Displaying publications 1 - 20 of 111 in total

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  1. Rajakumar MK
    Republished in: Republished in: Teng CL, Khoo EM, Ng CJ (editors). Family Medicine, Healthcare and Society: Essays by Dr M K Rajakumar, Second Edition. Kuala Lumpur: Academy of Family Physicians of Malaysia, 2019: 23-26
    Matched MeSH terms: General Practitioners
  2. Das Gupta E, Goh EML, Gun SC, Hussein H, Shahril NS, Yeap SS
    APLAR Journal of Rheumatology, 2006;9 Suppl 1:A53.
    Background: In the ageing population, osteoporosis (OP) is becoming an increasingly common medical condition. Effective interventions are available that should enable clinicians to limit the magnitude of the burden but this will require the proper knowledge of OP and its management. Objective: To explore family physicians' perceptions of OP and to identify their educational needs in this area.
    Method: Self administered questionnaires about OP knowledge and management were distributed to attendees of Rheumatology Workshops for primary care physicians between March and November 2005, in Malaysia.
    Results: A total of 134 primary care physicians participated in this survey comprising 53% private practitioners, 44% government doctors, 2.2% from academic institutions and 0.7% not stated. The majority 73 (54.4%) had practiced for more than 10 years, 29 (21.6%) under 5 years and 32 (23.9%) between 5 and 10 years. 127 (94.4%) of them saw patients with osteoporosis. Those who had qualified for over 10 years were more likely to treat OP (p = 0.012). 82% felt that osteoporosis was under-diagnosed whereas 14.9% thought it was over diagnosed. This was not related to specialty or years qualified. Regarding the reasons for under-diagnosis of osteoporosis, 71% stated that they had no access to DXA screening, 74% had no access to heel ultrasound, 66% felt the disease was asymptomatic, 37% felt that investigations were costly and only 11% perceived the problem as a lack of referral for specialist opinion. Majority of respondents recognized the risk factors for OP such as increasing age (93%), post menopausal state (90%), positive family history (70%) and a previous low trauma fracture (65%). 7% were not sure how to further investigate a case of OP. For all categories of bone density, under 50% would advise changes in life-style measures. For osteopenia, 65.7% recommended calcium, 54.5% activated vitamin D products. For OP, 79.1% would use bisphosphonates, 50% calcium. In established OP, 80.6% would use bisphosphonates, 44% calcium. Usage of HRT and SERMs ranged between 20% and 30% in all categories. 63% were aware of the Malaysian Clinical Practice Guidelines on Osteoporosis. 22% would not refer to a specialist, whereas 50.4% would refer severe cases only. Almost all (98%) requested for further continuing medical education on OP.
    Conclusions: In this study, the majority of primary care physicians had a reasonable working knowledge of the management of OP. However, 71% had no access to DXA. Therefore, awareness needs to be supplemented by adequate facilities to further improve the management of OP in the community.
    Matched MeSH terms: General Practitioners
  3. Schottenfeld RS, Chawarski MC, Mazlan M
    Addiction, 2021 08;116(8):2135-2149.
    PMID: 33404150 DOI: 10.1111/add.15399
    BACKGROUND AND AIM: To address the widespread severe problems with opioid use disorder, buprenorphine-naloxone treatment provided by primary care physicians has greatly expanded treatment access; however, treatment is often provided with minimal or no behavioral interventions. Whether or which behavioral interventions are feasible to implement in various settings and improve treatment outcomes has not been established. This study aimed to evaluate two behavioral interventions to improve buprenorphine-naloxone treatment.

    DESIGN: A 2 × 2 factorial, repeated-measures, open-label, randomized clinical trial.

    SETTINGS: General medical practice offices in Muar, Malaysia.

    PARTICIPANTS: Opioid-dependent individuals (n = 234).

    INTERVENTIONS: Participants were randomly assigned to one of four treatment conditions and received study interventions for 24 weeks: (1) physician management with or without behavioral counseling and (2) physician management with or without abstinence-contingent buprenorphine-naloxone (ACB) take-home doses.

