Displaying publications 1 - 20 of 632 in total

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  1. Ngu MH, Zakaria R, Mohd Zulkifli M, Ab Rahman R
    PMID: 37207247 DOI: 10.51866/cr.282
    Metformin-induced sexual dysfunction is rare in patients with diabetes mellitus. Herein, we present the case of a 57-year-old man newly diagnosed with type 2 diabetes mellitus who developed erectile dysfunction following treatment with metformin 500 mg BD. Prior to taking metformin, he had well-controlled hypertension, hyperlipidaemia and normal sexual function. Two weeks after beginning metformin therapy, he was diagnosed with erectile dysfunction after experiencing persistent difficulty achieving an erection. After discontinuation of metformin, his sexual function returned to normal. To determine whether sexual dysfunction is caused by metformin, we rechallenged the patient with metformin 500 mg BD. After 15 days, he became impotent again, confirming that metformin was the most likely cause of his sexual problem. Metformin was stopped, and his sexual function returned to normal after 3 weeks. The adverse reaction is 'probable' according to the World Health Organization-Uppsala Monitoring Centre.
  2. Mohamad Ishak NN, Jamani NA, Mohd Arifin SR, Abdul Hadi A, Abd Aziz KH
    Malays Fam Physician, 2021 Mar 25;16(1):84-92.
    PMID: 33948146 DOI: 10.51866/oa1098
    Background: Menopause signifies the beginning of a non-reproductive phase from the reproductive period. Although it is considered a natural life transition, recent studies have indicated that a woman's menopausal experience may impact her quality of life. While studies have examined Malaysian women's knowledge and awareness of menopause, they have focused on the prevalence of menopausal symptoms and sociocultural aspects. These investigations also used a quantitative design that may have limited the information regarding the nature and experience of menopause. Objectives: This study explores women's perceptions and understanding of their menopausal experience.

    Methods: A total of 20 menopausal women were recruited using purposive sampling through social media in the state of Pahang, Malaysia. In-depth semi-structured interviews were used to explore how they perceived their menopausal experience. The data were then analyzed using thematic analysis.

    Results: Three themes that emerged from the findings included perceptions of menopause, biopsychosocial changes and help-seeking behavior. For many Muslim women, menopause was perceived as a time for them to engage in religious commitment more than they had before.

    Conclusion: The study findings uncovered a knowledge gap and a lack of support for women impacted by menopause. Muslim women regarded their menopause phase as a time for them to engage in religious duty fully. These results indicate the need for a psychosocial intervention and educational program to ensure women a better transition throughout their menopausal phase.

  3. Mohd Baharudin JA, Mohd Zain MR, Taib F, Abd Hamid IJ
    PMID: 38371722 DOI: 10.51866/oa.202
    INTRODUCTION: Parents are key decision-makers in the immunisation practice and compliance of children. This study aimed to determine the knowledge and practice of immunisation among parents in Kelantan, Malaysia, and their associated factors.

    METHODS: A cross-sectional study was conducted using a validated online questionnaire from May to June 2021. An invitation was distributed to parents attending a university hospital and extended families of staff through online platforms. A total of 311 parents participated in the study. The questionnaire consisted of 10 questions each on knowledge and practice and three questions on vaccination status. Descriptive analysis was performed. The associations between the sociodemographic characteristics and knowledge and practice scores were determined using the chi-square test, and predictive factors were identified using logistic regression analysis.

    RESULTS: Most respondents were Malay (94.2%), Muslim (94.5%), women (79.7%) and married (96.1%). The median score for immunisation knowledge and practice was 8 (interquartile range [IQR]=2) and 7 (IQR=3), respectively. Multiple logistic regression revealed that parents who were unmarried or single, less educated, and had lower incomes were predicted to have poor knowledge of childhood vaccination (P<0.05). Conversely, those living outside Kota Bharu, less educated, and younger parents were predicted to have poor vaccination practice of childhood vaccination (P<0.05). Most respondents (97.8%) indicated completing their children's vaccination schedule.

