Displaying publications 261 - 280 of 2797 in total

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  1. A review of free flap failures in the University Hospital, Kuala Lumpur
    Ahmad TS, Musa G, Lee JK
    Ann Acad Med Singap, 1997 Nov;26(6):840-3.
    PMID: 9522989
    Sixty-one free flaps performed in 59 patients from April 1983 to April 1995 were analysed. Various factors that might have affected the outcome of the surgery were studied. These included the patient's age, history of smoking, pre-existing medical problems such as hypertension and diabetes mellitus, the type of free flaps, flap infection, use of postoperative anticoagulation, postoperative anaemia and re-exploration. The infection rate was 16.4% and this had a strong correlation with the free flap failure in our study population. Postoperative anaemia could adversely affect the tissue oxygenation of the free flap and delay the re-exploration due to the high anaesthetic risk. Dextran was routinely used for postoperative anticoagulation. There were also rescue attempts using heparin infusion when needed. The overall failure rate was 13.1%. Besides good anaesthetic support, a well-prepared protocol is necessary both for the preoperative planning of free flap surgery as well as salvaging a failure.
    Matched MeSH terms: Child, Preschool
  2. Neuroblastoma and diagnostic imaging
    Sherazi ZA, Abdullah AW, Malik AS, Saad R
    Ann Acad Med Singap, 1993 Sep;22(5):701-6.
    PMID: 8267349
    To assess the utility of the current imaging modalities, a six-year retrospective study was conducted from May 1985 through April 1991 on 11 patients with histopathologically confirmed neuroblastoma. There were four males and seven females. Median age at presentation was six years. All patients underwent intravenous urography (IVU), abdominal ultrasonography (US), skeletal surveys and bone marrow aspiration. Computed tomographic (CT) scanning was performed in nine patients and trephine bone biopsy in five. Suprarenal gland was the primary site in six patients, including one bilateral neuroblastoma. Two presented with primary paraspinal mass, one with posterior mediastinal mass, one had a retroperitoneal tumour and one presented as primary cerebral neuroblastoma. IVU showed indirect evidence of suprarenal tumours in five patients. US demonstrated suprarenal mass in six and calcification within the mass in five patients. US also documented retroperitoneal lymphadenopathy in five patients. US-guided fine needle aspiration biopsy was performed in seven patients and it gave correct histological diagnosis in all. CT accurately depicted all the primary tumours and their involvement of the surrounding structures and metastases in the brain and orbits. US proved to be quite accurate in diagnosing primary abdominal tumours despite its limitations but in other sites, CT was of greater help. Solid appearance of a suprarenal mass on US made the diagnosis of neuroblastoma very likely and calcification within the mass further supported the diagnosis.
    Matched MeSH terms: Child, Preschool
  3. Spectrum of inherited metabolic disorders in Malaysia
    Thong MK, Yunus ZM
    Ann Acad Med Singap, 2008 Dec;37(12 Suppl):66-5.
    PMID: 19904455
    Issues pertaining to the diagnosis and management of inborn errors of metabolism (IEM) in Malaysia included low awareness of atypical and variable presentations in IEMs leading to delayed diagnosis or treatment, absence of reliable population data on IEMs and involvement of multiple siblings in the same family due to consanguinity. The importance of careful family history taking and genetic counselling are emphasised. Selected testing of ill infants and children for IEM yielded a positive 2% (264/13,500) results for IEMs in Malaysia. Out of the 264 patients, the spectrum of IEMs in Malaysia included organic acidurias (98), aminoacidopathies (78), urea cycle defects (54), neurotransmitter conditions (12) and lysosomal disorders, mainly mucopolysaccharidosis (14). Confirmatory studies of IEMs are an important aspect of management of IEMs. There is a need for more metabolic specialists and funding for diagnosis and treatment of IEMs in Malaysia. Long-term care issues and cost-effectiveness of IEM therapy, supportive and preventive aspects will need further studies in Malaysia.
    Matched MeSH terms: Child, Preschool
  4. Parasitic infections among aborigine children at Post Brooke, Kelantan, Malaysia
    Rahmah N, Ariff RH, Abdullah B, Shariman MS, Nazli MZ, Rizal MZ
    Med J Malaysia, 1997 Dec;52(4):412-5.