    MEASUREMENTS: The primary outcomes were proportions of opioid-negative urine tests and HIV risk behaviors [assessed by audio computer-assisted AIDS risk inventory (ACASI-ARI)].

    FINDINGS: The rates of opioid-negative urine tests over 24 weeks of treatment were significantly higher with [68.2%, 95% confidence interval (CI) = 65-71] than without behavioral counseling (59.2%, 95% CI = 56-62, P 

    Matched MeSH terms: General Practitioners*
  4. Tan NC, Ng CJ, Rosemary M, Wahid K, Goh LG
    Asia Pac Fam Med, 2014;13(1):17.
    PMID: 25606021 DOI: 10.1186/s12930-014-0017-9
    Primary care research is at a crossroad in South Pacific. A steering committee comprising a member of WONCA Asia Pacific Regional (APR) council and the President of Fiji College of General Practitioners garnered sponsorship from Fiji Ministry of Health, WONCA APR and pharmaceutical agencies to organize the event in October 2013. This paper describes the processes needed to set up a national primary research agenda through the collaborative efforts of local stakeholders and external facilitators using a test case in South Pacific.
    Matched MeSH terms: General Practitioners
  5. Teng CL, Leong KC, Aljunid SM, Cheah M
    Asia Pac Fam Med, 2004;3(1&2):38-45.
    Aims. To document the antibiotic prescribing rate for upper respiratory tract infections (URTI) in general practice and its associated factors. Methods. Data extracted from a morbidity survey of 150 general practice clinics in three urban areas in Malaysia. Participating general practitioners recorded demographic, morbidity and process of care data for 30 consecutive adult patients using a structured form. [year of study=1999] Results. URTI contributed 940 (27.0%) of the total of 3481 encounters recorded. Antibiotic was prescribed in 68.4% of encounters with URTI; a significant proportion of the antibiotic choice was inappropriate. Half the antibiotics prescribed in this study were due to URTI. [overall antibiotic prescribing rate for all encounters=33.4%] Conclusions. General practitioners need to re-examine their own prescribing for URTI and decide whether it is consistent with current guidelines. Rational prescribing is not just part of the professional role of doctors, but will go a long way to impede the emergence of antibiotic resistance.
    Matched MeSH terms: General Practitioners
  6. Azhar N, Doss JG
    Asian Pac J Cancer Prev, 2018 Oct 26;19(10):2935-2941.
    PMID: 30362327
    Background: The aim of this study was to explore reasons for delayed health-seeking for late stage oral cancer
    patients. Methods: Semi-structured in-depth interviews were conducted with 35 oral cancer patients with TNM stage
    III to IV disease, who were treated at six tertiary regional centres managing oral cancer throughout Malaysia. Interviews
    were audio-recorded, transcribed verbatim, coded using NVivo (version 10.0) qualitative software and analysed
    using framework analysis. Results: Participants interpreted their early symptoms as a minor condition and did not
    consider it as requiring immediate attention. Four types of coping strategies causing delayed help-seeking emerged:
    1) self-remedy 2) self-medication 3) seeking traditional healers and 4) consulting general medical practitioners (GPs)
    instead of dentists. Socio-economic factors, cultural beliefs and religious practices have some influence on diagnostic
    delay. Conclusion: Low levels of public knowledge and awareness regarding early signs and symptoms of oral cancer
    as well as GPs’ misdiagnosis of early lesions results in delayed diagnosis.
    Matched MeSH terms: General Practitioners
  7. Low WY, Ng CJ, Tan NC, Choo WY, Tan HM
    Asian J Androl, 2004 Jun;6(2):99-104.
    PMID: 15154082
    Aim: To explore the barriers faced by general practitioners (GPs) in the management of patients with erectile dysfunction (ED).
    Methods: This was a qualitative analysis of focus group discussions and in-depth interviews involving 28 Malaysian GPs.
    Results: GPs' perception of ED being not a serious condition was a major determinant of their prescribing practice. Doctor's age (younger), gender (female), short consultation time and lack of experience were cited as barriers. The GPs' prescribing habits were heavily influenced by the feedback from the first few patients under treatment, the uncertainty of etiology of ED without proper assessment and the profit margin with bulk purchase. Other barriers include Patients' coexisting medical conditions, older age, lower socio-economic status, unrealistic expectations and inappropriate use of the anti-impotent drugs. Cardiovascular side effects and cost were two most important drug barriers.
    Conclusion: The factors influencing the management of ED among the general practitioners were multiple and complex. An adequate understanding of how these factors (doctors, patients and drugs) interact can assist in the formulation and implementation of strategies that encourage GPs to identify and manage ED patients.
    Matched MeSH terms: General Practitioners
  8. Ho KC, Russell V, Nyanti L, Chan MW, Hassali MA, Dawood OT, et al.
    Asian J Psychiatr, 2020 Feb;48:101899.
    PMID: 31901584 DOI: 10.1016/j.ajp.2019.101899
    INTRODUCTION: Most primary care in Malaysia is provided by general practitioners in private practice. To date, little is known about how Malaysian General Practitioners (GPs) manage patients with depression. We surveyed privately practising primary care physicians in the state of Penang, Malaysia, in relation to their experience of the Malaysian Clinical Practice Guideline (CPG) in Major Depressive Disorder, their current practice and perceived barriers in managing depression effectively.

