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Fulltext Psycho-social and spiritual backgrounds, experiences, and needs as a transsexual: a qualitative study within Persatuan Insaf Pahang

Drama, S., Maliya, S., Liyana, A., Farhani, S., Jannah, R., Razman., M.R.

International Medical Journal Malaysia, 2016;15(2):27-36.
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Introduction: Transsexuals face discriminations and rejections from the Malaysian society. The number of
studies done on understanding the phenomenology, experiences, and problems faced by transsexuals is still
few in Malaysia. This research aims to document their psycho-social and spiritual backgrounds and the
relevant experiences, and to explore their perceptions and needs as male-to-female transsexuals in the
context of Persatuan Insaf Pahang, Malaysia. Materials and Methods: A qualitative research was carried out
in July and August 2015 among eight male-to-female transsexual adults in Kuantan, Pahang. Snowball
sampling was used. Participants who gave consent were interviewed in two focus groups. Data obtained was
transcribed and used as the primary data source. Results: Subjects in this study reported confusions over
their gender identity since childhood. They struggled against conflicts regarding their transsexuality in
adolescence, and eventually many quit their studies. As adults, they were discriminated against in
employment and religious settings. They provided positive feedbacks on religious authorities who could
understand problems unique to transsexuals and empathise with the transsexual community. Conclusion: The
psycho-sexual phenomenology is the same in transsexuals all over the world. Misunderstanding and
discrimination from the society remain heavy towards this community. Transsexuals should learn to adapt to
meeting expectations from the society as well, so they could be accepted in public. They will need religious
guidance and spiritual support for better quality of life. Dedicated efforts are still needed in training
professionals in the educational, medical, and religious fields to attend to the specific needs of transsexuals
in this country.
An eight-year old girl with fever and rash: What is the possible diagnosis?

Farhani S, Hayaatul Najaa M, Hu SE

Malays Fam Physician, 2023;18:55.
PMID: 38026578 DOI: 10.51866/tyk.298

In this clinical challenge, we describe the case of a previously healthy 8-year-old girl who presented to a primary care clinic with fever, reduced oral intake and malaise on day 3 of her illness. Clinical examination revealed that she was tachypnoeic and tachycardic. An erythematous rash was found across the bridge of her nose and cheeks, and several painless ulcers were noted in the oral cavity. Blood investigation showed thrombocytopenia, while urinalysis revealed microscopic haematuria and proteinuria. Useful initial diagnostic imaging studies were discussed, including bedside ultrasound in the ambulatory care setting. It is imperative that primary care providers be vigilant when encountering cases like this.
Usage of vildagliptin among patients with type 2 diabetes mellitus attending a public primary healthcare clinics in Kuala Selangor District, Selangor

Farhani S, Sulizah S, Siti Khalimah R, Jasrinjeet Kaur K, Nur Hidayah Z, Nur Athirah R, et al.

Med J Malaysia, 2024 Jan;79(1):68-73.
PMID: 38287760

INTRODUCTION: Studies showed that vildagliptin can lower HbA1c levels by 0.8%-1%. However, there is limited data looking at vildagliptin use among suburban populations. The efficacy of vildagliptin use may differ among different populations, especially those with low socio-economic status. Thus, this study aimed to assess the HbA1c reduction after vildagliptin initiation, treatment patterns and the reason for its initiation among patients with type 2 diabetes mellitus attending outpatient clinics in Kuala Selangor District, Selangor.
MATERIALS AND METHODS: This is a cross-sectional, retrospective study design. All patients who received vildagliptin in the Pharmacy Integrated Health System (PHIS) registry database from 2016 to 2021 were included as study samples. The exclusion criteria were being less than 18 years old and having type 1 diabetes mellitus. Patients' medical records were retrieved after sampling, and data were collected. One medical record was missing, thus SPSS analysis were performed on 144 vildagliptin users.
RESULTS: In total, 84 females (58.3%) and 60 males (41.7%) with a mean age of 62.1 (±10.1) years were analysed in this study. Mean HbA1c pre-therapy was 8.5 ± 2.1%; while posttherapy 6 months demonstrated a mean HbA1c of 7.9 ± 1.8%. Use of vildagliptin alone or as an adjunct was associated with a mean reduction of 0.6% in HbA1c (p = 0.01). Factors influencing this HbA1c reduction were advancing age, specifically individuals aged 62 years and older (p = 0.02), patients who are already receiving insulin therapy (p=0.00) and those who express a willingness to commence insulin treatment during the counselling session prior to initiating the treatment plan (p = 0.00). Reasons for vildagliptin initiation documented by prescribers were non-insulin acceptance (n = 59, 40.97%), frequent hypoglycaemia (n = 6, 4.1%) and non-compliance with medications (n = 23, 15.9%). There was no association between demographic, medical background and reason for starting vildagliptin variables and HbA1c reduction (p < 0.001).
CONCLUSION: This study showed that initiating vildagliptin alone or as an adjunct therapy significantly reduced HbA1c and is beneficial for uncontrolled diabetes patients. While advancing age, concurrent administration of insulin and the patients' willingness to accept insulin treatment prior to the commencement of therapy were the factors that influenced HbA1c reduction among patients receiving vildagliptin therapy, we recommend primary care providers prioritise all of the significant variables discovered before initiating vildagliptin for their patients.
Fulltext Utilisation of the web-based Home Assessment Tool among patients with COVID-19 in Selangor, Malaysia: An observational study

Farhani S, Roslina AJ, Nik Mazlina M, Noor Hasliza H, Lih Bing L, Noorul Amilin S, et al.

Malays Fam Physician, 2024;19:19.
PMID: 38623415 DOI: 10.51866/oa.205

INTRODUCTION: The COVID-19 pandemic has caused many countries to turn to web-based solutions. The Home Assessment Tool (HAT) is a web-based system using the MySejahtera application developed by the government. It serves as a communication platform for patients with COVID-19 to self-monitor their clinical symptoms and enables authorised healthcare personnel to access and manage collected data for clinical monitoring. Our study aimed to examine the utilisation of this internet-based tool among patients with COVID-19 in Selangor.
METHODS: This observational study analysed secondary data from the self-reported HAT within MySejahtera. It included all patients who were diagnosed with COVID-19 through molecular assays such as RT-PCR or RTK-Ag on 1-21 February 2021, aged >18 years and residing in Selangor. Patients who had documented their symptoms at least once in the HAT during the prescribed 10-day isolation period were classified as HAT users.
RESULTS: A total of 4438 patients were included, of whom 39.4% were HAT users, while 60.6% were non-HAT users. Logistic regression analysis revealed three significant factors associated with low utilisation of the HAT: absence of medical condition (odds ratio [OR]: 9.4; 95% confidence interval [CI]: 7.49-12.01), advanced age (OR: 1.35; 95% CI: 1.20-1.52) and non-Malaysian citizenship (OR: 3.4; 95% CI: 2.50-4.72).
CONCLUSION: The utilisation of the HAT is low, which is associated with advanced age (>65 years), absence of medical conditions and foreign nationality. It is imperative to develop inventive strategies tailored to address the unique needs of these particular demographics.