Displaying publications 41 - 60 of 638 in total

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  1. Fulltext Bezold's abscess: A rare complication of acute otitis media
    Nasir F, Asha'ari ZA
    Malays Fam Physician, 2017;12(2):26-28.
    PMID: 29423127
    Otitis media is a common disease encountered in the primary practice. Most cases are successfully treated with antibiotics without any sequelae. Because of these, potential serious complications of otitis media may be overlooked. We report a rare case of Bezold's abscess, as a complication of otitis media and discuss its pathophysiology and management.
  2. Fulltext The association between body mass index and the oral Firmicutes and Bacteroidetes profiles of healthy individuals
    Mohamed Qadir R, Assafi MS
    Malays Fam Physician, 2021 Nov 30;16(3):36-43.
    PMID: 34938391 DOI: 10.51866/oa1129
    Introduction: Microbiome status is considered an important factor that contributes to obesity. Investigations have shown that the oral microbiome comprises a vast array of bacterial species that can influence human health.

    Objective: To determine the association between the presence of the bacterial phyla Firmicutes and Bacteroidetes and the body mass index (BMI) status of normal, overweight and obese subjects in Duhok, Iraq. Additionally, to investigate the composition of oral Firmicutes and Bacteroidetes profiles for individuals with different BMI statuses.

    Methods: A total of 155 saliva samples were collected from participants in Duhok, Iraq. Bacterial genomic DNA was then extracted from the collected saliva. The presence of Firmicutes and Bacteroidetes phyla was detected via polymerase chain reaction.

    Results: Firmicutes and Bacteroidetes were detected in 63.2 and 37.4% of the population, respectively. Differences in the carriage rates of oral Firmicutes in overweight (78%) and obese individuals (83%) were statistically significant when compared to normal weight individuals (36%) (P<0.0001). The percentage rates of Bacteroidetes in obese individuals (26.4%) was statistically significant when compared to normal weight individuals (50.8%) (P=0.0078). The Firmicutes/ Bacteroidetes ratios (obese=3.1, overweight= 2.5 and normal weight=0.7) were higher with increasing BMI.

    Conclusion: This study provides evidence of the Firmicutes/Bacteroidetes ratio growing with increasing BMI. High rates of Firmicutes could serve a role in the development of obesity. Further studies are required to clarify the exact relationship between oral bacteria and obesity, which could lead to a promising therapeutic method for improving the physical health of humans.

  3. Blood pressure profile for children aged 5 to 6 years and its associated factors - a cross-sectional study in Kuching district, Sarawak
    Cheah WL, Edmund Shin CV, Ayu Akida AR
    Malays Fam Physician, 2019;14(1):2-9.
    PMID: 31289625
    Introduction: This study aimed to determine the blood pressure profile for preschool children in Kuching Sarawak and its relationship with sociodemographic characteristics, nutritional status and parental hypertension.

    Methods: This was a cross sectional study conducted in a government preschool in Kuching district from January to June 2017. Data were collected using questionnaire as well as anthropometric and blood pressure measurements. Data were entered into and analyzed using SPSS Version 22.

    Results: A total of 229 preschool children participated in this study (response rate of 81%). About 9.7% of the respondents were at risk for hypertension. The mean systolic blood pressure was 95.6 mmHg (SD=8.36), and the mean diastolic blood pressure was 59.9 mmHg (SD=6.09). Ten percent of the children were overweight and 7.4% were obese. Binary logistics regression analysis indicated that gender (Male: OR = 3.085, p< 0.05), parent's education level (comparing primary education and below with secondary education: OR = 4.88, p<0.05; comparing primary education and below tertiary education: OR = 7.63, p<0.05) and ethnicity (comparing Malay with Chinese: OR = 0.10, p< 0.01) were significantly associated with being at risk for hypertension.

    Conclusion: The study showed that 9.7% of the children were at risk for hypertension and that 17.4% had abnormal body weights. Identifying and tackling the factors leading to these issues will help to improve and ensure a better quality of non-communicable disease programs offered in primary health clinics and school health programs.

