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Fulltext Home oxygen therapy for children with chronic lung diseases

Norzila MZ, Azizi BHO, Norrashidah AW, Yeoh NM, Deng CT

Med J Malaysia, 2001 Jun;56(2):151-7.
PMID: 11771074

Summary: Home oxygen therapy programme is new in Malaysia. This programme enables children with respiratory insufficiency to be discharged home early.
Materials and Methods: Long term oxygen therapy was initiated using an oxygen concentrator in patients who i) remained hypoxic while breathing room air, ii) experienced desaturations of more than 20% during sleep as seen in patients with severe laryngomalacia and obstructive sleep apnoea syndrome and iii) had pulmonary hypertension with or without polycythemia. The median with first and third quartile values are presented for the quantitative variables.
Results: A total of 71 patients mainly children with bronchopulmonary dysplasia (BPD) (32) and bronchiolitis obliterans (12) were discharged home on this programme. The median age at which home oxygen was initiated in children with BPD was 5.0 (Q1:2 Q3:8) months. The median total duration of oxygen requirement for BPD was 8.0 (Q1:5, Q3:12) months. The median duration of home oxygen dependency was 3.5 (Q1:3, Q3:6) months. However children with bronchiolitis obliterans required longer duration of oxygen therapy compared to children with BPD i.e. median duration of 28 months (Q1:14.5 Q3:66). In other respiratory conditions the mean duration of supplemental oxygen varies some of which may be life long.
Conclusions: This paper has shown the importance of home oxygen program in children with respiratory disorders. It has significantly shortened hospital stay and thus saves hospital costs and prevents prolonged separation from the family.

Matched MeSH terms: Infant; Infant, Newborn
Fulltext Enzyme replacement therapy for Gaucher Disease: the only experience in Malaysia

Chan LL, Lin HP

Med J Malaysia, 2002 Sep;57(3):348-52.
PMID: 12440275 MyJurnal

Gaucher Disease may now be treated with enzyme replacement therapy (ERT) or bone marrow transplantation (BMT). Both have their advantages and disadvantages. Results with BMT are curative when successful but limited by the scarcity of an appropriate donor. ERT offers very good relief of symptoms but treatment is lifelong and cost of treatment exorbitant. Patients in developing countries are particularly disadvantaged and management remains a dilemma for both doctor and patient.

Matched MeSH terms: Infant; Infant, Newborn
Fulltext Pattern of congenital heart disease and access to tertiary cardiac care in Malaysia

Hung LC, Mohan AJ, Soo TL, Ng HP

Med J Malaysia, 2000 Dec;55(4):424-32.
PMID: 11221153

This prospective, descriptive study was carried out to determine the pattern and the type of congenital heart disease seen in the Paediatric Departments in 4 government hospitals. The accessibility of surgical or transcatheter interventional treatment was also assessed. Consecutive new patients seen for suspected congenital heart disease from 1/1/95 till 31/12/95 (Group I) were registered. Records of patients seen from 1/1/95 to 31/8/95 (Group Ia) were reviewed 6 months after presentation to determine the nature of treatment received. Group II were cardiac patients who were first seen prior to the year 1995 and had undergone cardiac surgery or transcatheter interventional procedures in 1995. Of the 375 patients registered in the 4 hospitals, 250 were new patients and 125 were patients first seen prior to 1995 and had surgery or transcatheter interventional procedures in 1995. Of the 250 new patients, 83.2% had acyanotic cardiac lesions and 16.8% had cyanotic lesions. Ventricular septal defect was the commonest lesion, constituting 37.2%, followed by patent arterial duct (18.8%) and atrial septal defects (9.6%). At 6 month review, access to close-heart surgery or transcatheter interventional treatment were readily available. However, for patients with ventricular septal defects, 42.1% who required closure were still waiting for surgery 6 months after presentation. Of the 4 patients with Fallot's Tetralogy who required surgery, 2 had modified Blalock-Taussig shunt and 2 were awaiting surgery. In 1995, a total of 204 cardiac procedures were performed, there were 114 (55.9%) open heart procedures, 50 (24.5%) surgical ligation of the arterial duct, 28 (13.7%) modified Blalock-Taussig shunts, 11 (5.4%) transcatheter duct occlusion and 1 (0.5%) balloon valvuloplasty. The mean age of Fallot's Tetralogy repair was 6.4 years. No corrective surgery was performed for patients with complex cardiac lesions from the 4 hospitals in 1995. In conclusion, the pattern of congenital heart disease was similar to that seen world wide. Except for patent arterial duct, access to surgical treatment was inadequate.

