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  1. Fulltext A malignant looking unilateral enlarged tonsil with fungating surface is not always malignant: a case report
    A. B. M. Tofazzal Hossain, Shaila Kabir, Charissa Winston, Loo Yizhan, Sadia Choudhury Shimmi, M. Tanveer Hossain Parash, et al.
    Malaysian Journal of Medicine and Health Sciences, 2019;15(106):95-95.
    MyJurnal
    Introduction:A unilateral enlarged tonsil always is a suspicion of carcinoma. Especially if it is with fungating ulcer-ative surface. Neoplasms in unilaterally enlarged tonsil include squamous cell carcinomas and lymphomas. Lym-phomas in oropharynx are not common specially with fungating surface. Usually lymphomas in these areas are Non-Hodgkin’s type. Case description: A 62-year-old woman was admitted in the tertiary level hospital of Kota Kinabalu, Sabah, with the complaint of sore throat, odynophagia and right neck swelling. She was treated as a case of acute tonsillitis by general practitioner without any noticeable improvement. Oral cavity examination revealed a hugely enlarged right tonsil with fungating ulcerative surface and almost obstructing the oropharynx. Trismus was seen which make the examination difficult. A non-tender right upper neck swelling was palpable. All baseline lab-oratory investigations were normal. A contrast-enhanced computed tomography (CECT) showed a heterogeneously enhancing mass at oropharynx compromising the airway, right supraclavicular lymphadenopathy. Histology of biop-sy from right tonsillar mass showed High grade B-cell lymphoma. Chemotherapy was planned. First cycle of chemo-therapy was administered, Patient was discharged home with the complete plan of chemotherapy. Conclusion: This patient was clinically suspicious of carcinoma of palatine tonsil. But later proven as high grade B-cell lymphoma. All unilateral enlarged tonsils are not always carcinoma.
    Matched MeSH terms: General Practitioners
  2. Fulltext Primary care management of allergic rhinitis: a cross-sectional study in four ASEAN countries
    Abdullah B, Snidvongs K, Recto M, Poerbonegoro NL, Wang Y
    Multidiscip Respir Med, 2020 Jan 28;15(1):726.
    PMID: 33376593 DOI: 10.4081/mrm.2020.726
    Background: In primary care, general practitioners (GPs) and pharmacists are tasked with the frontline responsibility of identifying and managing allergic rhinitis (AR) patients. There are currently no consolidated data on current treatment practices, patient compliance, and usage of guidelines within Southeast Asian Nations (ASEAN). Objective: To assess the attitudes and practices on AR of GPs and pharmacists in 4 ASEAN countries (Philippines, Indonesia, Thailand, and Malaysia).

    Methods: A cross-sectional survey of 329 GPs and 548 pharmacists was conducted from May to November 2019. Participants answered a questionnaire focused on their i) current practice in the management of AR, ii) views on patient compliance, iii) understanding and usage of guidelines.

    Results: Clinical history was the most preferred method to diagnose AR by 95.4% of GPs and 58.8% of pharmacists. Second-generation antihistamines were the most widely available treatment option in GP clinics and pharmacies (94.8% and 97.2%) and correspondingly the most preferred treatment for both mild (90.3%, 76.8%) to moderatesevere rhinitis (90.3%, 78.6%) by GPs and pharmacists, respectively. Loratadine was ranked as the most preferred 2nd generation antihistamines (GP vs pharmacists: 55.3% vs 58.9%). More than 90% of GPs and pharmacists ranked length and efficacy of treatment as important factors that increase patient compliance. Awareness of the ARIA guidelines was high among GPs (80%) and lower among pharmacists (48.4%). However, only 63.3% of GPs and 48.2% of pharmacists knew how to identify AR patients.

    Conclusions: The survey in the 4 ASEAN countries has identified a need to strengthen the awareness and use of ARIA guidelines among the primary care practitioners. Adherence to ARIA guidelines, choosing the appropriate treatment option and prioritizing factors that increases patient compliance may contribute to better management outcomes of AR at the primary care practice.

