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  1. Nantha YS
    J Family Med Prim Care, 2014 Jul;3(3):207-12.
    PMID: 25374855 DOI: 10.4103/2249-4863.141611
    BACKGROUND: Patients presenting with chronic cough pose a common diagnostic dilemma during routine consultations at public primary care clinics in Malaysia. To date, there has been little attempt at designing a standardized model or algorithm to facilitate an accurate diagnosis of chronic cough. This study proposes a clinical method to detect the causes of chronic cough in a primary care setting in Malaysia.
    MATERIALS AND METHODS: A total of 117 patients aged above 18 at an urban primary care clinic were tracked over a span of 5 months to diagnose the cause of chronic cough. A therapeutic-diagnostic method was employed to help identify the causes of chronic cough. Subsequently, the demographic details of patients, the prevalence of the different causes of chronic cough and the relationship between history and diagnosis were analyzed statistically.
    RESULTS: Chronic cough had a slightly higher male preponderance (51.3% vs. 48.7%). Patients within the 'above 60' age category had the highest frequency of chronic cough. The most common cause of chronic cough was post-infectious cough (n = 42, 35.9%), followed closely by angiotensin-converting enzyme-inhibitor related cough (n = 14, 12%). Majority of patients had the symptom of phlegm production (n = 41, 54%). 33 patients (29.2%) had recent upper respiratory tract infection (<2 weeks ago) prior to the diagnosis of chronic cough. There were poor association between symptoms and the various entities comprising chronic cough. The exceptions were the following associations: (1) Bronchial asthma and itchiness of throat (P = 0021), (2) gastroesophageal reflux disease and heartburn (P < 0.001), (3) upper airway cough syndrome and running nose (P = 0.016) and (4) pulmonary tuberculosis and absence of weight loss (P = 0.004).
    CONCLUSION: This study demonstrates that the effectiveness of a therapeutic-diagnostic technique in the diagnosis of chronic cough. Consistent with previous studies, there was poor association between most symptoms and the causes of chronic cough. A study involving a larger primary care population is required to confirm the findings found in this analysis.
    KEYWORDS: Angiotensin-converting enzyme-I related cough; chronic cough; post-infectious cough; primary care; therapeutic-diagnostic evaluation
  2. Rathor MY, Abdul Rani MF, Shahar MA, Jamalludin AR, Che Abdullah ST, Omar AM, et al.
    J Family Med Prim Care, 2014 Jul;3(3):230-7.
    PMID: 25374860 DOI: 10.4103/2249-4863.141616
    INTRODUCTION: Due to globalization and changes in the health care delivery system, there has been a gradual change in the attitude of the medical community as well as the lay public toward greater acceptance of euthanasia as an option for terminally ill and dying patients. Physicians in developing countries come across situations where such issues are raised with increasing frequency. As euthanasia has gained world-wide prominence, the objectives of our study therefore were to explore the attitude of physicians and chronically ill patients toward euthanasia and related issues. Concomitantly, we wanted to ascertain the frequency of requests for assistance in active euthanasia.
    MATERIALS AND METHODS: Questionnaire based survey among consenting patients and physicians.
    RESULTS: The majority of our physicians and patients did not support active euthanasia or physician-assisted suicide (EAS), no matter what the circumstances may be P < 0.001. Both opposed to its legalization P < 0.001. Just 15% of physicians reported that they were asked by patients for assistance in dying. Both physicians 29.2% and patients 61.5% were in favor of withdrawing or withholding life-sustaining treatment to a patient with no chances of survival. Among patients no significant differences were observed for age, marital status, or underlying health status.
    CONCLUSIONS: A significant percentage of surveyed respondents were against EAS or its legalization. Patient views were primarily determined by religious beliefs rather than the disease severity. More debates on the matter are crucial in the ever-evolving world of clinical medicine.
    KEYWORDS: Attitude; euthanasia; legalization; multi-cultural; physician-assisted suicide
  3. Bamatraf AA, AlAmodi AA, Ali MA, Chan CM, Mazlan M, Shareef MA
    J Family Med Prim Care, 2020 Jun;9(6):2990-2994.
    PMID: 32984161 DOI: 10.4103/jfmpc.jfmpc_247_20
    Purpose: This study aims to investigate the level of strain and various influencing factors among informal care providers of traumatic brain injury (TBI) patients.

