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  • 1
    Online Resource
    Online Resource
    A clinical audit of the diagnosis and management of chronic kidney disease in a primary care clinic
    Academy of Family Physicians of Malaysia ; 2021
    In:  Malaysian Family Physician Vol. 16, No. 3 ( 2021-9-7), p. 68-76
    Details
    In: Malaysian Family Physician, Academy of Family Physicians of Malaysia, Vol. 16, No. 3 ( 2021-9-7), p. 68-76
    Abstract: Introduction: This audit was performed to monitor the diagnosis and management of chronic kidney disease (CKD) according to the clinical practice guidelines (CPGs) of CKD 2018 in a primary care clinic. Methods: Patients who attended the clinic from April to June 2019 and fulfilled the diagnosis of CKD were included in this study, except for those diagnosed with a urinary tract infection, pregnant women and those on dialysis. These criteria were set based on the CPGs. The standards were set following discussions with the clinic team members with reference to local guidelines, the 2017 United Kingdom National CKD audit and other relevant studies. Results: A total of 384 medical records were included in this audit. Overall, 5 out of 20 criteria for processes and 3 of 8 clinical outcomes for CKD care did not meet the set standards. These included the following: documentation of CKD classification based on albumin category (43.8%); CKD advice (19.0%); dietitian referral (9.1%); nephrologist referral (45.5%); haemoglobin level monitoring (65.7%); overall blood pressure (BP) control (45.3%); BP readings for diabetic kidney disease (DKD) and non-DKD with 〉 1 g/day of proteinuria (≤ 130/80 mmHg, 37.0%); eGFR reduction of 〈 25% over the past year (77.2%). Identified problems included the absence of a CKD registry, eGFR and albuminuria reports, and a dedicated team, among other factors. Conclusions: Overall, 8 out of 28 criteria did not meet the standards of CKD care set for this audit. The problems identified in this audit have been addressed. Moreover, strategies have also been formulated to improve the diagnosis and management of CKD in this clinic.
    Type of Medium: Online Resource
    ISSN: 1985-207X , 1985-2274
    URL: Issue
    URL: Issue
    URL: Journal
    URL: Article
    DOI: 10.51866/mfpv16
    DOI: 10.51866/mfpv16n3
    DOI: 10.51866/mfp1985
    DOI: 10.51866/oa1171
    Language: Unknown
    Publisher: Academy of Family Physicians of Malaysia
    Publication Date: 2021
    detail.hit.zdb_id: 2265779-4
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  • 2
    Online Resource
    Online Resource
    Prevalence and factors associated with lipid-lowering medications use for primary and secondary prevention of cardiovascular diseases among Malaysians: the REDISCOVER study
    Springer Science and Business Media LLC ; 2022
    In:  BMC Public Health Vol. 22, No. 1 ( 2022-12)
    Details
    In: BMC Public Health, Springer Science and Business Media LLC, Vol. 22, No. 1 ( 2022-12)
    Abstract: Lipid-lowering medications (LLM) are commonly used for secondary prevention, as well as for primary prevention among patients with high global cardiovascular risk and with diabetes. This study aimed to determine the prevalence of LLM use among high-risk individuals [participants with diabetes, high Framingham general cardiovascular (FRS-CVD) score, existing cardiovascular disease (CVD)] and the factors associated with it. Methods This is a cross-sectional analysis from the baseline recruitment (years 2007 to 2011) of an ongoing prospective study involving 11,288 participants from 40 rural and urban communities in Malaysia. Multiple logistic regression was used to identify characteristics associated with LLM use. Results Majority (74.2%) of participants with CVD were not on LLM. Only 10.5% of participants with high FRS-CVD score, and 17.1% with diabetes were on LLM. Participants who were obese (OR = 1.80, 95% CI: 1.15–2.83), have diabetes (OR = 2.38, 95% CI: 1.78–3.19), have hypertension (OR = 2.87, 95% CI: 2.09–3.95), and attained tertiary education (OR = 2.25, 95% CI: 1.06–4.78) were more likely to be on LLM. Rural residents had lower odds of being on LLM (OR = 0.58, 95% CI: 0.41–0.82). In the primary prevention group, participants with high FRS-CVD score (OR = 3.81, 95% CI: 2.78–5.23) and high-income earners (OR = 1.54, 95% CI: 1.06–2.24) had higher odds of being on LLM. Conclusions LLM use among high CVD-risk individuals in the primary prevention group, and also among individuals with existing CVD was low. While CVD risk factors and global cardiovascular risk score were positively associated with LLM use, sociodemographic disparities were observed among the less-educated, rural residents and low-income earners. Measures are needed to ensure optimal and equitable use of LLM.
