MyMedR

Fulltext Induction of apoptosis in neurogenic pulmonary edema

Abu Bakar S, Shafee N, Chee HY

Med J Malaysia, 1999 Sep;54(3):402-3.

PMID: 11045072

Matched MeSH terms: Child, Preschool

Fulltext The results of treatment of dislocation and fracture--dislocation of the elbow--a review of 41 patients

Azmi I, Razak M, Hyzan Y

Med J Malaysia, 1998 Sep;53 Suppl A:59-70.

PMID: 10968184

Forty-one patients with 42 elbow dislocations, of which 13 had acute simple dislocations, 21 had fracture-dislocations and 8 had neglected elbow dislocations, were evaluated with regard to limitation of motion, pain, instability and residual neurovascular deficit. All patients with acute simple dislocation were treated with closed reduction, but the duration of immobilization before commencement of active motion varied. Open-reduction was indicated for failed closed reduction and neglected-dislocations. Internal fixation as a primary procedure was only performed for displaced fracture-dislocation. Excision of radial head or tricepsplasty were performed if the reduction was impossible in neglected elbow dislocation. Despite a good results in acute simple dislocation, 33.07% had flexion contracture of between 5 to 30 degrees. In fracture dislocation, satisfactory results were seen in whom the elbow was immobilized for three weeks or less. Neglected-dislocation is associated with poor functional outcome, 37.5% were good and 62.5% were poor. Prolonged immobilization after injury was strongly associated with an unsatisfactory result. The results indicate that early properly supervised active motion is a key factor in the rehabilitation of elbow dislocation.

Matched MeSH terms: Child, Preschool

Fulltext Displaced supracondylar fracture of humerus in children--comparative study of the result of closed and open reduction

Yusof A, Razak M, Lim A

Med J Malaysia, 1998 Sep;53 Suppl A:52-8.

PMID: 10968183

The displaced supracondylar fracture of the humerus in children (Gartland type 3) is a most challenging injury to treat. There is controversy regarding the initial treatment either closed manipulation and splint immobilization or open reduction and internal fixation. This is a retrospective study comparing two groups of patients with displaced supracondylar fracture of the humerus (Gattland 3) treated in the Orthopaedic Unit, Universiti Kebangsaan Malaysia. The first group, 13 patients treated with closed reduction and splint immobilization and a second group, 15 patients treated with open reduction and internal fixation as initial definitive treatment. The results showed a high failure rate of closed reduction and splint immobilization. This was due to difficulty in reduction, loss of reduction post operatively or during follow-up. Open reduction and internal fixation was more advantages with reduced hospitalization time, fewer complications, more stable fixation and better anatomical reduction with minimal complications for type 3 supracondylar fracture of humerus. We would recommend that all Gartland 3 supracondylar fracture of the humerus be treated with open reduction and two K-wire fixation.

Matched MeSH terms: Child, Preschool

Fulltext A review of haematogenous osteomyelitis in children in Kuala Lumpur Hospital

Razak M, Ismail MM, Omar A

Med J Malaysia, 1998 Sep;53 Suppl A:83-5.

PMID: 10968187

We review 81 cases of acute haematogenous osteomyelitis from 1983 to 1990 to establish current pattern of clinical presentation, modes of treatment and success of therapy. Majority of the patient (70%) presented within a week of symptom and significant number of them came with fever and swelling of the affected limb. Sedimentation rate was found to be raised in all of them. Fifty-four (55%) of them were treated surgically. The average antibiotic time was one week by intravenous administration followed by additional oral therapy for period up to four weeks. Average follow-up was 9 months. Six of them (7.5%) end up with various complication which was believed to be due to delay in getting medical treatment.

Matched MeSH terms: Child, Preschool

Fulltext Closed tibia fracture. "The effect of an intact fibula and the location of tibia fracture on fracture union"

Ibrahim MM, Mohd R, Ruslan R

Med J Malaysia, 1998 Sep;53 Suppl A:27-34.

PMID: 10968180

Tibial fractures are common and complications occur more frequently than any other long bone fractures. The effect of fibula and location of fracture on union of Tibia fracture remain controversial. A retrospective study of unilateral closed tibial shaft fractures without any associated injury was done. From 1988 to 1992, 74 out of 103 patients were available for the study. There were 60 males and 14 females with the age ranges from 3 to 75 years with an average of 29.7 years. The differences of fractures healing were analyses with respect to the status of the fibula and the location of the tibial fracture. This study concludes that the location of the fracture and the status of the fibula have no significant influence on healing (p > 0.05).

