Displaying publications 201 - 220 of 232 in total

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  1. The effect of providing expressed breast milk on infection rates, mortality and breast feeding of preterm babies
    Ram, S.P., Zabidi Azhar M Hussin
    Malaysian Journal of Child Health, 1997;9(1):83-87.
    MyJurnal
    Two active interventions were carried out in order to encourage breast feeding of low birth weight (LBW) neonates who were admitted to the neonatal intensive care unit (NICU), Universiti Sains Malaysia. These were the establishment of (a) an effective transport system for conveying expressed breast milk (EBM) from the motherk home to the neonatal intensive care unit and (b) providing rooming-infacilities in the neonatal ward. The EBM was transported by a male health assistant, by the parents themselves or by the local bus company. A total of 473 babies were admitted from April 1994 to September 1995. Thirty-three babies weighed between 540-1000g and 440 were between 1001-2000g. A total of 226 (47.8%) babies were given mixed formula (less than 20% of daily needs) and EBM feeds (Group A) and 247 (52.2%) were given only formula feeds (Group B). A total of 79 babies died of which 5 were in Group A and 74 were in group B. (P value is 0.00). In Group A, 45 babies had clinical sepsis, 9 of whom were blood culture positive. Four of these babies died. In group B, out of 108 babies with clinical sepsis 36 were blood culture positive. 29 died because of the sepsis This study shows that by providing an effective transport system for breast milk expressed at home and the availability of roomingfacilities in the neonatal ward a significant number of LBW babies admitted to the NICU continue to receive their mothers' milk. The incidence of nosocomial sepsis and the over all mortality due to sepsis was significantly higher in those on full formulafeeding compared to those given mixed formula and expressed breast milk.
    Matched MeSH terms: Sepsis
  2. Prophylactic low dose dopamine infusion on renal function in ventilated preterm newborns with respiratory distress syndrome
    Hassan, H., Quah, B.S., Haider, D., Rostenberghe, H.V.
    Malaysian Journal of Paediatrics and Child Health, 1998;10(2):24-33.
    MyJurnal
    The aim of the study was to determine the effect of pro-phylactic low dose dopamine infusion on renal function in ventilated premature newborns with respiratory dis-tress syndrome (RDS). A prospective, randomised con-trolled trial was conducted, using low dose dopamine [2.5μg/kg/min] in the treatment of preterm babies with gestational age 28-36 weeks requiring mechanical ventilation for RDS within six hours of age. Thirty-six babies were enrolled and 19 babies were randomly assigned to the treatment groups. The renal function after 72 hours for the treatment and control groups respectively were: urine output (ml/kg/hour) 3.3±0.4 and 3.0±0.3 [p=0.55], urine specific gravity 1006±0.6 and 1006±1.0 [p=0.68], fractional excretion of sodium 4.1±0.8 and 2.6±0.4 [p=0.10], fractional excretion of potassium 37.44 ± 5.6 and 16.49 ± 2.2 [p=0.001], glomerular filtration rate (ml/day/1.72m2) 16±2.6 and 25.6±4.5 [p=0.06]. There were no significant differ-ences in the frequency of hypotension, oliguria and sep-sis between the two groups. There were seven deaths (36.8%) in the treatment group (six due to sepsis and one due to prematurity) and two deaths (11.8%) in the control group (both due to sepsis) (p = 0.13). In con-clusion prophylactic low-dose dopamine infusion did not improve the renal function in ventilated premature babies with respiratory distress syndrome. The results of this study do not support the routine use of prophylac-tic low-dose dopamine in ventilated preterm babies with respiratory distress syndrome.
    Matched MeSH terms: Sepsis
  3. Fulltext A diagnostic workup of perioperative anaphylaxis reveals a selective type 1 hypersensitivity to cefazolin
    Meera Thalayasingam, Shek, Lynette Pei-Chi
    International e-Journal of Science, Medicine & Education, 2015;9(2):37-39.
