Acute Infective Myositis

Acute Viral or Infective Myositis

Common problem: My son had fever for few days and now he refused to walk because of calf pain bilateral?

Acute infective myositis is an illness characterized by muscle weakness and pain associated with elevated muscle enzyme levels and evidence of infection usually by symptoms of fever, lethargy, poor oral intake. It can be due to multiple type of virus infection but in our setup the commonest virus being Influenza virus infection and Dengue Virus Infection. Apart from viruses, bacteria (including mycobacteria), fungi, and parasites can also cause myositis.

Blood investigation usually showed elevated muscle enzyme CK (Creatinine Kinase), mostly consisting of the MM (muscle) isoenzyme, as high as 10-100x times normal.

Complications include rhabdomyolysis causing renal impairement.

Hence, treatment includes IV hydration, antibiotics and antiviral when indicated.

Please contact your doctor if you need any help.

Increased in Vaccine related infectious Diseases and Death in Malaysia. A Reemerging problem in Developed and 3rd World Countries due to social media and wrong information.

https://www.upworthy.com/16-years-ago-a-doctor-published-a-study-it-was-completely-made-up-and-it-made-us-all-sicker?g=3&c=ufb10 

Because of the false information of linking measles with Autism, more children are suffering from measles nowadays and even loss their life. 

The un-vaccinated child will post a danger even to the vaccinated children as they will spread the disease around and the weaker ones will suffers.

Ministry of Health change the MMR schedule for children in Malaysia delivered after July 2015 to twice at 9th and 12th months old.

Attention to All Parents,

Ministry of Health had revised the MMR (Measles, Mumps, Rubella) vaccination schedule of Malaysian children to twice in the first year of life for all children in view of the increasing cases of measles in the country.

For all children delivered after July 2015, the 1st MMR will be given at 9th months and the 2nd dose at 1 year old.

The circular of the changes is available as in link below:

http://www.mma.org.my/images/pdfs/Announcement/2016/Perubahan_Jadual_Imunisasi_Measles_-_V1.pdf

Ministry of Health Malaysia stopping BCG vaccination after Infancy. No more BCG at 7 and 12 years old starting February 2016.

Reminder to All Parents:

Ministry of Health KKM had decided to stop the BCG vaccination and screening in school in both Primary 1 (7 years old) and Primary 6 (12 years old) starting February 2016 as stated in the circular below.

Therefore, the BCG vaccination will only be given at birth nowadays.

http://www.moh.gov.my/index.php/database_stores/store_view_page/31/272

New Influenza vaccine FluQuadri 2015/2016 now available for prevention of Flu A and Flu B

The latest Flu A and Flu B vaccine is now available, FluQuadri which contained 2 Flu A and 2 Flu B vaccine is currently available for both Children and Adults.

Yearly vaccination is the most effective way of prevention of Flu infection especially for children and elderly group who are the most susceptible group of patients.

Important Flu Prevention Info can be available on:  http://www.cdc.gov/flu/protect/preventing.htm

CDC recommends 3 steps for preventing of Influenza (Read link above for details)

1.Take time to get a flu vaccine.
2.Take everyday preventive actions to stop the spread of germs.
3.Take flu antiviral drugs if your doctor prescribes them.

Please kindly contact your family doctor or contact us at 06-7677800 ext 1119 to book your vaccine for vaccination.

Dengue Fever is now a major infectious disease in Malaysia (Update 2014)

The number of Dengue cases had increased dramatically over the past few weeks and below is the statistic by the Ministry of Health of Malaysia.

Parents should be vigilant of the child's fever especially during current period and bring the child to doctor for examination and blood investigation if necessary.The type of blood test (either Dengue NS-1 or Ig M) is mentioned in the chart below.

Source: CDC

                               
                                       Source: PIDJ Volume 32, Number 9, September 2013

Chicken Pox Vaccine in Malaysia

After an absence for about 1 and a half year, the chickenpox (Varicella zoster) vaccine is finally back in Malaysia. This time round, we managed to get the vaccine from MSD called Varivax. For those parents who want the vaccine please called 06-7677800 ext 1119 to book for an appointment.

Common skin infection among children in Malaysia : Impetigo

2. Impetigo

Can be divided into 2 types:

Bullous:  which causes fluid filled, painless vesicles usually over  face, body and arms and legs.

Ethyma: Usually painful, pus filled that turns into deep ulcers commonly on the arms and legs.