    Methods: A cross-sectional study was conducted in a single center in Malaysia via recruiting care providers of patients with TBI. The modified caregiver strain index (MCSI) questionnaires were utilized to ascertain the level of strain. The demographic data of informal care providers were also obtained. Independent sample t-test, analysis of variance (ANOVA), and a linear regression model were processed for data analysis.

    Results: A total of 140 informal care providers were included in the study. More than half of informal care providers claimed to have strain (54.3%). Factors associated with increased strain include receiving tertiary education, being of Chinese background, and employed experience higher strain level. Informal care providers with characteristics such as being single, retired and provided care for 5 years experienced a lower level of strain.

    Conclusion: Guidance on integrating the TBI knowledge into practice, assessing the care provider's level of strain regularly and providing supportive measures may aid in supporting informal care providers at risk.

  4. Hamedanchi A, Momtaz YA, Khankeh HR, Zanjari N
    J Family Med Prim Care, 2020 Jun;9(6):2837-2842.
    PMID: 32984135 DOI: 10.4103/jfmpc.jfmpc_264_20
    Background: Statistics show that the age of the Iranian population is advancing, and the marriage age is increasing as well. Clearly, an increase in the number of never-married older adults is expected. The aim of this descriptive, analytical study was to determine the growth trend of never-married older population and its association with education level in Iran.

    Methods: Based on the raw data collected from the Statistical Center of Iran, we studied the population of never-married older adults in the past 25 years and evaluated the growth pattern in different parts of Iran, using ArcGIS software. We also examined the association of singlehood in late life with education in men and women residing in rural and urban areas, using the Chi-square test in SPSS version 22.

    Results: A sharp increase was observed in the population of never-married older adults, particularly women, in the past 10 years. Women with formal education from urban and rural areas were more likely to be never married in late life (χ2 = 10455.35, P < 0.001 and χ2 = 271.31, P < 0.001, respectively). Older men with formal education from urban areas were more likely to be never married (χ2 = 35.44, P < 0.001), while men with formal education from rural areas were less likely to be never married (χ2 = 179.13, P < 0.001).

    Conclusion: The rate of increase in the population of never-married older women was much higher than the overall growth of older population. Women with formal education, particularly those with university and pre-university degrees, were more likely to be single in late life. It is strongly suggested to determine the causes and process of singlehood in old age in future research, including qualitative studies.

  5. Nair AM, Shilpa PH, Shekhar V, Tiwari RVC, Shaik I, Dasari B, et al.
    J Family Med Prim Care, 2020 Jul;9(7):3200-3204.
    PMID: 33102270 DOI: 10.4103/jfmpc.jfmpc_496_20
    Recently coronavirus outbreak which started in Wuhan, China, has caused international concern that has affected more than 29 lakh people worldwide and with no vaccine or specific antiviral drugs present as well as oblivious testing of carriers who are generally asymptomatic, the use of general health intervention techniques are failing to comply. As compared to other epidemics like severe acute respiratory syndrome-coronavirus (SARS-CoV) and the Middle-East respiratory syndrome (MERS-CoV), coronavirus (also named as COVID-19) exhibit mild symptoms in the majority of cases. But in the case of a vulnerable population, it can prove to be life-threatening. Relying on proper barrier technique, use of chest computed tomography scans, managing co-morbid conditions of susceptible patients, identifying the pattern of disease spread as well as the use of polymerase chain reaction to assess the specificity of cases will eventually prove to be efficacious since most of the positive cases are asymptomatic at the beginning which poses a challenge to the primary health care physicians. The development of vaccines will also take some time so it is better to know about COVID-19 better and also follow quarantine restrictions properly till then. In this review, we try to put forward all the relevant studies which have been published by the end of March 2020 so as to summarize the natural history, diagnosis as well as treatment strategies for eradicating COVID-19, which will help in managing this pandemic.
  6. Ramasamy V, Nadarajah S
    J Family Med Prim Care, 2019 1 2;7(5):1083-1085.
    PMID: 30598962 DOI: 10.4103/jfmpc.jfmpc_47_18
    A foreign body in the nose is a common referral dealt by the otolaryngologist on daily basis. Here we report a case of a 5-year-old girl who was referred from a primary care center with complaints of left nasal blockage and epistaxis along with foul smelling brownish discharge for 1-day duration. Nasal endoscopic examination of the left side of the nose revealed an impacted button battery at the cartilaginous portion of the nasal septum.
  7. Aldubai SAR, Aljohani AM, Alghamdi AG, Alghamdi KS, Ganasegeran K, Yenbaawi AM
    J Family Med Prim Care, 2019 02;8(2):657-662.
    PMID: 30984690 DOI: 10.4103/jfmpc.jfmpc_268_18
    Background and Aim: Burnout is a common problem for interns and residents. It has been associated with physical and mental health of health care providers as well as low job satisfaction and medical errors. Few studies have investigated this problem among residents. This study aimed to determine the prevalence of burnout and its associated factors among family residents in Al Madina city, Saudi Arabia.

