Displaying publications 21 - 40 of 632 in total

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  1. Azhany Y, Norhayati A, Siti Raihan I, Liza Sharmini AT
    Malays Fam Physician, 2014;9(2):48-52.
    PMID: 25883765 MyJurnal
    To determine the clinical presentations, management and outcome of lens-induced glaucoma (LIG) in Hospital Universiti Sains Malaysia.
  2. Thevi T, Reddy SC, Shantakumar C
    Malays Fam Physician, 2014;9(2):41-7.
    PMID: 25883764 MyJurnal
    The aim of the study was to compare the outcomes of phacoemulsification (Phaco) and extracapsular cataract extraction (ECCE) in a district hospital setting.
  3. Nik Mazlina M, Ruziaton H, Nuraini DB, Izan Hairani I, Norizzati Bukhary IB, Mohamad Rodi I, et al.
    Malays Fam Physician, 2014;9(3):20-6.
    PMID: 26425301 MyJurnal
    BACKGROUND: The Ministry of Health is committed to achieve Millenium Development Goal (MDG) MDG 4 and 5 by 2015 and include pre-pregnancy care as a strategy. This study evaluates the risk factors detected during the pre-pregnancy screening at selected public primary care clinics in Selangor.
    OBJECTIVES: The objectives of this study were to determine the proportion of women with risk factors receiving pre-pregnancy care in selected clinics in Selangor, their socio demographic features, the types of risk factors detected and their significance.
    METHODS: A retrospective review using secondary data was carried out from the month of March until June 2013 in four public primary care clinics in Klang and Petaling districts of Selangor. Data were obtained through non-probability sampling, using the pre-pregnancy screening form utilised in 2012, which is a standard questionnaire to determine the presence of risk factors. Women with at least one defined risk factor were considered as being at risk of an adverse obstetric outcome. Data were analysed using SPSS version 16.
    RESULTS: A total of 840 pre-pregnancy screening forms were collected. However only 614 (73.1%) were analysed and studied. The proportion of women with at least one risk factor was 68.8% (95% CI: 65.1, 72.5). The majority was Malays who had tertiary education and earned more than RM 1000. Most were in the reproductive age group of 18-35 years old (350, 82.9%). The mean age was 28.68 + 5.78 years. Most of the women were parous (259, 65.1%) and did not practice any form of contraception (308, 80.8%) despite having risks. The percentage of those not receiving any form of immunisation was small i.e. 9.8% but it was of importance and needed to be addressed prior to the conception. This study did not reveal any person with mental disorder or those who endured domestic abuse. Additionally, 3% (12) of them had unhealthy lifestyle habits, which include smoking, alcohol and substance abuse. Approximately one-third (212, 35.2%) of the women screened were overweight and obese, putting them at risk of developing gestational diabetes mellitus, pregnancy induced hypertension or deep vein thrombosis. The mean body mass index (BMI) for those at risk was 25.36 + 5.94 compared to 21.06 ± 1.46 for those with no risk. This study also found a small percentage of women with raised blood pressure (3.9%), abnormal physical examination (1.5%) and anaemia (14.4%), which need to be investigated and treated prior to conception.
    CONCLUSION: More than half of the women who attended the pre-pregnancy screening were found to have at least one risk factor.
  4. Ho BK, Jasvindar K, Gurpreet K, Ambigga D, Suthahar A, Cheong SM, et al.
    Malays Fam Physician, 2014;9(3):12-9.
    PMID: 26425300 MyJurnal
    Diabetes mellitus is an important cardiovascular risk factor. The objective of this study was to provide population-based estimates on the prevalence, awareness, treatment and control rate of diabetes among the older persons in Malaysia. Analysis of secondary data from a cross-sectional national population-based survey was done, which was conducted in 2011 throughout Malaysia. A total of 2764 respondents (15.5%) were older persons. The overall prevalence of diabetes among older persons was 34.4% in which 65.2% were aware of their diabetes status. Out of those who were aware, 87.5% had been treated. Only 21.8% of those treated had their diabetes controlled. The results of multiple logistic regression showed that the factors associated with higher awareness rates were women, Indians and higher income groups; factors associated with higher treatment rates were urban residents and those who were married and widow/widower/ divorcee. There was a high overall prevalence, awareness and treatment rate of diabetes among older persons in Malaysia but with suboptimal control rate.
