A study on burden among caregivers of stroke patients in Hospital Universiti Sains Malaysia, Kelantan

Objective This study was carried out to determine the level of burden among caregivers of stroke patients attending Hospital Universiti Sains Malaysia in Kelantan and to evaluate the possible risk factors associated those with burden. Methodology A total of 116 caregivers of stroke patients were interviewed. The participants were recruited from the Klinik Rawatan Keluarga in Hospital Universiti Sains Malaysia. Caregivers were assessed for the level of burden using the Zarit Burden Interview. Results The mean burden score among the caregivers was 25.42 (SD 6.45). The minimum burden score is 11 and the maximum score is 49. This study significantly found that caregivers who look after bedbound patients have higher level of burden. While caregiver burden is lower with higher household income and among caregivers who have secondary or tertiary education level. Conclusion Factors that affect caregiver’s burden such as the condition of the patient, caregiver’s education level and household income should be taken into account in the evaluation of caregivers’ of stroke patients

A child with unique skin pattern: a case report of Tinea imbricata

This paper reports a case of Tinea imbricata in a young Orang Asli boy which was noted during his admission for severe symptomatic anemia. Upon discharge, he was started on syrup Griseofulvin 10mg/kg daily and Whitfield cream for 4 weeks. The Department of Orang Asli Development (JAKOA) and the local Health Clinic were contacted before discharge to facilitate patient’s follow-up and monitoring. Outbreaks of Tinea imbricata among the Orang Asli have been known to happen from time to time. Although this dermatophyte infection is rare in the urban population, transmission among travelers has been reported. This case report highlights its unique presentation and treatment approach

Communication skills in primary care

Apart from solid medical knowledge, a primary care physician must be equipped with good communication skills. One of the main advantages of having good communication skills is to make it easier for the physician and patient to connect in order to reach holistic medical management. History taking is a structured medical interview comprising several important components that a physician must cover. History taking is usually the main platform that a physician uses to communicate with patients. When history taking is combined with verbal and non-verbal techniques, hopefully, successful communication between a physicia

Prevalence of depression amongst caregivers of stroke patients attending Hospital Universiti Sains Malaysia

Introduction: Caregiving for stroke patients is a challenging task both emotionally and physically. Studies have shown that caregiving can affect caregivers’ wellbeing that could lead to depression. Objective: This study was carried out to determine the prevalence and associated risk factors of depression amongst caregivers of stroke patients attending Hospital Universiti Sains Malaysia (HUSM) in Kelantan over a 6 month period. Methodology: This is a cross sectional study at the primary care clinic in HUSM over a period of 6 months. A total of 116 caregivers of medically documented stroke patients who fulfilled the inclusion and exclusion criteria were recruited via convenience sampling. The brief patient health questionnaire (PHQ-9) were used to assess their depression. Descriptive statistics and bivariable analysis was used using SPSS version 23.Results: 63.8% of the caregivers of stroke patients are depressed. Caregiver’s burden, ethnicity and patient’s ethnicity were found to be significant associated risk factors for depression.Conclusion: Screening for depression in caregivers especially those with risk factors must be carried out in the clinic in order to detect and intervene early. Coping mechanisms especially in the religious aspect should be elicited in future studies

Right sided infective endocarditis masquerading as pulmonary tuberculosis: a case report

Right-sided infective endocarditis is not as common as left-sided infective endocarditis. The clinical signs and symptoms of right-sided infective endocarditis are subtle, making clinical detection more complex and easily leads to this diagnosis. We present a case of mild haemoptysis as a presentation of right-sided infective endocarditis but was initially misdiagnosed as pulmonary tuberculosis, which led to a delay in treatment. The patient had multiple visits to the health facilities (private clinic, government’s health clinic and hospital) and one admission to the hospital for recurrent cough, fever, and haemoptysis without any improvement. Later, he was diagnosed with right-sided infective endocarditis and was well after treatment. Delays in treatment can lead to an increased risk of permanent morbidity to the patient. This case report highlights the importance of a high index of suspicion and exploring other differential diagnoses of haemoptysis apart from pulmonary tuberculosis

Successful pregnancy outcome in Eisenmenger Syndrome in pregnancy: a case report

We present an antenatal case with established Eisenmenger Syndrome (ES) who refused termination of pregnancy. Her pregnancy continued until an emergency caesarean section for IUGR at 31 weeks gestation. This case report illustrates an example of a good health care model especially for primary care level that led to a successful pregnancy outcome in a high-risk patient

