Displaying publications 561 - 580 of 2815 in total

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  1. Hashim NA, Yusof ZYM, Saub R
    Community Dent Oral Epidemiol, 2019 02;47(1):24-31.
    PMID: 30187941 DOI: 10.1111/cdoe.12417
    OBJECTIVES: To evaluate the sensitivity and responsiveness of the Malay version of Early Childhood Oral Health Impact Scale (Malay-ECOHIS) to dental treatment of early childhood caries (ECC) under general anaesthesia (GA) and determine the minimally important difference (MID) for the Malay-ECOHIS.

    METHODS: A sample of 158 preschool children with ECC awaiting dental treatment under GA was recruited over an 8-month period. Parents self-completed the Malay-ECOHIS before and 4 weeks after their child's dental treatment. At 4 weeks follow-up, parents also responded to a global health transition judgement item. Data were analysed using independent and paired samples t tests, ANOVA and Pearson correlation coefficients.

    RESULTS: The response rate was 87.3%. The final sample comprised 76 male (55.1%) and 62 female (44.9%) preschool children with mean age of 4.5 (SD = 1.0) years. Following treatment, there were significant reductions in mean scores for total Malay-ECOHIS, child impact section (CIS), family impact section (FIS) and all domains, respectively (P child's oral condition to be "a little improved" while 37.7% reported it to be "much improved" following treatment, with Malay-ECOHIS mean change scores of 6.7 (ES = +1.1) and 9.6 (ES = +1.2), respectively. There was an observed gradient in the Malay-ECOHIS change scores and ES in relation to parents' perception of their child's oral health improvement after treatment, supporting the responsiveness of the measure. The Malay-ECOHIS MID was found to be 7 scale points.

    CONCLUSION: The Malay-ECOHIS is empirically shown to be sensitive and responsiveness to dental treatment of ECC under GA.

    Matched MeSH terms: Child, Preschool
  2. Leung AKC, Sergi CM, Lam JM, Leong KF
    World J Pediatr, 2019 Dec;15(6):521-527.
    PMID: 31134587 DOI: 10.1007/s12519-019-00269-9
    BACKGROUND: Gianotti-Crosti syndrome is characterized by an acute onset of a papular or papulovesicular eruption with a symmetrical distribution.

    DATA SOURCES: A PubMed search was conducted using Clinical Queries with the key terms "Gianotti-Crosti syndrome" OR "papular acrodermatitis". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. This paper is based on, but not limited to, the search results.

    RESULTS: The eruption of Gianotti-Crosti syndrome is found predominantly on the cheeks, extensor surfaces of the extremities, and buttocks. There is a sparing of antecubital and popliteal fossae as well as palms, soles, and mucosal surfaces. Although often asymptomatic, the lesions may be mildly to moderately pruritic. Gianotti-Crosti syndrome is most common in children between 1 and 6 years of age. The Epstein-Barr virus and the hepatitis B virus are the most common pathogens associated with Gianotti-Crosti syndrome. No treatment for Gianotti-Crosti syndrome is necessary because it is self-limited. In an era of vaccine hesitancy and refusal, Gianotti-Crosti syndrome may be important to mention to parents, because it can occur and trigger alarmism.

    CONCLUSIONS: Gianotti-Crosti syndrome is mainly a disease of early childhood, characterized by an acute onset of a papular or papulovesicular eruption with a symmetrical distribution. With the advent of more universal vaccination against hepatitis B virus, Epstein-Barr virus has become the most common etiologic agent of Gianotti-Crosti syndrome. Few cases of post-vaccination Gianotti-Crosti syndrome have been reported. Currently, the emphasis should be placed on its self-limiting attribution.

