Malaysian Family Physician最新文献

{"title":"A rare convergence: Gangrenous bowel secondary to closed-loop obstruction with elevated urine amylase levels - A comprehensive case report.","authors":"Hassan Ahmed Abrizan, Sani Mohamad Ikhwan, Wan Mokhter Wan Mokhzani, Hashim Merican Isa Siti Rahmah, Maya Mazuwin Yahya, Syed Abd Aziz Syed Hassan","doi":"10.51866/cr.624","DOIUrl":"10.51866/cr.624","url":null,"abstract":"<p><p>Urine amylase levels are usually used to diagnose acute pancreatitis. However, there are reported cases where urine amylase levels are slightly increased in individuals without pancreatitis. Herein, we report the case of a young lady who presented with acute abdominal pain for 3 days. Her urine amylase level was 1717 U/L upon admission, and her condition was initially treated as acute pancreatitis. Unfortunately, the patient demonstrated abdominal guarding after 24 h; thus, urgent computed tomography (CT) was performed. CT revealed the presence of a dilated small bowel. She underwent emergency laparotomy, wherein a gangrenous small bowel with no evidence of saponification at the lesser sac was noted. Due to the non-specific nature of hyperamylasaemia, an alternative diagnosis other than acute pancreatitis should be considered if the clinical symptoms are not suggestive of pancreatitis or the condition worsens despite conservative management.</p>","PeriodicalId":40017,"journal":{"name":"Malaysian Family Physician","volume":"19 ","pages":"50"},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11366275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poncet disease in a patient with smear-negative pulmonary tuberculosis: A case report.","authors":"Poh Siang Ooi, Hartini Ismail, Gayatherri Meganathan, Nurfathehatul Nabila Saidi, Yeogeashweary Dhamotharan, Hui Heng Chua","doi":"10.51866/cr.581","DOIUrl":"10.51866/cr.581","url":null,"abstract":"<p><p>Pulmonary tuberculosis poses a diagnostic dilemma to clinicians especially in the absence of typical presentation. The hypersensitivity to tuberculosis infection in other parts of the body can lead to nondestructive, para-infectious arthritis. This is known as Poncet disease, one of the clinical syndromes of musculoskeletal tuberculosis. Herein, we report a case of smear-negative pulmonary tuberculosis presenting with atypical features. It started with multiple joint pain, followed by the presence of multiple tender nodular skin lesions over the bilateral shins and wrist. Subsequent investigations led to the diagnosis of smear-negative pulmonary tuberculosis. Joint pain and erythema nodosum disappeared soon after antituberculosis therapy, supporting the diagnosis of Poncet disease.</p>","PeriodicalId":40017,"journal":{"name":"Malaysian Family Physician","volume":"19 ","pages":"49"},"PeriodicalIF":0.0,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11366276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term effect of a moderate-potency topical corticosteroid on epidermal biophysical parameters in patients with mild-to-moderate atopic dermatitis: A randomised controlled study.","authors":"Zainal Abdullah Zainal Adlishah, Adawiyah Jamil","doi":"10.51866/oa.611","DOIUrl":"10.51866/oa.611","url":null,"abstract":"<p><strong>Introduction: </strong>Skin barrier dysfunction is an important component of atopic dermatitis (AD) pathophysiology. Topical corticosteroids (TCSs) are the mainstay therapy, but steroid phobia is emerging due to potential side effects. We aimed to determine the short-term effect of clobetasone butyrate on patients with AD.</p><p><strong>Methods: </strong>This investigator-blinded, randomised, moisturiser-controlled study evaluated patients with stable mild-to-moderate AD. Clobetasone butyrate ointment plus aqueous cream (Aq) or Aq alone was applied on randomised sites twice daily for 6 weeks. The itch score, modified Eczema Area and Severity Index (M-EASI) and epidermal biophysical parameters were assessed at baseline and 1 h, 3 h, 2 weeks and 6 weeks after application.</p><p><strong>Results: </strong>Sixteen patients, among whom 14 (87.5%) were women and two (12.5%) were men, participated in the study. There were no significant differences in pH, transepidermal water loss (TEWL) and hydration between TCS + Aq and Aq from 1 h to 6 weeks. A non-significant trend of pH increment was observed with TCS + Aq from baseline to 6 weeks. TEWL and hydration improved at 6 weeks for both treatment arms. The difference in TEWL from baseline was significant with Aq (P=0.01). The M-EASI at 6 weeks was comparable between the two arms. TCS + Aq improved itch and erythema better than Aq (P=0.02). No cutaneous adverse effects were observed at both sites.</p><p><strong>Conclusion: </strong>Short-term application of clobetasone butyrate with Aq is safe with no significant changes in epidermal biophysical parameters while controlling the symptoms and signs of eczema faster than Aq alone.