PTB. We were able to convince the patient and his employer that the bacteriological presence of Mycobacterium tuberculosis needed to be confirmed by sputum acid-fast bacillus (AFB) smear and culture. Sputum AFB smears on three different days were positive. Because of financial constraints, the patient requested referral to the government Chest Clinic (Klinik Dada) for treatment. This case report highlights a good learning point for the primary care physician evaluating a chronic cough with a chest radiograph. A ‘normal-looking’ chest radiograph does not rule out PTB. PTB may manifest radiographic patterns we are not familiar with; the tennis racket sign is a good case in point.
Prevalence and factors associated with psychological distress among adult patients with hypertension in a primary care clinic: A cross-sectional study
Authors: Loke Wen How , Ching Siew Mooi
Published: July 2022

Introduction: Psychological distress worsens the control of hypertension. This study aims to fill the knowledge gap and evaluate the prevalence and factors associated with depression, anxiety, and stress among patients with hypertension in a primary care clinic.
Methods: A cross-sectional study was conducted at Klinik Kesihatan Bandar Jerantut on hypertensive patients using a systematic random sampling method. Data were collected from 391 hypertensive patients using a self-administered questionnaire. Multiple logistic regression analysis was performed to identify the associated factors.
Results: The response rate was 99.5% (389/391). The mean age of respondents was 60.1 years and 44.7% were male. The prevalence of psychological distress was the highest at 28.8%, followed by anxiety (21.3%), depressive (16.2%), and stress symptoms (13.9%). Uncontrolled blood pressure was significantly associated with depressive (OR: 6.4; 95% CI: 3.32–12.28), anxiety (OR: 4.9; 95% CI: 2.75–8.82), and stress symptoms (OR: 6.3; 95% CI: 3.06–12.98). Worry about the complications of hypertension was significantly associated with depressive (OR: 4.5; 95% CI: 2.08–9.94), anxiety (OR: 10.8; 95% CI: 4.15–28.17), and stress symptoms (OR: 5.3; 95% CI: 2.14–13.22). Other associated factors were physical inactivity, employment, lack of formal education, and low household income.
Conclusion: A quarter of hypertensive patients experienced psychological distress in terms of depressive, anxiety, or stress symptoms. We recommend screening for psychological distress among high-risk hypertensive patients, especially those cannot achieve adequate blood pressure control or those who are worried about the complications of hypertension.
Factors Influencing Pap Smear Screening Uptake among Women Visiting Outpatient Clinics in Johor
Authors: Chin Suzane Shiyun , Jamonek@Jamhuri Nor Adlina , Hussin Norhayati , Md Zubir Nizatul Laili , Tan Jih Ren , Chan Stanley Chun Wai
Published: July 2022

Introduction: Despite the benefits of cervical cancer screening, Pap smear uptake remains variable in Malaysia, with Johor previously reported as the state with the lowest uptake. This study aims to fill the gap in epidemiological knowledge and assess factors affecting the uptake of Pap smear screening among women in Johor.
Methods: A cross-sectional study was conducted in several government and private clinics across Johor, including Pagoh, Muar, Batu Pahat, Kulai, and Johor Bahru districts. Data was collected from 452 women using self-administered questionnaires, and logistic regression was performed to determine factors associated with Pap smear uptake.
Results: Findings showed that 48.5% of the women reported having undergone Pap smear screening in the previous 3 years, and 40.0% and 51.3% of respondents accurately answered questions on symptoms and risk factors of cervical cancer, respectively. Increasing age (ORadj 2.322, 95% CI 1.708–3.158), being married (ORadj 4.860, 95% CI 1.100–21.476), parity of ≥5 (ORadj 8.381, 95% CI 1.326–52.958), young age at first pregnancy (ORadj 0.932, 95% CI 0.877–0.991), knowledge of cervical cancer symptoms (ORadj 1.745, 95% CI 1.065–2.857), support from family (ORadj 3.620, 95% CI 2.081–6.298), and contraception use (ORadj 2.220, 95% CI 1.314–3.750) were significantly associated with increased Pap smear uptake among women visiting outpatient clinics in Johor.
Conclusion: Pap smear uptake remains suboptimal in Johor, and broad-based awareness campaigns tailored towards improving knowledge of cervical cancer with family involvement are crucial to improving uptake among women in Johor.
A multi-faceted intervention to improve screening of erectile dysfunction for men with diabetes mellitus in public health clinics: A pilot study
Authors: Tay Chai Li , Ng Chirk Jenn
Published: July 2022