    Matched MeSH terms: Child, Preschool
  3. Ramli R, Mohd Yunus SS
    PMID: 32187977 DOI: 10.3390/ijerph17061922
    The child restraint legislation in Malaysia becomes mandatory from 1 January 2020. Prior to commencement of the rule, a survey showed that only 36% of Malaysian parents were aware of the importance of a child restraint system (CRS) and only 27% usage was reported during travel. The Malaysian Institute of Road Safety report showed that children transported in private vehicles were the leading groups of casualties among children aged 1 to 4 years old (43.8%) and 5 to 9 years old (30.2%), respectively. We performed a narrative review using the PubMed, ScienceDirect and Google Scholar databases using keywords such as child restraint system, unrestrained injuries, Malaysia and epidemiology. The objectives of this review were: (1) to determine the prevalence on the use of CRS in Malaysia, (2) to evaluate the injuries related to unrestrained children and (3) to show the nation's preparation towards implementation of the child restraint law. Six papers on prevalence, one paper on injury and six mainstream newspaper were included in this study. The prevalence of a CRS use was shown between 5% to 41.8%. In relation to injury, the only publication from this country showed that among 19 children involved in a car crash, five (26.3%) children had non-craniomaxillofacial (CMF) injuries, ten (52.6%) with CMF injuries only, two (10.5%) with both CMF and non-CMF injuries and two (10.5%) without any injury. Overall, the Injury Severity Score (ISS) range was between 0 to 13 (median, 1.00; interquartile range, 1). Preparation to comply with the best practice of the child restraint law is still ongoing, especially those addressing the issues related to the low-income parents in the country. Due to scarcity of publication and data on the CRS use and injuries related to its non-usage, it is advocated that parallel with the implementation legislation, vigorous forms of public education as well as good data management must be performed and monitored regularly by the road safety authority in this country.
    Matched MeSH terms: Child, Preschool
  4. Verboon C, Doets AY, Galassi G, Davidson A, Waheed W, Péréon Y, et al.
    Neurology, 2019 07 02;93(1):e59-e76.
    PMID: 31175208 DOI: 10.1212/WNL.0000000000007719
    OBJECTIVE: To define the current treatment practice of Guillain-Barré syndrome (GBS).

    METHODS: The study was based on prospective observational data from the first 1,300 patients included in the International GBS Outcome Study. We described the treatment practice of GBS in general, and for (1) severe forms (unable to walk independently), (2) no recovery after initial treatment, (3) treatment-related fluctuations, (4) mild forms (able to walk independently), and (5) variant forms including Miller Fisher syndrome, taking patient characteristics and hospital type into account.

    RESULTS: We excluded 88 (7%) patients because of missing data, protocol violation, or alternative diagnosis. Patients from Bangladesh (n = 189, 15%) were described separately because 83% were not treated. IV immunoglobulin (IVIg), plasma exchange (PE), or other immunotherapy was provided in 941 (92%) of the remaining 1,023 patients, including patients with severe GBS (724/743, 97%), mild GBS (126/168, 75%), Miller Fisher syndrome (53/70, 76%), and other variants (33/40, 83%). Of 235 (32%) patients who did not improve after their initial treatment, 82 (35%) received a second immune modulatory treatment. A treatment-related fluctuation was observed in 53 (5%) of 1,023 patients, of whom 36 (68%) were re-treated with IVIg or PE.

    CONCLUSIONS: In current practice, patients with mild and variant forms of GBS, or with treatment-related fluctuations and treatment failures, are frequently treated, even in absence of trial data to support this choice. The variability in treatment practice can be explained in part by the lack of evidence and guidelines for effective treatment in these situations.