    CONCLUSION: Parental education and household income are associated with immunisation knowledge and practice. Improving access to information about childhood vaccination among targeted groups may further boost immunization coverage.

  4. Ng CJ, Teo CH, Ang KM, Kok YL, Ashraf K, Leong HL, et al.
    Malays Fam Physician, 2020;15(1):6-14.
    PMID: 32284799
    Introduction: This study aimed to determine the views and practices of healthcare providers and barriers they encountered when implementing the national health screening program for men in a public primary care setting in Malaysia.

    Methods: An online survey was conducted among healthcare providers across public health clinics in Malaysia. All family medicine specialists, medical officers, nurses and assistant medical officers involved in the screening program for adult men were invited to answer a 51-item questionnaire via email or WhatsApp. The questionnaire comprised five sections: participants' socio-demographic information, current screening practices, barriers and facilitators to using the screening tool, and views on the content and format of the screening tool.

    Results: A total of 231 healthcare providers from 129 health clinics participated in this survey. Among them, 37.44% perceived the implementation of the screening program as a "top-down decision." Although 37.44% found the screening tool for adult men "useful," some felt that it was "time consuming" to fill out (38.2%) and "lengthy" (28.3%). In addition, 'adult men refuse to answer' (24.1%) was cited as the most common patient-related barrier.

    Conclusions: This study provided useful insights into the challenges encountered by the public healthcare providers when implementing a national screening program for men. The screening tool for adult men should be revised to make it more user-friendly. Further studies should explore the reasons why men were reluctant to participate in health screenings, thus enhancing the implementation of screening programs in primary care.

  5. Zubir FS, Saniasiaya J, Abdul Gani H
    Malays Fam Physician, 2021 Mar 25;16(1):133-135.
    PMID: 33948154 DOI: 10.51866/cr1070
    Temporal bone rhabdomyosarcoma is an aggressive entity that simulates chronic otitis ear infection. It is the most common soft tissue sarcoma amongst pediatric patients. Herein, we would like to report a case of temporal bone rhabdomyosarcoma involving a 2-year-old boy who presented with a one-month history of otorrhea with facial asymmetry. Early treatment led to remission of this severe neoplasm.
  6. Ramasamy K, Kanapaty Y, Abdul Gani N
    Malays Fam Physician, 2019;14(3):74-76.
    PMID: 32175046
    Oral squamous papillomas are benign neoplasms of the oral cavity that occur commonly on the palate. Albeit benign and often asymptomatic, they may still cause concern due to their appearance, which may mimic other malignant oral pathologies. Human papillomavirus (HPV) is usually implicated in papilloma pathogenesis. We present a rare case of symptomatic oral squamous papilloma arising from the uvula and causing tongue and throat irritation. This benign lesion was excised with electrocautery.
  7. Mohamad F, Yahya AS, Abdul Rashid A, Devaraj NK, Abdul Manap AH
    Malays Fam Physician, 2021 Mar 25;16(1):121-123.
    PMID: 33948151 DOI: 10.51866/cr1117
    Ectopic pregnancy is an extra-uterine pregnancy and is a potentially life-threatening condition that can lead to death from intra-peritoneal hemorrhage. This case reports a rare occurrence of ruptured tubal pregnancy in which the patient presented early with abdominal pain and a negative urine pregnancy test but subsequently presented again with evidence of intra-peritoneal hemorrhage. A negative urine pregnancy test is often used to rule out pregnancy, but it is not 100% sensitive. Complete assessment is critical in this important diagnosis in order to plan for the appropriate emergency management.
  8. Ooi ZY, Mohd Ghazali NA, Nik Zahari NJ, Chan HK, Md Noor N, Harun NL, et al.
    Malays Fam Physician, 2022 Nov 30;17(3):74-83.
    PMID: 36606160 DOI: 10.51866/oa.38
    INTRODUCTION: Upper respiratory tract infection (URTI) is commonly encountered at the primary care level. Its management is particularly challenging due to the similarity of its symptoms to coronavirus disease 2019 (COVID-19) infection. Our study evaluated the profiles and antibiotic use of patients seeking care from a dedicated community-based URTI clinic during the COVID-19 pandemic.

