Browse publications by year: 2019

  1. Sindhu CK, Nijar AK, Leong PY, Li ZQ, Hong CY, Malar L, et al.
    Malays Fam Physician, 2019;14(3):18-27.
    PMID: 32175037
    Background: Colorectal cancer (CRC) is the second most common cancer in Malaysia. Awareness of risk factors, symptoms and warning signs of CRC will help in early detection. This paper presents the level of CRC awareness among the urban population in Malaysia.
    Method: A cross-sectional study was conducted from November 2015 till December 2016 at three government clinics in the Klang Valley. The validated Bowel Cancer Awareness Measure questionnaire in both English and Malay was used. The mean knowledge scores for the warning signs and risk factors of CRC in different socio-demographic groups were compared using ANOVA in SPSS version 23. Statistical significance was set at p<0.05 and a 95% confidence level.
    Results: Of the 426 respondents, 29.1% were unable to recall the warning signs and symptoms of CRC. Average recall was less than two warning signs and symptoms (mean 1.62, SD 1.33). The mean total knowledge score for CRC was 9.91 (SD 4.78), with a mean knowledge scores for warning signs and risk factors at 5.27 (SD 2.74) and 4.64 (SD 2.78), respectively. Respondents with a higher level of education were found to have higher level of knowledge regarding the warning signs of CRC. There was a significant positive association between knowledge score for warning signs and level of confidence in detecting warning signs. Regarding the total knowledge score for CRC, 3.3% of respondents scored zero. For warning signs and risk factors, 8.2% and 8.5% of respondents had zero knowledge scores, respectively.
    Conclusions: Generally, awareness of CRC is poor among the urban population of Klang Valley. Greater education and more confidence in detecting warning signs are significantly associated with better knowledge of warning signs. CRC awareness programs should be increased to improve awareness.
    MeSH terms: Ambulatory Care Facilities; Analysis of Variance; Colonic Neoplasms; Cross-Sectional Studies; Demography; Educational Status; Humans; Malaysia; Surveys and Questionnaires; Risk Factors; Urban Population; Colorectal Neoplasms; Early Detection of Cancer
  2. Kabir MJ, Hassanzadeh-Rostami Z, Ashrafian Amiri H, Nasrollapour Shirvani SD, Keshavarzi A, Hosseini S
    Malays Fam Physician, 2019;14(3):28-36.
    PMID: 32175038
    Background and objective: A successful family physician program needs ongoing and full cooperation between people and the organizations in charge. Ensuring the satisfaction of family physicians through improvement of the underlying factors could motivate them to provide high-quality services. This study aimed to determine the family physicians' satisfaction level with the factors affecting the dynamism of the urban family physicians program in the Fars and Mazandaran provinces of Iran.

    Method: This cross-sectional study was carried out in urban areas in the Fars and Mazandaran provinces in 2016. The sample consisted of 143 and 96 family physicians, respectively, in Fars and Mazandaran provinces and was selected using the stratified random sampling method. Data were collected using a questionnaire and included both sociodemographic variables and factors assessing the family physicians' satisfaction levels. Each factor was scored based on a Likert scale from 0 to 5 points, and any satisfaction level higher than 3 out of 5 was equated with being satisfied.

    Results: The overall satisfaction levels among family physicians in Fars and Mazandaran provinces were 2.77±0.53 and 3.37±0.56, respectively, revealing a statistically significant difference between provinces (p<0.001). Moreover, the mean satisfaction scores for the performances of healthcare centers, insurance companies, specialists, healthcare workers, and the population covered were 2.78±0.1, 2.54±0.9, 2.52±0.8, 4.24±0.07, and 2.96±0.8, respectively. The family physicians' levels of satisfaction were significantly correlated with population size (p=0.02, r= -0.106), and willingness to stay in an urban family physician program (p<0.001, r= +0.398).

    Conclusion: This study revealed that family physicians exhibited a low level of satisfaction with the urban family physician program. Given the direct association between family physicians' satisfaction levels and retention in the program, it is expected that family physicians will no longer stay in the program, and it is likely to have subsequent executive problems.

