Displaying publications 21 - 40 of 48 in total

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  1. 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.
  2. Isa NMM, Aziz AFA
    Korean J Fam Med, 2020 Jul;41(4):256-262.
    PMID: 32019295 DOI: 10.4082/kjfm.19.0012
    BACKGROUND: Lower urinary tract symptoms (LUTS) are common among elderly men. However, seeking help for this problem is mostly delayed until complications arise. Primary care clinics serve as the first point of contact for a person's health needs throughout their life. This study aimed to determine the prevalence of LUTS among primary care attendees, and the factors that influence seeking medical intervention at primary care clinics.

    METHODS: Using a universal sampling technique, 460 male patients aged 60 and above visiting an urban based public primary care clinic were recruited. An interviewer administered the questionnaire which used International Prostate Symptoms Score and International Consultation on Incontinence Modular Questionnaire-Lower Urinary Tract Symptoms-Quality of Life.

    RESULTS: The prevalence of any LUTS and clinically significant LUTS were 89.8% and 20.5%, respectively. Among the 385 participants who completed the study, only 41.8% had consulted a doctor for LUTS. Among those with moderate/severe symptoms only 57.6% had sought medical intervention. Multiple logistic regression analysis showed that the presence of more than two comorbidities (P=0.004; odds ratio [OR], 4.695; 95% confidence interval [CI], 1.632-13.508) and quality of life (P=0.002; OR, 1.271; 95% CI, 1.091-1.481) were independent factors significantly associated with seeking help.

    CONCLUSION: Prevalence of LUTS among elderly men undergoing primary care is high, but more than half of the patients had not sought medical attention. Increasing comorbidities and impact on quality of life influenced elderly men with LUTS to seek help.

  3. Nantha YS, Hs AS
    Korean J Fam Med, 2020 Jul;41(4):267-270.
    PMID: 31992021 DOI: 10.4082/kjfm.18.0056
    BACKGROUND: The provision of sick leave to patients in general practice often entails a complex decision-making process. Commonly, general practitioners believe that the act of providing sick leave can become confrontational. We assessed the intention, attitude, subjective norm, and perceived behavioral control of general practitioners in relation to sick leave provision at public health clinics in Malaysia.

    METHODS: A cross-sectional study design was implemented using data from 86 primary health care clinics in two states in Malaysia from February 2014 to March 2015. A questionnaire that comprised indirect measures were developed on the basis of the Theory of Planned Behavior. The questionnaire assessed several dimensions related to sickness certification provision viz., intention, attitude, subjective norm, and perceived behavioral control.

    RESULTS: The mean scores in this study revealed that physicians acknowledged that patient factors such as clinical symptoms (6.59±0.04), debilitating signs and symptoms of diseases (6.45±0.06), importance of illness recovery (6.07±0.07), and approval of employers (5.35±0.09) played an important role in their decision to provide sick leave.

    CONCLUSION: The act of providing sickness certification to patients is a complex decision-making process. The findings of this study can be used to devise a targeted intervention to reduce the conflict that physicians face in issuing sick leaves.

