MyMedR

New paediatric contrast test: Hiding Heidi low-contrast 'face' test

Chen AH, Mohamed D

Clin Exp Ophthalmol, 2003 Oct;31(5):430-4.

The Hiding Heidi low-contrast 'face' test is a new paediatric contrast test to evaluate the ability to detect objects with low contrast. The purpose of the present study was to compare the Hiding Heidi low-contrast 'face' test (HH) with the Pelli-Robson contrast sensitivity test (PR) and the functional acuity contrast test (FACT) in the low-contrast assessment.

Matched MeSH terms: Pediatrics/methods*

Fulltext A comparison of the induction and emergence characteristics of sevoflurane and halothane in children

Chiu CL, Chan YK, Ong G, Delilkan AE

Med J Malaysia, 1999 Sep;54(3):346-51.

PMID: 11045061

This open labelled, randomised, controlled study was designed to compare the induction and recovery characteristics of sevoflurane and halothane anaesthesia in children. Forty American Society of Anaesthesiologist (ASA) physical status class 1 or 2 children (aged 1-10 year, weighed less than 25 kg) scheduled for elective urological procedure lasting less than one hour were allocated randomly to receive either sevoflurane (group S, n = 20) or halothane (group H, n = 20). The induction time in children receiving sevoflurane was significantly shorter than in those receiving halothane (mean (SD) 46 (13.6) second vs 69 (19.4) seconds, p < 0.005). The emergence from anaesthesia was also faster in children receiving sevoflurane than in those receiving halothane (mean (SD) 9 min (4.3 min) vs 21 min (8.9 min), p < 0.001). No major adverse effects were encountered in each group. We concluded that sevoflurane is comparable to halothane in Malaysian children.

Matched MeSH terms: Pediatrics/methods*

Fulltext Managing the solitary thyroid nodule

Meah FA, Qureshi MA

Med J Malaysia, 1998 Dec;53(4):453-6; quiz 457-8.

PMID: 10971996

Solitary thyroid nodules are commonly seen in surgical outpatient clinics. A detailed history and a careful physical examination are essential. In the management of the solitary thyroid nodule, fine needle aspiration cytology has become the cornerstone investigation. Ultrasound cannot differentiate between benign and malignant nodules, however is useful in the follow-up period to identify any further nodular growth. As thyroid malignancy occurs in both hot and cold nodules, radionuclide scans are not useful in the management of solitary thyroid nodules. We have attempted to outline the process of managing the solitary thyroid nodule and discuss the options available.

Matched MeSH terms: Pediatrics/methods

Fulltext Assess, adapt and act: a paediatric surgery division's initial approach in a rapidly evolving pandemic

Sanmugam A, Vythilingam G, Singaravel S, Nah SA

Pediatr Surg Int, 2020 Aug;36(8):925-931.

PMID: 32594243 DOI: 10.1007/s00383-020-04704-1

PURPOSE: The COVID-19 pandemic has placed an unprecedented test on the delivery and management of healthcare services globally. This study describes the adaptive measures taken and evolving roles of the members of the paediatric surgery division in a developing country during this period.

METHODS: We adopted multiple adaptive strategies including changes to stratification of surgeries, out-patient services by urgency and hospital alert status, policy writing involving multidisciplinary teams, and redeployment of manpower. Modifications were made to teaching activities and skills training to observe social distancing and mitigate reduced operative learning opportunities. Roles of academic staff were expanded to include non-surgical duties.

RESULTS: The planned strategies and changes to pre COVID-19 practices were successful in ensuring minimal disruption to the delivery of essential paediatric surgical services and training. Despite the lack of established guidelines and literature outlining strategies to address the impact of this pandemic on surgical services, most of the initial measures employed were consistent with that of other surgical centres.

CONCLUSION: Changes to delivery of surgical services and surgical training warrant a holistic approach and a constant re-evaluation of practices with emergence of new experiences and guidelines.

