Ophthalmia neonatorum remains a significant cause of ocular morbidity, blindness and even death in underdeveloped countries. The organisms causing ophthalmia neonatorum are acquired mainly from the mother's birth canal during delivery and a small percentage of cases are acquired by other ways. Chlamydia and Neisseria are the most common pathogens responsible for the perinatal infection. Fortunately in most cases, laboratory studies can identify the causative organism and unlike other form of conjunctivitis, this perinatal ocular infection has to be treated with systemic antibiotics to prevent systemic colonization of the organism. Routine prophylaxis with 1% silver nitrate solution (credes method) has been discontinued in many developed nations for the fear of development of chemical conjunctivitis.
Purpose. To highlight the importance of using the Farnsworth Panel D-15 Hue test in colour vision testing in patients on ethambutol treatment. Case Report. A 70 year-old lady received ethambutol as part of her anti-tuberculous regime. She developed blue-yellow colour defect detectable with the Farnsworth Panel D-15 Hue test, but not with the Isihara Pseudoisochromatic Plates. Ethambutol was immediately discontinued from her anti-tuberculous regime. Two months later, her colour vision returned to normal. Conclusion. This case report illustrates the importance of regular monitoring of patients receiving ethambutol for blue-yellow colour defect using the Farnsworth Panel D-15 Hue Test.
The massive 2008 Sichuan earthquake brought unprecedented international humanitarian aid to China. The monstrous damages and casualties aroused all human's sympathy. I took the opportunity to join a Malaysian voluntary medical relief team to Sichuan in June 2008. This essay recounts the immediate events post-earthquake and reports on my experience during the mission.
A twin registry is a registry of twin pairs (monozygotic = MZ and Dizygotic = DZ) who are willing to consider participating in health-related research. Twins are able to help researchers study the impact of genetic and environmental factors on health and the treatment and prevention of disease in a special way. Throughout the world, twin registries have been established by the governments via the National Health and Medical Research in order to put researchers in touch with twins who might be willing to take part in particular projects. In Australia, for example, more than 30,000 pairs of twins have joined the registry, making it the largest volunteer registry of its kind in the world. However, in some countries such as Denmark, the first twin registry was born in a medical faculty and it was then expanded to the National Twin Registry of Denmark. (Copied from article).
Catharanthus roseus (synonymous with Vinca rosea) is a perennial plant commonly seen in tropical countries. Seven species of this genus are native to Madagascar and one species is native to Southern Asia. It is more commonly known as Madagascar periwinkle. The local name in Malaysia is Kemunting Cina. The National Cancer Council of Malaysia (Majlis Kanser Nasional, MAKNA) uses the periwinkle logo as its symbol of hope for cancer patients. (Copied from article).
Schizophrenia is one of the most incapacitating forms of mental disorder that runs a chronic and relapsing course. It typically starts in adolescence or early adulthood and can be life-long. It is more common in people with learning disabilities than in the general population. Its prodromal features include depression, anxiety, suspiciousness, social isolation and bizarre behaviour. It may result in significant functional, social and economic impairments. The care of patients with schizophrenia places a considerable burden on all carers including patient's family, health and social services. Treatment includes pharmacotherapy and psychosocial interventions. In this case report we describe a thirteen-year-old patient with schizophrenia who has a background history of mental retardation.
This article described the author's reflection on conducting research in primary care. Certainly hand-on experience will give a better learning experience for a person to explore further in research and research training will help too. Conducting a collaborative research with other institutions also help in better research outcome. Research capacity building is important as most patients are seen in primary care.
138 headaches sufferers and 138 subjects without headaches were studied to investigate if there were differences between headache and non-headache sufferers in terms of their mental health and social support levels. The overall results of this study indicated that headache sufferers, as compared with non-headache sufferers had slightly more mental health problems, and more social support from their family members. When the results were scrutinised in more detail, it was observed that headache sufferers reported that they felt less capable of making decisions about things, were not always able to face up to their problems, and sometimes thought about themselves as a worthless. Given that the study was based on a community, rather than clinic sample, further research would be required to examine the differing the types of headaches that people are suffering from, and the intensity of the headaches, in relation to mental health problems.
Poor patient adherence to medication is one of the major factors contributing to poor disease control, in particular in asymptomatic chronic diseases like hypertension and dyslipidaemia. The physical and economic burden on patients and the health care system as a result of non-adherence is great. It is estimated that poor adherence to hypertension medication accounts for as many as 7.1 million preventable deaths annually. Hence recognising and identifying non-adherence is the first step to addressing this problem. Medication adherence can be measured in various ways including self-report to electronic monitoring. In order to be more successful in managing non-adherence, attention must be paid to barriers to adherence, namely the interplay of patient factors, the health care providers themselves and the health care system itself. Taking these into account will probably have the greatest impact on improving medication adherence. Consequently strategies to help overcome these barriers are of paramount importance. Some of these strategies will include education of patients, improving communication between patients and health care providers, improving dose scheduling, providing drugs with less adverse effects, and improving accessibility to health care. Poor mediation adherence continues to be a huge challenge. While the patient is ultimately responsible for the taking of medication, good communication, involving the patient in decision making about their care and simplifying drug regimens go a long way in improving it.