    MyJurnal
    Anaphylaxis in the operating room although infrequent can be potentially fatal. The diagnosis of perioperative anaphylaxis is complex due to a multitude of factors. Firstly, patients under anesthesia cannot verbalize their complaints, the anesthetic agents themselves can alter vital parameters (e.g. heart rate and blood pressure) and cutaneous signs in a completely draped patient may be missed. Secondly, the differential diagnosis of intraoperative anaphylaxis is wide. Conditions such as asthma exacerbation, arrhythmia, hemorrhage, angioedema, mastocytosis, acute myocardial infarction, drug overdose, pericardial tamponade, pulmonary edema, pulmonary embolus, sepsis, tension pneumothorax, vasovagal reaction, venous air embolism, laryngospasm, blood transfusion reaction and malignant hyperthermia need to be considered. Thirdly, the diagnostic workup is challenging due to the multiple medications administered and other exposures encountered such as latex and chlorhexidene. However, through a timely allergy consultation and a systematic approach, identification of the culprit agent and safe alternatives can be established to prevent future occurrences as illustrated in the case below.
    Matched MeSH terms: Sepsis
  4. Gastroenterological problems in the neonates
    Lee, W.S.
    Malaysian Journal of Paediatrics and Child Health, 2001;13(1):45-49.
    MyJurnal
    Significant advances in perinatology and neonatology in the last decade have resulted in increased survival of extremely premature infants.' Survival rates at 25 and 26 weeks of gestation age ranging from 60% to 82% and from 75% to 93%, respectively, have been reported.' In Malaysia, the survival rates among premature very low birth weight infants (< 1500 g) were reported to be between 69% and 78%.2,3 Such improvements of survival have been attributed to the advances in the management of respiratory disease and intra-ventricular haemorrahge in the premature infants.',2 Thus, attention have recently been focused on the need to secure adequate nutrient intake of these premature infants. Parenteral nutrition has often been used to manage the transition between transplacental nutrition in-utero and post-natal enteral nutrition, but is associated with cholestasis and sepsis.4 However, the ability to deliver nutrition is limited not only by immature absorptive or digestive function but by inadequate motor activity. Gastroesophageal efflux (GER) and feeding intolerance are the major gastro-enterological problems of the premature neonates.
    Matched MeSH terms: Sepsis
  5. Exchange transfusion for neonatal hyperbilirubinaemia: experience in an inborn neonatal intensive care unit
    Lim, N.L., Boo, N.Y., Nur Atiqah, N.A., Padma Soosai, A., Musa Mohd Nordin, M Sham. Kasim
    Malaysian Journal of Child Health, 1998;10(1):46-51.
    MyJurnal
    Severe jaundice (serum bilirubin level > 340 gmol/L) occurred in 81 infants admitted to the Neonatal Intensive Care Unit (NICU) of the Maternity Hospital Kuala Lumpur (MHKL) in 1993. Of these 46 (56.8%) underwent 53 exchange transfusions. In-patient case notes were available for study on 41 of them. Two infants had no cause identified while 12 were associated with prematurity, 13 ABO incompatibility, 8 G6PD deficiency, 6 sepsis 2 Rh isoimmunisation and 6 miscellaneous causes. In 14 infants it was felt that exchange transfusions might have been avoided if they were detected earlier and phototherapy instituted promptly. Twenty six (26) infants were deemed to have been given phototherapy at the appropriate time but jaundice increased to exchange transfusion levels, threshold values depending on the unit in charge. Use of higher intensity phototherapy might have been more effective in some of the cases. Available data showed similar outcomes in both groups.
    Matched MeSH terms: Sepsis
  6. Fulltext The effectiveness of tocotrienol rich fraction and αlpha tocoferol with combination of vitamin C in the management of systemic inflammatory response syndrome (SIRS)
    Husam, Y.E., Raha, A.R., Jaafar, M.Z., Mohd Heikal, M.Y.
    Journal of Surgical Academia, 2017;7(1):4-12.
