Displaying publications 101 - 120 of 167 in total

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  1. General practice research and the family physician
    Md Shajahan MY
    Family Physician, 1994;6:3-3.
    Matched MeSH terms: Family Practice
  2. Primary Care Research in Malaysia
    Mohd Sidik S
    International Perspectives on Primary Care Research, 2016.
    ISBN: 978-1-4987-6752-1
    Citation: Sherina Mohd Sidik. Chapter 36: Primary Care Research in Malaysia. In: Goodyear-Smith F, Mash B (editors). International Perspectives on Primary Care Research. Boca Raton, Florida, United States of America: CRC Press (Taylor & Francis Group), World Organization of Family Doctors (WONCA); 2016, p199-201
    Matched MeSH terms: Family Practice
  3. The pathway followed by psychotic patients to a tertiary health center in a developing country: a comparison with patients with epilepsy
    Razali SM, Mohd Yasin MA
    Epilepsy Behav, 2008 Aug;13(2):343-9.
    PMID: 18514034 DOI: 10.1016/j.yebeh.2008.04.009
    The objective of this study was to describe and compare the pathways followed by Malay patients with psychoses (schizophrenia and schizophreniform disorder) and Malay patients with epilepsy to a tertiary health center in the northeastern area of peninsular Malaysia. There were 60 patients in each group. The most popular pathway for both groups was first contact with traditional or alternative healers. Consultation with Malay traditional healers (bomohs) and/or homeopathic practitioners (44.2%) was significantly higher for psychotic patients (61.7%) than for patients with epilepsy (26.7%) (chi(2)(2)=15.609, P<0.001). Direct access (24.2%) was the second most popular pathway and almost equally followed by both groups of patients. The third and last pathway was initial contact with private general practitioners and government doctors, respectively. Patients with epilepsy dominated the last two pathways. The treatment delay (TD) was significantly longer in epileptic than psychotic patients regardless of their visit to a bomoh and/or homeopathic practitioner (P<0001) or not (p<0.01). The socioeconomic status of psychotic patients also was significantly better than people with epilepsy (chi(2)=9.957, chi(2)(4), p=0.041).

    Study site: Psychiatric clinic, Hospital Universiti Sains Malaysia HUSM
    Matched MeSH terms: Family Practice/statistics & numerical data
  4. Fulltext Mackenzie's puzzle--the cornerstone of teaching and research in general practice
    Murdoch JC
    Br J Gen Pract, 1997 Oct;47(423):656-8.
    PMID: 9474833
    The new-found popularity of generalism as a political force has emphasized the need to clarify the essential philosophy that underpins its practice, teaching, and research. Drawing on the example of Sir James Mackenzie, the author seeks to clarify certain essential issues that need to be emphasized if we are to promote and develop general practice as a distinct academic discipline. Dissatisfaction, uncertainty about our role, and continuing contact with real people seems to be essential to continuing creativity.
    Matched MeSH terms: Family Practice/education*
  5. Factors involved in the diagnosis of oral squamous cell carcinoma in Malaysia
    Khoo SP, Shanmuhasuntharam P, Mahadzir WM, Tay KK, Latif A, Nair S
    Asia Pac J Public Health, 1998;10(1):49-51.
    PMID: 10050209 DOI: 10.1177/101053959801000111
    The delay in the diagnosis of oral cancer has been variously reported as being contributed by the clinicians, patients or both. The purpose of this study was to evaluate the referral pattern of 65 patients eventually diagnosed as having oral squamous cell carcinoma. The results showed that 50% of the patients delayed seeking professional help for more than 3 months after being aware of the lesion. The majority of the patients consulted medical practitioners as the first source of help. The mean clinicians' and patients' delay were 10.3 weeks and 28.9 weeks respectively. Dental practitioners showed a tendency to refer more advanced lesions compared to the medical practitioners. The findings raise the concern that lack of patients' awareness, misdiagnosis by clinicians and late detection by dental practitioners prevail thus calling for urgent measures towards early detection of the disease.
    Matched MeSH terms: Family Practice
  6. Fulltext Insomnia and its correlates among elderly patients presenting to family medicine clinics at an academic center
    Farazdaq H, Andrades M, Nanji K
    Malays Fam Physician, 2018;13(3):12-19.
    PMID: 30800228
    Objective: The objective of this study is to determine the frequency and correlates of insomnia among elderly patients presenting to family medicine clinics at an academic center in Karachi, Pakistan.

    Study design: This is a cross-sectional study.

    Place and duration of study: The study was conducted at the Outpatient Family Medicine Clinics at Aga Khan University Hospital between February 2013 and June 2013.