    MeSH terms: Cross-Sectional Studies; Health Personnel; Humans; Iran; Longitudinal Studies; Motivation; Organizations; Personal Satisfaction; Physicians, Family; Population Density; Surveys and Questionnaires; Specialization
  3. Malek KA, Abdul-Razak S, Abu Hassan H, Othman S
    Malays Fam Physician, 2019;14(3):37-45.
    PMID: 32175039
    Introduction: Managing adolescent pregnancy in the primary care setting is complex, as it requires doctors to navigate through a combination of medical, social, financial and legal needs. Objective: This study explores the perspectives of private general practitioners on their roles and challenges in managing adolescent pregnancy in Malaysia.

    Methods: Nineteen private general practitioners in Selangor and Kuala Lumpur participated in in-depth interviews in 2015. A topic guide was used for interview navigation. Participants were asked to discuss their experiences and approaches in managing pregnant adolescents. We used purposive sampling to recruit consenting private general practitioners who had experience in managing adolescent pregnancy. The verbatim transcripts of the audio-recorded interviews were analyzed using thematic analysis. Data reached saturation at the nineteenth in-depth interview. Results: Two themes emerged. Under the theme 'inadvertent advocator,' participants described their tasks with regards to building trust, calming angry parents and delivering comprehensive counseling and care related to the sexual and reproductive health of adolescents, including requests for abortions. Theme two, 'challenges of private general practitioners,' refers mainly to personal and religious conflicts arising from a request for an abortion and deficiencies in support and multidisciplinary integration within their practice settings.

    Conclusion: General practitioners practicing in the private sector identify themselves as active players in supporting pregnant adolescents but face many challenges arising from the personal, religious, professional and community levels. Addressing these challenges is important for optimal care delivery to pregnant adolescents in this community.

    MeSH terms: Abortion, Induced; Adolescent; Counseling; Female; Humans; Malaysia; Parents; Pregnancy; Pregnancy in Adolescence; Primary Health Care; Private Sector; General Practitioners; Reproductive Health
  4. Cheah WL, Chang CT, Helmy H, Wan Manan WM
    Malays Fam Physician, 2019;14(3):46-54.
    PMID: 32175040
    Introduction: Physical inactivity is the one of the leading causes of major non-communicable diseases in the world. The aim of this study is to assess the feasibility of an intervention program based on the stages of change, physical activity levels and health profiles of selected overweight and obese adults in Sarawak.

    Methods: This intervention study was carried out using selected overweight and obese adults in Sarawak. A total of 75 participants were placed in the intervention group, and 80 respondents were placed in the control group participated. Respondent-determined weekly aerobic exercise sessions were conducted for six months. The Malay version of the long-form International Physical Activity Questionnaire (IPAQ) and Transtheoretical model of change (TTM) questionnaire were used, together with anthropometric measurements and the collection of venous fasting blood profiles. Data was entered and analyzed using SPSS Version 20.

    Results: The intervention group had significant better stage transitions compared to the control group (p<0.01). They also had significantly lower total cholesterol, although both groups showed significant results (difference= 0.53, p<0.01; difference= 0.38, p=0.01). The respondent-determined intervention program was effective in improving stage transition; however, an intervention of longer duration could provide more conclusive health outcomes.

    Conclusion: Physical activity plays a role in assisting overweight and obese adults to be more active and healthier.

