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