  4. Fulltext Post-treatment impact and needs of prostate cancer survivors in Malaysia; a qualitative study
    Lee PY, Ng CJ, Ong TA, Lee YK, Khatijah Lim A, Cheong AT, et al.
    Malays Fam Physician, 2017;12(3):18-24.
    PMID: 29527275 MyJurnal
    Introduction: There are limited studies conducted on the needs of cancer survivors in developing countries like Malaysia. This qualitative study aimed at exploring the post-treatment impact and needs of prostate cancer survivors.

    Methods: A qualitative study design was used. One in-depth interview and four focus group discussions were conducted with 24 prostate cancer survivors (age range: 58-79 years) from government and private hospitals in Malaysia in 2013. Trained researchers used a topic guide to guide the interviews, which were audio-recorded, transcribed verbatim, checked and managed with Nvivo 10 software. A thematic approach was used to analyse the data.

    Results: Three main themes emerged from the analysis: (a) impact of prostate cancer on the survivors, (b) support needed for coping and (c) information needs. Prostate cancer has an important impact on the survivors' lifestyle after treatment. Some of them have to live with the post-treatment side effects. They were anxious about the possibility of relapse. In addition to family and peer support, there were participants who felt that spiritual support was important in helping them cope with the possibility of relapse. The survivors felt that they did not receive enough information about post-treatment care, dietary measures and supplements for relapse prevention, treatment and prognosis.

    Conclusion: Prostate cancer has a significant impact on the survivor's lifestyle, emotional and physical health. They need information and emotional support from the healthcare professionals, family and peers. Therefore, it is important for healthcare providers to explore the needs of prostate cancer survivors and provide the necessary support.
  5. Fulltext Recurrent transient visual loss in a middle aged woman
    Chow SY, Draman N, Teh WM, Azhany Y
    Malays Fam Physician, 2017;12(3):42-46.
    PMID: 29527282 MyJurnal
    Visual loss is a common presenting complaint in primary care. We present a case of recurrent transient visual loss in a middle aged woman. Her funduscopy showed bilateral optic disc swelling. We have highlighted the differentiation of bilateral optic disc swelling at the primary care level as the management differs according to the diagnosis.
  6. Fulltext Monkeypox: A review of data essential in primary care
    Ng YY, Azidah AK
    Malays Fam Physician, 2023;18:9.
    PMID: 36992955 DOI: 10.51866/rv.213
    Monkeypox is known to be endemic in Africa, but recently, the unusually increasing number of cases of monkeypox in non-endemic countries has caught the attention of the world. The World Health Organization has declared the monkeypox outbreak a public health emergency. The spread pattern is unlikely associated with the previous outbreak outside of Africa, which is related to travelling or contact with exotic animals. The current outbreak is linked to sexual history and presents with atypical localised genital eruptions with an unpredictable onset of viral prodromal symptoms. Although the monkeypox virus is not easily transmittable compared with severe acute respiratory syndrome coronavirus 2, anyone who has been in close contact with a patient with monkeypox is at risk. Most patients will present to a primary care centre for assessment and treatment; therefore, it is important to increase awareness of the infection among primary care providers for early recognition of monkeypox, containment of the outbreak and prevention of healthcare-associated infection. A physician who suspects any patient with monkeypox should notify local or state health authorities immediately.
  7. Fulltext A mysterious clavicular swelling
    Mohamad NS, Che Rahim MJ, Aziz A
    Malays Fam Physician, 2021 Nov 30;16(3):97-100.
    PMID: 34938397 DOI: 10.51866/cr1113
    The clavicle or collarbone is a horizontal-axis bony structure located between the neck and thoracic area. Tumour metastasis at the clavicle is very rare. Due to its location at the border of the neck and chest area, a primary tumour could originate from both areas. We report the case of a 39-year-old man who presented with a painful right sternal-end clavicular mass and intermittent fever. Chest radiography was normal. Musculoskeletal ultrasound of the clavicle revealed a mass. Computed tomography (CT) thorax further identified a mass at the upper lobe of the right lung. CT-guided tissue biopsy confirmed that it was a lung adenocarcinoma. This case shows an atypical presentation of lung carcinoma and how musculoskeletal ultrasound helped in the diagnosis when other features and investigations were inconclusive.
  8. Fulltext Low vision rehabilitation and ocular problems among industrial workers in a developing country
    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.
  9. Fulltext Drug reaction with herbal supplement: a possible case of drug induced lupus erythematosus
    Muthupalaniappen L, Jamani N, Muhammad M, Adawiyah J, Aziz N
    Malays Fam Physician, 2010;5(2):99-100.
    PMID: 25606196 MyJurnal
    A 24-year-old lady presented with four days history of fever, non-pruritic rash, ankle pain and swelling. She had consumed herbal supplement five days before the onset of symptoms. Examinations revealed erythematous maculo-papular lesions of varying sizes on sun exposed areas. Patient was suspected to have Drug Induced Lupus Erythematosus (DILE) and subsequently symptoms subsided rapidly on withholding the herbal medication.
  10. Fulltext Lime juice as a dietary alternative to mist potassium citrate for urine alkalinisation: A prospective, cross-over clinical trial
    Sivananthan K, Nagappan P, Md Mansor M, Abdullah U, Azman A
    Malays Fam Physician, 2023;18:5.
    PMID: 36992952 DOI: 10.51866/oa.216
    INTRODUCTION: Urinary citrate is a potent inhibitor of urinary crystallization that is freely filtered in the proximal tubule of the kidney. We aimed to investigate the effect of citrate supplementation with fresh lime juice on the urinary pH and calcium excretion level among healthy individuals compared with that of mist potassium citrate.

