MyMedR

Fulltext Reliability and validity of the Malay translated version of diabetes quality of life for youth questionnaire

Jalaludin MY, Fuziah MZ, Hadhrami MH, Hong JYH, Jamaiyah H, Mohamad Adam B

Malays Fam Physician, 2013;8(1):12-9.

Many studies reported poorer quality of life (QoL) in youth with diabetes compared to healthy peers. One of the tools used is the Diabetes Quality of Life for Youth (DQoLY) questionnaire in English. A validated instrument in Malay is needed to assess the perception of QoL among youth with diabetes in Malaysia.

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.

Fulltext Comparing the disease profiles of adult patients with type 2 diabetes mellitus attending four public health care facilities in Malaysia

Chew BH, Mastura I, Bujang MA

Malays Fam Physician, 2013;8(3):11-8.

PMID: 25893052 MyJurnal

AIM: We examined disease profiles of patients with type 2 diabetes mellitus (T2D) at four different public health facilities in Malaysia to determine which site would be the most suitable for early and intensive diabetes care against diabetes-related complications.
METHODS: This study analysed 57,780 T2D patients in the Adult Diabetes Control and Management registry database in the year 2009. The four public health facilities were hospital with specialists (HS), hospital without specialists (HNS), health clinics with family medicine specialists (CS) and health clinic without doctors (CND). Descriptive analyses were used to examine age, duration of diseases, intervals from the onset of diabetes to co-morbidities (hypertension and dyslipidaemia) and complication of T2D patients at the four public health facilities.
RESULTS: Patients were significantly older in HS. Patients with T2D at HS had significantly longer duration of diabetes, hypertension and dyslipidaemia. Health clinics, both the CS and the CND, were seeing T2D patients with shorter duration of macrovascular and microvascular complications.
CONCLUSION: Public health clinics in this country managed T2D patients who were younger and at the early stage of diabetes, hypertension, dyslipidaemia and complications. Thus, primary care physicians are best positioned to provide early and intensive diabetes care for this group of T2D patients to prevent the development of diabetes-related complications.
KEYWORDS:
diabetes complications; disease management; health facilities; primary health care; type 2 diabetes mellitus
Study name: Adult Diabetes Control and Management (ADCM) 2009

Fulltext Evidence-based practice in Malaysia: where are we and what more can be done?

Teng CL

Malays Fam Physician, 2013;8(2):2-6.

PMID: 25606274 MyJurnal

Fulltext Hot water immersion as a treatment for stonefish sting: A case report

Darlene FO, Phee-Kheng C

Malays Fam Physician, 2013;8(1):28-32.

PMID: 25606265 MyJurnal

The North Borneo state of Sabah is known worldwide for its beautiful islands and dive sites. Local hospitals deal with a number of marine-related injuries, including marine fauna envenomation by Scorpaenidae and Synanceiidae families of fish. We report a case of a tourist who presented with excruciating pain on her right foot after stepping on a stonefish. Despite being given parenteral analgesia and regional anaesthesia, the pain persisted. Her pain improved after she soaked her foot in hot water for about 30 minutes. No further treatment was required. We reviewed the literature comparing this inexpensive mode of treatment with other conventional treatments. We also explored the possibility of using hot water immersion for treatment of envenomation by other types of marine animals.

Fulltext A case study of human immunodeficiency virus with positive seroconversion to negative

Paranthaman V, Yip HL, Ker HB

Malays Fam Physician, 2015;10(1):44-6.

PMID: 26425294 MyJurnal

This case study demonstrates a 36-year-old ex-intravenous drug user (IVDU) who had been initially tested positive for human immunodeficiency virus (HIV) twice using Enzyme Immunoassay (EIA) method (Particle agglutination, PA done), but a year later he was tested HIV-negative. The patient was asymptomatic for HIV and T helper cells (CD4) count remained stable throughout this period. In light of this case, there may be a need to retest by molecular methods for high risk category patients who were initially diagnosed HIV-positive, but later showing an unexpected clinical course, such as a rising or stable CD4 titre over the years.

Fulltext Social support and self-care activities among the elderly patients with diabetes in Kelantan

Siti Khuzaimah AS, Shdaifat EA, Mohd Abd Majid HA, Shohor NA, Ahmad F, Zakaria Z

Malays Fam Physician, 2015;10(1):34-43.