    METHOD: A cross-sectional study was conducted. Data were obtained from the medical records of patients visiting the URTI clinic at the Alor Setar Primary Healthcare Centre between March and April 2020.

    RESULTS: Overall, 587/4388 (13.3%) patients received treatment at the URTI clinic. Most patients were male (60.6%) and aged between 20 and 39 years (35.5%). Their most common symptoms were cough (68.4%), fever (31.6%), runny nose (24.6%), and sore throat (24.1%). Most patients were diagnosed with acute nasopharyngitis (52.5%), acute pharyngitis (18.6%), or acute tonsillitis (5.3%). The symptomatic medication prescription rate was 96.5%. Only 26 of the 435 patients diagnosed with URTI received antibiotics, yielding an antibiotic use rate of only 6.0% for URTI relative to overall drug use. Acute tonsillitis was more common in children <12 years old (p<0.001), while a cough and runny nose were more commonly indicative of acute nasopharyngitis than other conditions (p<0.001). Sore throat was more likely to be a symptom of acute pharyngitis (p<0.001) and acute tonsillitis (p<0.001).

    CONCLUSION: Despite the challenges faced during the COVID-19 pandemic, the findings suggest that patients with URTI-like symptoms were properly managed, and the rate of antibiotic usage remained reasonable.

  9. 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.

