Displaying publications 1 - 20 of 576 in total

  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: Primary Health Care
  2. Davatchi F
    DOI: 10.1111/j.1479-8077.2006.00177.x
    Matched MeSH terms: Primary Health Care
  3. Hatta Sidi, Marhani Midin, Sharifah Ezat Wan Puteh, Norni Abdullah
    ASEAN Journal of Psychiatry, 2007;8(2):97-105.
    Objective: To investigate the prevalence of genital arousal disorder and the potential risk
    factors that may impair genital arousal among women at a primary care setting in Malaysia.
    Methods: A validated questionnaire for sexual function was used to assess genital arousal
    function. A total of 230 married women aged 18–70 years old participated in this study. Their sociodemographic and marital profiles were compared between those who had genital arousal disorder and those who did not. The risk factors were examined. Results: The prevalence of genital arousal disorder in the primary care population was 50.4% (116/230). Women with genital arousal disorder were found to be significantly higher in groups of more than 45 years old (p55) (p=.001), those having 4 children or more (p=.028), those having less sexual intercourse (less than 1–2 times a week) (p=.001), and those at post-menopausal state (p=.002). There was no significant difference between these two groups in term of salary (p=.29), suffering from medical problems (p=.32), dysmenorrhea (p=.95), menarche (p=.5) and hormonal replacement therapy (p=.6). Conclusion: Women with infrequent sexual intercourse are less likely to be sexually aroused (OR=0.29, 95% CI: 0.11-0.74).
    Matched MeSH terms: Primary Health Care
  4. Zakaria N, Baharudin A, Razali R
    ASEAN Journal of Psychiatry, 2009;10(2):89-99.
    Objective: To study the effect of depressive disorders, severity of depression and, sociodemographic factors on drug compliance among hypertensive patients at primary care clinics. Methods: A total of 201 hypertensive patients on treatment for at least 3 months who attended the HUKM Primary Care Clinic and Salak Polyclinic were selected for this study. Patients were screened for depressive disorders using the Hospital Anxiety Depression Scale (HADS) and those who scored 8 and more were further interviewed to establish a diagnosis using the Mini International Neuropsychiatric Interview (MINI). Patients who were diagnosed to have depressive disorders were further rated for the severity of the illness by using Hamilton Rating Scale for Depression (HAMD). Drug compliance was assessed during a 2 month follow up using the pill counting method (ratio 0.8 – 1.2 considered as compliant). Results: The prevalence of non-compliance among hypertensive patients was 38.3%. There was no association between the diagnosis of depressive disorders and drug compliance. Among the 12 patients who had depressive disorders, severity of depression as rated by HAMD, showed significant association with drug compliance (Mann-Whitney test z = -2.083, p
    Matched MeSH terms: Primary Health Care
  5. Nik Jaafar NR, Midin M, Wan Puteh SE, Musa R
    ASEAN Journal of Psychiatry, 2009;10(1):43-53.
    Objective: To investigate the correlation between sexual desire and sexual arousal among Malaysian women in a primary care setting. Methods: The Malay Version of Female Sexual Function Index (MVFSI) was used to assess low sexual desire and lack of sexual arousal among the respondents. A total of 230 married women aged 18 – 70 years old participated in this study. Their sociodemographic, marital profiles and correlation between low sexual desire and lack of sexual arousal were examined. Results: More than 60% respondents with low sexual desire have co-exist low sexual arousal and 94.4% respondents with high sexual desire do have high sexual arousal ( χ²= 79.6, p
    Matched MeSH terms: Primary Health Care
  6. Mukhtar F, Abu Bakar AK, Mat Junus M, Awaludin A, Abdul Aziz S, Midin M, et al.
    ASEAN Journal of Psychiatry, 2012;13(2):157-164.
    Objective: The MINI International Neuropsychiatric Interview (MINI) is a short, structured diagnostic interview compatible with the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). It was designed for clinical practice, research in psychiatric, primary care settings and epidemiological surveys. This preliminary study aims to evaluate the reliability and validity of the Malaysian Version of MINI for Major Depressive Disorder and Generalized Anxiety Disorder symptoms criteria only.

