Displaying publications 1 - 20 of 27 in total

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  1. Fulltext Management of a young teenager with recurrent cough and a feeding problem
    Mariana D, Rus Anida A, Hasniah AL, Zaleha AM, Zakaria M, Norzila MZ
    Breathe (Sheff), 2006;3(2):195-198.
    Matched MeSH terms: Hospitals, Pediatric
  2. Fulltext Immunisation status in hospitalised infants: reasons for incomplete immunisation
    Norlijah O, Menon BS, Azlyna Nur Yanty MY, Noranida S
    Malaysian Journal of Medicine and Health Sciences, 2005;1(1):51-59.
    Objective: Immunisation is known to be an effective health intervention that protects children from infectious diseases. Of all children, infants are the most vulnerable if they experience a vaccine preventable disease. The aim of the study was to determine the immunisation status of hospitalised infants, to obtain the reasons of incomplete immunisation and to assess carers' knowledge on immunisation.
    Methods: This was a cross-sectional study conducted in the Institute of Paediatrics at Hospital Kuala Lumpur over a 2-month period from June to August 2001. Data were collected through an interview using a structured questionnaire, with the carer of the infant. Questions pertaining to the immunisation status of the infant, reasons of incomplete immunisation and the carer's knowledge of immunisation were assessed.
    Results: 115 infants were admitted during the study period; however, only 100 carers of the infants were available for an interview. The average age of the infants was 5.7 months. 22% of the infants had incomplete immunisation. 64% of them had missed more than one vaccine. The commonest missed vaccine was the 3'4 dose of diptheria-pertussistetanus (DP1) and polio vaccine. Reasons of incomplete immunisation include misconception on contraindication of immunisation perceived by both parents and health providers, missed appointment and communication breakdown with health facilities regarding appointment dates. The under-immunisation rate in the study population was 22%. The underimmunisation rate in the study population was 22%.
    Conclusion: Health providers and the public need to be educated on the importance of immunisation and the associated valid contraindications.
    Keywords: Infants, carer, under-immunisation, incomplete immunisation
    Matched MeSH terms: Hospitals, Pediatric
  3. Pediatric Flexible Bronchoscopy in Singapore: A 10-year Experience
    Woodhull S, Goh Eng Neo A, Tang Poh Lin J, Chay OM
    J Bronchology Interv Pulmonol, 2010 Apr;17(2):136-41.
    PMID: 23168729 DOI: 10.1097/LBR.0b013e3181dc993a
    To determine the results of children who underwent flexible bronchoscopy and bronchoalveolar lavage (BAL) in the Respiratory Medicine Service of Kandang Kerbau Women's and Children's Hospital from 1996 to 2005.
    Matched MeSH terms: Hospitals, Pediatric
  4. Stress experienced by mothers of Malaysian children with mental retardation
    Ong LC, Chandran V, Peng R
    J Paediatr Child Health, 1999 Aug;35(4):358-362.
    PMID: 28871653 DOI: 10.1046/j.1440-1754.1999.00383.x
    OBJECTIVE: To compare parenting stress among Malaysian mothers of children with mental retardation and a control group, and to determine factors associated with stress.
    METHODOLOGY: Seventy-five mothers of children with mental retardation aged 4-12 years and 75 controls (those without disabilities who attended the walk-in paediatric clinic) participated in the Parenting Stress Index (PSI). Intelligence quotient (IQ) and Child Behaviour Checklist (CBCL) scores, together with sociodemographic data, were entered into a multiple stepwise regression analysis, using the PSI as the criterion.
    RESULTS: Mothers of children with mental retardation scored significantly higher than control subjects in both the child-related domain (difference between means 26.1, 95% confidence interval 19.6-32.5) and parent-related domain (difference between means 15.0, 95% confidence interval 7.9-22.1) of the PSI. The total child behaviour scores from the CBCL (P < 0.01), IQ scores (P < 0.01) and sibship size (P < 0.01) were associated with child-related domain scores. For the parent-related domain, CBCL (P < 0.01) and IQ scores (P = 0.01) remained important factors but Chinese ethnicity (P < 0.01) and maternal unemployment (P < 0.01) were also significant predictors of stress.
