MyMedR

Fulltext Percutaneous central venous catheterisation in critically ill children

Goh AYT, Lum LCS, Chan PWK, Roziah M

Med J Malaysia, 1998 Dec;53(4):413-6.

PMID: 10971986

An 18-month analysis of 52 percutaneously placed central venous catheters in 48 critically ill children was done. Success rate were 91.7% (33/36) and 93.8% (15/16) for femoral and non-femoral catheters respectively. Presence of hypotension (48.1%) and significant coagulopathy (26.9%) did not affect the success rate significantly. Minor bleeding and venous congestion was seen in 5.5% (2/36) of patients with femoral catheters. Infections were found in 2.7% (1/36) of femoral and 6.6% (1/15) of non-femoral catheters. The low incidence of complications and the relative ease of insertion makes the femoral route the preferred site for trainee medical officers in critically ill children when central access is indicated.

Matched MeSH terms: Child, Preschool

Fulltext A seroprevalence study of viral hepatitis E infection in human immunodeficiency virus type 1 infected subjects in Malaysia

Ng KP, He J, Saw TL, Lyles CM

Med J Malaysia, 2000 Mar;55(1):58-64.

PMID: 11072492 MyJurnal

Hepatitis E virus (HEV) is a RNA virus transmitted enterically. A study of anti-HEV antibodies in 145 human immunodeficiency virus type 1 (HIV-1) infected subjects found that 14.4% of them were reactive to anti-HEV antibodies. Anti-HEV IgG and anti-HEV IgM was detected in 10.3% and 4.1% of the subjects respectively. Prevalence of anti-HEV (either IgG or IgM) was similar across all adult ages (p = 0.154), between the three ethnic groups (p = 0.378), and across risk groups (p = 0.120). The results showed that HEV infection in subjects recruited in this study was most likely transmitted via faecal-route.

Matched MeSH terms: Child, Preschool

Fulltext Residual deformity following surgical treatment of congenital talipes equinovarus

Simbak N, Razak M

Med J Malaysia, 1998 Sep;53 Suppl A:115-20.

PMID: 10968193

A study was carried out on 24 patients (36 clubfeet) surgically treated at the Orthopaedic Department National University of Malaysia, Kuala Lumpur, over a period of four and half years. Nine feet underwent posterior release, 24 feet underwent posteromedial release combined with Evan's procedure. The overall operative result was 63.3% good, 9.5% fairly and 27.2% poor. Patients who underwent surgery between 3 to 12 months showed a high percentage of good results (66.7%). Metatarsal adduction was found to be the commonest residual deformity (63.9%), followed by heel varus (11.1%), cavus (11.1%) and equinus (5.6%). Inadequacy of primary surgery and post operative period of immobilization resulted in a significant high failure rate.

Matched MeSH terms: Child, Preschool

Fulltext Spinal cord injury without radiological abnormality (SCIWORA)

Izma MKO, Zulkharnain I, Ramli B, Muhamad AR, Harwant S

Med J Malaysia, 2003 Mar;58(1):105-10.

PMID: 14556334

SCIWORA or Spinal Cord Injury Without Radiological Abnormality; is a pre-MRI term that includes injuries to the spinal cord in the absence of radiological (plain radiographs, tomographs and CT scans) evidence of injury to the spinal column or cord. It occurs in skeletally immature spines because of the inherent plasticity of the bony structures in this age group. The prognosis is dependent on the extent of cord damage, and the role of active management is limited. A high index of suspicion is needed to establish a diagnosis. This diagnostic accuracy can be improved with the free availability of MRI scanning for the spines. We describe three cases of SCIWORA with a minimum follow-up of three years and a review of current literature.

Matched MeSH terms: Child, Preschool

Fulltext Enzyme replacement therapy for Gaucher Disease: the only experience in Malaysia

Chan LL, Lin HP

Med J Malaysia, 2002 Sep;57(3):348-52.

PMID: 12440275 MyJurnal

Gaucher Disease may now be treated with enzyme replacement therapy (ERT) or bone marrow transplantation (BMT). Both have their advantages and disadvantages. Results with BMT are curative when successful but limited by the scarcity of an appropriate donor. ERT offers very good relief of symptoms but treatment is lifelong and cost of treatment exorbitant. Patients in developing countries are particularly disadvantaged and management remains a dilemma for both doctor and patient.

Matched MeSH terms: Child, Preschool

Fulltext Providing a cure for beta thalassaemia major

Chan LL, Lin HP, Ariffin WA, Ariffin H

Med J Malaysia, 2001 Dec;56(4):435-40.