    Matched MeSH terms: General Practitioners
  3. Fulltext Professional training and roles of community pharmacists in Malaysia: views from general medical practitioners
    Ahmad Hassali MA, Awaisu A, Shafie AA, Saeed MS
    Malays Fam Physician, 2009;4(2-3):71-6.
    PMID: 25606167 MyJurnal
    AIM: This pilot study aimed to explore the perceptions of general medical practitioners (GPs) towards the professional training and roles of community pharmacists.
    METHODS: A self-administered questionnaire was distributed to all private clinics (n=160) run by GPs in a northern state of Malaysia. The instrument contained questions to evaluate the practitioners' level of agreement using a 5-point Likert-type scale.
    RESULTS: Of 160 GPs, 80 returned the questionnaire (response rate 50%). The respondents agreed that: GPs should consider the community pharmacists' recommendations whenever there is/are any problem(s) with the prescriptions given by them (46.3%); community pharmacists are the best healthcare professionals to educate patients about safe and appropriate use of medications (52.5%); the pharmacy profession had undergone a major metamorphosis from a product-oriented profession to a more patient-centred and outcome-oriented one (61.3%); if dispensing separation is implemented, they will work closely with the community pharmacists in monitoring patients' pharmacotherapeutic outcomes (77.5%).
    CONCLUSION: The current findings suggest that GPs would support an extension of the role of the community pharmacists in number of activities of patient care activities such as medication counselling. Thus, suggesting potential collaborative care between GPs and community pharmacists towards patient care and the needs to develop and incorporate topics on inter-professional relationship in the current medical and pharmaceutical education curriculums.
    KEYWORDS: Community pharmacists; general practitioners; perceptions; roles; training
    Matched MeSH terms: General Practitioners*
  4. Fulltext Do health professionals have positive perception towards consumer reporting of adverse drug reactions?
    Alshakka MA, Ibrahim MI, Hassali MA
    J Clin Diagn Res, 2013 Oct;7(10):2181-5.
    PMID: 24298470 DOI: 10.7860/JCDR/2013/5778.3464
    The aim of this study was to evaluate the perceptions of general practitioners (GPs) and community pharmacists (CPs) in Penang, Malaysia, towards consumer reporting of Adverse Drug Reactions (ADRs).
    Matched MeSH terms: General Practitioners
  5. Views of healthcare professionals on complementary and alternative medicine use by patients with diabetes: a qualitative study
    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*
  6. How should front-line general practitioners use personal protective equipment (PPE)?
    Ambigapathy S, Rajahram GS, Shamsudin UK, Khoo EM, Cheah WK, Peariasamy KM, et al.
    Malays Fam Physician, 2020;15(1):2-5.
    PMID: 32284798
    The COVID-19 outbreak continues to evolve with the number of cases increasing in Malaysia, placing a significant burden on general practitioners (GPs) to assess and manage suspected cases. GPs must be well equipped with knowledge to set up their clinics, use Personal Protective Equipment (PPE) appropriately, adopt standard protocols on triaging and referrals, as well as educate patients about PPE. The correct use of PPE will help GPs balance between personal safety and appropriate levels of public concern.
    Matched MeSH terms: General Practitioners
  7. Fulltext A child with coated tonsils
    Appannan VR, Mohamad I, Ramli RR, Johan KB
    Malays Fam Physician, 2018;13(1):55-56.
    PMID: 29796214 MyJurnal
    A 5-year-old girl presented with a history of
    fever for four days associated with odynophagia.
    She was treated with amoxycillin prescribed
    by a general practitioner for 3 days prior to
    presentation. However, the symptoms were
    worsening and associated with drooling of
    saliva and poor oral intake. There was history
    of recurrent acute tonsillitis in the past two
    years, with 5 to 6 episodes per year. The child
    had completed regular immunizations up to her
    current age. There was no similar presentation
    amongst family members and friends. (Copied from article).
    Matched MeSH terms: General Practitioners
  8. A survey of the primary care management of osteoarthritis in Malaysia: A view from a rheumatologist's perspective
    Arshad A, Rashid R, Das Gupta E
    Int J Rheum Dis, 2008;11(3):246-250.
    DOI: 10.1111/j.1756-185X.2008.00367.x
    Objective: Primary care management of knee osteoarthritis (OA) has received little attention in the scientific literature and the main reason for this survey is to study and explore the variations and patterns of primary care management and assess both conventional and complementary therapy usage in knee OA in the primary care setting.
    Methods: A cross-sectional survey of 200 randomly selected general practitioners (GPs) in the peninsular states of Malaysia was undertaken using a questionnaire. The GPs involved were asked about basic knowledge of OA in terms of diagnosis, investigation, and treatment. They were also asked about their usage of conventional and complementary medication.
