Publications by authors named "Anna-Marie Nathan"

Article Synopsis
  • In Malaysia, pertussis (whooping cough) is often underreported in children older than infant age, prompting a study to assess its prevalence among those 4 years and older with respiratory infections.
  • The study analyzed 298 children from the Paediatric Emergency Department, finding a very low incidence of pertussis (0.67%) but noted that the majority had low protective antibodies against the disease.
  • The results suggest a significant decline in immunity, indicating a need for booster vaccinations for pertussis in school-aged children to enhance protection.
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Objectives: This study aimed to devise a modified oximetry scoring system and calculate its diagnostic accuracy in detecting paediatric obstructive sleep apnoea syndrome (OSAS).

Study Design: This prospective diagnostic accuracy study was divided into two phases.

Setting: The study was conducted at a quaternary teaching hospital.

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Study Objectives: The effect of recombinant human growth hormone (rhGH) on sleep-disordered breathing (SDB) in Malaysian children with Prader-Willi syndrome (PWS) is under-investigated. We determined (1) the short- and long-term effects of rhGH and (2) factors associated with worsening SDB in children with PWS receiving rhGH.

Methods: This retrospective study included children with PWS (with and without rhGH) who had undergone at least 1 polysomnography.

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Introduction: : Asian children with cystic fibrosis (CF) managed in Malaysia have significant morbidity with limited access to life-sustaining treatments. We determined the morbidity and treatment cost of CF in a resource-limited country.

Methods: This cross-sectional study included all children diagnosed with CF in our centre.

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Article Synopsis
  • Overweight and obese children face risks of obstructive sleep apnoea (OSA) and abnormal pulmonary function (PF).
  • A study involving 74 children found that as OSA severity increased, measures of lung function like forced expiratory volume (FEV) and forced vital capacity (FVC) decreased.
  • Findings suggest a significant link between BMI, OSA severity, and pulmonary function, indicating that children with OSA show notable lung function issues regardless of their BMI.
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Background: Sleep disturbance in children with atopic dermatitis (AD) frequently goes unnoticed and can be associated with behavioral challenges. The aims of this study were to determine (a) the prevalence and factors associated with sleep disturbance and behavioral problems and (b) the correlation between sleep disturbance and behavioral problems in children with AD.

Methods: This cross-sectional study involved children aged 4-12 years old with moderate to severe AD.

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Objectives: We aimed to determine the association between newborn bacterial colonization and infant respiratory morbidity in the first 6 months of life.

Methods: This prospective study included healthy newborn infants. Nasopharyngeal swabs performed within 72 hours of delivery were analyzed using polymerase chain reaction.

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Background: Most studies examining survival of neonates with congenital diaphragmatic hernia (CDH) are in high-income countries. We aimed to describe the management, survival to hospital discharge rate, and factors associated with survival of neonates with unilateral CDH in a middle-income country.

Methods: We retrospectively reviewed the medical notes of neonates with unilateral CDH admitted to a pediatric intensive care unit (PICU) in a tertiary referral center over a 15-year period, from 2003-2017.

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Background And Objectives: Maternal diet during pregnancy may impact infant respiratory morbidity. The aim was to determine the association between antenatal maternal diet and respiratory morbidity of their infants during their first 6 months of life.

Methods And Study Design: This prospective cohort study included healthy motherinfant pairs.

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Introduction: Overnight pulse oximetry is an alternative to polysomnography (PSG) in diagnosing obstructive sleep apnoea syndrome, but its sensitivity is reported to be low.

Aims: To determine the (a) diagnostic accuracy, interobserver reliability and reliable oxygen desaturation index of 4% (ODI) score at diagnosing obstructive sleep apnoea syndrome in children and (b) correlation between the apnoea hypopnoea index (AHI) with ODI and oxygen nadir between both PSG and oximetry.

Methods: This cross-sectional study included children aged 1-18 years old, undergoing a fully attended overnight PSG for suspected obstructive sleep apnoea syndrome.

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Background: Acute respiratory infections (ARI) are a major cause of morbidity and mortality in Malaysian children < 5 years. Knowledge of associated economic costs is important for policymakers to determine cost-effectiveness of interventions, such as pneumococcal or influenza vaccines, which are underused in Malaysia.

Methods: Children < 5 years admitted with ARI to a teaching hospital in Kuala Lumpur were prospectively recruited between July 2013 and July 2015.

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Repetitive hypoxia seen in obstructive sleep apnoea syndrome (OSAS) may affect bone metabolism increasing the risk for secondary osteoporosis. This study investigates the association between OSAS in children and secondary osteoporosis. This cross-sectional study included 150 children aged 10-17 years: 86 with OSAS and 64 with no OSAS.

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Background: Provision of home mechanical ventilation (HMV) to children with chronic respiratory insufficiency enhances growth and quality of life. The hypothesis was that health-related quality of life (HRQoL) and the development of these children were poorer than in healthy children.

Objectives: To determine the HRQoL and developmental outcome of children on HMV.

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Article Synopsis
  • This study investigated the effectiveness of mechanical chest physiotherapy (CPT) using the LEGA-Kid® device compared to manual CPT for children under five with lower respiratory tract infections (LRTI).
  • Results showed that while both methods reduced respiratory rates and distress scores, mechanical CPT significantly outperformed manual CPT in lowering respiratory rates.
  • The study concluded that both CPT methods improved respiratory distress without adverse effects, but mechanical CPT provided better results, suggesting it might be the preferred choice for treating LRTI in young children.
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Introduction: Pneumonia in children is a common disease yet determining its aetiology remains elusive.

Objectives: To determine the a) aetiology, b) factors associated with bacterial pneumonia and c) association between co-infections (bacteria + virus) and severity of disease, in children admitted with severe pneumonia.

Methods: A prospective cohort study involving children aged 1-month to 5-years admitted with very severe pneumonia, as per the WHO definition, over 2 years.

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() is one of the main causative agents of pneumococcal diseases. To date, more than 90 distinct serotypes have been identified. Implementation of vaccines has caused a drastic reduction in vaccine-serotype pneumococcal diseases but increase in cases due to non-vaccine serotype has been observed in Malaysia.

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Background & Objectives: Streptococcus Pneumoniae: (pneumococcus) is a highly invasive extracellular pathogen that causes diseases such as pneumonia, otitis media and meningitis. This study was undertaken to determine the serotype diversity and penicillin susceptibility of S. pneumoniae isolated from paediatric patients in a tertiary teaching hospital in Malaysia.

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Objectives: To describe the severity, human adenovirus (HAdV) type and respiratory morbidity following adenovirus pneumonia in children.

Methodology: Retrospective review of children under 12 years of age, admitted with HAdV pneumonia, between January 2011 and July 2013, in a single centre in Malaysia. HAdV isolated from nasopharyngeal secretions were typed by sequencing hypervariable regions 1-6 of the hexon gene.

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Non-cystic fibrosis bronchiectasis (NCFB) has gained renewed interest, due to its increasing health-care burden. Annual mortality statistics in England and Wales showed that under 1,000 people die from bronchiectasis each year, and this number is increasing by 3% yearly. Unfortunately, there is a severe lack of well-powered, randomized controlled trials to guide clinicians how to manage NCFB effectively.

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Congenital bony nasal stenosis (CBNS) is a very rare but life-threatening cause of airway obstruction in neonates and infants. This review aims to assess the presentation and early airway management of 4 new cases of craniosynostosis with bilateral nasal cavity stenosis. Patients were treated with endoscopic endonasal widening of the nasal cavity and stenting.

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