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The views and experiences of Malaysian primary care doctors in managing patients with chronic low back pain: a qualitative study

Hani SS, Liew SM

Malays Fam Physician, 2018;13(1):18-27.
PMID: 29796206 MyJurnal

BACKGROUND: Chronic low back pain (CLBP) is a common and often difficult to treat condition in the primary care setting. Research involving in-depth exploration on the views and experiences faced by primary care doctors in managing patients with CLBP in Malaysia is limited.
OBJECTIVE: To explore the primary care practitioners' views and experiences in managing patients with CLBP.
STUDY DESIGN: A qualitative approach was employed using focus group discussions (FGD) at an academic primary care clinic in Kuala Lumpur, Malaysia. Twenty-three primary care doctors were purposively selected. Data were collected through audio-recorded interviews, which were transcribed verbatim and checked for accuracy. Data saturation was reached by the third FGD. An additional FGD was included to ensure completeness. A thematic approach using the one sheet of paper (OSOP) method was used to analyse the data.
RESULTS: Participants view managing patients with CLBP as challenging. This is mainly due to the difficulty in balancing the doctors' expectations with the patients' perceived expectations during consultation. Barriers identified include lack of awareness and conflicting views regarding the usefulness of the local clinical practice guideline (CPG) in clinical practice. Other barriers include time constraints and perceived lack of support from multidisciplinary teams in managing these patients.
CONCLUSION: Managing patients with CLBP is still a challenge for Malaysian primary care doctors. Any intervention should target identified barriers to improve the management of patients with CLBP.
Fulltext The shaman told me so!

Hani S, Ching SM, Sanwani MA

Fam Med, 2012 May;44(5):356-7.
PMID: 23027120
Fulltext Ergonomic risk assessment of manual handling tools by oil palm collectors and loaders

Nur Syazwani, M. N., Baba, M. D., Mohd Nizam, A.R., Ezrin Hani, S., Norani, N., Shamsul Bahri, M.T., et al.

Malaysian Journal of Public Health Medicine, 2016;16(20):56-60.
MyJurnal

Oil palm workers are exposed to ergonomics problems in their routine works. Although many technological advances have been developed, a large number of workers are still using manual handling tools in their daily work. A study was done to identify and solve the problems or issues of material handling effect on oil palm collectors and loaders during their daily work activities. A cross sectional study was done in an oil palm plantation in Negeri Sembilan, Malaysia. Twenty five workers were selected randomly to participate in this study. Musculoskeletal symptoms were recorded using Modified Nordic Questionnaires and awkward postures of the workers were assessed using Rapid Entire Body Assessment (REBA). Result showed that 61% of workers were exposed to high risk level and 39% to very high risk level of working posture problems. In conclusion, majority of oil palm collectors and loaders need to correct their working posture as soon as possible. The manual handling activities need to be improved with respect to correct procedure for health and safety concerns.
Fulltext Berberine nanoparticles with enhanced in vitro bioavailability: characterization and antimicrobial activity

Sahibzada MUK, Sadiq A, Faidah HS, Khurram M, Amin MU, Haseeb A, et al.