Matched MeSH terms: Infant; Infant, Newborn
Fulltext Characteristics of Malaysian infants with biliary atresia and neonatal hepatitis

Karnameedi S, Lim CT

Med J Malaysia, 1997 Dec;52(4):342-7.
PMID: 10968111

Cholestatic disorders of infancy (viz neonatal hepatitis and biliary atresia) have not been well studied in Malaysia. In a retrospective study in the Department of Paediatrics, University Hospital, Kuala Lumpur from January 1982 through December 1991, a total of ninety-three infants with such conditions were identified: 35 (38%) had biliary atresia, 58 (62%) neonatal hepatitis. There was a statistically significant male preponderance in the neonatal hepatitis group (P = 0.020). There was no significant difference in the racial distribution and in the proportions of low birthweight infants between the two groups of disorders. When the biliary atresia group was compared with the neonatal hepatitis group, significant differences were observed in the age of presentation (mean +/- SD) 9.8 +/- 6.8 VS 20 +/- 17.3 weeks (P < 0.001), proportion of infants with prolonged jaundice (> seven weeks) 28/35 (80%) VS 20/58 (34.5%) (P < 0.00001), occurrence of alcoholic stools 26/35 (74.3%) VS 27/58 (46.6%) (P = 0.020), liver size (mean +/- SD): 4.3 (1.6 cm VS 3.3 +/- 1.8 cm (P < 0.01) and splenic size: 2.5 (1.8 cm VS 1.4 (1.2 cm (P < 0.001). There was however considerable overlap between the two groups in these features at presentation, making clinical differentiation between the two conditions difficult. Infants with cholestasis tended to present late, compromising the chance of survival. In order to improve the medical care of these patients, these conditions must be emphasised during the training of medical practitioners, and efforts to increase public awareness of these conditions must be created.

Matched MeSH terms: Infant; Infant, Newborn
Viral aetiology of lower respiratory tract infection in young Malaysian children

Chan PW, Goh AY, Chua KB, Kharullah NS, Hooi PS

J Paediatr Child Health, 1999 Jun;35(3):287-90.
PMID: 10404452

OBJECTIVE: To study the viral aetiology of lower respiratory tract infection (LRTI) in young Malaysian children.
METHODOLOGY: A retrospective review was performed of LRTI patients aged less than 24 months who were admitted to the University Malaya Medical Centre between 1982 and 1997. Respiratory viruses in their nasopharyngeal secretion were identified by indirect immunofluorescence, viral culture, or both.
RESULTS: A total of 5691 children were included in the study. The mean age was 8.6 +/- 6.6 months and the M:F ratio was 1.6:1. The most common diagnosis was pneumonia (52%) followed by bronchiolitis (45%) and croup (2%). Positive viral isolation rate was 22.0%. Respiratory syncytial virus (RSV) was the commonest virus isolated (84%), followed by parainfluenza virus (8%), influenza virus (6%) and adenovirus (2%). Patients with positive virus isolation were younger (7.8 +/- 6.2 vs 8.7 +/- 6.7 months, P = 0.0001) and were more likely to have bronchiolitis.
CONCLUSION: Young Malaysian children admitted with LRTI had a 22% viral isolation rate and RSV was the commonest virus isolated.

