Hans Van Rostenberghe

• University of Science Malaysia

The physical examination of the newborn is essential in diagnosing neurological or neurosurgical conditions in the newborn. This article focuses on three clinical assessments of newborns and infants that are especially important if neurological problems are suspected: The Ballard score, the examination of the head in a baby with (suspected) hydroce...

Caregiving and living with a Down Syndrome (DS) child is distressing and has given a negative impact on the quality of life of parents. The study aims examine the parents with DS children on the health-related quality of life (HRQoL) and family functioning and to identify potential factors affecting them. The cross-sectional study involved 94 paren...

At own risk (AOR) discharge in the paediatric setting is a complex phenomenon due to the triad of patient, caregiver, and clinician's involvement. It would cross disciplines from legal (child protection), moral (professional conducts and legal decisions), and ethical (age, condition, and nationality) perspectives in managing these situations. There...

Introduction: The latest Cochrane review supported high-position umbilical artery catheters (UAC) as it led to fewer complications and reduced the need for replacement or re-insertion of the catheters. However, the studies included were dated more than three decades ago. Objectives: To determine the safety (short-term complications) of UAC in the n...

Introduction: Renal scarring, which can be detected by DMSA renal scan, has been demonstrated to cause hypertension, proteinuria and chronic kidney disease (CKD). We reviewed the proportion of renal scarring, risk factors and outcomes among children who were referred for DMSA scan in a tertiary teaching hospital. Methods: All records of children le...

Chronic Granulomatous Disease (CGD) is an inherited disease affecting the nicotinamide adenine dinucleotide phosphate (NADPH) oxidase enzyme complex causing defective formation of superoxide in phagocytes. Patients usually manifested with recurrent bacterial and fungal infections and maybe fatal. They may also present with inflammatory manifestatio...

Background: There is presently no certainty about the ideal feeding intervals for preterm infants. Shorter feeding intervals of, for example, two hours, have the theoretical advantage of allowing smaller volumes of milk. This may have the potential to reduce the incidence and severity of gastro-oesophageal reflux. Longer feeding intervals have the...

Caffeine is the most commonly used methyl xanthine for the prevention of apnoea in prematurity, but the ideal dose was uncertain, until now. This study compared two doses of caffeine for the prevention of apnoea in prematurity. A clinical trial was conducted on 78 preterm infants ≤32 weeks in Neonatal Intensive Care Unit. They were randomly allocat...

The objectives of ATAP-NEPAH are to enhance and nurture healthy habits among adolescents as well as to empower adolescents in inculcating these healthy habits among them. Health education through peer-to-peer approach is used to instill the knowledge on important areas such as sexual and reproductive health, smoking, substance abuse, illegal street...

Caregiving for children with cerebral palsy (CP) has proved to negatively impact on the physical and psychological well-being of their primary caregivers. The aim of the current study was to examine the overall impact of caregiving for children with CP on the primary caregivers’ health-related quality of life (HRQOL) and family functioning and to i...

Systematically evaluate the safety and efficacy of different antiseptic solutions in preventing catheter related blood-stream infection and other related outcomes in neonates with CVC.

Objective: To determine the strain of caregivers of patients receiving palliative care by YOKUK@Sayang Home Care in the community of Kelantan state. Design: Cross sectional study using a validated Malay version of Caregiver Strain Index (CSI). Setting: Caregivers of patients who resided and looking after patients at home. The patients were those wh...

Background: Phototherapy is a well-established effective therapy for treating babies with significant neonatal jaundice. Studies have shown that increasing light intensity will increase its efficiency. A potentially inexpensive and easy way of increasing the intensity of light on the body of the infant may be to hang reflective materials from the...

Background: The low yield and quality of buccal-derived genomic DNA have reduced its applicability in various genetic research. The aim of this study was to assess the quantity, purity and genotyping efficiency of genomic DNA isolated from neonatal buccal swabs. Methods: Paired buccal swabs and whole blood samples were collected from 60 neonates wi...

Unwell medical students and trainees may pose significant medical risks to the patients and ethical challenge for colleagues, clinical supervisors and governing institutions. Medical students who suffer from medical or psychological illnesses, which directly affect their function, may deem hazardous for the safety of the patients. Fitness to practi...

Aim: The optimal placement of the endotracheal tube (ETT) in ventilated infants is essential, but birthweight may be not the best parameter to predict it. The aim of this study was a direct comparison of shoulder-umbilical length (experimental group) versus birthweight (control group) as predictor of optimal ETT placement in Malaysian ventilated i...

Neonatal mastitis and abscess are rare and most often unilateral. Neonatal breast massage for physiological breast hypertrophy is suspected to be a predisposing factor in the case reported here: a 14-day-old neonate with bilateral neonatal breast abscess, treated effectively with intravenous cloxacillin and surgical aspiration.

Background: Infants undergo various painful procedure such as vitamin K injection. Oral sucrose has been a standardized analgesia used during these procedures. Objective: To investigate the analgesic and anti-nociceptive properties of honey by using a locally derived Tualang honey. Methods: 78 newborns were randomized into 2 groups (using randomiza...