    Materials and Methods: This cross-sectional study was conducted among 75 residents in the family medicine residency programs in Al Madina, Saudi Arabia. A self-administered questionnaire was used that includes questions on sociodemographic characteristics and sources of stress and burnout. T test, analysis of variance (ANOVA) test, and multiple linear regression analysis were employed.

    Results: Majority were female (54.7%) and aged 26 to 30 years (84.0%). The significant predictors of burnout in the final model were "tests/examinations" (P = 0.014), "large amount of content to be learnt" (P = 0.016), "unfair assessment from superiors" (P = 0.001), "work demands affect personal/home life" (P = 0.001), and "lack of support from superiors" (P = 0.006).

    Conclusion: Burnout is present among family medicine residents at a relatively high percentage. This situation is strongly triggered by work-related stressors, organizational attributes, and system-related attributes, but not socio-demographics of the respondents. Systemic changes to relieve the workload of family medicine residents are recommended to promote effective management of burnout.

  8. Jha A, Singh R, Jha S, Singh S, Chawla R, Prakash A
    J Family Med Prim Care, 2020 Apr;9(4):2052-2055.
    PMID: 32670964 DOI: 10.4103/jfmpc.jfmpc_967_19
    Background and Aims: Host immune response is altered by a series of physiologic and pathologic factors like age, gender, inflammation, surgery, medication etc., The present study was conducted to evaluate differences in salivary IgA (S-IgA) levels among pedodontic subjects undergoing active orthodontic treatment with fixed and removable appliance. The levels of S- IgA were determined before 3 months and 6 months post active orthodontic treatment.

    Methods: A total of 40 healthy pedodontic subjects (aged 8-15 years) were recruited in the present study. They were equally divided into Group A (fixed orthodontic group) and Group B (removable orthodontic group) with 20 subjects each. 1.5 mL of saliva per subject was obtained before 3 and 6 months after treatment. Enzyme Linked Immunosorbent Assay (ELISA) technique was used for measurement of Salivary IgA levels.

    Results: Group A and B both showed significant rise in S-IgA levels 3 months and 6 months post active orthodontic treatment. Mean value of S-IgA 3 months post treatment in the saliva of children in group B and group A were (144.27 ± 5.32) and (164.0 ± 3.23) μg/ml respectively. While mean value of S-IgA after 6 months of treatment in group B and group A were (149.8 ± 6.02) and (166.4 ± 3.65) μg/ml respectively.

    Conclusion: Salivary Immunoglobulin A level values were significantly higher statistically in both group A and group B post active orthodontic treatment than before. The results however, showed that Group A (fixed orthodontic group) showed statistically significant higher levels of S-IgA than Group B (removable orthodontic group). Active orthodontic treatment triggered a stronger stimulus for oral secretory immunity, hence the increase in levels were detected. There is a significant positive correlation between S-IgA and active fixed as well as removable orthodontic treatment. Orthodontic treatment is hence a local immunogenic factor.