    Methods: Six hours of MINI training was given as part of a National Health Morbidity Survey training program for layman interviewers (n=229) and three videos were prepared by an expert psychiatrist for inter-rater reliability purposes. Meanwhile, for validity purposes, the MINI was administered to patients with Major Depressive Disorder (n=30), Generalized Anxiety Disorder (n=20) and to a normal population (n=60), to conform against the Diagnostic and Statistical Manual of Mental Disorder (DSM-IV) that was administered by psychiatrists.

    Results: Overall the inter-rater reliability was satisfactory (0.67 to 0.85) and the concordance between the MINI’s and expert diagnoses was good, with kappa values of greater than 0.88.

    Conclusions: The Malay version of the MINI is adjusted to the clinical setting and for the assessment of positive cases in a community setting. Modifications were highlighted to correct any identified problems and to improve the reliability of the MINI for future research and clinical use.
    Matched MeSH terms: Primary Health Care
  7. Russell V, Clarke M, Loo CE, Bharathy A, Vasudevan U, Byrne E, et al.
    Acad Psychiatry, 2019 Apr;43(2):157-166.
    PMID: 30069698 DOI: 10.1007/s40596-018-0960-0
    OBJECTIVE: The study's objective was to determine the educational value of participation in a consultation/liaison psychiatry service to primary care clinics, from the perspective of Malaysian medical undergraduates.

    METHODS: A mixed method design was used. Fourth-year medical students participated in a consultation/liaison psychiatry service to two government-operated primary care clinics. Each student attended two half-day consultations to the clinics during the psychiatry clinical clerkship. Students joined in discussions with primary care clinicians, performed supervised clinical assessments, and administered a depression screening instrument. The learning experience was evaluated through four focus groups, each with 9-10 participants, held throughout the academic year. An end-of-year, anonymous, online questionnaire survey was administered to the entire class. Thematic analysis of focus group transcripts was performed and quantitative statistics were calculated (Stata version 13).

    RESULTS: Focus group themes included the following: (a) active learning opportunities in primary care psychiatry consultation had perceived added educational value, (b) students benefited from contact with patients with previously undiagnosed common mental disorders, and (c) students' primary care experience raised their awareness of societal and professional responsibilities. Of the class of 113 students, 93 (82%) responded to the questionnaire. The survey responses reflected the qualitative themes, with 79 respondents (85%) stating that the learning experience met or exceeded their expectations.

    CONCLUSIONS: Academic psychiatry has been criticized for its overreliance on secondary care settings in undergraduate clinical teaching. Our findings suggest that supervised clinical placements in primary care are feasible and provide added educational value as a routine component of the undergraduate psychiatry clinical clerkship.

