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A case of nasopharyngeal carcinoma and precious pregnancy

Abdul Satar NF, Cheong EV, Jasmin LPY, Ngu MR

Med J Malaysia, 2020 11;75(6):738-741.
PMID: 33219188

Cancer during pregnancy is a rare condition. We report here a case of a lady diagnosed with nasopharyngeal carcinoma (NPC) at University of Malaya Medical Centre during her first pregnancy conceived via In Vitro Fertilisation (IVF). A multidisciplinary (MDT) meeting among Oncology, Obstetrics, Rheumatology and Otolaryngology teams was conducted to discuss her treatment options. She opted for treatment with Complementary and Alternative Medicine (CAM). This case illustrates the unique challenges in the oncological management of a patient diagnosed with NPC during pregnancy. It also serves as a reminder that the use of CAM in cancer patients is prevalent. It is important for doctors to inquire about use of CAM and to be well-informed about it. Transparent communication and taking cognizance of the goals and concerns of the patients are essential in delivering patient-centred care.

Matched MeSH terms: Physicians
Fulltext Development of a Personalized Mobile Mental Health Intervention for Workplace Cyberbullying Among Health Practitioners: Protocol for a Mixed Methods Study

Kim YJ, Qian L, Aslam MS

JMIR Res Protoc, 2020 Nov 20;9(11):e23112.
PMID: 33216000 DOI: 10.2196/23112

BACKGROUND: Workplace cyberbullying harms the psychological and social functioning of professionals working in an organization and may decrease the productivity and efficiency of daily life tasks. A recent study on trainee doctors across 8 different United Kingdom National Health Service trusts found health issues and job dissatisfaction in people who have experienced workplace cyberbullying. This disabling effect is even more noticeable in low-socioeconomic communities within low-income countries. In Malaysia, there is a need to create a personalized mobile mental health intervention program for health care professionals. These programs should be directed to prevent and decrease psychosocial issues and enhance coordination among health care professionals to solve health issues in the community.
OBJECTIVE: Our main objective is to study the pre-effects and posteffects of the Personalized Mobile Mental Health Intervention (PMMH-I) for workplace cyberbullying in public and private hospitals in Malaysia.
METHODS: A hospital-based multimethod multi-analytic evidential approach is proposed, involving social and psychological health informatics. The project has been subdivided into 3 stages, starting with Phase 1, a prevalence study, followed by exploratory studies. Phase 2 consists of a quasi-experimental design, whereas the development of a prototype and their testing will be proposed in Phase 3. Each stage includes the use of quantitative and qualitative methods (mixed-method program), using SPSS (version 26.0; IBM Corp) and Stata (version 16.1; StataCorp) as tools for quantitative research, and NVivo (version 1.0; QSR International) and Atlas.ti (version 9.0.16; ATLAS.ti Scientific Software Development GmbH) for qualitative research.
RESULTS: The results of this study will determine the pre- and posteffectiveness of an integrated PMMH-I for health care professionals. The prototype system platform will be developed and implemented in a public and private hospital. Results from Phase 1 will be published in 2021, followed by the implementation of Phase 2 in subsequent years.
CONCLUSIONS: This study will provide evidence and guidance regarding the implementation of a personalized mobile mental health intervention for health care professionals into routine public and private hospitals to enhance communication and resolve conflicts.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/23112.

Matched MeSH terms: Physicians
Fulltext Development and validation of antisnake venom knowledge assessment tool (AKAT) for healthcare practitioners

Bala AA, Jatau AI, Yunusa I, Mohammed M, Mohammed AH, Isa AM, et al.