Matched MeSH terms: Infant; Infant, Newborn
Chronic diarrhoea in infants and young children: causes, clinical features and outcome

Lee WS, Boey CC

J Paediatr Child Health, 1999 Jun;35(3):260-3.
PMID: 10404446

OBJECTIVES: To review the causes, clinical features and outcomes of Malaysian children who had chronic diarrhoea.
METHODOLOGY: A prospective study was performed on children with diarrhoea of more than 14 days' duration who were managed at the Department of Paediatrics, University of Malaya Medical Centre, Kuala Lumpur from 1 January 1996 to 31 December 1997.
RESULTS: Twenty-seven patients (14 boys and 13 girls) were studied. The median age of onset of diarrhoea was 6 months and the mean duration of symptoms before referral was 66.5 days. The underlying causes of diarrhoea were found to be: (i) prolonged diarrhoea due to well-defined entities (intestinal lymphangiectasia, two cases; congenital glucose-galactose malabsorption, one case; post-small bowel resection, one case; (ii) postenteritis diarrhoea (cow's milk protein intolerance, eight cases; secondary lactose intolerance, four cases; transient monosaccharide intolerance, one case; (iii) gastrointestinal infections (nontyphoid Salmonella gastroenteritis, three cases; trichuriasis, two cases; amoebiasis, one case; adenovirus, one case; (iv) cases in which a firm diagnosis could not be established (three cases). The mean duration of hospital admission was 63 days. Sixteen cases required a change in diet, while nine cases required total parenteral nutrition. One death occurred.
CONCLUSIONS: Chronic childhood diarrhoea in Malaysia had a variety of aetiologies. A specific diagnosis could be established in 90% of cases. Making a diagnosis was important because this led to appropriate therapy and a good outcome in 96% of cases.

Matched MeSH terms: Infant; Infant, Newborn
Stratified partial likelihood estimation

Ridder G, Tunali I

J Econom, 1999 Oct;92(2):193-232.
PMID: 12322577

When multiple durations are generated by a single unit, they may be related in a way that is not fully captured by the regressors. The omitted unit-specific variables might vary over the durations. They might also be correlated with the variables in the regression component. The authors propose an estimator that responds to these concerns and develop a specification test for detecting unobserved unit-specific effects. Data from Malaysia reveal that concentration of child mortality in some families is imperfectly explained by observed explanatory variables, and that failure to control for unobserved heterogeneity seriously biases the parameter estimates.

Matched MeSH terms: Infant Mortality*
Fulltext Alpha-1-antitrypsin deficiency in babies with prolonged jaundice

Zakiah I, Zaini AR, Jamilah B, Zawiah A

Malays J Pathol, 1992 Dec;14(2):91-4.
PMID: 1304630

Over a three-year-period, 310 babies with prolonged jaundice admitted to GHKL were studied, to determine the incidence of alpha-1-antitrypsin deficiency as a cause of the problem. Ninety-two babies (29.7%) were found to be alpha-1-antitrypsin deficient. The percentage incidence was found to be highest in Indians (33.3%), followed by Malays (31.9%) and Chinese (26.7%). There was a male preponderance with a M:F ratio of 1.6:1. Most of these babies presented at the hospital at the age of more than two weeks but less than one month. Apart from the problem of prolonged jaundice and alpha-1-antitrypsin deficiency, 2 had associated bleeding problems, 11 associated infections and 3 respiratory problems. Two babies had clinical features of Down's syndrome, 2 had G6PD deficiency and 1 had congenital hypothyroidism. AST, ALT and ALPO4 were high in 20, 26 and 3 babies respectively.

Matched MeSH terms: Infant; Infant, Newborn
Fulltext Paediatric day care anaesthesia--our first two years experience at the Paediatric Institute, Hospital Kuala Lumpur

Lim SK, Lew YS

Med J Malaysia, 1997 Jun;52(2):151-4.
PMID: 10968073

The first two years anaesthetic experience of paediatric day care surgery is reviewed. Four hundred and three patients underwent 447 general surgical procedures. The mean age of the patients was 5.4 years with the youngest being 5 months old. The commonest procedures performed were herniotomy, circumcision, correction of hydrocoele and orchidopexy. The overall postoperative admission rare was 2.5%. No major complications were seen. Anaesthesia for paediatric day care surgery is safe provided patients are carefully selected and evaluated, appropriate anaesthetic management instituted and proper discharge criteria adhered to.

