MyMedR

Displaying all 4 publications

Abstract:

Sort:

Prevalence and documented causes of hyponatraemia among geriatric patients attending a primary care clinic

Tay CL, Myint PK, Mohazmi M, Soiza RL, Tan MP

Med J Malaysia, 2019 04;74(2):121-127.
PMID: 31079122

INTRODUCTION: Hyponatraemia is the commonest electrolyte abnormality and has major clinical implications. However, few studies of hyponatraemia in the primary care setting has been published to date.
OBJECTIVES: To determine the prevalence, potential causes and management of hyponatraemia and to identify factors associated with severity of hyponatraemia among older persons in a primary care setting.
METHODS: Electronic records were searched to identify all cases aged ≥60 years with a serum sodium <135mmol/l, attending outpatient clinic in 2014. Patients' medical records with the available blood test results of glucose, potassium, urea and creatinine were reviewed.
RESULTS: Of the 21,544 elderly, 5873 patients (27.3%) had electrolyte profile tests. 403 (6.9%) had hyponatraemia in at least one blood test. Medical records were available for 253, mean age 72.9±7.3 years, 178 (70.4%) had mild hyponatraemia, 75 (29.6%) had moderate to severe hyponatraemia. Potential causes were documented in 101 (40%). Patients with moderate to severe hyponatraemia were five times more likely to have a cause of hyponatraemia documented (p<0.01). Medications were the commonest documented cause of hyponatraemia (31.7%). Hydrochlorothiazide use was attributed in 25 (78.1%) of 32 with medication-associated hyponatraemia. Repeat renal profile (89%) was the commonest management of hypotonic hyponatraemia.
CONCLUSION: Whilst hyponatraemia was common in the clinic setting, many cases were not acknowledged and had no clear management strategies. In view of mild hyponatraemia has deleterious consequences, future studies should determine whether appropriate management of mild hyponatraemia will lead to clinical improvement.
Effectiveness of Fit and Trimmed Staffs (FATS) program on weight management among the healthcare providers at Simpang Health Clinic, Perak: A pre-post interventional study

Leow SN, Tay CL, Ng WW, Mior Mohammad Jafri MN

Malays Fam Physician, 2022 Nov 30;17(3):89-96.
PMID: 36606163 DOI: 10.51866/oa.107

INTRODUCTION: Obesity is associated with an increased risk for non-communicable diseases. Local studies have shown that 33.1% of healthcare providers (HCPs) are overweight, while 21.1% are obese. Interventions that consist of diet, physical exercise and cognitive behavioural training have been shown to be successful in reducing weight.
METHOD: We designed a weight loss programme for our HCPs named the 'Fit and Trimmed Staff programme, which consisted of 3 months of group education on obesity-related health problems led by a doctor, a pharmacist, a nutritionist and an occupational therapist among HCPs. Monthly individual dietary counselling by a nutritionist was also provided for 6 months. We measured the body weight, body mass index, percentage of body fat, visceral fat and percentage of skeletal muscle of the HCPs before and after the intervention.
RESULTS: Forty-five (56.25%) HCPs at Simpang Health Clinic were either overweight or obese; the majority of them were drivers and administrative clerks (100%), followed by health attendants (69.2%) and medical assistants (63.6%). At 6 months post-intervention, there was a trend towards a non-significant reduction in the fat percentage (median=-0.8%, P=0.423). Approximately 42% (n=19) of the HCPs lost weight, while 58% gained weight. Weight loss was observed more commonly in the male HCPs (>50%) than in the female HCPs.
CONCLUSION: A weight loss programme solely consisting of health discussion and nutritional advice is inadequate to induce weight reductions. A multimodal approach may be considered in managing weight among HCPs.
Fulltext May Measurement Month 2017 blood pressure screening: findings from Malaysia-South-East Asia and Australasia

Chia YC, Ching SM, Chew BN, Devaraj NK, Siti Suhaila MY, Tay CL, et al.

Eur Heart J Suppl, 2019 Apr;21(Suppl D):D77-D79.
PMID: 31043885 DOI: 10.1093/eurheartj/suz061

Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. However there are still many individuals, particularly in many countries in Asia, who have poor BP control. In Malaysia, less than two-fifths have achieved BP control. We participated in BP screening in Malaysia in conjunction with the May Measurement Month 2017 (MMM17), a global initiative by the International Society of Hypertension (ISH) aimed at screening more individuals for earlier detection of hypertension. A nationwide screening of adults aged ≥18 was carried out through health campaigns at clinics, hospitals, during family day events, and charity runs from 1 April 2017 to 31 May 2017 in 42 centres. We used the detailed protocol provided by ISH for data collection. A total of 4116 individuals were screened during MMM17. After multiple imputation, 32.4% (n = 1317/4059) had hypertension. Out of this, 63.9% (842/1317) of those with hypertension were on treatment. Of individuals receiving antihypertensive medication with an imputed BP, 59.5% (n = 496/834) of them had controlled BP. MMM17 was the largest organized BP screening campaign undertaken by health professionals in Malaysia. This study identified that 32.4% of screened individuals had hypertension and 59.5% individuals with treated hypertension had achieved BP control.
Fulltext Relationship of an adherence score with blood pressure control status among patients with hypertension and their determinants: Findings from a nationwide blood pressure screening program

Chia YC, Devaraj NK, Ching SM, Ooi PB, Chew MT, Chew BN, et al.

J Clin Hypertens (Greenwich), 2021 03;23(3):638-645.
PMID: 33586334 DOI: 10.1111/jch.14212

This study aimed to examine the relationship of adherence with blood pressure (BP) control and its associated factors in hypertensive patients. This cross-sectional nationwide BP screening study was conducted in Malaysia from May to October 2018. Participants with self-declared hypertension completed the Hill-Bone Compliance to High Blood Pressure Therapy Scale (Hill-Bone CHBPTS) which assesses three important domains of patient behavior to hypertension management namely medication taking, appointment keeping and reduced salt intake. Lower scores indicate better compliance while higher scores indicate otherwise. Participant's body mass index and seated BP were measured based on standard measurement protocol. Determinants of adherence to treatment were analyzed using multiple linear regression. Out of 5167 screened subjects, 1705 were known hypertensives. Of these, 927 (54.4%) answered the Hill-Bone CHBPTS and were entered into analysis. The mean age was 59.0 ± 13.2 years, 55.6% were female and 42.2% were Malays. The mean Hill-Bone CHBPTS score was 20.4 ± 4.4 (range 14-47), and 52.1% had good adherence. The mean systolic BP and diastolic BP were 136.4 ± 17.9 and 80.6 ± 11.6 mmHg, respectively. BP was controlled in 58.3% of those with good adherence compared to 50.2% in those with poor adherence (p = .014). Based on multiple linear regression analysis, female gender (β = -0.72, 95% confidence interval [CI] -1.30, -0.15, p = .014), older age (β = -0.05, 95% CI -0.07, -0.03, p