Toxicon X, 2020 Dec;8:100064.
PMID: 33319211 DOI: 10.1016/j.toxcx.2020.100064

Antisnake venom (ASV) is the only specific and standard treatment for snakebite envenoming worldwide. The knowledge of antivenom dosage, mode of administration, availability, and logistics is essential to the healthcare practitioners (HCPs) in the management of snakebites. It is vital for the HCPs involved in the handling of ASVs to have its basic knowledge. The ASV contains proteins and can, therefore, easily get denatured if not handled appropriately, leading to poor therapeutic outcome. It is also essential for clinicians to be aware of the tendency of ASV to cause a severe life-threatening hypersensitivity reaction. There is currently no validated tool for assessing the knowledge of ASV among HCPs. Therefore, we developed and validated a tool for evaluating the HCPs knowledge of ASV. The items included in the tool were first generated from a comprehensive literature review. Face validity were conducted by presenting the drafted tool to ten experts on the subject matter. A validation study was conducted among doctors, pharmacists, nurses, pharmacy technicians, and the general public. The objectives of the study were to test the tool for content validity using the content validity index (CVI), construct validity using contrast group approach, difficulty index, readability, and reliability test using the test-retest method. We developed and validated a final tool containing thirty-three items. The tool was valid for face validity and had a scale-level (average) content validity (S-CVI/Ave) of 0.91. The ASV knowledge of pharmacists was higher than that of doctors, pharmacy technicians, nurses, and the general public (p

Matched MeSH terms: Physicians
Fulltext Validity and reliability of an adapted questionnaire measuring knowledge, awareness and practice regarding familial hypercholesterolaemia among primary care physicians in Malaysia

Azraii AB, Ramli AS, Ismail Z, Abdul-Razak S, Badlishah-Sham SF, Mohd-Kasim NA, et al.

BMC Cardiovasc Disord, 2021 01 19;21(1):39.
PMID: 33468051 DOI: 10.1186/s12872-020-01845-y

BACKGROUND: Primary care physicians (PCP) play an important role in detecting Familial Hypercholesterolaemia (FH) early. However, knowledge, awareness and practice (KAP) regarding FH among Malaysian PCP are not well established, and there was no validated tool to assess their FH KAP. Thus, the aim of this study was to adapt an FH KAP questionnaire and determine its validity and reliability among Malaysian PCP.
METHODS: This cross-sectional validation study involved Malaysian PCP with ≥ 1-year work experience in the primary care settings. In Phase 1, the original 19-item FH KAP questionnaire underwent content validation and adaptation by 7 experts. The questionnaire was then converted into an online survey instrument and was face validated by 10 PCP. In Phase 2, the adapted questionnaire was disseminated through e-mail to 1500 PCP. Data were collected on their KAP, demography, qualification and work experience. The construct validity was tested using known-groups validation method. The hypothesis was PCP holding postgraduate qualification (PCP-PG-Qual) would have better FH KAP compared with PCP without postgraduate qualification (PCP-noPG-Qual). Internal consistency reliability was calculated using Kuder Richardson formula-20 (KR-20) and test-retest reliability was tested on 26 PCP using kappa statistics.
RESULTS: During content validation and adaptation, 10 items remained unchanged, 8 items were modified, 1 item was moved to demography and 7 items were added. The adapted questionnaire consisted of 25 items (11 knowledge, 5 awareness and 9 practice items). A total of 130 out of 1500 PCP (response rate: 8.7%) completed the questionnaire. The mean percentage knowledge score was found to be significantly higher in PCP-PG-Qual compared with PCP-noPG-Qual (53.5, SD ± 13.9 vs. 35.9, SD ± 11.79), t(128) = 6.90, p

Matched MeSH terms: Physicians, Primary Care
Fulltext A cross-sectional assessment of shared-decision making among patients visiting public healthcare institute of Quetta city, Pakistan

Waheed, Hira, Haider, Sajjad, Iqbal, Qaiser, Khalid, Adnan, Hassali, Mohamed Azmi, Bashaar, Mohammad, et al.

