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Fulltext Prolonged paralysis with atracurium use in a patient with Rubinstein-Taybi syndrome

Dharmalingam TK, Liew Sat Lin C, Muniandy RK

BMJ Case Rep, 2018 Feb 22;2018.
PMID: 29472422 DOI: 10.1136/bcr-2017-222692

Rubinstein-Taybi syndrome (RTS) is a rare autosomal dominant disorder that occurs due to a microdeletion of chromosome 16p13. The craniofacial abnormalities in these patients may pose a challenge for anaesthetist performing tracheal intubation. However, there are no known reported cases of drug interaction with non-depolarising muscle relaxant in patients with RTS. This young patient with RTS presented with an unexpected prolonged atracurium effect during the course of anaesthesia. After ruling out other possible causes, we have come to a conclusion that RTS itself could have played a role in the prolonged effect of atracurium. However, further studies will be needed to confirm this hypothesis. In the meantime, care should be used when using muscle relaxants in patients with RTS.
Fulltext Unusual Presentation of Cerebral Lupus: A Case Report of Parkinsonism in Cerebral Lupus

Chang CK, Mohd Noh M, Liew Sat Lin C, Payus AO

Case Rep Neurol, 2021 09 13;13(3):591-594.
PMID: 34703447 DOI: 10.1159/000518912

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with multisystem involvement that follows a relapsing and remitting course. It is characterized by an immune-mediated response to own body defense mechanism and mistakenly attacked healthy cells of the skin, joints, kidneys, blood cells, and nervous system. Cerebral lupus refers to a constellation of neurological and/or behavioral clinical syndromes in patients with SLE. The spectrum of presentation can vary widely ranging from mild symptoms such as headaches, slight cognitive dysfunction, and mood disorders to more serious conditions like seizures, stroke, or coma. This case report is about a case of cerebral lupus manifested with symptoms of Parkinsonism. The purpose of this case report is to share an uncommon occurrence of cerebral lupus which manifested as Parkinsonism and to highlight the importance of early diagnosis of the condition which is potentially reversibility with prompt treatment [4].
Fulltext Children's eating behaviour: A comparison between normal, overweight and obese children

Kimin LS, Liew Sat Lin C, Avoi R, Hayati F, Mohd Daud MN, Mandrinos S, et al.

Ann Med Surg (Lond), 2022 Dec;84:104890.
PMID: 36536714 DOI: 10.1016/j.amsu.2022.104890

BACKGROUND: Childhood obesity has become a major global health concern and has been increasing dramatically over the years. Previous study has shown that specific eating behaviours may have been associated with obesity especially under-responsiveness to internal satiety cues and over-responsiveness to external food cues such as the taste, smell, availability and emotions. However, there is still inadequate number of studies present to describe the association between the children's body mass index (BMI) and their eating behaviours, especially in Sabah, Malaysia. Therefore, the objective of this study is to established the association between the children's eating behaviours with their nutritional status based on their body mass index.
MATERIALS AND METHODS: A cross-sectional study involving 484 children aged 6-12 years old was conducted in Kota Kinabalu, which is a developing urban area in Sabah. The children were recruited from five primary schools that were selected based on multistage stratified and convenience sampling method. Sociodemographic details and anthropometric measures both parents and children, and eating behaviours of children were assessed using Children Eating Behaviour Questionnaires (CEBQ). Age-adjusted BMI z-scores were then calculated according to the World Health Organization recommendations to assess nutritional status.
RESULTS: The prevalence of childhood obesity among children aged 6-12 years old is 13.2%. The mean scores of 'Food Approach' subscales from the CEBQ showed higher mean score in overweight and obese groups as compared to the mean score in normal weight group. The mean scores of 'Food Avoidance' subscales showed lower mean score in overweight and obese groups as compared to mean score in normal weight group.
CONCLUSION: This study provides evidence that childhood obesity is yet to be a prevalent health problem in a developing urban area considering the "Food approach" subscales were positively associated with the excess weight in children.
Fulltext SARS-CoV-2 infection of the nervous system: A review of the literature on neurological involvement in novel coronavirus disease-(COVID-19)

Payus AO, Liew Sat Lin C, Mohd Noh M, Jeffree MS, Ali RA

Bosn J Basic Med Sci, 2020 Aug 03;20(3):283-292.
PMID: 32530389 DOI: 10.17305/bjbms.2020.4860

The novel coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is believed to have emerged from an animal source and has been spreading rapidly among humans. Recent evidence shows that SARS-CoV-2 exhibits neurotropic properties and causes neurological diseases. Here, we review the literature on neurological involvement in SARS-CoV-2 infections and the possible mechanisms of invasion of the nervous system by this virus, to provide a summary and critical analysis of the early reporting of neurological involvement in COVID-19. An exhaustive search of scientific articles on neurological involvement in COVID-19 was performed in the Web of Science, Scopus, Medline/PubMed, and several other databases. Nineteen relevant articles that had been published or were in preprint were carefully selected according to the inclusion and exclusion criteria. Based on our research, we found that patients with COVID-19 can present with neurological symptoms that can be broadly divided into central nervous system involvement, such as headache, dizziness, altered mental state, and disorientation, and peripheral nervous system involvement, such as anosmia and hypogeusia. Most of these patients are in the older age group and exhibit comorbidities, especially hypertension, and severe infection. In extreme presentations of COVID-19, some patients exhibit seizures, stroke, flaccid paraparesis, corticospinal weakness, and even coma. Moreover, the neurological man-ifestations can occur independently of the respiratory system. In conclusion, SARS-CoV-2 infection can cause multiple neurological syndromes in a more complex presentation. Therefore, this review elucidated the involvement of the nervous system in SARS-CoV-2 infection and will hopefully help improve the management of COVID-19.