Displaying publications 41 - 60 of 638 in total

Abstract:
Sort:
  1. Cheah KL, Yaacob LH, Abdul Rahman R
    PMID: 37292225 DOI: 10.51866/cr.257
    Dumping syndrome after bariatric surgery is common. However, it is rarely seen during pregnancy because patients are usually advised to avoid pregnancy immediately after surgery. This case highlights the importance of avoidance of pregnancy after bariatric surgery. We report a case of unplanned pregnancy in a 35-year-old woman with a history of subfertility for 8 years who conceived spontaneously 3 months after gastric bypass surgery. This occurred because there was no contraception offered to her after the procedure. The pregnancy was complicated with recurrent episodes of hypoglycaemia secondary to dumping syndrome. Primary care providers need to be vigilant and have a high index of suspicion for dumping syndrome in pregnant obese women who have undergone bariatric surgery.
  2. Choong SM, Lee PY, Rashid AA
    PMID: 36992959 DOI: 10.51866/oa.2l4
    INTRODUCTION: This study aimed to determine the prevalence of suspected depression and its associated factors among patients with hypertension in a Malaysian primary care clinic.

    METHOD: This cross-sectional study was conducted in a primary care clinic from 1 June to 31 August 2019 using the Patient Health Questionnaire-9.

    RESULTS: The prevalence of suspected depression was 9.0%. The significant predictors of depression were Indian ethnicity (adjusted odd ratio [AOR]: 2.373; confidence interval [CI]: 1.147-4.907), divorce (AOR: 3.5; CI: 1.243-9.860), singleness (AOR: 2.241; CI: 1.182-4.251), heavy episodic drinking (AOR: 7.343; CI: 2.494-21.624), low physical activity level (AOR: 1.921; CI: 1.0932.274), low fibre intake (AOR: 1.836; CI: 1.061-3.178), uncontrolled blood pressure (AOR: 1.800; CI: 1.134-2.858) and presence of hypertension complications (AOR: 3.263; CI: 2.053-5.185).

    CONCLUSION: Primary health care providers must screen for depression among patients with hypertension, particularly those within high-risk groups, and implement interventions that address modifiable risk factors.

  3. Lee YS, Jamaluddin J, Ho BK
    PMID: 37593088 DOI: 10.51866/oa.285
    INTRODUCTION: Primary care service plays a vital role in early clinical assessment of patients with COVID-19 in Malaysia. This study aimed to evaluate the potential risk factors of COVID-19 severity at presentation to primary care facilities in the post-vaccination period.

    METHOD: Clinical records from the Selangkah system of all patients with COVID-19 aged above 18 years seen at COVID-19 assessment centres located in 10 government health clinics in Gombak district, Selangor, from 1 October to 31 December 2021 with complete documentation and outcomes were retrieved. Demographics, comorbidities, clinical features and vaccination statuses and types were retrospectively evaluated. The variables were compared between mild and severe diseases. Univariate and multivariable logistic regressions were used to identify the factors affecting disease severity.

    RESULTS: A total of 4406 patients (median age=37 years, men=51.2%) were analysed. Approximately 97.1% of the cases were mild, while 2.9% were severe. Fever, difficulty breathing, lethargy, throat irritation/runny nose, oxygen saturation of <95%, respiratory rate of >20 breaths per minute, CoronaVac vaccination and hypertension were the determinants of severity (P<0.05).

    CONCLUSION: The high proportion (97.1%) of mild cases in this study compared with an earlier report (81.8%) during the pre-vaccination period may suggest the impact of vaccine, as 84.9% of this cohort was fully vaccinated. Our study also demonstrated a significant difference in COVID-19 severity between the vaccine types. The identified clinical features and comorbidities could assist primary care doctors in stratifying patients with COVID-19 judiciously in terms of hospital referral or home quarantine.