Matched MeSH terms: Pediatrics/methods*

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: Pediatrics/methods

Classification of childhood epilepsies in a tertiary pediatric neurology clinic using a customized classification scheme from the international league against epilepsy 2010 report

Khoo TB

J Child Neurol, 2013 Jan;28(1):56-9.

PMID: 22532543 DOI: 10.1177/0883073812439623

In its 2010 report, the International League Against Epilepsy Commission on Classification and Terminology had made a number of changes to the organization, terminology, and classification of seizures and epilepsies. This study aims to test the usefulness of this revised classification scheme on children with epilepsies aged between 0 and 18 years old. Of 527 patients, 75.1% only had 1 type of seizure and the commonest was focal seizure (61.9%). A specific electroclinical syndrome diagnosis could be made in 27.5%. Only 2.1% had a distinctive constellation. In this cohort, 46.9% had an underlying structural, metabolic, or genetic etiology. Among the important causes were pre-/perinatal insults, malformation of cortical development, intracranial infections, and neurocutaneous syndromes. However, 23.5% of the patients in our cohort were classified as having "epilepsies of unknown cause." The revised classification scheme is generally useful for pediatric patients. To make it more inclusive and clinically meaningful, some local customizations are required.

Study site: The pediatric neurology clinic at the Institute of Pediatrics, Kuala
Lumpur Hospital

Matched MeSH terms: Pediatrics/methods

Fulltext Pneumatic ureterolithotripsy in paediatric and adolescent patients: a ten-year experience at the Hospital Universiti Sains Malaysia

Hussein NS, Gohar MR

Singapore Med J, 2011 Jan;52(1):42-6.

PMID: 21298240

Two to three percent of stone disease cases occur in the paediatric age group. It is common in some parts of the world, such as in Turkey, India and Thailand. More than 50 percent of stones in children are still managed through open surgery. Ureteroscopic intervention for children remains a challenging treatment option. However, in contemporary urology practice, this mode of intervention is becoming more common. In this retrospective study, we reviewed our experiences with ureteroscopy and pneumatic lithotripsy in the paediatric and adolescent age group.

Matched MeSH terms: Pediatrics/methods*

Fulltext The impact of high frequency oscillatory ventilation on mortality in paediatric acute respiratory distress syndrome

Wong JJ, Liu S, Dang H, Anantasit N, Phan PH, Phumeetham S, et al.

Crit Care, 2020 01 31;24(1):31.

PMID: 32005285 DOI: 10.1186/s13054-020-2741-x

BACKGROUND: High-frequency oscillatory ventilation (HFOV) use was associated with greater mortality in adult acute respiratory distress syndrome (ARDS). Nevertheless, HFOV is still frequently used as rescue therapy in paediatric acute respiratory distress syndrome (PARDS). In view of the limited evidence for HFOV in PARDS and evidence demonstrating harm in adult patients with ARDS, we hypothesized that HFOV use compared to other modes of mechanical ventilation is associated with increased mortality in PARDS.

METHODS: Patients with PARDS from 10 paediatric intensive care units across Asia from 2009 to 2015 were identified. Data on epidemiology and clinical outcomes were collected. Patients on HFOV were compared to patients on other modes of ventilation. The primary outcome was 28-day mortality and secondary outcomes were 28-day ventilator- (VFD) and intensive care unit- (IFD) free days. Genetic matching (GM) method was used to analyse the association between HFOV treatment with the primary outcome. Additionally, we performed a sensitivity analysis, including propensity score (PS) matching, inverse probability of treatment weighting (IPTW) and marginal structural modelling (MSM) to estimate the treatment effect.

RESULTS: A total of 328 patients were included. In the first 7 days of PARDS, 122/328 (37.2%) patients were supported with HFOV. There were significant differences in baseline oxygenation index (OI) between the HFOV and non-HFOV groups (18.8 [12.0, 30.2] vs. 7.7 [5.1, 13.1] respectively; p

Matched MeSH terms: Pediatrics/methods

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