    Matched MeSH terms: Primary Health Care*
  8. Cheung TK, Lim PW, Wong BC
    Aliment Pharmacol Ther, 2007 Aug 15;26(4):597-603.
    PMID: 17661763 DOI: 10.1111/j.1365-2036.2007.03403.x
    BACKGROUND: Non-cardiac chest pain is an important disorder in Asia. The practice and views of gastroenterologists on non-cardiac chest pain in this region are not known.
    AIMS: To determine the current understanding, diagnostic practice and treatment strategies among gastroenterologists on the management of non-cardiac chest pain in Asia.
    METHODS: A 24-item questionnaire was sent to gastroenterologists in Mainland China, Hong Kong, Malaysia, Indonesia, Philippines, Singapore, Taiwan and Thailand.
    RESULTS: 186 gastroenterologists participated with a response rate of 74%. 98% of gastroenterologists managed patients with non-cardiac chest pain over the last 6 months. 64% felt that the number of non-cardiac chest pain patients was increasing and 85% believed that the most common cause of non-cardiac chest pain was GERD. 94% of the gastroenterologists believed that they should manage non-cardiac chest pain patients, but only 41% were comfortable in diagnosing non-cardiac chest pain. The average number of investigations performed was four in non-cardiac chest pain patients, and oesophago-gastro-duodenoscopy was the most commonly used initial test. A proton pump inhibitor was considered the first-line treatment in non-cardiac chest pain and was reported as the most effective treatment by the gastroenterologists.
    CONCLUSION: Most gastroenterologists were practicing evidence-based medicine, but frequent use of investigations and a lack of awareness of the role of visceral hypersensitivity in non-cardiac chest pain patients were noted.
    Matched MeSH terms: Primary Health Care
  9. Nurul Farahah Bahari, Nur Iffah Izzaty Jamal, John, Jacob
    Ann Dent, 2019;26(1):8-14.
    This cross sectional study investigated the clinical and radiographic status of crowned teeth with and without root canal treatment. The study used secondary data from records of patients who received crown treatment at the Faculty of Dentistry, University of Malaya before 2015 and walk-in patients attending the primary care clinic between July - December 2016. The inclusion criterion was crown fitted for more than 12 months. Once identified, the patients were assessed for clinical and radiographic status. Data were entered into and analysed using SPSS Version 20 software. A total of 66 crowns [35 root canal treated (RCT) and 31 non-root canal treated (n-RCT)] were identified. Chi-square test was carried out to determine the health of crowned teeth and for its longevity in the oral cavity. There were 43 crowns (46.5% RCT; 53.5% n-RCT) with plaque accumulation, 15 (66.7% RCT; 33.3% n-RCT) with gingival swelling/recession, 17 (46.5% RCT; 53.5% n-RCT) with widening of the periodontal ligament, 13 (53.8% RCT; 46.2% n-RCT) with bone loss and 5 (60% RCT; 40% n-RCT) crowns with periapical lesion. There was no statistically significant difference except for poorer alveolar bone condition for crowns that have been in the mouth for >10 years. Based on the study, no significant adverse pulpal involvement between crown with RCT and crown without RCT was observed.
    Matched MeSH terms: Primary Health Care
  10. Cahir C, Wallace E, Cummins A, Teljeur C, Byrne C, Bennett K, et al.
    Ann Fam Med, 2019 Mar;17(2):133-140.
    PMID: 30858256 DOI: 10.1370/afm.2359
    PURPOSE: To evaluate a patient-report instrument for identifying adverse drug events (ADEs) in older populations with multimorbidity in the community setting.

    METHODS: This was a retrospective cohort study of 859 community-dwelling patients aged ≥70 years treated at 15 primary care practices. Patients were asked if they had experienced any of a list of 74 symptoms classified by physiologic system in the previous 6 months and if (1) they believed the symptom to be related to their medication, (2) the symptom had bothered them, (3) they had discussed it with their family physician, and (4) they required hospital care due to the symptom. Self-reported symptoms were independently reviewed by 2 clinicians who determined the likelihood that the symptom was an ADE. Family physician medical records were also reviewed for any report of an ADE.

    RESULTS: The ADE instrument had an accuracy of 75% (95% CI, 77%-79%), a sensitivity of 29% (95% CI, 27%-31%), and a specificity of 93% (95% CI, 92%-94%). Older people who reported a symptom had an increased likelihood of an ADE (positive likelihood ratio [LR+]: 4.22; 95% CI, 3.78-4.72). Antithrombotic agents were the drugs most commonly associated with ADEs. Patients were most bothered by muscle pain or weakness (75%), dizziness or lightheadedness (61%), cough (53%), and unsteadiness while standing (52%). On average, patients reported 39% of ADEs to their physician. Twenty-six (3%) patients attended a hospital outpatient clinic, and 32 (4%) attended an emergency department due to ADEs.

    CONCLUSION: Older community-dwelling patients were often not correct in recognizing ADEs. The ADE instrument demonstrated good predictive value and could be used to differentiate between symptoms of ADEs and chronic disease in the community setting.