Introduction: Erectile dysfunction (ED) is common in men with diabetes and is associated with coronary artery disease and psychological distress. However, discussion of ED in primary care consultations is uncommon. Interventions, such as audit and feedback, mandate of management, and workshop on men’s sexual health, have been proposed to improve ED screening in public health clinics. This study aimed to pilot test a multi-faceted intervention to increase ED screening among men with diabetes and to improve knowledge and confidence in ED screening among primary healthcare providers (PHPs).
Methods: We conducted an interrupted time-series quasi-experimental study with PHPs at public health clinics in Perak, Malaysia from February 2019 to February 2020. Doctors, nurses, and assistant medical officers involved in diabetes care were recruited. The intervention was conducted between July and September 2019 and comprised two phases: audit and feedback, and mandate from management (phase 1), and an interactive face-to-face workshop (phase 2). The primary outcome measure was monthly ED screening rate, and the data were retrieved from health records and the clinical diabetes registry. The PHPs completed a questionnaire on ED knowledge and confidence in ED screening before and after the workshop.
Results: The total number of attendances by patients with diabetes was 50,325 during the study period, of which 21,413 were by men. A total of 30 PHPs participated in the training workshop: 7 (23.3%) doctors, 12 (40%) medical assistants, and 11 (36.7%) nurses. The mean duration of employment at a health clinic was 7 ± 5 years. The majority of the participants were male (56.7%), Malay (80%), married (76.7%), and had no experience with working in a urology department (76.7%). There was a significant improvement in the mean knowledge score (39.0 ± 11.4 vs. 63.6 ± 6.2, p<0.001) and median confidence level in ED screening from 2 (IQR 2–3) to 4 (IQR 4–4) after the workshop (p<0.001). After phase 1, the rate of ED screening increased from a baseline of between 10.3% (February 2019) and 12.7% (June 2019) before intervention to between 15% (July 2019) and 18.9% (September 2019) and was maintained between 18% (October 2019) and 17.9% (December 2019) after phase 2. Subsequently, the ED screening rate declined from 14.6% (January 2020) to 10.9% (February 2020).
Conclusion: This study found that audit and feedback with mandate from management increased ED screening and detection rate. The workshop improved the participants’ knowledge and confidence in ED screening but did not further increased ED screening. The improved practice was sustained for 6 months after the intervention, while the detection rate of ED persisted. We propose regular audit and feedback with mandate from management to sustain the practice of ED screening in men with diabetes.
Prevalence and factors associated with sexual dysfunction among middle-aged women in a multi-ethnic country: A cross sectional study in Malaysia
Authors: Tey Yin Yee , Ching Siew Mooi , Maharajan Mari Kannan , Lee Kai Wei , Chow Zhen Yee , Chua Pei Wen , Tan Chin Xuan , Lim Shi Nie , Tan Chun Han , Thew Hui Zhu , Ramachandran Vasudevan , Hoo Fan Kee
Published: July 2022

Introduction: This study aimed to determine the prevalence and factors associated with female sexual dysfunction in an outpatient clinic in Malaysia.
Methods: The study was conducted among female patients aged 50 years and older who attended the outpatient clinic of a public hospital in Malaysia. A self-administered questionnaire was used that was based on the Malay version of the Female Sexual Function Index questionnaire. The predictors of female sexual dysfunction were identified using multivariate logistic regression analysis.
Results: A total of 263 females were recruited in this study, with a mean age of 60.6 ± 6.7 years. The distribution of the respondents’ ethnicities was mostly Malay (42.2%), followed by Chinese (41.8%) and Indian (16.0%). The prevalence of female sexual dysfunction among participants was 68.8%. The prevalence of the subscales of female sexual dysfunction was as follows: desire (85.2%), satisfaction (74.9%), arousal (71.1%), lubrication (66.9%), pain (61.2%), and orgasm (60.8%). According to multivariate logistic regression, patients of Indian ethnicity had an increased risk of female sexual dysfunction (OR=16.60, 95% CI=2.54–108.63), and a higher frequency of sexual intercourse was correlated with a lower risk of female sexual dysfunction (OR=0.13, 95% CI=0.08–0.24).
Conclusion: Seven-tenths of the middle-aged female patients attending the outpatient clinic suffered from female sexual dysfunction. Indian ethnicity and having a lower frequency of sexual intercourse were predictors of female sexual dysfunction. Future intervention studies are needed to address this problem.
Knowledge on postpartum type-2 diabetes mellitus screening among pregnant women with gestational diabetes mellitus in Malaysia
Authors: Minhat Halimatus Sakdiah , Thangarajah Puganeswary , Ahmad Norliza
Published: July 2022

