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Fulltext Non-specific skin purpura

Shalihin SE, Harun Z, Osman IF

Malays Fam Physician, 2018;13(2):39-41.
PMID: 30302184 MyJurnal

Essential thrombocythemia is one of the myeloproliferative neoplasms. Palpable purpura is a rare manifestation that may delay diagnosis and treatment. We report a case of essential thrombocythemia in a 50-year-old man, who presented with recurrent thigh pain for the past one year with nonspecific localized purpura. His full blood count revealed isolated thrombocytosis of 880,000/µL with an impression of myeloproliferative disorder from peripheral blood film. He was referred urgently to the hematology team, which proceeded with a venesection. His condition improved with hydroxyurea. This was a rare case of chronic presentation of myeloproliferative neoplasm detected at a primary care clinic.
Fulltext A young man with chronic dry cough

Shalihin SE, Osman IF, Harun Z, Mukhali HB, Gnathimin B

Malays Fam Physician, 2020;15(1):68-70.
PMID: 32284811 MyJurnal

In primary care, chest X-rays are commonly performed to assess patients presenting with a prolonged
cough. However, the extent to which the flms are accurately interpreted depends on the skill of the
doctors. Doctors with insufcient experience may miss an exact diagnosis when evaluating a flm,
especially in patients with nonspecifc symptoms, such as in the case discussed in this paper.
( Copied from article ).
Anti-diabetic medication burden amongst older persons with diabetes and associated quality of life

Shalihin SE, Fauzi A, Zulkifli NA, Aziz AA

Med J Malaysia, 2020 09;75(5):525-530.
PMID: 32918421

BACKGROUND: Older persons with diabetes are the major demographic of diabetic patients followed up in primary health clinics. Despite their increasing age and morbidities, they are still being managed strictly towards good sugar control in order to achieve the ideal HbA1c level without taking their quality of life into consideration. This study aimed to determine the prevalence in the use of antidiabetic drugs among older persons with diabetes and its association with their quality of life.
METHODOLOGY: A cross-sectional study was conducted among 269 older persons with diabetes in all government health clinics in Kuantan using Diabetes Quality of Life questionnaire. SPSS version 23 was used for the statistical analysis.
RESULTS: Majority of the respondents were females (61%), Malays (84.8%), pensioners (54.3%) with education up to primary school (52%) and are staying with family members (93.7%). Most of the patients were on two antidiabetic agents (48%) followed by a single antidiabetic agent (32%). Despite the risk of hypoglycaemia, 0.4% of them are on glibenclamide. The use of insulin is still common among 21% of them that are on intermediate-acting insulin, 15.6% on premixed insulin and 7.8% on short-acting insulin. Those taking a higher number of antidiabetic agents were found to be associated with poorer quality of life (p=0.001) compared to those taking one or two antidiabetic medications. Those on insulin also have significantly poorer quality of life score (p=0.012).
CONCLUSION: Despite aiming for controlled diabetes, older persons suffer poor quality of life with further intensification of their antidiabetic medications according to the guidelines. This includes the complexity of insulin usage and polypharmacy, which contribute to the low quality of life score.

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