MyMedR

Lin HP, Chan LL, Tan A, Ariffin WA, Lam SK

Bone Marrow Transplant, 1994 Jun;13(6):725-9.

PMID: 7920303

The sole BMT centre in Malaysia caters only for children. Since 1987, 89 transplants have been performed using reverse barrier nursing techniques. The overall survival rate is 73% with the majority of survivors leading normal lives. The early and late infection rates of 46% and 13%, respectively, are comparable to those of other centres. Although the early septicaemia rate is 36% the immediate mortality rate is < 10%. GVHD is less frequent and severe and the interstitial pneumonitis rate lower than that in the West. The average cost of US $8000 per transplant is much lower than the cost of a transplant performed overseas. Thus we believe that our paediatric BMT programme is simple and cost-effective.

Matched MeSH terms: Child, Preschool

Global Emergencies in Child Health: Challenges and Solutions-Viewpoint and Recommendations from the European Paediatric Association and the International Pediatric Association

Thacker N, Hasanoglu E, Dipesalema J, Namazova-Baranova L, Pulungan A, Alden E, et al.

J Pediatr, 2022 Feb;241:266-266.e3.

PMID: 34756940 DOI: 10.1016/j.jpeds.2021.10.052

Matched MeSH terms: Child, Preschool

Fulltext Impact of Pediatric Acute Otitis Media on Child and Parental Quality of Life and Associated Productivity Loss in Malaysia: A Prospective Observational Study

Crawford B, Hashim SS, Prepageran N, See GB, Meier G, Wada K, et al.

Drugs Real World Outcomes, 2017 Mar;4(1):21-31.

PMID: 27888477 DOI: 10.1007/s40801-016-0099-9

BACKGROUND: Acute otitis media (AOM) affects both child and parental quality of life (QoL). Data on QoL associated with AOM in Malaysia is sparse, and the burden of indirect costs have not been previously reported.

OBJECTIVE: To determine the effect of pediatric AOM on child and parental QoL in Malaysia and its economic impact (indirect costs).

METHODS: We utilized a set of QoL questionnaires (PAR-AOM-QOL, OM-6, and EQ-5D) combined with questions addressing work/productivity loss and financial costs associated with caring for a child during his or her illness in an observational, multicenter, prospective study.

RESULTS: One hundred and ten AOM patients aged ≤5 years were included in the analysis. The majority of respondents were the patient's mother. Parental QoL was negatively affected for both emotional and daily disturbance scales, but the level of disturbance was low. Using OM-6, the greatest negative impact was on the child's QoL, followed by caregiver concerns, physical suffering, and emotional distress. Using EQ-5D, a moderately positive relationship between parents' emotional disturbance and daily disturbance, and a weak, negative correlation between parental emotional disturbance and parental health status was found. Parents with paid employment took an average of 21 h from work to care for their child, at an average cost of 321.8 Malaysian ringgit (US$97) in addition to their contribution to direct medical costs. Productivity losses whilst at work, uncompensated wage losses, and leisure time losses are also reported.

CONCLUSIONS: This study found that AOM is associated with some negative impact on parental QoL and significant economic impact at both patient and societal levels. The findings provide useful data on healthcare resource utilization and disease burden of AOM in Malaysia.

Matched MeSH terms: Child, Preschool

Neonatal hypoxic encephalopathy: Correlation between post-cooling brain MRI findings and 2 years neurodevelopmental outcome

Rusli ERM, Ismail J, Wei WS, Ishak S, Jaafar R, Zaki FM

Indian J Radiol Imaging, 2019 12 31;29(4):350-355.

PMID: 31949335 DOI: 10.4103/ijri.IJRI_62_19

Objective: This study aims to evaluate the magnetic resonance imaging (MRI) brain patterns among hypoxic-ischemic encephalopathy (HIE) babies who underwent post-cooling MRI brain as well as to correlate the post-cooling brain scoring with patient's neurodevelopmental outcome at 2 years.

Subjects and Methods: It was a retrospective cross sectional study carried out at a tertiary university hospital. Record of patients diagnosed with neonatal HIE from 2007 until 2016 who completed 72 h of cooling therapy and had MRI brain within 2 weeks of life were included in this study. A new scoring system by Trivedi et al. that emphasizes on subcortical deep gray matter and posterior limb internal capsule injury were utilized upon MRI assessment, using TW, T2W, and diffusion-weighted imaging (DWI) sequences. Cumulative MRI brain score was obtained and graded as none, mild, moderate, and severe brain injury. The MRI brain scoring was then correlated with patient's 2 years neurodevelopmental outcome using Fisher's Exact Test.

