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Self-management approaches among hypertensive residents in nursing homes in Malaysia

Malaysian Family Physician.2017;12(3):8-17.

Introduction: The prevalence of hypertension in Malaysia is increasing and an effectivemanagement of hypertension is important to reduce cardiovascular morbidity and mortality.Objective: To determine the knowledge, awareness and perception towards hypertension amongresidents in nursing homes as well as the roles of caregivers in hypertension management.Method: A face-to-face survey with 200 hypertensive residents and 30 caregivers from 24 nursinghomes in Kuala Lumpur and Selangor, Malaysia was conducted.Result: Of all the hypertensive residents, 90.5% (n = 181) knew that lowering their blood pressure couldimprove their health. Most residents strongly believed that taking antihypertensive drugs is importantfor keeping their high blood pressure under control (n = 162, 81%). Taking medication was perceivedas the most important factor in controlling the high blood pressure (58%, n = 116) compared to lifestyleor diet modification. The majority of the caregivers reported that they played a major role in managinghypertension, especially with regards to medication-taking. task (66.7%, n = 20).Conclusion: The knowledge, attitude and perceptions of hypertension play a relatively major rolein the self-management of hypertension. The role of caregivers also needed to be recognised inmanaging hypertension in nursing homes.

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Post-treatment impact and needs of prostate cancer survivors in Malaysia; a qualitative study

Lee PY ; Ng CJ ; Ong TA ; Lee YK ; Khatijah Lim A ; Cheong AT ; Azad Hassan AR

Malaysian Family Physician.2017;12(3):18-24.

Introduction and Objectives There are limited studies conducted on the needs of cancer survivorsin developing countries like Malaysia. This qualitative study aimed at exploring the post-treatmentimpact and needs of prostate cancer survivors.Method: A qualitative study design was used. One in-depth interview and four focus groupdiscussions were conducted with 24 prostate cancer survivors (age range: 58–79 years) fromgovernment and private hospitals in Malaysia in 2013. Trained researchers used a topic guide toguide the interviews, which were audio-recorded, transcribed verbatim, checked and managed withNvivo 10 software. A thematic approach was used to analyse the data.Result: Three main themes emerged from the analysis: (a) impact of prostate cancer on thesurvivors, (b) support needed for coping and (c) information needs. Prostate cancer has animportant impact on the survivors’ lifestyle after treatment. Some of them have to live with thepost-treatment side effects. They were anxious about the possibility of relapse. In addition tofamily and peer support, there were participants who felt that spiritual support was important inhelping them cope with the possibility of relapse. The survivors felt that they did not receive enoughinformation about post-treatment care, dietary measures and supplements for relapse prevention,treatment and prognosis.Conclusion: Prostate cancer has a significant impact on the survivor’s lifestyle, emotional andphysical health. They need information and emotional support from the healthcare professionals,family and peers. Therefore, it is important for healthcare providers to explore the needs of prostatecancer survivors and provide the necessary support.

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Facial nerve palsy in a child: Bell’s palsy? Think again!

Sam JE ; Priya S ; Nasser AW

Malaysian Family Physician.2017;12(3):30-32.

Introduction: Half of facial paralysis in children is idiopathic at origin. However, dismissing facialparalysis as being idiopathic without a thorough history and meticulous examination could bedisastrous as illustrated by this case.Case report: We report a case of sphenoid wing meningioma in a 4-year-old girl. She firstpresented with only facial asymmetry that was noticed by her mother. Examination suggested aleft upper motor neuron facial nerve palsy. A sphenoid wing meningioma was found on magneticresonance imaging (MRI) of her brain. She underwent craniotomy and total tumour excision.Histopathological examination of the tumour showed a grade 1 transitional type meningioma.Meningiomas in children are rare compared to the adult population. Presentations in childrenmay be delayed due to their inability to recognise or communicate abnormalities. Distinguishingbetween upper and lower motor neuron facial palsy is crucial in decision making for facial paralysisin children.

