Browse publications by year: 2010

  1. Fulltext Iris mammillations in two female siblings with congenital adrenal hyperplasia
    Peyman M, Ong MJ, Iqbal T, Subrayan V
    BMJ Case Rep, 2010;2010.
    PMID: 22802477 DOI: 10.1136/bcr.08.2010.3266
    Iris mammillations are dark brown, smooth, mound- or dome-shaped protuberances that are typically found on the anterior iris surface and are presumed to be congenital in origin. This congenital anomaly is usually unilateral and can be hereditary or sporadic. Lisch nodules in neurofibromatosis, tapioca melanoma of the iris, inflammatory iris granulomata and Cogan-Reese syndrome should be considered in the differential diagnosis. In this case report, the authors present a case of a bilateral iris mammillations in two siblings with congenital adrenal hyperplasia (CAH). To our knowledge, this is the first case where bilateral iris mammilations have been found to be associated with a systemic condition. Iris mammillations can be considered as one of the clinical signs in CAH in view of the pathogenesis discussed. Detailed ocular examination in CAH may reveal an increased incidence.
    MeSH terms: Adrenal Hyperplasia, Congenital/complications*; Adrenal Hyperplasia, Congenital/genetics*; Child; Child, Preschool; Female; Humans; Iris/abnormalities*
  2. A comparative histopathological study of systemic candidiasis in association with experimentally induced breast cancer
    Choo ZW, Chakravarthi S, Wong SF, Nagaraja HS, Thanikachalam PM, Mak JW, et al.
    Oncol Lett, 2010 Jan;1(1):215-222.
    PMID: 22966285
    Systemic candidiasis is a fungal infection which coupled with solid malignancies places patients at high risk of succumbing to the disease. Few studies have shown evidence of the relationship between systemic candidiasis and malignancy-induced immunosuppression disease especially in breast cancer. At present, animal studies that exclusively demonstrate this relationship have yet to be conducted. The exact causative mechanism of systemic candidiasis is currently under much speculation. This study therefore aimed to demonstrate this relationship by observing the histopathological changes of organs harvested from female Balb/c mice which were experimentally induced with breast cancer and inoculated with systemic candidiasis. The mice were randomly assigned to five different groups (n=12). The first group (group 1) was injected with phosphate buffer solution, the second (group 2) with systemic candidiasis, the third (group 3) with breast cancer and the final two groups (groups 4 and 5) had both candidiasis and breast cancer at two different doses of candidiasis, respectively. Inoculation of mice with systemic candidiasis was performed by an intravenous injection of Candida albicans via the tail vein following successful culture methods. Induction of mice with breast cancer occurred via injection of 4T1 cancer cells at the right axillary mammary fatpad after effective culture methods. The prepared slides with organ tissues were stained with hematoxylin and eosin, periodic acidic schiff and gomori methenamine silver stains for a histopathological analysis. Grading of primary tumour and identification of metastatic deposits, as well as scoring of inflammation and congestion in all the respective organs was conducted. Statistical tests performed to compare groups 2 and 4 showed that group 4 exhibited a highly statistically significant increase in organ inflammation and congestion (p<0.01). The median severity of candidiasis in the kidneys and liver also increased in group 4 as compared to group 2. In conclusion, based on the above evidence, systemic candidiasis significantly increased in mice with breast cancer.
    MeSH terms: Animals; Axilla; Breast Diseases; Candida albicans; Candidiasis; Eosine Yellowish-(YS); Female; Hematoxylin; Humans; Inflammation; Injections, Intravenous; Liver; Methenamine; Mice, Inbred BALB C; Mycoses; Neoplasms; Tail; Mice
  3. Fulltext Visual analog scale in hearing loss
    Bokari S, Prepageran N, Raman R
    Indian J Otolaryngol Head Neck Surg, 2010 Jan;62(1):40-3.
    PMID: 23120679 DOI: 10.1007/s12070-010-0004-x
    OBJECTIVE: To determine if visual analog scale (VAS) that has been used to measure magnitude of internal states such as pain, mood and various functional capabilities can be applied for patients with hearing loss.

    MATERIALS AND METHODS: One hundred and sixty patients, aged 12-80 years with unilateral hearing loss were studied using a VAS (1-10) and pure tone audiometry (PTA) of responses to 500, 1,000 and 2,000 Hz to determine degree and type of hearing loss. The results of both were compared to determine if VAS can be used in measuring hearing loss.