    MyJurnal
    The pathophysiology of systemic inflammatory response syndrome (SIRS) had been described to involve various strong oxidative reactions affecting the status and progress of the patients. Antioxidant therapy had been suggested in many studies involving SIRS management. The objective of this study was to compare the role of vitamin E Tocotrienol and vitamin E Tocopherol combined with vitamin C as antioxidant therapy in the management of critically ill patients diagnosed with SIRS, admitted to the intensive care unit and high dependency wards of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). It was a single blind randomized clinical trial with a total of 72 patients in which 44.4% Malays, 34.7% Chinese, 19.4% Indians and 1.4% others with 59.7% males and 40.3% females were recruited. Patients in TRI E group received Tocotrienol with Vitamin C while TOCO group received Tocopherol with Vitamin C and a control group did not receive any antioxidant. The clinical parameters (heart rate, respiratory rate, systolic blood pressure) showed improvements with significant difference at the end of study (post-intervention) as compared to admission (pre-intervention).Whereas, the sepsis (temperature, PCT, CRP and WBC) and oxidative stress (8-OHdG/Creatinine) parameters showed improvements with significant difference at the end of study (post-intervention) as compared to admission (pre-intervention). The TRI E group showed obvious improvement in clinical, sepsis and oxidative stress parameters, as compared to TOCO and control groups. This study showed that Vitamin E Tocotrienol and Vitamin E Tocopherol in combination with Vitamin C demonstrated significant improvement in the clinical and laboratory parameters during the management of SIRS. Therefore, Vitamin E in combination with Vitamin C had therapeutic benefits in the treatment of critically ill patients with SIRS.
    Matched MeSH terms: Sepsis
  7. Fulltext Invasive pneumococcal disease in a tertiary paediatric hospital in Malaysia
    Aisha Fadhilah Abang Abdullah, Kee, Sze Ying, Kamarul Azhar Mohd Razali, Jamal Mohamed, Thahira A., Zubaidah Abdul Wahab, Norlijah Othman
    Malaysian Journal of Paediatrics and Child Health, 2017;23(1):0-0.
    MyJurnal
    Introduction and Objective: Pneumococcal disease is a leading cause of morbidity and mortality worldwide. There were limited publications on invasive pneumococcal infection (IPD) in Malaysia. The aim of this study is to describe restrospectively cases of IPD in hospitalised children of less than 12 years old and highlighting the unusual cases.

    Methodology: A retrospective review of children with IPD from March 2002 to November 2005 at a tertiary paediatric hospital. IPD cases were defined as isolates of Streptococcus pneumoniae from a normally sterile body fluid site.

    Results: Twenty-four patients were identified with a male preponderance. Two-thirds of patients were below 1-year-old; with three cases presenting in the premature newborn. Thirty-seven percent of cases had underlying conditions. Sepsis and pneumonia were the commonest manifestation, followed by meningitis. The unusual manifestations were in a form of postinfectious glomerulonephritis and overwhelming purpura fulminans. There were two mortalities; both infants had meningitis. Antibiotic susceptibility pattern showed that more than half of the isolates were sensitive towards penicillin and erythromycin. Penicillin resistance was found in 6 (25%) isolates. Conclusion: IPD results in significant morbidity and mortality, especially in young children below 2 years of age and justifies further evaluation of preventive strategies including the implementation of pneumococcal vaccine in the national immunisation programme.
    Matched MeSH terms: Sepsis
  8. Fulltext Melioidosis in acute cholangitis of diabetic patient: a forgotten diagnosis
    Mohamad N, Ponnusamy S, Devi S, Manikam R, Idrus II, Bakar NHA
    Res Rep Trop Med, 2012;3:103-106.
    PMID: 30100777 DOI: 10.2147/RRTM.S34483
    Melioidosis presents with a wide range of clinical presentations, which include severe community-acquired pneumonia, septicemia, central nervous system infection, and less severe soft tissue infection. Hence, its diagnosis depends heavily on the clinical microbiology laboratory for culture. In this case report, we describe an atypical presentation of melioidosis in a 52-year-old man who had fever, right upper-abdominal pain, and jaundice for 15 days. Melioidosis caused by Burkholderia pseudomallei was subsequently diagnosed from blood culture. As a primary care physician, high suspicion index is of great importance. High suspicion index of melioidosis in a high-risk group patient, such as the patient with diabetes mellitus and diabetic foot, is crucial in view of atypical presentations of pseudomonas sepsis. A correct combination of antibiotic administration in the early phase of therapy will determine its successful outcome.
    Matched MeSH terms: Sepsis
  9. Fulltext Clinical Manifestations and Risk Factors of Streptococcus suis Mortality Among Northern Thai Population: Retrospective 13-Year Cohort Study
    Rayanakorn A, Katip W, Goh BH, Oberdorfer P, Lee LH
    Infect Drug Resist, 2019;12:3955-3965.