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Xanthogranulomatous pyelonephritis with reno-colic fistula: A rare complication of urinary tract infection

Onn LV ; Bickle I ; Chua HB ; Telisinghe PU ; Chong CF ; Chong VH

Malaysian Family Physician.2017;12(3):33-36.

Urinary tract infection (UTI) is one of the most common presentations in general practice and,in most instances, occurs in a single episode and is easily treated with a course of anti-microbialtherapy. In the case of recurrent urinary tract infections, it is important to consider evaluation forany underlying causes. We report the case of a 32 year old female who had recurrent UTIs; this wasa case of recurrent UTI secondary to xanthogranulomatous pyelonephritis from renal stones withresultant reno-colic fistula formation.

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Varicella zoster causing preseptal cellulitis – uncommon but possible

Qualickuz Zanan NH ; Zahedi FD ; Husain S

Malaysian Family Physician.2017;12(3):37-39.

Background: Varicella has been known to be a harmless childhood disease. However, it hasbeen reported that severe complications have taken place following Varicella infection, in bothimmunocompetent, as well as immunocompromised, individuals. Cutaneous complications ofVaricella may manifest as preseptal cellulitis, albeit rarely.Report: We present a case of a 4-year-old boy who presented with symptoms and signs ofpreseptal cellulitis following Varicella infection. He was referred to the otorhinolaryngologyteam for a nasoendoscopy to rule out sinusitis, in view of the fear that a child presentingwith a swollen red eye may be a case of true orbital cellulitis. He was treated successfully withintravenous antibiotics and surgical drainage of the preseptal collection.Conclusion: It is imperative for clinicians to be aware that a simple Varicella infection may leadto cutaneous complications in the pediatric age group, especially in children who are 4 yearsand younger. They may develop preseptal cellulitis, whose presentation might mimic that oforbital cellulitis. Empirical treatment with antibiotics would be advantageous for the patient. Anasoendoscopic examination may also be warranted in these cases to rule out sinusitis as a causeof orbital cellulitis.

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Hypertension and its association with Anthropometric indices among students in a public university

Cheah WL ; Majorie Ensayan J ; Helmy H ; Chang CT

Malaysian Family Physician.2018;13(1):2-9.

Introduction: The present study aimed to determine the prevalence of hypertension and itsassociation with nutritional status (body mass index, body fat percentage, and visceral fat) amongstudents in a public university in Sarawak, Malaysia.Methods: This was a cross-sectional study among undergraduate students aged 18 years old andabove. Anthropometric measurements, such as weight, height, body composition, and bloodpressure measurements, were collected. Hypertension was defined as equal or more than 140/90mmHg. Statistical analyses were done using IBM SPSS version 20.Results: A total of 354 respondents participated in the study. Mean age for the respondents was21 years (SD 1.18 years). About 40% of the respondents were overweight or obese. Prevalence ofhypertension was 8.2%. Mean systolic blood pressure was 119.1mmHg (SD14.36mmHg), and themean diastolic blood pressure was 72.6mmHg (SD 9.73mmHg). There is a significant associationbetween male gender (odds ratio =3.519, 95% CI is 1.886-6.566), body fat percentage (odds ratio=1.944, 95% CI is 1.050-3.601), visceral fat (odds ratio = 2.830, 95% CI is 1.346-5.951), andfamily history of hypertension (odds ratio= 2.366, 95% CI is 1.334-4.194) and hypertension.Conclusion: The prevalence of hypertension was less than 10% and is associated with malegender, body composition, and family history of hypertension.

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Non-Adherence to recommended Pap smear screening guidelines and its associated factors among women attending health clinic in Malaysia

Yunus NA ; Mohamed Yusoff H ; Draman N

Malaysian Family Physician.2018;13(1):10-17.