    METHOD: In this prospective, cross-over single-centre study, 50 healthy medical student volunteers were randomly allocated to two treatment arms. One arm was prescribed with potassium citrate, while the other arm received citrate supplementation with a home preparation of fresh lime juice. The urinary pH and calcium-to-creatinine ratio (uCa/uCr) were measured at baseline and after 7 days of treatment. This was followed by a washout period of 2 weeks, after which each participant crossed over to the other treatment arm, and the urinary measurements were repeated.

    RESULTS: Potassium citrate significantly increased the urinary pH among all participants, while fresh lime juice did not. Both fresh lime juice and potassium citrate reduced the uCa/uCr, although this effect was not significant.

    CONCLUSION: Fresh lime juice is not as effective as potassium citrate in improving the urinary pH and calcium excretion level of healthy individuals. Therefore, it should be used as an adjunct rather than an alternative to potassium citrate.

  11. Fulltext Hoarseness in an older adult: Ortner syndrome
    Koh WJ, Azman M
    Malays Fam Physician, 2021 Nov 30;16(3):129-131.
    PMID: 34938406 DOI: 10.51866/tyk1244
    A detailed examination in an older adult presenting with chronic hoarseness is mandatory to exclude an upper aerodigestive tract malignancy. We describe a 71-year-old chronic smoker with essential hypertension who presented with hoarseness and vocal fatigue for 5 months. Laryngoscopic examination showed left vocal fold paralysis with phonation gap. No growth was seen at all laryngeal and hypopharyngeal subsites. The rest of the head and neck, chest, upper limbs and neurovascular examination were unremarkable. A plain chest radiograph demonstrated a cause for the left recurrent laryngeal nerve palsy. The diagnosis, complications and definitive management of the underlying cause and resultant voice problem will be discussed.
  12. Fulltext Alarming triad of progressive hoarseness in a male smoker
    Za'im NAN, Azman M
    Malays Fam Physician, 2021 Nov 30;16(3):119-122.
    PMID: 34938403 DOI: 10.51866/cr1163
    Hoarseness accounts for 1% of all consultations in primary care. Suspicion of malignancy should be considered in individuals with risk factors presenting with unexplained hoarseness lasting more than two weeks. A significant number of patients with laryngeal cancer present at an advanced stage due to lack of awareness regarding vocal health. It is important to educate both the public and primary care health providers concerning laryngeal cancer. We present the case of an 81-year- old male smoker who presented to us with a six-month history of progressive hoarseness. He was initially treated in two primary and one secondary care centres, where a diagnosis of laryngeal cancer was not considered. Careful assessment in our centre managed to determine a diagnosis of T3N0M0 glottic carcinoma. We will discuss this alarming triad of progressive hoarseness in a male smoker to help primary care physicians streamline their thoughts and identify red flags in a hoarse patient.
  13. Fulltext Illness perception among hypertensive patients in primary care centre UKMMC
    Norfazilah A, Samuel A, Law PT, Ainaa AA, Nurul Ain Z, Syahnaz MH, et al.
    Malays Fam Physician, 2013;8(3):19-25.
    PMID: 25893053 MyJurnal
    Hypertension is one of the chronic diseases with a rising trend globally, including Malaysia. Patients' own perception of their illness is a strong factor that determines their health-seeking behaviour. The objective of this study was to evaluate the illness perception of hypertensive patients and the associated factors.
  14. The risk factors of lower limb cellulitis: A case-control study in a tertiary centre
    Norazirah MN, Khor IS, Adawiyah J, Tamil AM, Azmawati MN
    Malays Fam Physician, 2020;15(1):23-29.
    PMID: 32284801
    INTRODUCTION: Lower limb cellulitis is a common superficial skin infection that leads to morbidity and mortality. Cellulitis risk factors have been well studied in many countries, but to date, not in Malaysia. Geographical and climate variables may affect risk factors. Early identification of the preventable risk factors is vital to prevent cellulitis and improve holistic patient care.