    MATERIAL AND METHODS: A questionnaire based on the study aims and previous literature was developed by the authors and mailed to all currently registered GPs in private clinics in Penang. Survey responses were analysed using SSPS version 21.

    RESULTS: From a total of 386 questionnaires distributed, 112 (29%) were returned. Half of the respondents were unaware of the existence of any CPG for depression. One quarter reported not managing depression at all, while one third used anxiolytic monotherapy in moderate-severe depression. Almost 75 % of respondents reported making referrals to specialist psychiatric services for moderate-severe depression. Time constraints, patient non-adherence and a lack of depression management skills were perceived as the main barriers to depression care.

    CONCLUSIONS: Our findings highlight the need to engage privately practising primary care physicians in Malaysia to improve their skills in the management of depression. Future revisions of the Malaysian Depression CPG should directly involve more GPs from private practices at the planning, development and implementation stages, in order to increase its impact.

    Matched MeSH terms: General Practitioners/statistics & numerical data*
  9. Javed A, Lee C, Zakaria H, Buenaventura RD, Cetkovich-Bakmas M, Duailibi K, et al.
    Asian J Psychiatr, 2021 Apr;58:102601.
    PMID: 33611083 DOI: 10.1016/j.ajp.2021.102601
    Mental health disorders are a burgeoning global public health challenge, and disproportionately affect the poor. Low- and middle-income countries (LMICs) bear 80 % of the mental health disease burden. Stigma associated with mental health results in delayed help seeking, reduced access to health services, suboptimal treatment, poor outcomes and an increased risk of individuals' human rights violations. Moreover, widespread co-occurrence of physical comorbidities such as noncommunicable diseases with mental health disorders makes the treatment of both conditions challenging and worsens prognosis. This paper explores various aspects of stigma towards mental health with a focus on LMICs and assesses measures to increase help-seeking and access to and uptake of mental health services. Stigma impacts persons living with mental illness, their families and caregivers and healthcare professionals (mental health professionals, non-psychiatric specialists and general practitioners) imparting mental health care. Cultural, socio-economic and religious factors determine various aspects of mental health in LMICs, ranging from perceptions of health and illness, health seeking behavior, attitudes of the individuals and health practitioners and mental health systems. Addressing stigma requires comprehensive and inclusive mental health policies and legislations; sustainable and culturally-adapted awareness programs; capacity building of mental health workforce through task-shifting and interprofessional approaches; and improved access to mental health services by integration with primary healthcare and utilizing existing pathways of care. Future strategies targeting stigma reduction must consider the enormous physical comorbidity burden associated with mental health, prioritize workplace interventions and importantly, address the deterioration of population mental health from the COVID-19 pandemic.
    Matched MeSH terms: General Practitioners
  10. Thuraisingham C, Nalliah S
    Aust Fam Physician, 2013 Apr;42(4):249-51.
    PMID: 23550254
    In many workplaces, employment is conditional on a successful pre-employment medical examination. This examination is usually conducted by a general practitioner on the employers' panel of approved clinics or by an in-house company doctor.
    Matched MeSH terms: General Practitioners/ethics*
  11. Alzahrani AS, Greenfield SM, Shrestha S, Paudyal V
    BMC Complement Med Ther, 2024 Feb 09;24(1):81.
    PMID: 38336657 DOI: 10.1186/s12906-024-04385-6
    BACKGROUND: Recent estimates indicate that a significant proportion of diabetic patients globally, up to 51%, are utilizing complementary and alternative medicine (CAM). To improve patient-provider communication and optimize prescribed treatments, healthcare professionals (HCPs) must understand the factors associated with CAM use among diabetic patients. There is a dearth of literature on HCPs perspectives on CAM use by diabetic patients. This study explored HCPs knowledge, perspective, and views on their diabetic patients' use of CAM.