    Type of Medium: Online Resource
    ISSN: 1471-2458
    URL: Article
    DOI: 10.1186/s12889-022-12595-1
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2041338-5
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  • 3
    Online Resource
    Online Resource
    High prevalence of dyslipidaemia subtypes and their associated personal and clinical attributes in Malaysian adults: the REDISCOVER study
    Springer Science and Business Media LLC ; 2021
    In:  BMC Cardiovascular Disorders Vol. 21, No. 1 ( 2021-12)
    Details
    In: BMC Cardiovascular Disorders, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract: Dyslipidaemia refers to lipid abnormalities consisting of either one or any combination of the following: elevated total cholesterol (TC), elevated low-density lipoprotein cholesterol (LDL-c), elevated triglycerides (TG), and low high-density lipoprotein cholesterol (HDL-c). The prevalence of hypercholesterolaemia is steadily increasing in Malaysia. However, data on the prevalence of dyslipidaemia subtypes among Malaysians are lacking. This is important as it may have implications for preventive and management strategies for this increasing public health challenge. This study is aimed at determining the prevalence of dyslipidaemia subtypes and their associated personal and clinical attributes in Malaysians. Methods REDISCOVER, a prospective study, enrolled 11,288 adults where sociodemographic data, anthropometric and blood pressure measurements, fasting lipid profile and glucose, and history of diabetes, hypertension, and smoking were obtained. The cross-sectional analytic sample presented in this article comprised 10,482 participants from baseline recruitment. The data was analysed by descriptive statistics and multivariable logistic regression. Results The overall prevalence of elevated TC, elevated LDL-c, elevated TG, low HDL-c, and elevated non-HDL-c were 64.0% (95% CI 63.0–65.0), 56.7% (CI 55.7–57.7), 37.4% (CI 36.5–38.4), 36.2% (CI 35.2–37.1), and 56.2% (CI 55.3–57.2), respectively. Overweight, obesity, and central obesity were highly prevalent and significantly associated with elevated TC and all dyslipidaemia subtypes. Older age was associated with elevated TC, elevated LDL-c and elevated non-HDL-c. Hypertension was associated with elevated TC, elevated TG, and elevated non-HDL-c, while diabetes was associated with elevated TG and low HDL-c. Conclusions Elevated TC and all dyslipidaemia subtypes are highly prevalent in Malaysia where increased body mass seems the main driver. Differences in the prevalence and associated personal and clinical attributes may facilitate specific preventive and management strategies.
    Type of Medium: Online Resource
    ISSN: 1471-2261
    URL: Article
    DOI: 10.1186/s12872-021-01956-0
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2059859-2
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  • 4
    Online Resource
    Online Resource
    Frequency and predictors of inappropriate medication dosages for cardiovascular disease prevention in chronic kidney disease patients: A retrospective cross-sectional study in a Malaysian primary care clinic
    Elsevier BV ; 2023
    In:  Heliyon Vol. 9, No. 4 ( 2023-04), p. e14998-
    Details
    In: Heliyon, Elsevier BV, Vol. 9, No. 4 ( 2023-04), p. e14998-
    Type of Medium: Online Resource
    ISSN: 2405-8440
    URL: Article
    DOI: 10.1016/j.heliyon.2023.e14998
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
    detail.hit.zdb_id: 2835763-2
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  • 5
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    Online Resource
    Design, development, utility and usability testing of the EMPOWER-SUSTAIN Self-Management Mobile App © among primary care physicians and patients with metabolic syndrome
    SAGE Publications ; 2023
    In:  DIGITAL HEALTH Vol. 9 ( 2023-01), p. 205520762311766-
    Details
    In: DIGITAL HEALTH, SAGE Publications, Vol. 9 ( 2023-01), p. 205520762311766-
    Abstract: This study aimed to design, develop, assess and refine the EMPOWER-SUSTAIN Self-Management Mobile App © among primary care physicians (PCP) and patients with metabolic syndrome (MetS) in primary care. Methodology Using the software-development-life-cycle (SDLC) iterative model, storyboard and wireframe were drafted; and a mock prototype was designed to illustrate the content and function graphically. Subsequently, a working prototype was developed. Qualitative studies using the ‘think-aloud’ and cognitive-task-analysis methods were conducted for the utility and usability testing. Topic guide was based on the 10-Nielsen's-Heuristic-Principles. Utility testing was conducted among PCP in which they ‘thought-aloud’ while performing tasks using the mobile app. Usability testing was conducted among MetS patients after they were given the app for 3 weeks. They ‘thought-aloud’ while performing tasks using the app. Interviews were audio- and video-recorded, and transcribed verbatim. Thematic content analysis was performed. Result Seven PCP and nine patients participated in the utility and usability testing, respectively. Six themes (efficiency of use, user control and freedom, appearance and aesthetic features, clinical content, error prevention, and help and documentation) emerged. PCP found the mobile app attractive and relevant sections were easy to find. They suggested adding ‘zoom/swipe’ functions and some parts needed bigger fonts. Patients commented that the app was user-friendly, has nice interface, and straightforward language. It helped them understand their health better. Based on these findings, the mobile app was refined. Conclusion This app was produced using a robust SDLC method to increase users’ satisfaction and sustainability of its use. It could potentially improve self-management behaviour among MetS patients in primary care.