    Results: One hundred and eighty (90%) GPs responded to the questionnaires sent: 77% were in solo practice and 33% in group practice. Most of the GPs surveyed (60%) had been in practice for more than 10 years, 30% for 5-10 years and 10% were in practice for less than 5 years. Of GPs surveyed, 55% saw an average of more than 20 patients per week, 35% about 10-20 patients and 10% less than 10 patients per week. Of GPs surveyed, 65% would arrange an X-ray, 55% would arrange a blood test, mostly serum uric acid, rheumatoid factor and erythrocyte sedimentation rate. Pharmacological management consists of first-line treatment with non-steroidal anti-inflammatory drugs (NSAIDs) (61%), analgesics (35%) or a combination of the two (4%). Non-pharmacological management consisted of advice on exercise (27%), weight reduction (33%) and referral to physiotherapy (10%). Of GPs surveyed, 85% prescribed some form of complementary medications, 60% prescribed glucosamine sulphate, 21% chondroitin sulphate, 11% cod liver oil and 9% evening primrose oil. Only 10% of GPs surveyed perform intra-articular injections.
    Conclusion: The data suggest that in the primary care setting, the majority of GPs over-investigate the diagnosis of OA. Pharmacological interventions largely concentrate on analgesics and NSAIDs. The use of physiotheraphy and non-drug approaches were significantly under-utilized. There is a need to further educate GPs in the management of OA.
    Matched MeSH terms: General Practitioners
  9. Fulltext A pilot study of the primary care management of knee osteoarthritis in the Northern States of Malaysia.
    Arshad, A., Rashid, R.
    International Medical Journal Malaysia, 2008;7(2):31-36.
    MyJurnal
    Introduction: Primary care management of knee osteoarthritis OA has received little attention in the scientific literature and the main reason of this survey is to study and explore the variations and patterns of primary care management and assess both conventional and complementary therapy usage in knee OA in the primary care setting. Materials and Methods: A cross sectional survey of 100 randomly selected general practitioners (GPs) in the northern states of Malaysia (Kedah, Perlis, Pulau Pinang) was undertaken using questionnaires. The GPs involved were asked about basic knowledge of OA in terms of diagnosis, investigation, and treatment of OA. They were also asked their usage of conventional and complementary medication. Results: 80 (80%) GPs responded to the questionnaires sent. 85% of GPs were in solo practice and 15% in group practice. Most of the GPs surveyed (69%) were in practice for more than 10 years, 21% in 5- 10 years and 10% were in practice for less than 5 years. 65% GPs surveyed see an average of more than 20 patients per week, 25% see about 10- 20 patients and 10% see less than 10 patients per week. 75% of GPs surveyed would arrange an X-ray. 65% of GPs surveyed will arrange a blood test, mostly serum uric acid, rheumatoid factor and ESR. Pharmacological management consists of first line treatment with analgesics (32%), NSAIDs (59%) or a combination of the two (4%). Non-pharmacological management consist of advise an exercise (37%), weight reduction (23%) and referral to physiotherapy (8%). 89% of GPs surveyed prescribed some form of complementary medications. 68% prescribed glucosamine sulphate, 29% chondroitin sulphate, 18% cod liver oil, 12% evening primrose oil. Only 5% of GPs surveyed perform intra- articular injection. Conclusion: The data suggest that in the primary care, majority of GP over investigate the diagnosis of OA. Pharmacological interventions largely concentrate on analgesic and NSAIDs. The use of physiotherapy and non drug approach were enormously under-utilized. There is a need to further educate GPs in the management of OA.
    Matched MeSH terms: General Practitioners
  10. Fulltext Chronic Back Pain in a Young Female Patient: A Case of Ependymoma Originating from the Conus Medullaris
    Asahar SF, Malek KA, Zohdi WNWM, Peter AB
    Korean J Fam Med, 2020 Jan;41(1):68-72.
    PMID: 31902199 DOI: 10.4082/kjfm.18.0157
    We present the case of a 14-year-old Malay girl with an ependymoma of the conus medullaris who presented to multiple general practitioner clinics with a 24-month history of chronic low back pain. The pain was symptomatically managed as a simple musculoskeletal pain and sciatica. Further imaging to aid diagnosis was delayed until the appearance of severe pain with neurological deficits. Magnetic resonance imaging revealed an enhancing spinal mass at L1 through L3, and histopathological investigations confirmed the grade II ependymoma according to the World Health Organization classification. She underwent gross resection of the tumor. After the surgery, she developed neurogenic urinary bladder and bowel, which required intermittent self-catheterization, intermittent enema use, and intensive physical therapy.
    Matched MeSH terms: General Practitioners
  11. Nocturnal hypoxia and the difference in morning and evening blood pressure measured at home
    Azahar NM, Ganbaatar G, Kitaoka K, Sawayama Y, Yano Y