    RESULTS: Patients with mild, moderate hearing loss correlate well with corresponding VAS but other degrees of hearing loss (severe and profound) have poor correlation. The best correlation between PTA and VAS were found in conductive type of hearing loss.

    CONCLUSION: This study suggest that there may be a role for VAS in mild and moderate hearing loss. This may be more applicable in rural setting as a screening procedure when audiometry is not available and can enhance clinical hearing assessment especially in mild-to-moderate conductive hearing loss.

  4. Fulltext Anterior external bony ear canal bulge
    Rajagopalan R
    Indian J Otolaryngol Head Neck Surg, 2010 Jan;62(1):90-1.
    PMID: 23120691 DOI: 10.1007/s12070-010-0001-0
    To study the prevalence of anterior external bony ear canal bulge.
    MeSH terms: Ear Canal; Prevalence
  5. Donated materials in assisted reproductive technologies: an ethico-legal analysis of art legislations worldwide
    Zawawi M
    J Med Ethics Hist Med, 2010;3:2.
    PMID: 23908737
    This paper provides an appraisal of countries that have legislations pertaining to assisted reproductive technologies (ART). In doing so, the paper highlights the emphasis on the protection of reproductive freedom of the couples seeking ART treatment. This belief is grounded primarily on the basic notion of liberalism that attaches primary importance to respect for individual freedom, which is the foundation of the notion of reproductive rights as understood by western standards today. The main aim of the appraisal is to see how these legislations address the drastic changes in familial relationships when ART involves the use of donated materials.
  6. Fulltext A study on knowledge, attitude and practice of contraception among college students in Sikkim, India
    Renjhen P, Kumar A, Pattanshetty S, Sagir A, Samarasinghe CM
    J Turk Ger Gynecol Assoc, 2010;11(2):78-81.
    PMID: 24591903 DOI: 10.5152/jtgga.2010.03
    To assess the knowledge, attitude and practice of contraception among the college students.
  7. Fulltext Evaluation of breast cancer awareness among female university students in Malaysia
    Hadi MA, Hassali MA, Shafie AA, Awaisu A
    Pharm Pract (Granada), 2010 Jan;8(1):29-34.
    PMID: 25152790
    Breast cancer is the most common cancer and the leading cause of cancer death among women of all ethnic and age groups in Malaysia.

    OBJECTIVE: The objectives of this study were to evaluate the knowledge of breast cancer risk factors, symptoms and methods of screening among female university students and their perception towards the disease treatment outcomes.

    METHODS: A cross-sectional survey was conducted from February to March 2008 at Universiti Sains Malaysia. Two hundred participants from 10 randomly selected faculties were interviewed face to face by a trained pharmacist using a validated questionnaire. In addition to their demographic characteristics, participants were required to answer 22 questions concerning knowledge of breast cancer and five questions related to their perception of breast cancer management and treatment outcomes. Data were analyzed using SPSS version 15.

    RESULTS: The mean age of the respondents was 26.7 (SD=1.9) years. The results showed that the vast majority of the female university students had inadequate knowledge of breast cancer. The mean total knowledge score of the students was 60.7%. Indian students had significantly less knowledge of breast cancer compared to their Chinese and Malay counterparts (p<0.05). However, more than two third of the students were aware of breast self examination (BSE) and clinical breast examination (CBE) recommendations. Furthermore, the students had positive perceptions towards the treatment outcomes of breast cancer.

