MyMedR

Morbidly adherent placenta with spontaneous rupture of membrane at extreme prematurity poses poor pregnancy outcome. Various issues on different management modalities still remain perplexed and individual consideration is vital. Two cases of morbidly adherent placenta with symptomatic per vaginal bleeding and spontaneous rupture of membrane at severe prematurity were reviewed and discussed. We found that, active intervention by termination of pregnancy and methotrexate therapy at early gestation can prevent the need of hysterectomy following major obstetrics haemorrhage.

Matched MeSH terms: Infant, Newborn; Infant, Premature

Fulltext Nutritional status of Rohingya children in Kuala Lumpur

Sok Teng, T., Zalilah, M. S.

Malaysian Journal of Medicine and Health Sciences, 2011;7(1):41-49.

MyJurnal

The Rohingya is a group of refugees from Myanmar who have been residing in Malaysia since the 1980s. At present, there is no published information on health and nutritional status of refugee children
in Malaysia. This study was conducted to assess nutritional status of the Rohingya children aged
6 months to 12 years old (N=87) and to determine the associations between nutritional status with
socio-demographic, dietary diversity and health (birth weight, immunization and childhood illness)
variables. Children were measured for weight and height while their guardians were interviewed for
socio-demographic, dietary diversity and health information. About 27.5% of the Rohingya children
were underweight, 11.5% stunted, 16.1% thin and 12.6% at risk of overweight and overweight. The
percentage of children with low birth weight (< 2.5 kg) and no immunization was 17.8% and 11.5%,
respectively. Fever (67.8%) and flu (62.1%) were the most common childhood illnesses reported in
previous month with 44-75% of the children with these illnesses did not receive any medical treatment.
The mean dietary diversity score was 8.9+3.2 out of a possible 14, with a higher score indicating a
more diverse diet. There were significant correlations between frequency of immunization received
by the children with weight-for-age-z score (rs=0.27, p

Matched MeSH terms: Infant, Low Birth Weight; Infant, Newborn

Teong TS

Med J Malaysia, 1975 Sep;30(1):38-42.

PMID: 1207530

Matched MeSH terms: Infant; Infant, Newborn

The male Turner's syndrome

Boon WH, Seng CT

Med J Malaya, 1968 Sep;23(1):20-8.

PMID: 4237551

Matched MeSH terms: Infant; Infant, Newborn

MULTIPLE PEPTIC ULCERS IN CHILDREN PRESENTING WITH COMPLICATIONS

BALASEGARAM M

Med J Malaysia, 1963 Dec;18:125-8.

PMID: 14117281

Matched MeSH terms: Infant; Infant, Newborn

Fulltext A Case of Congenital Syphilis Presenting with Unusual Skin Eruptions

Leung AKC, Leong KF, Lam JM

Case Rep Pediatr, 2018;2018:1761454.

PMID: 29770234 DOI: 10.1155/2018/1761454

Once believed to be a rare disease in developed countries, recent data suggest that there is a surge in incidence of congenital syphilis in many developed countries. Diagnosis of congenital syphilis can be difficult because more than two-thirds of affected infants are asymptomatic at birth, and signs of symptomatic infants may be nonspecific or subtle. On top of this, some affected infants may have atypical presentations. Familiarity with the diverse presentations is essential to diagnosis. We report a 2-week-old male infant with congenital syphilis whose cutaneous manifestations included diffuse, erythematous keratoderma with desquamation and fissures on his hands and feet, multiple linear scaly fissures at the angles of his mouth, and onychauxis of the fingernails and toenails To our knowledge, diffuse, erythematous keratoderma of the hands and feet and thick nails have not been reported previously in congenital syphilis.

Matched MeSH terms: Infant; Infant, Newborn

Fulltext Factors associated with birth weights among infants

Rusnani Ab Latif

The Malaysian Journal of Nursing, 2018;9(103):45-53.

MyJurnal

Introduction: Birth weight is the single most important factor which determines infant morbidity and
mortality. Birth weight of the newborn is believed to be influenced by several factors. Therefore, it is
important to understand the possible factors that influence birth weight.

Methodology: The respondents were 230 postnatal mothers who participated in this study. A selfadministered
questionnaire was used for interviewing the postnatal mothers. One Way Analysis of
Variance (ANOVA), Chi-square tests and the independent t-test were used. Statistically significant data
were those that had a p- value < 0.05.