  4. Sengupta T, Paul B, Banerjee A, Das R, Halder R
    PMID: 37205144 DOI: 10.51866/oa.232
    INTRODUCTION: The high prevalence among elderly individuals and potential adverse impact on their overall life quality make chronic musculoskeletal pain a significant public health concern. Chronic musculoskeletal pain is an important cause of self-medication, which must be addressed to avoid various side effects and improve elderly health. This study aimed to determine the prevalence of chronic musculoskeletal pain and its associated factors among individuals (age ≥60 years) in rural West Bengal and explore their perspectives and perceived barriers regarding pain and its management.

    METHOD: This mixed-method study was conducted in rural West Bengal from December 2021 to June 2022. The quantitative strand was conducted by interviewing 255 elderly participants (age ≥60 years) using a structured questionnaire. The qualitative strand was conducted via in-depth interviews of 10 patients with chronic pain. Quantitative data were analyzed using SPSS version 16, and chronic pain-related factors were analyzed using logistic regression models. Qualitative data were analyzed thematically.

    RESULTS: Among the participants, 56.8% reported chronic musculoskeletal pain. The most frequently affected site was the knee joint. Comorbidity (adjusted odds ratio [aOR]=7.47, 95% confidence interval [CI]=3.2-17.5), age (aOR=5.16, 95% CI=2.2-13.5), depression (aOR=2.96, 95% CI=1.2-6.7) and over-the-counter drug usage (aOR=2.51, 95% CI=1.1-6.4) were significantly associated with chronic pain. Analgesic dependency, lack of motivation to adopt lifestyle modifications, lack of knowledge on analgesic side effects were considered pain management barriers.

    CONCLUSION: Managing comorbidities, providing mental support, generating awareness of analgesic side effects, strengthening healthcare facilities should be prioritized for holistic chronic musculoskeletal pain management.

  5. Abdullah NS, Ching SM, Ali H
    PMID: 37292226 DOI: 10.51866/oa.260
    INTRODUCTION: Booster vaccination has been shown to reduce transmission and serious infection with COVID-19. This study examined the willingness to receive a COVID-19 booster vaccine and its associated factors among high-risk patients at Klinik Kesihatan Putrajaya Presint 9.

    METHOD: A cross-sectional study was conducted among patients aged >18 years attending Klinik Kesihatan Putrajaya Presint 9 with a high risk of contracting COVID-19 recruited via systematic random sampling. Data were collected using a self-administered questionnaire. A multiple logistic regression analysis was performed to identify the associated factors.

    RESULTS: The response rate for this study was 97.4% (N=489). The median patient age was 55 years. Approximately 51.7% were men, and 90.4% were Malays. Approximately 81.2% were willing to receive a COVID-19 booster vaccine. The patients who perceived COVID-19 as a serious illness (Adjusted Odd Ratio, AOR=2.414), those who perceived COVID-19 booster vaccines as beneficial (AOR=7.796), those who disagreed that COVID-19 booster vaccines have many side effects (AOR=3.266), those who had no doubt about the content of COVID-19 vaccines (AOR=2.649) and those who were employed (AOR=2.559) and retired (AOR=2.937) were more likely to be willing to receive a booster vaccine than those who were unemployed and those who did not have close friends or family members who contracted severe COVID-19 (AOR=2.006).

    CONCLUSION: The majority of the participants were willing to receive a COVID-19 booster vaccine. Healthcare authorities should take initiatives to design targeted public intervention programmes to increase the willingness for COVID-19 booster vaccination.

  6. Chaknum P, Harniratisai T, Somprasert C, Chiang LC
    PMID: 36992957 DOI: 10.51866/oa.138
    INTRODUCTION: Caring for stroke survivors in primary care settings substantially impacts family life and health. Caregivers of stroke survivors have different challenging experiences in providing care in relation to family happiness. This study aimed to explore family happiness and its contributing factors among family members caring for stroke survivors in suburban Thailand.