Malaysian Journal of Pharmaceutical Science, 2020;18(1):15-29.
MyJurnal

Shared-decision making (SDM), occasionally called “participatory governance” is the approach in healthcare to ensure that patients have the right to participate effectively in the decision-making (DM) process. The aim of this research was to discuss the external aspect of SDM and put forward applicable solutions to ensure SDM at both patient and physician levels. A standardised validated nine-item SDM questionnaire (patient version SDM-Q-9) was employed. SPSS version 25 was used to perform data analysis. Multiple tests such as Mann-Whitney U and Jonckheere-Terpstra were used. Kendall’s Tau coefficient was used for interpretation of the significant relationship among all items of SDM-Q-9 and education. A total of 465 chronically ill patients took part, where majority (63.4%) of patients was above the age of 47. The cohort was dominated by females (67.5%) with 92% of the sample was married. Majority (86.9%) of the patient reported not involved in any decision. During analysis, considerable association was reported between gender and all items of SDM-Q-9, where more men were involved in SDM when compared with women. Our findings did produce significant association between education and SDM-Q-9, which reveals that increase in education can improve the SDM. SDM should not be limited to chronic or emergency in practice. Specific and tailored shared medical DM programmes must be developed for low literacy population implementation. SDM is to be supported at policy and operation levels.

Matched MeSH terms: Physicians
Barriers to Making House Calls by Primary Care Physicians and Solutions: A Literature Review

Seah JY

Malays Fam Physician, 2020;15(3):3-9.
PMID: 33329858

Background: The number of house calls made by physicians has been declining over the years, while the number of people requiring house calls, especially the elderly, is growing.
Aim: To consolidate the literature regarding the barriers faced by primary care physicians in making house calls.
Design of the study: Literature review.
Method: Studies were sourced from PubMed and Embase.
Results: 7 studies were selected to be in the literature review. Barriers to making house calls by primary care physicians include inadequate remuneration, lack of time and training, unconducive home environment, concerns with professional liability and safety, and perceived low value-added in the patient's quality of care.
Conclusion: While primary care physicians do recognize the value of house calls in patient care, the perceived limited standard of care that can be achieved in the home setting, busy clinic practice (large patient loads), coupled with inadequate remuneration make house calls unrealistic for many doctors. These barriers must be addressed to ensure accessibility to primary health care services for the immobile, frail, and sick is not being compromised. One of the solutions may be to expose medical students and residents to house calls early through mentorship.

Matched MeSH terms: Physicians, Primary Care
Neurological Examination Techniques of Speech in Bahasa Malaysia for Adults: Simple Approach Practiced in Hospital Universiti Sains Malaysia

Noorsham AH, Abdullah MM, Abdul Halim S, Ghani ARI, Idris Z, Abdullah JM

Malays J Med Sci, 2020 Dec;27(6):148-182.
PMID: 33447142 DOI: 10.21315/mjms2020.27.6.14

There are four classification levels for speech disorders namely dysphonia, dysarthria, dysprosody and dysphasia. In general, speech examination mainly focuses on three main components that are spontaneous speech, auditory comprehension, and oral motor examination. Quick bedside assessment on speech in Bahasa Malaysia is essential to assist the speech language therapist (SLT) and other physicians to determine the disorders. Speech therapy is also essential in monitoring and continuous assessment for patients with speech and language disorders such as dysphasia and dysarthria. Speech clinicians in Hospital Universiti Sains Malaysia (HUSM) have been adapting two most widely used batteries of speech assessment tools namely Western aphasia battery-revised (WAB-R) by Andrew Kertesz and Boston diagnostic aphasia examination (BDAE). These tools have been modified into simple and validated speech assessments in Bahasa Malaysia. This video manuscript will demonstrate the use of both tools in performing bedside speech assessment for patients with speech disorders. The Bahasa Malaysia speech examination should not be difficult when WAB-R and BDAE speech assessment tools are applied. The aim of this simple approach using the adapted version of BDAE and WAB-R is to assist the clinician to achieve quick and accurate diagnosis with a validated scoring system.

