Browse publications by year: 2022

  1. Shahrir NF, Aziz NRA, Ahmad FL, Muzaid NA, Samat F, Syed Ghazaili SNA, et al.
    Malays Fam Physician, 2022 Nov 30;17(3):53-63.
    PMID: 36606172 DOI: 10.51866/oa.122
    INTRODUCTION: Microalbuminuria presents significant health risks for the progression of endstage renal-failure (ESRF) among type 2 diabetes mellitus (T2DM) patients. This study aims to determine the proportion and associated factors of microalbuminuria among T2DM patients in Kuala Selangor district, Malaysia.

    METHOD: A retrospective cross-sectional study was conducted from December 2020 to February 2021 using secondary data from the National Diabetic Registry (NDR), Malaysia, and reviewed patients' diabetic records for the year 2020. All T2DM patients aged >18 years who were registered with the NDR in 2020 and fulfilled the inclusion and exclusion criteria were included in the study. Descriptive statistics and multiple logistic regression analysis were performed. Data were analysed using SPSS version 26.0. A total of 343 samples were included in this study for the determination of the proportion of microalbuminuria and its associated factors.

    RESULTS: Of 343 respondents, 34.4% had microalbuminuria. HbAlc >7.0% (AdjOR 2.19, 95% CI: 1.35, 3.55, p=0.001), HDL <1.04 mmol/L (AdjOR 2.44, 95% CI: 1.323, 4.52, p=0.004), dyslipidaemia (AdjOR 1.90, 95% CI: 1.03, 3.48, p=0.039), and peripheral neuropathy (AdjOR 3.01, 95% CI: 1.02, 8.93, p=0.047) were significantly associated with microalbuminuria. Conclusion: Microalbuminuria is a modifiable risk factor in preventing the progression of ESRF among T2DM patients. Therefore, identification of factors associated with microalbuminuria among this high-risk group is important to facilitate early screening and prompt treatment to prevent progression of diabetic kidney disease to ESRF.

  2. Mustapa A, Justine M, Manaf H
    Malays Fam Physician, 2022 Nov 30;17(3):22-32.
    PMID: 36606173 DOI: 10.51866/rv.208
    INTRODUCTION: Patient education is an integral component of diabetes mellitus care. The emergence of different methods and characteristics of patient education has led to varying outcomes of quality of life (QoL). Herein, we systematically searched for published studies reporting patient education and its methods and characteristics for improving the QoL of patients with type 2 diabetes mellitus (T2DM).

    METHOD: In this scoping review, eligible studies from six databases (PubMed, Scopus, Cochrane Library, Springer Link, Science Direct and Google Scholar) were identified. The keywords used in the search strategies were as follows: health education, health promotion, patient education, diabetes care, QoL, diabetes mellitus and type 2 diabetes mellitus. Two reviewers independently screened all references and full-text articles retrieved to identify articles eligible for inclusion.

    RESULTS: A total of 203 articles were identified in the initial search. Of them, 166 were excluded after screening the titles and abstracts. Further full-text screening led to the subsequent removal of 22 articles, leaving 15 articles eligible for data extraction.

    CONCLUSION: There is a broad array of methods of patient education for improving the QoL of patients with T2DM. Self-management education with supplementary supervision and monitoring effectively improves QoL. Future studies must emphasise the application of holistic education covering psychological distress, diet plan, and physical health.