    Study name: National Health and Morbidity Survey (NHMS-2011)
  5. Ang KT, Ho BK, Mimi O, Salmah N, Salmiah MS, Noridah MS
    Malays Fam Physician, 2014;9(3):2-11.
    PMID: 26425299 MyJurnal
    Primary care providers play an important gatekeeping role in ensuring appropriate referrals to secondary care facilities. This cross-sectional study aimed to determine the level, pattern and rate of referrals from health clinics to hospitals in the public sector, and whether the placement of resident family medicine specialist (FMS) had made a significant difference. The study was carried out between March and April in 2012, involving 28 public primary care clinics. It showed that the average referral rate was 1.56% for clinics with resident FMS and 1.94% for those without resident FMS, but it was not statistically significant. Majority of referred cases were considered appropriate (96.1%). Results of the multivariate analysis showed that no prior consultation with senior healthcare provider and illnesses that were not severe and complex were independently associated with inappropriate referrals. Severity, complexity or uncertain diagnosis of patients' illness or injury significantly contributed to unavoidable referrals. Adequate facilities or having more experienced doctors could have avoided 14.5% of the referrals. The low referral rate and very high level of appropriate referrals could indicate that primary care providers in the public sector played an effective role as gatekeepers in the Malaysian public healthcare system.
  6. Abdul Rahaman JA, Ker HB, Yusof M, Hanafi NS, Wong JL
    Malays Fam Physician, 2014;9(3):34-7.
    PMID: 26425303 MyJurnal
    Tuberculosis (TB) in Malaysia is rising due to multiple factors and issues related to its management are addressed in the updated evidence-based clinical practice guidelines. Screening for active TB should be considered in high risk groups. Light emitting diode-based fluorescence microscopy and nucleic acid amplification tests are recommended investigations. Health education and standardised 6-month daily antituberculosis (antiTB) regimen are among important elements for successful treatment. Latent TB infection screening should only be performed on high risk individuals. AntiTB regimen offered to HIV-positive adults should be the same as for HIV-negative adults and timing to initiate highly active antiretroviral therapy in patients with TB is based on CD4 count. All patients on antiTB treatment should be monitored to assess their response to treatment and to identify problems associated with it.
  7. Omar R, Knight VF, Aziz Mohammed MA
    Malays Fam Physician, 2014;9(3):27-33.
    PMID: 26425302 MyJurnal
    Work-related ocular injuries and illnesses were among the major causes of job absenteeism. This study was conducted to determine if low vision rehabilitation was provided following work-related ocular problems among industrial workers in a developing country. This was a retrospective analysis of case records.
  8. Ng HK, Yaakub A, Ong LB
    Malays Fam Physician, 2014;9(3):42-8.
    PMID: 26425305 MyJurnal
    Full thickness macular hole is an eye disease, which can cause permanent visual impairment. Current advancement in vitreoretinal surgery has high success rates in repairing them, leading to a significant visual improvement, especially if patient presents early. In this article, three cases of idiopathic full thickness macular hole with different visual outcomes have been presented. All cases were referred by the primary care practitioners and had undergone macular hole surgery with the same vitreoretinal surgeon. The visual outcome was best in the patient who had the earliest presentation and referral. Early detection and referral of these patients is vital so that early surgical intervention can be carried out to improve their vision.
  9. Thevi T, Maslina B, Reddy SC
    Malays Fam Physician, 2012;7(1):6-10.
    PMID: 25606238
    Objective: To determine the prevalence of eye diseases and visual impairment among new patients at the eye clinic of Hospital Sultan Haji Ahmad Shah, Temerloh, Pahang.
    Method: In this cross-sectional prospective study, 1081 new patients were examined over a period of six months. Age, gender, ethnicity, visual acuity and diagnosis were noted from the medical records.
    Results: Out of 1081 examined, 607 (56.1%) were males, 783 (72.4%) were Malays. The mean age of patients was 45.2 years (ranging from one month to 91 years). Cataract (248, 22.9%) was the most common eye disease, followed by retinal diseases (124, 11.5%) and ocular trauma (106, 9.8%). Majority of the patients (48) suffering from ocular trauma had foreign body cornea. In 85 premature infants screened for retinopathy, 19 showed different stages of retinopathy of prematurity. Visual impairment was noted in 89 (8.2%) patients, severe visual impairment in 12 (1.1%) and blindness in 35 (3.2%); vision could not be determined in 85 premature infants (7.9%). Cataract was singled out as the cause of severe visual impairment in 11 out of 12 patients.