    METHODS: Qualitative study using one-to-one semi-structured interviews conducted with 22 HCPs involved in the care of diabetic patients (6 endocrinologists, 4 general practitioners, 4 nurses and 8 pharmacists). Participants were recruited through general practices, community pharmacies and a diabetic centre in Saudi Arabia. Data were analyzed using thematic analysis.

    RESULTS: Five key themes resulted from the analysis. HCPs generally demonstrated negative perceptions toward CAM, particularly regarding their evidence-based effectiveness and safety. Participants described having limited interactions with diabetic patients regarding CAM use due to HCPs' lack of knowledge about CAM, limited consultation time and strict consultation protocols. Participants perceived convenience as the reason why patients use CAM. They believed many users lacked patience with prescribed medications to deliver favourable clinical outcomes and resorted to CAM use.

    CONCLUSIONS: HCPs have noted inadequate engagement with diabetic patients regarding CAM due to a lack of knowledge and resources. To ensure the safe use of CAM in diabetes and optimize prescribed treatment outcomes, one must address the communication gap by implementing a flexible consultation protocol and duration. Additionally, culturally sensitive, and evidence-based information should be available to HCPs and diabetic patients.

    Matched MeSH terms: General Practitioners*
  12. Lim WY, Turner RM, Morton RL, Jenkins MC, Irwig L, Webster AC, et al.
    BMC Health Serv Res, 2018 06 20;18(1):477.
    PMID: 29925350 DOI: 10.1186/s12913-018-3291-7
    BACKGROUND: Patients may decide to undertake shared care with a general practitioner (GP) during follow-up after treatment for localised melanoma. Routine imaging tests for surveillance may be commonly used despite no evidence of clinical utility. This study describes the frequency of shared care and routine tests during follow-up after treatment for localised melanoma.

    METHODS: We randomly sampled 351 people with localised melanoma [American Joint Cancer Committee (AJCC) substages 0 - II] who had not had recurrent or new primary melanoma diagnosed from a total of 902 people diagnosed and treated for localised melanoma at a specialist centre in 2014. We interviewed participants by telephone about their experience of follow-up in the past year, and documented the proportion of patients who were undertaking shared care follow-up with a GP. We also recorded the frequency and type of investigations during follow-up. We calculated weighted estimates that are representative of the full inception cohort.

    RESULTS: Of the 351 people who were invited to participate, 230 (66%) people consented to the telephone interview. The majority undertook shared care follow-up with a GP (61%). People who choose to have shared care follow-up with a GP are more likely to be male (p = 0.006), have lower AJCC stage (p for trend = 0.02), reside in more remote areas (p for trend

    Matched MeSH terms: General Practitioners
  13. Harapan H, Rajamoorthy Y, Utomo PS, Anwar S, Setiawan AM, Alleta A, et al.
    BMC Infect Dis, 2019 Aug 06;19(1):693.
    PMID: 31387537 DOI: 10.1186/s12879-019-4297-4
    BACKGROUND: The aim of this study was to assess the knowledge and attitudes towards pregnancy-related issues of Zika virus (ZIKV) infection among general practitioners (GPs), a frontline healthcare worker group, in Indonesia.