Introduction: Despite the effectiveness of postpartum type 2 diabetes mellitus (T2DM) screening to detect and manage T2DM among women with a history of gestational diabetes mellitus (GDM), the uptake remains low, indicating the potentially low level of relevant knowledge. This study aims to identify the prevalence of postpartum T2DM screening and its associated factors.
Methods: A cross-sectional study was conducted involving 116 pregnant women with GDM who attended antenatal care follow-up at government health clinics in Seremban District, Negeri Sembilan. Multistage cluster sampling was performed to recruit the respondents from 6 mukims and 10 public health clinics. The data were collected using a validated and pre-tested questionnaire, with Cronbach’s alpha values ranging from 0.81 to 0.95 for each section of the questionnaire. Data were collected through face-to-face interviews during the respondents’ routine antenatal follow-ups for blood sugar monitoring.
Results: Poor knowledge on postpartum T2DM screening (55.2%) was observed, which was significantly predicted by low educational level (AOR = 6.898, 95% CI 3.62–9.055) and low self-efficacy (AOR =17.905, 95% CI 5.470–58.611).
Conclusion: Most of the respondents had poor knowledge regarding postpartum T2DM screening, which was predicted by low education and self-efficacy. The findings highlight the need for continuous education and health promotion during antenatal follow-up targeting women with GDM with low self-efficacy and education level in order to ensure better adherence to screening.
Patients’ satisfaction with healthcare services providers and its determinants in the urban family physician program in Iran: A cross-sectional study
Authors: Kabir Mohammad Javad , Nasrollahpour Shirvani Seiyed Davoud , Amiri Hasan Ashrafian , Vasokolaei Ghasem Rajabi , Rabiee Seyed Mozafar , Hassanzadeh-Rostami Zahra
Published: July 2022

Introduction: The quality of healthcare services can be determined by patient satisfaction as it affects the performance, sustainability, and durability of health services. This study aims to determine patients’ satisfaction with healthcare service providers and its determinants in the urban family physician program in Fars and Mazandaran provinces, Iran.
Methods: A cross-sectional study was conducted on the populations covered by the urban family physician program in Fars and Mazandaran provinces in 2016. In total, 864 households were selected in each province using random cluster sampling. Socio-demographic variables and underlying factors were gathered. Patient satisfaction levels were evaluated using a validated questionnaire.
Results: Of the 1,480 participants with a mean age of 46.9 ± 14.2 years, 53.3% lived in Fars province and 74.2% were female. Furthermore, 67.9% of the patients were satisfied with their healthcare service providers. A higher satisfaction level was observed among the patients who resided in Fars province, lived in cities with <100,000 residents, walked <10 minutes to the family physician’s office, had a family physician they previously knew, accepted the family
physician, had a positive attitude towards the importance of having a family physician and a referral system, and had adequate knowledge of the family physician program.
Conclusion: The results indicated that two-thirds of the patients were satisfied with healthcare service providers. Several socio-demographic variables were associated with the patients’ satisfaction levels. Improving the family physician program by providing adequate medical equipment and monitoring physicians’ performance could increase patient satisfaction and improve the sustainability of the program.
A cross sectional study on patient satisfaction and its association with length of consultation at the University Malaya Medical Centre Primary Care Clinic
Authors: Leow Hong Tee , Liew Su May
Published: July 2022

Introduction: Patient satisfaction has been found to be a determinant of patient compliance to medical advice and treatment, medical service utilisation, the doctor–patient relationship, and continuity of care. Assessment of patient satisfaction can be used to evaluate health care services and identify areas to target for quality improvement.
Methods: A cross-sectional study was conducted to determine the satisfaction level of patients attending a primary care clinic and its associated factors. Participants’ experience of time at the clinic, socio-demographic data, and personal health information were collected. The 18-Item Patient Satisfaction Questionnaire was used to determine patient satisfaction. Univariate and multivariate analyses were employed to identify the factors associated with patient satisfaction.
Results: We recruited 327 participants and 50.46% reported satisfaction. The highest satisfaction was reported in the communication domain (80.80% of the maximum score) and the lowest score was reported in the accessibility and convenience domain (66.40%). The only significant positive correlation with total patient satisfaction score was the difference between perceived and expected length of consultation.
Conclusion: The only independently associated factor was the difference between perceived and expected length of consultation; therefore, changing how time is spent during consultations may prove useful in improving patient satisfaction.