PMID: 12014762

The current treatment options for beta thalassaemia major patients include conservative treatment with blood cell transfusions and iron chelation or stem cell transplantation. Regular blood transfusions inevitably lead to multi-organ haemosiderosis and are attended by risks of blood-borne infections. Results from stem cell transplantation are good and suggest that this should be offered as first line therapy when a matched sibling donor is available because the patient is often cured and able to live a normal life. Of 38 Malaysian children who underwent bone marrow or cord blood transplantations using matched sibling donors, 29 (76%) are now cured.

Matched MeSH terms: Child, Preschool

Fulltext Treating high risk childhood solid tumours with autologous peripheral blood stem cell transplantation--early experience in University Hospital, Kuala Lumpur

Chan LL, Lin HP, Ariffin WA, Ariffin H, Saw MH

Med J Malaysia, 1999 Jun;54(2):175-9.

PMID: 10972026

Although survival rates for childhood cancers have improved steadily over the past two decades, the outcome for advanced stage solid tumours remains poor. Many of these tumours are chemosensitive but most chemotherapeutic regimens are limited by their haematological toxicities. Much attention is now focused on mega-dose chemotherapy followed by stem cell rescue in the treatment of disseminated neuroblastoma, rhabdomyosarcoma, germ cell tumour and brain tumours. There is a preferential shift towards peripheral blood stem cell transplantation instead of bone marrow transplantation because of its advantages of faster engraftment, decreased transfusion and antibiotic usage and shortened hospitalisation. This mode of therapy is dependent on technologies including peripheral blood stem cell harvesting, cell cryopreservation and thawing. These technologies were recently made available in Malaysia and we report our early experience.

Matched MeSH terms: Child, Preschool

Fulltext The incidence of human herpesvirus 6 infection in children with febrile convulsion admitted to the University Hospital, Kuala Lumpur

Chua KB, Lam SK, AbuBakar S, Koh MT, Lee WS

Med J Malaysia, 1997 Dec;52(4):335-41.

PMID: 10968110

From October 1996 to March 1997, 31 children with febrile convulsions were admitted to the University Hospital, Kuala Lumpur. Human Herpesvirus 6 (HHV 6) was virologically and/or serologically confirmed to be the cause of the febrile episode in 5 of these children (16.1%). Age, sex and other associated clinical features (diarrhoea, cough, running nose and type of seizure) were not useful in differentiating cases of febrile convulsion due to HHV 6 from those of other aetiology. However, uvulo-palatoglossal junctional ulcers were noted in children in whom the cause of the seizure could be attributed to HHV 6 but not in the remaining cases in the study group. HHV 6 DNA was detected in peripheral blood mononuclear cells from all patients with febrile convulsions attributed to HHV6, and in patients shown serologically to have already been exposed to the virus by nested polymerase chain reaction amplification. Only genotype HHV 6B was detected from patients with seizure due to HHV 6 but both genotype 6A and 6B were detected in the remaining cases studied.

Matched MeSH terms: Child, Preschool

Food and asthma symptoms in Malaysian children

Chan PWK, Debruyne JA, Goh AYT

J Trop Pediatr, 1999 Jun;45(3):184.

PMID: 10401205 DOI: 10.1093/tropej/45.3.184

Study site: not reported.

Matched MeSH terms: Child, Preschool

Chronic diarrhoea in infants and young children: causes, clinical features and outcome

Lee WS, Boey CC

J Paediatr Child Health, 1999 Jun;35(3):260-3.

PMID: 10404446

OBJECTIVES: To review the causes, clinical features and outcomes of Malaysian children who had chronic diarrhoea.

METHODOLOGY: A prospective study was performed on children with diarrhoea of more than 14 days' duration who were managed at the Department of Paediatrics, University of Malaya Medical Centre, Kuala Lumpur from 1 January 1996 to 31 December 1997.

RESULTS: Twenty-seven patients (14 boys and 13 girls) were studied. The median age of onset of diarrhoea was 6 months and the mean duration of symptoms before referral was 66.5 days. The underlying causes of diarrhoea were found to be: (i) prolonged diarrhoea due to well-defined entities (intestinal lymphangiectasia, two cases; congenital glucose-galactose malabsorption, one case; post-small bowel resection, one case; (ii) postenteritis diarrhoea (cow's milk protein intolerance, eight cases; secondary lactose intolerance, four cases; transient monosaccharide intolerance, one case; (iii) gastrointestinal infections (nontyphoid Salmonella gastroenteritis, three cases; trichuriasis, two cases; amoebiasis, one case; adenovirus, one case; (iv) cases in which a firm diagnosis could not be established (three cases). The mean duration of hospital admission was 63 days. Sixteen cases required a change in diet, while nine cases required total parenteral nutrition. One death occurred.

CONCLUSIONS: Chronic childhood diarrhoea in Malaysia had a variety of aetiologies. A specific diagnosis could be established in 90% of cases. Making a diagnosis was important because this led to appropriate therapy and a good outcome in 96% of cases.