Matched MeSH terms: Child, Preschool

Extraocular retinoblastoma

Menon BS, Reddy SC, Maziah WM, Ham A, Rosline H

Med. Pediatr. Oncol., 2000 Jul;35(1):75-6.

PMID: 10881012

Matched MeSH terms: Child, Preschool

Hepatitis A shifting epidemiology in South-East Asia and China

Barzaga BN

Vaccine, 2000 Feb 18;18 Suppl 1:S61-4.

PMID: 10683551

A review of the epidemiology of hepatitis A virus (HAV) infection over the last 20 years shows shifting patterns in the prevalence of antibodies to HAV (anti-HAV) throughout South-East Asia and China. A number of countries have shifted from high to moderate and from moderate to low endemicity, with a corresponding increase in the age of exposure from childhood to early adulthood. The changes have resulted from improvements in hygiene, sanitation and the quality of drinking water, reflecting improvements in living standards and socioeconomic progress. In general in the late 1970s and early 1980s, 85-95% of the population of developing countries like the Philippines, Korea, China and Thailand were anti-HAV-positive by age 10-15 years, compared with only about 50% in the more affluent countries like Malaysia and Singapore. In the early 1990s, 85-95% of the population were immune by age 30-40 years in the Philippines, Korea, China and Thailand, and by 50 years of age and above in Malaysia and Singapore. Similar trends were noted in Hong Kong, Taiwan and Japan. Exposure to HAV at a later age may be associated with an increase in hepatitis A morbidity and a greater propensity for outbreaks.

Matched MeSH terms: Child, Preschool

Intestinal parasites in Malaysian children with cancer

Menon BS, Abdullah MS, Mahamud F, Singh B

J Trop Pediatr, 1999 Aug;45(4):241-2.

PMID: 10467838

In this prospective study, we examined stool specimens from children with cancer receiving chemotherapy who were admitted for fever to the Universiti Sains Malaysia Hospital in Kota Baru, Kelantan. Stool specimens were examined for ova and cysts of parasites. Over a period of 15 months, there were 129 febrile episodes in 50 children with cancer and, in all, 237 stool specimens were examined. Sixty-six per cent of febrile episodes were associated with neutropenia and 9 per cent were associated with diarrhoea. Stool parasites were found in 42 per cent of children. The most common were helminths, followed by protozoa. Trichuris trichiura was the most common parasite (24 per cent), followed by Ascaris lumbricoides (22 per cent). Hookworm was found in 2 per cent. Giardia lamblia was found in 6 per cent of children, Blastocystis hominis in 4 per cent, and Cryptosporidium parvum in 2 per cent.

Matched MeSH terms: Child, Preschool

Drug and chemical poisoning admissions at a teaching hospital in Malaysia

Ab Rahman AF

Hum Exp Toxicol, 2002 Jul;21(7):377-81.

PMID: 12269700

A retrospective review of medical records was carried out to determine the pattern of drug and chemical poisoning cases admitted to a teaching hospital in Malaysia. Medical records of patients admitted during the period January 1987 to December 1995 were reviewed. They accounted for 0.2% of total admissions during the period. While all ages were represented, there was predominance of children, which showed little change throughout the nine-year period. Of all cases of poisoning, 77.8% were unintentional, 12.6% intentional and 9.6% were undetermined. Kerosene, pesticides and medicinal substances remained the common agents associated with poisoning. A significant number of patients sought treatment elsewhere before being admitted to the hospital. Of those who came directly to the hospital, many were presented late in the course of their poisoning. Only seven patients died and none were children. This study supports the need for greater emphasis on prevention of poisoning in children and among farmers in the state.

Matched MeSH terms: Child, Preschool

Audit and cost of treatment modalities provided for respiratory syncytial virus bronchiolitis in a Malaysian teaching hospital

Chan PW

J Paediatr Child Health, 2002 Feb;38(1):104.

PMID: 11869413

Matched MeSH terms: Child, Preschool

Early epileptic encephalopathies including West syndrome: a 3-year retrospective study from Klang Hospital, Malaysia

Thambyayah M

Brain Dev, 2001 Nov;23(7):603-4.