PMID: 26425293 MyJurnal

INTRODUCTION: Diabetes is common among the elderly and can significantly affect their lives including the issues related with social support and diabetic self-care activities.
OBJECTIVES: The objective of this study was to examine the social support and self-care activities among the elderly patients with diabetes.
METHODS: A survey involving 200 patients was conducted from March 2013 to May 2013 in three hospitals in Kelantan. Data were obtained through self-administered questionnaires and clinical characteristics were acquired from the patients' records.
RESULTS: The scores for social support (mean = 19.26; SD = 2.63) and self-care activities (mean = 14.83; SD = 4.92) were moderate. Higher social support was associated with high levels of glycated haemoglobin (HbA1c), fasting blood sugar (FBS) level, the duration of diabetes and a decrease in body mass index (BMI) (p<0.05). It was observed that the patients with low educational, Hb1Ac and FBS level, with other chronic diseases and who have had diabetes for some time had low self-care activities (p<0.05). There was a significant negative relationship between an increase in social support and decrease in self-care activity (p<0.05).
CONCLUSION: Healthcare providers, family and friends have to strengthen their relationship with the elderly patients with diabetes to provide more social support and promote the compliance with diabetic self-care activities to improve clinical outcomes.
KEYWORDS: Social support; diabetes; elderly; self-care activities
Study site: medical and diabetic clinics, three government hospitals in Kelantan, Malaysia (Gua Musang Hospital, Kuala Krai Hospital and Machang Hospital).

Fulltext Management of pulmonary tuberculosis in health clinics in the Gombak district: How are we doing so far?

Ariffin F, Ahmad Zubaidi AZ, Md Yasin M, Ishak R

Malays Fam Physician, 2015;10(1):26-33.

PMID: 26425292 MyJurnal

This audit report assessed the structure, processes and outcome of the pulmonary tuberculosis (PTB) management in adults conducted at eight government health clinics within the high TB burden Gombak district. All newly diagnosed PTB patients from November 2012 to November 2013 were identified from the tuberculosis registry. Patients less than 18 years old, were transferred out or extrapulmonary tuberculosis was excluded from the study. The assessment criteria for PTB were defined according to the latest Malaysian TB clinical practice guidelines (TB CPG) 2012. A total of 117 patients were included in this report and data were extracted and analysed using SPSS version 20.0. The mean age of patients was 40.4 ± 14.4 SD. Majority was men (63.2%). Out of 117 patients, 82.1% were Malaysian citizens and 17.9% were foreigners. Malays were the majority (65%) followed by 7.7% Chinese, 10.3% Indian and 17.1% others. The most common clinical feature was cough (88.0%) followed by loss of weight (58.1%), loss of appetite (57.3%), fever (56.4%), night sweat (30.8%) and haemoptysis (32.5%). Acid-fast bacilli (AFB) smear was positive in 94% of cases. Chest X-ray and human immunodeficiency virus (HIV) screening results were available for 89.1 and 82.1% cases respectively. The results for the sputum culture were available in 27.4% of patients and 54.7% were documented as done but pending results. The clinics have a successful directly observed therapy (DOT) program with 94.0% patients documented under DOT. Out of 53 patients on maintenance phase, 47.2% were identified as cured. Cure rate for those completed treatment was 100%. The defaulter rate was 17.1%. This audit demonstrated the attempt made by the clinics to adhere to the recommended guidelines. However, improvements are to be made in the documentation of medical records, tracing of investigation results and reduction of the number of defaulters.

Fulltext Poor blood pressure control and its associated factors among older people with hypertension: A cross-sectional study in six public primary care clinics in Malaysia

Cheong AT, Sazlina SG, Tong SF, Azah AS, Salmiah S

Malays Fam Physician, 2015;10(1):19-25.

PMID: 26425291 MyJurnal

INTRODUCTION: Hypertension is highly prevalent in the older people. Chronic disease care is a major burden in the public primary care clinics in Malaysia. Good blood pressure (BP) control is needed to reduce the morbidity and mortality of cardiovascular disease (CVD). This study aimed to determine the status of BP control and its associated factors among older people with hypertension in public primary care clinics.
MATERIALS AND METHODS: A cross-sectional study on hypertensive patients aged 18 years and above was conducted in six public primary care clinics in Federal Territory, Malaysia. A total of 1107 patients were selected via systematic random sampling. Data from 441 (39.8%) patients aged 60 years and more were used in this analysis. BP control was determined from the average of two BP readings measured twice at an interval of 5 min. For patients without diabetes, poor BP control was defined as BP of ≥140/90 mm Hg and ≥150/90 for the patients aged 80 years and more. For patients with diabetes, poor control was defined as BP of ≥140/80 mm Hg.
RESULTS: A total of 51.7% (n = 228) of older patients had poor BP control. The factors associated with BP control were education level (p = 0.003), presence of comorbidities (p = 0.015), number of antihypertensive agents (p = 0.001) and number of total medications used (p = 0.002). Patients with lower education (less than secondary education) (OR = 1.7, p = 0.008) and the use of three or more antihypertensive agents (OR = 2.0, p = 0.020) were associated with poor BP control.
CONCLUSION: Among older people with hypertension, those having lower education level, or using three or more antihypertensive agents would require more attention on their BP control.

Fulltext A boy with blue sclera and recurrent fractures

Md Shukri N, Mohamad I, Salim R

Malays Fam Physician, 2015;10(1):52-3.

