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  1. Fulltext A Hidden Condition: Multiple Tarlov Cysts Unveiled in a Young Woman Seeking Primary Care for Debilitating Low Back Pain
    Abu Hussain SM, Shibraumalisi NA, Miptah HN, Mohamad Ali ND, Yahaya MY, Ramli AS
    Am J Case Rep, 2023 Jul 30;24:e940600.
    PMID: 37516905 DOI: 10.12659/AJCR.940600
    BACKGROUND Tarlov cysts are rare, with a prevalence of 3.3% in the Asian population, and symptomatic cases are even rarer. Here, we report a case of a young woman with multiple Tarlov cysts presenting in primary care with severe low back pain. CASE REPORT A 23-year-old Malay woman presented to a primary care clinic with sudden-onset, severe, and persistent low back pain for 1 week, affecting her activities of daily living (ADL), especially as a medical student, as she could not stand for more than 10 minutes. There were no other associated symptoms or recent trauma prior to the onset of back pain. Examinations revealed para-vertebrae muscle tenderness and restricted movements at the L4/L5 lumbosacral spine. A plain radiograph of the lumbosacral spine showed sclerosis and erosion of the right pedicle at the L4/L5 levels. Tuberculosis and haematological tests were normal. A lumbosacral MRI of the spine was ordered and the patient was urgently referred to the orthopaedic spine team. The MRI confirmed the diagnosis of multiple Tarlov cysts, with the dominant cyst located at the S2 level. Her symptoms and ADL improved with conservative management. She is being monitored closely by the orthopaedic team and primary care physician. CONCLUSIONS This case highlights red flag symptoms, ie, sudden-onset, severe, and persistent low back pain, that warrant further investigation. Tarlov cysts should be considered as a differential diagnosis. Close monitoring is vital and early surgical intervention is indicated if symptoms worsen, to prevent potential irreversible nerve damage.
  2. Fulltext Factors associated with usability of the EMPOWER-SUSTAIN Self-management mobile app© among individuals with cardiovascular risk factors in primary care
    Abu Hussain SM, Miptah HN, Shibraumalisi NA, Mohamed-Yassin MS, Baharudin N, Badlishah-Sham SF, et al.
    Digit Health, 2024;10:20552076241242795.
    PMID: 38571876 DOI: 10.1177/20552076241242795
    OBJECTIVE: This study aimed to determine the usability of the EMPOWER-SUSTAIN Self-Management Mobile App© and evaluate the factors associated with its usability among patients with cardiovascular risk factors in primary care.

    METHODOLOGY: This was a cross-sectional study, conducted among patients aged ≥ 18 years with cardiovascular risk factors attending a university primary care clinic. Patients were given the app to use for at least three months. Those who fulfilled the eligibility criteria were recruited. Data gathered were on sociodemographic, clinical characteristics, self-management support by doctors, utilisation of the app at home and social support in using the app. The previously translated and validated Malay version of the mHealth App Usability Questionnaire was used to measure usability. The mean usability score was calculated and linear regressions analysis was conducted to determine the factors associated with the usability of the app.

    RESULTS: A total of 247 patients with at least one cardiovascular risk factor(s) were recruited. The mean age was 60.2 (±8.2). The majority were Malays (86.2%) and half of them were males (52.2%). The total mean (±SD) usability score was 5.26 (±0.67) indicating a high usability of the app. Usability of the app declined with increasing age in the simple linear regressions analysis. The multiple linear regressions yielded that being Malay (b = 0.31, 95% CI 0.08,0.54), using the app at home to understand their medications (b = 0.33, 95% CI 0.12,0.53) and having social support from family members and friends (b = 0.28, 95% CI 0.07,0.49) were significantly associated with higher usability of the app.

    CONCLUSION: The usability of the EMPOWER-SUSTAIN Self-Management Mobile App© was high among patients with cardiovascular risk factors in our primary care clinic. This finding supports the widespread use of this app among our patients. Involvement of family members and friends should be encouraged to improve the usability of the app.

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