  4. Mahmud R, Ariffin F, Shanmuganathan P
    Korean J Fam Med, 2020 Jul;41(4):263-266.
    PMID: 32512984 DOI: 10.4082/kjfm.18.0161
    The presence of erythrocytosis along with the diagnosis of chronic obstructive pulmonary disease (COPD) may veer a primary care clinician in a busy clinic towards attributing the erythrocytosis to hypoxia secondary to COPD; however, this is not always the case. This case highlights the importance of investigation and the significance not excluding a primary cause in COPD patients with erythrocytosis. A 57-year-old male, presenting with chronic cough, was subsequently diagnosed with COPD clinically and confirmed by spirometry. Erythrocytosis was also incidentally noted. The patient did not have any symptoms of polycythemia or hepatosplenomegaly. Therefore, the erythrocytosis was initially thought to be caused by hypoxia secondary to COPD. However, the JAK2 V617F gene mutation was detected and hence the diagnosis of polycythemia vera was made. Although the erythrocytosis was initially attributed secondary to the underlying pulmonary disease, investigations proved it to be primary in origin. This case report highlights the importance of investigating the underlying cause and to confirm the diagnosis of erythrocytosis as primary and secondary polycythemia differ in their management approach. This will avoid inappropriate diagnosis, treatment, and undesirable outcomes.
  5. Abu Bakar AA, Kadir AA, Idris N
    Korean J Fam Med, 2021 Sep;42(5):403-406.
    PMID: 32418398 DOI: 10.4082/kjfm.20.0063
    This case illustrates the medical complication of a child that arose as a consequence of parents with intellectual disabilities in a primary care setting. A 9-month-old girl presented with multiple admissions because of recurrent pneumonia and was later diagnosed with failure to thrive based on child neglect resulting from the parents' disabilities. This exemplifies a failure to thrive case with a complex and undiagnosed psychosocial background that required interdepartmental involvement to mitigate the health problem.
  6. Alagirisamy P, Sidik SM, Rampal L, Ismail SIF
    Korean J Fam Med, 2022 Jan;43(1):42-55.
    PMID: 35130639 DOI: 10.4082/kjfm.21.0011
    BACKGROUND: The awareness and practice of pelvic floor muscle exercise (PFME) in the prevention and reduction of the rate of urinary incontinence among pregnant women was considerably poor, despite the increased prevalence of urinary incontinence during pregnancy across Malaysia. There healthcare providers do not give adequate attention to the potential impact of PFME on urinary incontinence and there is limited local intervention addressed urinary incontinence during pregnancy. The objective of this study was to determine the effectiveness of a newly developed PFME intervention in terms of knowledge, attitude, practice, self-efficacy, and urinary symptoms.

    METHODS: A single-blinded, two-armed, randomized control trial was included pregnant women from 18 to 20 weeks of gestation and was conducted at the Maternity Hospital of Kuala Lumpur. The intervention group received PFME in addition to the usual perinatal care. The data were collected using validated questionnaires at 4 time points: baseline, post-intervention in the early third trimester, late third trimester, and early postnatal period. The intervention effects were analyzed using a generalized estimating equation.

    RESULTS: The primary analysis included pregnant women who had at least one follow-up; 122 women (71.8%) in the intervention group had significant improvement in knowledge, attitude, practice, and self-efficacy, as well as in the severity of urinary incontinence over time. However, improvement was not observed in self-reported urinary incontinence.

    CONCLUSION: PFME can be considered an effective initial intervention to provide information about urinary incontinence prevention to pregnant women.

  7. Amaran S, Kamaruzaman AZM, Mohd Esa NY, Sulaiman Z
    Korean J Fam Med, 2021 Nov;42(6):425-437.
    PMID: 34871483 DOI: 10.4082/kjfm.20.0117
    The year 2020 saw the emergence of a novel coronavirus-the severe acute respiratory syndrome coronavirus 2- which has led to an unprecedented pandemic that has shaken the entire world. The pandemic has been a new experience for Malaysia, especially during the implementation of large-scale public health and social measures called the Movement Control Order (MCO). This paper seeks to describe the experiences of the Malaysian healthcare system thus far in combatting the pandemic. The Malaysian healthcare system comprises two main arms: public health and medicine. The public health arm focuses on early disease detection, contact tracing, quarantines, the MCO, and risk stratification strategies in the community. The medical arm focuses on the clinical management of coronavirus disease 2019 (COVID-19) patients; it encompasses laboratory services, the devising of clinical setting adjustments, and hospital management for COVID-19 and non-COVID-19 patients. Malaysia experienced intense emotions at the beginning of the pandemic, with great uncertainty regarding the pandemic's outcome, as the world saw a frighteningly high COVID-19 mortality. As of writing (May 30, 2020), Malaysia has passed the peak of its second wave of infections. The experience thus far has helped in preparing the country's healthcare system to be vigilant and more prepared for future COVID-19 waves. To date, the pandemic has changed many aspects of Malaysia's life, and people are still learning to adapt to new norms in their lives.
  8. Hussain NHN, Noor NM, Ismail SB, Zainuddin NA, Sulaiman Z
    Korean J Fam Med, 2021 Nov;42(6):453-463.
    PMID: 34871486 DOI: 10.4082/kjfm.20.0238
    BACKGROUND: Breastfeeding is recognized as the optimal form of nutrition for the physical and neurological development of infants and is considered the most significant way to prevent child mortality. This study aimed to assess the effectiveness of metoclopramide for enhancing milk production in lactating women.

