Displaying publications 41 - 60 of 612 in total

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  1. Risk factors for hypoxemia and respiratory failure in respiratory syncytial virus bronchiolitis
    Chan PW, Lok FY, Khatijah SB
    Southeast Asian J. Trop. Med. Public Health, 2002 Dec;33(4):806-10.
    PMID: 12757230
    Respiratory syncytial virus (RSV) bronchiolitis is a common infection in young children and may result in hospitalization. We examined the incidence of, and risk factors associated with, hypoxemia and respiratory failure in 216 children aged < 24 months admitted consecutively for proven RSV bronchiolitis. Hypoxemia was defined as SpO2 < 90% in room air and severe RSV bronchiolitis requiring intubation and ventilation was categorized as respiratory failure. Corrected age at admission was used for premature children (gestation < 37 weeks). Hypoxemia was suffered by 31 (14.3%) children. It was more likely to occur in children who were Malay (OR 2.56, 95%CI 1.05-6.23, p=0.03) or premature (OR 6.72, 95%CI 2.69-16.78, p<0.01). Hypoxemia was also more likely to develop in children with failure to thrive (OR 2.96, 95%CI 1.28-6.82, p<0.01). The seven (3.2%) children who were both premature (OR 11.94, 95%CI 2.50-56.99, p<0.01) and failure to thrive (OR 6.41, 95%CI 1.37-29.87, p=0.02) were more likely to develop respiratory failure. Prematurity was the only significant risk factor for hypoxemia and respiratory failure by logistic regression analysis (OR 1.17, 95%CI 1.06-1.55, p<0.01 and OR 1.14 95%CI 1.02-2.07, p=0.02 respectively). Prematurity was the single most important risk factor for both hypoxemia and respiratory failure in RSV bronchiolitis.
    Matched MeSH terms: Severity of Illness Index
  2. Fulltext Serological evaluation of malaria patients in Thailand: antibody response against electrophoresed antigenic polypeptides of Plasmodium falciparum
    Kano S, Onda T, Matsumoto Y, Buchachart K, Krudsood S, Looareesuwan S, et al.
    Southeast Asian J. Trop. Med. Public Health, 1998 Jun;29(2):341-3.
    PMID: 9886125
    It was reported that a 47kDa antigenic polypeptide of Plasmodium falciparum had been strongly presented by the sera from 1) imported Japanese malaria patients with severe symptoms and 2) symptomatic and parasitemic inhabitants in endemic areas in the Sudan, Malaysia and the Philippines. In the present study, we observed the reactivity of the sera from falciparum malaria patients who had been hospitalized in the Bangkok Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, and compared the antibody response against the 47kDa antigenic polypeptide according to the severity of the patients. It was observed that antibodies to this molecule were more commonly shared in sera from severer patients, although the IFAT titers against the whole P. falciparum parasite antigen were lower in the group, which suggested that this antibody against the 47kDa molecule was playing a specific role at a severe stage of the infection. Determination of the immunological features of the antigenic molecules of parasites by this type of sero-epidemiological study will provide a new assay system for evaluation of immune status of individuals in different severity and suggest a way of vaccine development.
    Matched MeSH terms: Severity of Illness Index
  3. Fulltext Efficacy of single dose albendazole on the prevalence and intensity of infection of soil-transmitted helminths in Orang Asli children in Malaysia
    Norhayati M, Oothuman P, Azizi O, Fatmah MS
    Southeast Asian J. Trop. Med. Public Health, 1997 Sep;28(3):563-9.
    PMID: 9561609
    The efficacy of a single-dose 400 mg albendazole to treat Ascaris, Trichuris and hookworm infection was studied in Orang Asli community. Kato-Katz examination was performed on fecal samples which were collected before treatment, 1 and 4 months after treatment. A total of 123 children were involved in all three surveys. The cure rate of Ascaris infection was 97.4% and the egg reduction after treatment was 99.9%. The cure rate for hookworm infection was 93.1% with 96.6% egg reduction. Although the cure rate was low in Trichuris infection (5.5%), egg reduction was more evident (49.1%). The reinfection rate at 4 months after treatment was 54.5%, 3.6% and 10.3% for Ascaris, Trichuris and hookworm infection, respectively. Within 4 months after treatment almost one-fifth children with Ascaris and hookworm infection reached pre-treatment intensity infection. In Trichuris infection, however more than half of the children reached their pre-treatment intensity infection at 4 months after treatment. Findings suggest that 4-monthly targeted periodic treatment with 400 mg single-dose albendazole in highly endemic areas can have a significant impact on intensity infection of Ascaris and hookworm, but not on Trichuris infection.