    PMID: 10968120
    This study investigated the prevalence of parasitic infections among aborigine children at Post Brooke, Kelantan. Eighty-four formalin-fixed specimens and 78 PVA-fixed specimens were obtained. 79.8% and 35.9% of the samples were positive for helminth ova and protozoa respectively. The parasites detected (single plus mixed infections) were A. lumbricoides (50/84, 59.5%), T. trichiura (35/84, 41.7%), hookworm (5/84, 6.0%), S stercoralis (1/84, 1.2%), G. intestinalis (18/78, 23.1%), E. histolytica (7/78, 9.0%) and E. coli (7/78, 9.0%). Two hundred thick blood film examinations detected only one case of Plasmodium falciparum infection. A high prevalence of intestinal parasitic infections among the children at Post Brooke was demonstrated in this study; thus there is an urgent need to improve the hygiene, education and living standards of this population.
    Matched MeSH terms: Child, Preschool
  5. Abusive head trauma: Annual medical costs for inpatient care of children managed at a single tertiary care centre in Malaysia
    Rais UM, Marret MJ, Azzeri A
    Child Abuse Negl, 2024 Dec;158:107126.
    PMID: 39488966 DOI: 10.1016/j.chiabu.2024.107126
    BACKGROUND: Abusive head trauma (AHT) is a leading cause of traumatic head injury in young children. This study estimated the annual direct medical cost of managing AHT at a single tertiary care centre in Malaysia.

    METHODS: Criteria were set for categorisation of patients as moderate or severe based on resource utilisation. The two methods used for cost computation were (1) cost estimation based on predefined clinical pathways for case management (2) computation of actual costs using patient-level data from retrospective review of all AHT admissions in 2021. Both methods utilised a combination of activity-based and top-down costing according to availability of reference data. Costs are presented in USD.

    RESULTS: Costs for 9 severe and 3 moderate cases in 2021 amounted to $70,532.16, of which 93 % was for severe cases. Cost estimate for moderate cases was $2009.88 while actual costs ranged between $749.37-3115.47 (median $1422.76). Cost estimates of $15,125.76-$17,958.18 for severe cases exceeded actual costs of $2195.57-$13,186.03 (median $7379.40) for severe cases due to shorter-than-expected duration of stay, with only 2 who underwent neurosurgical procedures. Major cost contributors were duration of stay, intensive care, ventilation and neurosurgical procedures.

    CONCLUSION: Cost comparison utilising predefined treatment standards versus actual patient data which reveals major cost determinants enables refinement of budget allocation. Median medical costs for severe cases which exceeded the monthly income ceilings of low- and middle-income households in Malaysia demonstrate the economic burden of AHT, reinforcing the need to invest in prevention.

    Matched MeSH terms: Child, Preschool
  6. The Prevalence and Determinants of Anemia Among Indigenous (Orang Asli) Children in Peninsular Malaysia: A Systematic Review
    Ab Aziz M, Ai Kah N, Ismail M, Majid HA
    Asia Pac J Public Health, 2024 Jul;36(5):437-446.
    PMID: 38695359 DOI: 10.1177/10105395241248545
    Low- and lower-middle-income countries bear the greatest burden of anemia, particularly those living in rural settings such as an indigenous community. The objective of this systematic review was to determine the prevalence of anemia and its determinants among the Orang Asli children in Peninsular Malaysia. A web-based search of PubMed, Web of Science, Scopus, Medline, and ProQuest from January 2000 to June 2022, using specified search/MeSH (Medical Subject Headings) terms and keywords, was conducted. The search identified studies reported the prevalence of anemia among the children of Orang Asli and its causes. Eight studies were included in the final analysis. The prevalence of anemia among the Orang Asli children was high (61.6%). Most research has focused primarily on iron-deficiency anemia and soil-transmitted helminth infections. Other causes include female gender, mothers with low education levels, and low household incomes. Despite being a public health concern, this study found no studies associating Orang Asli children with hereditary anemia and malaria, which is a limitation. In conclusion, the Orang Asli children are more likely to have anemia compared with the general Malaysian population. To overcome this, a comprehensive examination of the determinants of anemia in this community is required. Thus, interventions can be personalized.
    Matched MeSH terms: Child, Preschool
  7. Fulltext The impact of preschool children's physical fitness evaluation under self organizing maps neural network
    Wang L, Zou W, Wang Y, Koh D, Munsif Bin Wan Pa WA, Gao R
    Sci Rep, 2025 Jan 09;15(1):1461.