Results: A total of 23 patients were eligible of which 19 term neonates were included. 13% of these neonates (n = 3) had mild MRI brain injury grading with 52.2% (n = 12) moderate and 34.8% (n = 8) severe. There was no significant correlation seen between MRI brain grading and developmental outcome at 2 years old (P > 0.05).

Conclusion: There was no significant correlation between neonatal MRI brain injury grading and 2 years neurodevelopmental outcome. Nevertheless, the new MRI brain scoring by Trivedi et al. is reproducible and comprehensive as it involves various important brain structures, assessed from different MRI sequences.

Matched MeSH terms: Child, Preschool

Fulltext Clinical profile and visual outcome of traumatic paediatric cataract in suburban Malaysia: a ten-year experience

Adlina AR, Chong YJ, Shatriah I

Singapore Med J, 2014 May;55(5):253-6.

PMID: 24862748

INTRODUCTION: Available data on traumatic cataract in Asian children is primarily confined to South Asian countries. We aimed to describe the demographics, nature of injury and visual outcomes of Malaysian children with traumatic cataract from a suburban area, and discuss the literature on Asian children with this condition.

METHODS: We conducted a retrospective study of 29 children below 17 years of age who were diagnosed with traumatic paediatric cataract and who attended Hospital Universiti Sains Malaysia, Kelantan, Malaysia, between January 2000 and December 2010. Follow-up periods ranged from 12 to 120 months. Demographic data, clinical features, mechanism and extent of injury, and final visual outcome were recorded.

RESULTS: The study population was predominantly male. The right eye was injured in 62.07% of patients. A majority of patients had penetrating injuries, with the most common cause being injury by an organic foreign body (24.14%). Presenting visual acuity worse than 6/60 was observed in 68.97% of patients. Only 34.48% of patients had a final corrected visual acuity of 6/12 and better. 55.18% of patients were operated on within less than one month of their injuries. A majority of children sustained concurrent injuries to the anterior segment structures. Corneal opacity and amblyopia were the most common causes of poor final visual acuity.

CONCLUSION: Health education and awareness are essential tools that can prevent avoidable blindness due to traumatic cataract in the paediatric population. The importance of rehabilitation programmes for these patients should be emphasised.

Matched MeSH terms: Child, Preschool

Fulltext Juxtarenal/pararenal Wilms' tumour in a six-year-old Malay girl

Ngan KW, Shaari S, Subramaniam T

Singapore Med J, 2009 Sep;50(9):e329-31.

PMID: 19787163

We report a six-year-old Malay girl who presented with a right retroperitoneal tumour that measured 7.5 cm in diameter. A wide excision of the lesion was performed. The tumour was separated from a normal-appearing right kidney by a capsule. Microscopically, this well-encapsulated tumour was composed of classical triphasic components: epithelial, mesenchymal and blastemal areas. The immunohistochemical study showed WT1 expression in the blastemal area. Thus, a diagnosis of Wilms' tumour with favourable histology was made. The patient was well for 12 months. Extrarenal Wilms' tumour is uncommon, with the majority of cases occurring in the retroperitoneal and inguinal areas. Wilms' tumour that is not arising from the intrarenal area but shares a common capsule with the ipsilateral kidney, is even rarer. Indeed, our case would be more appropriately classified as juxtarenal/pararenal Wilms' tumour. Despite its rarity, an extrarenal or even juxtarenal/pararenal Wilms' tumour should be included in the differential diagnosis of retroperitoneal tumour.

Matched MeSH terms: Child, Preschool

Fulltext Malaysian children with spina bifida: relationship between functional outcome and level of lesion

Ong LC, Lim YN, Sofiah A

Singapore Med J, 2002 Jan;43(1):12-7.

PMID: 12008770

To determine the relationship between spinal lesion level and functional outcome in children with spina bifida.

Matched MeSH terms: Child, Preschool

Fulltext Risk factors associated with severe viral croup in hospitalised Malaysian children

Chan PW

Singapore Med J, 2002 Mar;43(3):124-7.

PMID: 12005337

To determine the risk factors associated with severe viral croup in hospitalised Malaysian children.

Matched MeSH terms: Child, Preschool

Fulltext Clinical measurement of longitudinal femoral overgrowth following fracture in children

Nordin S, Ros MD, Faisham WI

Singapore Med J, 2001 Dec;42(12):563-5.

