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Fulltext The Global Landscape of Domestic Violence against Women during the COVID-19 Pandemic: A Narrative Review

Kunasagran PD, Mokti K, Ibrahim MY, Rahim SSSA, Robinson F, Muyou AJ, et al.

Korean J Fam Med, 2024 Jan;45(1):3-11.
PMID: 37848369 DOI: 10.4082/kjfm.23.0084

The coronavirus disease (COVID-19) pandemic has led to an alarming increase in domestic violence against women owing to lockdown measures and limited access to support services. This article provides insights into the global prevalence of domestic violence, barriers to seeking help, its impact on women and children, and the best practices implemented worldwide. Domestic violence encompasses various forms of abuse; many young women experience partner violence. Barriers to seeking help include fear, financial constraints, lack of awareness of available services, and distrust among stakeholders. The consequences of domestic violence affect the mental health of both mothers and children. Countries have increased shelter funding and developed innovative protocols to reach survivors and address this issue. However, the healthcare sector's involvement in addressing domestic violence has been limited. This review advocates collaboration among healthcare institutions and government bodies. Key recommendations include utilizing telehealth services, implementing comprehensive training programs, establishing effective referral systems, enhancing health education, developing a domestic violence registry, improving the responses of law enforcement and justice systems through healthcare integration, promoting data sharing, and conducting further research. Healthcare systems should recognize domestic violence as a public health concern and detect, prevent, and intervene in cases to support survivors.
Fulltext Decision-Making on Contraceptive Use among Women Living with Human Immunodeficiency Virus in Malaysia: A Qualitative Inquiry

Sukeri S, Sulaiman Z, Hamid NA, Ibrahim SA

Korean J Fam Med, 2024 Jan;45(1):27-36.
PMID: 37848368 DOI: 10.4082/kjfm.23.0088

BACKGROUND: Malaysia is the first country in the Western Pacific Region to receive the validation certificate for the elimination of mother-to-child transmission of human immunodeficiency virus (HIV). The validation report recommends making sexual and reproductive health and rights of women living with HIV a priority. This article explores and assesses the sexual and reproductive health, rights, and access to healthcare services of Malaysia's women living with HIV (WLHIV).
METHODS: A qualitative secondary analysis conducted on 73 WLHIV from all over Malaysia comprised 11 in-depth interviews and 16 focus group discussions. Data were extracted from the original interview transcripts that emerged from the following questions: (1) "What are your experiences as a woman living with HIV in relation to your sexual and reproductive health and rights?" (2) "What are your experiences in accessing contraception?" (3) "What are your day-to-day experiences as a woman living with HIV?" Data were analyzed using thematic analysis.
RESULTS: Four themes emerged from the study findings: "lack of negotiation," "idealism in pregnancy," "coping with restrictions," and "past and future fears." The four themes are grounded in religion, a patriarchal culture, meaning and expectations of motherhood, taking risks and going against medical advice to pursue fertility desires, fear of HIV transmission, and the side effects of contraceptive use.
CONCLUSION: The complexities involved in decision-making regarding contraceptive use revealed how WLHIV may have unresolved reproductive health needs inconsistent with healthcare providers' focus on HIV management and prevention. Suggestions are made for improving the sexual and reproductive health and rights of WLHIV in Malaysia, which include establishing a reproductive health counseling program.
Fulltext Essential Oils as an Alternative Treatment for Migraine Headache: A Systematic Review and Meta-Analysis