    Methodology: Patients 60 years old and above were recruited (n=152) through non- probability consecutive sampling. Information was collected on a pretested structured questionnaire on demographics, insomnia symptoms, medical co-morbidities, lifestyle factors and sleep disorders. Data was analyzed on SPSS 19. Proportions and the Chi-Square test were used in the analyses, along with binary logistic regression.

    Results: The mean age of the participants was 65.68 years, and 38.80% of the participants were male and 61.20% were female. The prevalence of insomnia was 42.1%. It was more common in women than in men (64.10% vs. 35.9%). Increasing age [ORadj: 4.54; 95%CI: 1.85-11.17], being divorced/widowed [ORadj: 10.26; 95%CI: 2.79-37.73] and having an average household income of over Rs.50, 000, were significantly related to insomnia. The other factors associated with insomnia were Gastro Esophageal Reflux Disease [ORadj: 4.30; 95% CI: 1.67-11.04], depression [ORadj: 2.88, 95% CI: 1.13-7.33], caffeine consumption [ORadj: 6.50; 95% CI: 2.27-18.57], and cigarette smoking close to bed time [ORadj: 4.78; 95% CI: 0.88-25.90].

    Conclusion: The study showed that older adults with multiple diseases were at high risk of insomnia. Certain life style practices enhanced the risk; hence, physicians should incorporate sleep history and tailor treatment to target both insomnia and related factors to optimize quality of life.
    Matched MeSH terms: Family Practice
  7. Fulltext Avoiding common errors in key feature problems
    Kwa SK, Sheikh Mohd Amin MM, Ng AC
    Malays Fam Physician, 2007;2(1):18-21.
    MyJurnal
    Questions on Key Features Problems (KFP) are an important component of the theory paper for Part 1 of the membership examination of the Academy of Family Physicians of Malaysia (MAFP) and the Fellowship for the Royal Australian College of General Practitioners (FRACGP).This paper will attempt to provide information on the format and marking scheme of KFP. Expected answers for some KFP cases will be discussed and common errors made by candidates highlighted with suggestions on how to avoid them.
    Matched MeSH terms: Family Practice
  8. Fulltext Accuracy of urinalysis in detection of urinary tract infection in a primary care setting
    Othman S, Chia YC, Ng CJ
    Asia Pac Fam Med, 2003;2(4):206-212.
    Aim: To determine the accuracy of urinalysis in the detection of urinary tract infection (UTI) in symptomatic patients at primary care level. Methods: A cross sectional study was undertaken on 100 patients with symptoms of UTI presenting at the Primary Care Clinic of University Malaya Medical Center, Kuala Lumpur, Malaysia during the months of August to November 1999. Their urine samples were tested simultaneously using urine dipstick, urine microscopy and urine culture. Urine culture was used as the gold standard and UTI was diagnosed when the urine culture showed a bacteria count of >= 105 organisms per mL. The sensitivity and specificity of each test was calculated. Results: The prevalence of UTI was 25% in symptomatic patients. The urine dipstick for leukocyte esterase, nitrite and red blood cell had sensitivities of 76, 56 and 76%, respectively. Their specificities were 60, 81 and 61%, respectively. Urine microscopy for leukocytes, red blood cells and bacterial count had sensitivities of 80, 52 and 84%, while their specificities were 76, 80 and 54%, respectively. Conclusion: The prevalence of UTI in the present study was low despite reported symptoms of UTI. Urinalysis is needed to support the diagnosis of UTI. In the present study, while there is accuracy in the urinalysis (as the sensitivities and specificities of various tests are comparable with other studies); lack of precision in each test because of the wide range of 95% confidence interval make it less reliable. Caution should be made in interpreting each test.
    Matched MeSH terms: Family Practice
  9. Surgical emergencies in general practice
    Ng CW
    Family Practitioner, 1978;3:5-7.
    Matched MeSH terms: Family Practice
  10. Disseminated intravascular coagulation
    Ng SC
    Family Practitioner, 1988;11:62-64.
    Matched MeSH terms: Family Practice
  11. Fulltext Prescribing patterns for childhood asthma treatment in general practice
    Chan PWK, Norzila MZ
    Med J Malaysia, 2003 Oct;58(4):475-81.
    PMID: 15190621
    The treatment preferences of 109 general practitioners (GPs) for childhood asthma were determined. Availability and adherence to clinical practice guidelines (CPG) for the treatment of childhood asthma was also assessed. Ninety eight (90%), 60 (55%) and 33 (30%) GPs considered nocturnal symptoms > 2 times/week, exercise induced wheeze and cough respectively as indications for preventer therapy. An oral preparation was preferred for relief medication [72 (66%) for 2-5 years, 60 (55%) for > 5 years]. An inhaled preparation was however preferred for preventer medication [60 (55%) for 2-5 years, 85 (78%) for > 5 years]. The oral form was more likely prescribed for asthmatic children 2-5 years (p < 0.001). Corticosteroids and ketotifen were the commonest inhaled and oral preventer treatment prescribed respectively. Only 36(33%) GPs have a CPG copy for reference. Children with asthma symptoms that require preventer therapy may not always be identified in general practice. The oral route remains important for asthma medication especially in young children. The accessibility to the CPG among GPs is disappointing.