    Matched MeSH terms: Primary Health Care
  11. Hussein Z, Taher SW, Gilcharan Singh HK, Chee Siew Swee W
    Ann Glob Health, 2016 4 25;81(6):851-62.
    PMID: 27108152 DOI: 10.1016/j.aogh.2015.12.016
    BACKGROUND: Diabetes is a major public health concern in Malaysia, and the prevalence of type 2 diabetes (T2D) has escalated to 20.8% in adults above the age of 30, affecting 2.8 million individuals. The burden of managing diabetes falls on primary and tertiary health care providers operating in various settings.

    OBJECTIVES: This review focuses on the current status of diabetes in Malaysia, including epidemiology, complications, lifestyle, and pharmacologic treatments, as well as the use of technologies in its management and the adoption of the World Health Organization chronic care model in primary care clinics.

    METHODS: A narrative review based on local available health care data, publications, and observations from clinic experience.

    FINDINGS: The prevalence of diabetes varies among the major ethnic groups in Malaysia, with Asian Indians having the highest prevalence of T2D, followed by Malays and Chinese. The increase prevalence of overweight and obesity has accompanied the rise in T2D. Multidisciplinary care is available in tertiary and primary care settings with integration of pharmacotherapy, diet, and lifestyle changes. Poor dietary adherence, high consumption of carbohydrates, and sedentary lifestyle are prevalent in patients with T2D. The latest medication options are available with increasing use of intensive insulin regimens, insulin pumps, and continuous glucose monitoring systems for managing glycemic control. A stepwise approach is proposed to expand the chronic care model into an Innovative Care for Chronic Conditions framework to facilitate implementation and realize better outcomes in primary care settings.

    CONCLUSIONS: A comprehensive strategy and approach has been established by the Malaysian government to improve prevention, treatment, and control of diabetes as an urgent response to this growing chronic disease.

    Matched MeSH terms: Primary Health Care/methods*
  12. Wee HL, Loke WC, Li SC, Fong KY, Cheung YB, Machin D, et al.
    Ann Acad Med Singap, 2007 Jun;36(6):403-8.
    PMID: 17597964
    INTRODUCTION: The aims of this study were to cross-culturally adapt and evaluate the validity of the Singaporean Malay and Tamil versions of the EQ-5D.

    MATERIALS AND METHODS: The EQ- 5D was cross-culturally adapted and translated using an iterative process following standard guidelines. Consenting adult Malay- and Tamil-speaking subjects at a primary care facility in Singapore were interviewed using a questionnaire (including the EQ-5D, a single item assessing global health, the SF-8 and sociodemographic questions) in their respective language versions. Known-groups and convergent construct validity of the EQ-5D was investigated by testing 30 a priori hypotheses per language at attribute and overall levels.

    RESULTS: Complete data were obtained for 94 Malay and 78 Indian patients (median age, 54 years and 51 years, respectively). At the attribute level, all 16 hypotheses were fulfilled with several reaching statistical significance (Malay: 4; Tamil: 5). At the overall level, 42 of 44 hypotheses related to the EQ-5D/ EQ-VAS were fulfilled (Malay: 22; Tamil: 20), with 21 reaching statistical significance (Malay: 9; Tamil: 12).

    CONCLUSION: In this study among primary care patients, the Singapore Malay and Tamil EQ-5D demonstrated satisfactory known-groups and convergent validity.