  3. Tong SF, Tan CE
    Malays Fam Physician, 2022 Nov 30;17(3):2-8.
    PMID: 36606174 DOI: 10.51866/cm0004
    Evidence-based medicine is the foundation of current medical practice. Suitable evidence is needed to support the holistic approach in clinical practice. Quantitative research produces some evidence needed for disease treatment based on probabilities or averages. However, the practice of evidence-based medicine should be personalised to individual patients without relying solely on an average perspective. Beliefs, values and expectations are unique for each individual and may differ significantly from the average. Therefore, understanding individual differences requires evidence from qualitative research. This is particularly important in family medicine practice, which focuses on holistic care for the person, family and community. Findings from properly conducted qualitative research can offer in-depth and comprehensive accounts on healthcare issues from patient and practice perspectives. Qualitative research also provides explanatory power and analytical transferability, which can be applied into daily family medicine practice. In conclusion, evidence from qualitative research should be rightfully equally acknowledged in family medicine and healthcare.
  4. Jamaluddin J, Lee YS
    Malays Fam Physician, 2022 Nov 30;17(3):153-155.
    PMID: 36606175 DOI: 10.51866/tyk.148
    We described the case of a 42-year-old man who presented with left index finger mass persisting for 6 months. The mass was small and, painless and had gradually increased in size with limited finger flexion. Physical examination showed a firm mass over the volar surface of the left index finger. There was no tenderness, redness, warmth or punctum. The overlying skin was normal, and the mass did not transilluminate. Further examination of the head and neck, chest, upper limbs and neurovascular system revealed normal findings. No similar masses were found elsewhere in the body. Bedside ultrasound with further investigation and management confirmed the suspected diagnosis.
  5. Leong WC, Tang JJ
    Malays Fam Physician, 2022 Nov 30;17(3):84-88.
    PMID: 36606176 DOI: 10.51866/oa.146
    INTRODUCTION: Psoriasis affects approximately 2-3% of the population worldwide, although the overall prevalence in Asia is <0.5%. Scalp psoriasis is a common initial presentation of psoriasis, which affects almost 80% of patients with psoriasis.

    METHOD: This retrospective descriptive study investigated 1,671 patients with psoriasis with scalp involvement registered with the Malaysian Psoriasis Registry (MPR) from January 2007 to December 2018.

    RESULTS: A total of 21,859 patients with psoriasis were registered with the MPR during the study period; among them, scalp involvement was seen in 7.6% (n= 1,671). Female sex preponderance (61%) was observed in the majority of Malay patients (58.5%), followed by the Chinese (16.9%), Indian (17.1%) and other ethnic patients (7.5%). A positive family history of psoriasis was identified in 22.7% (n=380). Approximately 34.8% (n=581) and 11% (n=172) of the patients had nail changes and psoriatic arthropathy, respectively. The mainstay treatment modality was topical treatment (93.6%), followed by systemic therapy (10%) and phototherapy (0.5%). The comorbidities found among the patients with scalp psoriasis included hypertension (27.9%), obesity (26%), dyslipidaemia (21%), diabetes mellitus (18.4%), ischaemic heart disease (5.4%) and cerebrovascular disease (1.3%). Approximately 23% reported a Dermatology Life Quality Index (DLQI) of >10, which indicated moderate-to-severe impairment.

    CONCLUSION: The proportion of patients with psoriasis with scalp involvement in our study (7.6%) is much lower than previous reports. Scalp psoriasis markedly negatively impacts the DLQI.

  6. Zahid E, Bhatti O, Zahid MA, Stubbs M
    Malays Fam Physician, 2022 Nov 30;17(3):9-21.
    PMID: 36606178 DOI: 10.51866/rv.37
    This article summarises common oral lesions that clinicians may face in everyday practice by categorising them by clinical presentation: ulcerated lesions, white or mixed white-red lesions, lumps and bumps, and pigmented lesions. The pathologies covered include recurrent aphthous stomatitis, herpes simplex virus, oral squamous cell carcinoma, geographic tongue, oral candidosis, oral lichen planus, pre-malignant disorders, pyogenic granuloma, mucocele and squamous cell papilloma, oral melanoma, hairy tongue and amalgam tattoo. The objective of this review is to improve clinician knowledge and confidence in assessing and managing common oral lesions presenting in the primary care setting.
  7. Noorman MF, Sofian AA, Kandar MK, Ab Halim AH, Harun MH, Mohamed Ramlee FA, et al.
    Malays Fam Physician, 2022 Nov 30;17(3):121-127.
    PMID: 36606180 DOI: 10.51866/oa.64
    INTRODUCTION: Bertolotti's syndrome (BS) is defined as the presence of low back pain (LBP), radiculopathy or both with a dysplastic transverse process (TP) of the fifth lumbar vertebra that is articulated or fused with the sacral base or iliac crest. This study aimed to investigate the prevalence and severity of BS to promote awareness of this disease.