    Hypertens Res, 2023 Mar;46(3):781-783.
    PMID: 36642752 DOI: 10.1038/s41440-022-01164-z
    Matched MeSH terms: General Practitioners*
  12. Health-Seeking Behaviour and Delayed Presentation of Oral Cancer Patients in a Developing Country: A Qualitative Study based on the Self-Regulatory Model
    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
  13. Fulltext Extending the roles of community pharmacists: views from general medical practitioners
    Azmi S, Nazri N, Azmi AH
    Med J Malaysia, 2012 Dec;67(6):577-81.
    PMID: 23770948 MyJurnal
    This study investigates the views of general medical practitioners (GP) to the extended role of the community pharmacists (CP). A self-administered questionnaire was distributed to all private clinics (n=438) run by GPs in the state of Penang. The questionnaire asked GP's views on ideas for new services provided by community pharmacists. Three hundred and twenty-seven questionnaires were collected, giving a response rate of 74.5%. More than 50% of respondents were in favour of the community pharmacist involvement in activities of providing public health education (58.7%), contacting GPs on matters related to prescribing and prescription errors (56.0%), and referring patients who exhibit drug-related problems (53.0%). However, the respondents had a mixed opinion regarding the roles of CPs in smoking cessation programme (34.8%) and providing drug information to physicians (43.0%). Additional research is needed to explain GPs attitudes towards the acceptability of the new role of the pharmacist.
    Matched MeSH terms: General Practitioners
  14. Physical disability and the role of the general practitioner in rehabilitation
    Balasubramaniam P
    Family Practitioner, 1981;4:11-14.
    Matched MeSH terms: General Practitioners
  15. Fulltext Radiology in general practice
    Balasundaram R
    Family Physician, 1993;5(3):35-45.
    A survey of laws and regulations governing the practice of radiology by general practitioners in Malaysis and ten other selected countries wascarried out. It showedvaryingdegrees oflegal restrictions on the use of x-ray machines in the countries studied. Most regulations reflected the concern of radiation protection forpatients andstaff. Only some countries provide training for non-medical persons in the use of x-ray machines. Radiology has an important role in primary care. Undergraduate and post-graduate education should ensure competence in basic radiological practice. KEYWORDS: X-ray, general practice, regulations.
    Matched MeSH terms: General Practitioners
  16. Fulltext Presidentia address. The bedside manner in medical practice
    Cameron IG
    Journal of the Malaya Branch of the British Medical Association, 1937;1:1-5.
    Matched MeSH terms: General Practitioners
  17. The general practitioner and the diagnosis of hypertension
    Catterall RA
    Family Practitioner, 1976;2:13-17.
    Matched MeSH terms: General Practitioners
  18. Fulltext Prescribing patterns for childhood asthma treatment in general practice
    Chan PWK, Norzila MZ
    Med J Malaysia, 2003 Oct;58(4):475-81.
    PMID: 15190621
    The treatment preferences of 109 general practitioners (GPs) for childhood asthma were determined. Availability and adherence to clinical practice guidelines (CPG) for the treatment of childhood asthma was also assessed. Ninety eight (90%), 60 (55%) and 33 (30%) GPs considered nocturnal symptoms > 2 times/week, exercise induced wheeze and cough respectively as indications for preventer therapy. An oral preparation was preferred for relief medication [72 (66%) for 2-5 years, 60 (55%) for > 5 years]. An inhaled preparation was however preferred for preventer medication [60 (55%) for 2-5 years, 85 (78%) for > 5 years]. The oral form was more likely prescribed for asthmatic children 2-5 years (p < 0.001). Corticosteroids and ketotifen were the commonest inhaled and oral preventer treatment prescribed respectively. Only 36(33%) GPs have a CPG copy for reference. Children with asthma symptoms that require preventer therapy may not always be identified in general practice. The oral route remains important for asthma medication especially in young children. The accessibility to the CPG among GPs is disappointing.
    Study site: General practitioners attending a pharmaceutical industry sponsored asthma management workshop
    Matched MeSH terms: General Practitioners
  19. Fulltext Implementing standard setting into the Conjoint MAFP/FRACGP Part 1 examination - Process and issues
    Chan SC, Mohd Amin S, Lee TW
    Malays Fam Physician, 2016;11(2-3):2-8.
    PMID: 28461851
    BACKGROUND: The College of General Practitioners of Malaysia and the Royal Australian College of General Practitioners held the first Conjoint Member of the College of General Practitioners (MCGP)/Fellow of Royal Australian College of General Practitioners (FRACGP) examination in 1982, later renamed the Conjoint MAFP/FRACGP examinations. The examination assesses competency for safe independent general practice and as family medicine specialists in Malaysia. Therefore, a defensible standard set pass mark is imperative to separate the competent from the incompetent.