    METHODS: A cross-sectional, online survey assessing knowledge and attitudes towards ZIKV infection on multiple-item scales was sent to GPs in the Sumatra and Java islands of Indonesia. The associations between independent factors and either knowledge or attitude were assessed with logistic regressions. The correlation and association between knowledge and attitude were estimated.

    RESULTS: We included 457 (53.7%) out of 850 responses in the analysis. Among these, 304 (66.5%) and 111 (24.2%) respondents had a good knowledge and attitude, respectively. No demographic, workplace, professional development, or experiential characteristics related to ZIKV infection were associated with knowledge. In the multivariate analysis, only contact experience was associated with attitude. There was a significant, positive correlation between knowledge and attitude scores.

    CONCLUSIONS: Although knowledge of pregnancy-related complications of ZIKV infection is relatively high among GPs in Indonesia, more than 75% of them had a poor attitude towards pregnancy-related issues of Zika. Strategies for enhancing the capacity of GPs to develop positive attitudes and respond to ZIKV infection are needed.

    Matched MeSH terms: General Practitioners*
  14. Wattanapisit A, Teo CH, Wattanapisit S, Teoh E, Woo WJ, Ng CJ
    BMC Med Inform Decis Mak, 2020 01 06;20(1):5.
    PMID: 31906985 DOI: 10.1186/s12911-019-1016-4
    BACKGROUND: Mobile health applications (mHealth apps) are increasingly being used to perform tasks that are conventionally performed by general practitioners (GPs), such as those involved in promoting health, preventing disease, diagnosis, treatment, monitoring, and support for health services. This raises an important question: can mobile apps replace GPs? This study aimed to systematically search for and identify mobile apps that can perform GP tasks.

    METHODS: A scoping review was carried out. The Google Play Store and Apple App Store were searched for mobile apps, using search terms derived from the UK Royal College of General Practitioners (RCGP) guideline on GPs' core capabilities and competencies. A manual search was also performed to identify additional apps.

    RESULTS: The final analysis included 17 apps from the Google Play Store and Apple App Store, and 21 apps identified by the manual search. mHealth apps were found to have the potential to replace GPs for tasks such as recording medical history and making diagnoses; performing some physical examinations; supporting clinical decision making and management; assisting in urgent, long-term, and disease-specific care; and health promotion. In contrast, mHealth apps were unable to perform medical procedures, appropriately utilise other professionals, and coordinate a team-based approach.

    CONCLUSIONS: This scoping review highlights the functions of mHealth apps that can potentially replace GP tasks. Future research should focus on assessing the performance and quality of mHealth apps in comparison with that of real doctors.

    Matched MeSH terms: General Practitioners*
  15. Fletcher E, Burns A, Wiering B, Lavu D, Shephard E, Hamilton W, et al.
    BMC Prim Care, 2023 Jan 20;24(1):23.
    PMID: 36670354 DOI: 10.1186/s12875-023-01973-2
    BACKGROUND: Electronic clinical decision support tools (eCDS) are increasingly available to assist General Practitioners (GP) with the diagnosis and management of a range of health conditions. It is unclear whether the use of eCDS tools has an impact on GP workload. This scoping review aimed to identify the available evidence on the use of eCDS tools by health professionals in general practice in relation to their impact on workload and workflow.

    METHODS: A scoping review was carried out using the Arksey and O'Malley methodological framework. The search strategy was developed iteratively, with three main aspects: general practice/primary care contexts, risk assessment/decision support tools, and workload-related factors. Three databases were searched in 2019, and updated in 2021, covering articles published since 2009: Medline (Ovid), HMIC (Ovid) and Web of Science (TR). Double screening was completed by two reviewers, and data extracted from included articles were analysed.

    RESULTS: The search resulted in 5,594 references, leading to 95 full articles, referring to 87 studies, after screening. Of these, 36 studies were based in the USA, 21 in the UK and 11 in Australia. A further 18 originated from Canada or Europe, with the remaining studies conducted in New Zealand, South Africa and Malaysia. Studies examined the use of eCDS tools and reported some findings related to their impact on workload, including on consultation duration. Most studies were qualitative and exploratory in nature, reporting health professionals' subjective perceptions of consultation duration as opposed to objectively-measured time spent using tools or consultation durations. Other workload-related findings included impacts on cognitive workload, "workflow" and dialogue with patients, and clinicians' experience of "alert fatigue".