Matched MeSH terms: Physicians
Fulltext Autoimmune Thyroiditis as Initial Presentation of Systemic Lupus Erythematosus Complicated by Massive Ascites: A Case Report

Abdullah NRA, Akbar RZA

J ASEAN Fed Endocr Soc, 2017;32(1):50-53.
PMID: 33442085 DOI: 10.15605/jafes.032.01.09

Autoimmune thyroiditis in the course of other autoimmune diseases such as systemic lupus erythematosus (SLE) is common because these disorders are attributed to the production of autoantibodies against various autoantigens. Beyond this association, autoimmune thyroiditis can occur before, during or after the development of SLE. In this report, we describe a female who presented with facial puffiness, lethargy and progressive abdominal distension. She was diagnosed with autoimmune thyroiditis followed by the diagnosis of SLE complicated by a massive ascites, a rare form of lupus peritonitis, which is sterile ascites that results from severe serositis. Her presentation was complex and posed a diagnostic challenge and dilemma to the physicians involved in her care.

Matched MeSH terms: Physicians
Fulltext Habits and attitudes of Malaysian military doctors towards smoking

Supramaniam V

Med J Malaysia, 1980 Mar;34(3):205-10.
PMID: 7412660

A postal questionnaire survey was carried out among military doctors during June to August 1979 on habits and attitudes to smoking. An 87% response rate was obtained. Smoking prevalence was found to be 50%. 45% of medical officers are heavy smokers. Age at starting influence the amount smoked. Service life had no influence on smoking habits. Attitudes to smoking vary between the different categories of doctors. The habits and attitudes indicate a mental revolution on the part of doctors is required prior to any anti-smoking programme as they have to be sufficiently motivated to lead the fight.

Matched MeSH terms: Physicians
A study of patients' self-interpretation of prescription instructions

Sarriff A, Aziz NA, Hassan Y, Ibrahim P, Darwis Y

J Clin Pharm Ther, 1992 Apr;17(2):125-8.
PMID: 1583080

This study examined out-patients' interpretation of prescription instructions at a community hospital. The results showed a wide range of misinterpretation with respect to drug name, dose schedule, and auxiliary labels. Age level, education and financial status emerged as the most significant variables associated with the patient's response. Therefore, both physicians and pharmacists may wish to review their traditional prescribing and dispensing procedures to help out-patients make better use of potent medication.

Matched MeSH terms: Physicians
Fulltext Turkish healthcare providers’ level of knowledge, attitude and practice toward diagnosis related group system – a cross sectional study

Saad Ahmed Ali Jadoo, Syed Mohamed Aljunid, Dastan, Ilker, Dilmac, Elife, Kahveci, Rabia, Tutuncu, Tanju, et al.

Malaysian Journal of Public Health Medicine, 2016;16(1):121-128.
MyJurnal

Diagnosis-related group (DRG) system is patient classification system designed to produce limited number of classes
which are relatively similar in terms of resource consumption and clinical characteristics. The aim of this study was to
assess the level of knowledge, attitude and practice (KAP) of Turkish health care providers toward DRG system
implemented in Turkey.A total of 238 healthcare providers were randomly selected from two urbanand one rural hospital
in Turkey.A questionnaire was used for data collection; contacting 32 items (10 items about knowledge, 12 items about
attitude and 10 items about the practice) and its validity and reliability were confirmed. Data analysis was performed
using chi-square and multivariate logistic regression.In this study,only one third of healthcare providers showed good
knowledge (35.7%) and good practice (37.4%) about DRG system,compared to 54.2% of them showed good attitude.There
was significant difference between age, gender, occupation groups and whether the respondents have attended a
workshop for DRG system in terms of KAP (p > 0.05).These results indicated the need for further actions to implement
DRG system in terms of creation of suitable environment and increasing awareness among healthcare providers,
especially male, medical doctors, nurses, elderly, and those who have never attended a workshop, in addition to regular
review to ensure the program would reach its targets.

Matched MeSH terms: Physicians
Fulltext Ethnic groups difference in discriminatory attitude towards HIV/AIDS patients among medical students: a cross-sectional study

Chew, B.H., Cheong, A.T.