Murtey P, Noor NM, Ishak A, Idris NS

Korean J Fam Med, 2024 Jan;45(1):18-26.
PMID: 37899272 DOI: 10.4082/kjfm.23.0106

BACKGROUND: Alternative and complementary medicines are widely used to treat migraine headaches. This review aimed to determine the effectiveness of essential oils as an alternative treatment approach.
METHODS: A structured search was conducted to identify randomized trials comparing essential oils with a placebo for migraine headaches, using databases (MEDLINE and CENTRAL) to search for articles published between 1966 and 2021. We included trials involving adult males and females diagnosed with migraine headaches according to the International Headache Society. The outcomes included number of attacks, headache severity, associated symptoms, number of days of limited activity, headache duration, use of analgesics, and adverse effects. Seven trials were included with a total of 558 participants.
RESULTS: No difference was observed in the number of migraine headache attacks compared to placebo (mean difference [MD], -1.34; 95% confidence interval [CI], -3.31 to 0.64; I2=94%; P=0.190; four trials, 242 participants; moderate- quality evidence). There was no difference in this outcome between the essential oils treated group and the placebo (MD, -0.38; 95% CI, -1.76 to 0.99; I2 statistics=86%; P=0.580; five trials, 240 participants; moderate-quality evidence).
CONCLUSION: We found no significant difference between the use of essential oils and placebo in managing migraine headaches.
Fulltext Clival Chordoma in an Adolescent: A Perspective from Primary Care

Miptah HN, Badlishah-Sham SF, Hashim H, Ramli AS

Korean J Fam Med, 2020 Nov;41(6):427-430.
PMID: 32438537 DOI: 10.4082/kjfm.19.0004

Clival chordoma is a rare malignant tumor of the brain that typically occurs in older adults. It has a high local recurrence rate and is hence associated with poor prognosis. Here, we report a case of an adolescent who presented with a 1-month history of worsening headache and blurring of vision, as well as a 6-month history of left-sided facial and body numbness. Clinical findings were consistent with left upper motor neuron lesion of the seventh cranial nerve with involvement of the fifth cranial nerve. He was also found to have a sixth cranial nerve palsy demonstrated by diplopia upon lateral gaze with no evidence of papilledema. Magnetic resonance imaging of the brain suggested clival chordoma. He was subsequently referred to the neurosurgical team, and he successfully underwent an endoscopic trans-sphenoidal surgery to excise the lesion. He recovered well, continued his follow-ups with the neurosurgical team, and showed good progress. He also attended regular follow-ups with his primary care physician to ensure ongoing psychosocial support and monitoring of his overall health status. This case demonstrates the importance of prompt identification and treatment of clival chordoma in an adolescent. Long-term follow-ups and shared care between primary and secondary care physicians are essential to monitor recurrence of tumor and to provide psychosocial support.
Fulltext Unsuccessful Exclusive Breastfeeding and Associated Factors among the Healthcare Providers in East Coast, Malaysia

Hashim S, Ishak A, Muhammad J

Korean J Fam Med, 2020 Nov;41(6):416-421.
PMID: 33242382 DOI: 10.4082/kjfm.19.0060

BACKGROUND: Breastfeeding is widely recognized as the optimal and natural method of feeding infants. However, there are obstacles that can limit exclusive breastfeeding practices during the first 6 months of an infant's life. This study aimed to determine the prevalence of unsuccessful exclusive breastfeeding and its associated factors among mothers who work as healthcare providers at Universiti Sains Malaysia Hospital.
METHODS: A cross-sectional study was conducted among 295 medical doctors and staff nurses from June to December 2015. Simple random sampling was applied. The data were collected using a self-administered questionnaire and analyzed using IBM SPSS ver. 22.0 (IBM Corp., Armonk, NY, USA). Descriptive statistics and logistic regression analysis were performed.
RESULTS: The prevalence of unsuccessful exclusive breastfeeding among the study participants was 58.3%. Mothers who preferred formula milk (odds ratio [OR], 4.40; 95% confidence interval [CI], 1.45-13.31) delivered via lower segment cesarean section (OR, 2.31; 95% CI, 1.07-4.98) and produced inadequate breast milk (OR, 4.06; 95% CI, 2.40- 6.89) were significantly associated with unsuccessful exclusive breastfeeding.
CONCLUSION: The prevalence of unsuccessful exclusive breastfeeding among the study participants was high. Maternal characteristics such as preference towards formula milk, mode of delivery and adequacy of breast milk must be assessed to prevent unsuccessful exclusive breastfeeding among healthcare providers.
Fulltext Managing COVID-19 Pandemic in the Community: A Primary Health Clinic Experience

Yusof NA, Juhari SN, Daud N, Pauzi MF, Ngah ND

Korean J Fam Med, 2022 Jul;43(4):220-224.
PMID: 35615872 DOI: 10.4082/kjfm.21.0062

