MyMedR

Fulltext Knowledge of and attitudes towards of menstrual disorders adults in north-eastern state of Peninsular Malaysia

Yaacob NA, Abdullah SK, Ahmad I, Yahya NA, Draman N, Ismail SB, et al.

Malays Fam Physician, 2015;10(3):2-10.

Introduction: In Malaysia, the prevalence of menstrual disorders among adolescents and young adults is high. However, most of them are not aware of the signs and symptoms of menstrual
disorders in terms of medical issue as well as Islamic ruling. Awareness of the menstrual disorder
symptoms is important so that early and appropriate treatment can be given.

Objectives: The objective of the study was to compare the knowledge and attitude of premarital
men and women on menstrual disorders.

Methods: This was a comparative cross sectional study conducted in Kota Bharu, Kelantan. Self-administered
questionnaires were given for data collection. The questionnaires consisted of 3 parts
that required information on the women’s and men’s socio-demographic data, women’s menstrual
history and information in knowledge and attitude of men and women on menstrual disorders.

Results: A total of 460 respondents were involved in this study with a response rate of 93.5%. The
prevalence of good knowledge was higher among women compared to men with 73.2% and 26.8%,
respectively. There was a significant difference on knowledge and attitude on menstrual disorders
between premarital men and women.

Conclusion: Both premarital men and women had low knowledge on menstrual disorder with men
knowing less than the women.

Fulltext Purple urine bag syndrome: A startling phenomenon of purple urine in a urine drainage bag. A primary care approach and literature review

Wong Y, Abdullah N

Malays Fam Physician, 2018;13(2):42-44.

PMID: 30302185

Purple urine bag syndrome (PUBs) is a rare and startling phenomenon of purple discolouration in the urine or urinary catheter and bag. It is reported in chronically debilitated elderly patients, mostly in women on long-term urinary catheters. Its prevalence is strikingly more common in nursing home residents. Several factors contribute to the formation of indigo (blue) and indirubin (red) pigments from a breakdown of dietary tryptophan, which stains the urine purple. These factors include constipation, dysmotility of the bowel, bowel bacterial overgrowth, dehydration, and urinary tract infection. The presence of purple urine may cause undue alarm to both the patient and the doctor. Thus, we present this case report on an 86-year-old woman, a nursing home resident on a long-term urinary catheter, who presented to the primary care clinic. Her urine cleared after antibiotic therapy, replacement of her urinary catheter, and supportive management, which included hydration and nutrition. In addition to these measures, reducing the time between urinary catheter changes was recommended to prevent recurrence of this condition.

Fulltext Pharmacist-structured review of proton pump inhibitor utilisation in primary care: A nonrandomised control study

Wong SL, Sulaiman N, Ng KM, Lee ZY

Malays Fam Physician, 2021 Nov 30;16(3):87-96.

PMID: 34938396 DOI: 10.51866/oa1153

Introduction: In the primary care setting, proton pump inhibitor (PPI) overutilisation often stems from the failure to discontinue prophylaxis treatment prior to tertiary care discharge and consider step-down therapy following discharge. Long-term PPI use can result in potential drug-related problems and unnecessary drug expenditure. This study aimed to evaluate the effectiveness of pharmacist-structured review in reducing inappropriate PPI prescriptions and estimate the potential cost saving.

Methods: This non-randomised controlled study was conducted for 16 weeks at 17 government health clinics in Selangor, Malaysia. Eligible patients attending the outpatient pharmacies of intervention clinics were recruited consecutively and their consent was obtained. A structured review of PPIs was performed in which pharmacists identified patient demographics, indications and the length of PPI therapy using a PPI intervention form. Recommendations were discussed with physicians before prescription changes were made and documented. Moreover, standard management was conducted in the control clinics.

Results: A total of 568 patients with prescriptions containing PPIs were sampled, with a total of 284 patients being placed into the control and intervention groups, respectively. Compared to the control group, inappropriate PPI utilisation in the intervention group significantly decreased from 79.9 to 30.4% (p<0.05). The changes to PPI prescriptions observed in the intervention group included: stop PPI therapy (30.8%), step-down therapy (22.9%), start substitution therapy (15.9%) and no change (30.4%). The physicians' acceptance rate for pharmacist intervention was 67.8%. A 66.1% reduction in monthly PPI pill count and a 72.0% reduction in monthly medication expenditure (RM44.85/patient/year) were observed.