  9. Chu ECP, Lo FS, Bhaumik A
    J Family Med Prim Care, 2020 May;9(5):2517-2520.
    PMID: 32754534 DOI: 10.4103/jfmpc.jfmpc_95_20
    The cervical spine is responsible for allowing mobility and stability to the head and neck. Any deviation to the center of gravity of the head results in an increase in cantilever loads, which can be particularly damaging to the upper cervical joints. Excessive neck bending also exaggerates stretching through the cervical spine and all of the spinal structures below. It has been reported that forward head posture (FHP) can cause a multitude of disorders including cervical radiculopathy, cervicogenic headaches and cervicogenic dizziness. Most of these conditions manifest with clusters of painful symptoms and spine dysfunctions. The purpose of this case study is to describe the radiographic imaging considerations and to illustrate the potential impacts in symptomatic adults with FHP. We randomly selected radiographs of three individuals with FHP who had undergone cervical adjustment for cervical pain. The occipito-axial (C0-C2) and atlanto-axial (C1-C2) joints were assessed via the C0-2 distance from the C2 base to the McGregor line (Redlund-Johnell criterion) and the Ranawat C1-2 index, in addition to subjective radiographic parameters. By comparing the radiographs of before-and-after intervention of each patient, a regressive joint spacing was observed from both indices. Such a long-lasting stretching concordant with FHP was assumed to be hazardous to joint stability. A definite conclusion, however, cannot be drawn due to the small sample size and a lack of convincing measurements.
  10. Chattu VK, Kumar R, Kumary S, Kajal F, David JK
    J Family Med Prim Care, 2018 8 10;7(2):275-283.
    PMID: 30090764 DOI: 10.4103/jfmpc.jfmpc_137_18
    Nipah virus (NiV) encephalitis first reported in "Sungai Nipah" in Malaysia in 1999 has emerged as a global public health threat in the Southeast Asia region. From 1998 to 2018, more than 630 cases of NiV human infections were reported. NiV is transmitted by zoonotic (from bats to humans, or from bats to pigs, and then to humans) as well as human-to-human routes. Deforestation and urbanization of some areas have contributed to greater overlap between human and bat habitats resulting in NiV outbreaks. Common symptoms of NiV infection in humans are similar to that of influenza such as fever and muscle pain and in some cases, the inflammation of the brain occurs leading to encephalitis. The recent epidemic in May 2018 in Kerala for the first time has killed over 17 people in 7 days with high case fatality and highlighted the importance of One Health approach. The diagnosis is often not suspected at the time of presentation and creates challenges in outbreak detection, timely control measures, and outbreak response activities. Currently, there are no drugs or vaccines specific for NiV infection although this is a priority disease on the World Health Organization's agenda. Antivirals (Ribavirin, HR2-based fusion inhibitor), biologicals (convalescent plasma, monoclonal antibodies), immunomodulators, and intensive supportive care are the mainstay to treat severe respiratory and neurologic complications. There is a great need for strengthening animal health surveillance system, using a One Health approach, to detect new cases and provide early warning for veterinary and human public health authorities.
  11. Hussin S, Yusoff SSM, Zin FM, Ghani ARI
    J Family Med Prim Care, 2018 6 20;7(1):252-254.
    PMID: 29915770 DOI: 10.4103/jfmpc.jfmpc_157_17
    Frontal meningioma is often asymptomatic and patient may present with psychiatric symptoms. We report a case of 45- year-old female patient with no premorbid medical illness presented with 6 months history of depressive symptoms and changes in personality. Her worsening cognitive impairment brought her to psychiatry clinic and led to further investigation with contrast-enhanced computed tomography (CECT) Brain. The result showed well defined markedly enhancing lesion in the frontal region measuring 5.5 cm X5.2 cm X 4.4 cm with mass effect to the adjacent brain parenchyma and associated surrounding edema. Diagnosis of bifrontal tumour-olfactory Groove Meningioma was made. Patient underwent bifrontal craniotomy and tumour excision. The quality of life improved after surgical excision.
  12. Soe HHK, Than NN, Lwin H, Phyu KL, Htay MNN, Moe S, et al.
    J Family Med Prim Care, 2018 9 21;7(4):756-761.
    PMID: 30234049 DOI: 10.4103/jfmpc.jfmpc_300_17
    Background: Disease surveillance is one of the major components to combat against infectious diseases. As health-care professionals are indispensable to mandatory notifiable disease surveillance, their knowledge and attitudes toward infectious disease notification played an important role for timely and effective reporting to the surveillance system. Therefore, we aimed to determine the knowledge of mandatory notifiable infectious diseases in Malaysia and attitude towards infectious disease reporting among final year medical students.

    Methods: A cross-sectional study was conducted from May to June 2017 in the private medical college in Malaysia.

    Materials and Methods: We purposively selected the final year (semester 10) medical students and a total of 124 students participated in this study. We collected data using a self-administered, structured questionnaire. Data were analyzed using descriptive statistics, independent t-test, and one-way analysis of variance.

    Results: Among the final year medical students, 47.5% had moderate knowledge but 4.2% had good knowledge of mandatory infectious disease notification. Only 3.2% of the students correctly answered all the notifiable diseases listed in the questionnaire. Most of the students had positive attitude toward communicable diseases reporting, rewards, and penalty for notification. There was no significant relationship between sociodemographic characteristics and knowledge and attitude of infectious disease notification.

    Conclusions: The majority of the final year medical students had moderate level of knowledge and positive attitude of infectious disease notification; however, there were some deficiencies. Better instruction and training on infectious disease notification procedures of Malaysia should be provided to the final year medical students which could not only reduce underreporting but also improve timely and effective reporting in future.

