Malaysian Family Physician最新文献

Cardiovascular diseases remain a primary contributor to death worldwide, with hypertension being a key determinant. Excessive salt intake is a contributing factor of high blood pressure and cardiovascular diseases. To address this, the World Health Organization recommends keeping daily salt consumption under 5 g and aiming for a 30% decrease by 2025. In Malaysia, efforts to reach this target have faced delays. A local study found that 79% of Malaysians consume an average of 7.9 g of salt per day, which is significantly higher than the WHO's recommendations. Despite efforts such as voluntary food reformulation, mandatory sodium labelling and public education campaigns, challenges remain. Industry reluctance, low consumer awareness and inadequate enforcement slow down such efforts. This commentary reviews these issues and suggests applicable approaches to strengthen Malaysia's salt reduction strategies.

Herein, we present the case of a 45-year-old woman with a history of Graves' disease who underwent radioactive iodine therapy and was prescribed different oral preparations of thyroxine. Despite initial tolerance to the medication, she developed hypersensitivity reactions 3 months after consumption, which presented as urticarial rashes, erythematous maculopapular eruptions and angio-oedema. She tried a different preparation of thyroxine accompanied by antihistamines but continued having persistent reactions. This led to her discontinuation of thyroxine, resulting in overt hypothyroidism with secondary dyslipidaemia and weight gain. A diagnosis of delayed thyroxine hypersensitivity was made based on history, clinical assessment and supportive evidence from the Naranjo Adverse Drug Reaction Probability Scale.

Garlic is one of the most popular natural home remedies for a variety of illnesses. Many different cultures have recognised its beneficial properties as a herbal remedy since ancient times. Nevertheless, inappropriate usage of garlic can cause unwanted side effects despite its numerous positive qualities. Although they may appear to be the least dangerous, natural remedies like garlic can also cause burn themselves. Garlic typically resulted in second-degree burns, but in some cases, necrotic tissue could also develop. This case report described burn injuries caused by the application of raw garlic. We aimed to demonstrate the possible adverse effects of using garlic as a natural home remedy as well as to educate the public and healthcare providers about inappropriate usage of natural home remedy for self-treatment.

Introduction: Chronic illnesses have added to the demand in informal caregiving. Culturally, family members are expected to provide physical care and psychosocial support to their sick members, but the challenges they face have adversely impacted their employment, financial, physical and emotional wellbeing. This study aimed to explore the lived experiences of family caregivers of patients with chronic illnesses.

Methods: This qualitative research was based on the interpretative phenomenological analysis (IPA) approach. Purposive sampling was used to recruit five family caregivers of patients with chronic illnesses. Data were collected through in-depth semi-structured individual interviews and document analysis and later analysed systematically according to the six-step IPA process.

Results: The data revealed the informants' meaning of experience in four themes: 1) adversities, 2) adjustment challenges, 3) adaptation and acceptance and 4) identity.

Conclusion: The findings suggest that constructive lived experiences may be cultivated by increasing knowledge in caregiving, receiving greater appreciation and support from family members and learning to embrace the new identity. Caregiver support programmes or workshops focusing on emotional resilience or communication strategies can help to boost the positive life experiences of caregivers. The findings can be useful for healthcare professionals in understanding and addressing the needs of caregivers and improving the support and services provided to them.

Family medicine is a medical discipline that has been recognised globally for nearly six decades. Postgraduate family medicine training was introduced more recently in Southeast Asia. This article presents the characteristics of postgraduate family medicine training in eight Southeast Asian countries: Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand and Vietnam. The duration of training varies across countries and programmes within each country, ranging from 1 to 5 years. Completion of training leads to qualifications such as master's degree, diploma or certificate. Some countries also offer further training following postgraduate family medicine training, classified into two types: capacity-based training (e.g. family medicine fellowship) and discipline-based training (e.g. palliative care fellowship). The increasing burden of non-communicable diseases and the ageing population as well as the shortage of family physicians are significant concerns and challenges that influence postgraduate family medicine training in Southeast Asia.

Introduction: Intrauterine contraceptive device (IUCD) insertion is a reversible and effective way to reduce unplanned pregnancy. Doctors play a key role in IUCD usage. This study aimed to assess knowledge, views, practice and self-efficacy regarding copper IUCD usage among public primary care doctors in Sarawak.

Methods: A cross-sectional study was conducted in all public primary care clinics in Sarawak. A selfadministered online survey form was distributed to doctors in the eligible clinics.

Results: A total of 312 doctors participated in the survey. Most of them (81.4%) worked in a clinic where IUCDs were available. The median knowledge score among the medical officers was 15 (maximum score: 20). The knowledge score was correlated with the length of primary care experience and was higher among the doctors who had prior IUCD training and ever had inserted IUCDs. The doctors were concerned about the side effects of IUCDs, especially perforation and pelvic inflammatory diseases, and were negatively influenced by the additional counselling time required when recommending IUCDs. They recognised IUCD usage as a long-term and reversible contraception method. Most (69.2%) doctors had inserted IUCDs before, but only 45.9% had inserted five or more IUCDs. The self-efficacy of the doctors regarding IUCD insertion was moderate (63% of the total score).

Conclusion: The knowledge and self-efficacy of the public primary care doctors in Sarawak were moderate. Although IUCDs were widely available, the number of IUCD insertions was relatively small. Further research is warranted to quantify IUCD usage and identify its barriers among nurses and patients.

Introduction: Sarcopenia has many risk factors and an increased likelihood of adverse effects. However, the exact mechanism of how these risk factors cause sarcopenia remains to be elucidated. This study aimed to evaluate the association between physical components, olfactory function impairment and sarcopenia in urban communities.

Methods: This cross-sectional study involved 334 participants aged 60 years and above residing in urban villages in West Jakarta. The medical history, physical ability, cognitive function and olfactory function of participants were examined. Physical ability was assessed based on activities of daily living and instrumental activities of daily living (IADLs). Regarding olfactory function, six scratch test-type odours common in Indonesia were used. Sarcopenia was measured based on muscle mass, muscle strength and physical performance. Binary logistic analysis and backward logistic regression analysis were utilised to explore the association of sarcopenia with the other variables.

Results: Sarcopenia was significantly associated with older age (adjusted odds ratio [AOR]=2.613, 95% confidence interval [CI] = 1.471-4.640), obesity (AOR=0.190 (0.110-0.329), impaired olfactory function (AOR=1.822, 95% CI=1.086-3.056) and frailty (AOR=3.117, 95% CI=1.375-7.064).

Conclusion: The associated factors of sarcopenia include olfactory function, older age, unemployment, impaired IADLs, obesity and frailty.