Malaysian Journal of Medicine and Health Sciences, 2014;10(1):61-69.
MyJurnal

Medical students are future doctors who are trained to treat all kinds of diseases including people living with HIV/AIDS (PLWHA) without prejudice. Teaching basic scientific knowledge and technical skills is no longer adequate for today’s medical students. There is also a need for them to be provided with high personal and professional values. This study examined stigmatizing attitude towards people living with HIV/AIDS (PLWHA) among the medical students in a public medical school. The participants were stratified to preclinical-year (year 1 and year 2) and clinical-year (year 3 and year 4) medical students. Simple random sampling was carried out to select 170 participants from each category of students. Self-administered questionnaires captured socio-demographic data, HIV/AIDS knowledge and stigmatisation attitudes towards PLWHA. Multiple linear regression was used to assess the relationship between ethnic groups and stigmatization attitude. Three hundred and forty participants were recruited. Malay medical students who did not have previous encounter with PLWHA were associated with stigmatizing attitude towards HIV/AIDS patients, whereas clinical-year medical students who had no clinical encounter with PLWHA were more likely to feel uncomfortable with PLWHA. Malay ethnicity and medical students in clinical years who had not encounter a PLWHA were more likely to have stigmatizing attitude towards PLWHA.

Matched MeSH terms: Physicians
Fulltext Outcome of Traumatic Intracapsular Neck of Femur Fractures in Patients Aged Above 60 Years Treated by Hemiarthroplasty

Harjeet, S., Suhail, A., Shahril, Y., Masbah, O., Subanesh, S.

Malays Orthop J, 2009;3(1):24-27.
MyJurnal

Fracture of the femoral neck is one of the most common types of osteoporotic fractures. Hemiarthroplasty continues to be a good option despite current calls for total hip arthroplasty in this subset of patients. The hemiarthroplasty is less expensive and easier to perform, and can be adequately carried out in smaller hospitals with basic orthopaedic facilities staffed by general orthopaedists. Functional demands of the elderly among Asians are often less compared to similar subsets of Western population on which most comparative hip studies are based. This study was undertaken to investigate the outcome for femoral neck fractures treated with conventional hemiarthroplasty. The authors hope to provide information based on local data as a reference for our doctors and patients.

Matched MeSH terms: Physicians
Fulltext An adolescent with anorexia nervosa - a case report

Khairani O, Majmin SH, Saharuddin A, Loh SF, Noor Azimah M, Hizlinda T

Malays Fam Physician, 2011;6(2):79-81.
PMID: 25606230 MyJurnal

This case report illustrates an adolescent with clinical presentation of moderate anorexia nervosa with no significant co-morbidities. It highlights the management of anorexia nervosa in the outpatient setting by a multi-disciplinary health care team which includes a family physician, a dietician, a psychologist and a child psychiatrist.

Matched MeSH terms: Physicians, Family
Late diagnosis of congenital hypothyroidism : the case for newborn screening

Tan, Kah Kee, Kaur, Pyar

Malaysian Journal of Child Health, 1994;6(1):36-39.
MyJurnal

26 cases of congenital hypothyroidism were diagnosed at the Penang General Hospital from 1979 to 1993. Therewere 19 femalesand7males, thefemaletomaleratiowas2 .7 : 1. All three main ethnic groups were almost equally afflicted (10 Chinese,8Malays,8 Indians). The mean age at diagnosis was 15.8 months (range 21 days — 9 years) and only 11 (42.3%) patients were diagnosed within thefirst three months of life. 19 (73.7%) patients were diagnosed within thefirstyear and 7 (26.3%) after the firstyear. The correct referral diagnosis was made in less than half (n = 11) of the patients, with a mean of 2.3 doctors being consulted prior to the diagnosis. The five most common clinical features were coarse facies (n = 22), dry skin (n = 22), macroglossia (n = 21), lethargy (n = 20) and constipation (n = 19). The develop-ment quotient was appropriate for chronologi-cal age in less than one third (n = 8) of patients while the school performance was at least average in only less than one third (n = 5) of school-goers (n = 16). The mean (SD) T4 at diagnosis was 23.7 (12.2) nmollL while the mean (SD) TSH at diagnosis was 72.7 (37.0) mUIL. In the light of these clinical findings, screening for congenital hypothyroidism with a view to early diagnosis and prompt treatment are strongly recommended.

