MyMedR | Browse publications by year: 2008

Fulltext Training in male sexual and reproductive health for a primary care physician

Shaiful BI

Malays Fam Physician, 2008;3(1):58-60.

In 2006, I was awarded a scholarship from Universiti Sains Malaysia for Fellowship training at Monash University (MU) for one year. The objective of the training programme was to develop knowledge and skills in several areas, including androgen deficiency, male infertility, prostate disease, testicular tumours, sexual dysfunction and sexually transmitted diseases. The training programme consisted of attachments with clinical specialists, completion of a course work module and a research project. After completion of the training programme, I believe that Primary Care Physicians (PCPs) will benefit from undertaking the training programme that I had completed. It will enable PCPs to assume leadership roles in this multidisciplinary area. The ability of PCPs in handling sexual and reproductive health issues in men will definitely be a more cost effective form of care for patients, particularly as the number of specialists is limited, and even more importantly, it will be satisfying for the patient and the physician.

MeSH terms: Humans; Reproductive Health

Fulltext Training program in the field of addiction medicine - an experience of learning while abroad

Norsiah A, Whelan G, Piterman L

Malays Fam Physician, 2008;3(1):61-3.

PMID: 25606116

This paper illustrates the training program in the field of Addiction Medicine designed for primary care doctors by the Department of General Practice, School of Primary Care at Monash University in Melbourne. The nine month program was based around coursework, field visits and clinical observations. There were five modules that were completed and passed, twenty six Continuous Medical Education sessions attended, twenty nine field visits on Drug & Alcohol services, forty seven clinical visits and a total of three hundred and sixty clinical observations made. The comprehensive training program has benefited the first author in several ways to improve the Drugs & Alcohol services in Malaysia.

MeSH terms: Humans; Substance-Related Disorders

Fulltext Family physicians with special interest in dermatology

Muthupalaniappen L

Malays Fam Physician, 2008;3(1):64-5.

PMID: 25606117

MeSH terms: Dermatology; Humans; Physicians, Family

Fulltext Qualitative research methods in family medicine: what and why?

Wong LP

Malays Fam Physician, 2008;3(1):70.

PMID: 25606118

MeSH terms: Humans; Review; Qualitative Research

Fulltext Prehypertension: What is the current status?

Chia YC

Malays Fam Physician, 2008;3(2):72-6.

PMID: 25606120 MyJurnal

Cardiovascular disease (CVD) risk is a continuum across blood pressure. The term prehypertension was introduced because it is now recognized that blood pressure readings between what is deemed optimal and hypertension is associated with increased CVD risk. The prevalence of prehypertension is high and the progression to hypertension is also high. Prehypertension is also commonly associated with other CVD risk factors namely dyslipidaemia, dysgylcaemia and overweight/ obesity. Eighty-five percent of prehypertensives have one other or more CVD risk factor compared to normotensives. A recent study has shown a reduction in the development of hypertension from prehypertension with the use of an angiotensin receptor blocker. Unfortunately to date, the impact of treatment of prehypertension on CVD outcome is still unknown except in those with high CVD risk like diabetes or established CVD. However this does not mean nothing can be done for those with prehypertension. The aim of managing prehypertension is to lower the BP, prevent progression to hypertension and to prevent BP related CVD deaths. Lifestyle changes can reduce BP and this by itself can lower CVD risk. Until more evidence about other modalities of treatment become available this is a sensible and cost-effective way to manage prehypertension.

MeSH terms: Blood Pressure; Blood Pressure Determination; Diabetes Mellitus; Hypertension; Life Style; Obesity; Risk Factors; Prevalence; Dyslipidemias; Overweight; Angiotensin Receptor Antagonists; Prehypertension

Fulltext Is the combination of aspirin and clopidogrel always better than aspirin alone? Or will it be too much of a good thing?

Menon V

Malays Fam Physician, 2008;3(2):94-5.

PMID: 25606124 MyJurnal

MeSH terms: Aspirin

Is HIV Screening in the General Population Cost Effective?

Tan H, Koh K

Malays Fam Physician, 2008;3(2):96-7.