    PMID: 39789314 DOI: 10.1038/s41598-025-85725-5
    To improve the scientific accuracy and precision of children's physical fitness evaluations, this study proposes a model that combines self-organizing maps (SOM) neural networks with cluster analysis. Existing evaluation methods often rely on traditional, single statistical analyses, which struggle to handle the complexity of high-dimensional, nonlinear data, resulting in a lack of precision and personalization. This study uses the SOM neural network to reduce the dimensionality of high-dimensional health data. Moreover, it integrates cluster analysis to categorize and analyze key physical fitness attributes, such as strength, flexibility, and endurance. Experimental results show that the proposed optimized model outperforms comparison models such as T-distributed stochastic neighbor embedding, density peak clustering, and deep embedded clustering in terms of performance. The accuracy for the strength dimension reaches 0.934, the F1 score is 0.862, and the area under the curve of receiver operating characteristic is 0.944. The silhouette coefficients for cluster analysis in strength, flexibility, and endurance dimensions are 0.655, 0.559, and 0.601, respectively, demonstrating good intra-class and inter-class distances. The proposed model enhances the comprehensive analysis of children's physical fitness and provides a scientific basis for personalized health interventions, making an important contribution to research in this field.
    Matched MeSH terms: Child, Preschool
  8. An uncommon mediastinal cyst with a rare neurologic consequence
    Sivalingam S, Qureshi AU, Chern LM, Latiff HA
    Ann Thorac Surg, 2014 Apr;97(4):e93-5.
    PMID: 24694456 DOI: 10.1016/j.athoracsur.2013.12.060
    Enteric cysts are uncommon posterior mediastinal cysts, usually presenting with respiratory symptoms in infancy. We present a rare case of posterior mediastinal enteric cyst extending from below the diaphragm and perforating into the left atrium, causing a thromboembolic cerebral infarct in a 5-year-old boy.
    Matched MeSH terms: Child, Preschool
  9. Fulltext Nature and pattern of cricket injuries: the Asian Cricket Council Under-19, Elite Cup, 2013
    Das NS, Usman J, Choudhury D, Abu Osman NA
    PLoS One, 2014;9(6):e100028.
    PMID: 24927127 DOI: 10.1371/journal.pone.0100028
    Cricket has over the years gained much popularity in Asia, thus the number of cricket players has also grown in tandem. However, cricket players are not as fortunate as other athletes as they do not always have a standard cricket infrastructure to practice; therefore, the injury prevalence is expected to be high. Unfortunately, very few studies have been conducted to investigate the nature and pattern of cricket injuries prevalent to cricketers in this region. Therefore, a prospective cohort injury surveillance study was conducted during the Asian Cricket Council (ACC) Under-19 Elite Cup held in June 2013 in order to gather more data on the type of injuries sustained by cricket players. Overall, 31 injuries occurred to 28 players throughout the tournament, of which 7 injuries happened during practice sessions. The overall injury incidence rate (IIR) was 292.0 per 10,000 player hours (95% CI 176.9-407.1) and 10.4 per 10,000 balls faced and 2.6 per 1000 overs bowled delivered during batting and bowling, respectively. Injuries to the lower limb (IIR: 146; 95% CI 1.8-98.2) were the most frequent, followed by injuries to the upper limb (97.3;95% CI 30.2-164.5) and to the trunk and back (IIR: 36.5;95% CI 0.0-77.7). Sprain/strains (IIR 109.5;95% CI 38.4-180.7) to muscle/tendon and joint/ligament were the most commonly reported nature of injury. This is the first study investigating injury incidence among the players of the ACC. It provides an overview of injuries sustained by elite players' under-19 years of age from 10 Asian countries. The overall IIR is similar to earlier studies conducted in well-established cricket playing nations.
    Matched MeSH terms: Child, Preschool
  10. Motor function outcome in postnatal insult-related cerebral palsy
    Fauzi AA, Mustafah NM, Zohdi WN
    J Pediatr Rehabil Med, 2013;6(3):181-4.
    PMID: 24240839 DOI: 10.3233/PRM-130251
    The Gross Motor Function Classification System (GMFCS) was developed to establish uniform communication between healthcare providers, patients, and the patients' families. It is also used to prognosticate the outcome of motor function. Based on previous reports, prognostication of ambulation status in cerebral palsy is based on the motor development curve, which shows a plateau at a certain known age.