    Matched MeSH terms: Severity of Illness Index
  4. Fulltext Renal stones in Kelantan, Malaysia--has the pattern changed?
    Nazmi N, Zainal D, Hashim M
    Southeast Asian J. Trop. Med. Public Health, 1997 Sep;28(3):641-4.
    PMID: 9561623
    Records of 183 patients with renal stones managed at Hospital Universiti Sains Malaysia between 1985 and 1995 were retrospectively evaluated. The commonest symptom was lumbar pain which may be associated with either frequency, blood stained urine or dysuria. One hundred and sixty-one patients (88%) had upper tract stones while the remainder had lower tract stones. Positive urine cultures were seen in 33 patients. The commonest organism isolated was Escherichia coli followed by Klebsiella aeruginosa and Staphylococcus aureus. Almost all of our patients had renal impairment at presentation and 70% of them progressed to chronic renal failure. In contrast to previous findings, the pattern of renal stone in this region is similar to that described in Western society. Its effect on renal function is serious and hence warrant special attention.
    Matched MeSH terms: Severity of Illness Index
  5. Screening proteinuria and hematuria in Malaysian children
    Zainal D, Baba A, Mustaffa BE
    Southeast Asian J. Trop. Med. Public Health, 1995 Dec;26(4):785-8.
    PMID: 9139395
    Screening for proteinuria and hematuria is important in the prevention of chronic renal disease. In Malaysia to date no such attempt has been made to establish the prevalence of proteinuria and hematuria. A total of 45,149 primary school children from three districts in Kelantan were screened for proteinuria and hematuria. They were 23,289 boys and 21,860 girls. The prevalence of abnormal urinary sediments after third screening was 0.17% ie 0.07% were in boys and 0.10% were in girls. The commonest abnormality was proteinuria (0.12%), followed by hematuria (0.03%) and combination of proteinuria and hematuria (0.02%). Hematuria was more commonly seen in girls compared to boys while proteinuria was seen in almost equal proportion in boys and girls. Despite screening large number of children the prevalence of asymptomatic proteinuria and hematuria was far lower than in an earlier reported study. Furthermore the majority had mild abnormalities.
    Matched MeSH terms: Severity of Illness Index
  6. Fulltext Urinary iodine excretion in the northeast of Peninsular Malaysia
    Mafauzy M, Mohamad WB, Anum MY, Musalmah M
    Southeast Asian J. Trop. Med. Public Health, 1995 Mar;26(1):138-42.
    PMID: 8525401
    A total of 2,034 subjects aged 15 years and above from different parts of the State of Kelantan were studied to determine goiter size and urinary iodine excretion. The State was divided into 2 areas - area 1 consisting of localities in the districts near the coast and area 2 consisting of localities in the inland districts. There were 1,050 subjects in area 1 and 984 subjects in areas 2. The mean age (+/- SE) of subjects in areas 1 and 2 were 38.2 + 0.5 and 37.1 +/- 0.5 years, respectively. The prevalence of goiter was 31.4% in area 1 and 45.0% in area 2; the difference was statistically significant (p < 0.05). However, the prevalence of large and visible goiters (grades II and III) was only 2.0% in area 1 and 3.3% in area 2; the difference was not statistically significant. The mean (+/- SD) urinary iodine excretion in areas 1 and 2 was 57.1 +/- 2.1 and 56.8 +/- 2.1 micrograms I/g Cr, respectively. The values were below those recommended by WHO. There was no significant difference in urinary iodine excretion between those with and without goiters in both areas and also between the grades of goiters. There were significantly more females with goiters than males in both areas but there was no significant difference in the urinary iodine excretion between the 2 sexes. Thus based on urinary iodine excretion, the iodine intake of the population in this area, was suboptimal and this was associated with a high prevalence of goiter.
    Matched MeSH terms: Severity of Illness Index
  7. Fulltext The effect of repeated chemotherapy on the prevalence and intensity of Ascaris lumbricoides and Trichuris trichiura infection
    Chan L, Kan SP, Bundy DA
    Southeast Asian J. Trop. Med. Public Health, 1992 Jun;23(2):228-34.