Caused by: Bacteria (Streptococcal or Staphylococcal infection)

Treatment: Antibiotics and local antiseptic cream or solution. (Please consult your doctor)

Common skin infection among children in Malaysia :Scabies

1. Scabies

Occuring over the webspace of the fingers and folds in skin and spread to other parts of the body.

Usually very itchy.

Cause by: Sarcoptes scabii , a mites infected by direct contact with skin of a infected person. Common source is children in school or playground.

Treatment: Permethrine 5% lotion. (Please consult your doctor)

References

1. Americal Academy of Dermatology. https://www.aad.org/public/diseases/contagious-skin-diseases/scabies#overview

2. CDC.  https://www.cdc.gov/parasites/scabies/index.html

National Immunisation schedule Malaysia 2012

Adapted from Malaysia Paediatric Protocol 3rd Edition 2012

Latest 2013/2014 Influeanza vaccine for children is out. Contact your paediatrician for further details.

The latest vaccine for Influenza for 2013/14 season for north hemisphere is out. Get more info from your paediatrician.

Onychomadesis: A common sequalae and concern for patients after Hand Foot and Mouth Disease

There is an increased number of pediatric patients presented with Onychomadesis, seperation of nail from nail bed after the recent bout of Hand Foot Mouth Disease (HFMD) in Malaysia.

It usually occurs 1-2 months after the HFMD episode and recovered spontaneously without any treatment.


The photos of onychomadesis of a few of my patients is shown below as reference:


                            

Latest Influenza Vaccine 2011/2012 is now available

The latest vaccine for Influenza Season 201/2012 is now available.

For further information, please kindly contact my clinic at 06-7677800 ext 119.

Suggested Immunization Schedule 2012 for Children in Malaysia

Any further information, please kindly contact your pediatrician or visit our clinic at Clinic No: 1, 1st Floor, KPJ Seremban Specialist Hospital. (For appointment please call 06-767 7800 ext 119)

Recommendation of Pandemic Influenza A (H1N1) Vaccine for Children: Useful Tips.

At what age can my child take the Influenza A H1N1 vaccine?

All children aged 6 months and above can be given the Influenza A H1N1 vaccine.

How many doses of vaccine does my child need to take?

For all children above 9 years old, only one doses of the vaccine is needed.

For children between 6 months to 9 years old 2 doses is recommended for any child who had no previous influenza vaccination but will only need one dose if he had previous vaccination.

The influenza vaccination will have to be repeated yearly as the strains of the virus chosen will be different.

What are the different types of influenza vaccine available in Malaysia?

1. Monovalent Pandemic Influenza A (H1N1) Vaccine

2, Trivalent Seasonal Influenza Vaccine (with Pandemic A H1N1 vaccine included as one of the 3 vaccine)

What are the possible side effects of Influenza vaccine in children?

The 2009 H1N1 vaccine is made the same way as seasonal flu vaccines. Millions of seasonal flu vaccines have been given safely.

Mild problems that may be experienced include soreness, redness, or swelling where the shot was given, fainting (mainly adolescents), headache, muscle aches, fever, and nausea. If these problems occur, they usually begin soon after the shot and last 1-2 days. Life-threatening allergic reactions to vaccines are very rare. If they do occur, it is usually within a few minutes to a few hours after the shot is given.

After vaccination you should look for any unusual condition, such as a high fever or behavior changes. Signs of a serious allergic reaction can include difficulty breathing, hoarseness or wheezing, swelling around the eyes or lips, hives, paleness, weakness, a fast heart beat or dizziness.

If any unusual condition occurs following vaccination, seek medical attention right away.

More info available at: http://www.cdc.gov/h1n1flu/vaccination/vaccine_safety.htm

Fluid Management in Paediatric Dengue and Dengue Shock Syndrome

Official Immunisation Schedule of Malaysia by Ministry of Health as of 2009

Adapted from Malaysian Pediatric Protocol 2nd Edition

Update: the latest immunisation is at http://paedsid.blogspot.com/2013/09/national-immunisation-schedule-malaysia.html

Antibiotic Susceptibility Testing.

Microdilution Test

Disc Diffussion Test

Fellowship of Paediateic Infectious disease in SickKids Toronto.

Hospital For Sick Children, Toronto

Welcome

Welcome to the creation of the Paediatrics ID blog on July 1, 2008! Coincide with the Canada Day!