Knee osteoarthritis (KOA) is a leading cause of disability, and local data on its impact on quality of life (QoL) remain limited. This study aimed to determine the QoL and its associated factors among patients with KOA. A cross-sectional study was conducted among patients aged 40 years and older with clinically or radiographically confirmed KOA at Hospital Pakar Universiti Sains Malaysia. QoL was assessed using theye validated Malay version of the Osteoarthritis of Knee and Hip Quality of Life (OAKHQoL) questionnaire and the Malay version of the Western Ontario and McMaster University Osteoarthritis Index (WOMAC- VAS scale). Sociodemographic and clinical data were collected. Univariate analysis identified potential predictors of QoL, and multivariable linear regression was used to determine independent predictors. Of the 166 patients recruited, 152 completed the study (response rate 92%). Participants reported substantial pain and disability, reflected by a high mean WOMAC score of 939.7 ± 484.1 (range 49–2042). The most affected domain of the OAKHQoL was social functioning (59.1 ± 26.3). The overall OAKHQoL score was 41.8 ± 16.2, indicating a moderate reduction in QoL. Univariate analysis revealed that higher BMI (p = 0.033), a history of ischemic heart disease (p = 0.040), glucosamine use (p = 0.009), and higher WOMAC scores (p < 0.001) were associated with poorer QoL. Multivariable linear regression identified higher WOMAC scores (β = 0.025, 95% CI: 0.021–0.028, p < 0.001) and KOA grade 3 and 4 (β = 5.06, 95% CI: 0.048–10.06, p = 0.048) as independent predictors. Specifically, one unit increase in WOMAC score corresponded to a 0.025-unit increase in OAKHQoL score, while KL grades 3 and 4 were linked to a 5.06- unit higher OAKHQoL score. These findings highlight the central role of symptom severity and structural damage in shaping QoL in KOA. Early intervention, symptom management, and psychosocial support are essential to improve outcomes

Quetiapine-induced hypokalemic periodic paralysis (QIHPP) is a rare condition. Herein, we present the case of a 31-year-old pregnant Malay woman diagnosed with bipolar II disorder and QIHPP. She presented to the casualty department with a 2-day history of bilateral lower limb weakness and numbness. Her renal function tests showed moderate hypokalemia (2.5 mmol/L), whereas other investigations were normal. Quetiapine was suspected to be the cause, prompting a psychiatric referral to manage her acute condition. Balancing the risks of untreated QIHPP against the potential relapse of bipolar symptoms from quetiapine discontinuation or dosage reduction poses a significant treatment challenge for pregnant women with QIHPP. Finally, we reduced the quetiapine dosage after careful consideration, leading to the normalization of potassium levels and symptom resolution. Therefore, clinicians should be aware of this side effect when initiating or continuing quetiapine treatment in women of childbearing age or pregnant women with psychiatric disorders. It is crucial to monitor serum electrolytes, especially potassium, following quetiapine administration and warn patients about its potential side effects.

Quetiapine-induced hypokalemic periodic paralysis (QIHPP) is a rare condition. Herein, we present the case of a 31-year-old pregnant Malay woman diagnosed with bipolar II disorder and QIHPP. She presented to the casualty department with a 2-day history of bilateral lower limb weakness and numbness. Her renal function tests showed moderate hypokalemia (2.5 mmol/L), whereas other investigations were normal. Quetiapine was suspected to be the cause, prompting a psychiatric referral to manage her acute condition. Balancing the risks of untreated QIHPP against the potential relapse of bipolar symptoms from quetiapine discontinuation or dosage reduction poses a significant treatment challenge for pregnant women with QIHPP. Finally, we reduced the quetiapine dosage after careful consideration, leading to the normalization of potassium levels and symptom resolution. Therefore, clinicians should be aware of this side effect when initiating or continuing quetiapine treatment in women of childbearing age or pregnant women with psychiatric disorders. It is crucial to monitor serum electrolytes, especially potassium, following quetiapine administration and warn patients about its potential side effects.