    Matched MeSH terms: Child, Preschool
  5. Mortell M
    Br J Nurs, 2019 Nov 14;28(20):1292-1298.
    PMID: 31714835 DOI: 10.12968/bjon.2019.28.20.1292
    This article employs a paediatric case study, involving a 3-year-old child who had an anaphylactic reaction that occurred as a result of the multidisciplinary team's failure to identify and acknowledge the patient's documented 'known allergy' status. It examines and reconsiders the ongoing healthcare dilemma of medication errors and recommends that known allergy status should be considered the second medication administration 'right' before the prescribing, transcribing, dispensing and administration of any drug. Identifying and documenting drug allergy status is particularly important when caring for paediatric patients, because they cannot speak for themselves and must rely on their parents, guardians or health professionals as patient advocates. The literature states that medication errors can be prevented by employing a 'rights of medication administration' format, whether that be the familiar '5 rights' or a more detailed list. However, none of these formats specify known allergy status as a distinct 'right'. The medication safety literature is also found wanting in respect of the known allergy status of the patient. When health professionals employ a medication administration rights format prior to prescribing, transcribing, dispensing or administering a medication, the 'known allergy status' of the patient should be a transparent inclusion.
    Matched MeSH terms: Child, Preschool
  6. Haque S, Khamis MF, Alam MK, Ahmad WMAW
    J Craniofac Surg, 2020 May 04.
    PMID: 32371703 DOI: 10.1097/SCS.0000000000006464
    Studies have claimed that the maxillary arch dimension of unilateral cleft lip and palate (UCLP) patient is significantly smaller than normal patient. Multiple factors (both congenital and post natal treatment factors) are believed to have an impact on the treatment outcome (maxillary arch retardation) of UCLP patient. The aim of this study was to evaluate the effects of multiple factors on the treatment outcome by assessing the maxillary arch dimension of UCLP Children. Eighty-five Malaysian UCLP children were taken who received cheiloplasty and palatoplasty. Laser scanned 3D digital models of UCLP subjects were prepared before any orthodontic treatment and bone grafting at 7.69 ± 2.46 (mean± SD) years of age. Intercanine width (ICW), intermolar width (IMW), and arch depth (AD) measurements of maxillary arch were measured with Mimics software. Multiple linear regression analyses were used to evaluate the association between multiple factors (gender, UCLP type, UCLP side, family history of cleft, family history of class III malocclusion, techniques of cheiloplasty, and techniques of palatoplasty) and maxillary arch dimensions (ICW, IMW, and AD). P value was set at 5%. Significant association was found between 2 techniques of cheiloplasty and ICW (P = 0.001) and also between 2 techniques of palatoplasty and ICW (P = 0.046) of maxilla. No significant association observed in IMW and AD in relation to all other factors. Modified Millard techniques of Cheiloplasty and Bardach technique of palatoplasty had unfavorable effect on the treatment outcome by assessing the maxillary arch dimension (ICW) using laser scanned 3D digital models in Malaysian UCLP children.
    Matched MeSH terms: Child, Preschool
  7. Shafie AA, Chhabra IK, Wong JHY, Mohammed NS, Ibrahim HM, Alias H
    Health Qual Life Outcomes, 2020 May 14;18(1):141.
    PMID: 32408899 DOI: 10.1186/s12955-020-01381-5
    BACKGROUND: The treatment of children with transfusion-dependent thalassemia (TDT) in Malaysia has progressed since 2005. This study provides an updated health-related quality of life (HRQoL) assessment for children with the disorder and the factors affecting the HRQoL.

    METHODS: A cross-sectional HRQoL survey of Malaysian children with TDT was conducted using the PedsQL™ 4.0 Generic Core Scales. Patients with non-transfusion dependent thalassemia and other haemoglobinopathies were excluded. Parent-proxy and self-reported HRQoL scores were obtained using a multi-stage convenient sampling. The relationship between HRQoL scores and demographic factors were tested using association, correlation and regression analysis.

    RESULTS: A total of 368 patients were recruited. The mean (SD) Total Summary Score (TSS) was 80.12(13.87). Predictors for a lower TSS was an increasing age group and the use of dual chelating agents (R2 = 0.057, F (4, 359) = 5.40, p = 

    Matched MeSH terms: Child, Preschool
  8. Ahmad SA, Abdul Wahat NH, Zakaria MN, Wiener-Vacher SR, Abdullah NA
    Int J Pediatr Otorhinolaryngol, 2020 Aug;135:110132.
    PMID: 32502914 DOI: 10.1016/j.ijporl.2020.110132
    OBJECTIVE: Vestibular assessments in children are essential for the early identification of vestibular and balance dysfunctions. Vestibular evoked myogenic potentials, cervical (cVEMPs) and ocular (oVEMPs) have been reported to be feasible and effective when assessing otolith function in children. The main aim of the study was to obtain normative data for cVEMPs and oVEMPs from preschool and primary school-aged Malaysian children.

    METHODS: A group of 33 healthy children, aged from 5 years 9 months-12 years 4 months (mean ± SD = 8.83 ± 1.92 years), was recruited. Their otolith saccular function was assessed using 750 Hz tone burst for cVEMPs (with ER3A insert phone), while their utricular function was assessed using Brüel & Kjaer Mini-shaker Type 4810 (Naerum, Denmark) for oVEMPs.