    CONCLUSION: This study has highlighted the need of a breast cancer awareness campaign, which should also stress the importance of early detection and reporting of breast cancer.
    MeSH terms: Adult; Awareness; Breast Neoplasms; Cross-Sectional Studies; Demography; Faculty; Female; Humans; Malaysia; Pharmacists; Surveys and Questionnaires; Risk Factors; Students; Universities; Breast Self-Examination; Treatment Outcome; Early Detection of Cancer
  8. Fulltext Photoageing skin of the elderly
    Khoo SB
    Malays Fam Physician, 2010;5(1):9-12.
    PMID: 25606179 MyJurnal
    MeSH terms: Aged; Aging; Humans; Skin Diseases*
  9. Fulltext Cross-sectional survey of multi-centre patient registries in malaysia
    Sharmini S, Jamaiyah H, Jaya Purany SP
    Malays Fam Physician, 2010;5(1):13-8.
    PMID: 25606180 MyJurnal
    This survey set out to describe patient registries available in the country, to determine their security features, data confidentiality, extent of outputs produced and data quality of the registries.
    MeSH terms: Data Accuracy; Confidentiality; Environment; Humans; Surveys and Questionnaires; Registries
  10. Fulltext Can primary care clinic run MMT service well?
    Norsiah A, Dharmananda S, Mohammad Nazri MD, Marzafuan MM, Lee BWH, Khalijah MY
    Malays Fam Physician, 2010;5(1):19-23.
    PMID: 25606181 MyJurnal
    Methadone Maintenance Therapy (MMT) for opiate dependence was first started in Malaysia in 2005. The service was initially provided by psychiatric clinics in hospitals and primary care clinics. Handling patients with opiate dependency especially in a primary care clinic is very challenging due to various constraints hence the success is doubtful. 143 patients from Tampin Health Clinic were recruited from November 2006 until March 2009. Retention rate in the program was high. Significant improvement was seen in the World Health Organization Quality Of Life score (WHOQOL-BREF) in all 4 domains done at baseline, 1st year and 2nd year in the program. After joining the program, there were no new blood borne virus infection for HIV and Hepatitis B and only 1 had Hepatitis C. Minimal number of patients were involved in new drug related offences while in the MMT program. Existing primary care clinics can be empowered to scale up this service in Malaysia.
    MeSH terms: Adult; Ambulatory Care Facilities; China/ethnology; Humans; India/ethnology; Malaysia; Malaysia/ethnology; Male; Methadone*; Retrospective Studies; Cohort Studies; Substance-Related Disorders; Drug Users*
  11. Fulltext Barriers to the utilization of primary care services for mental health prolems among adolescents in a secondary school in Malaysia
    Aida J, Noor Azimah M, Mohd Radzniwan AR, Tuti Iryani MD, Ramli M, Khairani O
    Malays Fam Physician, 2010;5(1):31-5.
    PMID: 25606183
    OBJECTIVE: To study the barriers toward the utilization of primary care services for mental health problems among adolescents in a secondary school in Hulu Langat, Selangor, Malaysia.
    METHODS: This was a cross-sectional study conducted in July 2008 at a secondary school in Hulu Langat, Selangor. The respondents were selected using randomised cluster sampling among Form Four and Form Five students. Students were given self-administered questionnaire, consisting socio-demographic data and questions on their help-seeking barrier and behaviour. Help-seeking behaviour questions assess the use of medical facility and help-seeking sources. The formal help-seeking sources include from teachers, counsellors and doctors. The informal help-seeking sources include from friends, parents and siblings.
    RESULTS: A total of 175 students were included in the study. None of the students admitted of using the primary health care services for their mental health problems. Majority of the students were not aware of the services availability in the primary health care (97.1%). More than half of them thought the problems were due to their own mistakes (55.4%) and the problems were not that serious (49.1%). With regard to perception of the primary health care services, (43.2%) of the students were worried about confidentiality, half of them were concerned about other people's perception especially from their family members (44.6%) and friends (48.6%). Minority of them (10.8%) thought that nobody can help them. Few of them thought smoking (3.4%), alcohol (3.4%) and recreational drugs (1.1%) can solve their emotional problems.
    CONCLUSION: One of the major barriers identified in the students' failure to use the health care facilities was their unawareness of the availability of the service for them in the community. Thus there is a need to promote and increase their awareness on this issue.