    Study site: General practitioners attending a pharmaceutical industry sponsored asthma management workshop
    Matched MeSH terms: Family Practice/statistics & numerical data*
  12. Fulltext Doctor hopping in general practice: a Malaysian survey
    Ngeow TF, Chia SF, Ong CB
    Aust Fam Physician, 1981 May;10(5):397-9, 401-3.
    PMID: 7283844
    In a survey of 5233 patients seen in the clinics of three general practitioners, 339 patients were found to be doctor hoppers (6.48 per cent). Respiratory symptoms and fever were the commonest presentation affecting mainly the paediatric age group. No improvement in the symptoms was quoted as the most common reason for switching to another doctor. Many factors contributed to doctor hopping and these were best considered in relation to the illness, the patient and the doctor: From the point of prevention, the doctor himself has a significant role to play, particularly in improving the doctor-patient relationship and patient compliance.
    Study site: Johor (Johor Bahru, Batu Pahat, Muar)
    Matched MeSH terms: Family Practice*
  13. Fulltext Founding of the College of General Practitioners Malaysia
    Param Palam S
    Family Practitioner, 1973;1(1):9-12.
    Matched MeSH terms: Family Practice
  14. Problem oriented medical recording system for general practice
    Param Palam S
    Family Practitioner, 1977;2:94-99.
    Matched MeSH terms: Family Practice
  15. Laboratory needs in general practice
    Penang Chapter, College of General Practitioners, Malaysia
    Med J Malaysia, 1977 Sep;32(1):56-8.
    PMID: 609345
    Matched MeSH terms: Family Practice*
  16. Fulltext Rejuvenating chronic disease management in Malaysian private general practice - a global perspective
    Anis Safura R, Wijesinha S, Piterman L
    Malays Fam Physician, 2010;5(1):49-52.
    MyJurnal
    Rapid epidemiological transition globally has witnessed a rising prevalence of major chronic diseases such as hypertension, diabetes, hyperlipidaemia, obesity, chronic respiratory diseases and cancers over the past 30 years. In Malaysia, these conditions are commonly managed in primary care and published evidence has consistently shown suboptimal management and poor disease control. This in turn, has led to the massive burden of treating complications in secondary care, burden to the patients and their families with regards to morbidity and premature death, and burden to the country with regards to premature loss of human capital. The crushing burden and escalating health care costs in managing chronic diseases pose a daunting challenge to our primary care system, as we remain traditionally oriented to care for acute, episodic illnesses. This paper re-examines the current evidence supporting the implementation of Wagner Chronic Care Model in primary care globally; analyses the barriers of implementation of this model in the Malaysian private general practice through SWOT (strengths, weaknesses, opportunities and threats) analysis; and discusses fundamental solutions needed to bridge the gap to achieve better outcomes.
    Matched MeSH terms: Family Practice
  17. Physicians' professionalism from the patients' perspective: a qualitative study at a single-family practice in Saudi Arabia
    AlFaris E, Irfan F, Abouammoh N, Zakaria N, Ahmed AM, Kasule O, et al.
    BMC Med Ethics, 2023 Jun 07;24(1):39.
    PMID: 37287002 DOI: 10.1186/s12910-023-00918-9
    INTRODUCTION: Professionalism is a crucial component of medical practice. It is a culturally sensitive notion that generally consists of behaviors, values, communication, and relationships. This study is a qualitative study exploring physician professionalism from the patients' perspective.

    METHODS: Focus group discussions with patients attending a family medicine center attached to a tertiary care hospital were carried out using the four gates model of Arabian medical professionalism that is appropriate to Arab culture. Discussions with patients were recorded and transcribed. Data were thematically analyzed using NVivo software.

    RESULTS: Three main themes emerged from the data. (1) In dealing with patients, participants expected respect but understood delays in seeing physicians due to their busy schedules. In communication, participants expected to be informed about their health conditions and to have their questions answered. (2) In dealing with tasks, participants expected proper examination and transparency of diagnosis, but some expected the physician to know everything and did not appreciate them seeking outside opinions. They expected to see the same physician at every visit. (3) In physician characteristics preferences, participants preferred friendly smiling physicians. Some cared about the outer appearance of the physician whereas others did not.