Case report: a rare initial presentation of gastrointestinal symptoms in systemic Lupus Erythematosus

Initial clinical presentation of Systemic Lupus Erythematosus (SLE) is varied as it affects various organs in the body. While typical presentation of SLE are cutaneous signs and joint pain, gastrointestinal (GI) manifestation is a rare initial presentation of SLE. We discuss the case of a 13-year-old girl who was diagnosed with SLE after she presented with symptoms similar to acute gastroenteritis. She presented with diarrhoea, vomiting, abdominal pain and bilateral ankle oedema; and was treated as acute gastroenteritis. She returned after one week with worsening symptoms. Her full blood count showed bicytopenia; her urinalysis had proteinuria and haematuria; and her renal profile revealed acute on chronic kidney injury which triggered suspicions of a more serious disease rather than simple viral gastroenteritis. Further investigations of positive anti-nuclear antibody, low complements and positive Coombs’s test supported the diagnosis of SLE. The diagnosis of SLE was confirmed when her renal biopsy reported crescentic lupus nephritis ISN/RPS Class 4. Additional investigation to investigate the cause of her gastrointestinal symptoms included an ultrasound abdomen which showed minimal ascites and bilateral renal parenchymal disease. She was planned for colonoscopy but due to the unavailability of paediatric endoscopy, endoscopy referral to a tertiary centre was postponed. However, her symptoms markedly improved with intravenous Cyclophosphamide which supported the diagnosis of GI SLE. This case report is to highlight that a patient with symptoms of simple viral gastroenteritis might have a more serious underlying disease. Full examination is important to elicit other signs which does not fit with typical viral gastroenteritis such as anemia and ankle oedema in this case. Safety netting and follow-up is a good practice to detect worsening symptoms earlier and to initiate further investigations. Lastly, though rare, SLE can present with gastroenteritis symptoms and is one of the differential diagnoses that should be considered

A rare initial presentation: gastrointestinal symptoms in systemic lupus erythematosus and its differential diagnosis

Diarrhoea and vomiting acute gastroenteritis Typical presentations of SLE: skin manifestation and joint pain. Gastrointestinal (GI) symptoms are rare presentation of SLE at the onset of diagnosis

SMARTPHONE ADDICTION AND ITS RELATIONSHIP WITH PSYCHOLOGICAL HEALTH AMONG STUDENTS OF A MEDICAL SCHOOL IN EAST COAST MALAYSIA

Objective: Smartphones have now become a common and almost essential tool in our daily living activities. Students are among those who use smartphones regularly, which could lead to addiction if overused. This study aims to measure the prevalence of smartphone addiction and its relationship with psychological health among clinical year medical students in International Islamic University Malaysia (IIUM), Kuantan. Methods: A total of 226 medical students in their clinical years were recruited through quota sampling method. The students filled in a four-part online-based questionnaire consisted of questions on sociodemographic characteristics, smartphone usage information, smartphone addiction scale-short version, and WHOQOL-BREF. Data were analyzed using IBM SPSS Statistics. Results: The prevalence of smartphone addiction among clinical year medical students in IIUM was 51%. Bivariate analysis showed that the majority of students chose social networking as their primary purpose of using a smartphone, and this was significantly associated with smartphone addiction (p=0.037). Following multiple logistic regression analysis, students who had chosen games as their primary purpose of smartphone users are 88% less likely to be related with smartphone addiction (p=0.009, 95% CI: 0.025–0.595) as compared to those who used it for academic performance tasks. Students who were not addicted to smartphones reported significantly better psychological quality of life compared to those who were addicted (p<0.001). Conclusion: Half of IIUM’s medical students in clinical years was found to have smartphone addiction, and those with smartphone addiction had poor psychological health. Immediate intervention such as creating awareness in the campus is important in curbing this problem

Prevalence of depression and anxiety and stress among HIV patients in Kuantan

Depression, anxiety and stress has been found to be present among people who are living with Human Immunodeficiency Virus (PLHIV) 1,2,3. Unfortunately, it is often missed during clinic visits. This could be a challenge to the primary care physician in managing patients in terms of their compliance to their long-term medication