</p>","PeriodicalId":40017,"journal":{"name":"Malaysian Family Physician","volume":"19 ","pages":"48"},"PeriodicalIF":0.0,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11366279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the pale: Insights into hypopigmented mycosis fungoides - A case report.","authors":"Zauddin Nur Zafirah, Azwanis Abdul Hadi","doi":"10.51866/cr.644","DOIUrl":"10.51866/cr.644","url":null,"abstract":"<p><p>Hypopigmented mycosis fungoides (MF) is a rare variant of cutaneous T-cell lymphoma, a type of extranodal non-Hodgkin lymphoma. This report presents the case of a 9-year-old boy with a 2-year history of asymptomatic, hypopigmented skin lesions that were resistant to topical treatment. He was initially treated for a fungal skin infection and had received multiple courses of topical antifungals and steroids but showed no improvement, which led to further evaluation and a referral to a dermatologist. A skin biopsy was performed, and the diagnosis of hypopigmented MF was confirmed through skin histopathology and immunohistochemistry study. His lesions responded well to cycles of narrowband ultraviolet B phototherapy, showing almost complete clearance after 4 months without any side effects.</p>","PeriodicalId":40017,"journal":{"name":"Malaysian Family Physician","volume":"19 ","pages":"47"},"PeriodicalIF":0.0,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11366274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic associated fatty liver disease (MAFLD): assessing the knowledge and practice of primary care doctors in Seremban District, Negeri Sembilan.","authors":"Kalaivaani Vijan, Athirah Ali, Nur Adhajirin Mohamed Idrus, Priscilla Lourdesamy, Shamini Margammuthu, Suguna Perumal, Cheong Lieng Teng, Imran Ahmad","doi":"10.51866/oa.629","DOIUrl":"10.51866/oa.629","url":null,"abstract":"<p><strong>Introduction: </strong>Metabolic-associated fatty liver disease (MAFLD) is the liver manifestation of metabolic syndrome, which is commonly seen in primary care settings. This study aimed to determine the knowledge and practice of primary care physicians regarding MAFLD in Seremban District, Negeri Sembilan.</p><p><strong>Methods: </strong>This cross-sectional study was conducted among medical officers in 14 health clinics in Seremban District, using a validated, self-administered online questionnaire.</p><p><strong>Results: </strong>A total of 240 medical officers from 14 health clinics in Seremban District, participated in this study. Most participants (85.4%) passed the knowledge test. Their practice was acceptable, but only a minority were familiar with non-invasive testing of liver fibrosis (e.g. APRI or FIB-4), medication and specific diet for the treatment of MAFLD.</p><p><strong>Conclusion: </strong>Most primary care physicians in Seremban District are knowledgeable in identifying risk factors and managing patients with MAFLD. However, there are still areas to improve in terms of management, particularly regarding the use of silymarin, vitamin E and pioglitazone.</p>","PeriodicalId":40017,"journal":{"name":"Malaysian Family Physician","volume":"19 ","pages":"51"},"PeriodicalIF":0.0,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11366277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posttraumatic stress disorder, depressive and cardiovascular disease symptoms among young patients receiving medical treatment in a heart centre: A cross-sectional study.","authors":"Yoke Yong Chen, Siti Raudzah Ghazali, Asri Said","doi":"10.51866/oa.557","DOIUrl":"10.51866/oa.557","url":null,"abstract":"<p><strong>Introduction: </strong>Exploring the connections between traumatic experiences and subsequent health outcomes is vital for informing clinical practices and public health policies. The study aimed to investigate the relationship between lifetime trauma exposure and posttraumatic stress disorder (PTSD), depressive and cardiovascular disease (CVD) symptoms.</p><p><strong>Methods: </strong>A total of 171 patients who received treatment in a local heart centre were included in this study. Several questionnaires such as the Life Event Checklist-5, Posttraumatic Stress Disorder Checklist for DSM-5 and Patient Health Questionnaire-9 were used to measure their traumatic experiences and PTSD and depressive symptoms, respectively. Physiological measures were also examined. Data were analysed using SPSS.</p><p><strong>Results: </strong>The chi-square test showed significant differences in the percentage of reported PTSD symptoms among the patients with CVD (24.0%), patients with kidney disease (4.3%) and patients with other health problems (7.1%). The patients with CVD reported having a significantly higher percentage of PTSD and depressive symptoms than the patients with other medical conditions. The patients with CVD who reported having PTSD symptoms had significant systolic blood pressure (SBP) and heart rate changes compared to the patients who did not. The patients who reported PTSD symptoms had a significantly shorter sleep duration than their counterparts. The SBP and diastolic blood pressure differed significantly between the patients with and without PTSD symptoms.</p><p><strong>Conclusion: </strong>Earlier detection, prevention and intervention related to trauma exposure and PTSD symptoms are suggested to reduce the CVD risk.</p>","PeriodicalId":40017,"journal":{"name":"Malaysian Family Physician","volume":"19 ","pages":"42"},"PeriodicalIF":0.0,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11366278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Migraine symptoms and association of triggers, coping strategies and clinical characteristics with COVID-19 diagnosis among university students in Peninsular Malaysia: A cross-sectional study.","authors":"Selvakumar Kiruthika, Lee Fan Tan, Chai Nien Foo","doi":"10.51866/oa.521","DOIUrl":"10.51866/oa.521","url":null,"abstract":"<p><strong>Introduction: </strong>Differentiating between migraine and COVID-19 headaches is essential for better treatment. Evidence-based research during the COVID-19 pandemic has found that university students are more likely to experience migraine. Migraine can affect academic performance, sleep pattern, social and emotional well-being if left untreated or misdiagnosed. This study aimed to determine the prevalence of migraine symptoms and the association of triggers, coping strategies and clinical characteristics with COVID-19 diagnosis.