    OBJECTIVE: This paper discusses the process and issues encountered in implementing standard setting to the Conjoint Part 1 examination.

    DISCUSSION: Critical to success in standard setting were judges' understanding of the process of the modified Angoff method, defining the borderline candidate's characteristics and the composition of judges. These were overcome by repeated hands-on training, provision of detailed guidelines and careful selection of judges. In December 2013, 16 judges successfully standard set the Part 1 Conjoint examinations, with high inter-rater reliability: Cronbach's alpha coefficient 0.926 (Applied Knowledge Test), 0.921 (Key Feature Problems).
    Matched MeSH terms: General Practitioners
  20. Fulltext Knowledge and attitude on infant oral health among graduating medical students in kulasekaram
    Chellaih P, Sivadas G, Vaishnavi Vedam VK
    J Educ Health Promot, 2020;9:207.
    PMID: 33062740 DOI: 10.4103/jehp.jehp_194_20
    AIM: This study was intended to evaluate the knowledge and attitudes regarding infant's oral health care among graduating medical students from Kulasekaram, Tamil Nadu.

    MATERIALS AND METHODS: A cross-sectional survey research design was employed in this study. Self-administered questionnaire of the validated "Graduating medical students' Knowledge and Attitudes Survey Regarding Infant's oral health care" were utilized to ascertain the baseline levels of knowledge and attitudes of graduating medical students' in Kulasekaram hospital. In this regard, a preliminary study with a convenience sample of 100 medical students was conducted so as to assess the knowledge of infant oral health care among graduating medical students in Kulasekaram. This study, while limited in sample size, benefits the general practitioners as target readers to assess the abnormalities in children at early stages of life.

    RESULTS: The results of the study revealed that the mean percentage score overall was 65.7%. Only 3.2% of participants obtained a passing score of 80% or greater. Widespread knowledge deficits and poor attitudes among graduating medical students were noted in this study, particularly in the domain of pharmacological management of pain. Positive correlations were observed between the respondents' score and level of education. Further analysis revealed respondents had an inaccurate self-evaluation of their pain management knowledge.

    CONCLUSION: The results of this study reveal that there is dearth of knowledge and attitudes of graduating medical students' regarding infant oral health care. Educational and quality improvement initiatives in oral health care of infants could enhance medical student's knowledge baseline in the area of oral health care and possibly improve practices.

    Matched MeSH terms: General Practitioners
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