Displaying publications 81 - 100 of 632 in total

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  1. Das Gupta E
    Malays Fam Physician, 2009;4(2-3):48-50.
    PMID: 25606162 MyJurnal
    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.
  2. Lee PY, Ong TA, Chua CB, Lei CCM, Teh GC
    Malays Fam Physician, 2009;4(1):15-8.
    PMID: 25606152 MyJurnal
    INTRODUCTION: Ketamine is frequently abused nowadays as a recreational drug. Case reports are emerging since 2007 to describe a new clinical entity of severe bladder dysfunction associated with chronic abuse of street ketamine.
    CLINICAL PRESENTATION: Severe lower urinary tract symptoms of urinary frequency and urgency which are refractory to conventional treatment. Quality of life is adversely affected as a consequence. Chronic kidney disease will develop in advanced cases. Investigation findings: The urine is sterile on culture. Ultrasound will show reduced bladder capacity with thickened bladder wall. In advanced stage, hydronephrosis and renal impairment will develop.
    TREATMENT: Patients should be advised to stop street ketamine use immediately. Anticholinergic medication could be tried to alleviate the symptoms. Refractory cases with dilatation of the upper urinary tract might need urinary diversion.
    CONCLUSION: Awareness of this new condition is essential in diagnosis. Early intervention offers better treatment outcome.
    KEYWORDS: Ketamine; bladder dysfunction; lower urinary tract symptoms
  3. Cheong AT, Khoo EM
    Malays Fam Physician, 2009;4(1):33-6.
    PMID: 25606157 MyJurnal
    This case illustrates an 80-year-old lady who presented with acute low back pain and finally succumbed from complications of osteoporotic vertebral fracture. Among the contributing factors are delayed diagnosis and a lack of continuity of care. It reminds the practitioners of the importance to look out for red flag symptoms and to have a high index of suspicion for vertebral fracture in high risk patients presenting with low back pain.
    Study site: Accident and Emergency Unit, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
  4. Keah SH, Chng KS
    Malays Fam Physician, 2009;4(1):37-9.
    PMID: 25606158
    We report a case of a young Chinese female who developed acute rhabdomyolysis with acute renal failure after a strenuous push-up exercise during a company motivation course. She managed to make full recovery after a period of outpatient treatment.
  5. Cheah PK, Ahmed R, Ho CV, Lim CC
    Malays Fam Physician, 2009;4(2-3):91-3.
    PMID: 25606171 MyJurnal
    Nasal foreign body in children is not an uncommon presentation to the Emergency Department. Removal is essential. Many methods of removal exist. Nasal wash technique is advocated mainly in friable foreign bodies. We report the successful use of the oral bag-valve-mask insufflation technique to remove friable facial tissue in the left nose of a 2 year-old girl. We used a pediatric bag-valve-mask with a pop-off pressure relief valve to avoid barotrauma. Pop-off pressure relief valve limits the pressure beyond 30mmHg. Conscious sedation was not required. There were no complications.
  6. Azimah M, Khairani O
    Malays Fam Physician, 2009;4(2-3):88-90.
    PMID: 25606170
    PURPOSE: To describe the management of mild conduct problems in an adolescent at the primary care level.
    CASE REPORT: A 16 year old girl presented with conduct problems with impending school suspension. The cause of her behavioural problems was mainly related to poor parenting skills of her parents and anger in herself. She was successfully managed with counselling and improvement of parenting styles in her parents.
    CONCLUSION: This case report illustrates the opportunity for family physicians to manage simple conduct problems at primary care level.
    KEYWORDS: Conduct problems; adolescents; anger management; parenting skills
  7. Nazimah I, Che Hatikah CH, Murizah MZ, Md Rushdan MN
    Malays Fam Physician, 2009;4(2-3):83-7.
    PMID: 25606169 MyJurnal
    To compare the efficacy of two screenings methods for gestational diabetes mellitus, namely the universal screening using 50g Glucose Challenge Test to that of selective screening based on risk factors.
  8. Khajotia R
    Malays Fam Physician, 2008;3(3):131-6.