  13. Chu ECP, Lo FS, Bhaumik A
    J Family Med Prim Care, 2019 Nov;8(11):3742-3744.
    PMID: 31803683 DOI: 10.4103/jfmpc.jfmpc_839_19
    Dermatomyositis (DM) is an idiopathic inflammatory myopathy characterized by progressive muscle weakness and pathognomonic skin eruptions. Systemic corticosteroid with or without an immunosuppressive agent is the current treatment of choice in most cases. Cutaneous disease in DM is often refractory and can become the most challenging component to manage effectively. Here, we report a case of recalcitrant DM in a 66-year-old female who sought chiropractic attention for recent episodes of pain and paresthesia in the neck and exacerbation of joint pain. As expected, the musculoskeletal complaints including neck pain, peripheral arthralgia, and muscle weakness that resolved within 1 month after starting treatment. Unexpectedly, dramatic remission of the characteristic skin rashes occurred concurrently. The underlying therapeutic mechanisms of chiropractic remain elusive. This case highlights the importance of family physicians becoming familiar with diagnosing the condition and using a multidisciplinary team approach to treat recalcitrant DM.
  14. Bhattacharya S, Pradhan KB, Bashar MA, Tripathi S, Semwal J, Marzo RR, et al.
    J Family Med Prim Care, 2019 Nov;8(11):3461-3464.
    PMID: 31803636 DOI: 10.4103/jfmpc.jfmpc_155_19
    In this paper, we have described the health care problem (maldistribution of doctors) in India. Later, we have introduced the concept of artificial intelligence and we have described this technology with various examples, how it is rapidly changing the health care scenario across the world. We have also described the various advantages of artificial intelligence technology. At the end of the paper, we have raised some serious concerns regarding complete replacement of human based health care technology with artificial intelligence technology. Lastly, we concluded that we have to use artificial intelligent technology to prevent human sufferings/health care problems with proper caution.
  15. Goud EVSS, Gulati S, Agrawal A, Pani P, Nishant K, Pattnaik SJ, et al.
    J Family Med Prim Care, 2021 Nov;10(11):4247-4252.
    PMID: 35136797 DOI: 10.4103/jfmpc.jfmpc_885_21
    Background: Down syndrome which is also known as "trisomy 21" is the commonest chromosomal defect that has been associated with intellectual disability or impairment. Clinically, it has been characterized by the generalized presence of hypotonic musculature, variety of neurobiological alterations, numerous respiratory diseases, and significantly higher risk of developing infection along with various dental abnormalities and oro-facial dysmorphological changes. Periodontal diseases are the most prominent oral health issue among individuals diagnosed with Down Syndrome.

    Aim: The objective of the present prevalence analysis was to study the implications of Down's syndrome on oral health status among patients.

    Materials and Methods: This was a descriptive and cross-sectional prevalence analysis conducted within a duration of 1 year. A total of 100 children diagnosed with Down syndrome (aged between 5 and 16 years) were selected as the study sample. Inclusion criteria were (a) cytogenetic positive trisomy 21, (b) cooperative behavior, and (c) written informed consent obtained from the legal care-takers. Exclusion criteria were (a) any debilitating form of systemic diseases, (b) any other disability, and (c) extremely uncooperative children. The gingival health status was assessed using gingival index (GI) [Loe and Silness], calculus index (CI) [Ramfjord], and plaque index (PI) [Silness and Loe]. Information involving the practice of oral hygiene maintenance, diet plans, and parental educational status was derived from each parent. Based upon their intelligence quotient (I. Q.) values, the subjects were classified into three groups: a) mild (I. Q. level = 50 to 70), b) moderate (I. Q. level = 35 to 50), and c) severe (I. Q. level ≤35). Statistical analysis was performed using the statistical software tool Statistical Package for Social Sciences (SPSS) version 20.0. Qualitative data were recorded as frequencies, and percentages and quantitative data were recorded as mean and standard deviation values. All categorical outcomes were analyzed by means of the Chi-square test. The quantitative outcomes of Calculus Index, Gingival Index, and Plaque Index were analyzed by either student's t-test or one-way analysis of variance (ANOVA). Significance was set at a cut-off value of P < 0.05.

    Results: Down syndromic children between 12 and 16 years were reported to have statistically significant higher Calculus Index, Gingival Index, and Plaque Index values in comparison with younger age syndromic children (P < 0.01). Those with severe mental retardation had significantly higher Plaque Index (P < 0.001) and Gingival Index (P < 0.04) values when compared with those with mild and moderate mental retardation. No significant difference in comparing Calculus Index was noted.

