Malaysian Family Physician最新文献

Introduction: Diabetes-related distress (DRD) affects disease control and quality of life. This study aimed to determine the prevalence of high-level DRD, compare the prevalence according to diabetes complications and identify the associated sociodemographic and clinical factors.

Methods: This cross-sectional study included 198 participants from three primary care clinics in northern Malaysia from 1 May 2023 to 31 July 2023. DRD was measured using the 17-Item Diabetes Distress Scale, with a score of >3 indicating high-level distress. Multiple logistic regression was used to assess the association between the sociodemographic and clinical characteristics and DRD.

Results: The prevalence of high-level DRD was 13.6%. The prevalence was significantly higher among the patients without nephropathy (17.2%) than among those with nephropathy (3.8%) (P=0.014) but did not significantly differ among those with other complications. Those who attended the clinics independently were less likely to be highly distressed than those using public transportation or sent by others (adjusted odds ratio [aOR]=0.31, 95% confidence interval [CI]=0.10-0.99, P=0.048). The participants who were obese (aOR=2.96, 95% CI=1.08-8.08, P=0.034) had higher odds of having high-level DRD than those who were not, while those who had nephropathy (aOR=0.11, 95% CI=0.02-0.58, P=0.010) had lower odds of having high-level DRD than those who did not.

Conclusion: The overall prevalence of high-level DRD is relatively low but significantly higher among individuals without nephropathy. 0besity, lack of transportation and the absence of nephropathy are positively associated with high-level DRD and should therefore be a focus of psychological support and intervention.

Crohn's disease (CD), a chronic inflammatory bowel condition, although rare in Malaysia, can present with atypical systemic features, including reproductive dysfUnction. We report the case of a 31-year-old woman referred for secondary amenorrhoea and presumed endometriosis, later diagnosed with CD following worsening gastrointestinal symptoms and significant weight loss. Hormonal evaluation revealed hypothalamic-pituitary axis suppression secondary to malnutrition and systemic inflammation. Treatment with corticosteroids and nutritional rehabilitation led to weight gain and resumption of menses within 3 months. This case highlights the importance of recognising functional hypothalamic amenorrhoea as a reversible consequence of chronic illness and nutritional deficiency. It also underscores how systemic diseases such as CD may mimic gynaecological conditions, potentially delaying accurate diagnosis. Early multidisciplinary collaboration is essential in evaluating menstrual disturbances with overlapping gastrointestinal symptoms, especially in regions where inflammatory bowel disease remains uncommon.

Tinea capitis is a common childhood fungal infection that is extremely rare in newborns, with limited data available. Its clinical presentation may closely resemble that of other dermatological conditions such as seborrheic dermatitis, neonatal lupus erythematosus and congenital syphilis. It is essential to make a definite diagnosis, as tinea capitis treatment requires systemic antifungal therapy. However, successful topical monotherapies have been reported. We report a rare case of neonatal tinea capitis diagnosed in a 24-day-old newborn, presenting with multiple scaly plaques on the scalp, discussing the diagnostic criteria, predisposing factors, appropriate treatment and preventive measures. The patient was treated with topical antifungal therapy, resulting in complete resolution within a week and no recurrence at the 2-year follow-up.

Introduction: Coronavirus disease (COVID-19) is a highly contagious disease caused by severe acute respiratory syndrome coronavirus 2 and was declared by the World Health Organization as a pandemic on 11 March 2020. However, COVID-19 will continue to occur in the future. Therefore, this research aimed to determine the factors that affect the risk of hospitalisation of patients infected with COVID-19 so that preventive measures can be taken promptly.

Methods: This study adopted a descriptive, analytic, cross-sectional research design. The sample included the people of North Sumatra who used Universitas Sumatera Utara's COVID-19 Telemedicine and met the research criteria. The data were analysed using the chi-square test, with odds ratios (ORs) calculated.

Results: Among the clinical symptoms of the patients, runny nose (OR=10.9), sore throat (OR=23.5), muscle pain (OR=24.3), headache (OR=33.7), diarrhoea (OR=7.7), nausea (OR=10.6), vomiting (OR=4.4), ageusia (OR=6.3) and anosmia (OR=5.5) were more commonly associated with an increased risk of hospitalisation. Among the comorbidities, hypertension (OR=2.5) and diabetes (OR=4.9) increased the risk of hospitalisation.