    PMID: 25606137 MyJurnal
    Bronchial asthma is an inflammatory disease of the airways manifested physiologically by a widespread narrowing of the air passages. Being an inflammatory disease of the airways, the most effective treatment available for the management of bronchial asthma are anti-inflammatory agents such as corticosteroids. However, it is known that at higher dosage levels, even inhaled corticosteroids have harmful systemic side-effects. Hence, justification of use of high-dose of inhaled corticosteroids can only be made if patients with severe asthma can be accurately identified. For this precise reason, methods have been devised to categorize asthma severity through various National Asthma Management Guidelines. The present guidelines predominantly stress on symptoms and lung functions as the yardstick for determining the severity of asthma attacks and parameters determining airway inflammation have not yet been incorporated into them. However, these guidelines have proved to be fairly accurate in determining asthma severity and in guiding the treatment in these patients and all healthcare personnel are strongly advised to follow them. It is hoped that future guidelines may incorporate measures of inflammation as well, in order to further improve the diagnostic and treatment modalities in these patients.
  9. Loh KY, Reddy SC
    Malays Fam Physician, 2008;3(3):128-30.
    PMID: 25606136 MyJurnal
    The invention of computer and advancement in information technology has revolutionized and benefited the society but at the same time has caused symptoms related to its usage such as ocular sprain, irritation, redness, dryness, blurred vision and double vision. This cluster of symptoms is known as computer vision syndrome which is characterized by the visual symptoms which result from interaction with computer display or its environment. Three major mechanisms that lead to computer vision syndrome are extraocular mechanism, accommodative mechanism and ocular surface mechanism. The visual effects of the computer such as brightness, resolution, glare and quality all are known factors that contribute to computer vision syndrome. Prevention is the most important strategy in managing computer vision syndrome. Modification in the ergonomics of the working environment, patient education and proper eye care are crucial in managing computer vision syndrome.
  10. Norsiah A, Whelan G, Piterman L
    Malays Fam Physician, 2008;3(1):61-3.
    PMID: 25606116
    This paper illustrates the training program in the field of Addiction Medicine designed for primary care doctors by the Department of General Practice, School of Primary Care at Monash University in Melbourne. The nine month program was based around coursework, field visits and clinical observations. There were five modules that were completed and passed, twenty six Continuous Medical Education sessions attended, twenty nine field visits on Drug & Alcohol services, forty seven clinical visits and a total of three hundred and sixty clinical observations made. The comprehensive training program has benefited the first author in several ways to improve the Drugs & Alcohol services in Malaysia.
  11. Shaiful BI
    Malays Fam Physician, 2008;3(1):58-60.
    PMID: 25606115
    In 2006, I was awarded a scholarship from Universiti Sains Malaysia for Fellowship training at Monash University (MU) for one year. The objective of the training programme was to develop knowledge and skills in several areas, including androgen deficiency, male infertility, prostate disease, testicular tumours, sexual dysfunction and sexually transmitted diseases. The training programme consisted of attachments with clinical specialists, completion of a course work module and a research project. After completion of the training programme, I believe that Primary Care Physicians (PCPs) will benefit from undertaking the training programme that I had completed. It will enable PCPs to assume leadership roles in this multidisciplinary area. The ability of PCPs in handling sexual and reproductive health issues in men will definitely be a more cost effective form of care for patients, particularly as the number of specialists is limited, and even more importantly, it will be satisfying for the patient and the physician.
  12. Chia YC
    Malays Fam Physician, 2008;3(2):72-6.
    PMID: 25606120 MyJurnal
    Cardiovascular disease (CVD) risk is a continuum across blood pressure. The term prehypertension was introduced because it is now recognized that blood pressure readings between what is deemed optimal and hypertension is associated with increased CVD risk. The prevalence of prehypertension is high and the progression to hypertension is also high. Prehypertension is also commonly associated with other CVD risk factors namely dyslipidaemia, dysgylcaemia and overweight/ obesity. Eighty-five percent of prehypertensives have one other or more CVD risk factor compared to normotensives. A recent study has shown a reduction in the development of hypertension from prehypertension with the use of an angiotensin receptor blocker. Unfortunately to date, the impact of treatment of prehypertension on CVD outcome is still unknown except in those with high CVD risk like diabetes or established CVD. However this does not mean nothing can be done for those with prehypertension. The aim of managing prehypertension is to lower the BP, prevent progression to hypertension and to prevent BP related CVD deaths. Lifestyle changes can reduce BP and this by itself can lower CVD risk. Until more evidence about other modalities of treatment become available this is a sensible and cost-effective way to manage prehypertension.
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