    Conclusion: Higher age group children with Down syndrome require close monitoring by parents for assisting in maintaining oral hygiene practices just as in younger age group children.

  16. Marzo RR, Bhattacharya S
    J Family Med Prim Care, 2022 Nov;11(11):6772-6777.
    PMID: 36993001 DOI: 10.4103/jfmpc.jfmpc_271_19
    INTRODUCTION: Globally, mental health today poses a significant hazard to all of us. It is more vital for students, whose survival in a highly competitive atmosphere places them under enormous pressure.

    AIM AND OBJECTIVE: This qualitative study sought to determine how mental health counsellors now address the mental health concerns of their pupils. To achieve this objective, two research questions were developed to direct this study: (1) What are the experiences of counsellors who provide support to students with mental health issues? (2) How might guidance and counselling services and programmes enhance the academic success of students with mental health issues?

    METHODOLOGY: Participants were selected from a university in a northern Malaysian neighbourhood. Several semi-structured, in-depth interviews were conducted with two counsellors to collect data.

    RESULTS: Overall, the counsellors regarded multitasking to be a hindrance to their job performance. Participants felt that their caseloads prevented them from being proactive with each student, resulting in irritation. According to the participants, the job's requirements have changed, but the number of tasks and caseload have not. This has led to feelings of exhaustion and frustration. The study revealed two important research's findings: first, there has been an increase in the number of mental health concerns, particularly anxiety and depression, among students; second, counsellors would be able to effectively support children intellectually and personally if they had appropriate staffing and professional development.

    CONCLUSION: It was concluded that the counselors regarded multitasking was a hindrance to their job performance. Participants reported an increase in the frequency of anxiety and depression exhibited by their students and they felt that additional programming with friends, family, and professors could increase students' social well-being.

  17. Hosadurga R, Kyaw Soe HH, Peck Lim AT, Adl A, Mathew M
    J Family Med Prim Care, 2020 Feb;9(2):925-932.
    PMID: 32318447 DOI: 10.4103/jfmpc.jfmpc_811_19
    CONTEXT: Cardiovascular diseases (CVD) are one of the leading causes of premature deaths among noncommunicable disease. Hypertension increases the risk of cardiovascular events. In addition to well-known risk factors for hypertension like obesity, lack of physical activity, studies have shown independent association between tooth loss and increased blood pressure and stroke. However, the relevant literature is not conclusive.

    AIMS: Aim of our study was to investigate the association between tooth loss and increased blood pressure among adult patients.

    METHODS AND MATERIAL: A cross-sectional study among 270 adults aged 20-59 years was conducted. The dependent variables were systolic blood pressure (SBP) and diastolic blood pressure (DBP). The main exploratory variable was the number of self-reported natural teeth for each dental arch. They were recorded as 10 or more natural teeth, less than 10 natural teeth, and no natural teeth. Data were analyzed using descriptive statistics, independent t-test, ANOVA, and multiple linear regression analysis.

    RESULTS: Mean SBP was 125.3 mmHg and DBP was 78.9 mmHg. Moreover, 29.3% of participants had hypertension, 8.9% were edentulous, 22.8% had lost more than 10 teeth, and 68.3% had lost less than 10 teeth. Increased SBP was seen with increased tooth loss among participants. After adjusting for all covariates, no significant association between tooth loss and SBP and DBP was seen.

    CONCLUSIONS: The mean SBP was higher among the participants who were edentulous than partially edentulous. However, there was no significant association between tooth loss and SBP and DBP after adjusting for confounding factors.

  18. Bhattacharya S, Tripathi S, Marzo RR, Gokdemir O, Borocco M
    J Family Med Prim Care, 2023 Feb;12(2):397-399.
    PMID: 37091001 DOI: 10.4103/jfmpc.jfmpc_1218_22
    "Health for All" will never be attained if sociocultural bias and pervasive hypocrisy are not eliminated. The patient mentioned in this case study had difficulty gaining access to health care for more than two decades. The seizure history was modified due to social pressure. The primary healthcare workers' ability to provide timely access to healthcare regardless of caste, religion, or gender, even in the most remote regions of the country, is of paramount importance. The patient was diagnosed with hypoparathyroidism and treated with calcium and vitamin D in high oral doses. The case also illustrates the significance of medical examination in preventing future difficulties in patients with presenile cataract.
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