ObjectivesThis study aimed to determine the prevalence of anaemia among patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) at primary care settings and its associated factors.Design, setting and participantsThis cross-sectional study involved 808 adult patients with T2DM and CKD who were recruited via systematic sampling from 20 public primary care clinics in Peninsular Malaysia. Their sociodemographic, clinical and biomedical profiles were collected through interviews, examination of medical records and blood testing.ResultsThe prevalence of anaemia was 31.7% (256/808). The anaemia was mainly mild (61.5%) and normocytic normochromic (58.7%). About 88.7% of the patients with anaemia were not known to have anaemia prior to the study. Among 36 patients with documented history of anaemia, 80.6% were still anaemic, and only a half received iron therapy. Multivariate regression analysis showed that women (adjusted odd ratio (AOR): 1.57, 95% CI: 1.12 to 2.21, p=0.009) and those with older age (AOR: 1.04, 95% CI: 1.01 to 1.06, p<0.001), CKD stage 3a (AOR: 2.47; 95% CI: 1.25 to 4.87, p=0.009), CKD stage 3b (AOR: 4.36; 95% CI: 2.14 to 8.85, p<0.001), CKD stage 4 (AOR: 10.12; 95% CI: 4.36 to 23.47, p<0.001), CKD stage 5 (AOR: 10.80; 95% CI: 3.32 to 35.11, p<0.001) and foot complication (AOR 3.12, 95% CI: 1.51 to 6.46, p=0.002) were more likely to have anaemia. Having higher body mass index (AOR 0.95, 95% CI: 0.92 to 0.99, p=0.012) and higher diastolic blood pressure (AOR 0.97, 95% CI: 0.95 to 0.99, p<0.001) were associated with lower odds to have anaemia.ConclusionAnaemia among patients with T2DM and CKD in primary care was common, and the majority was unrecognised. Inadequate treatment of anaemia was also prevalent. Therefore, screening of anaemia should be incorporated into the routine assessment of diabetic complications particularly for those with significant associated factors. It is hoped that such strategy could lead to early treatment and hence improve their overall care.Trial registration numberNMRR-15-660-24324.

IntroductionErectile dysfunction (ED) is defined as the "inability to attain or maintain penile erection sufficient for satisfactory sexual performance".1 The prevalence of ED is increasing, and it is estimated that 322 million men worldwide will be affected by 2025, with the largest projected increase occurring in developing countries. 2 The prevalence of ED varies from 6.4-70.1%, and the wide variation is mainly due to the difference in assessment tools used, and the populations studied. [3][4][5][6][7][8] Physiologically, normal erection is maintained by a complex interplay between vascular and neurological events. Any condition that affects the vascular supply or the neuronal pathways to the penis, whether medical or psychological in origin, may cause ED. 1,9,10 Studies have shown that the prevalence of ED is significantly associated with age, the presence of co-morbid conditions and smoking. 3,4,6 Millions of men are affected by ED, often suffering in silence, while experiencing significant mental and psychological stress that affects their familial relationships and their social lives. AbstractBackground: Erectile dysfunction (ED) is common amongst hypertensive men. Hypertensive patients often attribute it to antihypertensive drugs, although conflicting evidence linking ED with antihypertensive medication exists. The objectives were to determine the prevalence and severity of ED, the type of treatment sought, and the risk factors for ED among hypertensive men.

Mastitis is a common disease in small ruminant industry. The present study aimed to determine the presence of protease activated receptor-2 (PAR2) mRNA expression in the mammary gland of mastitis challenged goats. 30 clinically healthy mix breed lactating goats were divided into three groups, consisting of Staphylococcus aureus (Group 1), methicillin-resistant S. aureus (Group 2) and sterile phosphate-buffered saline (Control) groups. The data regarding physical condition of udder and clinical parameters of goats were recorded while milk samples and mammary gland tissues were collected at 24 and 48 hours post infection. Somatic cell count (SCC) was measured by direct microscopic method. The presence of PAR2 mRNA in the mammary gland tissue samples was detected by real-time PCR. Goats from group 1 developed mild to moderate clinical signs while Group 2 exhibited moderate to severe clinical signs. SCC was higher in both challenged groups than control group. PAR2 mRNA expression was detected in all mammary gland samples from Group 1 and Group 2. The gene expression was significantly highly in mammary gland tissue with severe clinical signs. The finding of PAR2 expression in caprine mammary gland is novel and important, suggesting serine proteases involved the development of mastitis in goat.

Introduction: Obesity is a global issue called as “globesity”. Overweight and obesity may lead to many noncommunicable diseases (NCDs). Primary care is the first centre to monitor and follow-up the progress of NCD patients. Therefore, the objective of this study was to determine the effectiveness of an integrated-Weight Management Programme (i-WMP) to reduce body weight among NCD patients from two Government primary care clinics from Hulu Langat District. Methods: This study was single-blinded randomised controlled trial by design. There were 244 eligible patients were randomised into intervention (n = 122) or wait-list control group (n = 122). The i-WMP was developed based on the behaviour change wheel through the operationalization of behaviour change techniques. The duration of this intervention programme was four weeks. Data collected at week 0, week 4, and week 12. The software IBM SPSS was used to analyse the data. Generalized linear mixed model analysis with intention-to-treat principle was applied. Results: The retention rate was 74.2%. Findings showed that the i-WMP was significantly effective in reducing not only body weight as primary outcome but also secondary outcomes such as waist-to-height ratio, waist circumference, body mass index, and total sitting time. It also improved effectively other secondary outcomes such as participants’ knowledge, attitude, and practice towards dietary and towards physical activity. However, no significant changes were reported for body fat percentage and total physical activity metabolic equivalent of task-minutes/week. Conclusion: Implications surrounding the implementation of i-WMP in the primary care clinics are recommended.

No abstract