MyMedR

Comparison of antimicrobial resistance in neonatal and adult intensive care units in a tertiary teaching hospital

Ariffin N, Hasan H, Ramli N, Ibrahim NR, Taib F, Rahman AA, et al.

Am J Infect Control, 2012 Aug;40(6):572-5.

PMID: 22854380 DOI: 10.1016/j.ajic.2012.02.032

Intrahospital variations in antimicrobial profiles may be related to many factors. This study compared causative agents of nosocomial bloodstream infections between a neonatal intensive care unit (NICU) that adopted a ward-tailored antibiotic policy and adult intensive care units (ICUs). Data on organisms from blood cultures obtained from the respective wards between 2005 and 2009 were analyzed. Compared with the adult ICUs, the NICU had a higher frequency of Enterobacteriacae and lower frequencies of typical hospital-acquired pathogens (eg, Klebsiella pneumoniae, 17.4% vs 10.0% [P < .001]; Acinetobacter baumannii, 3.9% vs 11.6% [P < .001]). Antibiotic resistance of gram-negative organisms was also significantly lower in the NICU, including resistance to imipenem (5.7% vs 32.1%; P < .001), amikacin (8.8% vs 30.3%), and ceftriaxone (36.1% vs 74.6%; P < .001). This could possibly be due to the ward-tailored antibiotic policy adopted by the NICU but not by the other ICUs.

Fulltext First isolation of Burkholderia tropica from a neonatal patient successfully treated with imipenem

Deris ZZ, Van Rostenberghe H, Habsah H, Noraida R, Tan GC, Chan YY, et al.

Int J Infect Dis, 2010 Jan;14(1):e73-4.

PMID: 19482535 DOI: 10.1016/j.ijid.2009.03.005

We report the first case of a human Burkholderia tropica infection. The patient was a premature neonate who had necrotizing enterocolitis with bowel perforation requiring surgical intervention. The stoma care and difficulties in feeding were a chronic problem. At the age of almost 4 months he developed septicemia due to B. tropica. Three consecutive blood cultures grew this organism. The organism was cleared from the blood after a course of imipenem and resolution of post-operative ileus. Our case suggests that environmental and plant pathogens can cause human infection especially in those in an immunocompromised condition.

Frequencies of A(TA)7TAA, G71R, and G493R mutations of the UGT1A1 gene in the Malaysian population

Yusoff S, Van Rostenberghe H, Yusoff NM, Talib NA, Ramli N, Ismail NZ, et al.

Biol. Neonate, 2006;89(3):171-6.

PMID: 16210851

Gilbert syndrome is caused by defects in the uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1) gene. These mutations differ among different populations and many of them have been found to be genetic risk factors for the development of neonatal jaundice.

Poor correlation between hemolysis and jaundice in glucose 6-phosphate dehydrogenase-deficient babies

Jalloh S, Van Rostenberghe H, Yusoff NM, Ghazali S, Nik Ismail NZ, Matsuo M, et al.

Pediatr Int, 2005 Jun;47(3):258-61.

PMID: 15910447

The role of hemolysis in the pathophysiology of neonatal jaundice (NNJ) in patients with glucose 6-phosphate dehydrogenase (G6PD) deficiency has been questioned recently. The aim of the present study was to determine the contribution of hemolysis to the pathophysiology of jaundice in Malay neonates with G6PD deficiency and NNJ.

Molecular heterogeneity of glucose-6-phosphate dehydrogenase deficiency in Malays in Malaysia

Yusoff NM, Shirakawa T, Nishiyama K, Ghazali S, Ee CK, Orita A, et al.

Int J Hematol, 2002 Aug;76(2):149-52.

PMID: 12215013 DOI: 10.1007/BF02982577

Multiplex polymerase chain reaction (PCR) using multiple tandem forward primers and a common reverse primer (MPTP) was recently established as a comprehensive screening method for mutations in X-linked recessive diseases. In the work reported here, MPTP was used to scan for mutations of the glucose-6-phosphate dehydrogenase (G6PD) gene. Mutations in exons 3,4,5,6,7,9, 11, and 12 of the G6PD gene were screened by MPTP in 93 unrelated Malaysian patients with G6PD deficiency. Of the 93 patients, 80 (86%) had identified mutations. Although all of these were missense mutations, identified nucleotide changes were heterogeneous, with 9 mutations involving various parts of the exons. These 9 mutations were G-to-A nucleotide changes at nucleotide 871 of the G6PD gene (G871A), corresponding to G6PD Viangchan, G6PD Mediterranean (C563T), G6PD Vanua Lava (T383C), G6PD Coimbra (C592T), G6PD Kaiping (G1388A), G6PD Orissa (C131G), G6PD Mahidol (G487A), G6PD Canton (G1376T), and G6PD Chatham (G1003A). Our results document heterogeneous mutations of the G6PD gene in the Malaysian population.