Results: The mean birth weight was 3080.02±400.61g. The incidence of low birth weight (LBW) was
12.6%. By using One-Way ANOVAtest, the factors that were found to be significantly associated with birth
weight (p

Matched MeSH terms: Infant, Low Birth Weight; Infant, Newborn

Fulltext Palliative care approach for preemie – an ethical case learning

Fahisham Taib, Lee, Chee Chan

Education in Medicine Journal, 2018;10(2):55-59.

MyJurnal

Palliative care for life limiting conditions usually starts at birth. In neonatal period, planning,
discussion and goal of care should focus towards improving the baby quality of life. It does not mean
palliative care in this age group mainly as end of life care. We illustrate a complex 30 weeks baby
who was born with genetic abnormality complicated with intracranial bleeding and acute myeloid
leukaemia. There were various ethical issues related to the approach of death and dying infant and
psychosocial challenges surrounding the case.

Matched MeSH terms: Infant; Infant, Newborn

Microwave pyrolysis valorization of used baby diaper

Lam SS, Wan Mahari WA, Ma NL, Azwar E, Kwon EE, Peng W, et al.

Chemosphere, 2019 Sep;230:294-302.

PMID: 31108440 DOI: 10.1016/j.chemosphere.2019.05.054

Used baby diaper consists of a combination of decomposable cellulose, non-biodegradable plastic materials (e.g. polyolefins) and super-absorbent polymer materials, thus making it difficult to be sorted and separated for recycling. Microwave pyrolysis was examined for its potential as an approach to transform used baby diapers into value-added products. Influence of the key operating parameters comprising process temperature and microwave power were investigated. The pyrolysis showed a rapid heating process (up to 43 °C/min of heating rate) and quick reaction time (20-40 min) in valorizing the used diapers to generate pyrolysis products comprising up to 43 wt% production of liquid oil, 29 wt% gases and 28 wt% char product. Microwave power and operating temperature were observed to have impacts on the heating rate, process time, production and characteristics of the liquid oil and solid char. The liquid oil contained alkanes, alkenes and esters that can potentially be used as chemical additives, cosmetic products and fuel. The solid char contained high carbon, low nitrogen and free of sulphur, thus showing potential for use as adsorbents and soil additives. These observations demonstrate that microwave pyrolysis has great prospect in transforming used baby diaper into liquid oil and char products that can be utilised in several applications.

Matched MeSH terms: Diapers, Infant*

Fulltext Hair Thread Tourniquet Syndrome in an Infant: Emergency Exploration Saves Limbs

Kesu Belani L, Leong JF, Narin Singh PSG, Abdullah S

Cureus, 2019 Dec 13;11(12):e6377.

PMID: 31938655 DOI: 10.7759/cureus.6377

Hair thread tourniquet syndrome (HTTS) is a rare condition where fibres constrict around appendages causing ischaemia and necrosis. It is a sporadically reported condition, where almost all reported cases showed involvement of fingers, toes or genitalia. A significant number of the cases are infants aged two weeks to six months where it is attributed to the mother's excessive hair fall due to hormonal changes after delivery. We present a two-month-old infant who was irritable for the past two days with her left ring finger exhibiting an ischaemic constriction with no apparent insulting agent. She successfully treated surgically after we suspected an incomplete removal of hair thread in the emergency department. We would like to highlight the importance of a high index of suspicion in cases as such as early intervention saves the appendage.

Matched MeSH terms: Infant; Infant, Newborn

Stridor in a Newborn with Double Aortic Arch-A Case Report

Anastasius EJ, Sawali H

Iran J Otorhinolaryngol, 2019 Jan;31(102):61-63.

PMID: 30783601

Introduction: Double aortic arch (DAA) is a congenital anomaly of the aortic arch. It is the most common type of complete vascular ring. When it occurs, the connected segment of the aortic arch and its branches encircle the trachea and esophagus, leading to symptoms related to these two structures.

Case Report: We present a case of a newborn baby who developed biphasic stridor immediately after a normal vaginal delivery. Endoscopic assessment of the trachea revealed a pulsatile narrowing at the level of the thoracic trachea, suggestive of an external compression. A contrast-enhanced computed tomography scan of the thorax with three-dimensional reconstruction confirmed the diagnosis of DAA with compression of the trachea and esophagus.