    Conclusion: Health education at primary health centres and availability of eye specialists in all the district hospitals will facilitate the rehabilitation of visually impaired and blind persons by providing early treatment for eye problems (specifically prescription for spectacles, medical treatment and cataract surgery with intraocular lens implantation).
    Keywords: Visual impairment, cataract, diabetic retinopathy, glaucoma, refractive errors, ocular trauma, conjunctivitis
    Study site: Eye clinic, Hospital Sultan Haji Ahmad Shah, Temerloh, Pahang, Malaysia
  10. Yaroko AA, Irfan M
    Malays Fam Physician, 2012;7(1):2-5.
    PMID: 25606237 MyJurnal
    Foreign bodies or objects in the ear are one of the most common problems encountered by otorhinolaryngologist (ORL) with attendant complications, removal of which requires expertise. Patients with this problem who sought treatment in the otorhinolaryngology clinic of Hospital Universiti Sains Malaysia (HUSM) were studied for duration of one year from January 2010 to December 2010. Specifically, the clinical presentation, type of foreign body and management outcome were analysed. 72 patients were reviewed - 44 (61.1%) males and 28 (38.9%) females. The age range was one year to 75 years with 59.8% being children below 10 years old. Ear pain (56.9%) was recorded as the most common and persistent symptom and insects (54%) were the commonest foreign body encountered. 95% (69) of the foreign bodies were removed under clinic setting with only three (4.2%) cases requiring general anaesthesia. Post-removal complications were noted in only one patient (1.4%). Repeated attempts by untrained personnel should be avoided and timely referral is vital to avoid undesirable complications.

    Study site: torhinolaryngology clinic of Hospital Universiti Sains Malaysia (HUSM)
  11. Cheah WL, Lee PY, Lim PY, Fatin Nabila AA, Luk KJ, Nur Iwana AT
    Malays Fam Physician, 2012;7(2-3):21-30.
    PMID: 25606252 MyJurnal
    Diabetes is a chronic disease that affects a patient's quality of life. This cross-sectional study aimed to determine the socio-demographic and disease profile factors associated with poor quality of life among patients with diabetes. The study was conducted at a primary health care clinic in Kuching between August to November 2010. Short Form - 36 (SF - 36) questionnaire was used to assess the quality of life of diabetic patients aged ≥ 18. A total of 142 respondents participated in the survey. After adjusting for age, those with no education scored lower at vitality (p=0.043) and emotional health (p=0.033) compared with those who have tertiary education. Those working in the private sector scored better for physical functioning (p=0.042) compared with pensioners and the unemployed. Patients with uncontrolled diabetes scored lower in the role-emotional domain (p=0.003). Participants who were on <3 (p=0.014) and ≥3 (p=0.024) oral medications had better score for role-physical than those on insulin. Those on insulin had worse score for bodily pain than those on oral medication only (vs <3 oral drugs, p=0.026; vs ≥3 oral drugs, p=0.001). Various socio-demographic factors, uncontrolled diabetes and insulin usage were found to have negative impact on a diabetic patient's quality of life. Programmes addressing the physical and emotional needs of diabetic patients at the primary health care setting are essential to help improve their quality of life.
  12. Jalaludin MY, Fuziah MZ, Hong JYH, Mohamad Adam B, Jamaiyah H
    Malays Fam Physician, 2012;7(2-3):10-20.
    PMID: 25606251 MyJurnal
    BACKGROUND: Self-care plays an important role in diabetes management. One of the instruments used to evaluate self-care in patients with diabetes is the Summary of Diabetes Self-Care Activities (SDSCA) questionnaire. A validated instrument in the Malay language is used to assess self-care practice among children and adolescents with diabetes in Malaysia.
    OBJECTIVE: To translate and evaluate the psychometric properties of the revised version of the SDSCA questionnaire in the Malay language.
    METHODS:Forward and backward translations were performed. An expert panel reviewed all versions for conceptual and content equivalence. The final version was administered to paediatric patients with diabetes between August 2006 and September 2007. Reliability was analysed using Cronbach's alpha and validity was assessed using exploratory factor analysis.