Drug Des Devel Ther, 2018;12:303-312.
PMID: 29491706 DOI: 10.2147/DDDT.S156123

BACKGROUND: Berberine is an isoquinoline alkaloid widely used in Ayurveda and traditional Chinese medicine to treat illnesses such as hypertension and inflammatory conditions, and as an anticancer and hepato-protective agent. Berberine has low oral bioavailability due to poor aqueous solubility and insufficient dissolution rate, which can reduce the efficacy of drugs taken orally. In this study, evaporative precipitation of nanosuspension (EPN) and anti-solvent precipitation with a syringe pump (APSP) were used to address the problems of solubility, dissolution rate and bioavailability of berberine.
METHODS: Semi-crystalline nanoparticles (NPs) of 90-110 nm diameter for APSP and 65-75 nm diameter for EPN were prepared and then characterized using differential scanning calorimetry (DSC) and X-ray powder diffractometry (XRD). Thereafter, drug content solubility and dissolution studies were undertaken. Berberine and its NPs were evaluated for their antibacterial activity.
RESULTS: The results indicate that the NPs have significantly increased solubility and dissolution rate due to conversion of the crystalline structure to a semi-crystalline form.
CONCLUSION: Berberine NPs produced by both APSP and EPN methods have shown promising activities against Gram-positive and Gram-negative bacteria, and yeasts, with NPs prepared through the EPN method showing superior results compared to those made with the APSP method and the unprocessed drug.
Fulltext Risk factors associated with multi-drug-resistant Acinetobacter baumannii nosocomial infections at a tertiary care hospital in Makkah, Saudi Arabia - a matched case-control study

Al-Gethamy MM, Faidah HS, Adetunji HA, Haseeb A, Ashgar SS, Mohanned TK, et al.

J Int Med Res, 2017 Jun;45(3):1181-1189.
PMID: 28480813 DOI: 10.1177/0300060517706284

Objective To determine risk factors for multi-drug-resistant Acinetobacter baumannii (MDR-AB) nosocomial infections in intensive care units in a tertiary care hospital, Makkah, Saudi Arabia. Methods We performed a hospital-based, matched case-control study in patients who were admitted to Al Noor Specialist Hospital between 1 January 2012 and 31 August 2012. The study included cases of A. baumannii nosocomial infection and controls without infection. Controls were matched to cases by age and ward of admission. Results The most frequent site of infection was the respiratory tract (77.3%). Susceptibility to antimicrobial MDR-AB was 92.0% for ceftazidime and ciprofloxacin, while it was 83.3% for imipenem, 83.0% for trimethoprim, 79.0% for amikacin, and 72.7% for gentamicin. Multiple logistic regression of risk factors showed that immunosuppression (OR = 2.9; 95% CI 1.5-5.6; p = 0.002), clinical outcome (OR = 0.4; 95% CI 0.3-0.9; p = 0.01), invasive procedures (OR = 7.9; 95% CI 1.8-34.2; p = 0.002), a central venous catheter (OR = 2.9; 95% CI 1.5-5.6; p = 0.000), and an endotracheal tube (OR = 3.4; 95% CI 1.6-7.3; p = 0.001) were associated with MDR-AB. Conclusions Acinetobacter nosocomial infections are associated with admission to the ICU (Intensive care unit) and exposure to invasive procedures.
Fulltext Antisperm Antibody Testing: A Comprehensive Review of Its Role in the Management of Immunological Male Infertility and Results of a Global Survey of Clinical Practices

Gupta S, Sharma R, Agarwal A, Boitrelle F, Finelli R, Farkouh A, et al.

World J Mens Health, 2022 Jul;40(3):380-398.
PMID: 35021297 DOI: 10.5534/wjmh.210164

Antisperm antibodies (ASA), as a cause of male infertility, have been detected in infertile males as early as 1954. Multiple causes of ASA production have been identified, and they are due to an abnormal exposure of mature germ cells to the immune system. ASA testing (with mixed anti-globulin reaction, and immunobead binding test) was described in the WHO manual 5th edition and is most recently listed among the extended semen tests in the WHO manual 6th edition. The relationship between ASA and infertility is somewhat complex. The presence of sperm agglutination, while insufficient to diagnose immunological infertility, may indicate the presence of ASA. However, ASA can also be present in the absence of any sperm agglutination. The andrological management of ASA depends on the etiology and individual practices of clinicians. In this article, we provide a comprehensive review of the causes of ASA production, its role in immunological male infertility, clinical indications of ASA testing, and the available therapeutic options. We also provide the details of laboratory procedures for assessment of ASA together with important measures for quality control. Additionally, laboratory and clinical scenarios are presented to guide the reader in the management of ASA and immunological male infertility. Furthermore, we report the results of a recent worldwide survey, conducted to gather information about clinical practices in the management of immunological male infertility.