Objectives: This is a retrospective study in which all neonates with confirmed dengue fever mother admitted to our special care nursery from March 2014 to March 2015 were recruited. This is to determine the percentage of positive dengue serology in the neonates of mother with confirmed dengue fever and to investigate the correlation between the duration of maternal illness with these neonatal seropositivity of dengue antibody and their presenting symptoms.
Method: A total of 22 neonates whose mother with confirmed dengue fever were recruited out of which 14 (63.6%) neonates of confirmed dengue fever mothers had positive dengue serology.
Results: Eight out of fourteen neonates were dengue seropositive when mother dengue illness was between day 1 to 5 of illness (acute phase) at the time of delivery. Thirteen out of twenty-two neonates (59%) were symptomatic, out of which 61.5% (8 out of 13) were delivered during maternal acute phase of illness.
Conclusion: From this study, we concluded that neonates were more likely to be dengue seropositive and symptomatic when mother presented in acute phase of illness during delivery. However, our sample size was small, only 22 neonates were recruited from a single centre, therefore a larger sample size from multicentre is required in future.
Child abuse's trend has been on the rise in Malaysia. Despite strong legislative rules of Child Act 2001, the response of the community is believed to be inadequate. Various factors have been highlighted to ensure effective management of the issue. Child abuse is considered a social emergency due to its complexity and involvement of emotional, family dynamic and domestic instability. The success of the managing these cases largely depends on our urgency and collaborative partnership between multidisciplinary team members, to improve on the welfare of these children, albeit a slower outcome. The community as a whole has to be proactive in reporting hidden cases to avoid mortality or morbidity, as a result of the perpetrator's actions.
Objectives: This study was conducted with two objectives, i) to assess the prevalence of malnutrition among children and adolescents with learning disability (LD) in Kelantan, a rural state located at the north-eastern region of Peninsular Malaysia; and ii) to examine the associations of participants’ socioeconomic and feeding characteristics with their body mass index (BMI).
Methods: A total of 271 children and adolescents with LD aged between 4 to 19 years old were recruited from 32 community-based rehabilitation centres using purposive sampling method. Standing height and body weight of participants were measured. Socioeconomic and feeding information were obtained from their primary caregivers through interviews using structured questionnaire. Multiple linear regression analyses were performed to examine the associations of socioeconomic and feeding characteristics with participants’ BMI.
Results: The prevalence of underweight among children and adolescents with LD was 22.5%; while another 22.1% of them were overweight and obese. Multiple linear regression models showed that being Down’s syndrome (Adjusted regression coefficient β=2.63, p
Background: A 9 year old boy presented with history of persistent headache and recurrent vomiting for 1 month post dental extraction. CT brain was performed for the possibility of space occupying lesion but it was normal. Subsequently, he was treated as migraine after exclusion of meningitis and intracranial lesion. Unfortunately, he developed 3rd, 4th and 6th cranial nerve palsy two weeks later. Repeated CT brain showed subtle finding and inconclusive. MRI brain performed at the time showed features suggestive of basal skull osteomyelitis with congestion of right orbit and optic nerve swelling. Case was referred to Paediatric Neurologist and he was diagnosed to have cranial nerve palsy secondary to basal skull osteomyelitis, post dental extraction.
Conclusion: Dental procedure is common among children, however basal skull osteomyelitis with cranial nerve palsy is a rare complication. Adequate treatment of dental infection post dental procedure is important to prevent this complication.
Henoch – Schonlein purpura (HSP) is a vasculitis of small sized blood vessels. It is the most common acute systemic vasculitis in childhood. It mainly affects skin, gastrointestinal tract, joints and kidney. It results from Immunoglobulin A mediated inflammation. The characteristic skin findings are palpable purpuric lesions over the lower limbs and buttocks. The occurance of haemorrhagic bullae in children with HSP is rarely encountered. This case report describes a 12 year old boy with bullous haemorrhagic HSP treated at Institute Paediatric, Hospital Kuala Lumpur.
Objective: To study the demographic, clinical features, management and outcome of neonatal tetanus treated at Tawau Hospital.
Method: A retrospective study of neonatal tetanus admitted to a district hospital in Sabah was conducted.
Results: In 2015, the hospital handled 18 cases of babies with neonatal tetanus in the Tawau Hospital. This implies an occurrence of 1.5 cases per month. All the mothers were non-citizens and did not have any proper antenatal follow up. All the tetanus babies required invasive mechanical ventilation with a median of 20 days (range, 5 to 32 days). The survival rate was 94.4%.
Conclusion: Despite the promotion of maternal and childhood vaccination along with hygienic practices of delivery, neonatal tetanus still remains a threat to babies born in Sabah.
