1.Severe Dengue with Hemophagocytosis Syndrome
Siti Hartini Ishak ; Lili Husniati Yaacob ; Azlina Ishak
Malaysian Family Physician 2020;15(1):47-49
Dengue is known to cause high morbidity and mortality worldwide. In recent years, there have been
increasing cases of dengue fever associated with a rare complication: hemophagocytic syndrome
(HPS), which is a dangerous disorder that carries high mortality. It is associated with infections,
autoimmune disorders, and malignancies. Prolonged duration of fever and cytopenia together
with multi-organ dysfunction out of proportion to the plasma leakage phase should alert clinicians
to consider this condition. In this case study, we highlight a 45-year-old woman with underlying
diabetes who was admitted due to dengue fever with warning signs. Her conditions deteriorated
quickly: she had spontaneous bleeding, evidence of plasma leakage, severe hepatitis, and coagulopathy on the 11th day of illness. With the support of other blood results, such as raised serum ferritin and lactate dehydrogenase, she was diagnosed with severe dengue with hemophagocytosis syndrome. She responded well to intravenous dexamethasone and recovered on the 19th day of illness.
2.Parental Knowledge on Thalassaemia and Factors Associated with Refusal to Screen Their Children
Mohammad Azmi Che Mat ; Lili Husniati Yaacob ; Rosnani Zakaria
Malaysian Journal of Medical Sciences 2020;27(1):124-133
Introduction: Acceptance of a screening programme for thalassemia is important in
managing the disease and its associated complications. The objective of this study was to determine
the knowledge of thalassemia and factors associated with thalassemia screening refusal among
parents of secondary school children.
Methods: This cross-sectional study was carried out from May 2017 to October 2017 among
parents of fourth form students in three schools in Besut, Terengganu, Malaysia. Parents who are
able to read and understand Malay and consented to the study were required to answer a validated
questionnaire on their knowledge regarding thalassemia. They were also asked the reason for their
acceptance or refusal of the thalassemia screening of their children.
Results: In total, 273 participants took part in the study. The mean thalassemia knowledge
score was 11.8 out of a maximum score of 21. Low knowledge scores (adjusted odds ratio [adj
OR] 0.87; 95% confidence interval [CI]: 0.79, 0.95; P = 0.002) and female sex (adj OR 2.60;
95% CI: 1.04, 6.53; P = 0.040) had significant associations with parental thalassemia screening
refusal. The main reason for screening refusal was that parents perceived that their children were
not at risk for the disease since they did not have a family member with thalassemia.
Conclusion: The mean thalassemia knowledge score among parents remains
unsatisfactory. A high knowledge score is important since it is associated with parental acceptance
of thalassemia screening for their children.
3.Achievement of LDL Cholesterol Goal and Adherence to Statin by Diabetes Patients in Kelantan
Zainab Mat Yudin ; Lili Husniati Yaacob ; Norul Badriah Hassan ; Saiful Bahari Ismail ; Nani Draman ; Siti Suhaila Mohd Yusoff
Malaysian Journal of Medical Sciences 2017;24(3):44-50
Background: Statins are a class of potent drugs that can be used to reduce cholesterol,
especially low-density lipoprotein cholesterol (LDL-C). However, their effectiveness is limited
if adherence to treatment is poor. The objectives of the study are to estimate the proportion
of diabetic patient who has achieved LDL-C goal and to determine the association of LDL-C
achievement with socio demographic factors and statin therapy adherence
Methods: This is a cross-sectional study involving 234 patients with type 2 diabetes
mellitus (T2DM) and dyslipidaemia attending an outpatient clinic in a hospital in Kelantan.
Interviews and self-administered questionnaires were used to determine their sociodemographic
and clinical characteristics. Adherence to therapy was assessed using the Medication
Compliance Questionnaire (MCQ). The associations between the achievement of LDL targets
and sociodemographic/clinical factors, including adherence, were analysed with simple logistic
regression.
Results: About 37.6% of patients achieved their LDL-C target. The percentage of patients
who adhered to statin use was 98.3%, and 20.5% of these patients reported full adherence. There
was no significant association between achievement of LDL-C targets with adherence or any other
sociodemographic factors, such as age, gender and educational or economic status (all P-value <
0.05).
Conclusion: Despite a high level of adherence, the majority of patients failed to achieve
LDL-C targets. More concerted efforts are needed to improve this.
4.A Case Report of Steroid Withdrawal Syndrome
Faziana WAHAB ; Razlina Abdul RAHMAN ; Lili Husniati YAACOB ; Norhayati Mohd NOOR ; Nani DRAMAN
Korean Journal of Family Medicine 2020;41(5):359-362
We report a case of steroid withdrawal syndrome in a 74-year-old woman who was suspected of having an occult exogenous Cushing’s syndrome secondary to prolonged traditional complementary medicine use. She presented with non-specific symptoms of lethargy, malaise, and poor oral intake with weight loss for 1 month, and investigations showed suboptimal 9 AM cortisol level. She has responded well to steroid replacement.