    Matched MeSH terms: Primary Health Care
  13. Ray R, Lim LH, Ling SL
    Ann Acad Med Singap, 1994 May;23(3):335-41.
    PMID: 7944246
    The Programme on Prevention and Management of Obesity in Preschool Children, aged three to six years, was implemented in 17 Primary Health Clinics in November 1991. The study sample comprised 1128 preschool children who qualified to enter the obesity register, using the defined criteria for obesity of 2 standard deviations above the normal weight for height and age. This group was divided into three categories, namely, mildly overweight (120% to below 140%), moderately overweight (140% to below 160%), and severely overweight (above 160%). The severely overweight category was referred to dietitians for follow-up management, while the other two categories were managed by the clinic staff through pre-planned nurse-conducted counselling sessions. In this paper, we analysed the first 1128 preschool children aged three to six years on the Programme with respect to their demographic characteristics; medical conditions; family history of obesity, diabetes, hypertension and ischaemic heart disease; number of siblings and parents' educational and occupational status. The Malay children showed significantly more severe grades of obesity compared to the Chinese and Indian children. A family history of obesity and hypertension among the three groups were significant (P < 0.001). After one year of follow-up with the intervention programme, the following were found: 40.4% (456) of the children improved in their obesity status and 20.2% (228) reached normal status. The severe, moderate and mild categories reduced from 6.3% to 5.9%, 29.3% to 23.2% and 64.4% to 50.7% respectively and was found to be statistically significant (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
    Matched MeSH terms: Primary Health Care
  14. Parham S, Kharazi AZ, Bakhsheshi-Rad HR, Nur H, Ismail AF, Sharif S, et al.
    Antioxidants (Basel), 2020 Dec 21;9(12).
    PMID: 33371338 DOI: 10.3390/antiox9121309
    Recently, increasing public concern about hygiene has been driving many studies to investigate antimicrobial and antiviral agents. However, the use of any antimicrobial agents must be limited due to their possible toxic or harmful effects. In recent years, due to previous antibiotics' lesser side effects, the use of herbal materials instead of synthetic or chemical drugs is increasing. Herbal materials are found in medicines. Herbs can be used in the form of plant extracts or as their active components. Furthermore, most of the world's populations used herbal materials due to their strong antimicrobial properties and primary healthcare benefits. For example, herbs are an excellent material to replace nanosilver as an antibiotic and antiviral agent. The use of nanosilver involves an ROS-mediated mechanism that might lead to oxidative stress-related cancer, cytotoxicity, and heart diseases. Oxidative stress further leads to increased ROS production and also delays the cellular processes involved in wound healing. Therefore, existing antibiotic drugs can be replaced with biomaterials such as herbal medicine with high antimicrobial, antiviral, and antioxidant activity. This review paper highlights the antibacterial, antiviral, and radical scavenger (antioxidant) properties of herbal materials. Antimicrobial activity, radical scavenger ability, the potential for antimicrobial, antiviral, and anticancer agents, and efficacy in eliminating bacteria and viruses and scavenging free radicals in herbal materials are discussed in this review. The presented herbal antimicrobial agents in this review include clove, portulaca, tribulus, eryngium, cinnamon, turmeric, ginger, thyme, pennyroyal, mint, fennel, chamomile, burdock, eucalyptus, primrose, lemon balm, mallow, and garlic, which are all summarized.
    Matched MeSH terms: Primary Health Care
  15. 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: Primary Health Care
  16. Wan Puteh SE, Ahmad SNA, Aizuddin AN, Zainal R, Ismail R
    Asia Pac Fam Med, 2017;16:5.
    PMID: 28392749 DOI: 10.1186/s12930-017-0035-5
    BACKGROUND: Malaysia is an upper middle income country that provides subsidized healthcare to ensure universal coverage to its citizens. The challenge of escalating health care cost occurs in most countries, including Malaysia due to increase in disease prevalence, which induced an escalation in drug expenditure. In 2009, the Ministry of Health has allocated up to Malaysian Ringgit (MYR) 1.402 billion (approximately USD 390 million) on subsidised drugs. This study was conducted to measure patients' willingness to pay (WTP) for treatment of chronic condition or acute illnesses, in an urbanized population.