    RESULTS: A total of 117 patients aged 10-18 years were enrolled from nine hospitals. The reliability of overall core items was 0.735 (with item 4) while the reliabilities of the four domains were in the range of 0.539-0.838. As core item number 4 was found to be problematic and it was subtituted by item 5a (from the expanded SDSCA) to suit local dietary education and practice; and the reliabilities of the overall core item (0.782) and the four domains (0.620 - 0.838) improved. Factor loadings of all the items were greater than 0.4, loaded into the original domains, and accounted for 73% of the total variance.
    CONCLUSION: The Malay translation of the revised English SDSCA is reliable and valid as a guide for Malaysian children and adolescents suffering from diabetes.
    KEYWORDS: Adolescents Diabetes self-care; Children; Malay-translated version of SDSCA
    Study site: Pediatric Clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
  13. Ching SM, Chia YC, Wan Azman WA
    Malays Fam Physician, 2012;7(2-3):2-9.
    PMID: 25606250 MyJurnal
    Left ventricular hypertrophy (LVH) has prognostic significance on cardiovascular mortality and morbidity. However, echocardiography screening for LVH is not routinely done for hypertensive patients in a primary care setting. Thus, this quantitative study aims to determine the prevalence and factors associated with LVH in hypertensive patients at a primary care setting. This was a cross-sectional study of 359 consecutive patients with uncomplicated essential hypertension attending a hospital-based clinic in Malaysia. All subjects underwent an echocardiography test. LVH occur when the left ventricular posterior wall thickness together with inter-ventricular septal thickness is ≥11 mm. It was found that 24% patients fulfilled the criteria for LVH. The mean age of the study population was 59.2±7.7 years; mean duration of hypertension was 9.7±7.5 years; and mean blood pressure was 136.5/81.5 (±13.7/7.7) mmHg. Using multiple logistic regression analysis, patients who were obese [odds ratio (OR) 8.34, 95% confidence interval (CI) 3.14, 22.22] and male gender (OR 1.96, 95% CI 1.08, 3.16) had significant positive association with LVH. LVH was found in approximately one fourth of the hypertensive patients at a hospital-based primary care setting. There was a significant positive association between LVH and obesity and being male. Guidelines for enhancing use of echocardiography in detecting LVH may be needed.

    Study site: university primary care centre in Kuala Lumpur, Malaysia
  14. Ramli M, Nora M, Roszaman R, Hatta S
    Malays Fam Physician, 2012;7(1):24-7.
    PMID: 25606241 MyJurnal
    OBJECTIVE: To analyse the features of patients with vaginismus first presented to a gynaecologist for infertility before being referred for psychiatric evaluation and management. The case series aim to provide some insight on features and presentations of Asian women with vaginismus. Vaginismus is characterised by persistent or recurrent difficulties in vaginal penetration despite the woman's wish for coitus. Avoidance, phobia, anticipatory fear of pain and involuntary pelvic muscle contraction are the most common symptoms.

    METHOD: We report a series of cases of Malaysian women who had been suffering from vaginismus and 'infertility'. All the cases had never been attended to medically and there were long delays in seeking intervention. There was no history of traumatic sexual experience or any major psychiatric illness in these patients. Majority of the patients had prominent symptoms of anxiety.

    CONCLUSION: The cases illustrate that it is important to rule out the possibility of vaginismus among patients with infertility. The former have unique psychological features which require psychological interventions.
  15. Khaw K, Ramli N, Rahmat K
    Malays Fam Physician, 2012;7(1):31-3.
    PMID: 25606243 MyJurnal
    Complications of breast cancer metastasis may be the first manifestation of the disease. We report a rare case of left eye ptosis secondary to cavernous sinus syndrome in a 34-year-old lady due to refusal of proper medical treatment for metastatic breast cancer. The delay in seeking medical treatment was attributed to her use of Traditional Chinese Medicine (TCM).
  16. Irfan M, Hasme Zam H, Mohd Khairi M
    Malays Fam Physician, 2012;7(1):28-30.
    PMID: 25606242 MyJurnal
    The incidence of rhinolith is by far very low compared to the nasal foreign bodies, especially in adult. Foreign body (FB) in the nostril will lead to unilateral nasal symptom which can start with nasal obstruction or discomfort. In younger children, they may miss to report the problem to the parents but, later on, the FB will manifest itself with unilateral nasal discharge, which at most of the time fouls smells. We report a case of a healthy adult female who presented with unilateral foul smelly nasal discharge which later was diagnosed as rhinolith, with rubber-tip pencil eraser as the nidus of calcification.
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