    RESULTS: For cVEMPs, the mean value of P13 latency, N23 latency, P13-N23 interamplitude and asymmetry ratio were 12.62 ± 1.38 ms, 19.85 ± 1.95 ms, 92.47 ± 50.35 μV and 14.03 ± 9.75%, respectively. For oVEMPs, the mean value of N10 latency, P15 latency, N10-P15 interamplitude and asymmetry ratio were 9.23 ± 1.07 ms, 14.41 ± 1.04 ms, 10.32 ± 5.65 μV and 15.84 ± 11.49%, respectively. Two-way ANOVA analysis found that ear laterality and gender had no significant effect on all cVEMPs and oVEMPs parameters. No significant correlation was found between age and all VEMPs parameters.

    CONCLUSIONS: The normative data for cVEMPs and oVEMPs obtained in this study can be used as a guide by health professionals to assess saccular and utricular functions among children age from 5 to 12 years of age.

    Matched MeSH terms: Child, Preschool
  9. Foo LH, Lee YH, Suhaida CY, Hills AP
    BMC Public Health, 2020 Apr 25;20(1):552.
    PMID: 32334561 DOI: 10.1186/s12889-020-08461-7
    BACKGROUND: There is little information about the diet, lifestyle and parental characteristics associated with habitual sugar-sweetened beverage (SSB) consumption in Asian children. The aim of the present study was to assess cross-sectional associations between habitual SSB consumption and preschoolers' diet, physical activity, sedentary behaviour as well as parental and child characteristics in Malaysian preschoolers aged 3 to 6 y.

    METHODS: A total of 590 preschoolers, comprising 317 boys and 273 girls were included. Pre-pilot parental questionnaires were used to assess diet, physical activity (PA) and sedentary behaviour practices and anthropometry was assessed in preschoolers and their parents.

    RESULTS: Multiple logistic regression analyses showed that preschoolers with more frequent weekly intake of snacks [OR 2.7; 95% CI, 1.6-4.4; p Preschoolers with higher daily fruit and vegetable intake had lower SSB intake [OR 0.4; 95% CI, 0.2-0.8; p = 0.011]. A positive association of higher weekly vigorous PA [OR 2.0; 95% CI, 1.1-3.7; p = 0.030] and daily screen-based practices [OR 2.0; 95% CI, 1.2-3.6; p preschoolers. Continued effort is required to encourage healthier beverage choices, as well as healthy diet and active lifestyle practices among children during the critical early years of growth and development.

    Matched MeSH terms: Child, Preschool
  10. Asahar SF, Malek KA, Isa MR
    PMID: 34574788 DOI: 10.3390/ijerph18189861
    Caring for children with autism spectrum disorder (ASD) negatively impacts quality of life (QoL). This cross-sectional study aimed to determine the factors associated with perceived QoL and how problematic a child's autism-specific difficulties are among the main caregivers of children with ASD who attend specialized preschool programs at the National Autism Society of Malaysia and IDEAS Autism Centre located in Selangor and Kuala Lumpur. Utilizing the questions from Parts A and B of the Quality of Life in Autism Questionnaire (QoLA), the data from 116 responders were analyzed using univariate and multivariate linear regression. The mean scores of Part A and Part B were 88.55 ± 17.25 and 56.55 ± 12.35, respectively. The QoL was significantly associated with staying in an apartment/flat -11.37 (95%CI: -19.52, -1.17, p = 0.008), main caregivers attending two training sessions 10.35 (95%CI: 1.17, 19.52, p = 0.028), and more than three training sessions 13.36 (95%CI: 2.01, 24.70, p = 0.022). Main caregiver perceptions of their child's autistic-specific difficulties were significantly associated with not receiving additional help for childcare: no maid -13.54 (95%CI: -24.17, -12.91, p = 0.013); no grandparent -8.65 (95%: -14.33, -2.96, p = 0.003); and main caregivers not having asthma 8.44 (95%CI: 0.02, 16.86, p = 0.049). These identified factors can be considered to inform main caregivers and health care providers on targeted ways to improve the QoL of main caregivers.
    Matched MeSH terms: Child, Preschool
  11. Joginder Singh S, Gan B, Chu SY
    J Dev Behav Pediatr, 2020 10 8;42(2):146-151.
    PMID: 33027107 DOI: 10.1097/DBP.0000000000000873
    OBJECTIVE: Language and symbolic play require the same underlying symbolic ability and develop parallel to one another. The aim of this study was to determine the association between symbolic play and vocabulary in typically developing children and children with Down syndrome in Malaysia.