High prevalence of Southeast Asian ovalocytosis in Malays with distal renal tubular acidosis

Yusoff NM, Van Rostenberghe H, Shirakawa T, Nishiyama K, Amin N, Darus Z, et al.

J Hum Genet, 2003;48(12):650-653.

PMID: 14618420 DOI: 10.1007/s10038-003-0095-2

Southeast Asian ovalocytosis (SAO) is a red blood cell abnormality common in malaria-endemic regions and caused by a 27 nt deletion of the band 3 protein gene. Since band 3 protein, also known as anion exchanger 1, is expressed in renal distal tubules, the incidence of SAO was examined in distal renal tubular acidosis (dRTA) in Malays in Kelantan, Malaysia. Twenty-two patients with dRTA and 50 healthy volunteers were examined for complication of SAO by both morphological and genetic analyses. SAO was identified in 18 of the 22 dRTA patients (81.8%), but only two of the 50 controls (4%). The incidence of SAO was significantly high in those with dRTA (p<0.001), indicating a dysfunctional role for band 3 protein/anion exchanger 1 in the development of dRTA.

Fulltext Autonomy in refusing life saving interventions: religious and cultural misconceptions

van Rostenberghe H, Yong A, Mohd Zin F, Fuad MDF, Idris B, Tahir NA, et al.

Education in Medicine Journal, 2014;6(1):70-73.

MyJurnal

Autonomy is widely accepted to be the third pillar of medical ethics. However, if it comes to refusal of life saving treatments, some extra considerations are necessary, especially if decisions are made by surrogate decision makers. Four cases of problematic decision making are presented here, followed by a discussion about the cultural and religious misconceptions about the rights of surrogate decision makers.

Two-hourly versus 3-hourly feeding for very low birthweight infants: a randomised controlled trial

Ibrahim NR, Kheng TH, Nasir A, Ramli N, Foo JLK, Syed Alwi SH, et al.

Arch. Dis. Child. Fetal Neonatal Ed., 2017 May;102(3):F225-F229.

PMID: 27671836 DOI: 10.1136/archdischild-2015-310246

OBJECTIVE: To determine whether feeding with 2-hourly or 3-hourly feeding interval reduces the time to achieve full enteral feeding and to compare their outcome in very low birthweight preterm infants.

DESIGN: Parallel-group randomised controlled trial with a 1:1 allocation ratio.

SETTING: Two regional tertiary neonatal intensive care units.

PATIENTS: 150 preterm infants less than 35 weeks gestation with birth weight between 1.0 and 1.5 kg were recruited.

INTERVENTIONS: Infants were enrolled to either 2-hourly or 3-hourly interval feeding after randomisation. Blinding was not possible due to the nature of the intervention.

MAIN OUTCOME MEASURES: The primary outcome was time to achieve full enteral feeding (≥100 mL/kg/day). Secondary outcomes include time to regain birth weight, episode of feeding intolerance, peak serum bilirubin levels, duration of phototherapy, episode of necrotising enterocolitis, nosocomial sepsis and gastro-oesophageal reflux.

RESULTS: 72 infants were available for primary outcome analysis in each group as three were excluded due to death-three deaths in each group. The mean time to full enteral feeding was 11.3 days in the 3-hourly group and 10.2 days in the 2-hourly group (mean difference 1.1 days; 95% CI -0.4 to 2.5; p=0.14). The mean time to regain birth weight was shorter in 3-hourly group (12.9 vs 14.8 days, p=0.04). Other subgroup analyses did not reveal additional significant results. No difference in adverse events was found between the groups.

CONCLUSION: 3-hourly feeding was comparable with 2-hourly feeding to achieve full enteral feeding without any evidence of increased adverse events.

TRIAL REGISTRATION NUMBER: ACTRN12611000676910, pre-result.

The impact of children with disabilities on parent health-related quality of life and family functioning in Kelantan and its associated factors

Isa SN, Aziz AA, Rahman AA, Ibrahim MI, Ibrahim WP, Mohamad N, et al.