    METHODS: We searched the Cochrane Central Register of Controlled Trials and MEDLINE for randomized controlled trials comparing metoclopramide with a placebo, no treatment, or other galactagogue drugs. We included breastfeeding women with term or preterm infants.

    RESULTS: We retrieved 164 records from our search of the electronic databases and 20 records from other sources. Eight trials involving 342 lactating women that used metoclopramide were included in this review after assessing the eligibility criteria. The meta-analysis of these trials revealed that metoclopramide did not increase the milk volume of the intervention groups compared to that of the control groups. There was a significant increase in the serum concentrations of prolactin when the mothers were administered metoclopramide. No significant adverse events were reported.

    CONCLUSION: Metoclopramide did not improve milk production in lactating women. Therefore, we do not recommend using metoclopramide to increase milk production in lactating women.

  9. Ying NY, Idris NS, Muhamad R, Ahmad I
    Korean J Fam Med, 2021 Nov;42(6):487-490.
    PMID: 32475104 DOI: 10.4082/kjfm.20.0090
    Coronavirus disease 2019 (COVID-19) is an infectious disease caused by a novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The world is currently challenged to handle this pandemic. The common symptoms of COVID-19 are fever, cough, fatigue, and shortness of breath. There are few reports on the association of SARS-CoV-2 with ocular abnormalities including conjunctivitis. We report a case of a 54-year-old woman who presented solely with conjunctivitis subsequently diagnosed with COVID-19. A lack of full history of her travel abroad was another issue leading to a delay in evaluating her COVID-19 status that increased the infection risk to her managing team. Thus, primary care practitioners should be suspicious of this atypical feature of COVID-19, thus enabling us to identify such patients at entry points. Maintaining safety measures while managing patients is also crucial.
  10. Lamry NA, Misron K, Tengku Kamalden TMI, Aziz A, Salim R
    Korean J Fam Med, 2021 Nov;42(6):483-486.
    PMID: 32456405 DOI: 10.4082/kjfm.20.0071
    Malignant otitis externa (MOE) is a rare and potentially life-threatening disease of the ear and temporal bone. Bilateral simultaneous MOE is extremely rare. Due to bilaterally symmetrical facial nerve palsy, it can easily be missed at the initial presentation, causing delay in management. Here, we report a case of bilateral MOE managed aggressively with regular ear toileting, ear packing with a ribbon gauze soaked with topical antimicrobials, and long-term intravenous and oral antibiotics. The patient showed good improvement in pain control, facial nerve status, and ear findings.
  11. Nantha YS, Malek SA
    Korean J Fam Med, 2017 Jul;38(4):229-232.
    PMID: 28775814 DOI: 10.4082/kjfm.2017.38.4.229
    Cardiac myxoma is often discovered as an incidental finding and presents with various subtle symptoms and signs. Electrocardiographic findings are mostly non-specific. Atrial flutter or conduction abnormalities are known to be rare. We report a case of large left atrial myxoma that was diagnosed by transthoracic echocardiography at a primary care clinic. An asymptomatic, 71-year-old woman presented with serial abnormal electrocardiogram changes during a routine consultation. A diagnosis of left atrial myxoma was obtained through transthoracic echocardiography. We report this case with a review of literature on cardiac myxoma associated with arrhythmia.
  12. Badrin S, Mohamad N, Yunus NA, Zulkifli MM
    Korean J Fam Med, 2017 Nov;38(6):380-382.
    PMID: 29209479 DOI: 10.4082/kjfm.2017.38.6.380
    Psychiatric symptoms may be related to a silent cerebral infarct, a phenomenon that has been described previously in literature. Acute psychosis or other neuropsychiatric symptoms including depression may present in stroke patients and patients with lesions either within the prefrontal or occipital cortices, or in subcortical areas such as the basal ganglia, thalamus, mid-brain, and brainstem. Psychosis in clinical stroke or in silent cerebral infarction is uncommon and not well documented in the literature. Neurological deficits are the most common presentation in stroke, and nearly a third of patients that suffer a stroke may experience psychological disorders such as depression and anxiety, related to physical disability. The present case report describes an elderly female patient who presented with hallucinations and depressive symptoms, and was discovered to have a recent right frontal brain infarction, without other significant neurological deficits.
  13. Nantha YS
    Korean J Fam Med, 2017 Nov;38(6):315-321.
    PMID: 29209469 DOI: 10.4082/kjfm.2017.38.6.315
    A prescriptive model approach in decision making could help achieve better diagnostic accuracy in clinical practice through methods that are less reliant on probabilistic assessments. Various prescriptive measures aimed at regulating factors that influence heuristics and clinical reasoning could support clinical decision-making process. Clinicians could avoid time-consuming decision-making methods that require probabilistic calculations. Intuitively, they could rely on heuristics to obtain an accurate diagnosis in a given clinical setting. An extensive literature review of cognitive psychology and medical decision-making theory was performed to illustrate how heuristics could be effectively utilized in daily practice. Since physicians often rely on heuristics in realistic situations, probabilistic estimation might not be a useful tool in everyday clinical practice. Improvements in the descriptive model of decision making (heuristics) may allow for greater diagnostic accuracy.
  14. Ismail TAT, Jalil RA, Wan Ishak WR, Hamid NF, Wan Nik WS, Jan Mohamed HJ, et al.
    Korean J Fam Med, 2018 Jan;39(1):15-22.
    PMID: 29383207 DOI: 10.4082/kjfm.2018.39.1.15
    Background: A qualitative study providing an in-depth exploration of people's view and the increasing burden of overweight and obesity is required. This study aimed to explore the understanding of dieting and previous experiences on weight loss attempts among overweight and obese government employees in Kelantan, Malaysia, prior to recruitment into the intervention program.