    METHODS: Twenty-five typically developing children and 25 children with Down syndrome aged between 12 and 36 months were involved in this study. They were recruited from an early intervention center and various kindergartens from the West Coast of Peninsular Malaysia. Their play skills were assessed using the Symbolic Play Test Second Edition, and information about their vocabulary was obtained through the MacArthur Bates Communicative Development Inventories that was filled out by their parents.

    RESULTS: There was a significant difference in the vocabulary and symbolic play scores of children with Down syndrome compared with typically developing children. There was also a positive correlation between symbolic play scores and receptive and expressive vocabulary scores for both groups of children.

    CONCLUSION: When providing intervention, speech-language pathologists need to promote the development of symbolic play in addition to language, given the association between the two. They should also look into introducing an augmentative and alternative communication system to the children who demonstrate age-appropriate symbolic play skills but have trouble with symbolic language production.

    Matched MeSH terms: Child, Preschool
  12. Yang YF, Chong HH, Yang YK
    Med J Malaysia, 2001 Mar;56(1):104-5.
    PMID: 11503288
    Matched MeSH terms: Child, Preschool
  13. Baughan S, Rodd H
    Evid Based Dent, 2022 06;23(2):64-65.
    PMID: 35750730 DOI: 10.1038/s41432-022-0268-5
    Design This was a non-blinded multiple-site randomised controlled clinical trial.Case selection Children, aged 5-6 years, were recruited from 11 government-funded kindergartens (pre-schools) in Selangor, Malaysia. The kindergartens were randomly allocated to either the Intervention Group (n = 185 children) or the Control Group (n = 142 children). A clinical examination was conducted to determine the participants' baseline caries experience. Over a 24-month period (commencing in 2015), the Intervention Group received six -monthly dental home visits (DHVs) to provide the families with oral hygiene and dietary instruction, along with educational leaflets. The Control Group received only the educational leaflets. Caries incidence was measured in terms of both the proportion of children who developed new carious lesions, and the number of primary molars in which new carious lesions were seen at 24 months.Data analysis A chi-squared test was used to compare baseline socioeconomic characteristics as well as the proportion of children in each arm who developed new carious lesions. A t-test was used to compare the mean number of primary molars that developed new caries in each group. In addition, the number needed to treat (NNT) was determined.Results There was a 70% (n = 132) and 71% (n = 100) completion rate for participants in the Intervention and Control Groups, respectively. At 24 months, the key finding was that significantly fewer children in the Intervention Group (14.4%; n = 19) had developed new caries lesions compared to the Control Group (60%; n = 60) (p = 0.001). The NNT was calculated as 2.2, to prevent new caries in one child. After controlling for parental education level and household crowding, children in the Control Group were 8.2 times more likely to develop caries in their primary molars than those in the Intervention Group.Conclusions The authors concluded that in a middle-income country such as Malaysia, six -monthly dental home visits are an effective caries prevention strategy for children aged 5-6 years old from low-income families.
    Matched MeSH terms: Child, Preschool
  14. Bong Y, Shariff AA, Mohamed AM, Merican AF
    Ann Hum Biol, 2015 Mar;42(2):108-15.
    PMID: 24853607 DOI: 10.3109/03014460.2014.912679
    Growth references are useful for the screening, assessment and monitoring of individual children as well as for evaluating various growth promoting interventions that could possibly affect a child in early life.
    Matched MeSH terms: Child, Preschool
  15. Alwi M, Kang LM, Samion H, Latiff HA, Kandavel G, Zambahari R
    Am J Cardiol, 1997 May 15;79(10):1430-2.
    PMID: 9165178 DOI: 10.1016/s0002-9149(97)00160-4
    Two hundred eleven patients with small- to moderate-sized native patent ductus arteriosus underwent closure using Gianturco coils, employing the transvenous multiple catheter approach. Short-term results showed a high rate of complete occlusion and a potential long-term complication of mild left pulmonary artery stenosis in a small number of patients.
    Matched MeSH terms: Child, Preschool
  16. Chear CT, Nallusamy R, Chan KC, Mohd Tap R, Baharin MF, Syed Yahya SNH, et al.
    J Clin Immunol, 2021 08;41(6):1178-1186.
    PMID: 33713249 DOI: 10.1007/s10875-021-01017-3
    X-linked agammaglobulinemia is a rare primary immunodeficiency due to a BTK mutation. The patients are characteristically deficient in peripheral B cells and serum immunoglobulins. While they are susceptible to infections caused by bacteria, enteroviruses, and parasites, fungal infections are uncommon in XLA patients. Here, we report a boy of Malay ethnicity who suffered from recurrent upper respiratory tract infections and severe progressive necrotizing fasciitis caused by Saksenaea erythrospora. Immunological tests showed a B cell deficiency and hypogammaglobulinemia. Whole-exome sequencing identified a dinucleotide deletion (c.1580_1581del) in BTK, confirmed by Sanger sequencing and predicted to be disease causing by in silico functional prediction tools (Varsome and MutationTaster2) but was absent in the gnomAD database. This mutation resulted in a frameshift and premature termination (p.C527fs), which disrupted the protein structure. The mother was heterozygous at the mutation site, confirming her carrier status. Flow cytometric analysis of monocyte BTK expression showed it to be absent in the patient and bimodal in the mother. This study describes a novel BTK mutation in a defined hotspot and an atypical fungal phenotype in XLA. Further studies are required to understand the pathogenesis of fungal infection in XLA.
    Matched MeSH terms: Child, Preschool
  17. Noor Shafina MN, Abdul Rasyid A, Anis Siham ZA, Nor Izwah MK, Jamaluddin M
    Med J Malaysia, 2020 05;75(3):221-225.
    PMID: 32467536
    INTRODUCTION: The trend of childhood obesity is on the rise and hence leading towards the increase in obesity related complications. Early recognition of obesity in children and accurate parental perception of the status of the weight of their children is vital. Furthermore, identification of sociodemographic risk factors contributing to obesity is crucial in order to identify children who are in the risk group and thus prevent potential complications. This study is aimed to establish the parental perception of the status of the weight of their children. Secondly, the study also to identify the sociodemographic risk factors associated with obesity in children.