Matched MeSH terms: Physicians
Fulltext Building professional qualities through a community placement programme for medical students

Mat Pa MN, Ab Rahman A, Abdul Rahim AF, Yusoff MSB, Yaacob NA

Education in Medicine Journal, 2011;3(1):60-62.
MyJurnal

The community placement programme was first introduced to our medical students in 2007. The objectives of this community service programme are to enable students to explore and understand the importance of various skills such as leadership, teamwork and interest towards community services, as well as to improve their skills in those areas for becoming better students and future doctors. The first year medical students were tasked to plan, organize and implement activities in selected communities such as disabled people, orphans, neglected elderly, the poor, HIV positive single mothers and children. Amongst the activities conducted were sharing experiences and thoughts, games, donation and ‘gotong-royong’. The objective of this study was to evaluate the students’ perception on the successfulness of the community placement programme in building their professional qualities. A cross-sectional study was conducted among the first year medical students using a self-administered questionnaire. The questionnaire consists of 5 elements of professional qualities such as leadership and team work skills, interest towards community services, volunteerism and empathy. Self-reflection sessions were also held to explore the learning points gained. A total of 147 students answered the questionnaires. The students rated the overall programme as highly useful (80.6%) and as achieving the objectives (80.1%). They perceived that this programme helped them to improve their personal and professional skills such as leadership (70.0%), team work (71.4%), interest towards community services (87.1%), volunteerism (85.0%), and empathy (89.1%). Self-reflection revealed that the programme made them realize the role of doctors in a community, appreciate the spirit of teamwork and helped them to understand the need of vulnerable groups. As a conclusion, this programme was well-accepted and perceived as assisting medical students to build professional qualities to become caring and competent doctors.

Matched MeSH terms: Physicians
Fulltext Confirmatory factor analysis (CFA) of USM Emotional Quotient Inventory (USMEQ-i) among medical degree program applicants in Universiti Sains Malaysia (USM)

Wan Nor Arifin, Muhamad Saiful Bahri Yusoff, Nyi Nyi Naing

Education in Medicine Journal, 2012;4(2):26-44.
MyJurnal

Introduction: Emotional intelligence (EI) is deemed an important aspect of being good medical doctors. Universiti Sains Malaysia (USM) Emotional Quotient Inventory (USMEQ-i) is an EI inventory in Malay language developed primarily as medical student selection tool in USM. Although it was already validated by exploratory factor analysis (EFA), EFA is considered insufficient evidence of construct validity, thus confirmatory factor analysis (CFA) was conducted. Objectives: To determine measurement model validity and construct validity of USMEQ-i among medical degree program applicants in USM by CFA. Methods: USMEQ-i data file for medical degree program applicants in USM for year 2010/2011 and 2011/2012 academic sessions were obtained from Medical Education Department in USM. A random sample of 512 cases was drawn from the data file. Of the sample, only 453 cases were valid study sample after preliminary data screening and assumption checking. CFA was conducted on the sample using maximum likelihood (ML) estimation with bootstrapping technique due to violation of multivariate normality assumption. USMEQ-i measurement model was proposed as a second-order EI factor with seven first-order factors of EI and a Faking Index (FI) factor, with correlation between second-order EI factor and FI factor. Results: The proposed model could not be fit into the study sample data. EI factors and FI factor had to be analyzed separately due to non-positive definite problem. After modifications to the model, CFA of EI factors were suggestive of two-factor model instead of the proposed seven-factor model. Consciousness, Maturity and Control (CoMaCt). CFA of FI factor maintained one-factor model and also valid in term of construct. Conclusion: The modified USMEQ-i, which consisted of separate EI and FI models, was proven to have valid measurement models and reliable constructs. It is considered to be suitable for use among applicants to medical degree program in USM. However, its use as medical student selection tool may require further research, especially how predictive USMEQ-i scores with real performance of medical students, generalizability of the inventory and its stability over time.