    Methods: Thirteen focus group discussions involving 129 participants from a weight-loss intervention program were conducted within the first 1 month of recruitment. These discussions were moderated by two trained researchers in the Malay language and assisted by an interview guide. They were audio-recorded and transcribed verbatim. A thematic analysis was performed, and codes and themes from each discussion were constructed.

    Results: The participants understood dieting with various meanings, including skipping meals and removing rice from daily diets. They applied numerous methods to lose weight and achieved various outcomes. Health and appearance, social support, and compliance with current trends were the factors motivating these participants to lose weight. Their determination to lose weight was limited by lack of self-control and motivation, experiences of unpleasant effects, influence on weight, and environmental and health factors.

    Conclusion: Real-life weight loss experiences and perceptions provided relevant insights into current weight loss management strategies. Some of these issues and misunderstandings should be emphasized in weight loss strategies during health promotion.

  15. Muhammad J, Ngah ND, Ahmad I
    Korean J Fam Med, 2023 Jan;44(1):44-52.
    PMID: 36709960 DOI: 10.4082/kjfm.22.0016
    BACKGROUND: A written asthma action plan (WAAP) is one of the treatment strategies to achieve good asthma control in children.

    METHODS: This randomized controlled trial was conducted to observe the effect of WAAP on asthma control and quality of life using the Asthma Control Questionnaire and Pediatric Asthma Quality of Life Questionnaire (PAQLQ) at baseline and after 3 months. A repeated measure analysis of variance was used to analyze the mean score difference between the two groups.