The coronavirus disease 2019 (COVID-19) pandemic has affected several countries worldwide, including Malaysia, with the first reported case occurring in January 2020. Terengganu, a state on the east coast of Malaysia, is finding it challenging to contain the disease by aggressively instituting all public health measures to reduce the number of COVID-19 cases and community transmission. Our primary health clinic, which is situated in a semi-rural district in Terengganu, is also involved in the implementation of containment measures, community risk measurement, and the initial management of COVID-19 cases. The health clinic changed the clinic system for the delivery of healthcare services to avoid overcrowding of patients and adapted innovative ways of providing medical services, such as telemedicine and "drive-through" pharmacy. It also provided continuous health education and awareness regarding COVID-19 to both patients and clinic attendees. The essential element of combating the infection is the effective control of infection in a small, isolated clinic in which space and adequate facilities are known challenges. This study aimed to highlight the flow of COVID-19 management starting from screening, triaging, and management based on protocol, implementation of infection control measures, and training of healthcare workers in our health clinic. The mental health of these workers was managed by the Mental Health and Psychosocial Support Unit, as recommended by the Ministry of Health Malaysia. The role of primary care clinics in the ongoing pandemic is currently increasing. Hence, higher authority and the government must increase the number of facilities, human resources, and financial budget to ensure that all initiatives can be implemented effectively.
Fulltext A Rare Presentation of Probable Training-Related Chronic Myopericarditis in an Endurance Cyclist: A Case Report

Mohamad AA, Mohamed NA

Korean J Fam Med, 2024 Mar;45(2):116-120.
PMID: 38351744 DOI: 10.4082/kjfm.23.0082

We report a rare case of high-volume training-related myopericarditis. A male, 18 years old, elite road bicycle racing cyclist with high-volume training of 1,000 km per week for >7 years, presented with progressively worsening exertional breathlessness, reduced effort tolerance, and one episode of cardiac syncope. The symptoms were present prior to the coronavirus disease 2019 pandemic but made worse with the sudden increase in the volume of training after lockdown periods in preparation for competition. He exhibited multiple premature ventricular ectopic beats during his resting electrocardiogram, with a normal echocardiogram and non-elevated cardiac enzyme. The exercise stress test revealed similar multiple premature ventricular beats, warranting further investigation using cardiac magnetic resonance imaging (MRI). The findings of the cardiac MRI were suggestive of myopericarditis. He was instructed to refrain from training and initially started with a short course of colchicine. However, his symptoms deteriorated, and cardiac MRI revealed a decrease in the left ventricular ejection fraction from 59% to 50%. His treatment was escalated to a short course of tapered dose steroid, anti-failure medication and gradual, supervised, return to sports program. This case report highlights the discussion of return to play in athletes with myopericarditis.
Fulltext The Impact of Pharmacist Medication Reviews on Geriatric Patients: A Scoping Review

Yaacob NLC, Loganathan M, Hisham NA, Kamaruzzaman H, Isa KAM, Ibrahim MIM, et al.

Korean J Fam Med, 2024 Apr 05.
PMID: 38583876 DOI: 10.4082/kjfm.23.0220

Medication review is an intervention with the potential to reduce drug-related problems (DRPs) in the elderly. This study aimed to determine the effect of pharmacists' medication reviews on geriatric patients. This study accessed two online databases, MEDLINE Complete and Scopus, and examined all studies published in English between 2019 and 2023, except for reviews. The studies included (1) participants over 65 years of age and (2) medication reviews conducted by pharmacists. The titles, abstracts, and full texts were reviewed for data extraction to determine whether the studies satisfied the inclusion and exclusion criteria. Forty-four of the initial 709 articles were included in this study. The articles included discussions on the incidence rates of DRPs and potentially inappropriate medications (PIMs) (n=21), hospitalization (n=14), medication adherence (n=9), quality of life (QoL) (n=8), and falls (n=7). Pharmacist medication reviews were associated with a reduced incidence of DRPs and PIMs, and improved adherence to medications. Patients' overall QoL is also increasing. However, pharmacist medication reviews were not strongly associated with decreased hospitalization or falls. A pharmacist's medication review may be a feasible intervention for reducing the incidence rates of DRPs and PIMs, regardless of whether it is performed as a sole intervention or supplemented with other interventions. The intervention was also effective in increasing medication adherence and QoL.