    PMID: 1439974
    The prevalence and intensity of intestinal nematode infections were assessed during 3 anthelminthic interventions in an urban community in Malaysia. The prevalence levels of Ascaris lumbricoides at Interventions 1, 2 and 3 were 30.6%, 18.9% and 15.5%, respectively and the mean intensities were 1.9, 0.75 and 0.81 worms per person. For Trichuris trichiura, the prevalence levels at Interventions 1, 2 and 3 were 46.9%, 21.6% and 15.7%, respectively. The mean intensities for T. trichiura at Interventions 1, 2 and 3 were 3.30, 0.92 and 0.07 worms per person. No gender-related prevalence and intensity were observed for the two geohelminths in this community. Prevalences and intensity had convex age profiles. Although repeated chemotherapeutic intervention reduced both prevalence and intensity levels, intensity was a more sensitive indicator than prevalence. The results indicate that age-targetting treatment at school children of 7-12 years of age would be an appropriate strategy for this community.
    Matched MeSH terms: Severity of Illness Index
  8. Fulltext Fulminant hepatitis in dengue infection
    Lum LC, Lam SK, George R, Devi S
    Southeast Asian J. Trop. Med. Public Health, 1993 Sep;24(3):467-71.
    PMID: 8160054
    Eight cases of liver failure and encephalopathy were observed among twenty cases of grade 3 and grade 4 dengue hemorrhagic fever/dengue shock syndrome admitted to the Department of Pediatrics, University Hospital, Kuala Lumpur from January 1990 to December 1991. All patients with deterioriation in mental status showed a marked increase in liver enzymes (aspartate and alanine aminotransaminases) and severe coagulopathy. Six patients needed cerebral protection, including ventilation, intravenous sedation and muscle relaxants. There was one death during the period of study and one case of residual hemiparesis in a boy who had, in addition, intracerebral hemorrhage. All other survivors had complete recovery of liver and neurological function.
    Matched MeSH terms: Severity of Illness Index
  9. Characteristics of HIV-infected tuberculosis patients in Kota Bharu Hospital, Kelantan from 1998 to 2001
    Mohammad Z, Naing NN
    Southeast Asian J. Trop. Med. Public Health, 2004 Mar;35(1):140-3.
    PMID: 15272757
    To characterize the demographic profiles, clinical features, radiological patterns and outcomes of treatment of HIV-infected TB patients, a descriptive study was carried out on 149 HIV-infected TB cases diagnosed from 1998 through 2001 at Kota Bharu Hospital, Kelantan, Malaysia. The majority of the patients were males (94.6%), single (45.0%), ethnic Malay (94.0%) with a mean age of 34 years (standard deviation 7.8, range 18-76). The most common HIV transmission category was through injecting drug use (73.8%) and being the inmates or former inhabitants of drug rehabilitation centers and prisons were the commonest high-risk groups. One hundred and seventeen patients were diagnosed as having pulmonary TB, while about 20% were extra-pulmonary in type with 9 cases of milliary TB. The majority (45%) presented with cough symptoms while only 51% had a positive sputum smear. Fifty-five percent were found to have pulmonary lesions on chest x-ray, such as localized, milliary or diffuse pulmonary infiltrates, or opacities. Eight (5.4%) had pleural lesions while another 8 cases had hilar or mediastinal lymph node lesions. Overall, fifty-eight (38.9%) patients had died by the completion of data collection. The median weeks or survival from the time of starting TB treatment was 13.5 (range 1-56) and the majority of them (74%) died without completing the 6-month regime of treatment.
    Matched MeSH terms: Severity of Illness Index
  10. Fulltext Review on human toxoplasmosis in Malaysia: the past, present and prospective future
    Nissapatorn V, Abdullah KA
    Southeast Asian J. Trop. Med. Public Health, 2004 Mar;35(1):24-30.
    PMID: 15272740
    We reviewed various studies regarding human toxoplasmosis in Malaysia. They showed a varying prevalence of specific Toxoplasma antibodies among the Malaysian population. The Malays have shown the highest seroprevalence of toxoplasmosis, by most studies, when compared to other races. Demographic profiles have shown that Toxoplasma seropositivity is higher in males than females, lower in people with higher incomes, higher in the unemployed and tends to increase with age. In general, the route of transmission, such as contact with a cat, consumption of undercooked meat and blood transfusion were shown to have no significant association with Toxoplasma seropositivity (p > 0.05). The immune status (CD4 cell count < 200 cell/mm3) was strongly associated with toxoplasmic encephalitis (p < 0.05).