Conclusion: The pharmacist-structured review was effective in increasing appropriate PPI utilisation and led to substantial cost savings.

Covid-19, not your normal flu: A case report on Covid-19 psychosis and mania in a Malaysian hospital

Wong RPY, George P

Malays Fam Physician, 2022 Nov 30;17(3):144-148.

PMID: 36606171 DOI: 10.51866/cr1369

Evidence suggests that acute severe coronavirus disease 2019 (COVID-19) may be associated with neuropsychiatric symptoms. This is a case report of a patient who had recently been infected with COVID-19 and had no history of psychiatric disorders presenting a few days after inpatient discharge from COVID-19 treatment with acute onset of psychosis and manic symptoms. This case illustrates the psychiatric presentation, possible causes, and management of post-COVID-19 psychosis.

Fulltext Reply letter to: Rule out alternative entities before diagnosing post-COVID psychosis

Wong RPY

Malays Fam Physician, 2023;18:34.

PMID: 37292228 DOI: 10.51866/lte.315r

Fulltext Achieving sustainable development goals with primary care physicians

Wong PF, Lee WK, Paranthaman V

Malays Fam Physician, 2024;19:1.

PMID: 38371723 DOI: 10.51866/ed0008

Fulltext Qualitative research methods in family medicine: what and why?

Wong LP

Malays Fam Physician, 2008;3(1):70.

PMID: 25606118

Fulltext Current Issues Facing The Introduction Of Human Papillomavirus Vaccine In Malaysia

Wong LP, Sam IC

Malays Fam Physician, 2007;2(2):47-53.

PMID: 25606080 MyJurnal

Certain human papillomavirus (HPV) types are strongly associated with cervical cancer. Recently-described effective vaccines against these HPV types represent a great medical breakthrough in preventing cervical cancer. In Malaysia, the vaccine has just received regulatory approval. We are likely to face similar barriers to implementing HPV vaccination as reported by countries where vaccination has been introduced. Most women have poor understanding of HPV and its link to cervical cancer. Physicians who will be recommending HPV vaccines may not have extensive knowledge or experience with HPV-related disease. Furthermore, a vaccine against a sexually-transmitted infection may elicit negative reactions from potential recipients or their carers, particularly in a conservative society. Given the high cost of the vaccine, reaching the most vulnerable women is a concern. To foster broad acceptance of HPV vaccine, education must be provided to health care providers, parents and young women about the risks of HPV infection and the benefits of vaccination.

Fulltext Summarizing research findings: systematic review and meta-analysis

Wong LP

Malays Fam Physician, 2007;2(1):8-12.

PMID: 25606070 MyJurnal

The explosion of biomedical publishing makes keeping up with the primary studies an impossible task. The often disparate, confusing and contradicting findings of individual studies makes healthcare professionals turn to review articles where knowledge has been collated and published in summaries. Narrative reviews lack rigorous, systematic and reproducible synthesis. In contrast, systematic reviews are conducted using systematic and explicit methods to identify, select and critically appraise relevant research, and to collect and analyse data from the studies that are included in the review. The final pathway for systematic review is a statistical summary of the results of primary studies, or meta-analysis. This article provides some guidelines to health care providers in understanding the key aspects of systematic review and meta-analysis. Steps involved in systematic review are discussed. The potential pitfall of meta-analysis was also explored.

Data analysis in qualitative research: a brief guide to using nvivo

Wong L

Malays Fam Physician, 2008;3(1):14-20.