Matched MeSH terms: Infant; Infant, Newborn
Reversal of the decline in breastfeeding in Peninsular Malaysia? Ethnic and educational differentials and data quality issues

DaVanzo J, Sine J, Peterson C, Haaga J

Soc Biol, 1994 1 1;41(1-2):61-77.
PMID: 7973841

Data from the First and Second Malaysian Family Life Surveys in 1976 and 1988, respectively, are analyzed to examine long-term trends in breastfeeding in Peninsular Malaysia, educational and ethnic differences therein, and the quality of retrospective data on infant feeding. The steady decrease between the mid-1950's and mid-1970's in breastfeeding was reversed to become a nearly monotonic increase since 1975. Part of the change is attributable to the changing composition of the Malaysian population. Over time, the percentages of births to subgroups with higher rates of breastfeeding--particularly Malays and more highly educated women--have increased. However, there is also evidence of changes in rates of breastfeeding within these subgroups. Many Malaysian infants have a total duration of breastfeeding (including with supplementation) considerably shorter than WHO's recommended four months of exclusive (unsupplemented) breastfeeding. Moreover, nearly all breastfed infants are first given supplementary food or beverage shortly after birth. Breastfeeding promotion efforts in Malaysia need to emphasize the appropriate timing of and types of supplementary feeding.

Matched MeSH terms: Infant; Infant, Newborn
Aetiology of stridor in Malaysian children

Elango S, Htun YN

Ann Trop Paediatr, 1994;14(4):329-32.
PMID: 7880097

Eighty-five children who presented with stridor were reviewed in order to determine the aetiology of stridor in these cases. Congenital causes accounted for 57.6% of cases. Laryngomalacia was the commonest congenital abnormality (77.5%). Other common causes of stridor were a foreign body in the airway (acquired) and laryngotracheobronchitis (33.3%) (infective). Tracheostomized children are a problem in developing countries, requiring prolonged hospitalization. We overcome this problem by teaching parents how to maintain the tracheostomy tube at home.

Matched MeSH terms: Infant; Infant, Newborn
Fulltext Adequacy of lactation: dysreflexia vs. maternal nutrition

Jelliffe DB

Med J Malaysia, 1986 Mar;41(1):77-83.
PMID: 3796355

Problems with assessing the effect of maternal nutrition and lactation performance are presented in relation to a conceptual mathematical ziggurat. Difficulties, variations and flows are to be found in stages of this sequence of "logic" [e.g., assessment of maternal nutrition, volume and composition of breast milk, nutritional satisfactions of the nursling). It is concluded that the various steps in this process of reasoning are subject to much more variation and adaptation than appreciated. Much so-called "faltering" in the second trimester is physiologically normal ("pseudo-faltering").

Matched MeSH terms: Infant; Infant, Newborn
Fulltext Growth charts based on longitudinal study of Malaysian children from birth to six years

Chen ST

Med J Malaysia, 1985 Jun;40(2):80-9.
PMID: 3834290

Percentile growth charts of weight, length and head circumference, from birth to six years of age, for boys and girls, are presented. These can be used to monitor the growth of Malaysian children.

Matched MeSH terms: Infant; Infant, Newborn
Fulltext The modern killer

Chen PCY

Med J Malaysia, 1983 Jun;38(2):90-3.
PMID: 6621452
Matched MeSH terms: Infant; Infant, Newborn
Fulltext Perforated peptic ulcers in West Malaysia--a series of 73 cases treated by simple closure in a general hospital between 1972 and 1974

Said MY

Med J Malaysia, 1982 Sep;37(3):261-4.
PMID: 7177009

In a 3 year period 73 cases of perforated peptic ulcers were treated by simple closure. The overall mortality of 3.77 percent is acceptable when compared with other reports. There was a marked male preponderance (11 males: female 1). Biopsy results confirmed the operatiue findings that perforations were seven times more common in gastric peptic ulcers than duodenal ones. The disease affected young adults, the middle aged and elderly, the peak incidence occurring between the fifth and seventh decades oflife. Simple closure was an effective surgical procedure for our group of patients.