  10. Cheah KL, Yaacob LH, Abdul Rahman R
    PMID: 37292225 DOI: 10.51866/cr.257
    Dumping syndrome after bariatric surgery is common. However, it is rarely seen during pregnancy because patients are usually advised to avoid pregnancy immediately after surgery. This case highlights the importance of avoidance of pregnancy after bariatric surgery. We report a case of unplanned pregnancy in a 35-year-old woman with a history of subfertility for 8 years who conceived spontaneously 3 months after gastric bypass surgery. This occurred because there was no contraception offered to her after the procedure. The pregnancy was complicated with recurrent episodes of hypoglycaemia secondary to dumping syndrome. Primary care providers need to be vigilant and have a high index of suspicion for dumping syndrome in pregnant obese women who have undergone bariatric surgery.
  11. Abdul Rahman YR
    Malays Fam Physician, 2007;2(3):120-2.
    PMID: 25606098
    Doctor-patient communication skills are important in family medicine and can be taught and learned. This paper summarises the salient contents and main methods of the teaching and learning of doctor-patient communication, especially those applicable to the discipline.
  12. Bahrom NH, Ramli AS, Isa MR, Baharudin N, Badlishah-Sham SF, Mohamed-Yassin MS, et al.
    Malays Fam Physician, 2020;15(3):22-34.
    PMID: 33329860
    Introduction: The Patient Activation Measure (PAM) is one of the most extensively used, widely translated, and tested instruments worldwide in measuring patient activation levels in self-management. This study aimed to determine the validity and reliability of the PAM-13 Malay version among patients with Metabolic Syndrome (MetS) attending a primary care clinic.
    Methods: This work is a cross-sectional validation study among patients with MetS attending a university primary care clinic in Selangor. The PAM-13 Malay version underwent a validation process and field testing. Psychometric properties were examined using principal component analysis (PCA) with varimax rotation, scree plot, Monte Carlo simulation, internal consistency, and test-retest reliability analyses.
    Results: The content of the PAM-13 Malay version and the original version were conceptually equivalent. The questionnaire was refined after face validation by 10 patients with MetS. The refined version was then field-tested among 130 participants (response rate 89.7%). The Kaiser-Meyer-Olkin test was 0.767, and Bartlett's test of sphericity was ≤0.001, indicating sampling adequacy. Two factors were identified and labeled as (1) Passive and Building Knowledge, and (2) Taking Action and Maintaining Behavior. These labels were chosen as they were conceptually consistent with the items representing the levels of activation in PAM-13. The validated PAM-13 Malay version consisted of 13 items, framed into two domains. The overall Cronbach's α was 0.79, and the intraclass correlation coefficient was 0.45.
    Conclusions: The PAM-13 Malay version is valid, reliable, and fairly stable over time. This questionnaire can be used to evaluate the levels of activation among patients with MetS in primary care in Malaysia.
    Study site: Universiti Teknologi MARA (UiTM) primary care clinic, Sungai Buloh, Selangor, Malaysia
  13. Wong Y, Abdullah N
    Malays Fam Physician, 2018;13(2):42-44.
    PMID: 30302185
    Purple urine bag syndrome (PUBs) is a rare and startling phenomenon of purple discolouration in the urine or urinary catheter and bag. It is reported in chronically debilitated elderly patients, mostly in women on long-term urinary catheters. Its prevalence is strikingly more common in nursing home residents. Several factors contribute to the formation of indigo (blue) and indirubin (red) pigments from a breakdown of dietary tryptophan, which stains the urine purple. These factors include constipation, dysmotility of the bowel, bowel bacterial overgrowth, dehydration, and urinary tract infection. The presence of purple urine may cause undue alarm to both the patient and the doctor. Thus, we present this case report on an 86-year-old woman, a nursing home resident on a long-term urinary catheter, who presented to the primary care clinic. Her urine cleared after antibiotic therapy, replacement of her urinary catheter, and supportive management, which included hydration and nutrition. In addition to these measures, reducing the time between urinary catheter changes was recommended to prevent recurrence of this condition.
  14. Zainuddin N, Abdullah O
    Malays Fam Physician, 2015;10(2):52-4.
    PMID: 27099662 MyJurnal
    Discharging ear is a common symptom in the primary care and private general clinics. Most of the cases are treated with the antibiotic ear drops for otitis externa or otitis media. However, despite an adequate standard therapy, a malignant tumour can also be present with non-specific symptom such as ear discharge, especially in the case of persistent ear discharge. In this paper we have reported a case of an adult woman presented with non-resolving ear discharge who was treated repeatedly with antibiotic ear drop, which was later diagnosed as squamous cell carcinoma.
  15. Abdul Rashid A, Kamarulzaman A, Sulong S, Abdullah S
    Malays Fam Physician, 2021 Jul 22;16(2):14-18.
    PMID: 34386159 DOI: 10.51866/rv1048
    Online activities have become the norm. From searching for new information to conducting business meetings, social media's role in daily life continues to grow in prominence. It is estimated that the majority of the population uses social media, and users include doctors and other healthcare professionals. It is critical for primary care doctors to note how social media can substantially influence one's healthcare behaviour and decision making. Because primary care doctors are usually the first line of contact for patients, they are the most easily accessible and most instrumental in using social media to steer the public toward proper information on healthcare.
  16. Manoharan A, Mohammad NM, Abdul Samad A, Hamid D, Abdullah ZA
    PMID: 37449278 DOI: 10.51866/oa.156
    INTRODUCTION: With the rising number of COVID-19 cases in Malaysia and the overwhelming strain on the tertiary healthcare system, home isolation has been introduced by the Ministry of Health Malaysia to reduce the admission of patients with mild COVID-19 to tertiary and low-risk quarantine centres. COVID-19 assessment centres (CACs) have been set up to provide initial assessment, triaging and monitoring of patients with COVID-19 prior to and during their home isolation. In this study, we aimed to share our experience in setting up CACs in Selangor, Malaysia.

    METHOD: We described the steps taken in developing assessment tools and guidelines for assisting healthcare providers in safely monitoring patients with COVID-19 undergoing home isolation.

    RESULTS: A total of 26,826 patients were clinically assessed from 1 to 28 February 2021 in various CACs in the state. The majority of the cases seen in the CACs were under category (CAT) 1 and 2. Only 0.2% (n=53) of the cases were categorised as severe COVID-19 (CAT 3 and above).

    CONCLUSION: CACs coordinated by primary care providers play an important role in triaging, assessing and monitoring patients with COVID-19 undergoing home isolation in the community. There needs to be a better partnership between various stakeholders and the private healthcare sector to improve the services. The usage of a pulse oximeter in home monitoring of all patients with COVID-19 in Selangor needs to be seriously considered.

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