    CONCLUSIONS: The published literature on the impact of eCDS tools in general practice showed that limited efforts have focused on investigating the impact of such tools on workload and workflow. To gain an understanding of this area, further research, including quantitative measurement of consultation durations, would be useful to inform the future design and implementation of eCDS tools.

    Matched MeSH terms: General Practitioners*
  16. Othman N, Vitry AI, Roughead EE, Ismail SB, Omar K
    BMC Public Health, 2010;10:743.
    PMID: 21118551 DOI: 10.1186/1471-2458-10-743
    BACKGROUND: Pharmaceutical representatives provide medicines information on their promoted products to doctors. However, studies have shown that the quality of this information is often low. No study has assessed the medicines information provided by pharmaceutical representatives to doctors in Malaysia and no recent evidence in Australia is present. We aimed to compare the provision of medicines information by pharmaceutical representatives to doctors in Australia and Malaysia.
    METHODS: Following a pharmaceutical representative's visit, general practitioners in Australia and Malaysia who had agreed to participate, were asked to fill out a questionnaire on the main product and claims discussed during the encounter. The questionnaire focused on provision of product information including indications, adverse effects, precautions, contraindications and the provision of information on the Pharmaceutical Benefit Scheme (PBS) listings and restrictions (in Australia only). Descriptive statistics were produced. Chi-square analysis and clustered linear regression were used to assess differences in Australia and Malaysia.
    RESULTS: Significantly more approved product information sheets were provided in Malaysia (78%) than in Australia (53%) (P < 0.001). In both countries, general practitioners reported that indications (Australia, 90%, Malaysia, 93%) and dosages (Australia, 76%, Malaysia, 82%) were frequently provided by pharmaceutical representatives. Contraindications, precautions, drug interactions and adverse effects were often omitted in the presentations (range 25% - 41%). General practitioners in Australia and Malaysia indicated that in more than 90% of presentations, pharmaceutical representatives partly or fully answered their questions on contraindications, precautions, drug interactions and adverse effects. More general practitioners in Malaysia (85%) than in Australia (60%) reported that pharmaceutical representatives should have mentioned contraindications, precautions for use, drug interaction or adverse effects spontaneously (P < 0.001). In 48% of the Australian presentations, general practitioners reported the pharmaceutical representatives failed to mention information on PBS listings to general practitioners.
    CONCLUSIONS: Information on indications and dosages were usually provided by pharmaceutical representatives in Australia and Malaysia. However, risk and harmful effects of medicines were often missing in their presentations. Effective control of medicines information provided by pharmaceutical representatives is needed.
    Matched MeSH terms: General Practitioners
  17. Tun Firzara AM, Ng CJ
    BMJ Open, 2016 Sep 29;6(9):e011467.
    PMID: 27687897 DOI: 10.1136/bmjopen-2016-011467
    OBJECTIVE: Screening for prostate cancer remains controversial. General practitioners (GPs) play an important role in assisting men to make an informed decision on prostate cancer screening. The aim of this study was to determine the knowledge and practice of prostate cancer screening among private GPs in Malaysia.
    DESIGN: A cross-sectional study.
    SETTING: Private general practices in Selangor, Malaysia.
    PARTICIPANTS: 311 randomly selected full-time private GPs were recruited between September 2013 and January 2014.
    OUTCOME MEASURES: Questionnaires were distributed to the GPs via postal mail and clinic visits. The main outcomes were: knowledge of prostate cancer risk factors and screening tests; GPs' prostate cancer screening practices; and factors influencing GPs' decision to screen for prostate cancer. Associations between covariates and propensity to screen for prostate cancer were determined using logistic regression.
    RESULTS: The response rate was 65%. The proportion of GPs who overestimated the positive predictive values of prostrate-specific antigen (PSA), digital rectal examination (DRE) and a combination of PSA and DRE was 63%, 57% and 64%, respectively. About 49.5% of the respondents would routinely screen asymptomatic men for prostate cancer; of them, 94.9% would use PSA to screen. Male GPs who would consider having a PSA test performed on themselves were six times more likely to screen asymptomatic men than GPs who would not have the test (OR=6.88, 95% CI 1.40 to 33.73), after adjusting for age and duration of practice.