    PMID: 32021313 DOI: 10.2147/IDR.S233326
    Purpose: Streptococcus suis (S. suis) is an emerging zoonotic disease mainly in pigs, causing serious infections in humans with high prevalence in Southeast Asia. Despite a relatively high mortality rate, there are limited data regarding the risk factors of this life-threatening infection. Therefore, a 13-year retrospective cohort study in Chiang Mai, Thailand during 2005-2018 was conducted to explore risk factors associated with S. suis mortality and to update the outcomes of the disease.

    Patients and methods: S. suis positive cases were derived from those with positive S. suis isolates from microbiological culture results and Matrix-Assisted Laser Desorption Ionization Time of Flight (MALDI-TOF). Potential risk factors of mortality were identified using univariate and multivariate logistic regression.

    Results: Of 133 patients with culture-proven S. suis infection identified, there were 92 males and 41 females. The mean age was 56.47 years. Septicemia (55.64%) was the most common clinical manifestation followed by meningitis (37.59%) and infective endocarditis (25.56%). Alcohol drinking and raw pork consumption were documented in 66 (49.62%) and 49 (36.84%) cases respectively. The overall mortality rate was 12.03% (n=16). According to the multivariate analysis, the independent risk factors for mortality were prolonged bacteremia ≥ 6 days (OR = 43.57, 95% CI = 2.46-772.80, P =0.010), septic shock (OR = 13.34, 95% CI = 1.63-109.03, P =0.016), and direct bilirubin > 1.5 mg/dL (OR = 12.86, 95% CI = 1.91-86.59, P =0.009).

    Conclusion: S. suis is not infrequent in Northern Thailand, where the cultural food habit of raw pork eating is still practiced. To the best of our knowledge, this is the largest series focusing on risk factors of S. suis mortality which has been conducted in Thailand. Prolonged bacteremia ≥ 6 days, septic shock, and direct bilirubin > 1.5 mg/dL were strong predictors associated with S. suis mortality. The mortality risk factors identified may be further utilized in clinical practice and future research to improve patient outcomes.

    Matched MeSH terms: Sepsis
  10. Common diseases of children as seen in the general hospital, Singapore
    Williams CD
    Journal of the Malaya Branch of the British Medical Association, 1938;2:113-23.
    Matched MeSH terms: Sepsis
  11. Treatment of the fractures of the jaws
    Tratman EK
    Journal of the Malaya Branch of the British Medical Association, 1940;3:357-73.
    Matched MeSH terms: Sepsis
  12. Talaromyces (Penicillium) species infection in the central nervous system
    Chuah CH, Ong YC, Kong BH, Woo YY, Wong PS, Leong KN, et al.
    J R Coll Physicians Edinb, 2020 Jun;50(2):138-140.
    PMID: 32568283 DOI: 10.4997/JRCPE.2020.211
    Talaromycosis typically occurs as an opportunistic infection among immunocompromised individuals. Infection caused by species other than T. marneffei is uncommon. While most reported cases describe infection in the lungs, we report an extremely rare intracranial Talaromyces species infection. This 61-year-old with end-stage renal disease who was unwell for the previous two months, presented with fever and worsening confusion lasting for three days. Lumbar puncture was suggestive of meningitis. Cerebrospinal fluid (CSF) culture was later confirmed to be Penicillium chrysogenum. The patient was co-infected with Group B Streptococcus sepsis. He improved with amphotericin B and ceftriaxone and was discharged with oral itraconazole for four weeks. However, he died of unknown causes two weeks later at home. Talaromyces species infection in the central nervous system is uncommon. This case highlighted a rare but life-threatening fungal meningitis. Among the four reported cases worldwide, none of the patients survived.
    Matched MeSH terms: Sepsis
  13. Fulltext Fatal infections in older patients with inflammatory bowel disease on anti-tumor necrosis factor therapy
    Lee WS, Azmi N, Ng RT, Ong SY, Ponnampalavanar SS, Mahadeva S, et al.
    Intest Res, 2017 Oct;15(4):524-528.