    OBJECTIVE: To determine the risk factors of lower limb cellulitis amongst hospitalized patients at a tertiary center.

    METHODS: A prospective case-control study of hospitalized patients with a clinical diagnosis of lower limb cellulitis was conducted at UKM Medical Centre, January-August 2015. Each patient was compared to two age and gender-matched control patients. All patients were interviewed and examined for risk factors of cellulitis.

    RESULTS: A total of 96 cellulitis patients and 192 controls participated in this study. The cellulitis patients included 61 males and 35 females with a mean age of 62.07±15.43 years. The majority of patients were experiencing their first episode of cellulitis. Multivariate analysis showed a previous history of cellulitis (OR 25.53; 95% CI 4.73-137.79), sole anomalies (OR 16.32; 95% CI 6.65-40.06), ulceration (OR 14.86; 95% CI 1.00-219.39), venous insufficiency (OR 10.46 95% CI 1.98-55.22), interdigital intertrigo (OR 8.86; 95% CI 3.33-23.56), eczema (OR 5.74; 95% CI 0.96.-34.21), and limb edema (OR 3.95; 95% CI 1.82-8.59) were the significant risk factors for lower limb cellulitis.

    CONCLUSION: Previous cellulitis and factors causing skin barrier disruption such as sole anomalies, ulceration, venous insufficiency, eczema, intertrigo, and limb edema were the risk factors for lower limb cellulitis. Physician awareness, early detection, and treatment of these factors at the primary care level may prevent hospital admission and morbidity associated with cellulitis.

  15. Fulltext Prevalence, risk factors and treatment outcomes of syphilis among people living with human immunodeficiency virus at primary care clinics in Malaysia: A retrospective study
    Gani AH, Saleh NA, Selvam SB, Azwa I
    Malays Fam Physician, 2024;19:13.
    PMID: 38496768 DOI: 10.51866/oa.471
    INTRODUCTION: Syphilis and human immunodeficiency virus (HIV) coinfection is a common clinical problem with a significant rising trend worldwide. In Malaysia, the burden of care is shared between hospitals and primary care clinics. This study aimed to determine the prevalence of syphilis among people living with HIV (PLHIV) at primary care clinics in Malaysia and assess its association with sociodemographic characteristics, risk factors and treatment outcomes.

    METHODS: This retrospective study included 750 PLHIV aged ≥18 years who attended primary care clinics in three different locations in Malaysia from 1 January 2017 to 31 December 2019. Data were obtained from the patients' clinical notes using a structured questionnaire evaluating the sociodemographic characteristics, history of sexual and lifestyle behaviours, diagnosis and management.