    CONCLUSIONS: GPs overestimated the accuracy of PSA in prostate cancer screening. Their intention to screen for prostate cancer themselves predicted their propensity to screen their patients for prostate cancer. This finding highlights the potential of using a new approach to change GPs' screening practices via addressing GPs' own screening behaviour.
    KEYWORDS: PREVENTIVE MEDICINE; PRIMARY CARE
    Matched MeSH terms: General Practitioners
  18. Go, Zher Lin, Low, Qin Jian, Nurul Aisyah Abd Rahman, Ng, Ling Fong, Faizah Ahmad, Lau, Ngee Siang
    MyJurnal
    Prurigo nodularis (PN) is an uncommon skin condition known to be associated with underlying systemic diseases. This case report is about PN secondary to underlying Hodgkin’s lymphoma. A 30-year-old man presented with this skin condition three months before lymphadenopathy and systemic symptoms due to lymphoma. He had made multiple visits to general practitioners for the disturbing rash, given multiple courses of topical treatment without relief. His PN showed marked improvement after initiation of chemotherapy. This case reminds that an unexplained skin condition should prompt clinicians for investigating for an underlying systemic disease. This case, to our knowledge, is the first Hodgkin’s lymphoma-associated prurigo nodularis reported in Malaysia.
    Matched MeSH terms: General Practitioners
  19. Musiun, Aldrin Alexander
    MyJurnal
    Infectious disease remains a public health concern in Malaysia. Efficient public health infectious disease surveillance is needed in order to address the issues posed by infectious disease. The main goal of public health infectious disease surveillance is to facilitate the control and prevention of the infectious diseases. For that, infectious disease surveillance needs involvement of multidiscipline either in government or non-government/private to ensure its success. General practitioners (GPs) have an important role in public health infectious disease surveillance considering their role and position as one of the main front liner medical personnel.
    Matched MeSH terms: General Practitioners
  20. Recto MT, Gabriel MT, Kulthanan K, Tantilipikorn P, Aw DC, Lee TH, et al.
    Clin Mol Allergy, 2017;15:19.
    PMID: 29118675 DOI: 10.1186/s12948-017-0074-3
    Background: Allergic diseases are on the rise in many parts of the world, including the Asia-Pacific (APAC) region. Second-generation antihistamines are the first-line treatment option in the management of allergic rhinitis and urticaria. International guidelines describe the management of these conditions; however, clinicians perceive the additional need to tailor treatment according to patient profiles. This study serves as a consensus of experts from several countries in APAC (Hong Kong, Malaysia, the Philippines, Singapore, Thailand, Vietnam), which aims to describe the unmet needs, practical considerations, challenges, and key decision factors when determining optimal second-generation antihistamines for patients with allergic rhinitis and/or urticaria.

    Methods: Specialists from allergology, dermatology, and otorhinolaryngology were surveyed on practical considerations and key decision points when treating patients with allergic rhinitis and/or urticaria.

    Results: Clinicians felt the need for additional tools for diagnosis of these diseases and a single drug with all preferred features of an antihistamine. Challenges in treatment include lack of clinician and patient awareness and compliance, financial constraints, and treatment for special patient populations such as those with concomitant disease. Selection of optimal second-generation antihistamines depends on many factors, particularly drug safety and efficacy, impact on psychomotor abilities, and sedation. Country-specific considerations include drug availability and cost-effectiveness. Survey results reveal bilastine as a preferred choice due to its high efficacy and safety, suitability for special patient populations, and the lack of sedative effects.

    Conclusions: Compliance to the international guidelines is present among allergists, dermatologists and otorhinolaryngologists; however, this is lower amongst general practitioners (GPs). To increase awareness, allergy education programs targeted at GPs and patients may be beneficial. Updates to the existing international guidelines are suggested in APAC to reflect appropriate management for different patient profiles and varying symptoms of allergic rhinitis and urticaria.

    Matched MeSH terms: General Practitioners
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