    METHOD: A retrospective review of anteroposterior lumbosacral plain radiographs was conducted between 1 January and 31 December 2017. Patients were recruited via systematic randomised sampling and were then interviewed and examined. The severity of BS was measured objectively using the numerical pain rating scale (NPRS) and Oswestry disability questionnaire (ODQ). Data were analysed using IBM SPSS for Windows version 22.

    RESULTS: The prevalence of BS was 9.6% (16/166). Age significantly affected the severity of BS. The older and younger groups had a mean ODQ score of 42.86% and 24.08%, respectively (P=0.006). There was no significant relationship found between the prevalence of BS and age (P=0.126). Only one patient was diagnosed with BS during medical consultation. The mean NPRS score was 5.5. The majority of the BS cases were of moderate severity (43.8%), followed by those of minimal severity (31.2%) and severe disability (25%).

    CONCLUSION: Early diagnosis of BS and orthopaedic referral are crucial to halt its progression. BS should be considered in patients presenting with LBP during assessments of lumbosacral radiographs.

  8. Kaur J, Gulati M, Corrie L, Awasthi A, Jha NK, Chellappan DK, et al.
    Nanomedicine (Lond), 2022 Oct;17(25):1951-1960.
    PMID: 36606499 DOI: 10.2217/nnm-2022-0260
    The prevalence of lung diseases is increasing year by year and existing drug therapies only provide symptomatic relief rather than targeting the actual cause. Nucleic acids can be used as an alternative therapeutic approach owing to their potential to reform a homeostatic balance by upregulating protective genes or downregulating damaging genes. However, their inherent properties, such as poor stability, ineffective cellular uptake, negative charge and so on, hinder their clinical utility. Such limitations can be overcome by exploiting the functional chemistry of polymeric micelles (PMs) for site-specific delivery, transfection efficiency and improved stability. With this objective, the present work describes the advancements made in designing nucleic acid-based PMs for treating lung diseases followed by approaches requiring consideration for clinical applications.
    MeSH terms: Biological Transport; Drug Carriers/chemistry; Micelles*; Transfection; Drug Delivery Systems
  9. Chandran C, Tham HY, Abdul Rahim R, Lim SHE, Yusoff K, Song AA
    PeerJ, 2022;10:e12648.
    PMID: 35251775 DOI: 10.7717/peerj.12648
    BACKGROUND: Staphylococcus aureus is an opportunistic Gram-positive bacterium that can form biofilm and become resistant to many types of antibiotics. The treatment of multi-drug resistant Staphylococcus aureus (MDRSA) infection is difficult since it possesses multiple antibiotic-resistant mechanisms. Endolysin and virion-associated peptidoglycan hydrolases (VAPGH) enzymes from bacteriophage have been identified as potential alternative antimicrobial agents. This study aimed to assess the ability of Lactococcus lactis NZ9000 secreting endolysin and VAPGH from S. aureus bacteriophage 88 to inhibit the growth of S. aureus PS 88, a MDRSA.

    METHOD: Endolysin and VAPGH genes were cloned and expressed in L. lactis NZ9000 after fusion with the SPK1 signal peptide for secretion. The recombinant proteins were expressed and purified, then analyzed for antimicrobial activity using plate assay and turbidity reduction assay. In addition, the spent media of the recombinant lactococcal culture was analyzed for its ability to inhibit the growth of the S. aureus PS 88.