    METHODS: A cross-sectional study, through face-to-face interview was conducted in an urban state in 2012-2013. Systematic random sampling of 324 patients was selected from a list of patients attending ten public primary cares with Family Medicine Specialist service. Patients were asked using a bidding technique of maximum amount (in MYR) if they are WTP for chronic or acute illnesses.
    RESULTS: Patients are mostly young, female, of lower education and lower income. A total of 234 respondents (72.2%) were not willing to pay for drug charges. WTP for drugs either for chronic or acute illness were at low at median of MYR10 per visit (USD 3.8). Bivariate analysis showed that lower numbers of dependent children (≤3), higher personal and household income are associated with WTP. Multivariate analysis showed only number of dependent children (≤3) as significant (p = 0.009; 95% CI 1.27-5.44) predictor to drugs' WTP.
    CONCLUSION: The result indicates that primary care patients have low WTP for drugs, either for chronic condition or acute illness. Citizens are comfortable in the comfort zone whereby health services are highly subsidized through universal coverage. Hence, there is a resistance to pay for drugs.
    Matched MeSH terms: Primary Health Care
  17. Rajakumar MK
    Asia Pac Fam Med, 2003;2(1):8-9.
    Matched MeSH terms: Primary Health Care
  18. Mohd Sidik S, Mohd Zulkefli NA, Shah SA
    Asia Pac Fam Med, 2003;2(3):148-152.
    Aim: To identify the factors associated with depression among elderly patients attending a primary health care clinic in Malaysia. Methods: A cross sectional study was conducted on patients aged 60 years and above in Klinik Kesihatan Butterworth, Seberang Perai Utara, Pulau Pinang, Malaysia from April to September 1999. The Geriatric Depression Scale questionnaire was used as a screening instrument. Results: The response rate was 99.0%. A total of 18% of the patients were found to have depression. The associated factors were females (odds ratio (OR) = 2.87, 95% confidence interval (CI) = 1.37-6.02), those who were unmarried (OR = 3.46, 95% CI = 1.66-7.21), without formal education (OR = 8.0, 95% CI = 2.97-21.48), low total family income (OR = 7.97, 95% CI = 2.71-23.46) and urban residence (OR = 2.23, 95% CI = 1.09-4.58). Conclusion: Depression is very common among the elderly. As this is an important problem in primary care practice, primary care doctors should be aware of this problem so that early detection and management can be implemented., (C) 2003 Blackwell Science Ltd
    Matched MeSH terms: Primary Health Care
  19. Khoo SB
    Asia Pac Fam Med, 2003;2(3):143-147.
    The concept of palliative care is still quite new in Malaysia. Through the experience of delivering palliative care in both the hospital and community settings, the author has realized that there are many false beliefs among the medical and nursing professionals, as well as patients and their caregivers. By exploring and providing factual explanations to these beliefs, the present article highlights the differences in approach between acute and palliative management and the importance of good communication skills, as well as correcting the myths of patients and their caregivers, with the aim of improving the understanding of palliative care., (C) 2003 Blackwell Science Ltd
    Matched MeSH terms: Primary Health Care
  20. Bury G, Cullen W, Khoo SB
    Asia Pac Fam Med, 2003;2(4):200-205.
    Background: Penang Medical College is a joint Ireland-Malaysia project in which Malaysian students spend their initial 3 years in Ireland and complete their clinical training in Penang and receive Irish qualifications and registration. The educational foundations for such a program, particularly in general practice/primary care, are complex. Objectives: To explore the experiences of current students undertaking clinical training at Penang. Methods: All students were invited to complete an anonymous, confidential questionnaire dealing with foundation course availability and participation, the perceived value of such courses and suggestions for change. Results: Two thirds of all students responded. Attendance at foundation courses varied greatly as did the perceived value of such courses for clinical training. Early patient contact and communications skills courses scored most highly. More 'hands-on' clinical skills training was requested. No student raised ethical, legal or economic issues although these areas include very significant differences between the countries. Discussion: Educational bridges which link the learning and healthcare environments in which students work are crucial in this novel undergraduate setting. Conventional educational structures have value for students but access and relevance can be improved. Students are highly conscious of the differences between these environments but prize familiar themes such as clinical skills training over less tangible areas such as ethical or social structures.
    Matched MeSH terms: Primary Health Care
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