    CONCLUSION: A large proportion of mothers of children with mental retardation experienced substantial parenting stress, especially Chinese and unemployed mothers, and this warrants appropriate intervention.
    Study site: Outpatient clinic, Paediatric Institute, Hospital Kuala Lumpur, Malaysia
    Matched MeSH terms: Hospitals, Pediatric
  5. Bacterial pathogens isolated from cockroaches trapped from paediatric wards in peninsular Malaysia
    Oothuman P, Jeffery J, Aziz AH, Abu Bakar E, Jegathesan M
    Trans R Soc Trop Med Hyg, 1989 1 1;83(1):133-5.
    PMID: 2603192
    A survey was conducted in 4 paediatric wards in Malaysia to determine the distribution of various species of cockroaches and to examine their gut contents for bacteria. Cockroaches were trapped from food dispensing areas (kitchens), store rooms, cupboards and open wards. 104 cockroaches were caught, consisting of Periplaneta americana (67.3%), Blattella germanica (26%), P. brunnea (4.8%), and Supella longipalpa (1.9%). Bacteria were isolated from all cockroaches except 3 P. americana. Many bacterial species were identified, including the pathogenic and potentially pathogenic species Shigella boydii, S. dysenteriae, Salmonella typhimurium, Klebseilla oxytoca, K. ozaena and Serratia marcescens.
    Matched MeSH terms: Hospitals, Pediatric
  6. Perioperative anaphylaxis: A five-year review in a tertiary paediatric hospital
    Toh TS, Foo SY, Loh W, Chong KW, En Goh A, Hee HI, et al.
    Anaesth Intensive Care, 2021 Jan;49(1):44-51.
    PMID: 33472385 DOI: 10.1177/0310057X20964470
    Making a diagnosis of perioperative anaphylaxis and identifying culprit drugs are diagnostic challenges. The aim of this study is to describe the perioperative presentation of anaphylaxis and results of patients who underwent allergy evaluation. This is a retrospective review of perioperative anaphylaxis of severity Grade 2 and above based on the Australian and New Zealand Anaesthetic Allergy Group criteria from 2015 to 2019 in a tertiary paediatric hospital. Data collected were demographics, clinical features, investigations and management. Of the 35,361 cases of paediatric anaesthesia, there were 15 cases of perioperative anaphylaxis, giving an incidence of four in 10,000. The median age was seven years (interquartile range four-15 years) with a male predominance of 86.7% (13/15). The severity of anaphylaxis was Grade 2 in 33.3% (5/15) and Grade 3 in 66.7% (10/15). The commonest presenting feature was hypotension (13/15, 86.7%) while the earliest symptom was respiratory change (9/15, 60.0%). Dynamic tryptase was raised in 75% (6/8) of the patients with adequate tryptase samples. Eight patients (53.3%) completed allergy testing, of whom five patients (62.5%) had IgE-mediated anaphylaxis with skin test positive to cefazolin (n = 3), atracurium (n = 1) and rocuronium (n = 1). Three patients (25.0%) had non-IgE-mediated reactions with negative skin tests. Although only half the patients completed allergy evaluation, a culprit drug could be identified in 62.5%, with antibiotics being the commonest. This emphasises the need for appropriate evaluation in cases of suspected perioperative anaphylaxis.
    Matched MeSH terms: Hospitals, Pediatric
  7. Fulltext Factors affecting severity of neonatal jaundice in patients presenting from home
    Pang MF, Ling SG
    JUMMEC, 2000;5(1):24-27.