    Matched MeSH terms: Severity of Illness Index
  11. Inhibition of the Interleukin-36 Pathway for the Treatment of Generalized Pustular Psoriasis
    Bachelez H, Choon SE, Marrakchi S, Burden AD, Tsai TF, Morita A, et al.
    N Engl J Med, 2019 03 07;380(10):981-983.
    PMID: 30855749 DOI: 10.1056/NEJMc1811317
    Matched MeSH terms: Severity of Illness Index
  12. Trial of Spesolimab for Generalized Pustular Psoriasis
    Bachelez H, Choon SE, Marrakchi S, Burden AD, Tsai TF, Morita A, et al.
    N Engl J Med, 2021 12 23;385(26):2431-2440.
    PMID: 34936739 DOI: 10.1056/NEJMoa2111563
    BACKGROUND: Generalized pustular psoriasis (GPP) is a rare, life-threatening, inflammatory skin disease characterized by widespread eruption of sterile pustules. Interleukin-36 signaling is involved in the pathogenesis of this disorder. Spesolimab, a humanized anti-interleukin-36 receptor monoclonal antibody, is being studied for the treatment of GPP flares.

    METHODS: In a phase 2 trial, we randomly assigned patients with a GPP flare in a 2:1 ratio to receive a single 900-mg intravenous dose of spesolimab or placebo. Patients in both groups could receive an open-label dose of spesolimab on day 8, an open-label dose of spesolimab as a rescue medication after day 8, or both and were followed to week 12. The primary end point was a Generalized Pustular Psoriasis Physician Global Assessment (GPPGA) pustulation subscore of 0 (range, 0 [no visible pustules] to 4 [severe pustulation]) at the end of week 1. The key secondary end point was a GPPGA total score of 0 or 1 (clear or almost clear skin) at the end of week 1; scores range from 0 to 4, with higher scores indicating greater disease severity.

    RESULTS: A total of 53 patients were enrolled: 35 were assigned to receive spesolimab and 18 to receive placebo. At baseline, 46% of the patients in the spesolimab group and 39% of those in the placebo group had a GPPGA pustulation subscore of 3, and 37% and 33%, respectively, had a pustulation subscore of 4. At the end of week 1, a total of 19 of 35 patients (54%) in the spesolimab group had a pustulation subscore of 0, as compared with 1 of 18 patients (6%) in the placebo group (difference, 49 percentage points; 95% confidence interval [CI], 21 to 67; P<0.001). A total of 15 of 35 patients (43%) had a GPPGA total score of 0 or 1, as compared with 2 of 18 patients (11%) in the placebo group (difference, 32 percentage points; 95% CI, 2 to 53; P = 0.02). Drug reactions were reported in 2 patients who received spesolimab, in 1 of them concurrently with a drug-induced hepatic injury. Among patients assigned to the spesolimab group, infections occurred in 6 of 35 (17%) through the first week; among patients who received spesolimab at any time in the trial, infections had occurred in 24 of 51 (47%) at week 12. Antidrug antibodies were detected in 23 of 50 patients (46%) who received at least one dose of spesolimab.

    CONCLUSIONS: In a phase 2 randomized trial involving patients with GPP, the interleukin-36 receptor inhibitor spesolimab resulted in a higher incidence of lesion clearance at 1 week than placebo but was associated with infections and systemic drug reactions. Longer and larger trials are warranted to determine the effect and risks of spesolimab in patients with pustular psoriasis. (Funded by Boehringer Ingelheim; Effisayil 1 ClinicalTrials.gov number, NCT03782792.).

    Matched MeSH terms: Severity of Illness Index
  13. Fulltext Clinical use of Malay Version of Vertigo Symptom Scale (MWSS) in patients with peripheral vestibular disorder (PVD)
    Zainun Z, Zakaria MN, Sidek D, Ismail Z
    Med J Malaysia, 2012 Aug;67(4):386-9.
    PMID: 23082446
    The Vertigo symptom scale (VSS) is a well established tool for the evaluation of vestibular disorders and the associated symptoms of autonomic arousal and somatosensation. By using a validated Malay version of vertigo symptom scale (MVVSS) questionnaire, the severity of the vertigo from patients' perspective can be determined and rated. Before MVVSS can be applied clinically among Malaysians, it was of interest to determine its clinical value in identifying vestibular disorders.