    Matched MeSH terms: Child, Preschool
  11. Fulltext Distribution of alpha thalassaemia gene variants in diverse ethnic populations in malaysia: data from the institute for medical research
    Ahmad R, Saleem M, Aloysious NS, Yelumalai P, Mohamed N, Hassan S
    Int J Mol Sci, 2013;14(9):18599-614.
    PMID: 24025420 DOI: 10.3390/ijms140918599
    Alpha thalassaemia is highly prevalent in the plural society of Malaysia and is a public health problem. Haematological and molecular data from 5016 unrelated patients referred from various hospitals to the Institute for Medical Research for α thalassaemia screening from 2007 to 2010 were retrieved. The aims of this retrospective analysis were to describe the distribution of various alpha thalassaemia alleles in different ethnic groups, along with their genotypic interactions, and to illustrate the haematological changes associated with each phenotype. Amongst the patients, 51.2% (n = 2567) were diagnosed with α thalassaemia. Of the 13 α thalassaemia determinants screened, eight different deletions and mutations were demonstrated: three double gene deletions, --(SEA), --(THAI), --(FIL); two single-gene deletions, α-³·⁷ and -α⁴·²; and three non-deletion mutations, Cd59G > A (haemoglobin [Hb] Adana), Cd125T > C (Hb Quong Sze) and Cd142 (Hb Constant Spring). A high incidence of α-³·⁷ deletion was observed in Malays, Indians, Sabahans, Sarawakians and Orang Asli people. However, the --SEA deletion was the most common cause of alpha thalassaemia in Chinese, followed by the α-³·⁷ deletion. As many as 27 genotypic interactions showed 1023 α thalassaemia silent carriers, 196 homozygous α⁺ thalassaemia traits, 973 heterozygous α⁰ thalassaemia carriers and 375 patients with Hb H disease. Statistical analysis showed a significant difference in the distribution of α thalassaemia determinants amongst the various ethnic groups. Hence, the heterogeneous distribution of common determinants indicated that the introduction of an ethnicity-targeted hierarchical α thalassaemia screening approach in this multi-ethnic Malaysian population would be effective.
    Matched MeSH terms: Child, Preschool
  12. Comparison of Lea Symbols chart and Sheridan Gardiner chart in assessing vision screening among pre-school children: a Malaysia perspective
    Omar R, Hussin DA, Knight VF
    J Med Assoc Thai, 2012 Mar;95(3):412-7.
    PMID: 22550841
    Compare the performance of Lea Symbols and Sheridan Gardiner charts against the standard test chart used to determine reduced VA during vision screening among pre-schoolers.
    Matched MeSH terms: Child, Preschool
  13. Fulltext A rare case of heterotopic ossification in a newborn: a case report
    Khoo S, Felix L, Azura L, Manmohan S, Jeffry A
    Malays Orthop J, 2012 Nov;6(3):48-50.
    PMID: 25279058 MyJurnal DOI: 10.5704/MOJ.1207.006
    Heterotopic ossification (HO) is the growth of bone in soft tissue, and can be broadly classified into neurogenic, genetic and traumatic causes. The pathophysiology of HO remains unknown. This disorder is extremely rare in infants and can mimic or coexist with thrombophlebitis, cellulitis or osteomyelitis. Most importantly, HO has to be differentiated from bone-forming tumours such as osteosarcoma and osteochondroma. We report a case of traumatic HO in a fiveday- old newborn following intravenous cannulation of the right wrist and left ankle, with the latter complicated with osteomyelitis. We highlight the clinical and radiological features of HO and differential diagnoses of soft tissue ossification in early childhood.
    Matched MeSH terms: Child, Preschool
  14. Fulltext Gangrenous small bowel obstruction secondary to congenital internal herniation: a case report
    Tan YL, Alhagi MV
    Med J Malaysia, 2012 Feb;67(1):118-20.
    PMID: 22582563 MyJurnal
    Congenital internal herniation is a rare condition presenting as recurrent abdominal pain or acute intestinal obstruction. In cases in which bowel incarceration or strangulation develop, rapid progression to bowel ischemia, necrosis or perforation is inevitable. Mortality in such cases has been reported to be as high as 50%. Despite advances in imaging modalities, arriving at a pre-operative diagnosis of a congenital internal herniation remains a challenge. We report such a case where imaging was unsuccessful in determining the cause of intestinal obstruction in a 3 year old child. Congenital internal herniation may result in disastrous consequences if not addressed in a timely fashion due to its rarity. Hence a high index of clinical suspicion is needed to avoid missing this diagnosis in a child presenting with recurrent abdominal pain or acute intestinal obstruction.