    METHODS: This was a cross-sectional study involving 245 children from 5 to 12 years of age. Following informed consent, the children were classified into either normal (body mass index (BMI) >5th to <85th percentile), overweight (BMI >85th to <95th percentile) or obese (BMI >95th percentile) groups. Parents responded to questionnaires which assessed their perception and sociodemographic factors.

    RESULTS: A total of 157 participants (64.1%) had normal BMI while 41(16.7%) were overweight and 47(19.2%) were obese. More parents of overweight and obese group had misperceptions of their children's weight status (p=0.001). Families with higher household income, children with higher birth weight, higher education of mothers and family history of obesity and type 2 diabetes had increased risk of higher BMI among their children (p=0.029, p=0.013, p=0.041 and p=0.001 respectively).

    CONCLUSIONS: Most parents of either overweight or obese children had inaccurate perception of the status of weight of their children. Higher household income, birth weight and education level of the mothers as well as history of diabetes and obesity in the family are associated with increased risk of childhood obesity.
    Matched MeSH terms: Child, Preschool
  18. Al-Herz W, Zainal M, Nanda A
    Front Immunol, 2021;12:751469.
    PMID: 34659256 DOI: 10.3389/fimmu.2021.751469
    Background and Objectives: Reports on skin manifestations in inborn errors of immunity (IEI) are based on retrospective analysis, small series, or isolated case reports. The present prospective study aimed to determine the spectrum of skin manifestations in children with IEI and their relevance to specific molecular defects.

    Materials and Methods: The data were obtained from the Kuwait National Primary Immunodeficiency Disorders Registry during the period of 2004-2020.