    RESULTS: Extracellular recombinant endolysin (Endo88) and VAPGH (VAH88) was successfully expressed and secreted from L. lactis which was able to inhibit S. aureus PS 88, as shown by halozone formation on plate assays as well as inhibition of growth in the turbidity reduction assay. Moreover, it was observed that the spent media from L. lactis NZ9000 expressing Endo88 and VAH88 reduced the viability of PS 88 by up to 3.5-log reduction with Endo88 being more efficacious than VAH88. In addition, Endo88 was able to lyse all MRSA strains tested and Staphylococcus epidermidis but not the other bacteria while VAH88 could only lyse S. aureus PS 88.

    CONCLUSION: Recombinant L. lactisNZ9000 expressing phage 88 endolysin may be potentially developed into a new antimicrobial agent for the treatment of MDRSA infection.

    MeSH terms: Bacteriophages*; N-Acetylmuramoyl-L-alanine Amidase/genetics; Staphylococcus aureus
  10. Choon SE, Wright AK, Griffiths CEM, Tey KE, Wong KW, Lee YW, et al.
    Br J Dermatol, 2022 Nov;187(5):713-721.
    PMID: 35830199 DOI: 10.1111/bjd.21768
    BACKGROUND: There are no population-based epidemiological data on psoriasis in Southeast Asia, including Malaysia.

    OBJECTIVES: To determine the incidence and prevalence of psoriasis over 11 years in multiethnic Johor Bahru, Malaysia.

    METHODS: A population-based cohort study was made using the Teleprimary Care database between January 2010 and December 2020. Cases of psoriasis, identified by ICD-10 diagnostic codes, were validated by dermatologists. Annual prevalence and incidence were estimated and stratified by age, sex and ethnicity.

    RESULTS: We identified 3932 people with dermatologist-confirmed psoriasis, including 1830 incident cases, among 1 164 724 Malaysians, yielding an 11-year prevalence of 0·34% [95% confidence interval (CI) 0·33-0·35] and incidence of 34·2 per 100 000 person-years (95% CI 32·6-35·8). Rates were higher in Indian patients; the prevalences were 0·54% (0·50-0·58) in Indian, 0·38% (0·36-0·40) in Chinese and 0·29% (0·28-0·30) in Malay patients, and the respective incidences per 100 000 person-years were 52·5 (47·3-57·7), 38·0 (34·1-41·8) and 30·0 (28·2-31·8). Rates were higher in males; the prevalence was 0·39% (0·37-0·41) in males and 0·29% (0·27-0·30) in females, and the respective incidences per 100 000 person-years were 40·7 (38·2-43·2) and 28·3 (26·4-30·3). Between 2010 and 2020, annual psoriasis prevalence and incidence increased steadily from 0·27% to 0·51% and from 27·8 to 60·9 per 100 000 person-years, respectively. Annual rates were consistently higher in male and Indian patients. Overall, psoriasis was significantly more common in males than females [odds ratio (OR) 1·37, 95% CI 1·29-1·46] and in Indian and Chinese patients vs. Malay (OR 1·85, 1·71-2·01 and OR 1·30, 1·20-1·41, respectively). Prevalence increased with age, with the highest rates in the groups aged 50-59 and 60-69 years at 0·67% and 0·66%, respectively. A modest bimodal trend in age of psoriasis onset was observed, with first and second peaks at 20-29 and 50-59 years. Disease onset was significantly earlier in females than males [mean (SD) 36·8 (17·3) vs. 42·0 (17·2) years, P 

