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  1. Khoo WV, Choo YM, Zahari N, Kamar AA
    Med J Malaysia, 2021 07;76(4):566-568.
    PMID: 34305120
    Pericardial effusion (PCE) and cardiac tamponade (CT) are rare but life-threatening complications of percutaneouslyinserted central catheter (PICC) use in neonates. There is often a lack in index of suspicion in a neonate with sudden deterioration, resulting in high mortality. We describe a series of three cases of PICC-related PCE/CT in low birth weight infants whose timely diagnosis with echocardiography and pericardiocentesis led to successful resuscitation and survival. We suggest that echocardiographic skills to determine tip position and pericardiocentesis be taught in neonatal resuscitation programs to ensure good outcomes of this otherwise fatal complication.
  2. Ang SC, Marret MJ, Jayanath S, Khoo WV, Takwir MFM
    Child Abuse Negl, 2021 Oct;120:105187.
    PMID: 34218125 DOI: 10.1016/j.chiabu.2021.105187
    BACKGROUND: Abusive head trauma (AHT) is a severe manifestation of physical abuse in young children. This study examines the outcome of AHT in children under 2 years and features associated with mortality and disability.

    METHODS: Retrospective chart review of 72 children under 2 years diagnosed to have AHT between 2011 and 2018 at a tertiary teaching hospital in Malaysia. Demographic variables, clinical features, results of neuroimaging and their associations with outcome were explored.

    RESULTS: The median age at presentation was 4 months, 78% were six months or younger and 68% were male. Two-thirds became unwell in the care of an alternative caregiver. Subdural hemorrhage was present in 98%. Mortality was 10%. Forty-nine survivors returned with median interval of 16 months (IQR 5-44 months) between discharge and last follow-up. At least 35% of 65 survivors were disabled with 29% having multiple disabilities. Multiple disabilities (61.1% versus 25.8%) and cognitive impairment (61.1% versus 22.6%) were significantly higher in children 3 years or older at last follow-up (p 

  3. Goh LC, Azman A, Siti HBK, Khoo WV, Muthukumarasamy PA, Thong MK, et al.
    Int J Pediatr Otorhinolaryngol, 2018 Jun;109:50-53.
    PMID: 29728184 DOI: 10.1016/j.ijporl.2018.03.010
    OBJECTIVE: To study the audiological outcome and early screening of pre-school going children with craniosynostosis under follow-up at the University of Malaya Medical Center(UMMC), Kuala Lumpur, Malaysia over a 10 year period.

    METHODS: A retrospective descriptive cohort study on the audiological findings detected during the first hearing assessment done on a child with craniosynostosis using otoacoustic emissions, pure tone audiometry or auditory brainstem response examination. The main aim of this study was to evaluate the type and severity of hearing loss when compared between syndromic and non-sydromic craniosynostosis, and other associated contributory factors.

    RESULTS: A total of 31 patients with 62 ears consisting of 14 male patients and 17 female patients were evaluated. Twenty two patients (71%) were syndromic and 9 (29%) were non-syndromic craniosynostosis. Amongst the syndromic craniosynostosis, 9 (41%) had Apert syndrome, 7 (32%) had Crouzon syndrome, 5 (23%) had Pfieffer syndrome and 1 (4%) had Shaethre Chotzen syndrome. Patients with syndromic craniosynostosis were more likely to present with all types and severity of hearing loss, including severe to profound sensorineural hearing loss while children with non-syndromic craniosynostosis were likely to present with normal hearing (p 

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