    METHOD: Qualitative semi-structured interviews and observations were conducted among 54 family caregivers in suburban Thailand communities from January to July 2020. Interviews and focus group discussions were digitally recorded, independently transcribed and analysed using ATLAS.ti 8.0. Qualitative data analysis method was used.

    RESULTS: Family happiness was found to help a family function and be satisfied with caring. The analysis revealed three themes for achieving family happiness: 1) ideal caregiver characteristics: virtue, love and gratitude, experience in caring, good health and self-care ability, good management of emotions and freedom to manage problems and obstacles; 2) family function: family structure, roles and duties, relationships and management of family problems; and 3) resource support: financial, health and environmental supports.

    CONCLUSION: The findings demonstrate how life adaptations can improve family happiness within families of stroke survivors. Understanding caregivers' perceptions of their experiences in caring for stroke survivors is a challenge for healthcare providers; overcoming this could transform an unpleasant life into caregiving happiness. Appropriate and practical support from healthcare authorities could empower families of stroke survivors to succeed in caregiving and achieve family happiness.

  7. Cipta DA, Kusumadewi I, Siste K, Werdhani RA, Diatri H
    PMID: 37139475 DOI: 10.51866/oa.196
    INTRODUCTION: Depression is a common mental disorder in primary care settings both globally and locally. Even with considerable impacts on patients' quality of life and public healthcare costs, most people with depression do not receive evidence-based treatment. Integrating mental healthcare services into primary care is essential to address the treatment gap for depression. As counsellors and care coordinators, family physicians have a vital role in providing primary mental healthcare services. This study aims to assess Indonesian family physicians' knowledge of depression and identify the associated factors.

    METHOD: This cross-sectional observational study included a total of 83 family physicians from the Association of Indonesian Family Physicians. Data were collected using online questionnaires, including demographic and knowledge assessment instruments and the Care Coordinator Scale (CCS). Descriptive and multiple linear regression analyses were performed.

    RESULTS: The knowledge of depression, particularly in terms of prevention, diagnosis, pharmacological treatment, and post-referral treatment, was insufficient among the family physicians. The medication education (P=0.006) and follow-up care plan (P=0.04) domains of the CCS were associated with the family physicians' knowledge of the management of depression in the linear regression analysis (R2=0.077).

    CONCLUSION: Interventions to improve Indonesian family physicians' knowledge of depression, focusing on medication/pharmacological treatment and considering them as care coordinators, are essential.

  8. Tengku Muhammad Fakhruddin TMF, Aminnuddin M, Shafei MN
    PMID: 36969333 DOI: 10.51866/oa.188
    INTRODUCTION: The number of unvaccinated children and the rate of vaccination refusal among parents have recently increased despite the robust vaccination programme in Malaysia. The purpose of this study was to determine the level of knowledge of the Malaysian National Immunisation Programme among Malaysian parents as well as the variables that contribute to poor knowledge.

    METHOD: Methods: This study used systematic random sampling to recruit 375 parents from seven health clinics in the Dungun District of Malaysia. The participants were asked to complete a selfadministered validated questionnaire that included sociodemographic and knowledge questions. A multiple logistic regression analysis was applied to determine the associated factors of poor knowledge of immunisation. P-values of <0.05 were considered statistically significant.

    RESULTS: A total of 189 (50.4%) respondents had poor knowledge of immunisation. The multiple logistic regression analyses revealed that a low educational level (adjusted odds ratio (OR): 1.92; 95% CI 1.25-2.95) was associated with poor knowledge while the age-group of 30-40 years old (adjusted OR: 0.56; 95% CI 0.34-0.93) was protected against it as compared to the age-group of <30 years old.

    CONCLUSION: The prevalence of poor knowledge of immunisation among parents in Dungun, Terengganu, is relatively high. The focus of health promotion and education must be switched to increasing immunisation knowledge among the public, particularly among high-risk groups.