</p><p><strong>Methods: </strong>This cross-sectional study was conducted across higher educational institutions in Peninsular Malaysia. Convenience sampling was applied to recruit full-time university students. A reliable and validated instrument was used to evaluate demographic data, migraine symptoms, triggers, coping strategies and clinical characteristics of migraine (frequency, intensity, severity and duration) during COVID-19 diagnosis.</p><p><strong>Results: </strong>The response rate was 98.3%, where 485 out of 493 responses were analysed. The prevalence of migraine was 35.9% (n=174). None of the triggers, coping strategies and clinical characteristics of migraine were significantly associated with COVID-19 diagnosis.</p><p><strong>Conclusion: </strong>The university students in Peninsular Malaysia showed a considerable prevalence of migraine symptoms. During the pandemic, the common triggers for existing symptoms were stress and a lack of sleep (combined triggers). The coping strategy adopted by most of the university students was lifestyle changes and in the COVID-19 positive group maladaptive coping strategies were adopted indicating the need for further investigation.</p>","PeriodicalId":40017,"journal":{"name":"Malaysian Family Physician","volume":"19 ","pages":"43"},"PeriodicalIF":0.0,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11330543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Five-year trend in secondary prevention medication prescription and risk factor control among patients with diabetes mellitus and cardiovascular diseases in Perak health clinics.","authors":"Jazlan Jamaluddin, Mohd Azzahi Mohamed-Kamel, Nor Shazatul Salwana Din, Mohamad Zikri Mohamad-Isa","doi":"10.51866/oa.572","DOIUrl":"10.51866/oa.572","url":null,"abstract":"<p><strong>Introduction: </strong>Prescription of secondary prevention medications (SPMs) and effective control of cardiovascular risk factors (RFs) are crucial to reduce the risk of recurrent cardiovascular events, particularly in high-risk individuals including those with diabetes mellitus (DM). This study aimed to analyse the trends in SPM prescription and identify the factors associated with RF control among patients with DM and cardiovascular diseases in Perak health clinics.</p><p><strong>Methods: </strong>Data of patients with ischaemic heart disease (IHD) and cerebrovascular diseases (CeVDs) audited from 2018 to 2022, excluding those lost to follow-up, were extracted from the National Diabetes Registry. Descriptive and trend analyses were conducted. Multivariable logistic regression was utilised to identify the factors associated with RF control.</p><p><strong>Results: </strong>Most patients (76.7%) were aged ≥60 years and were Malays (62.3%). The majority had IHD (60.8%) and CeVDs (54.7%) for ≥5 years. SPM prescription increased significantly over the past 5 years. However, blood pressure (BP) and lipid control remained static. Good BP control was associated with a DM duration of ≥10 years and poor control with Malay ethnicity and prescription of two or three antihypertensives. Good DM control was associated with an age of ≥60 years and age at DM diagnosis of ≥60 years and poor control with Malay and Indian ethnicities, DM duration of ≥10 years and prescription of two or three and more glucose-lowering drugs. Poor lipid control was associated only with Malay and Indian ethnicities.</p><p><strong>Conclusion: </strong>SPM prescription has increased over time, but the achievement of treatment targets, particularly for lipid control, has remained poor and unchanged. Statin use is not associated with lipid control. The accessibility and availability of alternative lipid-lowering drugs must be improved to enhance overall RF control, especially lipid control, in patients with DM and cardiovascular diseases.</p>","PeriodicalId":40017,"journal":{"name":"Malaysian Family Physician","volume":"19 ","pages":"46"},"PeriodicalIF":0.0,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11330545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Off-label use of repurposed ivermectin for SARS-CoV-2 infection should be banned by authorities unless efficacy is proven.","authors":"Josef Finsterer","doi":"10.51866/lte.664","DOIUrl":"10.51866/lte.664","url":null,"abstract":"","PeriodicalId":40017,"journal":{"name":"Malaysian Family Physician","volume":"19 ","pages":"41"},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11330542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to: Off-label use of repurposed ivermectin for SARS-Cov-2 infection should be banned by authorities unless efficacy is proven.","authors":"Abdul Jalil Aina Amanina, Tar'ali Filza Nur Athirah","doi":"10.51866/lte.671","DOIUrl":"10.51866/lte.671","url":null,"abstract":"","PeriodicalId":40017,"journal":{"name":"Malaysian Family Physician","volume":"19 ","pages":"45"},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11330546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}