    A descriptive study of full-term neonates with jaundice was carried out to determine factors affecting severity of neonatal jaundice for those infants presenting to the hospital from their homes. Severe jaundice (serum bilirubin >=250 µmol/l) was significantly more likely in infants whose mothers consumed traditional herbs during the postpartum period (p<0.001) and if the jaundice was first detected by the parents or relatives rather than by medical personnel (p<0.05). In addition, the interval between detection of jaundice and presentation to hospital was significantly longer in jaundice that was first detected by parents compared to those detected by medical personnel. In conclusion, factors affecting severity of neonatal jaundice for infants who present from home could be influenced by the socio-cultural practices of maternal postpartum use of herbs, the ability of parents to detect jaundice and the urgency of tlie parents in seeking medical treatment once the jaundice was detected. Further studies need to be done to explore the association of these factors with neonatal jaundice more specifically. KEYWORDS: Hyperbilirubinaemia, socio-cultural practices, herbs.
    Study site: Paediatric Institute, Kuala Lumpur Hospital, Malaysia
    Matched MeSH terms: Hospitals, Pediatric
  8. A clinical audit on the practice of platelet transfusions at a tertiary paediatric referral centre
    Jamal R, Hoe TS, Ong LC, Afifah I, Khuzaiah R, Doraisamy G
    Malays J Pathol, 1998 Jun;20(1):35-40.
    PMID: 10879262
    Platelet transfusions are indicated in a wide variety of clinical conditions especially those with thrombocytopenia. However, without proper clinical practice guidelines, inappropriate transfusions are bound to happen. To ascertain the provision of a quality and appropriate practice of platelet transfusions, an audit study was carried out over a period of one month at the Paediatric Institute, Kuala Lumpur Hospital. A prospective audit was performed during that period whilst a retrospective collection of data was carried out for the previous month for comparison. Based on a set of criteria agreed upon by the audit committee, it was found that in 18.5% (22 of 119) of the cases, the indications for platelet transfusions were inappropriate. The audit committee concluded that there is a need for a more detailed clinical practice guideline for local use to reduce or lower the incidence of inappropriate transfusions of platelets.
    Matched MeSH terms: Hospitals, Pediatric/standards*
  9. Fulltext Local experience in paediatric flexible bronchoscopy
    Norzila MZ, Norrashidah AW, Rusanida A, Sushila S, Azizi BHO
    Med J Malaysia, 2003 Aug;58(3):350-5.
    PMID: 14750374
    All children who underwent flexible bronchoscopy in the respiratory unit at Paediatric Institute, Hospital Kuala Lumpur from June 1997 to June 2002 were reviewed. A hundred and ten children underwent the procedure under sedation or general anaesthesia. The median age of these children was eight months. (Q1 3, Q3 30) The commonest indication for performing flexible bronchoscopy was for chronic stridor (50 cases) followed by persistent or recurrent changes such as lung infiltrates, atelectasis and consolidation on the chest radiographs (22). Laryngomalacia was found to be the commonest cause of stridor in 29 children. Two patients were diagnosed with pulmonary tuberculosis. With regard to safety, three procedures were abandoned due to recurrent desaturation below 85%. One of these patients had severe laryngospasm that required ventilation for 48 hours but recovered fully. Two neonates developed pneumonia requiring antibiotics following bronchoscopy. No patients developed pneumothorax or bleeding following the procedure. Bronchoscopy is a safe procedure when performed by well-trained personnel. Since it is an invasive procedure the benefits must outweigh the risks before it is performed.
    Matched MeSH terms: Hospitals, Pediatric/statistics & numerical data*
  10. Genotypes of rotavirus diarrhoea in a children hospital of Bangladesh
    Ahmed S, Hussain M, Akhter S, Islam T, Ahmed SU, Kabir ML
    Mymensingh Med J, 2012 Jul;21(3):497-502.