Matched MeSH terms: Infant; Infant, Newborn
Grandmultiparity in Malaysian women

Tai C, Urquhart R

Asia Oceania J Obstet Gynaecol, 1991 Dec;17(4):327-34.
PMID: 1801678

Grandmultiparity is an ill defined term, but it is generally believed that increasing parity after the fifth delivery increases the risks of child bearing for both the mother and fetus. Four hundred seventy-seven women aged less than 35 years of parity 5 and above who delivered during one year period at the University Hospital, Kuala Lumpur were studied. There were 406 women of parity 5 and 6 and 71 women of parity 7 and above. The 2 groups as a whole comprised 7.5% of the obstetric population for that year. Obstetric performance in the 2 groups of grandmultipara was compared with 1,135 women, aged 25 to 34 years, having their second baby during the same period. Women of parity 7 and above were significantly more likely to be from lower socioeconomic groups, and suffer from anaemia, hypertension and pre-eclampsia. They were also significantly at risk of preterm delivery and delivering infants weighing less than 2.5 kg. In addition, the perinatal mortality rate was significantly greater in the highly parous group (Para greater than 7) than in women of parity 5 and 6 or the control group. Apart from a significant increase in the incidence of anaemia, women of parity 5 and 6 had a similar obstetric performance and perinatal outcome to that of the control group. We conclude that grandmultiparity per se is not an obstetric risk factor until after the seventh delivery. These findings have implications for those who plan the provision of obstetric services for the community.

Matched MeSH terms: Infant Mortality; Infant, Newborn
Influence of immunization schedule on immunization coverage

Chen ST

J Trop Med Hyg, 1989 Dec;92(6):386-90.
PMID: 2607571

The infant immunization coverage for triple antigen (DPT) from 1968 and trivalent oral polio vaccine (TOPV) from 1972 to 1985 for Peninsular Malaysia are presented. It shows that immunization coverage improved when the recommended age for first dose of DPT was changed from the fourth to the second month of life in 1972 and declined when the recommended age for the first dose of DPT and TOPV was revised again from the second to the third month of life in 1980. The advantages of immunizing children early in life are discussed.

Matched MeSH terms: Infant; Infant, Newborn
Comparison between the development of Malaysian and Denver children

Chen ST

J Singapore Paediatr Soc, 1989;31(3-4):178-85.
PMID: 2638722

126 Malay children from higher income families were followed-up regularly from birth to six years of age in the University Hospital, Kuala Lumpur. Their developmental performance was compared to that of Denver children. Generally, Malaysian and Denver children appear to be similar in their development during the first six years of life except for some minor differences in the personal-social, language and gross motor sectors. Malaysians appear to be slower in self-care but more advanced in "helping around the house", "playing interactive games" and in "separating from mother". They were slightly slower in gross motor function during the first year of life but more advanced during the second year of life. However, they were slightly more advanced in language development. The differences in development between the two groups of children are discussed and it is concluded that the differences can partly be explained by differences in socio-economic or cultural differences between the two groups of children. However, the influence of genetic factors cannot be dismissed.

Matched MeSH terms: Infant; Infant, Newborn
Mortality trends of young children in developing countries

Rutstein SO

IPPF Med Bull, 1983 Dec;17(6):2-4.
PMID: 12279694
Matched MeSH terms: Infant Mortality*
Undescended testis: a study of 212 cases treated surgically

Joseph VT, Fong PH

Ann Acad Med Singap, 1981 Oct;10(4):502-6.
PMID: 6124206

Two hundred and twelve of undescended testes were operated on in the Department of Surgery, Singapore General Hospital between the years 1974 through 1980. There was a 51.9% incidence of right undescended testis, 34.9% left undescended testis and 13.2% were bilateral. The method of treatment was surgical exploration with orchidopexy wherever technically feasible or orchidectomy if the testis was found to be severely hypoplastic. Of the total series, 42% were operated on before the age of 5 years. The oldest patient undergoing orchidopery was aged 40. Failure of orchidopexy to secure the scrotal position for the testis was noted in 14 cases. This was probably due to inadequate mobilisation at the first operation. There was no mortality and no significant morbidity following surgical treatment in this series.

Matched MeSH terms: Infant; Infant, Newborn

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