ABSTRACT
Background: Obstructive sleep apnea (OSA) despite being the most common type of sleep disorder, may presenta myriad of clinical features, ranging from simple fatigue and lack of concentration to per-sonality changes andheart diseases. The association between the genetic, physiological built, so-cial status, and behaviour plays themajor role in disease risk factors diagnosis and management plans. The most often used treatment method of OSAis Continuous Positive Airway Pressure (CPAP) aimed at monitoring respiratory effort and Apnea-HypopneaIndex (AHI) measuring the number of apnea and hypopnea events per hour of sleep or the RespiratoryDisturbance Index (RDI). Objective: The focus of this paper is providing a review on obstructive sleep apnea,different treatment ap-proaches and the recent perspectives with regard to family physicians’ enrolment inmanagement and modulation of pain in OSA patients. Methodology: PubMed database was used for articlesselection using the keywords obstructive sleep apnea, its evaluation, management, and diagnosis. Conclusion: Insummary, family doctors and primary care providers play a major role in controlling OSA and are involved indealing with CPAP, AHI measurement and RDI. Obstructive sleep apnea re-quires a high cost which may furthercontribute to late detection, complications deterioration, and increasing in the drop of follow-ups. Increasingawareness of the primary care providers especial-ly family physicians would help to avoid such outcomes. OSAremains a common condition that requires attention, identification, and more directed research.
ABSTRACT
Background: Psoriasis is a common dermatological condition affecting both adults and children. It causes significant physical and psychological burden on patients and adversely affect their quality of life. Aim: To evaluate the clinical characteristics of paediatric patients with psoriasis in Malaysia. Materials & Methods: Data were obtained from the Malaysian Psoriasis Registry (MPR). All paediatric patients aged <18 years notified to the registry from July 2007 to December 2012 were included in this study. Results: A total of 677 patients were notified from 18 participating centres. There was a slight female preponderance (ratio 1.3:1). Malay accounted for 70.6%, followed by Chinese (8.9%), Indian (12.3%) and others (8.1%). Mean age of onset was 9.8 ± 4.4 years. Positive family history was noted in 19.1%. Plaque psoriasis was the commonest type of psoriasis (79.6%), followed by guttate psoriasis (7.4%), pustular psoriasis (1.6%), erythrodermic (1.2%) and flexural psoriasis (1.2%). Psoriatic arthropathy was reported in only 2.2% of patients. Nail involvement is common, affecting 38.1%. Pitting was the commonest (89.9%). Topical treatment remains the most popular choice of treatment and was given in 95.1% of our patients. Topical steroid was the commonest prescribed (81.4%), followed by tar preparations (78.7%) and emollients (51.6%). Only 1.2% of our patients received phototherapy. Of the patients who had phototherapy, narrowband UVB (NBUVB) was the commonest used (87.5%). Systemic therapy was given in 5.3% of paediatric patients. The most frequently used systemic therapy was methotrexate (50%) and acitretin (27.8%). The mean CDLQI score for paediatric patients with psoriasis was 7.7 ± 5.5. Conclusion: Data from the Malaysian Psoriasis Registry highlights the clinical features of paediatric patients with psoriasis in Malaysia. We hope to get more participation from other centres in the future, especially from private sectors, so that our results can represent the Malaysian data more accurately.