Quetiapine-induced hypokalemic periodic paralysis (QIHPP) is a rare condition. Herein, we present the case of a 31-year-old pregnant Malay woman diagnosed with bipolar II disorder and QIHPP. She presented to the casualty department with a 2-day history of bilateral lower limb weakness and numbness. Her renal function tests showed moderate hypokalemia (2.5 mmol/L), whereas other investigations were normal. Quetiapine was suspected to be the cause, prompting a psychiatric referral to manage her acute condition. Balancing the risks of untreated QIHPP against the potential relapse of bipolar symptoms from quetiapine discontinuation or dosage reduction poses a significant treatment challenge for pregnant women with QIHPP. Finally, we reduced the quetiapine dosage after careful consideration, leading to the normalization of potassium levels and symptom resolution. Therefore, clinicians should be aware of this side effect when initiating or continuing quetiapine treatment in women of childbearing age or pregnant women with psychiatric disorders. It is crucial to monitor serum electrolytes, especially potassium, following quetiapine administration and warn patients about its potential side effects.

Quetiapine-induced hypokalemic periodic paralysis (QIHPP) is a rare condition. Herein, we present the case of a 31-year-old pregnant Malay woman diagnosed with bipolar II disorder and QIHPP. She presented to the casualty department with a 2-day history of bilateral lower limb weakness and numbness. Her renal function tests showed moderate hypokalemia (2.5 mmol/L), whereas other investigations were normal. Quetiapine was suspected to be the cause, prompting a psychiatric referral to manage her acute condition. Balancing the risks of untreated QIHPP against the potential relapse of bipolar symptoms from quetiapine discontinuation or dosage reduction poses a significant treatment challenge for pregnant women with QIHPP. Finally, we reduced the quetiapine dosage after careful consideration, leading to the normalization of potassium levels and symptom resolution. Therefore, clinicians should be aware of this side effect when initiating or continuing quetiapine treatment in women of childbearing age or pregnant women with psychiatric disorders. It is crucial to monitor serum electrolytes, especially potassium, following quetiapine administration and warn patients about its potential side effects.

PREVALENCE AND ASSOCIATED FACTORS OF INTERNET ADDICTION AMONG ADOLESCENTS DURING THE COVID-19 PANDEMIC IN KOTA BHARU, KELANTAN, MALAYSIA: A CROSS-SECTIONAL STUDY Introduction: The study aimed to determine the prevalence and associated factors of internet addiction (IA) among early adolescents during the COVID-19 pandemic in Kota Bharu, Kelantan, Malaysia. Methods: A cross-sectional online survey was conducted from February to April 2021 among adolescents in Kota Bharu, Kelantan. Participants completed the Malay Version of the Internet Addiction Test, the Depression, Anxiety and Stress Scale-21 and a sociodemographic information form. A multiple logistic regression analysis was performed to determine the associations between variables. Results: A total of 535 adolescents participated in this study. Among them, 65.9% were girls. The prevalence of IA among the participants was 48.6%. Male sex [adjusted odds ratio (AOR)=2.15, 95% confidence interval (CI)=1.30–3.57], internet usage at home (AOR=6.17, 95% CI=1.94–19.58), internet usage to watch/download music (AOR=2.50, 95% CI=1.52–4.12), internet usage to engage in social networking (AOR=2.29, 95% CI=1.19–4.40), inadequate parental/guardian bonding (AOR=2.19, 95% CI=1.31–3.65), depression (AOR=2.03, 95% CI=1.07–3.85), anxiety (AOR=2.79, 95% CI=1.64–4.76) and stress (AOR=4.67, 95% CI=2.00–10.91) were significantly associated with IA. Conclusion: IA was prevalent among Malaysian adolescents during the COVID-19 pandemic. Sex, internet usage profile and psychological factors were significant predictors of IA.