Conclusion: Clinicians should strongly consider the possibility of a congenital vascular ring compression should an infant with a normal upper airway present with stridor. A precise diagnosis can be made by radiological examination.

Matched MeSH terms: Infant; Infant, Newborn

Fulltext Factors Related to Early Recurrence of Idiopathic Clubfoot Post the Ponseti Method

Limpaphayom N, Sailohit P

Malays Orthop J, 2019 Nov;13(3):28-33.

PMID: 31890107 DOI: 10.5704/MOJ.1911.005

Introduction: Idiopathic clubfoot or congenital talipes equinovarus (CTEV) is managed by the Ponseti method worldwide; however, the recurrence of the deformity is a challenging problem. The purpose was to review the factors associated with early recurrence of CTEV post the Ponseti method. Materials and Methods: During 2011-2016, 34 infants with 52 CTEV, who underwent the Ponseti method and a minimum follow-up period of six months, were reviewed. Twenty-two infants (65%) were male, and 18 infants (53%) had bilateral CTEV. Recurrence of CTEV was defined as a reappearance of at least one of the four components of the deformity. The association between recurrence and factors, including age, gender, bilaterality, family geography, type of principal caregiver, severity at presentation, centre where the Ponseti method was initiated, compliance to foot abduction brace (FAB), practice of stretching exercise, type of FAB, and complications of casting, were evaluated using univariate logistic regression analysis. Results: The median age at initiation of the treatment was 3.4 (IQR; 2.1-12.6) weeks. A median of six (range; 3-12) casts were required. Tenotomy was performed in 32/34 (94%) of cases. Recurrence occurred in 14/52 feet (27%) at an average follow-up period of 2.3±1.1 years. Non-compliance to FAB protocol began at an average age of 11.2±6.5 months, and significantly increased the risk of recurrence during the weaning phase [OR (95%CI)=8.4 (1.2-92.4), p=0.03]. Other factors were not associated with the recurrence. Conclusion: Non-compliance to FAB occurred early during the treatment and related to a risk of recurrence of CTEV. Physicians should encourage the parents and/or guardians to follow the protocol to decrease the risk of recurrence.

Matched MeSH terms: Infant; Infant, Newborn

MPA given orally during the first trimester for threatened miscarriage carries no specific risk for foetal abnormalities albeit the rate is higher than non-threatened pregnancies

Yovich JL, Mariappen U, Hinchliffe PM, Dhaliwal SS, Keane KN

Reprod Biol, 2020 Sep;20(3):424-432.

PMID: 32389607 DOI: 10.1016/j.repbio.2020.03.008

This observational study examines the outcomes of pregnancies arising in women referred for infertility, where those who experienced threatened miscarriage were treated with medroxyprogesterone acetate (MPA) tablets. The 14-year study period covers comprehensive real-time data entries into the validated electronic database including details of the infertility management, pregnancy outcomes and any foetal anomalies among the infants, each being tracked and recorded. Of 4057 clinical pregnancies, 1343 received MPA for threatened miscarriage; 934 (69.6 %) of which continued to livebirths. These were compared with the remaining 2714 clinical pregnancies without threatened miscarriage or MPA and which resulted in 2075 (76.5 %) livebirths. There were 134 developmental abnormalities recorded among the 3009 livebirths of which 78 (2.6 %) were categorised appropriate for the Western Australian Developmental Abnormalities Register; WARDA. These comprised 55 in the MPA group, 36 of which were categorised as serious (being 2.7 % of clinical pregnancies and 3.9 % of births). In the group without MPA, there were 79 abnormalities, of which 42 were categorised as serious (being 1.7 % of clinical pregnancies and 2.2 % of births). Specifically, there were no cases of androgenisation noted among the female infants. The abnormality rates were low overall and well within the annual WARDA ranges. We cautiously suggest that oral MPA can be considered for studies throughout pregnancy including the early first trimester to assess a potential role in reducing miscarriage, as well as advanced pregnancies to evaluate a potential role in reducing stillbirths and preterm delivery.