  9. Kangan RZ, Cheah WL, Hazmi H
    PMID: 36992958 DOI: 10.51866/oa.211
    INTRODUCTION: Hypertension is an emerging health concern among children owing to its increasing prevalence and association with obesity. However, hypertension screening is uncommon, and childhood hypertension-related data are limited. This cross-sectional study determined the prevalence and associated factors of hypertension among primary school children in Kuching, Sarawak.

    METHOD: Standard procedures and validated equipment were used to measure blood pressure and anthropometric indicators. The body mass index (BMI)-for-age and waist-to-height ratio (WHtR) were calculated. Questionnaires were used to obtain family sociodemographic data and health history.

    RESULTS: A total of 1,314 children aged 6-12 years were enrolled, of whom 107 (8.1%) and 178 (13.5%) were hypertensive and pre-hypertensive, respectively. The chi-squared test indicated that hypertension was significantly associated with male sex (P<0.05), >1 standard deviation BMI-for-age (P<0.001), percentage of excess body fat (BF)(P<0.001), 5th to 95th height percentile (P<0.001), >90th excess waist circumference (WC) percentile (P<0.001), >90th WHtR percentile (P<0.001), clerical, service, sales and skilled parental work (P<0.05), excess weight (P<0.05) and cardiovascular disease (P<0.01). Multivariate logistic regression analysis showed that the percentage of excess BF [odds ratio (OR): 4.84, 95% confidence interval (CI): 2.01-11.66] and excess WC (OR: 2.33, 95% CI: 1.15-4.72) were significantly related to hypertension after adjusting for sex and age.

    CONCLUSION: The prevalence of hypertension among the study population is higher than that among children worldwide. Childhood hypertension-related factors must be identified to aid in routine blood pressure screening, which is crucial for early detection and intervention to reduce future morbidity burden.

  10. Sutan R, Ahmad N
    PMID: 37205145 DOI: 10.51866/rv.210
    INTRODUCTION: The Malaysian healthcare system, particularly for maternal and child health, has been well recognised to provide high-quality services and be at par with systems in other developed countries. Current health programmes and technological advancements effectively detect vulnerable groups of children, such as small-for-gestational-age (SGA) infants, antenatally. However, the postnatal care for SGA infants is not clearly evaluated, as this group of children is mostly classified as healthy in many medical contexts, especially in primary care settings. Available health programmes and healthcare service delivery must be continuously evaluated by implementing beneficial and relevant evidence-based theories.

    METHOD: Articles, reports and guidelines used in providing mother and child health services in Malaysia published since 2000 were reviewed.

    RESULTS: There was no specific monitoring strategy used for SGA infants without critical health issues in early childhood, as they were commonly treated as healthy infants. Several challenges in aligning theory with the current practice of healthcare service delivery and recommendations for dealing with such challenges were identified.

    CONCLUSION: The alignment of theory with the current practice of service delivery should be tailored to the needs and demands parallel to the dynamic change in populations in the urbanisation era.

  11. Idris H, Tuzzahra F
    PMID: 37205142 DOI: 10.51866/oa.265
    INTRODUCTION: Depression is one of the mental illnesses that affect adolescents worldwide. This study analysed the factors associated with depressive symptoms among adolescents in Indonesia.

    METHOD: A quantitative cross-sectional study was conducted using secondary data from the Indonesian Family Life Survey 2014. The sample included 3,603 adolescents aged 10-19 years. Data were analysed using logistic regression statistical tests.

    RESULTS: Of the adolescents, 29.1% had depressive symptoms. The bivariate analysis showed that sex, region, economic status, chronic illness history, sleep quality, smoking habit, and personality type were associated with a higher probability of depressive symptoms among the adolescents.

    CONCLUSION: A history of chronic diseases contributes the most to the occurrence of depressive symptoms among adolescents. To reduce the prevalence of chronic diseases associated with depression, the Indonesian government must make preventive efforts through early detection among young people.