    MeSH terms: Adult; Cholesterol; Fasting; Feasibility Studies; Humans; Malaysia; Obesity; Surveys and Questionnaires; Exercise; Control Groups; Overweight
  5. Nurain MN, Marmuji LZ, Mastura I, Michael FH, Barakatun-Nisak MY, Yusof M, et al.
    Malays Fam Physician, 2019;14(3):55-59.
    PMID: 32175041
    Diabetes in pregnancy is associated with risks to the woman and her developing fetus. Management of the condition at the primary care level includes pre-conception care, screening, diagnosis, as well as antenatal and postpartum care. A multidisciplinary approach is essential in ensuring its holistic management.
    MeSH terms: Diabetes Mellitus; Female; Fetus; Humans; Mass Screening; Postnatal Care; Pregnancy; Primary Health Care; Interdisciplinary Studies
  6. Swarna Nantha Y, Yeoh MH, Sharif SM
    Malays Fam Physician, 2019;14(3):60-64.
    PMID: 32175042
    Langerhans cell histiocytosis (LCH) in adults is rare and regarded as an 'orphan disease.' The systemic symptoms of LCH can mimic many other undifferentiated diseases seen at the primary care level. Failure to diagnose and delays in referral are common pitfalls in the management of this disease. We present a case of a 34-year-old woman with referred knee pain who was eventually diagnosed with multi-system LCH 4 years after the initial presentation. The mean age of presentation of LCH symptoms in adults is 33. Bone lesions are the frequent presentation of LCH in this age group. Endocrine involvement in LCH is seen in the form of diabetes insipidus (DI), which remains the most common extraskeletal presentation of LCH in adults. In the case discussed here, a definitive diagnosis of LCH was established through tissue biopsy. The spectrum of undifferentiated symptoms underscores the difficulty and delay in making a diagnosis associated with the condition. Most GPs not only face the predicament of initial recognition but also fail to merge presenting symptoms to form a purposeful referral of this elusive disease to a tertiary care unit.
    MeSH terms: Adult; Biopsy; Cartilage Diseases; Diabetes Insipidus; Diabetes Mellitus; Female; Histiocytosis, Langerhans-Cell; Humans; Knee Joint; Pain; Primary Health Care; Rare Diseases; Tertiary Healthcare
  7. Leow SN, Tang WS
    Malays Fam Physician, 2019;14(3):65-67.
    PMID: 32175043
    Anaphylaxis is a life-threatening emergency, and adrenaline is the mainstay treatment for this condition. However, there have been a few reported cases of patients experiencing cardiovascular complications, such as myocardial infarction and coronary vasospasm, after its use. We highlight such a case in a young, healthy patient and the important differentials to consider.
    MeSH terms: Anaphylaxis; Humans; Malaysia/ethnology; Myocardial Infarction*; Young Adult
  8. Boo WH, Lee PY
    Malays Fam Physician, 2019;14(3):68-70.
    PMID: 32175044
    Children with musculoskeletal symptoms are commonly seen by general practitioners (GPs). Those that present with atraumatic limp pose a particular diagnostic challenge. Although uncommon, Perthes disease (PD) is an important cause of atraumatic limp in children and may result in debilitating consequences if missed. We put forward a case of delayed diagnosis of PD in a child, thus highlighting the need for a greater index of suspicion among GPs in approaching any child with a limp.
    MeSH terms: Child; Humans; Legg-Calve-Perthes Disease*; Malaysia; Male
  9. Boo YL, Lim SY, P'ng HS, Liam C, Huan NC
    Malays Fam Physician, 2019;14(3):71-73.
    PMID: 32175045
    Thrombocytopenia is a common laboratory finding in dengue infection. However, it usually resolves as the patient recovers from the infection. Persistent thrombocytopenia following dengue infection requires further investigation. Here, we present a case of immune thrombocytopenic purpura (ITP) following dengue infection complicated by intracranial bleeding.
    MeSH terms: Anemia; Dengue; Humans; Leukopenia; Thrombocytopenia; Purpura, Thrombocytopenic, Idiopathic; Intracranial Hemorrhages
  10. Ramasamy K, Kanapaty Y, Abdul Gani N
    Malays Fam Physician, 2019;14(3):74-76.
    PMID: 32175046
    Oral squamous papillomas are benign neoplasms of the oral cavity that occur commonly on the palate. Albeit benign and often asymptomatic, they may still cause concern due to their appearance, which may mimic other malignant oral pathologies. Human papillomavirus (HPV) is usually implicated in papilloma pathogenesis. We present a rare case of symptomatic oral squamous papilloma arising from the uvula and causing tongue and throat irritation. This benign lesion was excised with electrocautery.
    MeSH terms: Humans; Male; Uvula; Young Adult
  11. Kandiah R, Mohamad I
    Malays Fam Physician, 2019;14(3):77-79.
    PMID: 32175047
