MyMedR

Recent advances in human brown fat physiology

Muralidhara DV, Muralidhara KD

Indian J. Physiol. Pharmacol., 2011 Jul-Sep;55(3):197-206.

Of the two variants of adipose tissue, white fat is traditionally known as a lipid rich tissue which undergoes pathological expansion in obese conditions. To counter the excess accumulation of white fat in states of energy imbalance, the second and unique type of brown fat plays a key role by burning extra energy into heat through a special metabolic pathway. In addition brown fat also plays a vital role in thermoregulation in animals and newborn humans and infants. Recent progress in research areas of these two types of fat tissue has provided compelling evidence to show that they secrete a large number of chemicals that play an important role in body weight control that involves several mechanisms. Brown fat was considered absent in the adult humans until recently. But new techniques have provided ample support for its active existence. Based on the very recent data it has been suggested that brown fat can be a target organ in the treatment of obesity which can lead to exciting and informative outcomes in the future.

Matched MeSH terms: Infant, Newborn

Fulltext Risk factors associated with low birth weight infants in the Malaysian population

Boo NY, Lim SM, Koh KT, Lau KF, Ravindran J

Med J Malaysia, 2008 Oct;63(4):306-10.

PMID: 19385490 MyJurnal

This study aimed to identify the risk factors which were significantly associated with low birth weight (LBW, <2500 g) infants among the Malaysian population. This was a case-control study carried out at the Tuanku Jaafar Hospital, Seremban, Malaysia over a five-month period. Cases were all infants born with birth weight less than 2500 g. Control infant were selected with the help a random sampling table from among infants with birth weight of > or =2500 g born on the same day in the hospital. Of 3341 livebirths delivered in the hospital, 422 (12.6%) were LBW infants. Logistic regression analysis showed that, after controlling for various potential confounders, the only significant risk factors associated with infants of LBW were gestational age (adjusted odds ratio (OR)=0.6, 95% C.I.: 0.5, 0.6; < 0.0001), maternal pre-pregnancy weight (adjusted OR = 0.97, 95% C.I.: 0.95, 0.99; p < 0.0001), nulliparity (adjusted OR = 3.4, 95% C.I.: 2.2, 5.1; p < 0.0001), previous history of LBW infants (adjusted OR = 2.3, 95% C.I.: 1.4, 3.8; p=0.001) and PIH during current pregnancy (adjusted OR=3.3, 95% C.I.: 1.6, 6.6; p = 0.001). A number of potentially preventable or treatable risk factors were identified to be associated with LBW infants in Malaysia.

Matched MeSH terms: Infant, Newborn

Reducing nosocomial infection in neonatal intensive care: an intervention study

Rahim RH, Barnett T

Int J Nurs Pract, 2009 Dec;15(6):580-4.

PMID: 19958414 DOI: 10.1111/j.1440-172X.2009.01800.x

Nosocomial infection is a common cause of morbidity and mortality for hospitalized neonates. This report describes measures taken to reduce the prevalence of nosocomial infection within a 34-bed neonatal intensive care unit in Malaysia. Interventions included a one-to-one education programme for nursing staff (n = 30); the education of cleaners and health-care assistants allocated to work in the unit; and the introduction of routine (weekly) screening procedure for all infants with feedback given to staff. The education programme for nurses focused on the application of standard precautions to three common clinical procedures: hand washing, tracheobronchial suctioning and nasogastric tube feeding. These were evaluated using competency checklists. The prevalence of nosocomial blood and respiratory tract infections declined over the 7-month study period. This study highlights the importance of education in contributing to the control of nosocomial infection in the neonatal intensive care unit.

Matched MeSH terms: Infant, Newborn

Spectrum of inherited metabolic disorders in Malaysia

Thong MK, Yunus ZM

Ann Acad Med Singap, 2008 Dec;37(12 Suppl):66-5.

PMID: 19904455

Issues pertaining to the diagnosis and management of inborn errors of metabolism (IEM) in Malaysia included low awareness of atypical and variable presentations in IEMs leading to delayed diagnosis or treatment, absence of reliable population data on IEMs and involvement of multiple siblings in the same family due to consanguinity. The importance of careful family history taking and genetic counselling are emphasised. Selected testing of ill infants and children for IEM yielded a positive 2% (264/13,500) results for IEMs in Malaysia. Out of the 264 patients, the spectrum of IEMs in Malaysia included organic acidurias (98), aminoacidopathies (78), urea cycle defects (54), neurotransmitter conditions (12) and lysosomal disorders, mainly mucopolysaccharidosis (14). Confirmatory studies of IEMs are an important aspect of management of IEMs. There is a need for more metabolic specialists and funding for diagnosis and treatment of IEMs in Malaysia. Long-term care issues and cost-effectiveness of IEM therapy, supportive and preventive aspects will need further studies in Malaysia.