PMID: 25606106 MyJurnal

Qualitative data is often subjective, rich, and consists of in-depth information normally presented in the form of words. Analysing qualitative data entails reading a large amount of transcripts looking for similarities or differences, and subsequently finding themes and developing categories. Traditionally, researchers 'cut and paste' and use coloured pens to categorise data. Recently, the use of software specifically designed for qualitative data management greatly reduces technical sophistication and eases the laborious task, thus making the process relatively easier. A number of computer software packages has been developed to mechanise this 'coding' process as well as to search and retrieve data. This paper illustrates the ways in which NVivo can be used in the qualitative data analysis process. The basic features and primary tools of NVivo which assist qualitative researchers in managing and analysing their data are described.

Fulltext ChatGPT, medical research and scientific writing

Wiwanitkit S, Wiwanitkit V

Malays Fam Physician, 2024;19:3.

PMID: 38371717 DOI: 10.51866/lte.545

Fulltext Imaging as an aid to the diagnosis of acute appendicitis

Wijesuriya LI

Malays Fam Physician, 2007;2(3):106-9.

PMID: 25606095 MyJurnal

Acute appendicitis has been known as a disease entity for well over a century but a confident diagnosis before surgery in all patients suspected of the condition is still not possible. Timely diagnosis is essential to minimise morbidity due to possible perforation of the inflamed organ in the event treatment is delayed; so much so that surgeons often preferred to operate at the slightest suspicion of the diagnosis in the past. This resulted in the removal of many normal appendixes. When the diagnosis of appendicitis is clear from the history and clinical examination, then no further investigation is necessary and prompt surgical treatment is appropriate. Where there is doubt about the diagnosis however it is advisable to resort to imaging studies such as abdominal ultrasound or computed tomography to clear such suspicions before subjecting the patient to an appendicectomy. These studies would also help avoid delays in surgery in deserving patients.

Fulltext Self-management approaches among hypertensive residents in nursing homes in Malaysia

Wei TM, Omar MS

Malays Fam Physician, 2017;12(3):8-17.

PMID: 29527274 MyJurnal

Introduction: The prevalence of hypertension in Malaysia is increasing and an effective management of hypertension is important to reduce cardiovascular morbidity and mortality.

Objective: To determine the knowledge, awareness and perception towards hypertension among residents in nursing homes as well as the roles of caregivers in hypertension management.

Methods: A face-to-face survey with 200 hypertensive residents and 30 caregivers from 24 nursing homes in Kuala Lumpur and Selangor, Malaysia was conducted.

Results: Of all the hypertensive residents, 90.5% (n= 181) knew that lowering their blood pressure could improve their health. Most residents strongly believed that taking antihypertensive drugs is important for keeping their high blood pressure under control (n= 162, 81%). Taking medication was perceived as the most important factor in controlling the high blood pressure (58%,n= 116) compared to lifestyle or diet modification. The majority of the caregivers reported that they played a major role in managing hypertension, especially with regards to medication-taking. task (66.7%,n= 20).

Conclusion: The knowledge, attitude and perceptions of hypertension play a relatively major role in the self-management of hypertension. The role of caregivers also needed to be recognised in managing hypertension in nursing homes.

Fulltext An elderly woman with intermittent claudication

Wazir NN

Malays Fam Physician, 2006;1(1):23-24.

PMID: 26998205 MyJurnal

This case report illustrates the misdiagnosis of intermittent claudication in an elderly with multiple cardiac risk factors. Careful clinical evaluation and imaging shifts the diagnosis from peripheral vascular disease to spinal stenosis. The decision whether to offer conservative therapy or proceed to spinal surgery requires an accurate assessment of the severity of the symptoms without ignoring the important role of patient preferences.

Fulltext Journey between career and life traps: Reflections on academic family medicine

Wattanapisit A

Malays Fam Physician, 2023;18:52.

PMID: 37814672 DOI: 10.51866/mol.464

Fulltext Should ChatGPT be considered a medical writer?

Wattanapisit A, Photia A, Wattanapisit S

Malays Fam Physician, 2023;18:69.

PMID: 38111835 DOI: 10.51866/lte.483

Fulltext Six-minute walking distance reference value for healthy Indonesian children: A cross-sectional study from the largest country in South East Asia

Wardhani RK, Kekalih A, Wahyuni LK, Laksmitasari B, Benedicta SM, Lakmudin A, et al.

Malays Fam Physician, 2023;18:1.