    PMID: 22828550
    Globally, rotaviruses are the single most important etiologic agents of severe childhood dehydrating diarrhea that accounts for more than 125 million of cases, 25-55% of all hospital admissions for diarrhea and ≈600,000 deaths every year. In Bangladesh, while overall diarrhea related deaths are declining, the proportion of diarrhea deaths due to rotavirus is increasing. This study was aimed at estimating the burden of rotavirus diarrhea and isolating the genotypes of rotavirus in a children hospital of Bangladesh; thereby endorsing a logical search for an appropriate rotavirus vaccine. This cross sectional study was carried out in the Institute of Child and Mother Health, Matuail, Dhaka, Bangladesh during 2006-2007. Children aged between one month and five years suffering form diarrhea were enrolled in the study. Stool samples were analyzed by ELISA for rotavirus antigen. The rotavirus-positive samples were further analyzed for genotype determination. Among 656 stool samples, 39.5% samples were positive for rotavirus antigen. The mean age of the children studied was 12±9.9 months; the peak being in the second half of infancy. G2 was identified as the most dominant genotype (45.5%) followed by G1 (24.8%), G12 (9.6%), G9 (8.5%) and G4 (2.1%) genotypes. Since G2 were found to be the predominant circulating rotavirus strain in this study and some other studies in Bangladesh, the recommended vaccine for prevention of rotavirus infection in Bangladesh should cover this strain to have maximum effectiveness.
    Matched MeSH terms: Hospitals, Pediatric
  11. Fulltext Children with learning disabilities in the paediatric clinic, Hospital Tuanku Ja'afar Seremban: an overview
    Mariana AM, Wong SL
    Med J Malaysia, 2011 Dec;66(5):487-90.
    PMID: 22390107 MyJurnal
    The aim of the study was to document the prevalence of learning disability among the children attending the Paediatric Clinic in Hospital Tuanku Ja'afar Seremban. The demographic distribution of these patients; the age of detection of the problem; the associated medical conditions and types of intervention received by these patients were documented. Patients who were between the ages of five to twelve years were included in the study. Learning disability was divided into three categories: speech and articulation problems, academic skills disorder and other categories which included developmental delay. Children with cerebral palsy were excluded from the study. Out of 1320 patients screened, 355 were found to have learning disorders. Majority were Malays, with the male to female ratio of 1.9:1. Most of the patients stayed in Seremban. The learning problem was most commonly detected at the age of 4 years and below. The commonest type of learning disorder was developmental delay, followed by academic skills disorder, speech and academic skills problems and speech disorders. Problems that were detected early were speech problems and developmental delay. Majority of the children had associated medical conditions. Most of the patients received some form of intervention but 11.3% did not attend any intervention program at all. A strategy should be formulated and implemented to help this group of children.

    Study site: Paediatric Clinic in Hospital Tuanku Ja'afar Seremban
    Matched MeSH terms: Hospitals, Pediatric
  12. Fulltext Evaluation of vancomycin intial dosing anf the resultant trough level in paediatric patients
    Liang Ann Lim, Michelle Sze Hui Chin, Denish Kwasso Devan, Jun Hoe Hui, Thamron Keowmani
    Malaysian Journal of Pharmaceutical Science, 2014;12(1):67-77.
    MyJurnal
    This study aims to examine the vancomycin initial dosing and the resultant trough level in paediatric patients. In this retrospective observational study, all therapeutic drug monitoring (TDM) records of paediatric patients admitted to Sabah Women and Children Hospital (SWACH) from January 2011 to September 2013 were reviewed and 116 patients without renal disease were included in the study. Of the total, 38.8% were neonates, 32.8% were infants and 28.4% were children. The majority of the patients were intensive care patients (69.0%) and the most common clinical indication for vancomycin was sepsis (44.8%). The four initial dosing regimens identified were 40 mg/kg/day (38.8%), 30 mg/kg/day (31.0%), 60 mg/kg/day (25.0%) and 45 mg/kg/day (5.2%). The distribution of initial dosing regimen was significantly different between the three age groups (p40 mg/kg/day (p=0.007). The proportions of those who achieved the target therapeutic range (10–20 mg/L) in the 2 dosing groups were 30.9% and 60.0% respectively. In conclusion, the study showed that the initial dosing of >40 mg/kg/day is more likely to achieve the target therapeutic range (10–20 mg/L) compared to the initial dosing of ≤40 mg/kg/day.