Matched MeSH terms: Physicians
Fulltext Haematinics for anaemia in the elderly

Khoo SB

Malays Fam Physician, 2011;6(1):7-14.
MyJurnal

Anaemia is the most common haematological problem in the elderly population. Using WHO criteria for anaemia (Hb of <12 g/dL in women and <13 g/dL in men), the prevalence of anaemia in the elderly has been found to range from 8-44% with the highest prevalence in men 85 years and older. Anaemia must not be considered simply as part of ageing because in 80% of cases, there is an underlying cause for Hb
levels of <12 g/dL in the elderly. Anaemia has negative impacts on the quality of life for the elderly and there is evidence of improved morbidity and
mortality after correction of anaemia. Chronic disease and thalassaemia may also cause microcytic anaemia besides iron deficiency and not all vitamin B12 and folate deficiency present with macrocytic megaloblastic anaemia. Nutritional deficiency anaemias are common, easily diagnosed, treatments are simple, inexpensive and effective. Tests for nutritional anaemia have to be given priority in the assessment before a patient is subjected to invasive tests to look for less common causes of anaemia. Serum ferritin which is the best non-invasive test for the diagnosis of iron deficiency anaemia may be increased in the elderly while serum iron and transferrin decrease with ageing. Serum methylmalonic acid (MMA) and homocysteine (HC) levels are sensitive for detecting subclinical vitamin B12 and folate deficiency. Routine iron therapy in non-anaemic elderly or in those without iron deficiency anaemia is of no use and may be detrimental to their health. Folate therapy may improve anaemia but may mask the signs and symptoms of neurological damage due to concomitant
vitamin B12 deficiency. Blood transfusion offers prompt symptom relief of anaemia in patients with terminal malignancy irrespective of the causes for the anaemia.

Matched MeSH terms: Physicians, Family
Fulltext Palliative care for a child: role of a primary care doctor

Tan CE, Md Radzniwan R, Khairani O, Ednin H

Malays Fam Physician, 2011;6(1):26-28.
PMID: 25606216 MyJurnal

A 7-year-old boy with a diagnosis of advanced medulloblastoma refractory to treatment was discharged from hospital for further palliative care at home. During this short and eventful period, the child developed spinal cord compression with progressive weakness of upper and lower limbs, neck pain, faecal and urinary incontinence. This case highlights the important roles of a primary care doctor in the provision of palliative care for a child in the community.

Matched MeSH terms: Physicians
Fulltext Spotted bone disease (osteopoikilosis)

Omar M, Abdul Rahman AA, Mohd Hussein AM, Mustafa N

Family Physician, 2005;13(3):15-15.
MyJurnal

Osteopoikilosis is a rare bone dysplasia which is inherited as an autosomal dominant trait with a prevalence of less than 0.1 per million.1 It is characterised by dense ovoid or circular spots in cancellous bone which may appear at birth or during skeletal growth. It is usually found in the metaphyseal and epiphyseal regions of long bones, the carpals and tarsals, the end of large turbular bones and around the acetabula. It is clinically asymptomatic and occasionally associated with hereditary multiple exostosis and dermatofibrosis lenticularis disseminata. It is not associated with spontaneous fractures and treatment is unnecessary. However a case of osteosarcoma developing in a man with osteopoikilosis has been reported. The first case of osteopoikilosis was reported in Malaysia four years ago in a 25 years old lady who is also of Indian descent. It would be interesting to know if these two patients are related. Since the bone lesions could easily be mistaken for metastatic disease, it is important that family physicians be aware of the benign nature of this condition.

Matched MeSH terms: Physicians, Family

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