Matched MeSH terms: Infant, Newborn

Fulltext Risk factors associated with chronic lung disease in Malaysian very low birthweight infants

Ameenudeen SA, Boo NY, Chan LG

Med J Malaysia, 2007 Mar;62(1):40-5.

PMID: 17682569 MyJurnal

To determine the significant risk factors associated with development of chronic lung disease (CLD) in Malaysian very low birthweight (VLBW, < 1501g) infants. A prospective observational study was carried out at the Sarawak General Hospital (SGH) in Kuching, over a period of 29 months from 1 April 2003 to 31 August 2005. Infants with birthweight between 600g to 1500g admitted to this hospital were recruited. The progress of these infants was followed till discharge. CLD was defined as the persistent need for oxygen therapy to maintain oxygen saturation above 88% at 36 weeks of postmenstrual age. Of the 224 infants recruited, 36 (14.8%) had CLD. Logistic regression analysis showed that lower birth weight (adjusted odds ratio (OR) = 0.996, 95% confidence intervals (CI) = 0.994, 0.998; p = 0.001), male infants (adjusted OR = 3.9, 95% CI = 1.6, 11.7; p = 0.02), chorioamnionitis (adjusted OR = 9.0, 95% CI = 1.6, 50.8; p = 0.01), severe respiratory distress syndrome of grades 3 or 4 (adjusted OR = 4.6, 95% CI =1.6, 13.2; P = 0.005) and patent ductus arteriosus (adjusted OR = 4.3, 95% CI = 1.5, 12.8; p = 0.007) were significant risk factors associated with development of CLD. A number of treatable conditions are associated with development of CLD in Malaysian VLBW infants.

Matched MeSH terms: Infant, Newborn

Fulltext The importance of intraoperative evaluation in the management of anorectal atresia

Ramesh JC, Lu, Balasingh D, Qureshi A

Med J Malaysia, 2002 Sep;57(3):361-3.

PMID: 12516531

We report a neonate with anorectal atresia in whom preoperative evaluation prior to definitive operation revealed a short gap atresia. However, bidigital evaluation at operation revealed a septal atresia that was easily perforated from below through the anus. Unnecessary division of the anorectal sphincter complex was thus avoided.

Matched MeSH terms: Infant, Newborn

Treatment decisions in severely ill newborns

Lim CT

Med J Malaysia, 2000 Aug;55 Suppl B:17-22.

PMID: 11125515

Matched MeSH terms: Infant, Newborn

Randomized controlled trial of heparin for prevention of blockage of peripherally inserted central catheters in neonates

Kamala F, Boo NY, Cheah FC, Birinder K

Acta Paediatr, 2002;91(12):1350-6.

PMID: 12578294

AIM: To determine whether the addition of heparin to total parenteral nutrition (TPN) fluid would prevent blockage of peripherally inserted central catheters (PICCs) in neonates.

METHODS: This was a randomized, double-blind, controlled study of 66 eligible neonates with PICCs inserted for the administration of TPN. Infants were randomized to receive TPN containing either 1 IU ml(-1) of heparin (n = 35) or no heparin (n = 31).

RESULTS: There was no significant difference in the incidence of blocked catheters between the two groups of infants (heparin: 14.3%; no-heparin: 22.6%, p = 0.4). Although a higher percentage (62.9%) of infants in the heparin group received a complete course of TPN successfully via PICC than those in the no-heparin group (48.4%), the difference was not statistically significant (p = 0.3). There were no significant differences in the incidence of catheter-related sepsis, hypertriglyceridaemia, hyperbilirubinaemia, coagulopathy or intraventricular haemorrhage between the two groups.

CONCLUSION: Addition of heparin to TPN fluid was not associated with a significant reduction in the incidence of blocked PICCs. However, the sample size of this study was too small to exclude even rather marked differences between the groups.