Conclusion: Runny nose, sore throat, muscle pain, headache, diarrhoea, nausea, vomiting, ageusia, anosmia, diabetes and hypertension are associated with an increased risk of hospitalisation among patients with COVID-19.

Introduction: Adolescent pregnancies are often associated with a higher risk of adverse outcomes, including preterm birth, which may lead to severe physiological and psychological health impacts on both mothers and children. Despite the acknowledged risks, there is a knowledge gap regarding the risk factors of preterm birth among pregnant adolescents. This study aimed to determine the prevalence and associated sociodemographic, maternal, intrapartum and neonatal factors of preterm birth among pregnant adolescents in Kuala Lumpur.

Methods: A cross-sectional study was conducted in Kuala Lumpur, Malaysia, from March to June 2024. Samples were selected using simple random sampling from the Wilayah Persekutuan Kuala Lumpur and Putrajaya Department of Health pregnant adolescents' line listing from 2019 to 2023. Simple and multiple logistic regression analyses were used to determine the factors associated with preterm birth.

Results: A total of 175 pregnant adolescents were included in the study. The prevalence of preterm birth was 16%. Anaemia at booking (adjusted odds ratio [aOR]: 7.8; 95% confidence interval [CI]: 2.53, 23.997), history of preterm birth (aOR: 11.654; 95% CI: 1.517, 89.498), history of smoking (aOR: 6.89; 95% CI: 1.397, 34.002) and low birth weight (aOR: 12.503; 95% CI: 3.858, 40.522) were significantly associated with preterm birth.

Conclusion: Targeted interventions to address anaemia, history of smoking, previous history of preterm births and low birth weight babies in adolescent pregnancies are crucial to reduce the incidence of preterm birth and improve maternal and infant health outcomes in this population among adolescents.

Introduction: This study primarily aimed to determine the factors associated with home blood pressure monitoring (HBPM) practices among patients with hypertension in Putrajaya, Malaysia.

Methods: A cross-sectional study was conducted among patients with hypertension aged 18 years and above in a government health clinic in Putrajaya. An adopted and validated questionnaire on the knowledge, attitude and practice of HBPM was utilised. A total of 338 patients with hypertension were recruited.

Results: The median age of the participants was 52 years. Approximately 95.3%, 87.3%, 61.2%, 54.4% and 49.4% were Malay, were married, completed tertiary education, were men and were government servants, respectively. The prevalence of good HBPM knowledge, good attitude towards HBPM and HBPM practice among the participants was 79.0%, 57.1% and 81.7%, respectively. Having medical insurance (adjusted odds ratio [aOR]: 3.05, 95% confidence interval (CI): 1.47- 6.29, P=0.003), having diabetes mellitus (DM) (aOR: 4.58, 95% CI: 2.47-8.49, P<0.01), staying with household members (aOR: 2.95, 95% CI: 1.07-8.10, P=0.036), being a non-smoker (aOR: 3.72, 95% CI: 1.41-9.80, P=0.008) and engaging in physical activity (aOR: 2.47, 95% CI: 1.314.65, P=0.005) showed significant associations with HBPM practice.

Conclusion: The knowledge and practice of HBPM among patients with hypertension in Putrajaya, Malaysia, were excellent. The significant associated factors of HBPM practice were having medical insurance, having DM, staying with household members, being a non-smoker and being physically active. This study should be extended to the whole nation to obtain a true reflection of HBPM practice among Malaysians.

Glycogenic hepatopathy (GH) is a rare but reversible hepatic condition associated with poorly controlled type 1 diabetes mellitus (T1DM). It results from excessive glycogen accumulation in hepatocytes, leading to hepatomegaly and elevated liver enzyme levels. We report the case of a 28-year-old man with T1DM who presented to a primary care clinic with persistent transaminitis despite discontinuation of potential hepatotoxic agents. Extensive investigations were conducted to exclude common liver pathologies, all of which returned negative. His condition improved following the intensification of insulin therapy and improvement of glycaemic control. This case underscores the role of family physicians in recognising GH as a differential diagnosis in patients with diabetes mellitus with unexplained liver enzyme abnormalities. It also highlights the importance of timely interventions to prevent unnecessary invasive investigations. Early recognition and appropriate glycaemic management in primary care can reverse the condition and minimise the need for extensive testing.