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

  13. Yeoh ZY, Ramdzan SN
    PMID: 37205148 DOI: 10.51866/cr.184
    The mass vaccination against COVID-19 has saved millions of lives globally. The majority of people experience short-term mild side effects; however, in rare cases, some develop long-term severe adverse events. This case report illustrates the case of a middle-aged man with Parsonage-Turner syndrome, a rare adverse event following COVID-19 immunisation. The patient presented with pain and weakness of the right upper arm for 2 months, which developed 5 days after he received his mRNA COVID-19 booster vaccine. He sought medical attention after 9 weeks of experiencing weakness with obvious muscle wasting. He reported his condition only via a phone application, as he thought that his condition was self-limiting and will improve with time. Herein, we discuss the syndrome and highlight the importance of patient education and early recognition of serious adverse events related to vaccinations in the primary care setting.
  14. Ngu MH, Zakaria R, Mohd Zulkifli M, Ab Rahman R
    PMID: 37207247 DOI: 10.51866/cr.282
    Metformin-induced sexual dysfunction is rare in patients with diabetes mellitus. Herein, we present the case of a 57-year-old man newly diagnosed with type 2 diabetes mellitus who developed erectile dysfunction following treatment with metformin 500 mg BD. Prior to taking metformin, he had well-controlled hypertension, hyperlipidaemia and normal sexual function. Two weeks after beginning metformin therapy, he was diagnosed with erectile dysfunction after experiencing persistent difficulty achieving an erection. After discontinuation of metformin, his sexual function returned to normal. To determine whether sexual dysfunction is caused by metformin, we rechallenged the patient with metformin 500 mg BD. After 15 days, he became impotent again, confirming that metformin was the most likely cause of his sexual problem. Metformin was stopped, and his sexual function returned to normal after 3 weeks. The adverse reaction is 'probable' according to the World Health Organization-Uppsala Monitoring Centre.
  15. Banerjee A, Paul B, Das R, Bandyopadhyay L, Bhattacharyya M
    PMID: 37205146 DOI: 10.51866/oa.224
    INTRODUCTION: Despite policy actions and strategic efforts for improving the reproductive and sexual health of adolescents by promoting the uptake of adolescent reproductive and sexual health (ARSH) services, the utilisation rate remains significantly low, especially in rural areas of India. This study aimed to assess the utilisation of these services by adolescents in rural West Bengal and its associated determinants.

    METHOD: This mixed-method study was conducted from May to September 2021 in the Gosaba rural block of South 24 Parganas, West Bengal. Quantitative data were collected from 326 adolescents using a pre-tested structured questionnaire. Qualitative data were collected via four focus group discussions among 30 adolescents and key-informant interviews among six healthcare workers. Quantitative data were analysed using SPSS, while qualitative data were analysed thematically.

    RESULTS: Ninety-six (29.4%) adolescents had utilised ARSH services at least once during adolescence. The factors associated with non-utilisation of ARSH services were younger age, female sex, increasing reproductive health stigma and decreasing parent-adolescent communication related to sexual health. Qualitative exploration revealed that unawareness regarding services, perceived lack of privacy and confidentiality at healthcare facilities and disruption of services post-emergence of the COVID-19 pandemic were some major barriers to ARSH service utilisation.

    CONCLUSION: A multi-component strategy, including promotion of adolescent-friendly health clinics, community support interventions associated with motivation and counselling of parents regarding the importance of adolescent reproductive health, is needed to improve the utilisation of ARSH services. Necessary steps to correct the deficiencies at the facility level should also be prioritised.