    MeSH terms: Adolescent; Mental Disorders*; China/ethnology; Cross-Sectional Studies; Female; Humans; India/ethnology; Malaysia; Malaysia/ethnology; Male; Patient Acceptance of Health Care*; Primary Health Care; Schools; Students
  12. Fulltext Prescribing of antihypertensive agents in public primary care clinics - is it in accordance with current evidence?
    Ramli AS, Miskan M, Ng K, Ambigga D, Nafiza M, Mazapuspavina M, et al.
    Malays Fam Physician, 2010;5(1):36-40.
    PMID: 25606184
    Large population surveys in Malaysia have consistently shown minimal improvement of blood pressure control rates over the last 10 years. Poor adherence to antihypertensive medication has been recognized as a major reason for poor control of hypertension. This study aimed to describe the prescribing pattern of antihypertensive agents in 2 public primary care clinics and assess its appropriateness in relation to current evidence and guidelines.
    MeSH terms: Adult; Ambulatory Care Facilities; Antihypertensive Agents*; Cross-Sectional Studies; Humans; Hypertension; Malaysia; Guideline Adherence
  13. Fulltext Brief report: Do university students have high cardiovascular risk? A pilot study from Universiti Malaysia Sarawak (UNIMAS)
    Lee PY, Ong TA, Muna S, Syed Alwi SAR, Kamarudin K
    Malays Fam Physician, 2010;5(1):41-3.
    PMID: 25606185
    A health screening was done in UNIMAS in August 2008 for 237 undergraduate students. Body mass index (BMI), waist circumference (WC) and blood pressure (BP) were measured for all subjects. Total cholesterol and glucose levels were checked for those who fulfilled the screening criteria. The proportion of participants with cardiovascular (CVD) risk factors was high. The strategies for health promotion should not only be targeted to the older community but also to the younger community.
    MeSH terms: Adult; Blood Glucose; Blood Pressure; Body Weight; Cholesterol; Cross-Sectional Studies; Female; Humans; Malaysia; Male; Obesity; Risk Factors; Students; Universities; Body Mass Index; Prevalence; Overweight; Waist Circumference; Young Adult
  14. Fulltext Respiratory clinics: cough and melena in a 60-year-old man
    Khajotia R, Ng C
    Malays Fam Physician, 2010;5(1):44-5.
    PMID: 25606186
    MeSH terms: Adult; Humans; Lung Neoplasms; Male; Neoplasm Metastasis; Colorectal Neoplasms
  15. Fulltext Contact lens related corneal ulcer
    Loh KY, Agarwal P
    Malays Fam Physician, 2010;5(1):46.
    PMID: 25606187 MyJurnal
  16. Fulltext An older woman with pain and swelling of left leg
    Das Gupta E
    Malays Fam Physician, 2010;5(1):47-8.
    PMID: 25606188
    MeSH terms: Adult; Female; Humans; Leg; Venous Thromboembolism
  17. Fulltext Academic mobbing: hidden health hazard at workplace
    Khoo SB
    Malays Fam Physician, 2010;5(2):61-7.
    PMID: 25606190
    Academic mobbing is a non-violent, sophisticated, 'ganging up' behaviour adopted by academicians to "wear and tear" a colleague down emotionally through unjustified accusation, humiliation, general harassment and emotional abuse. These are directed at the target under a veil of lies and justifications so that they are "hidden" to others and difficult to prove. Bullies use mobbing activities to hide their own weaknesses and incompetence. Targets selected are often intelligent, innovative high achievers, with good integrity and principles. Mobbing activities appear trivial and innocuous on its own but the frequency and pattern of their occurrence over long period of time indicates an aggressive manipulation to "eliminate" the target. Mobbing activities typically progress through five stereotypical phases that begins with an unsolved minor conflict between two workers and ultimately escalates into a senseless mobbing whereby the target is stigmatized and victimized to justify the behaviours of the bullies. The result is always physical, mental, social distress or illness and, most often, expulsion of target from the workplace. Organizations are subjected to great financial loss, loss of key workers and a tarnished public image and reputation. Public awareness, education, effective counselling, establishment of anti-bullying policies and legislations at all levels are necessary to curb academic mobbing. General practitioners (GPs) play an important role in supporting patients subjected to mental and physical health injury caused by workplace bullying and mobbing.
    MeSH terms: Humans; Workplace; Bullying*
  18. Fulltext Management of chronic heart failure in primary care: What evidence do we have for heart failure with preserved systolic function?
    Ramli AS, Jackson B, Toh CT, Ambigga Devi SK, Piterman L
    Malays Fam Physician, 2010;5(2):68-76.