PMID: 25606125 MyJurnal

Are inhaled long-acting Beta-agonists (laba) really harmful in adult asthmatics?

Khajotia R, Tnew C

Malays Fam Physician, 2008;3(2):98-100.

PMID: 25606126 MyJurnal

Fulltext Notes for the primary care teacher: teaching in the family practice clinics

Kwa SK, Yong Rafidah A

Malays Fam Physician, 2008;3(2):101-3.

PMID: 25606127

MeSH terms: Education, Medical; Family Practice; Teaching

Fulltext Notes for the primary care teacher: quality assurance in teaching

Chan SC

Malays Fam Physician, 2008;3(2):104-6.

PMID: 25606128

MeSH terms: Education, Medical; Family Practice; Humans; Primary Health Care; Teaching*

Fulltext A woman presenting with dry cough, hoarseness of voice and significant weight loss

Khajotia R

Malays Fam Physician, 2008;3(2):107.

PMID: 25606129

MeSH terms: Aged; Female; Lung Neoplasms

Fulltext A baby with an abnormal upper limb

Keah SH

Malays Fam Physician, 2008;3(2):108.

PMID: 25606130

MeSH terms: Female; Infant; Brachial Plexus Neuropathies

Fulltext A man with an acute abdomen

Loh KY, Kew ST

Malays Fam Physician, 2008;3(2):109-10.

PMID: 25606131

MeSH terms: Adult; Humans; Male; Peptic Ulcer Perforation; Abdominal Pain

Fulltext The arthritis and musculoskeletal quality improvement program (amquip): a breakthrough series methodology project

Mastura I

Malays Fam Physician, 2008;3(2):113-6.

PMID: 25606133 MyJurnal

The Australian government had funded the National Primary Care Collaborative (NPCC) program with funding of $14.6 million over three years. One of the pilots project was the Arthritis and Musculoskeletal Quality Improvement Program (AMQuIP).The study aims to optimize general practitioners (GPs) management of patients with osteoarthritis (OA) of the hip and knee by identifying gaps between their current practice and best practice. The Breakthrough Series Collaborative methodology with several Plan-Do-Study-Act (PDSA) cycles was employed. Participants comprises of 12 GPs/practices from two Victorian Divisions of general Practice (one rural, one metropolitan) with 10 patients per GP/practice. GPs/practices attended an orientation and three learning workshops and a videoconference. GPs/practices completed PDSA cycles between workshop and reported results at workshops. GPs/practices reported use of guidelines, change in patient management and change in practice management/systems. All recruited patients completed the SF-12v2 Health Survey and WOMAC OA Index Questionnaire twice. Follow up activities including focus groups and face-to-face interviews were held six months after the final workshop. All GPs/practices used the guidelines/key messages, introduced "new" management strategies to patients, and made positive changes to their practice management/systems. Patient reported positive changes and outcomes. By using a structured methodology and evidence-based guidelines/key messages; GPs can introduce new patient management strategies, and by identifying gaps in practice management systems, positive changes can be achieved.

MeSH terms: Arthritis; Humans

Fulltext Know the Medicinal Herb: Catharanthus roseus (Vinca rosea)

Loh KY

Malays Fam Physician, 2008;3(2):123.

PMID: 25606134

Fulltext Understanding and preventing computer vision syndrome

Loh KY, Reddy SC

Malays Fam Physician, 2008;3(3):128-30.

PMID: 25606136 MyJurnal

The invention of computer and advancement in information technology has revolutionized and benefited the society but at the same time has caused symptoms related to its usage such as ocular sprain, irritation, redness, dryness, blurred vision and double vision. This cluster of symptoms is known as computer vision syndrome which is characterized by the visual symptoms which result from interaction with computer display or its environment. Three major mechanisms that lead to computer vision syndrome are extraocular mechanism, accommodative mechanism and ocular surface mechanism. The visual effects of the computer such as brightness, resolution, glare and quality all are known factors that contribute to computer vision syndrome. Prevention is the most important strategy in managing computer vision syndrome. Modification in the ergonomics of the working environment, patient education and proper eye care are crucial in managing computer vision syndrome.