Matched MeSH terms: Infant, Newborn

A novel complex mutation of the OTC (ornithine transcarbamylase) gene in a Malaysian pedigree

Khoo AS, Balraj P, Rachedi A, Chin CN, Volpi L

Hum Mutat, 1999 Nov;14(5):448.

PMID: 10533073

Matched MeSH terms: Infant, Newborn

Fulltext Fatal early-onset neonatal sepsis due to Streptococcus pneumoniae

Nallusamy R

Med J Malaysia, 1998 Dec;53(4):442-5.

PMID: 10971993

Two cases of invasive early-onset neonatal pneumococcal sepsis are reported. One neonate was born at term with no risk factors and the other preterm at 35 weeks. Sepsis was not detected at birth for either of these babies and diagnosis was made at the stage of severe sepsis. A fatal outcome resulted despite treatment. Pneumococcal sepsis was confirmed after death in both these cases. Although maternal carriage was not documented in either case, the ages at presentation and progression suggested perinatal acquisition of infection. Early onset neonatal pneumococcal sepsis presents similarly as early onset neonatal Group B streptococcal (GBS) sepsis. Vaginal carriage of pneumococcus is rare but the micro-organism may have a higher invasion to colonisation ratio (attack rate) than GBS. Risk factors for invasive disease are similar to GBS.

Matched MeSH terms: Infant, Newborn

Fulltext Two-stage management of mega occipito-encephalocele

Mardzuki AI, Abdullah J, Ghazaime G, Ariff AR, Ghazali M

Med J Malaysia, 2003 Mar;58(1):115-9.

PMID: 14556336 MyJurnal

We report three cases of large occipito-encephaloceles that were managed in the Neurosciences Unit, Hospital Universiti Sains Malaysia over the last 5 years. All patients had pre-operative MRI (magnetic resonance imaging) evolution and mapping of the sagittal sinus tract. The cerebrospinal fluid (CSF) of all three patients were initially diverted by means of ventricular shunt two weeks prior to shunt removal. The slow drainage of CSF prevented electrolyte and volume disturbances due to sudden decompression during their definitive occipital encephalocele operations. After 3 years follow-up, all these patients are progressing well.

Matched MeSH terms: Infant, Newborn

Fulltext Infantile myofibromatosis

Ariffin H, Teh KH, Looi LM, Ariffin WA, Lin HP

Med J Malaysia, 2001 Dec;56(4):497-9.

PMID: 12014771

Infantile myofibromatosis (IMF) is a rare tumour with a wide spectrum of disease activity ranging from a solitary cutaneous nodule through to a multicentric form with widespread visceral involvement. It is characterised by its unique ability to spontaneously regress and has a typical histological appearance of actin-positive fibroblasts arranged in whorls or fascicles and vessels in a pericytomatous pattern. A male infant with multiple lesions involving the subcutaneous tissue and bone from birth is described and followed-up for two years. Treatment of IMF is dependent on the location of the tumour/s with surgery or chemotherapy reserved for rapidly progressive or symptomatic disease. However, due to the low rate of recurrence and the possibility of spontaneous tumoral regression, therapeutic abstention, as practised in our patient, is justified.

Matched MeSH terms: Infant, Newborn

Fulltext Cytogenetic study of Malaysian neonates with congenital abnormalities in Maternity Hospital Kuala Lumpur

Norlasiah IS, Clyde MM, Boo NY

Med J Malaysia, 1995 Mar;50(1):52-8.

PMID: 7752977

During the period 1 January 1990-31 December 1990, 68 neonates with congenital abnormalities were successfully analysed for chromosome abnormalities in order to determine the contribution of chromosome aberrations to the aetiology of congenital abnormalities. The neonates were karyotyped employing the G-banding technique. Twenty-nine babies showed abnormal chromosome karyotypes. Twenty-six were observed to have classic trisomy syndromes; ie. trisomy 21 (32.3%), trisomy 18 (3.0%), and trisomy 13 (3.0%). The mean maternal age of the mothers with babies having normal karyotype was lower than the mean maternal age of the mothers having babies with abnormal karyotypes. From this study the incidence of congenital abnormalities due to chromosomal abnormalities is found to be 1:838 livebirths. Frequency of newborns having abnormal chromosomes is 0.14% for Malays, 0.12% for Chinese and 0.06% for Indians.

Matched MeSH terms: Infant, Newborn

Changes of perinatal statistics in a semiurban setup between two time periods in Malaysia

al-Mohdzar SA, Haque E, Abdullah WA

Asia Oceania J Obstet Gynaecol, 1993 Dec;19(4):401-5.