PMID: 26425297

Fulltext A boy with bluish neck swelling on screaming

Mohamad I, Abdul Karim AH, Mohamad H

Malays Fam Physician, 2015;10(1):50-1.

PMID: 26425296

Fulltext Night market contact lens-related corneal ulcer: Should we increase public awareness?

Ayesha MZ, Umi Kalthum MN, Jemaima CH, Faridah HA

Malays Fam Physician, 2015;10(1):47-9.

PMID: 26425295 MyJurnal

Fulltext Single rare central lesion with triple common aerodigestive symptoms

Mohamad I, Mohamad IS, Nik Hassan N

Malays Fam Physician, 2018;13(1):57-58.

PMID: 29796215 MyJurnal

An elderly gentleman with a known history of
well-controlled hypertension presented with
a three-week history of hoarseness associated
with mild breathlessness. There was no episode
of cyanosis, no noisy breathing, and no
reduction in effort tolerance. There was also no
history of chest pain or orthopnea. He denied
any feeling of food stuck in his throat or chest,
and he had no history of choking sensations
during meals. He, however, was unable to
count from 1 to 10 in one breath, and lung
auscultation revealed reduced air entry on both
sides. A chest radiograph was then obtained. (Copied from article).

Fulltext Hypopigmented patches in an 8-year-old boy

Malek KA, Kamal WW

Malays Fam Physician, 2018;13(1):49-51.

PMID: 29796212 MyJurnal

An 8-year-old boy presents with asymptomatic hypopigmented patches on his bilateral cheeks which
have been worsening for two weeks. The patches are oval in shape and have spared other parts of the
body. There is no preceding erythematous rash. Similar lesions appeared two years ago which took
several months to resolve. There are no recent triggers, such as personal care products. He has no history
of atopy, but his mother has a recent history of atopic eczema. There is no known history of thyroid
problems in the family. He was prescribed a topical cream from a general practitioner, but the patches
persisted, and new patches appeared. He is otherwise well and actively participating in outdoor physical
activities with frequent sun exposure. (Copied from article).

Fulltext Glomus tympanicum

Appannan VR, Md Daud MK

Malays Fam Physician, 2018;13(1):45-48.

PMID: 29796211

Glomus tympanicum is a tumour classified under the group glomus tumours, and is also known as paragangliomas. It is thought to commonly occur in women in the fifth to sixth decades of life. Here, we report a case of a 77-year-old lady with multiple co-morbids and a diagnosis of glomus tympanicum presenting to us. Her symptoms included pulsatile tinnitus, and reduced hearing, and the management of the case was done with consideration for her underlying multiple co-morbidities. This paper also describes the best modality of treatment for this patient with regard to her background history. The treatment goal was to improve her quality of life and control the disease.

Fulltext A child with coated tonsils

Appannan VR, Mohamad I, Ramli RR, Johan KB

Malays Fam Physician, 2018;13(1):55-56.

PMID: 29796214 MyJurnal

A 5-year-old girl presented with a history of
fever for four days associated with odynophagia.
She was treated with amoxycillin prescribed
by a general practitioner for 3 days prior to
presentation. However, the symptoms were
worsening and associated with drooling of
saliva and poor oral intake. There was history
of recurrent acute tonsillitis in the past two
years, with 5 to 6 episodes per year. The child
had completed regular immunizations up to her
current age. There was no similar presentation
amongst family members and friends. (Copied from article).

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).

Fulltext Tackling infectious diseases in primary care

Ng CJ

Malays Fam Physician, 2014;9(2):1.

PMID: 25893064

Fulltext Knowledge, utilization and barriers to primary care services for sexual and reproductive health among adolescents in secondary schools in Selangor, Malaysia

Othman S, Kong SZ, Mohd Mydin FH, Ng CJ

Malays Fam Physician, 2019;14(1):10-17.

PMID: 31289626

Early sexual debut, partner violence, pregnancy and sexually transmitted infections contribute to negative health outcomes among adolescents. While the primary care clinics offer accessible sexual and reproductive health (SRH) services to adolescents, it is uncertain whether adolescents are aware of and utilize these services. This study aimed to examine Malaysian adolescents' knowledge, utilization and barriers to primary care services for SRH. A cross-sectional survey was conducted from August to November 2011 among adolescent from five randomly selected schools in Selangor, Malaysia. A self-administered questionnaire was used to assess their knowledge, attitudes, sexual behaviors and utilization of SRH services. A total of 680 adolescents participated in the study. One in ten of the adolescents were aware of the availability of SRH services, and only 6.9% of them had ever visited a primary care clinic for SRH. About 75% of them felt uncomfortable going to a primary care clinic for SRH services. Knowledge and utilization of primary care clinics for SRH among adolescents in Malaysia is poor.

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.

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