    Matched MeSH terms: Hospitals, Pediatric
  13. Sociocultural factors leading to physical child abuse and neglect a case control study of 35 families admitted to the paediatric wards Hospital Kuala Lumpur
    Chandran, V., Mohd Sham Kasim, Haliza Mohd Shafie
    Malaysian Journal of Child Health, 1994;6(1):22-31.
    MyJurnal
    A case control study of the families of 35 physically abused and neglected children was conducted to examine some of the family characteristics and sociocultural factors which may contribute to physical abuse and neglect. The cases were matched for sex, ethnic group and as far as possible for age with children admitted to the children's hospital for other medical illness. Physically abused children were more likely to come from disrupted, reconstructed or single parent families and these children had separation experiencesfrom their families during early childhoodfor various reasons including periods of family crisis, parental death, financial difficulties, inability to cope with large family size and cultural beliefs and superstition. Social isolation, alcoholism and drug abuse were also shown to be statistically significant amongst these families.
    Matched MeSH terms: Hospitals, Pediatric
  14. Rotavirus infection in paediatric community-acquired acute gastroenteritis: a retrospective cross-sectional study in a private hospital in Malaysia
    Adele, Tan Guat Kean
    Malaysian Journal of Paediatrics and Child Health, 2007;15(1):7-15.
    MyJurnal
    Objectives: 1) To establish the incidence of rotavirus infection in paediatric patients admitted to a private hospital in Malaysia with a diagnosis of community-acquired acute gastroenteritis. 2) To determine whether patients with rotaviral acute gastroenteritis have greater disease severity. Design Retrospective cross-sectional study. Setting An urban private hospital in Malaysia. Participants All paediatric patients with a discharge diagnosis of acute gastroenteritis (AGE) admitted to the hospital between September 2005 and March 2006. A total of 261 patients were included in the study. Results Rotavirus infection contributed to 54% of paediatric hospital admissions with discharge diagnoses of acute gastroenteritis. 74% of children with rotavirus infection were aged 5 years and below. This study demonstrated that patients with rotaviral gastroenteritis had greater disease severity, as measured by two indicators. Firstly, the average length of hospital stay was longer in patients who were rotavirus positive (5.14 days) compared to those who were rotavirus negative (4.81 days). These results were statistically significant (p
    Matched MeSH terms: Hospitals, Pediatric
  15. Fulltext Bone health status among thalassemia children
    Yeo PS, Shahar S, Rajikan R, Mohd Yusoff NA
    Int J Public Health Res, 2014;4St(1):399-404.
    MyJurnal
    Introduction Low bone mineral density is a significant problem in children with Thalassemia which may lead to increased risk for fragility fractures and suboptimal peak bone mass. This cross-sectional study was conducted to
    determine the bone health status of Thalassemia children Universiti Kebangsaan Malaysia Medical Centre and Paediatrics Insititute Kuala Lumpur Hospital.
    Methods A total of 81 respondents diagnosed with transfusion dependant beta Thalassemia (41 boys and 40 girls) aged between 7 to 19 years old completed the study. The data collected were demographic information, anthropometric measurements, dairy frequency questionnaires, dietary habits of the respondents and their parents, dietary intakes and bone densitometry using Ultrasound Bone Densitometer.
    Results For Quantitative Ultrasound (QUS) parameters, T-score of 9.8% participants were lower than -1.0 and 30.9% of the participants had lower Speed of Sound (SOS) than healthy SOS. This study showed there was no difference in bone density by sex (p>0.05). The median bone density of boys was 1616.00 m/sec (IQR= 39.00) and girls’ was 1579.00 m/ sec (IQR= 116.00). SOS was not increased with age, height and weight; but girls’ Body Mass Index (BMI). Malay children had significantly higher SOS than non-Malay children.