    Matched MeSH terms: Severity of Illness Index
  14. Fulltext Paediatric airway reconstruction: a preliminary study
    Amin Z, Suzina SA
    Med J Malaysia, 2008 Dec;63(5):369-72.
    PMID: 19803292 MyJurnal
    To set the foundation for developing a centre for airway reconstruction, we performed a retrospective database review of patients operated at a tertiary-care university hospital. Over the past 3-year period from 2004 onwards, five paediatric cases of airway reconstruction procedures were performed. All cases had a two stages laryngotracheal reconstruction (TSLTR) for laryngotracheal stenosis (LTS). All patients were children below 15 years and the mean age was 9 years. Only one patient had a Grade IV Myer-Cotton stenosis, the rest all had Grade III stenosis. Three out of four of the Grade III stenosis patients were successfully decannulated within one year, the other one died of causes unrelated to LTS. The grade IV patient was still under followup and surgery was done only recently. This paper highlights the complexity of managing LTS in the paediatric age group and recommends the use of LTR with rib graft as a choice for the management of LTS.
    Matched MeSH terms: Severity of Illness Index
  15. Fulltext Pilot study on depression among secondary school students in Selangor
    Adlina S, Suthahar A, Ramli M, Edariah AB, Soe SA, Mohd Ariff F, et al.
    Med J Malaysia, 2007 Aug;62(3):218-22.
    PMID: 18246911 MyJurnal
    A cross sectional descriptive study of 2048 subjects was conducted to determine the prevalence of depression and factors influencing depression among students in secondary school from urban and rural areas in the state of Selangor, Malaysia. The children's depression inventory (CDI) developed by Maria Kovacs was used in this study. Students who participated in this study come from two urban schools and three rural schools. It was found that in the yield for scores for five factors were 9.2% have negative mood, 5% have interpersonal problems, 8.3% have ineffectiveness, 9.8% have anhedonia and 10.6% have negative self esteem. Following the interpretive guidelines for the T-scores, it was found that 10.3% of the students were much above average in the depression scale. This study also found that: 1% of students were smoking, 1.6% of students were gum sniffling, 0.9% took drugs, 4.1% took alcohol and 9.9% took things from other people. Females were more depressed than males. The Chinese students were more depressed compared to Indian students. Students whose parents had no formal education or had only primary education were more depressed than students whose parents had secondary, college or university education. Depression increased with increasing number of siblings. Depression contributed to the habit of drug abuse, gum sniffing and stealing but not to smoking and alcohol abuse. Suicidal tendencies were more likely among the depressed students. It is imperative that not only caregivers but also teachers have to be equipped with the knowledge, attitude and skills to assist secondary school children cope with their emotions, handle conflicts and manage stress early so that a more productive society will develop in the future.
    Matched MeSH terms: Severity of Illness Index
  16. Fulltext Outcome of moderate to severe malnutrition following persistent diarrhoea--a hospital-based retrospective study
    Lee WS, Gan CS, Chai PF, Harun F
    Med J Malaysia, 2008 Aug;63(3):229-36.
    PMID: 19248696
    We aimed to determine the outcome of nutritional intervention in children with moderate to severe malnutrition following persistent diarrhoea (PD), referred to a tertiary referral unit in Malaysia. Thirty-one (44%) of the 71 children (median age 19 months) with PD had moderate to severe malnutrition on admission. Fifty-three (75%) required dietary modification and 15 (21%) needed parenteral nutrition (PN, median duration 96 days). Of the 70 patients in whom remission of diarrhoea could be ascertained, 64 (91%) achieved remission. Three required home PN. At three months after discharge, there was a significant improvement in the mean weight-for-height z-score as compared to the original score at initial presentation (from -1.83 +/- -1.77 to -0.80 +/- -1.17; p < 0.001), although 12 (22%) of the 55 patients in whom nutritional status could be ascertained still had moderate to severe malnutrition. In conclusion, moderate to severe malnutrition was a common complication following PD resulting from diverse causes. With appropriate therapy, remission can be achieved in majority of patients, although a small number of patients needed home PN because of persistence of diarrhoea.