Scurvy resulting from dietary deficiency of vitamin C is characterized by anaemia, tender limbs swelling and hemorrhagic manifestations such as petechiae and bruises. We report a case of scurvy in a 13 years old boy with cerebral palsy who presented with history of limbs bruising and swelling for 2 months. On examination, he was cachexic and pale with poor dentition and swollen gum. There were extensive bruises and swollen limbs as well. His platelet count and coagulation profile were normal. Limbs X-ray revealed classical scorbutic changes in the long bones. Serum ascorbic acid level was low
Tuberculosis in children remains a public heath concern in Malaysia and other developing countries. Mycobacterium tuberculosis (TB) infection of the liver, known as hepatic TB, is an extra pulmonary manifestation of TB. Tuberculous bacilli can reach the liver via hematogenous dissemination through hepatic artery, or by local spread from the gastrointestinal tract via portal vein [1].(Copied from article)
Since 1994 to 2009, ascribed by the good coverage of immunization, the incidence of pertussis has been less than 1 in 100,000 populations [1]. Nevertheless, the incidence and prevalence increased tremendously for the past 2 years, i.e. 2014 and 2015.(Copied from article)
Adrenal hemorrhage (AH) is a relatively uncommon condition (0.55-1.9%) during the neonatal period [1]. The adrenal gland is vulnerable to haemorrhage because of its large size and high vascularity. Clinical features of AH are variable and nonspecific. AH in a newborn can present as anemia, hyperbilirubinemia, abdominal mass, painful swelling or hematoma of the scrotum, acute adrenal crisis or shock [2]. We report such a case of adrenal haemorrhage in a newborn.(Copied from article)
Neonates are obligate nasal breather until they are at least two to five months old. Congenital nasal airway obstruction is one of the commonest causes of respiratory problem in newborn. Congenital nasal pyriform aperture stenosis (CNPAS) was first described by Brown et al in 1989 [1] and is a rare cause of nasal airway obstruction which may clinically mimic choanal atresia.(Copied from article)
Subcutaneous fat necrosis is a recognised complication of hypothermia. There appears to be a resurgence in this condition when therapeutic hypothermia emerges as a standard of care for asphyxiated infants. The TOBY trial reported an incidence of 0.1% for 1239 infants cooled.(Copied from article)
Hepatopulmonary syndrome (HPS) is characterized by the triad of liver disease, pulmonary vascular dilatation and arterial oxygenation abnormality. It occurs in 4% to 47% in patient with liver cirrhosis [1]. We describe 2 cases of HPS with recovery from hypoxaemia after liver transplantation.(Copied from article)
Introduction: Parents of children with chronic illness such as thalassaemia, experience parental anxiety as a result of multiple stressors; these parents will consequently undergo the process of coping and adjustment in order to overcome the situation. Identifying families who may require psychosocial intervention is an important step towards providing holistic management for these children.
Methodology: A cross-sectional study was conducted to determine the level of parenting stress amongst parents of children with thalassaemia. Risk factors associated with high parenting stress score were identified. Research instruments used were the Parenting Stress Index/Short Form and Coping Inventory for Stressful Situations.
Results: A total of 54 subjects were recruited. High total parenting stress score (TPSS, defined at 75th centile) for this cohort was 99.5 whereas the mean TPSS was 86.18. Overall, 24% of these parents have high TPSS. Chinese ethnicity, number of children, monthly income, task-oriented and emotion-oriented coping mechanisms were significantly associated with a high TPSS. Logistic regression analysis revealed that low task-oriented but high emotion-oriented scores were risk factors with the greatest predictive power.
Conclusion: Early recognition of parenting stress is important to identify at risk parents so that interventions such as counseling and social support may be given.
Objective: To compare the mean duration of diarrhea between children taking yogurt and with the group taking commercial probiotics, containing lactobacillus in acute watery diarrhea. Materials and
Methods: This descriptive study was conducted in the Department of Pediatrics, Services Hospital, Lahore. The duration of this cross sectional study was 6 months, from June 2013 to November 2013. A total of 200 children suffering from acute watery diarrhea were involved in the study after the informed consent under the said hospital. Their demographic information was recorded and later divided in two groups of 100 each; group A received yogurt and group B was given commercial probiotic. The duration of diarrhea was observed in both groups. The results were compared by using independent sample t-test.
Results: The average duration of diarrhea in group A, was 1.98 + 1.31 day while that in group B was 3.09 + 1.64 days. Student's t-test was applied and the difference between the two groups was found to be statistically significant (p< 0.05).
Conclusions: Treatment with yogurt significantly decreases the mean duration of diarrhea as compared to probiotic among patients with acute watery diarrhea.
Thalassaemia is a hereditary blood disorder that is becoming a major health problem all over the world. This chronic illness harms the quality of life of the sufferers by interrupting their physical activities, school performance and social life. Hence, this review takes aim to assess the factors affecting the quality of life of thalassaemia among paediatrics patients. A comprehensive electronic search was conducted by using PubMed, Google Scholar and Science Direct. The search was limited to those articles written in English language and by using Pediatrics Quality of Life Inventory (PedsQLTM) 4.0 generic core scale questionnaire only. This review notifies emerging knowledge regarding the factors affecting the quality of life among thalassaemia patients and its implications in the essential core domains for paediatrics health-related quality of life measurements: physical, emotional, social and school functioning. It also empowers a better understanding regarding thalassaemia and assists as a foundation for the development of the effective preventive strategies for it.
Application of genome editing have garnered a lot of attention in the scientific world. Its ability to make permanent and precise modification or ‘edits’ in the genomic DNA sequences have open up the possibility of probing the functionality of genes and correcting abnormal genes to treat genetic diseases. The CRISPR/Cas9 which was adapted from Type II bacterial adaptive immune system is the most applied genome editing system due to the ease and efficiency of the system in customising the nucleases needed in editing the targeted sequences. However, the downside of this system is the high frequency of ‘off-target’ editing caused by the nature of the Cas9 protein that can tolerate mismatches between customised nucleases; sgRNA, and the genomic sequences. Despite the set-back, researchers continue applying CRISPR/Cas9 system to edit the genome by minimising the frequency of ‘off-target’ edits. Application of the improved system had successfully produced numerous results in the initial treatment of genetic diseases such as cystic fibrosis, β-thalassemia, and Duchenne Muscular Dystrophy. The fast-paced development and improvement made to this system will continue to be utilised by the researchers around the world for the treatment of human diseases, a progress much needed and awaited.