    Conclusions This study highlights a need of proper intervention for the high risk group to achieve optimal bone health.
    Study site: inpatient or outpatient, Institut Pediatrik (Hospital Kuala Lumpur), Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
    Matched MeSH terms: Hospitals, Pediatric
  16. Antihistamines prescribed off-label among paediatric patients at a tertiary care hospital setting in Malaysia
    Tan RW, Mohamed Shah N
    Int J Clin Pharm, 2016 Oct;38(5):1277-85.
    PMID: 27480982 DOI: 10.1007/s11096-016-0364-8
    Background Antihistamines are widely prescribed to children but should be used with caution in young children. Objective To determine the paediatric prescribing pattern of antihistamines with a focus on the off-label prescribing and factors that influence such prescribing. Setting Paediatric wards of a tertiary care hospital setting in Malaysia. Methods The pharmacy-based computer system and medical records were used to collect the required data. Labelling status of each antihistamine was determined based on the information provided in the product leaflets. Main outcome measure Antihistamines prescribed off-label and factors associated with such prescribing. Results Of the 176 hospitalised children aged <18 years prescribed with an antihistamine in the year 2012, 60.8 % received it in an off-label manner. Of 292 antihistamine prescription items, 55.5 % were prescribed off-label. Loratadine (35.3 %) was the most frequently prescribed antihistamine and chlorpheniramine maleate (34.0 %) was the most common antihistamine prescribed off-label. The main reason for the off-label prescribing of antihistamines was prescribing at higher than the recommended dose (30.2 %). Binary logistic regression showed that children aged <2 years (OR 12.65; 95 % CI 2.87-55.67) and the number of medications received (OR 1.14; 95 % CI 1.00-1.29) were significant predictors for the off-label prescribing of antihistamines. Conclusion Prescribing antihistamines for children in an off-label manner was prevalent at the studied locations and warrants further investigation on the consequences of such prescribing.
    Matched MeSH terms: Hospitals, Pediatric/standards*
  17. Fulltext Childhood epilepsy: what parents know, believe and do
    Norzila MZ, Azizi BH, Motilal R
    Med J Malaysia, 1997 Mar;52(1):60-3.
    PMID: 10968054
    This was a descriptive study to assess parents' knowledge of epilepsy in their children at the Klinik Pakar Pediatrik in Universiti Kebangsaan Malaysia from 1.1.93-31.6.93. Factors that influence the level of knowledge were examined. Our hypothesis was that the level of knowledge was low and level of education and social factors were important. Fifty consecutive parents were interviewed during the clinic appointments. The questionnaire consisted of 25 questions which had been used in a survey on epilepsy in Australia. In order to cater for the local population the questions were modified by adding new questions pertaining to local situation. The results showed that 90% (45/50) of parents were unaware of the type of epilepsy their children were suffering from. 50% (25/50) of parents knew the underlying cause of epilepsy of which 32% (8/25) attributed it to brain disease, 8% (2/25) to birth defects and 10% (3/25) to fever. Factors such as duration of epilepsy, parental education and racial differences between Malay and other races (Chinese, Indians) did not reach any statistical significance (p > 0.05). 80% of patients (30/50) were on monotherapy. However, 90% (45/50) of parents were unaware of their children's medications. 82% of parents (31/50) knew that the anti-convulsants would only control their children's convulsions. Only 10% (8/50) of parents knew the acute management of seizures. Wrong practices such as inserting spoons (5/50) or massaging their limbs (17/50) during an acute attack were still common. 70% of parents (35/50) attended the follow-up clinics hoping that their children's epilepsy would be cured. Parents with low economic status and of children with duration of epilepsy of less than five years had been coming to the clinic regularly. (p = 0.01 and p = 0.02 respectively). In conclusion, the overall knowledge of these parents was poor. In order to improve the management of epilepsy, it is necessary to educate parents with reading materials and effective educational packages.