    RESULTS: The patients' age ranged from 18 to 78 years (mean=34.7, standard deviation=10.2). The prevalence of syphilis among the PLHIV at the three primary care clinics was 33.8% (n=254). Syphilis was significantly associated with gender (P=0.038) as well as sexual activity (P<0.001), substance use (P=0.038), history of chemsex (P=0.001) and history of sexually transmitted infections (STIs) (P<0.001) within the past 12 months. The majority of the PLHIV with syphilis received treatment at the primary care clinics (n=248, 97.3%), and up to 96.1% (n=245) had completed such treatment.

    CONCLUSION: Syphilis is prevalent among PLHIV at primary care clinics, and most patients receive standard treatment. Therefore, primary care doctors must enhance their knowledge to effectively manage STIs, especially syphilis.

  16. Fulltext The man with sweaty palms and soles
    Jamani NA, Puteri Shanaz JK, Azwanis AH
    Malays Fam Physician, 2018;13(1):52-54.
    PMID: 29796213 MyJurnal
    A 21-year-old male college student presented with excessive severe bilateral sweating of his palms and
    soles for the past 3 years, which has progressively worsened. His symptoms occur throughout the day
    but worsened during exams or whenever he felt anxious. The condition has caused him difficulty in
    holding objects and writing assignments, and has resulted in public embarrassment on several occasions.
    He has to wipe his hands with a handkerchief each time they sweat. He also needs to change his socks
    frequently. No other area of his body is similarly affected. He denied any associated symptoms, such as
    pungent body odour, changes in weight, fever, heat intolerance, or changes in bowel habits. He has no
    known medical illness and is not on any medication. (Copied from article).
  17. Fulltext Parasitic infection in a young man presenting with non-specific abdominal pain
    Farnaza A, Baha L
    Malays Fam Physician, 2010;5(3):148-150.
    PMID: 25606208 MyJurnal
    A 27-year-old man presented with a two-week history of central colicky abdominal pain associated with loose stools. Further history revealed that he had been exposed to contaminated waters. Stool investigation by direct wet stool smears revealed the presence of Entamoeba histolytica and Blastocystis hominis cysts. A diagnosis of amoebiasis secondary to E. histolytica and concurrent B. hominis infestation was made. We would like to emphasise the importance of clinical history including recent travel to endemic areas. Any suspicion of parasitic infection should prompt the clinician to investigate. Early diagnosis and management would prevent serious complications associated with E. Histolytica infection.
  18. A red and swollen nose
    Mohamed-Yassin MS, Mohamad-Isa MZ, Baharudin N
    Malays Fam Physician, 2020;15(1):61-63.
    PMID: 32284809
  19. Unexpected sequelae of plantar fasciitis: Iatrogenic calcaneal osteomyelitis following plantar heel injection
    Mohd Khalid SA, Bajuri MY
    Malays Fam Physician, 2019;14(3):80-83.
    PMID: 32175048
    The injection of a local anesthetic in combination with a corticosteroid is an accepted choice in the treatment of plantar fasciitis with recalcitrant heel pain. When the injection is performed properly, post-injection infection is extremely rare. We are reporting a rare case of chronic calcaneal osteomyelitis that developed secondary to a local corticosteroid injection. A 56-year-old lady diagnosed with right plantar fasciitis presented with a 6-month history of pain and a persistent sinus with serous discharge of her right heel following a local infiltration of a corticosteroid. A Magnetic Resonance Imaging demonstrated right calcaneal osteomyelitis with intramuscular abscess. Surgical drainage and debridement were done, followed by antibiotic therapy. A recurrence of infection was not detected throughout the duration of follow-up. It is suggested that a plantar heel injection be done in a more controlled environment, such as in operating theatre, to reduce the risk of infection and to avoid injecting a steroid as compared to platelet-rich plasma (PRP) in view of their safety profiles. However, such an injection should only be offered after conservative treatment has failed, as 80% of patients recover well after initial conservative management.
  20. 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.

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