PMID: 11701263

It is difficult to give a country report from Malaysia. A study done in 1999 reported the incidence of West Syndrome to be 3% among newly diagnosed cases of epilepsy. In this 3 year retrospective hospital-based study (1997-1999), the prevalence of early epileptic encephalopathy (EEE) and West Syndrome were 4.1 and 2.5% respectively. There is difficulty classifying EEE cases into distinct sub-groups of EIEE (early infantile epileptic encephalopathy), WS (West Syndrome) and SMEI (severe myoclonic epilepsy of infancy), using a combination of clinical features, EEG and CT/MRI findings.

Matched MeSH terms: Child, Preschool

Parental awareness of side effects associated with the use of inhaled corticosteroids in Malaysian asthmatic children

Chan PW

J Paediatr Child Health, 2000 Oct;36(5):522.

PMID: 11036818

Matched MeSH terms: Child, Preschool

Paediatric intensive care in Kuala Lumpur, Malaysia: a developing subspecialty

Goh AY, Lum LC, Chan PW

J Trop Pediatr, 1999 Dec;45(6):362-4.

PMID: 10667007

Paediatric intensive care in Malaysia is a developing subspecialty with an increasing number of specialists with a paediatric background being involved in the care of critically ill children. A part prospective and part retrospective review of 118 consecutive non-neonatal ventilated patients in University Hospital, Kuala Lumpur was carried out from 1 June 1995 to 31 December 1996 to study the clinical epidemiology and outcome in our paediatric intensive case unit (PICU). The mean age of the patients was 33.9 +/- 6.0 months (median 16 months). The main mode of admission was emergency (96.6 per cent) with an overall mortality rate of 42 per cent (50/118). The mean paediatric risk of mortality (PRISM) score was 20 +/- 0.98 SEM, with 53 per cent of patients having a score of over 30 per cent. Multiorgan dysfunction (MODS) was identified in 71 per cent of patients. Admission efficiency (mortality risk > 1 per cent) was 97 per cent. Standardized mortality rate using PRISM was an acceptable 1.06. The main diagnostic categories were respiratory (32 per cent), neurology (22 per cent), haematology-oncology (18 per cent); the aetiology of dysfunction was mainly infective. Non-survivors were older (29.5 vs. 13.8 months, p < 0.0001), had more severe illness (mean PRISM score 30 vs. 14, p < 0.0001), were more likely to develop MODS (96 vs. 53 per cent, p < 0.0001) and required more intervention and monitoring. Paediatric intensive care in Malaysia differs widely from that in developed countries in patient characteristics, severity of illness, and care modalities provided.

Matched MeSH terms: Child, Preschool

Hepatitis B epidemiology in Asia, the Middle East and Africa

André F

Vaccine, 2000 Feb 18;18 Suppl 1:S20-2.

PMID: 10683538

Asia and Africa have previously been classified as areas of high endemicity for hepatitis B virus (HBV), but in some countries highly effective vaccination programmes have shifted this pattern towards intermediate or low endemicity. Thus, China is now the only country in Asia where HBV endemicity is high. Countries with intermediate endemicity include India, Korea, the Philippines, Taiwan and Thailand, and those with low endemicity include Japan, Pakistan, Bangladesh, Singapore, Sri Lanka and Malaysia. Most countries in Africa have high HBV endemicity, with the exceptions of Tunisia and Morocco, which have intermediate endemicity. Zambia has borderline intermediate/high endemicity. In the Middle East, Bahrain, Iran, Israel and Kuwait are areas of low endemicity, Cyprus, Iraq and the United Arab Emirates have intermediate endemicity, and Egypt, Jordan, Oman, Palestine, Yemen and Saudi Arabia have high endemicity. All of these Middle East countries reach a large proportion of their population with hepatitis B vaccination, which is reducing the infection rate, particularly in Saudi Arabia. The vaccination programme in Taiwan has also greatly reduced the HBV infection rate. Future vaccination programmes must take into account the mode of transmission of HBV, the healthcare infrastructure to deliver vaccination, and the socioeconomic and political factors in each individual country, to determine the most cost-effective way of infection control.

Matched MeSH terms: Child, Preschool

Fixed drug eruption associated with co-trimoxazole

Mohamed KB

J Pediatr, 1999 Sep;135(3):396.

PMID: 10484812

Matched MeSH terms: Child, Preschool

Withdrawal and limitation of life support in paediatric intensive care

Goh AY, Lum LC, Chan PW, Bakar F, Chong BO

Arch Dis Child, 1999 May;80(5):424-8.

PMID: 10208946

OBJECTIVES: To compare the modes of death and factors leading to withdrawal or limitation of life support in a paediatric intensive care unit (PICU) in a developing country.