AMLODIPINE-INDUCED BUCCAL LICHENOID LESIONS: A CASE REPORT Buccal lichenoid lesions (BLLs) are characterised by a unique, linear whitish striation in the buccal region and can be accompanied by ulcers, plaques, erythemas, atrophies and blisters. They are distinguished from oral lichen planus (OLP) by the association of the administration of a drug or contact with a metal. Herein, we present the case of a 42-year-old woman with underlying hypertension with amlodipine-induced BLLs. She complained of a 1-month history of right buccal whitish streaks and oral ulcers 2 months after taking amlodipine. She visited a private otorhinolaryngology clinic, and a biopsy for the right buccal ulcer was conducted. The biopsy result showed features suggestive of OLP. The patient was then diagnosed with OLP. Her symptoms were persistent despite treatment, so a dental referral was made. Amlodipine was suspected as the cause of her condition and was therefore stopped. Her condition gradually resolved after amlodipine withdrawal. Hence, primary care physicians should be aware of BLLs as one of the adverse drug reactions of amlodipine so that prompt management can be taken to avoid further debilitating impacts on patients.

Aim and design: L-carnitine supplementation combined with exercise may enhance metabolic responses and improve exercise performance. Thus, this systematic review article aims to identify the effects of the L-carnitine supplement on biochemical markers, and exercise performance when combined with exercise. Data Sources: The articles are screened and reviewed based on titles, abstracts and keywords. Only peer-reviewed studies written in the English language, dated January 2000 to March 2021, were considered in this review. Review Methods: The PRISMA method is used for this study. PubMed, EBSCOHost, SpringerLINK, and Scopus databases were used to systematically search. Results: From a search 731 articles, 12 articles were identified related to effect of L-carnitine intake with exercises on biochemical markers and exercise performance. Studies showed that L-carnitine supplementation can be consumed daily during aerobic or anaerobic exercises by different population including patients. Its combination could improve serum lipid profiles, antioxidant properties, markers of metabolic, oxidative stress, and inflammatory, and exercise performance. Conclusion and Impact: This review provides information regarding the beneficial effects of L-carnitine supplement with recommended dosages and exercise prescriptions on overall body health in human.

Monkeypox is known to be endemic in Africa, but recently, the unusually increasing number of cases of monkeypox in non-endemic countries has caught the attention of the world. The World Health Organization has declared the monkeypox outbreak a public health emergency. The spread pattern is unlikely associated with the previous outbreak outside of Africa, which is related to travelling or contact with exotic animals. The current outbreak is linked to sexual history and presents with atypical localised genital eruptions with an unpredictable onset of viral prodromal symptoms. Although the monkeypox virus is not easily transmittable compared with severe acute respiratory syndrome coronavirus 2, anyone who has been in close contact with a patient with monkeypox is at risk. Most patients will present to a primary care centre for assessment and treatment; therefore, it is important to increase awareness of the infection among primary care providers for early recognition of monkeypox, containment of the outbreak and prevention of healthcare-associated infection. A physician who suspects any patient with monkeypox should notify local or state health authorities immediately.
Mpox, Monkeypox ; Disease Outbreaks ; Primary Health Care

The Malaysian population is aging, and the elderly are less healthy than the young. The majority of the elderly remain in their own home, although some choose to live in a pondok and others are institutionalized. The main concern in the care of the elderly is maintaining the quality of life (QOL) up to the last moment. The aim of this study is to determine the effect of living place (home, pondok, or old folks’ home) on QOL of the elderly in Kelantan, Malaysia. Four-hundred seventy-one respondents participated in this cross-sectional study. Participants age 60 years old and above were selected conveniently and the WHOQOL-BREF questionnaire was administered by face to face interview to measure quality of life. Multivariate analysis of variance was applied to detect the impacts and p-value < 0.05 was considered significant. Significant differences in mean score of physical (p = 0.011), psychological (p < 0.001), social (p < 0.001), and environmental (p = 0.001) aspects of QOL were detected among participants living at home, in a pondok, and in an old folks’ home. The elderly living in their own home had the highest scores in the physical, social, and environmental domains. Those living in a pondok scored highest in the psychological domain. The elderly living in an old folks’ home had the lowest scores in all domains. A significant effect of living place on QOL of the elderly was detected (p < 0.001) and there was a significant effect of living place on QOL after medical illness and age were controlled (p < 0.001,). Conclusion: Living place had a significant effect on QOL of the elderly, with best QOL for own home living elderly. We recommend elderly should remain in their own home till the end of their life.
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