    Study site: Paediatric clinic, Institut Pediatrik, Kuala Lumpur, Malaysia
    Matched MeSH terms: Hospitals, Pediatric
  18. Fulltext Peripheral intravenous canula (PIVC) assessment skills among pediatric nurses: audit-based approach study
    Deena C T, Li Tsu Chong, Drina Dalie, Rose A Nain, Renie M Joanes, CheristyTumbil
    Malaysian Journal of Medicine and Health Sciences, 2020;16(105):4-0.
    MyJurnal
    Introduction: Peripheral Intravenous Cannula (PIVC) placement can cause undesirable effects, such as phlebitis. Poor PIVC care can irritate tunica intima layers of the superficial vein. The incidence of phlebitis had become a national nursing indicator, with a standard of less than 0.9%. The standard care of the patient with intravenous in- cludes a routine PIVC assessment. However, what the assessment should be based on remained unclear. The objec- tive of this study is to assess nurses’ skill in performing PIVC assessment. Methods: This is a descriptive study using an audit-based approach. It is conducted in a pediatric hospital. Nine pediatric wards were identified via stratified sampling methods. A total of 86 registered nurses consented to participate in this study. A validated research instru- ments (α = 0.83), PIVC Assessment Skill (PIVC-AS) checklist is used to audit nurses in performing PIVC assessment. PIVC-AS consists of nine audit criteria (AC), AC1: communication skill, AC2 until AC7: PIVC assessment skill, AC8: documentation skill and AC9: PIVC management. Results: Nurses communication skills to patient as in AC1 shows compliance rate of seventy six percent. The compliance rate can be explained that this study was done in the pedi- atric setting. Participants may skip this communication due to handling with a pediatric patient. More than eighty eight percent nurses comply with AC2 to AC6 which indicated their excellent skill in performing PIVC assessment every shift. However, in the AC7, only sixty seven percent comply to palpate PIVC area for any evidence of venous cord and warmth. Conclusion: This study concludes that communication between nurses and pediatric patients prior to PIVC assessment often missed out by nurses. The palpation techniques also not been carried out as compared to observation technique in pediatrics setting. Palpation technique is crucial to detect ‘warmth to touch’ because it differentiates between the early and medium stage of phlebitis.
    Matched MeSH terms: Hospitals, Pediatric
  19. 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: Hospitals, Pediatric
  20. Clinical spectrum of children receiving palliative care in Malaysian Hospitals
    Chong LA, Khalid F, Khoo TB, Teh SH, Kuan GL, Aina Mariana AM, et al.
    Med J Malaysia, 2017 02;72(1):32-36.
    PMID: 28255137 MyJurnal
    INTRODUCTION: Awareness for paediatric palliative care has resulted in the impetus for paediatrician-led palliative care services across Malaysia. However, there is paucity of local data on patients receiving hospital-based paediatric palliative care. We aim to review the clinical spectrum of patients referred to these services.

    METHODS: An observational study of children aged between 0-18 years receiving palliative care at 13 hospitals between 1st January and 31st December 2014 was carried out.

    RESULTS: There were 315 patients analysed, 90 (28.6%) and 46 (14.6%) were neonates and adolescents respectively. The main ICD-10 diagnostic categories for all patients were identified to be 'Congenital malformations, deformations and chromosomal abnormalities' 117 (37.1%), 'Diseases of nervous system' 76 (24.1%) and 'Neoplasms' 60 (19.0%). At referral 156 (50%) patients had holistic needs assessments. Patients with 'Diseases of nervous system' were assessed to have significantly more physical needs than the other two diagnostic categories. Majority of patients who knew of their diagnosis and prognosis were those with malignancy. Over a fifth of referrals were at their terminal admission. Of 144 who died, 111 (77.1%) had advanced care plans. There was bereavement follow-up in 98 (68.1%) patients.

    CONCLUSION: Patients referred for palliative care have varied diagnoses and needs. To ensure all paediatricians are competent to deliver quality care to all children, further education and training initiatives is imperative.

    Matched MeSH terms: Hospitals, Pediatric
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