Introduction: Cervical cancer ranks as the second most frequent cancer among women inMalaysia. Although a cervical screening program has been introduced since 1960s and isprovided free of charge in all government health facilities, the coverage and adherence rate torecommendation among Malaysian women remains low.Objectives: To determine the proportion of non-adherence to Pap smear screening guidelines andits associated factors among women attending a health clinic in Malaysia.Method: A cross sectional study involving 316 women aged 20 to 65 years who had undergonea Pap smear. Universal sampling method was applied to select participants among womenwho attended the selected health clinic from January 2013 to May 2013. A self-administeredquestionnaire was used to obtain the socio-demographic characteristics, socio-health data andperceptions about cervical cancer and Pap smear screening. The data was analysed using descriptivestatistics and multiple logistic regression.Result: The proportion of non-adherence to Pap smear screening was 90.5%. Age, marital status,duration of marriage, education level, employment, household income and number of children were notsignificantly associated with non-adherence. Perceived severity, perceived susceptibility, perceived benefit,perceived barrier and cues to action did not show significant association with non-adherence to Papsmear screening.Conclusion: Non-adherence to Pap smear screening was high among Malaysian women. Measuresshould be taken to increase Pap smear screening coverage in our country. Other factors beyondHealth Belief Model that influence Pap smear screening practice among Malaysian women shouldbe explored.

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The views and experiences of Malaysian primary care doctors in managing patients with chronic low back pain: a qualitative study

Hani SS ; Liew SM

Malaysian Family Physician.2018;13(1):18-24.

Background: Chronic low back pain (CLBP) is a common and often difficult to treat conditionin the primary care setting. Research involving in-depth exploration on the views and experiencesfaced by primary care doctors in managing patients with CLBP in Malaysia is limited.Objective: To explore the primary care practitioners’ views and experiences in managing patientswith CLBP.Study design: A qualitative approach was employed using focus group discussions (FGD) at anacademic primary care clinic in Kuala Lumpur, Malaysia. Twenty-three primary care doctorswere purposively selected. Data were collected through audio-recorded interviews, which weretranscribed verbatim and checked for accuracy. Data saturation was reached by the third FGD. Anadditional FGD was included to ensure completeness. A thematic approach using the one sheet ofpaper (OSOP) method was used to analyse the data.Results: Participants view managing patients with CLBP as challenging. This is mainly due to thedifficulty in balancing the doctors’ expectations with the patients’ perceived expectations duringconsultation. Barriers identified include lack of awareness and conflicting views regarding theusefulness of the local clinical practice guideline (CPG) in clinical practice. Other barriers includetime constraints and perceived lack of support from multidisciplinary teams in managing thesepatients.Conclusion: Managing patients with CLBP is still a challenge for Malaysian primary care doctors.Any intervention should target identified barriers to improve the management of patients with CLBP.

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A food bolus obstructing the oesophagus in a patient with infantile cerebral palsy

Vong KS ; Mohamad I ; Salim R

Malaysian Family Physician.2018;13(1):34-36.

Introduction: A foreign body (FB) in the upper aerodigestive tract is a fairly common encounter.Fish bones are the commonest FB seen in adults. The commonest presentation is odynophagia.Usually, the patient will point at the level of FB on the neck to indicate the location.Methods: Clinical report.Results: This case report describes a large FB in an adult with underlying infantile cerebral palsy.Besides dysphagia, it was associated with drooling of saliva and pain in the throat region.Conclusion: FB ingestion with complete obstruction of the oesophagus is an emergency. It maycause total dysphagia as the passage of food is completely blocked.

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Lemierre’s syndrome: A persistent unusual neck pain and swelling

Vincent Ngu CY ; Rohaizam J ; Jong YH

Malaysian Family Physician.2018;13(1):37-40.

Lemierre’s syndrome is a systemic complication commonly caused by oropharyngeal infection byFusobacterium species, which manifests itself as an internal jugular vein thrombosis formation.It is a rare occurrence nowadays with the availability of broad spectrum antibiotics for treatment.Most cases in the literature presented with a life-threatening condition. We are reporting a case ofLemierre’s syndrome that presented with persistent neck pain and swelling, initially diagnosed ascervical lymphadenitis.

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