J Dev Behav Pediatr, 2013 May;34(4):262-8.

PMID: 23538932 DOI: 10.1097/DBP.0b013e318287cdfe

Caring for children with disabilities brings about a significant impact on the parents and families. The purposes of this study were to determine the impact of having children with disabilities on parents' health-related quality of life (HRQOL), family functioning, and total family impact and to identify the associated factors.

Screening for G71R mutation of the UGT1A1 gene in the Javanese-Indonesian and Malay-Malaysian populations

Sutomo R, Talib NA, Yusoff NM, Van Rostenberghe H, Sadewa AH, Sunarti, et al.

Pediatr Int, 2004 Oct;46(5):565-9.

PMID: 15491385

There are significant differences in the prevalence and severity of neonatal jaundice among various populations. Recently, it has been reported that a mutation of the UGT1A1 gene, glycine to arginine at codon 71 (G71R), is related to the development of neonatal jaundice in East Asian populations. However, whether the G71R mutation contributes to the high incidence of neonatal jaundice in different Asian populations remains unknown. The authors screened for this mutation in the Javanese-Indonesian and Malay-Malaysian populations.

Fulltext High resolution melting analysis of the NR1I3 genetic variants: Is there an association with neonatal hyperbilirubinemia?

Cheung TP, Van Rostenberghe H, Ismail R, Nawawi NN, Abdullah NA, Ramli N, et al.

Gene, 2015 Dec 1;573(2):198-204.

PMID: 26188155 DOI: 10.1016/j.gene.2015.07.045

Constitutive androstane receptor (CAR) encoded by the nuclear receptor subfamily 1, group I, member 3 (NR1I3) gene regulates the elimination of bilirubin through activating the components of the bilirubin clearance pathway. Hence, NR1I3 genetic variants may affect bilirubin metabolism and result in neonatal hyperbilirubinemia. Thus far, research which investigates the association between NR1I3 variants and neonatal hyperbilirubinemia has not been undertaken in any population. The present study aimed to evaluate the influence of MPJ6_1I3008 (rs10157822), IVS8+116T>G (rs4073054) and 540A>G (rs2307424) on neonatal hyperbilirubinemia development in the Malay population. Buccal swabs were collected from 232 hyperbilirubinemia and 277 control term newborns with gestational age ≥37weeks and birth weight ≥2500g. The NR1I3 variants were genotyped by using high resolution melting (HRM) assays and verified by DNA sequencing. Gender, mode of delivery and birth weight did not differ between hyperbilirubinemia and control groups. The genotypic and allelic frequencies of MPJ6_1I3008, IVS8+116T>G and 540A>G were not significantly different between the groups. However, stratification by gender revealed a significant inverse association between homozygous variant genotype of MPJ6_1I3008 and risk of neonatal hyperbilirubinemia in the females (OR, 0.44; 95% CI, 0.20-0.95; p=0.034). This study demonstrates that the homozygous variant genotype of MPJ6_1I3008 was associated with a significant reduced risk of neonatal hyperbilirubinemia in the females.

Fulltext A psychologist-led educational intervention results in a sustained reduction in neonatal intensive care unit infections

Van Rostenberghe H, Short J, Ramli N, Geok TB, Subramaniam S, Che Yaakob CA, et al.

Front Pediatr, 2014;2:115.

PMID: 25478550 DOI: 10.3389/fped.2014.00115

Even though in the corporate world psychological science has been widely used, the formal use of evidence-based psychology in important areas of clinical medicine has been scanty at best. It was the aim of this study to determine the efficacy of a psychologist-led 2-week nurse educator training on the infection rate in the neonatal intensive care unit (NICU).

Fulltext A Preliminary Study on the Reliability of the Malay Version of PedsQL™ Family Impact Module among Caregivers of Children with Disabilities in Kelantan, Malaysia

Rahman AA, Mohamad N, Imran MK, Ibrahim WP, Othman A, Aziz AA, et al.

Malays J Med Sci, 2011 Oct;18(4):63-8.

PMID: 22589674 MyJurnal

No previous study has assessed the impact of childhood disability on parents and family in the context of Malaysia, and no instrument to measure this impact has previously been available. The objective of this cross-sectional study was to determine the reliability of a Malay version of the PedsQL™ Family Impact Module that measures the impact of children with disabilities (CWD) on their parents and family in a Malaysian context.

Displaying publications 21 - 33 of 33 in total