Matched MeSH terms: Child, Preschool

Fulltext The need for scoliosis screening in Malaysia

Oh KS, Chuah SL, Harwant S

Med J Malaysia, 2001 Jun;56 Suppl C:26-30.

PMID: 11814244 MyJurnal

Conflicting recommendations exist on the issue of scoliosis screening in the general population. Worldwide, opponents cite the relative inaccuracy of screening tests, cost-ineffectiveness and psychosocial effect of 'labelled' patients but advocates quote the successes in many centres and the advantages of timely intervention. We studied 205 patients with idiopathic scoliosis and found they presented at relatively later ages and with curves that showed rapid annual progression. We suggest that screening in Malaysia may identify patients early for treatment besides promoting health awareness.

Matched MeSH terms: Child, Preschool

Fulltext Pneumonia presenting as acute abdomen in children: a report of three cases

Vendargon S, Wong PS, Tan KK

Med J Malaysia, 2000 Dec;55(4):520-3.

PMID: 11221169

From 10th September 1998 till 5th June 1999, the Paediatric and Cardiothoracic Surgery Units of Sultanah Aminah Hospital Johor Bahru managed three children with lung collapse secondary to pneumonia. The dominant initial clinical presentation in all three cases was acute abdominal pain. Basal pneumonia was diagnosed in two cases post-operatively after surgical contributory causes were excluded intra-operatively. Thoracotomy, evacuation of infected debris and decortication of the collapsed lung was done in all three cases. In children presenting with acute abdominal pain, basal pneumonia should be considered as a possible contributory cause.

Matched MeSH terms: Child, Preschool

Fulltext High white cell count at presentation in children with acute lymphoblastic leukaemia

Menon BS, Wan Maziah WM, Jackson N, Jamaluddin N, Narazah MY, Dasgupta A, et al.

Med J Malaysia, 1999 Jun;54(2):283-4.

PMID: 10972046

Matched MeSH terms: Child, Preschool

Fulltext Intussusception as a complication of gastrostomy tube: a case report

Hussain M, Thambidorai CR

Med J Malaysia, 2000 Jun;55(2):271-2.

PMID: 19839160

A neurologically impaired child who had fundoplication and gastrostomy done for gastroesophageal at the age of three, presented two years later with intestinal obstruction. She underwent laparotomy and was found to have antegrade jejuno-jejunal intussusception. Intussusception is an unusual but recognised complication of gastrostomy tube placement.

Matched MeSH terms: Child, Preschool

Fulltext The efficacy of side arm traction in the reduction of supracondylar fracture humerus in children

Harwant S, Borhan TA

Med J Malaysia, 2000 Sep;55(3):311-7.

PMID: 11200710

156 consecutive children with supracondylar fracture humerus were reviewed. Of these, 56 children with severely displaced fractures were treated with side arm traction. A retrospective review revealed that a mean post-reduction Baumann angle of 74.2 degrees for boys and 75.9 degrees for girls; and mean post-reduction humero-ulna angle of 11.6 degrees for boys and 12.7 degrees for girls was achieved. A linear correlation was noted between the duration of traction and the age of the patient, older patients requiring longer traction. The region below the line in the graph, plotting the duration of traction (y-axis) versus the age of the patient (x-axis) shows when the fracture is unstable; and the region above the line shows when the fracture is stable and can only be reduced by surgery. 10 children presented late; 6 presented within the unstable period and were successfully reduced with traction; while 4 presented stable and required open reduction. We conclude that traction is an acceptable and safe method for reduction of this fracture, and can be used to reduce late presentations while their fractures are still unstable.

Matched MeSH terms: Child, Preschool

Fulltext Asthma education: how much does it improve knowledge of childhood asthma amongst medical students and paramedics?

Norzila MZ, Hasanah I, Deng CT, Azizi BHO

Med J Malaysia, 2000 Sep;55(3):324-30.

PMID: 11200712

The objective of this study was to measure the knowledge of childhood asthma among medical students and paramedics. A previously validated questionnaire about childhood asthma was completed by 281 of 314, third and fifth year medical students at Universiti Kebangsaan Malaysia, Kuala Lumpur. Their knowledge of asthma was assessed during the first and last weeks of their paediatric rotation. A similar questionnaire was completed by 23 of 60 paramedics from various medical disciplines in Hospital Kuala Lumpur. They had attended a two-day seminar on respiratory diseases and their knowledge was assessed prior to and six weeks after the seminar. On the initial assessment the mean score for the final year medical students was 24.5, third year medical students 20.9 and paramedics 18.3. After intervention their mean scores increased significantly to 26.3 (p < 0.0001), 24.6 (p < 0.0001) and 21.3 (p < 0.0001). After intervention, the final year medical students improved significantly in all questions except in the management of acute asthma. Post intervention, third year medical students showed a significant increase in knowledge pertaining to symptomatology, pathophysiology, trigger factors and prophylactic drugs used in asthma management. Although the knowledge of paramedics improved post intervention, they had major deficiencies in knowledge about pathophysiology, trigger factors, preventive and acute asthma therapy, side effects of asthma treatment as well as clinical scenarios. Improvement after intervention was only seen in six of the 31 questions. This study demonstrated an increase in knowledge about childhood asthma among medical students and paramedics after a short intervention.