    RESULTS: There was no significant difference in mean score for asthma control at baseline between groups (F[degree of freedom (df)]=1.17 [1, 119], P=0.282). However, at 3 months, a significant difference in mean scores between groups was observed (F[df]=7.32 [1, 119], P=0.008). The mean±standard deviation (SD) scores in the intervention and control groups were 0.96±0.53 and 1.21±0.49, respectively. For the analysis of the PAQLQ, no significant difference was observed in the mean score for the quality of life baseline in both groups. There were significant mean score changes for the quality of life (F[df]=10.9 [1, 119], P=0.001) at 3 months follow-up, where those in the intervention group scored a mean±SD score of 6.19±0.45, and those in the control group scored 5.94±0.38. A time-group interaction analysis using repeated-measures analysis of variance showed significant differences in mean score changes (F[df]=5.03 [1, 116], P=0.027) and (F[df]=11.55 [1, 116], P=0.001) where a lower mean score was observed in the intervention group, indicating better asthma control and quality of life, respectively. A significant (P<0.001) negative Pearson correlation between asthma control and quality of life (-0.65) indicated a moderate correlation.

    CONCLUSION: WAAP, along with standard asthma treatment, improves asthma care.

  16. Shohaimi S, Husain NRN, Zaki FM, Atan IK
    Korean J Fam Med, 2023 Mar;44(2):102-108.
    PMID: 36966740 DOI: 10.4082/kjfm.22.0035
    BACKGROUND: Diastasis rectus abdominis (DRA) involves the separation of the midline abdominal muscles and linea alba and affects more than half of postpartum women. This study aimed to assess the effect of a split tummy exercise program (STEP) on DRA closure in postpartum mothers.

    METHODS: A randomized controlled trial was conducted from 2008 to 2020 at the Obstetrics and Gynaecology Clinic of the Universiti Kebangsaan Malaysia Medical Centre. Primigravida mothers diagnosed with DRA were selected and randomly assigned to the intervention (n=21) or control (n=20) group. The intervention group underwent a home-based STEP consisting of three phases of nine abdominal exercises. DRA size was assessed at baseline and at 8 weeks postpartum using two-dimensional ultrasound.

    RESULTS: The mean age of the participants was 28 years (standard deviation, 3.6), with the majority of Malay ethnicity (87.8%) and working mothers (78%). After 8 weeks, the intervention group showed a significant reduction in DRA size of up to 27% (mean difference, 6.17 mm; 95% confidence interval, 3.7-8.7; P<0.001). No significant intergroup DRA changes were observed after 8 weeks of follow-up.

    CONCLUSION: Early postpartum screening for DRA should be advocated to allow early STEP intervention to ensure favorable outcomes. STEP intervention is an effective postnatal training program for managing DRA.

  17. Badrin S, Daud N, Ismail SB
    Korean J Fam Med, 2018 Nov;39(6):355-359.
    PMID: 29983039 DOI: 10.4082/kjfm.17.0132
    BACKGROUND: Body image is associated with the perception of people on themselves. Influencing factors are generated internally and/or externally. The most common issue pertaining to body image is body weight and weight loss. This study aimed to determine the association between body weight perception and weight loss practices among college students.

    METHODS: A cross-sectional study was conducted involving 297 college students from private nursing colleges in the state of Kelantan, Malaysia. A self-administered questionnaire was used to assess sociodemographic characteristics, body weight perception, and weight loss methods. Weight and height were measured, and body mass index (BMI) was calculated based on weight and height measurement. The World Health Organization BMI cutoffs were applied in the study.

    RESULTS: More than half (54.2%) of college students perceived their weight correctly as per actual measured BMI. A total of 51.5% of participants had tried various methods to reduce their weight. Body weight perception is associated with weight loss practices (odds ratio, 0.31; 95% confidence interval, 0.19-0.50; P<0.001) adjusted for sex, marital status, and status of having obese family members. Those who had correct body weight perception were less likely to engage in weight loss practice. Food intake restriction (42.4%) is the most popular weight reduction method among students in nursing colleges. Over a quarter of the participants chose physical exercise (25.3%) to reduce their weight, and a small number engaged in unhealthy weight loss practices.

    CONCLUSION: Body weight perception is an important factor that influences the practice to reduce weight especially among young adult group and college students.