    Matched MeSH terms: Severity of Illness Index
  17. Fulltext Admission to hospital with childhood acute gastroenteritis in Kuala Lumpur, Malaysia
    Izzuddin Poo M, Lee WS
    Med J Malaysia, 2007 Aug;62(3):189-93.
    PMID: 18246904 MyJurnal
    Mortality from acute diarrhoea in developed countries is low, but the morbidity and financial cost remains significant. A one-year prospective, descriptive, non-interventional, hospital-based study of acute gastroenteritis (AGE) was conducted in the year 2002 in the paediatric unit of University of Malaya Medical Centre, Kuala Lumpur, an urban hospital in Malaysia, to determine its morbidity and management. During the study period, 393 children with AGE were admitted, utilizing 0.50% of total patient-bed-day of the hospital. The median duration of symptoms before admission was two days. Seventy-seven percent of patients had consulted family physicians before admission. Antidiarrhoeal drugs (57%) and anti-emetics (48%) were commonly prescribed, but oral rehydrating solution (36%) was rarely advised. Upon admission, severe vomiting (24%) and severe diarrhea (24%) were not common, while 17% had moderate or severe dehydration. Rotavirus (22%) was the commonest pathogen identified. Electrolyte derangement, secondary septicaemia and chronic diarrhoea were all rare. Eighty-nine percent of patients received intravenous fluid therapy whilst in the hospital. No death was noted. The morbidity and mortality of children with AGE requiring hospital care in this study was low. However, preadmission management and fluid therapy after admission was not ideal. Efforts to encourage better adherence to established management protocol of AGE among family physicians and hospital clinicians should be instituted.
    Matched MeSH terms: Severity of Illness Index
  18. Fulltext Pain management: trends and challenges
    Cardosa MS
    Med J Malaysia, 2006 Jun;61(2):139-41.
    PMID: 16898301
    Pain remains as one of the most common reasons for visits to a doctor. The paper by Zalinawati et all published in this issue of the Journal confirmed this in two primary care settings, showing that a complaint of pain was recorded in almost a third of patients, similar to the prevalence reported in European studies.
    Matched MeSH terms: Severity of Illness Index
  19. Fulltext Blood pressure variability and arterial elasticity in hypertensive subjects
    Rafidah HM, Azizi A, Noriah MN
    Med J Malaysia, 2006 Jun;61(2):189-98.
    PMID: 16898310 MyJurnal
    Apart from the mean 24 hour ambulatory blood pressure (ABP), the blood pressure variability (BPV) also bears an independent relationship with target-organ damage in hypertension. A reduction in arterial compliance has been demonstrated in hypertension but its relation to BPV is still unknown. The aim of the study is to compare BPV and arterial compliance between hypertensive and normotensive subjects. Eighteen hypertensives and 18 controls were enrolled. Noninvasive 24-hour ABP monitoring was performed with BR-102 monitor (Schiller Inc. Germany). Arterial compliance was determined by the HDI/Pulsewave Research Cardiovascular Profiling Instrument (Hypertension Diagnostic Inc. USA). There were significantly higher systolic, diastolic and mean arterial BPV in hypertensives as compared to normotensive group. Only systolic BPV remained significantly high in hypertensives during night time. There were lower arterial compliances in hypertensive as compared to normotensive group. No significant relationship however was found between BPV and arterial compliance in hypertensive subjects. In conclusion, there were higher BPV and lower arterial compliances in hypertensive subjects as compared to normotensive subjects.
    Matched MeSH terms: Severity of Illness Index
  20. Fulltext Malignant myeloid transformation in a child with severe congenital neutropenia (Kostmann's syndrome)
    Chong LA, Josephine P, Ariffin H
    Med J Malaysia, 2006 Jun;61(2):236-8.
    PMID: 16898320 MyJurnal
    We report a case of a child with severe congenital neutropenia (Kostmann's syndrome) who was treated with daily prophylactic subcutaneous granulocyte colony-stimulating factor (G-CSF) from the age of eight to sixteen years before being discontinued for poor haematological and clinical response. She did not have a HLA-matched sibling to enable bone marrow transplantation. She subsequently developed acute megakaryoblastic leukemia at the age of 17 years and succumbed during induction chemotherapy. The role of G-CSF in the pathogenesis of her malignant transformation to AML is complicated as this disorder has a propensity for myelodysplasia or AML as part of its natural history.
    Matched MeSH terms: Severity of Illness Index
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