    PMID: 25606191 MyJurnal
    Chronic Heart Failure (CHF) is a debilitating illness commonly encountered in primary care. Its prevalence in developing countries is rising as a result of an ageing population, and an escalating epidemic of hypertension, type 2 diabetes and coronary heart disease. CHF can be specifically diagnosed as Heart Failure with Reduced Systolic Function (HF-RSF) or Heart Failure with Preserved Systolic Function (HF-PSF). This paper illustrates a common presentation of HF-PSF in primary care; and critically appraises the evidence in support of its diagnosis, prognosis and management. Regardless of the specific diagnosis, long term management of CHF is intricate as it involves a complex interplay between medical, psychosocial, and behavioural factors. Hence, there is a pressing need for a multidisciplinary team management of CHF in primary care, and this usually takes place within the broader context of an integrated chronic disease management programme. Primary care physicians are ideally suited to lead multidisciplinary teams to ensure better co-ordination, continuity and quality of care is delivered for patients with chronic conditions across time and settings. Given the rising epidemic of cardiovascular risk factors in the Malaysian population, preventive strategies at the primary care level are likely to offer the greatest promise for reducing the growing burden of CHF.
    MeSH terms: Adult; Heart Failure*; Humans; Primary Health Care; Review
  19. Fulltext Comparison between the panoptic ophthalmoscope and the conventional direct ophthalmoscope in the detection of sight threatening diabetic retinopathy: the kuching diabetic eye study
    Tan AK, Mallika P. S., Aziz S, Asokumaran T, Intan G, Faridah HA
    Malays Fam Physician, 2010;5(2):83-90.
    PMID: 25606193 MyJurnal
    OBJECTIVE: To determine the sensitivity and specificity of the conventional direct ophthalmoscope and the PanOptic ophthalmoscope in the detection of sight threatening retinopathy, as well as the "Ease of Use" of these equipments.
    METHODS: 200 diabetics, newly referred from primary health physicians were examined. Fundus examinations were performed with pupil dilatation in a dark room. The examinations were performed by a single investigator using the PanOptic ophthalmoscope, the conventional direct ophthalmoscope and slit lamp biomicroscopy.
    RESULTS: The overall sensitivity in detecting sight threatening retinopathy using the conventional direct ophthalmoscope was 73.2% (95% CI: 57.1-85.8%), specificity 93.7% (95% CI: 88.7-96.9%). For PanOptic ophthalmoscope, the overall sensitivity in detecting sight threatening retinopathy was 58.5% (95% CI: 42.1-73.7%), specificity 93.7% (95% CI: 88.7-96.9%). The conventional direct ophthalmoscope was 1.38 times (95% CI: 1.17-1.61 times) as easy to use compared to the PanOptic ophthalmoscope.
    CONCLUSION: The PanOptic ophthalmoscope is not superior to the conventional direct ophthalmoscope for the screening of Sight Threatening Retinopathy.
    KEYWORDS: PanOptic ophthalmoscope; conventional direct ophthalmoscope; sight threatening retinopathy
    Study site: Ophthalmology clinic, Sarawak General Hospital, Kuching, Sarawak, Malaysia
    MeSH terms: Cross-Sectional Studies; Diabetic Retinopathy*; Hospitals, General; Humans; Malaysia; Outpatient Clinics, Hospital; Retinal Diseases; Sensitivity and Specificity; Ophthalmoscopes
  20. Fulltext Self reported hearing loss among elderly malaysians
    Rosdina AK, Leelavathi M, Zaitun A, Lee VKM, Noor Azimah M, Majmin SH, et al.
    Malays Fam Physician, 2010;5(2):91-4.
    PMID: 25606194 MyJurnal
    A cross-sectional study was conducted on patients attending a primary care facility to determine the prevalence of self reported hearing loss using a single question, "Do you have hearing loss?" Pure tone audiometry was performed to compare the accuracy of the self report. A total of 111 patients were recruited. The prevalence of self reported hearing loss using a single question and pure tone audiometry was 24.3% and 36.9% respectively. By using pure tone audiometry at a cut-off-level of 25 dBHL (decibels Hearing level), the single question yielded a sensitivity of 41.4% and specificity of 85.0%.The single question performed better at 40 dBHL pure tone audiometry with sensitivity of 55.0% and specificity of 82.0%. In conclusion, the prevalence of hearing loss in elderly was high and the single question self reported hearing loss performed satisfactorily with moderate hearing loss.
    MeSH terms: Aged; Ambulatory Care Facilities; Cross-Sectional Studies; Humans; Malaysia; Sensitivity and Specificity; Prevalence; Hearing Loss*
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