METHODS: Retrospective analysis of all children (< 12 years) dying in the PICU from January 1995 to December 1995 and January 1997 to June 1998 (n = 148).

RESULTS: The main mode of death was by limitation of treatment in 68 of 148 patients, failure of active treatment including cardiopulmonary resuscitation in 61, brain death in 12, and withdrawal of life support with removal of endotracheal tube in seven. There was no significant variation in the proportion of limitation of treatment, failure of active treatment, and brain death between the two periods; however, there was an increase in withdrawal of life support from 0% in 1995 to 8% in 1997-98. Justification for limitation was based predominantly on expectation of imminent death (71 of 75). Ethnic variability was noted among the 14 of 21 patients who refused withdrawal. Discussions for care restrictions were initiated almost exclusively by paediatricians (70 of 75). Diagnostic uncertainty (36% v 4.6%) and presentation as an acute illness were associated with the use of active treatment.

CONCLUSIONS: Limitation of treatment is the most common mode of death in a developing country's PICU and active withdrawal is still not widely practised. Paediatricians in developing countries are becoming more proactive in managing death and dying but have to consider sociocultural and religious factors when making such decisions.

Matched MeSH terms: Child, Preschool

Bochdalek diaphragmatic hernia presenting with acute gastric dilatation

Quah BS, Hashim I, Simpson H

J Pediatr Surg, 1999 Mar;34(3):512-4.

PMID: 10211672

Congenital diaphragmatic hernia through the foramen of Bochdalek may present after infancy. A 21/2-year-old Malay girl presented with acute respiratory distress. Chest examination showed reduced chest expansion and decreased breath sounds on the left side. Chest radiograph showed a large "cyst" in the left chest, which was thought to be a lung cyst under tension. Tube thoracostomy resulted in clinical improvement. Results of a barium study showed that the cyst perforated by the thoracostomy tube was the stomach, which had herniated through a Bochdalek diaphragmatic defect. Surgical repair of the diaphragmatic defect and closure of the perforated stomach was performed successfully. Congenital diaphragmatic hernia should be included in the differential diagnosis of respiratory distress in young children. Nasogastric tube placement must be considered as an early diagnostic or therapeutic intervention when the diagnosis is suspected.

Matched MeSH terms: Child, Preschool

Asthma control in the Asia-Pacific region: the Asthma Insights and Reality in Asia-Pacific Study

Lai CK, De Guia TS, Kim YY, Kuo SH, Mukhopadhyay A, Soriano JB, et al.

J Allergy Clin Immunol, 2003 Feb;111(2):263-8.

PMID: 12589343

Few data on asthma management are available for the Asia-Pacific region.

Matched MeSH terms: Child, Preschool

Spermatic cord metastasis from a medulloblastoma

Thambi dorai CR, Azmi A, Rahman AJ, Subathra S, Hayati AR, Zulfiqar A

Pediatr Surg Int, 2001 Nov;17(8):654-6.

PMID: 11727063

A 4-year-old boy presented with metastases in the spermatic cord and ribs 2 years after treatment for a primary medulloblastoma (MB). The testis was free of tumor. A MB presenting with a metastasis to the spermatic cord has not been reported to date. The role of a ventriculo-peritoneal shunt in promoting such spread should be considered in planning management.

Matched MeSH terms: Child, Preschool

Fulltext Lamotrigine as an add-on therapy in intractable paediatric epilepsy--the Kuala Lumpur Hospital experience

Vigneswari G, Sofiah A, Hussain IHMI

Med J Malaysia, 2001 Sep;56(3):359-64.

PMID: 11732083

An observational study of all children with intractable epilepsy at the Paediatric Institute prescribed Lamotrigine as an add-on therapy between January 1994 and November 1998 was conducted. A total of 30 children were recruited. Three had adverse effects to the drug and it was withdrawn. Of the remaining 27, there were 20 boys and 7 girls, ranging from 2 to 17 years. Fifteen children had generalised epilepsy, 6 had partial epilepsy, 2 had West syndrome and 4 had Lennox Gastaut syndrome. Six children (20%) became seizure free, and 14 (54%) had a greater than 50% reduction in seizure frequency. However 7 children (23%) did not respond and 3 experienced a deterioration in seizure severity. Nine children were noted to have an improvement in alertness and behaviour. Our small series suggests that Lamotrigine is useful as add-on therapy in childhood intractable epilepsy.

Matched MeSH terms: Child, Preschool

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