    MeSH terms: Child; Female; Humans; Information Systems; Malaysia/epidemiology; Male; Cohort Studies; Incidence; Prevalence; Electronic Health Records*
  11. Sayed IS, Zamri MH
    Cureus, 2022 Nov;14(11):e32077.
    PMID: 36600822 DOI: 10.7759/cureus.32077
    To preserve public health and prevent the spread of COVID-19, academic institutions curtailed face-to-face instruction and learning after the outbreak. The traditional techniques for education were modified, and new ways of instructing students were implemented. It presented a number of difficulties for the educational system, particularly for universities offering healthcare education. Therefore, the aim of this research was to look into how COVID-19 affected the teaching and learning of undergraduate medical imaging students. The ScienceDirect, Oxford University Press Journals, Cambridge University Press Journals, and Taylor & Francis Online databases were searched, and a total of 14 papers met the inclusion and exclusion criteria and were selected for further analysis. The literature was analyzed using a thematic approach, with recurring themes brought to light. The effects of COVID-19 on medical imaging education include but are not limited to the more rapid adoption of online education and new approaches to assessing and guiding students. Online teaching for medical imaging students influenced their learning environment, interaction, and motivation. The new COVID-19 safety requirements and procedures in hospitals have profoundly impacted clinical practice. Additionally, students' research activities were also affected. We anticipate that the findings of this study will enable us to be better equipped to assist students in comparable circumstances in the future.
  12. Lee SY, Thow SY, Abdullah S, Ng MH, Mohamed Haflah NH
    Int J Nanomedicine, 2022;17:6723-6758.
    PMID: 36600878 DOI: 10.2147/IJN.S362144
    Peripheral nerve injury (PNI) is a worldwide problem which hugely affects the quality of patients' life. Nerve conduits are now the alternative for treatment of PNI to mimic the gold standard, autologous nerve graft. In that case, with the advantages of electrospun micro- or nano-fibers nerve conduit, the peripheral nerve growth can be escalated, in a better way. In this systematic review, we focused on 39 preclinical studies of electrospun nerve conduit, which include the in vitro and in vivo evaluation from animal peripheral nerve defect models, to provide an update on the progress of the development of electrospun nerve conduit over the last 5 years (2016-2021). The physical characteristics, biocompatibility, functional and morphological outcomes of nerve conduits from different studies would be compared, to give a better strategy for treatment of PNI.
    MeSH terms: Animals; Nerve Regeneration/physiology; Peripheral Nerves*; Sciatic Nerve/physiology; Prostheses and Implants*; Tissue Scaffolds
  13. Nik Abdull Halim NMH, Che Dom N, Dapari R, Salim H, Precha N
    Front Public Health, 2022;10:1074028.
    PMID: 36600940 DOI: 10.3389/fpubh.2022.1074028
    INTRODUCTION: The Aedes mosquito species, which are the vectors for the transmission of the dengue virus (DENV) to humans, are becoming increasingly susceptible to the formidable effects of influential factors, especially temperature. However, there are still very few studies that have systematically reviewed the existing literature. Hence, in the present study, a systematic literature review and meta-analysis was conducted into the effects of temperature on dengue vectors.

    METHOD: Several research methodologies were incorporated into the current study, and a review was carried out using PRISMA as a guide. The publications for this study were chosen from two prominent databases, Scopus and Web of Science. All of the studies were assessed, reviewed, and evaluated independently by two reviewers. The meta-analysis tool, Review Manager (RevMan Copenhagen Version 5.4.1), was used to record the extracted data for the meta-analysis. Moran's I 2 and a funnel plot were utilized to measure heterogeneity, and publication bias was investigated. A 95% confidence interval (CI) and overall risk difference (RD) were estimated using a random-effects model.

    RESULT AND DISCUSSION: As a consequence of the search efforts, a total of 46 articles were selected for inclusion in the systematic review and meta-analysis. This review was divided into five major themes, based on a thematic analysis: (i) hatching rate, (ii) development time, (iii) longevity, (iv) survival rate, and (v) wing morphology. In addition, the development time, survival rate, and wing morphology revealed significantly higher risk differences between the maximum and minimum temperatures (RD: 0.26, 95% CI: 0.16, 0.36; p = < 0.00001; RD: 0.10, 95% CI: 0.05, 0.14; p < 0.0001; and RD: 0.07, 95% CI: 0.02, 0.12; p = 0.006, respectively). This study makes several substantial contributions to the body of knowledge and to practical applications. Finally, a number of recommendations are made at the conclusion of this research for the future reference of researchers.