    Type of Medium: Online Resource
    ISSN: 2055-2076 , 2055-2076
    URL: Article
    DOI: 10.1177/20552076231176645
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2819396-9
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  • 6
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    Online Resource
    The Prevalence of Limited Health Literacy and Its Associated Factors among Elderly Patients Attending an Urban Academic Primary Care Clinic in Malaysia
    MDPI AG ; 2021
    In:  International Journal of Environmental Research and Public Health Vol. 18, No. 17 ( 2021-08-27), p. 9044-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 18, No. 17 ( 2021-08-27), p. 9044-
    Abstract: Limited health literacy (HL) is linked to many negative health outcomes, including poor self-management of chronic diseases and medication adherence among patients. There are a lack of data regarding HL in the elderly population in Malaysia. This study aimed to determine the prevalence of limited HL levels and its associated factors among elderly patients in an urban academic primary care clinic in Selangor, Malaysia. A cross-sectional study was conducted among 413 elderly patients (≥60 years old) who attended this academic primary care clinic between January 2020 and January 2021. Sociodemographic data, clinical characteristics, and health literacy scores were collected. Descriptive statistics (median with interquartile ranges (IQR), frequency, and percentages) and multiple logistic regression were utilized. The prevalence of limited HL in our population was 19.1% (95% CI: 15.3, 23). The middle-old (70–79 years) and very-old (≥80 years) age groups were more likely to have limited HL (aOR 4.05; 95% CI: 2.19, 7.52 and aOR 4.36; 95% CI: 1.02, 18.63, respectively). Those with at least secondary school education (aOR 0.06; 95% CI: 0.02, 0.24) and those who found medical information via the internet/television (aOR 0.21; 95% CI: 0.05, 0.93) had lower odds of having limited HL. In conclusion, having limited HL levels was not common among elderly patients in this primary care clinic. Further studies involving rural and larger primary care clinics in Malaysia are required to support these findings.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph18179044
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2175195-X
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  • 7
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    Online Resource
    Author Correction: A systematic review and meta-analysis of the prevalence of dyslipidaemia among adults in Malaysia
    Springer Science and Business Media LLC ; 2023
    In:  Scientific Reports Vol. 13, No. 1 ( 2023-09-07)
    Details
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 13, No. 1 ( 2023-09-07)
    Type of Medium: Online Resource
    ISSN: 2045-2322
    URL: Article
    DOI: 10.1038/s41598-023-41219-w
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2615211-3
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  • 8
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    Online Resource
    A Nearly Missed Hashimoto’s Thyroiditis: A Case of Refractory Anaemia
    UiTM Press, Universiti Teknologi MARA ; 2020
    In:  Journal of Clinical and Health Sciences Vol. 5, No. 1 ( 2020-06-30), p. 75-
    Details
    In: Journal of Clinical and Health Sciences, UiTM Press, Universiti Teknologi MARA, Vol. 5, No. 1 ( 2020-06-30), p. 75-
    Abstract: This is a case of a 68-year-old man who was diagnosed late with Hashimoto’s thyroiditis following a few admissions for symptomatic anaemia. Although hypothyroidism is common among the elderly, the classic symptoms are less likely to be evident and anaemia can be the first sign of hypothyroidism. This patient had multiple comorbidities including ischaemic heart disease, diabetes and chronic kidney disease which might have contributed to the delay in finding the underlying cause of his anaemia. He initially presented with symptomatic anaemia and received blood transfusions and iron supplementation. On subsequent follow up, his anaemia failed to improve. He was then referred to our primary care clinic. Hashimoto’s thyroiditis was diagnosed based on his clinical features, thyroid function test results and antithyroid peroxidase level. This case highlights the importance of determining the cause of anaemia as his haemoglobin level improved significantly after thyroxine was commenced. It also serves as a reminder that hypothyroidism should be considered in patients with anaemia, especially in those with uncertain aetiology. 