  16. Jamaluddin J, Mohamed Kamel MA, Jamil SN
    PMID: 37205147 DOI: 10.51866/tyk.291
    We describe the case of a 72-year-old housewife who presented to a primary care specialist clinic for reassessment following multiple hospitalisations for heart failure within the past 9 months. She presented with decreased effort tolerance and tiredness for the past 1 year. Her symptoms had remained the same despite current treatment. During the initial history-taking, she did not report any medical illnesses or surgeries. She had been well and had not undergone any screening for almost 30 years before the first hospitalisation for heart failure. There was neither cough, constipation, dyspepsia, abdominal pain, stool changes, haematuria, per vaginal bleeding nor hoarse voice. The physical examination findings were remarkable for slow movement and speech. Her skin was dry with a markedly increased serum lipid profile. Further investigation and management confirmed the suspected diagnosis.
  17. Hawa A, Teng CL, Devaraj NK, Saadatun A, Rawaida AL, Chong FY, et al.
    PMID: 37449277 DOI: 10.51866/oa.100
    INTRODUCTION: This study aimed to determine the prevalence and associated factors of lipohypertrophy in insulin-injecting patients with diabetes at selected primary care clinics in Malaysia.

    METHOD: This cross-sectional study was conducted among adults aged ≥18 years with type 1 or 2 diabetes treated with insulin for at least 6 months at six selected public primary care clinics in Malaysia. The Injection Technique Questionnaire was used, and physical examination was conducted to detect the presence of lipohypertrophy. Univariate and multivariate logistic regression analyses were conducted using IBM SPSS version 26.

    RESULTS: A total of 506 patients with type 2 diabetes were included in this study; of them, 60.47% were women, and 48.42% were Malays. The prevalence of lipohypertrophy was 39.6% (95% Confidence Interval, CI =35%-44%). The univariate analysis revealed that a larger number of injections per day, longer needle length, repeated use of needles, incorrect rotation of the injection site, longer insulin use duration, higher total insulin dose and higher HbA1c level were significantly associated with lipohypertrophy. In the multivariate logistic regression analysis, incorrect rotation of the injection site was the only independent associated factor of lipohypertrophy.

    CONCLUSION: The prevalence of lipohypertrophy in this study is comparable with that in other studies. The identified associated factors of lipohypertrophy must be addressed in ongoing health education for insulin-injecting patients at Malaysian primary care clinics. Educating healthcare professionals and increasing awareness among patients with diabetes are important steps in preventing this complication.

  18. Handajani YS, Turana Y, Widjaja NT, Hengky A
    PMID: 37449279 DOI: 10.51866/oa.267
    INTRODUCTION: This study aimed to evaluate the prevalence of frailty and its determinants, especially in relation to chronic disease and lifestyle among elderly individuals.

    METHOD: A cross-sectional study was conducted among 278 individuals aged 60 years and over living in Jakarta. All participants underwent assessment, including medical history-taking, physical examination and blood tests for the sugar level and lipid profile. Frailty was assessed using the Frailty Instrument for Primary Care of the Survey of Health, Ageing and Retirement in Europe. All data were analysed using the chi-square test and multinomial logistic regression analysis.

    RESULTS: The prevalence of pre-frailty and frailty among the older adults was 40.6% and 28.8%, respectively. Female sex, lack of exercise, presence of cardiovascular diseases and high low-density lipoprotein cholesterol (LDL-C) level were associated with pre-frailty and frailty. Education for <9 years was associated only with frailty. After adjustments for all covariates, female sex (adjusted odds ratio [AOR] = 1.96, 95% confidence interval [CI]=1.07-3.60; AOR=3.93, 95% CI=1.87-8.24), lack of exercise (AOR=l4.81, 95% CI=5.07-43.26; AOR=49.48, 95% CI=16.20-151.09) and presence of cardiovascular diseases (AOR=5.32, 95% CI= 1.40-19.20; AOR=6.06, 95% CI= 1.63-22.56) were associated with pre-frailty and frailty. Meanwhile, education for <9 years (AO R= 1.97, 95% CI=1.05-3.69) and high LDL-C level (AOR=3.52, 95% CI=1.14-10.88) were associated with frailty.

    CONCLUSION: Exercise, early screening and intervention for cardiovascular diseases and maintenance of lower LDL-C levels may prevent and slow the progression of frailty.

Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links