Matched MeSH terms: Infant; Infant, Newborn

A case of surgically resected cardiac rhabdomyoma with progressive left ventricular outflow tract obstruction

Mohammed F, Tan GC, Hor KN, Arnold M, Wong YP

Cardiovasc. Pathol., 2020 05 12;49:107226.

PMID: 32574866 DOI: 10.1016/j.carpath.2020.107226

Cardiac rhabdomyoma is the most prevalent cardiac tumors in the pediatric population, in close association with tuberous sclerosis complex. It is usually detected antenatally or postnatally by echocardiography. Clinical presentations depend greatly on the size and position of the tumor mass. Interestingly, rhabdomyoma has a propensity to regress spontaneously and is not usually operated upon, unless the patient becomes hemodynamically compromised. Herein, we report an unusual case of surgically treated cardiac rhabdomyoma in a baby boy presented at birth with a progressive enlarging intraventricular mass, complicated with left ventricular outflow tract obstruction 7 weeks later. Histopathological examination of the intracardiac mass revealed sheets of tumor cells with spider-like morphology (known as "spider cells"), confirmed the diagnosis of rhabdomyoma. Close disease monitoring of patient's hemodynamic status in a newly diagnosed cardiac rhabdomyoma is inevitable as the tumor, although rare, may progress.

Matched MeSH terms: Infant; Infant, Newborn

Fulltext Survival and associated risk factors for mortality among infants with persistent pulmonary hypertension of the newborn in Malaysia

Mat Bah MN, Tan RYH, Razak H, Sapian MH, Abdullah N, Alias EY

J Perinatol, 2021 04;41(4):786-793.

PMID: 33589728 DOI: 10.1038/s41372-021-00962-6

OBJECTIVE: This study aims to determine the immediate outcome of persistent pulmonary hypertension of the newborn (PPHN) and risk factors for mortality in the era of inhaled nitric oxide (iNO).

STUDY DESIGN: This observational cross-sectional study includes 195 confirmed PPHN with a gestational age of ≥34 weeks without congenital heart disease. Multivariable logistic regression was used to identify risk factors for mortality.

RESULTS: The mortality rate was 16.4%, with the highest mortality with pulmonary hypoplasia. Of 195, 65% received iNO; 18% were iNO non-responders with the majority having pulmonary hypoplasia. Independent risk factors for mortality were the presence of reversal of flow at the descending aorta, pulmonary hypoplasia, APGAR scores ≤ 5 at 5 min, and idiopathic PPHN with an adjusted odds ratio of 15.9, 7.5, 6.7, and 6.4, respectively.

CONCLUSIONS: Despite the usage of iNO, mortality due to PPHN remains high and is related to etiology and cardiac function.

Matched MeSH terms: Infant; Infant, Newborn

Fulltext Neonatal cholestasis and biliary atresia: perspective from Malaysia

Lee, W.S.

JUMMEC, 2010;13(2):72-79.

MyJurnal

The liver is an important organ of the human body, playing a major role in the metabolism and storage of nutrients, synthesis of protein and other nutrients, as well as detoxifying many metabolic by-products. The response of the foetal and newborn liver to external insult and injury is limited. This is because the ability of the closely interdependent structures of a developing liver of expressing in the face of a variety of insults is limited as well. Thus most infants with insults to the liver present as cholestatic jaundice with variable degree of pale stools, enlarged liver and conjugated hyperbilirubinaemia. Biliary atresia, an idiopathic condition characterized by progressive fibrosing obliteration of both intra- and extrahepatic bile ducts, is the most important cause of neonatal cholestasis worldwide, including Malaysia. It is also the most important indication for childhood liver transplantation the world over. Challenges facing infants with biliary atresia include a delay in the diagnosis and late surgery, leading to a poor outcome. This often results from a failure to recognise the potential serious nature of an infant with prolonged cholestatic jaundice and pale stools among health care professionals.

Matched MeSH terms: Infant; Infant, Newborn

Malaysian growth centiles for children under six years old

Bong Y, Shariff AA, Mohamed AM, Merican AF

Ann Hum Biol, 2015 Mar;42(2):108-15.

PMID: 24853607 DOI: 10.3109/03014460.2014.912679

Growth references are useful for the screening, assessment and monitoring of individual children as well as for evaluating various growth promoting interventions that could possibly affect a child in early life.

Matched MeSH terms: Infant; Infant, Newborn

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