    PMID: 29142521 DOI: 10.5217/ir.2017.15.4.524
    Anti-tumor necrosis factor (anti-TNF) is highly effective in inflammatory bowel disease (IBD); however, it is associated with an increased risk of infections, particularly in older adults. We reviewed 349 patients with IBD, who were observed over a 12-month period, 74 of whom had received anti-TNF therapy (71 patients were aged <60 years and 3 were aged ≥60 years). All the 3 older patients developed serious infectious complications after receiving anti-TNFs, although all of them were also on concomitant immunosuppressive therapy. One patient developed disseminated tuberculosis, another patient developed cholera diarrhea followed by nosocomial pneumonia, while the third patient developed multiple opportunistic infections (Pneumocystis pneumonia, cryptococcal septicemia and meningitis, Klebsiella septicemia). All 3 patients died within 1 year from the onset of the infection(s). We recommend that anti-TNF, especially when combined with other immunosuppressive therapy, should be used with extreme caution in older adult patients with IBD.
    Matched MeSH terms: Sepsis
  14. Comparison of the pattern of nosocomial infection between the neonatal intensive care units of hospitals kuala terengganu and universiti sains malaysia, kelantan
    Wan Hanifah W, Lee J, Quah B
    Malays J Med Sci, 2000 Jan;7(1):33-40.
    PMID: 22844213
    Nosocomial infection is a common problem in the Neonatal Intensive Care Unit (NICU) and a knowledge of the pattern of nosocomial infection will contribute greatly to the intensification of infection control measures and the development of antibiotic policies in the NICU. This study aims to compare the incidence and clinical characteristics of neonates with nosocomial infection in NICU of both Kuala Terengganu Hospital (HKT) and Universiti Sains Malaysia Hospital (HUSM). Neonates who had both clinical signs of sepsis and positive blood cultures, 48 hours after admission to NICU, from 1(st) January to 31(st) December 1998, in both hospitals were retrospectively studied. Among neonates admitted to NICU, 30 (5.4%) in HKT and 65 (3.6%) in HUSM had nosocomial infection (p = 0.07). The mean duration of hospitalisation was shorter (HUSM 37 days, HKT 49 days; p = 0.02), and the number of neonates with predisposing factors for infection is higher (HUSM 100%, HKT 73.3%; p < 0.001) in HUSM compared with HKT. There were no differences in gestation, mean age of onset of infection and mortality between both hospitals. The most common organism isolated from the blood in HKT was Klebsiella pneumoniae (33.3%), and in HUSM Klebsiella aerogenes (24.6%). Half of Klebsiella pneumoniae isolates were resistant to cephalosporins and aminoglycosides in HKT and a similar number of Klebsiella aerogenes isolates were resistant to piperacillin and aminoglycosides in HUSM. In conclusion nosocomial infection is a common problem in both hospitals. Except for more frequent predisposing factors for infection in HUSM, and a longer duration of hospital stay among neonates in HKT, the clinical characteristics of neonates with nosocomial infection in both hospitals were similar.
    Matched MeSH terms: Sepsis
  15. Fulltext Aorto-oesophageal fistula and aortic pseudoaneurysm caused by a swallowed fish bone
    Sia KJ, Ashok GD, Ahmad FM, Kong CK
    Hong Kong Med J, 2013 Dec;19(6):542-4.
    PMID: 24310662 DOI: 10.12809/hkmj133668
    We describe a rare case of aorto-oesophageal fistula and aortic pseudoaneurysm in a middle-aged man, who presented with chest pain and haematemesis 1 week after swallowing a fish bone. Oesophagogastroduodenoscopy and computed tomographic angiography findings were consistent with oesophageal perforation, proximal descending aortic pseudoaneurysm, and aorto-oesophageal fistula. Thoracic endovascular aortic repair was performed. The patient died from severe mediastinal sepsis. Early surgical intervention and broad-spectrum antibiotic therapy are crucial in preventing life-threatening mediastinal infection.
    Matched MeSH terms: Sepsis/etiology
  16. Hospital-acquired Clostridium difficile infection among patients with type 2 diabetes mellitus in acute medical wards
    Hassan SA, Rahman RA, Huda N, Wan Bebakar WM, Lee YY
    J R Coll Physicians Edinb, 2013;43(2):103-7.
    PMID: 23734349 DOI: 10.4997/JRCPE.2013.203
    Clostridum difficile (C. difficile) infection is increasingly seen among hospitalised patients with type 2 diabetes mellitus but its rate and associated risk factors are not known. We aimed to determine the rate and characteristics of hospital-acquired C. difficile infection in subjects with type 2 diabetes mellitus admitted into acute medical wards.