    Type of Medium: Online Resource
    ISSN: 0127-984X
    URL: Issue
    URL: Article
    DOI: 10.24191/jchs.v5i1
    DOI: 10.24191/jchs.v5i1.9823
    Language: Unknown
    Publisher: UiTM Press, Universiti Teknologi MARA
    Publication Date: 2020
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  • 9
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    Online Resource
    Recurrent Stroke in a Young Man with Moyamoya Disease on Medical Therapy: A Case Report
    UiTM Press, Universiti Teknologi MARA ; 2022
    In:  Journal of Clinical and Health Sciences Vol. 7, No. 1 ( 2022-02-23), p. 67-
    Details
    In: Journal of Clinical and Health Sciences, UiTM Press, Universiti Teknologi MARA, Vol. 7, No. 1 ( 2022-02-23), p. 67-
    Abstract: Moyamoya disease (MMD) is a rare intracranial vasculopathy characterized by the progressive occlusion of the terminal internal carotid arteries and their proximal branches. Various factors including genetic and inflammation are the proposed pathogenesis of MMD. We present a case of a 31-year-old man who had recurrent stroke secondary to MMD. Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) demonstrated an infarct in the right middle cerebral artery (MCA) territory, and stenosis of the terminal right internal carotid artery (ICA) and its proximal branches. He initially declined surgical management and was treated with antiplatelet. After his third stroke, he finally underwent right superficial temporal artery (STA) to middle cerebral artery (MCA) bypass surgery. He improved following rehabilitation with no further recurrence. The role of surgical revascularization in the prevention of stroke is well-described in the literature but evidence regarding medical therapy remain scarce and will be explored in this report.
    Type of Medium: Online Resource
    ISSN: 0127-984X
    URL: Issue
    URL: Article
    DOI: 10.24191/jchs.v7i1
    DOI: 10.24191/jchs.v7i1.12232
    Language: Unknown
    Publisher: UiTM Press, Universiti Teknologi MARA
    Publication Date: 2022
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  • 10
    Online Resource
    Online Resource
    Gender disparity in the prescription of secondary prevention medications in a Malaysian primary care clinic
    Academy of Family Physicians of Malaysia ; 2021
    In:  Malaysian Family Physician Vol. 16, No. 2 ( 2021-7-22), p. 37-44
    Details
    In: Malaysian Family Physician, Academy of Family Physicians of Malaysia, Vol. 16, No. 2 ( 2021-7-22), p. 37-44
    Abstract: Introduction: Cardiovascular disease is the leading cause of death worldwide. Despite the proven benefit of secondary prevention medications (SPMs), their utilisation remains suboptimal in many countries. This study aimed to assess the use of SPMs in a Malaysian primary care clinic and factors associated with it. Methods: A retrospective review of electronic medical records was conducted to assess the prescription of SPMs among patients with coronary artery disease who attended the clinic between 1st January 2018 and 31st December 2018. Presc riptions of SPMs were documented in numbers and percentages. Multiple logistic regressions were used to analyse factors associated with the prescription of SPMs. Results: Of the 662 patients included in the study, 99.1% were prescribed statins, 97% antiplatelets, 81.7% angiotensin-converting enzyme (ACE)-inhibitors or angiotensin Ⅱ receptor blockers (ARBs), and 78.7% beta-blockers. Male patients were more likely to be prescribed statins (OR = 8.584, 95% CI: 1.431 – 51.510) and antiplatelets (OR = 6.818, 95% CI: 2.294 – 20.257). Another significant factor for antiplatelets prescription was having diabetes (OR = 3.318, 95% CI: 1.148 – 9.590). Having hypertension was associated with ACE-inhibitors or ARBs prescription (OR = 4.008, 95% CI: 2.522 – 6.370). Conclusion: Although the majority of patients received SPMs, there were significant disparities for some SPMs prescriptions among female patients. As these medications are widely available in the Malaysian primary care setting, steps should be taken to ensure that these medications are prescribed equally for all eligible patients.
    Type of Medium: Online Resource
    ISSN: 1985-207X , 1985-2274
    URL: Issue
    URL: Issue
    URL: Journal
    URL: Article
    DOI: 10.51866/mfpv16
    DOI: 10.51866/mfpv16n2
    DOI: 10.51866/mfp1985
    DOI: 10.51866/oa1080
    Language: Unknown
    Publisher: Academy of Family Physicians of Malaysia
    Publication Date: 2021
    detail.hit.zdb_id: 2265779-4
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