MeSH terms: Accommodation, Ocular; Diplopia; Eye; Humans; Vision Disorders; Glare; Inventions

Fulltext Classifying asthma severity and treatment determinants: national guidelines revisited

Khajotia R

Malays Fam Physician, 2008;3(3):131-6.

PMID: 25606137 MyJurnal

Bronchial asthma is an inflammatory disease of the airways manifested physiologically by a widespread narrowing of the air passages. Being an inflammatory disease of the airways, the most effective treatment available for the management of bronchial asthma are anti-inflammatory agents such as corticosteroids. However, it is known that at higher dosage levels, even inhaled corticosteroids have harmful systemic side-effects. Hence, justification of use of high-dose of inhaled corticosteroids can only be made if patients with severe asthma can be accurately identified. For this precise reason, methods have been devised to categorize asthma severity through various National Asthma Management Guidelines. The present guidelines predominantly stress on symptoms and lung functions as the yardstick for determining the severity of asthma attacks and parameters determining airway inflammation have not yet been incorporated into them. However, these guidelines have proved to be fairly accurate in determining asthma severity and in guiding the treatment in these patients and all healthcare personnel are strongly advised to follow them. It is hoped that future guidelines may incorporate measures of inflammation as well, in order to further improve the diagnostic and treatment modalities in these patients.

MeSH terms: Adrenal Cortex Hormones; Anti-Inflammatory Agents; Asthma; Humans; Inflammation

Fulltext An Older Woman in Early Pregnancy: What Antenatal Screening is Appropriate?

Syed Aznal SS

Malays Fam Physician, 2008;3(3):137-9.

PMID: 25606138 MyJurnal

MeSH terms: Adult; Female; Mass Screening; Pregnancy

Pattern of ocular trauma in kuching, malaysia

Mallika P, Tan A, Asok T, Faisal H, Aziz S, Intan G

Malays Fam Physician, 2008;3(3):140-5.

PMID: 25606139 MyJurnal

OBJECTIVES: To analyze the causes and characteristics of ocular injuries presenting to Sarawak General Hospital (SGH), Kuching.

DESIGN: It is a prospective hospital-based study done for a period of 1 year.

SETTING: Department of Ophthalmology, Sarawak General Hospital, Malaysia.

PARTICIPANTS: All ocular injury patients seen for the first time in the Eye Department during the period January 2006 to December 2006 were included in the study. Eye injury patients on follow-up and treated elsewhere were excluded.

RESULTS: A total of 233 patients, and 257 eyes, were studied. Men had six-fold higher rates of injury than women. The average age of presentation was 30 years. The predominant age group was between 21-30 years, 26.2 % (n=61). Eye injuries related to work were seen in 36.9% of patients. There was a gross negligence in the use of personal protective devices in the work-related group. The common settings in which the injuries occurred included home 34.3% (n=80) and industrial premises 31.8% (n=74). Assault-related injuries 7.7% (n=18) were seen mostly among young men in the age between 20-30 years. The initial presenting visual acuity of the patients with blunt ocular trauma was better than penetrating injury.

CONCLUSION: Ocular injuries were common in young males. Work related eye injuries were noted in a significant number of cases. Health education and preventive strategies both in the working place and at home will help to decrease the occurrence of ocular injuries.

A mentally retarded patient with schizophrenia

Rabia K, Khoo E

Malays Fam Physician, 2008;3(3):146-50.

PMID: 25606140 MyJurnal

Schizophrenia is one of the most incapacitating forms of mental disorder that runs a chronic and relapsing course. It typically starts in adolescence or early adulthood and can be life-long. It is more common in people with learning disabilities than in the general population. Its prodromal features include depression, anxiety, suspiciousness, social isolation and bizarre behaviour. It may result in significant functional, social and economic impairments. The care of patients with schizophrenia places a considerable burden on all carers including patient's family, health and social services. Treatment includes pharmacotherapy and psychosocial interventions. In this case report we describe a thirteen-year-old patient with schizophrenia who has a background history of mental retardation.