    Matched MeSH terms: Child, Preschool
  15. Fulltext Children with learning disabilities in the paediatric clinic, Hospital Tuanku Ja'afar Seremban: an overview
    Mariana AM, Wong SL
    Med J Malaysia, 2011 Dec;66(5):487-90.
    PMID: 22390107 MyJurnal
    The aim of the study was to document the prevalence of learning disability among the children attending the Paediatric Clinic in Hospital Tuanku Ja'afar Seremban. The demographic distribution of these patients; the age of detection of the problem; the associated medical conditions and types of intervention received by these patients were documented. Patients who were between the ages of five to twelve years were included in the study. Learning disability was divided into three categories: speech and articulation problems, academic skills disorder and other categories which included developmental delay. Children with cerebral palsy were excluded from the study. Out of 1320 patients screened, 355 were found to have learning disorders. Majority were Malays, with the male to female ratio of 1.9:1. Most of the patients stayed in Seremban. The learning problem was most commonly detected at the age of 4 years and below. The commonest type of learning disorder was developmental delay, followed by academic skills disorder, speech and academic skills problems and speech disorders. Problems that were detected early were speech problems and developmental delay. Majority of the children had associated medical conditions. Most of the patients received some form of intervention but 11.3% did not attend any intervention program at all. A strategy should be formulated and implemented to help this group of children.

    Study site: Paediatric Clinic in Hospital Tuanku Ja'afar Seremban
    Matched MeSH terms: Child, Preschool
  16. Fulltext Images in clinical medicine. Retinoblastoma
    Kah TA, Annuar FH
    N Engl J Med, 2012 Jul 19;367(3):258.
    PMID: 22808961 DOI: 10.1056/NEJMicm1112964
    Matched MeSH terms: Child, Preschool
  17. Fulltext Measles among US-bound refugees from Malaysia to California, Maryland, North Carolina, and Wisconsin, August–September 2011
    Clin Infect Dis, 2011 Dec;53(12):i.
    PMID: 22080131 DOI: 10.1093/cid/cir815
    Matched MeSH terms: Child, Preschool
  18. Fulltext Partial deletion 9p syndrome in Malaysian children
    Chew HB, Thong MK
    Med J Malaysia, 2010 Sep;65(3):215-7.
    PMID: 21939171 MyJurnal
    We report the first two Malaysian children with partial deletion 9p syndrome, a well delineated but rare clinical entity. Both patients had trigonocephaly, arching eyebrows, anteverted nares, long philtrum, abnormal ear lobules, congenital heart lesions and digital anomalies. In addition, the first patient had underdeveloped female genitalia and anterior anus. The second patient had hypocalcaemia and high arched palate and was initially diagnosed with DiGeorge syndrome. Chromosomal analysis revealed a partial deletion at the short arm of chromosome 9. Karyotyping should be performed in patients with craniostenosis and multiple abnormalities as an early syndromic diagnosis confers prognostic, counselling and management implications.
    Matched MeSH terms: Child, Preschool
  19. Fulltext Trilateral retinoblastoma
    Limn YS, Juraida E, Alagaratnam J, Menon BS
    Med J Malaysia, 2011 Jun;66(2):156-7.
    PMID: 22106703 MyJurnal
    Trilateral retinoblastoma is the association of hereditary bilateral or unilateral retinoblastoma with a pineal neuroblastic tumour. We describe two cases of trilateral retinoblastoma from a total of 141 cases of retinoblastoma seen over an 8.5 year period. Both had a fatal outcome, with survival times of only 4 and 8 months respectively.
    Matched MeSH terms: Child, Preschool
  20. Abnormal per rectal bleed
    Singh AH
    Scott Med J, 2011 Feb;56(1):59.
    PMID: 21515535 DOI: 10.1258/smj.2010.010026
    A 3-year old girl presented to our A&E with a complaint of an acute event of per rectal bleed. The parent had given a history of a visit to a nearby waterfall one day ago. Upon admission she developed hypotension and had a fainting episode due to the excessive passing of blood per rectum. The case report shows how the appropriate investigations were carried out and the twist behind the cause.
    Matched MeSH terms: Child, Preschool
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