PMID: 8135673

Hospital University Sains Malaysia (HUSM) functions as the state referral centre and the only hospital for the state of Kelantan that can offer neonatal intensive care service. The deliveries in HUSM with grand multiparity, late booking and problems of late referrals resembles a hospital serving a semiurban rather than an urban community. A comparison between the year 1989 and 1991 showed marked improvement of perinatal mortality rate from 41.32 to 24.88, which is significantly better than the improvement achieved from 1987 to 1989 (46.0 to 41.32). This was possible due to a marked fall in the early neonatal mortality rate from 10.02 in 1989 to 5.45 in 1991 and fall in the stillbirth rate from 31.61 to 19.53.

Matched MeSH terms: Infant, Newborn

Fulltext A retrospective review of tracheal suction at birth in neonates with meconium aspiration syndrome

Manickam D

Med J Malaysia, 1992 Mar;47(1):60-4.

PMID: 1387452

A retrospective study of 54 neonates with Meconium Aspiration Syndrome (MAS) admitted to the Paediatric ICU Penang General Hospital from January 1989-December 1990 was carried out to determine if suction of the trachea at birth was performed in this group of patients. 63% were inborn and 27% outborn. The mean birth weight was 3.2 kg, 83% were ventilated, mean duration of ventilation was five days and the mortality was 24%. 63% had an Apgar Score of less than 5 at 1 min and 65% had thick meconium-stained liquor. Only 48% were intubated and suctioned at birth. Overall tracheal suction rate was low.

Matched MeSH terms: Infant, Newborn

Blood cholinesterase levels in the elderly and newborn

Chan L

Malays J Pathol, 1995 Dec;17(2):87-9.

PMID: 8935132

The spectrophotometric method of Ellman was used to determine cholinesterase (ChE) levels in plasma and whole blood in elderly patients and umbilical cord blood of newborn infants. The mean +/- SD for plasma and whole blood ChE levels were 2.24 +/- 0.58 micromol/min/ml and 4.38 +/- 0.65 micromol/min/ml respectively in a group of healthy elderly patients (n = 25). The mean +/- SD for plasma and whole blood ChE levels were 2.23 +/- 0.77 and 3.31 +/- 0.56 respectively in cord blood of healthy full term newborn infants (n = 25). In a group of healthy adult blood donors the general mean +/- SD for plasma and whole blood ChE have been shown to be 2.71 +/- 0.75 and 4.87 +/- 0.73 micromol/min/ml respectively. Statistical analysis revealed that the mean levels of plasma and whole blood ChE in elderly, newborn infants and adults were different (p < 0.001). However, there was no statistical difference between the mean level of plasma ChE in elderly and cord blood but each shared statistically significant difference when compared to the mean level in adults. The mean activity of whole blood ChE in the 3 groups was different from one another. Theoretically, decreased levels of ChE would suggest a careful assessment of drugs that are hydrolysed by ChE.

Matched MeSH terms: Infant, Newborn

Kasabach-Merritt syndrome and Down's syndrome

Ram SP

J R Soc Med, 1997 Mar;90(3):159-60.

PMID: 9135617

Matched MeSH terms: Infant, Newborn

Fulltext Congenital cytomegalovirus infection in Malaysia

Ho J

Med J Malaysia, 1994 Dec;49(4):429.

PMID: 7674985

Matched MeSH terms: Infant, Newborn

Fulltext Post mortem caesarian section

Ravindran J

Med J Malaysia, 1995 Sep;50(3):284-5.

PMID: 8926913

Matched MeSH terms: Infant, Newborn

Depressed skull fracture in a newborn successfully managed conservatively: a case report

Lim CT, Koh MT, Sivanesaratnam V

Asia Oceania J Obstet Gynaecol, 1991 Sep;17(3):227-9.

PMID: 1953432

A preterm baby was born to a multiparous mother by emergency caesarean section at 36 weeks of gestation. Apart from a depression on the right temporo-parietal region measuring 3 cm x 3 cm x 0.5 cm, no other abnormality was noted. A CT scan of the brain excluded the presence of intracranial haematoma and pressure effect on the brain. Spontaneous reduction of the fracture without any adverse neurological sequelae suggests that these fractures can be managed conservatively in some instances.

Matched MeSH terms: Infant, Newborn

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