    Jugular phlebectasia has been increasingly recognised with the advent of non-invasive diagnostic methods. Phlebectasia differs from varix, as it is an abnormal outward dilatation of a vein without tortuosity. It presents as a soft, compressible mass, apparent upon straining or execution of the Valsalva maneuver. The differentials for neck masses are broad, but if the swelling appears on the Valsalva maneuver, the type of mass narrows down to a laryngocele, superior mediastinal mass or phlebectasia. A simple non-invasive investigation, such as ultrasonography, is used as a diagnostic tool. We report a case of jugular phlebectasia that was suspected clinically and confirmed via ultrasound to be a vascular lesion which changed its size upon straining.
    MeSH terms: Dilatation; Dilatation, Pathologic; Ultrasonography; Valsalva Maneuver; Varicose Veins; Veins; Laryngocele
  12. Mohd Khalid SA, Bajuri MY
    Malays Fam Physician, 2019;14(3):80-83.
    PMID: 32175048
    The injection of a local anesthetic in combination with a corticosteroid is an accepted choice in the treatment of plantar fasciitis with recalcitrant heel pain. When the injection is performed properly, post-injection infection is extremely rare. We are reporting a rare case of chronic calcaneal osteomyelitis that developed secondary to a local corticosteroid injection. A 56-year-old lady diagnosed with right plantar fasciitis presented with a 6-month history of pain and a persistent sinus with serous discharge of her right heel following a local infiltration of a corticosteroid. A Magnetic Resonance Imaging demonstrated right calcaneal osteomyelitis with intramuscular abscess. Surgical drainage and debridement were done, followed by antibiotic therapy. A recurrence of infection was not detected throughout the duration of follow-up. It is suggested that a plantar heel injection be done in a more controlled environment, such as in operating theatre, to reduce the risk of infection and to avoid injecting a steroid as compared to platelet-rich plasma (PRP) in view of their safety profiles. However, such an injection should only be offered after conservative treatment has failed, as 80% of patients recover well after initial conservative management.
    MeSH terms: Abscess; Adrenal Cortex Hormones; Anesthesia, Local; Anesthetics, Local; Calcaneus; Debridement; Female; Follow-Up Studies; Heel; Humans; Injections; Middle Aged; Osteomyelitis; Pain; Patient Discharge; Fasciitis, Plantar; Platelet-Rich Plasma; Conservative Treatment
  13. Ramiza RR, Zulrusydi I, Wan Noor Hasbee WA, Anis O
    Malays Fam Physician, 2019;14(3):84-85.
    PMID: 32175049
  14. Ong TK, Harun N, Lim TW
    Eur Endod J, 2019;4(2):90-95.
    PMID: 32161894 DOI: 10.14744/eej.2019.13007
    In this case report, three teeth with complete or incomplete cemental tear in two patients were presented. Even though periapical radiograph could detect cemental tear in these three teeth, the cone-beam computed tomography scanning clearly revealed the pattern of the cemental tear, which was later confirmed by histopathological examination. Therefore, this case report shows the benefits of incorporating both cone-beam computed tomography and histopathological examination to diagnose cemental tear.
    MeSH terms: Humans; Radiography; Lacerations; Cone-Beam Computed Tomography
  15. Ong TK
    Eur Endod J, 2019;4(3):145-149.
    PMID: 32161902 DOI: 10.14744/eej.2019.03016
    A 27-year-old male patient complained of dental pain on previously root-treated tooth #17. Intentional replantation (IR) was performed. However, the symptoms returned at 10 months of follow-up, and a sinus tract was detected on the buccal gingiva of tooth #17. The patient refused extraction of the tooth and tooth was scheduled for non-surgical retreatment. Root canal retreatment was initiated with the removal of the previous root filling material while leaving the retrograde filling in situ. After 1 month of intracanal medication, the tooth became asymptomatic with complete healing of the sinus tract and the root canal filling was completed. Clinical and radiographic examination at 1 year follow-up revealed endodontic success with complete resolution of periapical radiolucency. This case report shows that non-surgical retreatment could be a viable alternative for failed IR.
    MeSH terms: Adult; Dental Pulp Cavity; Follow-Up Studies; Gingiva; Humans; Male; Mouth; Pain; Root Canal Obturation; Root Canal Therapy; Tooth Replantation; Retreatment
  16. Saslina Kamaruddin, Nadia Nabila Mohd Saufi, Muhammad Asrul Shah Bin Asman Shah, Nazsyaqeeqa Binti Mohamad Nasrudin
    Journal of Management & Science, 2019;17(1):106-111.
    MyJurnal