    MeSH terms: Aedes*; Animals; Fever; Humans; Longevity; Temperature; Mosquito Vectors
  14. Kumar P, Sharma N, Ahmed MA, Verma AK, Umaraw P, Mehta N, et al.
    Front Nutr, 2022;9:1044024.
    PMID: 36601080 DOI: 10.3389/fnut.2022.1044024
    Meat analogs have opened a new horizon of opportunities for developing a sustainable alternative for meat and meat products. Proteins are an integral part of meat analogs and their functionalities have been extensively studied to mimic meat-like appearance and texture. Proteins have a vital role in imparting texture, nutritive value, and organoleptic attributes to meat analogs. Processing of suitable proteins from vegetable, mycoproteins, algal, and single-cell protein sources remains a challenge and several technological interventions ranging from the isolation of proteins to the processing of products are required. The present paper reviews and discusses in detail various proteins (soy proteins, wheat gluten, zein, algal proteins, mycoproteins, pulses, potato, oilseeds, pseudo-cereals, and grass) and their suitability for meat analog production. The review also discusses other associated aspects such as processing interventions that can be adapted to improve the functional and textural attributes of proteins in the processing of meat analogs (extrusion, spinning, Couette shear cell, additive manufacturing/3D printing, and freeze structuring). '.
  15. Sapkota B, Bokati P, Dangal S, Aryal P, Shrestha S
    Medicine (Baltimore), 2022 Apr 22;101(16):e29192.
    PMID: 35482989 DOI: 10.1097/MD.0000000000029192
    The medication therapy management (MTM) pharmacists follow the philosophy of pharmaceutical care to address individualistic medication therapy requirements in their practice settings.The present study aimed to introduce the pharmacist-delivered MTM services among type 2 diabetes mellitus patients at a tertiary care hospital in Nepal.Cross-sectional study was conducted at Patan Hospital, Lalitpur, Nepal, among 200 patients with type 2 diabetes mellitus from July to December 2019. The intervention included maintenance of medication profile for individual patients, and then MTM service was proposed based on 5 core elements of MTM services proposed by the American Pharmacists Association. Both antidiabetic and non-antidiabetic medicines were coded as per the anatomic, therapeutic, and chemical classification and defined daily dose assignment 2020 for documentation. The Charlson Comorbidity Index was used to index comorbidities. The drug interaction profile was checked with the Medscape Drug Interaction Checker.Both fasting and postprandial blood sugar levels were significantly associated with age (P-values
    MeSH terms: Cross-Sectional Studies; Humans; Hypoglycemic Agents/therapeutic use; Nepal; Pharmacists; United States; Medication Therapy Management*; Tertiary Care Centers
  16. Abdelhafez MMA, Ahmed KAM, Than WW, Baharuddin DMP, Kadir F, Jeffree S, et al.
    J Obstet Gynaecol, 2022 Oct;42(7):2550-2557.
    PMID: 35666947 DOI: 10.1080/01443615.2022.2081801
    Intrahepatic cholestasis of pregnancy (ICP) is the commonest among the specific dermatoses of pregnancy. The disease is characterised by intense pruritus and specifically by elevated bile acid levels and owing to the rarity of data published in this context, the disease carries a great challenge in both diagnosis and management. The disease is associated with significant maternal as well as perinatal adverse effects, hence, this article aims at improving the knowledge of the women's health carers with the up-to-date and evidence-based, whenever possible, recommendations while managing patients with ICP.
    MeSH terms: Bile Acids and Salts; Female; Humans; Pregnancy; Pregnancy Outcome; Ursodeoxycholic Acid/adverse effects
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