Matched MeSH terms: Child, Preschool

Fulltext Proximal third femoral shaft fractures in children: prevention of angular deformities using bilateral Thomas splints

Kamal MH, Razak M, Ibrahim S, Lim A

Med J Malaysia, 2000 Sep;55 Suppl C:68-73.

PMID: 11200047

This is a prospective study to look at the outcome of unilateral proximal third femoral shaft fractures in children treated with a bilateral Thomas splint in the Department of Orthopaedic Surgery Universiti Kebangsaan Malaysia between the period of January 1996 and June 1998. Eighteen children aged between 2 years and 12 years old with unilateral proximal third fractures of the femoral shaft were treated using a bilateral Thomas splint. Angular deformities were measured using a goniometer metric scale before and after Thomas splints. The percentage of varus tilt corrected ranged from 17% to 72% with an average correction of 29% from the initial deformity and the difference was statistically significant (p < 0.05). The percentage of posterior tilt corrected ranged from 19% to 60% with the average correction of 20% from the initial deformity. The difference was statistically significant (p < 0.05). From this study, we conclude that bilateral Thomas splints can give a better correction of angular deformity for proximal third femoral shaft fractures in children below twelve years of age.

Matched MeSH terms: Child, Preschool

Fulltext The results of open reduction and pin fixation in displaced supracondylar fractures of the humerus in children

Srivastava S

Med J Malaysia, 2000 Sep;55 Suppl C:44-8.

PMID: 11200044

The treatment of displaced supracondylar fracture humerus (Gartland Type III) in children continues to be a challenging problem. We did a retrospective study of such fractures treated in Hospital Muar, over a 2 years period (from January 1998 to December 1999). A total of 42 cases with displaced supracondylar fractures, treated with open reduction and internal fixation were studied. All cases were operated using a posterior triceps splitting approach and crossed kirschner wires were used to stabilize the fracture site. An excellent outcome was seen in 34 patients (81%) and a good outcome in 7 patients (17%). The incidence of complications such as pin tract infection (14%), nerve injury (2%) was very low. None of the patients had vascular complications or myositis ossificans.

Matched MeSH terms: Child, Preschool

Fulltext The prevalence and intensity of soil-transmitted helminthiasis among pre-school children in Orang Asli resettlement villages in Kelantan

Zulkifli A, Khairul AA, Atiya AS, Abdullah B, Yano A

Med J Malaysia, 1999 Dec;54(4):453-8.

PMID: 11072462

A study of the prevalence and intensity of soil-transmitted helminthiasis among pre-school children aged 0 to 7 years from an Orang Asli village resettlement scheme in Gua Musang, Kelantan was undertaken. The overall prevalence of soil transmitted helminthic (STH) infections was 56.0%. The predominant helminth found was Ascaris lumbricoides while the commonest type of infection was a mixed infection with Ascaris lumbricoides and Trichuris trichiura. The prevalence rates of Ascaris, Trichuris and hookworm infections were 47.5%, 33.9% and 6.2% respectively. The intensity of Ascaris infections were 64.5% light, 27.3% moderate and 8.3% heavy whilst the intensity of Trichuris infections were 80.5% light, 18.3% moderate and 1.2% heavy. However, the intensity of hookworm infections were 86.7% light, 13.3% moderate and no heavy infection. The prevalence of helminthiasis (STH) shows an-age dependent relationship, with the lowest prevalence in 0-< 1 year age group and highest in the 6-< 7 year age group.

Matched MeSH terms: Child, Preschool

Fatal enterovirus 71 encephalomyelitis

Lum LC, Wong KT, Lam SK, Chua KB, Goh AY, Lim WL, et al.

J Pediatr, 1998 Dec;133(6):795-8.

PMID: 9842048

During an outbreak of hand-foot-mouth disease caused by enterovirus 71 (EV-71) in 1997, 4 children presented with sudden cardiopulmonary collapse and minimal neurologic features. All children received cardiopulmonary resuscitation but died within a few hours of admission. Postmortem studies showed infection by EV-71 with extensive damage to the medulla and pons. We postulate an etiologic link between EV-71 and brainstem encephalomyelitis as the cause of pulmonary edema and death.

Matched MeSH terms: Child, Preschool

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