PMID: 11989577

We have studied residual limb length inequality following femoral shaft fractures in 62 children. From 61.2% of the children who had shortening of more than 1 cm at union, 34.21% still maintained the shortening at the completion of study. The longitudinal femoral overgrowth occurred significantly during the first 18 months of the fracture in 77.4% of the children, with an average of 1.17 cm. Children with proximal-third fractures and those who sustained the fractures before eight years of age have higher capability to correct the limb length disparity.

Matched MeSH terms: Child, Preschool

Fulltext An outbreak of acute haemorrhagic conjunctivitis in Melaka, Malaysia

Ghazali O, Chua KB, Ng KP, Hooi PS, Pallansch MA, Oberste MS, et al.

Singapore Med J, 2003 Oct;44(10):511-6.

PMID: 15024454

This paper reports a second outbreak of acute haemorrhagic conjunctivitis due to coxsackievirus A24 in peninsular Malaysia. Between June 2002 and early October 2003, 10,327 patients, comprising 3,261 children and 7,066 adults, were treated for acute conjunctivitis in 11 government health clinics in the Melaka Tengah district of the state of Melaka. The figure grossly underestimates the size of the outbreak; as no patients treated in private clinics in the same district were included. Institution and household surveillance showed that the commonest presenting clinical feature of the illness was eye-discharge (91.2%), followed by foreign body sensation (81.8%), pain (78.3%) and subconjunctival haemorrhage (74.4%). The mean duration of illness was 6.5 and five days for patients with and without subconjunctival haemorrhage respectively.

Matched MeSH terms: Child, Preschool

Fulltext Does right leg require extra protection? Five-year review of type 3 open fractures of the tibia

Imran Y, Vishvanathan T

Singapore Med J, 2004 Jun;45(6):280-2.

PMID: 15181523

Open fracture of the tibia is very common among motorcyclists. The morbidity associated with this injury is well-documented as treatment of severe open fractures is very difficult. There is currently no study done in the literature to see the relationship between fracture severity and the side of the injury.

Matched MeSH terms: Child, Preschool

Fulltext Gradual reduction of supracondylar fracture of the humerus in children reporting late with a swollen elbow

Devnani AS

Singapore Med J, 2000 Sep;41(9):436-40.

PMID: 11193116

AIM: To study the outcome of gradual reduction by skin traction of supracondylar fracture of the humerus in children with swollen elbow, who seek treatment two days or longer after the injury.
METHOD: Fifteen children aged between 4 and 11 years (average 7 years 11 months), who had initially consulted a traditional practitioner, reported between 2 and 21 days (average 7.5) after the injury were treated by skin traction with the elbow kept straight and the forearm in position of comfort.
RESULTS: The average duration of stay in hospital was 14 days. All fractures healed; there was no incidence of myositis ossificans or neurovascular deficit. All patients had functional range of movements at the elbow within 6 months. Five patients developed cubitus varus deformity greater than 5 degrees, they were classified as poor result. Four out of these 5 patients had sought treatment after a delay of 7 days or longer. There were 9 good (60%), 1 fair (7%) and 5 poor (33%) results.
CONCLUSION: Gradual reduction by skin traction is safe. It is possible to achieve satisfactory reduction if the delay is up to 7 days. The results with regards to deformity and function were comparable with those obtained following open or closed Kirschner wire fixation.

Matched MeSH terms: Child, Preschool

Fulltext Seroprevalence of anti-HCV in an urban child population: a preliminary study from Kuala Lumpur

Lee WS, Ng KP

Singapore Med J, 2001 Mar;42(3):100-1.

PMID: 11405558

A pilot study to determine the seroprevalence of anti-HCV among children from Kuala Lumpur, Malaysia, was conducted using microparticle enzyme immunoassay. Serum samples were obtained randomly from children, aged between one to 16 years of age, admitted to the paediatric unit of University of Malaya Medical Centre, Kuala Lumpur for various medical reasons. Of the 179 samples assayed, only one was positive, giving the prevalence rate of 0.6%. It is reasonable to conclude that the seroprevalence of anti-HCV among children from Kuala Lumpur is low, less than 1%.

Matched MeSH terms: Child, Preschool

Fulltext A study of newly diagnosed epilepsy in Malaysia

Manonmani V, Tan CT

Singapore Med J, 1999 Jan;40(1):32-5.