    The Malaysian Employees Provident Fund (EPF) known as Kumpulan Simpanan Wang Pekerja (KWSP) is a social security institution for an employee in Malaysia and was created as a compulsory national saving plan in 1951. This institution is formed under the Laws of Malaysia which is the Employee Provident Fund Act 1991 (Act 452). KWSP provide retirement benefits by reliably managing their savings. The retirement age for Malaysian between 55 until 60 years old, then they will enjoy the benefit that is given by KWSP during retirement day. The problem occurs when there are certain employers did not perform their legal obligation to employees. The main objective of this paper is to analyses the general rules and laws regarding the duty of the employer to contribute to EPF, the punishment for any failure to perform such obligations. Also, the paper seeks to examine the reason behind such adherence to duty to contribute. This paper is mainly written to suggest ways to overcome problem regarding failure to contribute in EPF by the employer in Malaysia as compared to that in Japan. This research is adopted doctrinal legal analysis in which the primary source will be the Employee Provident Act 1991. On the secondary sources, the articles and journal wrote by local and international writers was referred. The authors contend that the Malaysian government has already enacted laws on the issues. However, the enforcement by the supervisory body is somehow weak based on the increase in the number of reported cases in the area.
  17. Myint, Myo Hla, Shyam Rao, Najimudeen M, Win, Mie Mie Cho, Risyallini A/P Rajan
    MyJurnal
    Postpartum period is perceived as an important period for women. It is associated with formalities, ceremonies and habits in many cultures. Different cultures practise different ways of traditional methods during this period. The common traditional practices are showering with herbs, traditional massage, eating food cooked with herbs, dietary precautions, behaviour precautions and many more. The aim of this study is to focus on the prevalence of traditional practices used during postpartum period among women in Ampang, Malaysia. A cross-sectional study was conducted among 235 women during six-month period, from June 2018 to December 2018. The data was collected by using questionnaire consisting of socio-demography (part A) and the traditional practices used (part B). Results showed 232 out of 235 women (98.7%) practiced different traditional methods during postpartum period. Among variety of methods used, traditional massage (68.9%) is the most common method practised by three races (Malay, Indian and Chinese). Showering with herbs (67.2%) and cooking with herbs (59.1%) were the second and third line popular traditional methods respectively. In addition, (29.8%) of women used some practices to increase breast milk production. Most of the women used more than one traditional methods. In conclusion, although there are many advanced modern technologies in medical field and in well facilitated urban areas, most of the women are still using their own traditional practices according to their races and cultures.
  18. Hasan, Tiba Nezar, Lubna Haida binti Mohd Fisal, Ghazi, Hasanain Faisal
    MyJurnal
    These days, media has become a huge part of everyday life. Unrealistic thin body weight and body shape portrayed by media has led to body weight concern especially among females. The aim of this study is to investigate the associations between media exposure and body weight concern among female university students in Management and Science University. A cross-sectional study was conducted among 363 female students aged 17 to 26 years from the Management and Science University. A self-administered questionnaire was used to assess on socio-demographic information, media usage, body shape concern, body appreciation scale, and the sociocultural attitudes toward appearance. The highest number of media usage were among students between 17 to 20 years old, 31.7% overweight students had high body shape concern, 40.8% student had high sociocultural attitudes towards appearance and 44.6% normal weight student perceived high body appreciation scale. In the association between media usage and body weight concern, a significant association was found on body shape concern (p=0.01), body appreciation scale (p=0.001) and sociocultural attitudes toward appearance (p=0.001). In socio-demographic and body weight concern, the result also indicated a significant association between BMI (p=0.001), monthly income (p=0.013) and education (p=0.001) with body shape concern, body appreciation scale and sociocultural attitudes towards appearance. As a conclusion, 52% in the present study showed that exposure to media have association with body weight concern among female university students.
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