  18. Jaafar H, Ismail SY, Azzeri A
    Korean J Fam Med, 2023 Jul;44(4):183-188.
    PMID: 37189262 DOI: 10.4082/kjfm.22.0206
    Period poverty is a global community health dilemma that has long been overlooked. This condition is described as having insufficient access to menstrual products, education, and sanitation facilities. Briefly, period poverty means that millions of women are subjected to injustice and inequity due to menstruation. This review aimed to explore the definition, challenges, and effects of period poverty on the community, especially among women at their productive ages. In addition, suggestions to minimize the impact of period poverty are discussed. A search strategy was applied using the keywords "period poverty," "period equity," "period poverty," and "menstrual hygiene" in Google Scholar, ScienceDirect, SpringerLink, MEDLINE, and PubMed electronic databases, journals, and articles on relevant topics. Trained researchers conducted a keyword search from January 2021 to June 2022. Based on the reviewed studies, it has been proven that many countries are still affected by the period stigma and taboo, inadequate exposure to menstrual health and its management, lack of education about menstruation, and shortage of access to menstrual products and facilities. The next step is to reduce and slowly eliminate the period poverty issue by conducting more research to increase clinical evidence and future references. This narrative review could inform policymakers of the magnitude of the burden related to this issue and guide them to develop effective strategies to minimize the impact of poverty, especially during the challenging years of the post-coronavirus disease 2019 era.
  19. Sulaiman Z, Noor NM, Ismail SB, Mohd Lukman ASF, Irfan M, Hussain NHN
    Korean J Fam Med, 2022 May;43(3):174-182.
    PMID: 35610964 DOI: 10.4082/kjfm.21.0029
    BACKGROUND: Vitamin D may enhance immune system function and provide a protective effect against infections. Feto-maternal circulation plays an important role in supplying the developing fetus with nutrients and antibodies for its development and health during pregnancy and for its early years of life after birth. This meta-analysis aimed to determine the effectiveness of maternal vitamin D supplementation in preventing respiratory tract infections (RTIs) in children.

    METHODS: We searched the Central and MEDLINE databases and went through all the reference lists in the related articles. We also searched for ongoing trials at http://www.who.int/ictrp/en/ and www.clinicaltrials.gov. Randomized controlled trials comparing vitamin D supplementation with a placebo or no treatment in pregnant women published in the English language up to March 2019 were included. Two reviewers extracted data independently using a predefined protocol and assessed the risk of bias using the Cochrane risk of bias tool, with differences agreed upon by consensus. The predefined primary outcome was the number of offspring who had RTIs. The secondary outcome was the presence of measurable serum immunoglobulin E levels.

    RESULTS: Three trials involving 3,224 participants (mother-child pairs) met the inclusion criteria and were included in this review. The present analysis reported that maternal supplementation with vitamin D had no effect on RTIs among children (n=1,486 offspring; risk ratio, 0.95; 95% confidence interval, 0.82-1.11; random effects; I2 statistics, 0%).

    CONCLUSION: Maternal vitamin D supplementation had no effect on RTIs in children. Therefore, consideration of other prevention methods in this regard is recommended.

  20. Alias AN, Mokti K, Ibrahim MY, Saupin S, Madrim MF
    Korean J Fam Med, 2023 Nov;44(6):311-318.
    PMID: 37641174 DOI: 10.4082/kjfm.23.0046
    Elderly abuse and neglect are among the primary public health problems linked to global demographic changes in the population, impacting not only the well-being of the elderly but also the growth of the nation or economy. This article discusses the effects of elder abuse and neglect on population health from the national and international perspectives through a narrative review of previously published articles on the concept of aging, the prevalence of elderly abuse and neglect, its risk factors and effects, and finally measures, legal perspectives, and recommendations to curb it. Interventions in Malaysia and selected nations, including Indonesia, South Korea, the United States, Australia, and Hong Kong, are examined. This issue is important as the majority of countries are moving toward being elderly populations. Improving global surveillance and the monitoring of instances is essential to inform policy actions to prevent elder abuse. In addition, a thorough assessment of the identified risk factors for violence and steps to prevent violence is required.
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