PMID: 10361483

To determine the characteristics of newly diagnosed epilepsy in the multiracial population of Malaysia.

Matched MeSH terms: Child, Preschool

Fulltext Cystic fibrosis in Malay children--a report of three cases

Norzila MZ, Azizi BH

Singapore Med J, 1996 Jun;37(3):273-4.

PMID: 8942227

Cystic fibrosis (CF) is a rare disease among Asians. Three Malay children with CF presenting with recurrent pulmonary symptoms, malabsorption and failure to thrive are reported. Problems in their management include availability of pancreatic enzymes, compliance to medications and climate factors.

Matched MeSH terms: Child, Preschool

Fulltext Colonisation factors amongst clinical isolates of enterotoxigenic Escherichia coli

Iyer L, Vadivelu J, Parasakthi N

Singapore Med J, 1995 Oct;36(5):495-7.

PMID: 8882532

The production of heat-labile (LT) and heat-stable (ST) enterotoxins, colonisation factor antigens (CFAs) and haemagglutinins was investigated amongst 310 Escherichia coli (E. coli) isolates obtained from 62 children under the age of five, with diarrhoea. Twenty-one isolates were found to produce enterotoxins, of which fifteen (71%) isolates produced ST only, 2 (10%) produced LT only and 4 (19%) produced both LT and ST. However, none of the isolates demonstrated any of the common CFAs identified to date, but 8 out of the 21 isolates demonstrated haemagglutination with rabbit, sheep or human group A erythrocytes, suggesting the presence of putative CFAs, yet unidentified.

Matched MeSH terms: Child, Preschool

Fulltext Hearing rehabilitation in congenital canal atresia

Mazita A, Fazlina WH, Abdullah A, Goh BS, Saim L

Singapore Med J, 2009 Nov;50(11):1072-6.

PMID: 19960162

The purpose of this study was to review the results of our patients with congenital canal atresia after implantation of bone-anchored hearing aids (BAHA). The occurrence of complications was also reviewed.

Matched MeSH terms: Child, Preschool

Fulltext Over-investigated and under-treated: children with febrile convulsion in a Malaysian district hospital

Lai NM, Tan ML, Quah SY, Tan EL, Foong KW

Singapore Med J, 2010 Sep;51(9):724-9.

PMID: 20938614

We conducted a retrospective audit on the inpatient assessment and care of children admitted with febrile convulsion to Hospital Batu Pahat, a district hospital in Malaysia, using the Malaysian national clinical practice guidelines and the American Academy of Paediatrics practice parameters on febrile convulsion as the reference standards.

Matched MeSH terms: Child, Preschool

Fulltext Mowat-Wilson syndrome: the first two Malaysian cases

Balasubramaniam S, Keng WT, Ngu LH, Michel LG, Irina G

Singapore Med J, 2010 Mar;51(3):e54-7.

PMID: 20428734

Mowat-Wilson syndrome (MWS) is a recently delineated mental retardation; a multiple congenital anomaly syndrome characterised by a typical facial gestalt, Hirschsprung disease or severe constipation, genitourinary anomaly, congenital heart defects, agenesis of corpus callosum and eye defects. Some cases also present with epilepsy, growth retardation with microcephaly and speech impairment. MWS was first described in 1998 by Mowat et al, and approximately 180 cases have been reported as of August 2008. The syndrome occurs as a result of heterozygous mutations or deletions in the zinc finger E-box-binding homeobox 2 gene, ZEB2, previously called ZFHX1B (SIP1). Most cases reported so far were sporadic occurrences; however, rare cases of sibling recurrence have been cited. The facial phenotype is particularly important for the initial clinical diagnosis and provides the hallmark, warranting ZEB2 mutational analysis even in the absence of Hirschsprung disease. We present the first two molecularly confirmed Malaysian MWS patients, one of whom has a novel mutation.

Matched MeSH terms: Child, Preschool

Fulltext Bilateral internal carotid artery hypotrophy in malignant osteopetrosis

Ramli N, Rahmat K, Tan GP

Singapore Med J, 2008 Jul;49(7):e175-7.

PMID: 18695851

Malignant osteopetrosis is associated with petrous carotid canal and internal carotid artery stenosis in the skull base. We present a four-year-old boy with malignant osteopetrosis who developed right frontal lobe infarction as a result of bilateral internal carotid artery hypotrophy.

Matched MeSH terms: Child, Preschool

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