Qualitative data is often subjective, rich, and consists of in-depth information normally presented in the form of words. Analysing qualitative data entails reading a large amount of transcripts looking for similarities or differences, and subsequently finding themes and developing categories. Traditionally, researchers 'cut and paste' and use coloured pens to categorise data. Recently, the use of software specifically designed for qualitative data management greatly reduces technical sophistication and eases the laborious task, thus making the process relatively easier. A number of computer software packages has been developed to mechanise this 'coding' process as well as to search and retrieve data. This paper illustrates the ways in which NVivo can be used in the qualitative data analysis process. The basic features and primary tools of NVivo which assist qualitative researchers in managing and analysing their data are described.
White coat hypertension (WCHT) and white coat effect (WCE) are often thought to be of the same entity. They are in fact different conditions which carry distinctive definitions and prognostic significance. WCHT is diagnosed when office blood pressure (OBP) is ≥140/90 mmHg on at least 3 occasions, while the average daytime or 24-hour blood pressure is <135/85 mmHg. It is common with 15% prevalence in the general population and may account for over 30% of individuals in whom hypertension is diagnosed. Although individuals with WCHT were reported to have a better cardiovascular (CV) prognosis when compared to those with sustained hypertension and masked hypertension; they were also shown to have a greater prevalence of target organ damage (TOD) and metabolic abnormalities than that of normotensive subjects. In contrast, WCE is defined as the transient elevation of OBP induced by the alerting response to a doctor or a nurse. WCE can occur in both normotensive and hypertensive persons; and is not substantially influenced by reassurance and familiarisation. There is conflicting evidence with regards to prognostic significance of WCE, where most data indicated that it does not predict future TOD, CV morbidity or mortality; with some studies showed otherwise. This case scenario aims to solve the diagnostic perplexity with regards to WCHT and WCE, followed by an evidence-based commentary of how to best manage such conditions.
BACKGROUND: High prevalence of high-risk behaviours and concurrent medical illnesses among opioid drug users would influence the outcome of Methadone Maintenance Programme. It would also require a special medical attention to contain these issues.
OBJECTIVES: This study explored patients' characteristics and their high-risk behaviours in order to understand more about opioid dependent users in Malaysia.
METHODS: A total of 172 patient case notes at Methadone Clinic Hospital Tengku Ampuan Afzan (HTAA) were retrieved for relevant data.
RESULTS: Many of the patients were engaged in high-risk behaviours such as needle sharing, unsafe sex and criminal activities. A large number of the subjects had contracted blood-borne diseases such as HIV and hepatitis infections.
CONCLUSIONS: Education on the issue of medical and psychosocial complications related to high risk behaviours is essential. Medical professionals dealing with this group have to pay attention and update their knowledge on the medical issue.
KEYWORDS: Methadone therapy; high-risk behaviours; opioid dependence
Study site: Methadone clinic, Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia
AIM: This pilot study aimed to explore the perceptions of general medical practitioners (GPs) towards the professional training and roles of community pharmacists.
METHODS: A self-administered questionnaire was distributed to all private clinics (n=160) run by GPs in a northern state of Malaysia. The instrument contained questions to evaluate the practitioners' level of agreement using a 5-point Likert-type scale.
RESULTS: Of 160 GPs, 80 returned the questionnaire (response rate 50%). The respondents agreed that: GPs should consider the community pharmacists' recommendations whenever there is/are any problem(s) with the prescriptions given by them (46.3%); community pharmacists are the best healthcare professionals to educate patients about safe and appropriate use of medications (52.5%); the pharmacy profession had undergone a major metamorphosis from a product-oriented profession to a more patient-centred and outcome-oriented one (61.3%); if dispensing separation is implemented, they will work closely with the community pharmacists in monitoring patients' pharmacotherapeutic outcomes (77.5%).
CONCLUSION: The current findings suggest that GPs would support an extension of the role of the community pharmacists in number of activities of patient care activities such as medication counselling. Thus, suggesting potential collaborative care between GPs and community pharmacists towards patient care and the needs to develop and incorporate topics on inter-professional relationship in the current medical and pharmaceutical education curriculums.
KEYWORDS: Community pharmacists; general practitioners; perceptions; roles; training
Breast cancer is becoming more important in Asia since it affect the younger age group. Question arises whether it is safe for breast lesions to be left in-situ if all the elements in triple assessment are benign. The aim of this study is to audit all the excision biopsies of breast lumps done in the University Malaya Medical Centre (UMMC), to review the association of age with the type of pathological finding and to evaluate the rate of carcinoma in these biopsies.
Many cluster headache (CH) patients waited several years to be accurately diagnosed because their symptoms are often mistaken for sinusitis or a dental disorder.1 Patients have also been mistakenly diagnosed as analgesic drug abusers or suffering from a psychiatric illness. This case report illustrates how a young lady was diagnosed to have cluster headache after several years of consultations with ophthalmologists for eye swelling and redness. It also highlights the importance of pain assessment and a general and holistic approach to medical care which is the main distinguishing feature of Family Medicine.
No screening test is ideal for detecting rheumatic diseases; diagnosis depends on appropriate history and thorough physical examination. Sometimes, laboratory investigations may be useful in confirming or ruling out rheumatic disease after a clinical diagnosis is considered. Once a rheumatic disease has been diagnosed, certain laboratory tests can help in assessing prognosis or determining the extent of the disease. Laboratory tests may also help the physician monitor certain rheumatic diseases, guide treatment or assess potential drug toxicity.