    Matched MeSH terms: Sepsis/complications*
  17. Retinopathy of prematurity in very low birth weight infants
    Chye JK, Lim CT, Leong HL, Wong PK
    Ann Acad Med Singap, 1999 Mar;28(2):193-8.
    PMID: 10497665
    This study aims to determine the prevalence of and risk factors associated with retinopathy of prematurity (ROP) in very low birth weight (VLBW) infants. All premature VLBW infants, admitted into the neonatal intensive care unit of the University Hospital Kuala Lumpur, were screened from 4 weeks of life. Perinatal and neonatal data were retrieved from the infants' medical notes. Between August 1994 and July 1996, 100 infants had their eyes examined serially. Of the 15 (15%) infants with ROP, all were less than 31 weeks gestation, and only 1 infant had birth weight above 1250 g. Five (5%) infants had severe ROP; 4 infants underwent cryotherapy for stage 3 threshold disease. Infants with ROP, as compared to infants without ROP, had lower birth weight [mean (SEM) 993 (50) g versus 1205 (22) g, P < 0.001], lower gestational age [mean (SEM) 28.0 (0.4) weeks versus 30.1 (0.2) weeks, P < 0.001], higher rates of patent ductus arteriosus and chronic lung disease, greater number of radiographic examinations and episodes of late-onset suspected/confirmed sepsis, and required longer duration of supplemental oxygen, ventilation, xanthine, antibiotics and intralipid use, but were slower to establish full enteral feeds. On multivariate logistic regression analysis, birth weight < or = 1000 g [OR 2.38, 95% CI 1.25, 4.55, P = 0.009] and gestational age < or = 28 weeks [OR 2.86, 95% CI 1.47, 5.56, P = 0.002] were significant predictors of increased risk of this disease. In conclusion, ROP is strongly associated with smaller, more immature and sicker neonates. Prevention of prematurity would help reduce the incidence of this disease.
    Matched MeSH terms: Sepsis/epidemiology
  18. Pancreatic pseudocyst: the controversial value of total parenteral nutrition
    Shahrudin MD, Noori SM
    Hepatogastroenterology, 1997 Mar-Apr;44(14):559-63.
    PMID: 9164537
    Total parenteral nutrition (TPN) for the non-operative treatment of acute pancreatic pseudocyst has been of hypothetical benefit.
    Matched MeSH terms: Sepsis/etiology
  19. Secondary B-cell acute lymphoblastic leukemia following Wilms' tumor: clinical and in vitro chemosensitivity studies
    Ariffin H, Muthukkumaran T, Stanslas J, Sabariah AR, Veerasekaran N, Lin HP
    Leuk Lymphoma, 2005 Aug;46(8):1233-7.
    PMID: 16085568
    We report the clinical features and in vitro chemosensitivity assay findings of a 13-year-old girl who developed secondary B-cell acute lymphoblastic leukemia (ALL) 7 years after a diagnosis of Wilms' tumor. The patient was treated using the Berlin - Frankfurt - Muenster (BFM) ALL chemotherapy protocol with poor response to initial therapy before succumbing to sepsis. An in vitro chemosensitivity assay on her peripheral blood lymphoblasts was performed while she was undergoing induction therapy and showed a high level of resistance to drugs commonly used for ALL therapy, e.g. steroids, anthracyclines, vincristine and L-asparaginase. The mechanism of chemoresistance was not elicited, but was probably not related to P-glycoprotein (P-gp) over-expression. We believe that the in vitro chemosensitivity assay is a good indicator of cellular response to chemotherapy and may provide reliable information for the basis of the selection of drugs to be used for the treatment of similarly rare patients rather than relying on "standard" protocols.
    Matched MeSH terms: Sepsis/drug therapy
  20. Fulltext Very low birth weight infants--mortality and predictive risk factors
    Chye JK, Lim CT
    Singapore Med J, 1999 Sep;40(9):565-70.
    PMID: 10628243
    To determine the survival rates and risk factors associated with mortality in premature very low birth weight or VLBW (< or = 1500 grams) infants.
    Matched MeSH terms: Sepsis/mortality
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