    DISCUSSION/CONCLUSIONS: The findings of the study explained only two themes of the four gates model namely dealing with patients and dealing with tasks. Cultural competence and how to benefit from patients' perceptions to be an ideal physician should be incorporated into the process of physicians' training.

    Matched MeSH terms: Family Practice*
  18. Fulltext Impact of various continuing medical education activities on clinical practice - a survey of Malaysian doctors on its perceived importance
    Loh LC, Ong HT, Quah SH
    Ann Acad Med Singap, 2007 Apr;36(4):281-4.
    PMID: 17483859
    INTRODUCTION: Medical talks, newsletter circulars, scientific meetings and conferences, and interaction with members of the pharmaceutical industry, have become convenient means of carrying out continuing medical education (CME) for many busy doctors.

    MATERIALS AND METHODS: To study the perceived importance of these various CME activities, a self-completed posted questionnaire survey was conducted among registered practitioners of a densely populated urban state in Malaysia.

    RESULTS: Of the 172 respondents [male, 77%; hospital-based, 37%; general practitioner (GP), 55%; private practice, 70%; respondent rate of 19.5%], most preferred local conferences and endorsements by local experts to their foreign counterparts. Meetings or conferences sponsored by the pharmaceutical industry were ranked similarly with those without such links, while the reputation of the pharmaceutical firms was of foremost importance. Among GPs (n = 95) and non-GPs (n = 77), medical society newsletters were rated significantly higher by GPs while overseas conferences were rated higher by non-GPs.

    CONCLUSION: Our findings provide an important first look at this under-explored area among Malaysian doctors and described a high degree of acceptance for the involvement of the pharmaceutical industry in CME activities.
    Matched MeSH terms: Family Practice/education*; Family Practice/standards
  19. Fulltext Planning a community-centred health delivery system
    Rajakumar M K
    Citation: Rajakumar MK. Planning a community-centred health delivery system. Kuala Lumpur: Academy of Family Physicians of Malaysia; 1995.
    Matched MeSH terms: Family Practice
  20. Health for all through family practice
    Rajakumar MK
    Fam Pract, 1985 Mar;2(1):55-6.
    PMID: 3988018 DOI: 10.1093/fampra/2.1.55-a
    In developing countries, the family persists as a key institution, the centre of the emotional, spiritual and economic life of the individual and the context of the individual's interactions with the community. The majority of the population still live in rural areas where the family-community interaction is close, indeed intense. This remains true too of peasants migrating to urban slums to exist in a new culture of poverty. The family in developing countries represents a more closely shared, psychological, sociological and economic destiny than is perhaps represented by the family in the wealthy nations of the West.

    'Health for all by the year 2000' is the promise of the Declaration of Alma-Ata to which all our governments have put their signatures. It is a noble ambition which is impossible to achieve unless the issues of poverty and maldistribution of wealth are seriously addressed. Nevertheless, much progress can be made during a campaign to achieve 'Health 2000' because an opportunity presents to discuss the prerequisites to achieving 'Health for all' and there is pressure to make some progress towards this.

    An important opportunity now presents itself to put into effect the new concepts of family practice on a global scale. Hitherto the World Health Organization, (of which WONCA has just become a non-governmental organization affiliate) has not found it necessary to turn to family physicians for advice or expertise whilst organizations of family physicians for their part have shown little interest in the primary health care movement. Family physicians have practised under constraints that have favoured chargeable procedures as against the preventive approach, episodic care as against continuing care, caring for the fee-paying individual as against caring for the family and large panels as against small populations. This practice falls short of our ideals. In developing countries, there is a need for a community-oriented, family-based practice in which the physician and the health care team accept responsibility to work with their community to achieve health for all. We must now give attention to develop this atrophied wing of family practice.

    This is truly a historic opportunity that we must seize to make available the concepts and skills of family practice and to universalize the relevance of our way of delivering primary health care. All of us in a great co-operative endeavour can do much for the health of the people of this small globe that we share.
    'There is a tide in the affairs of men,
    Which, taken at the flood, leads on to fortune;
    Omitted, all the voyages of their life
    Is found in shallows and miseries.
    On such a full sea are we now afloat,
    And we must take the current when it serves,
    Or lose our venture.'
    [Notes added by TCL: Full text of article. The quoted phrase was uttered by Brutus in William Shakespear's Julius Caesar Act 4, scene 3]
    Matched MeSH terms: Family Practice*
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