PMID: 36969334 DOI: 10.51866/oa.179

INTRODUCTION: There is no global reference value for the 6-minute walking distance (6MWD) in paediatric populations, as it can vary greatly depending on local characteristics and anthropometric measures. This study aimed to identify a 6MWD reference value that could be applied in both local and regional settings.

METHOD: This cross-sectional multicentre study investigated a healthy paediatric population aged 4-18 years in Indonesia. The 6-minute walk test (6MWT) was conducted in accordance with the American Thoracic Society guidelines. Data were presented as the 6MWD according to age and sex per year. Univariate and multivariate analyses were conducted on the basis of the 6MWDpred Rizky formula.

RESULTS: A total of 634 participants were included in this study. Age, sex, weight, leg length and height affected the 6MWD (P<0.001). In the regression model, sex and height were the predictors of 6MWD, with height as the best single predictor.

CONCLUSION: The reference charts and 6MWDpred Rizky formula are applicable in multi-ethnic paediatric Indonesian populations but in limited settings.

Fulltext Backward logistic regression analysis of the determinants of the hand function among patients with leprosy: A cross-sectional study

Wardhani RK, Harini M, Anestherita F, Ramadhani FN

Malays Fam Physician, 2024;19:20.

PMID: 38623418 DOI: 10.51866/oa.405

INTRODUCTION: The hands are the most common site of disability in leprosy. Hand dysfunction could result in difficulty performing activities of daily living. Therefore, hand function should be regularly assessed to ensure that any decrease in hand function could be diagnosed earlier.

METHODS: This study included 110 patients with leprosy from Likupang and Lembata, Indonesia. Hand function was assessed using the modified Jebsen test to measure hand function respective of the dominance. The grip and pinch strength were used as objective measures of clinical arm function. The World Health Organization (WHO) hand disability grade were used to determine the degree of impairment. Other factors such as age, sex and the type of leprosy were also considered. All factors were analysed using backward logistic regression.

RESULTS: Among the 110 participants, a decrease in the dominant (48.2%) and non-dominant (50.9%) hand functions were found. Pinch strength (OR: 3.39; 95% CI: 1.13-10.19) and age (OR: 4.91; 95% CI: 1.72-14.03) were significantly associated with hand function irrespective of the dominance. Conversely, the WHO hand disability grade (OR: 2.97; 95% CI: 1.10-8.04) and type of leprosy (OR: 0.34; 95% CI: 0.12-0.97) were significantly associated with only function of the dominant hand.

CONCLUSION: There is a significant association of age and pinch strength with hand function regardless of the hand dominance. In contrast, the WHO hand disability grade and type of leprosy are significantly associated with the function of the dominant hand only.

Fulltext Type 2 Diabetes Mellitus with HbJ trait: A management conundrum

Wan Yaacob WN, Yaacob LH, Draman N

Malays Fam Physician, 2022 Mar 28;17(1):86-89.

PMID: 35440968 DOI: 10.51866/cr1288

Optimal glycaemic control is crucial in patients with diabetes mellitus (DM) to avoid episodes of hypoglycaemia and both micro- and macrovascular complications. Diabetic control relies mainly on the evaluation of haemoglobin A1c (HbA1c), which is unfortunately unreliable in patients with haemoglobinopathies. This case report describes a patient with type 2 DM and haemoglobin J (HbJ) trait, which resulted in erratic HbA1c values throughout her follow-up. Other approaches, such as self-blood glucose monitoring, are needed to evaluate glycaemic control instead of relying on HbA1c alone to guide the management DM in these patients.

Fulltext Obstructive sleep apnoea hypopnoea syndrome – an overview

Wan Haniza WHW, Tengku Saifudin TI

Malays Fam Physician, 2011;6(1):2-6.

PMID: 25606213 MyJurnal

Obstructive sleep apnoea hypopnoea syndrome (OSAHS) is a common cause of breathing-related sleep disorder, causing excessive daytime sleepiness. Common clinical features of OSAHS include snoring, fragmented sleep, daytime somnolence and fatigue. This article aims to provide a comprehensive review of the condition, including its management.

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