    Results: A total of 313 pediatric cases of IEI, 71% diagnosed at molecular level, were registered with a cumulative follow-up period of 29,734 months. Skin manifestations were seen in 40.3% of the patients, and they were among the presenting manifestations in 33%. Patients with skin manifestations were older at both onset and diagnosis ages of IEI symptoms, but this was statistically significant for the latter only. The diagnosis delay was significantly longer in patients with skin manifestations. There was a statistically significant association between having skin manifestations and IEI category, being more common in patients with complement deficiencies, combined immunodeficiencies, and diseases of immune dysregulation. There was no statistically significant association between having skin manifestations and both gender and survival. Skin infections were the most frequent manifestations followed by eczema and autoimmune associations. Among IEI with more than 10 cases, skin lesions were a consistent finding in dedicator of cytokinesis 8 (DOCK8) deficiency, hyper IgE syndrome, ataxia-telangiectasia, and recombination activation gene (RAG)1 deficiency.

    Conclusions: Skin manifestations are common in IEI patients, and they had significant diagnosis delay and referral to specialists. Improvement of awareness about IEI is needed among pediatricians and dermatologists.

    Matched MeSH terms: Child, Preschool
  19. Amri MF, Abdullah A, Azmi MI, Mohd Zaki F, Md Pauzi SH
    Malays J Pathol, 2021 Aug;43(2):319-325.
    PMID: 34448796
    BACKGROUND: Ewing sarcoma (ES) is an aggressive tumour which is typically skeletal in origin. ES involving the head and neck region is uncommon and can be easily confused with other small round blue cell tumours. We herein present a rare case of ES involving the sinonasal area.

    CASE PRESENTATION: A 5-year-old Somalian boy with no known medical illness presented with progressive nasal blockage associated with clear nasal discharge and intermittent spontaneous epistaxis for three months. CT paranasal sinus and neck region revealed poorly enhancing expansile mass in the right maxillary sinus with areas of necrosis within. Initial radiological differential diagnoses were lymphoma and rhabdomyosarcoma. The mass was biopsied and histologically showed diffuse sheets of small round blue cells that was positive to CD99, NSE and vimentin. The muscle and lymphoid markers were negative. Fluorescence in-situ hybridisation (FISH) study revealed the presence of EWSR1 gene rearrangement thus diagnosis of ES was rendered.

    CONCLUSIONS: ES of sinonasal tract is a rare entity and its pathological features significantly overlap with others small round blue cells tumour. Demonstration of EWSR1 gene translocation is recommended for the diagnosis of ES particularly at uncommon sites.

    Matched MeSH terms: Child, Preschool
  20. Rahimi R, Omar E, Tuan Soh TS, Mohd Nawi SFA, Md Noor S
    Malays J Pathol, 2017 Aug;39(2):167-170.
    PMID: 28866699 MyJurnal
    BACKGROUND: Hand, foot and mouth disease (HFMD) is caused by enteroviruses such as Coxsackie virus A16 (CVA16) and Enterovirus 71 (EV71). The diagnostic hallmarks are oral ulcers and maculo-papular or vesicular rash on the hands and feet. Severe form of this disease can lead to death due to neurological and cardiopulmonary complications. This case report aims to describe a fatal case of HFMD with minimal oral and skin manifestations.
    CASE REPORT: A four-year-old girl was brought to a hospital after suddenly becoming unresponsive at home. She had a history of fever and lethargy for three days prior to her demise. The patient, and f ive other children in her neighbourhood had been diagnosed to have HFMD at a local health clinic; the other children had recovered without complications.
    RESULTS: Autopsy revealed a few punctate, sub-epidermal vesicles measuring 1 to 2 mm on the palm of her right hand and sole of the right foot, visible only with a magnifying glass. Internal examination revealed prominent nodularity at the oro- and hypopharynxes. The lungs were markedly congested and oedematous. Histopathology of the lung showed marked oedema and haemorrhage with mild pneumonic changes. Oedema with increase in macroglia and astrocytic proliferation were seen in the cerebral tissue, but no lymphocytic infiltration was evident. Enterovirus EV71 was detected by polymerase chain reaction in samples from the lung, cerebrospinal fluid and serum. The cause of death was given as HFMD complicated by pneumonia.
    CONCLUSION: Fatal HFMD may have minimal signs. A complete history, careful physical examination and relevant investigations lead to a diagnosis at post mortem examination. Awareness of the subtle signs and rapid deterioration associated with a fatal case of HFMD is a challenge to clinicians who encounter these cases.
    Matched MeSH terms: Child, Preschool
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