Introduction: Idiopathic nephrotic syndrome (INS) is the commonest type of nephrotic syndrome in children, and a majority has favourable outcomes. A small proportion of INS progresses to chronic kidney disease (CKD). We investigated the time to CKD and predictive risk factors associated with progression of CKD in these children. Methods: A retro...

Background: Oedema is a common clinical symptom in people with nephrotic syndrome and human albumin has been widely used in the treatment of oedema by increasing vascular volume and this inducing diuresis. It may be used with or without diuretics such as furosemide. However, the quantitative contribution of human albumin in treating oedema is not f...

Objective To determine whether feeding with 2-hourly or 3-hourly feeding interval reduces the time to achieve full enteral feeding and to compare their outcome in very low birthweight preterm infants. Design Parallel-group randomised controlled trial with a 1:1 allocation ratio. Setting Two regional tertiary neonatal intensive care units. Patien...

This is the protocol for a review and there is no abstract. The objectives are as follows: • To determine the most effective and safest feeding interval for bolus feeding for very preterm infants (less than 32 weeks' gestation at birth). • To assess whether short feeding intervals (such as one or two hours) compared with long feeding intervals (su...

Introduction: This study aimed to determine the prevalence of asthma-like symptoms among school children with low birth weight (LBW), and to compare the lung function of these children with that of children with normal birth weight. Methods: This was a comparative cross-sectional study. We recruited children aged 8-11 years from eight primary sc...

Riang Ria Rabu (RRR) is a unique programme for children in the hospital, pioneered by the Department of Paediatrics, School of Medical Sciences Universiti Sains Malaysia (USM). It is a weekly programme designed to provide a platform for and promote voluntarism spirit among the organisational staff, students and general public to contribute back to...

Background: Severe neonatal hyperbilirubinemia or neonatal jaundice (NNJ) characterised by an elevated total serum bilirubin (TSB) level may result in kernicterus or even death. Uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1) is the key enzyme which conjugates bilirubin with glucuronic acid for the subsequent bilirubin excretion. Conversel...

Constitutive androstane receptor (CAR) encoded by the nuclear receptor subfamily 1, group I, member 3 (NR1I3) gene regulates the elimination of bilirubin through activating the components of the bilirubin clearance pathway. Hence, NR1I3 genetic variants may affect bilirubin metabolism and result in neonatal hyperbilirubinemia. Thus far, research wh...

Objective: The objectives of this study were to determine the effect of a one and a half year educational intervention on the job dissatisfaction of teachers in 30 Community Based Rehabilitation (CBR) centres in Kelantan, Malaysia, and to identify the factors influencing changes in job dissatisfaction following the intervention. Method: Ten educati...

If a person who died in the early years of the twentieth century would come back today, he would not believe what he saw, heard, felt, tasted, and smelled. The twentieth century has been a century of so many discoveries and advances, unprecedented in any previous era. Also, the understanding, the prevention, the diagnosis and treatment of infectio...

Even though in the corporate world psychological science has been widely used, the formal use of evidence-based psychology in important areas of clinical medicine has been scanty at best. It was the aim of this study to determine the efficacy of a psychologist-led 2-week nurse educator training on the infection rate in the neonatal intensive care u...

Objective: The study aims to identify factors that associated with poor coping strategies among parents living with disabled children in Kelantan. Methods: This was a cross sectional study, conducted in 5 randomly selected districts in Kelantan. A total of 13 PDKs and 3 NGOs were involved. The lists of parents were obtained and those who fulfill t...

Literacy is a crucial aspect of a children's life in order to face the challenges in the information age. A literate person is who can read and has formal or informal education. Reading habits among 2 children is hard to cultivate especially when it’s related to healthcare condition. One of the solutions to culture reading habits among paediatric p...

Objectives: To determine the bacteriology of nosocomial infection within the neonatal intensive care unit (NICU) of Hospital Universiti Sains Malaysia (HUSM) and compare it to other intensive care and high dependency units (ICU/HD) in HUSM. Methodology: All records of cultured organisms from the NICU and ICU/HD in HUSM were retrieved from the micro...

Autonomy is widely accepted to be the third pillar of medical ethics. However, if it comes to refusal of life saving treatments, some extra considerations are necessary, especially if decisions are made by surrogate decision makers. Four cases of problematic decision making are presented here, followed by a discussion about the cultural and religio...

Malnutrition and growth failure are prevalent among Persons with Disabilities (PWD) and most trainers or care givers in the Community-based Rehabilitation (CBR) centres had limited knowledge in nutrition management for this vulnerable population. The purpose of this study was to develop and examine the validity and reliability of an evaluation inst...

Objectives The competency assessment of tomorrow’s doctors plays a vital role to offer insight into their clinical abilities and overall achievement. This study explores difficult index, discrimination index, areas under ROC curve, sensitivity and specificity of assessment components employed in the pediatric examination in Universiti Sains Malaysi...

The use of reflecting curtains with single phototherapy has not yet been directly compared with double phototherapy (DP). The objective of this study is to compare the efficacy of single phototherapy with reflecting curtains (SPRC) and DP in treating neonatal jaundice. This randomised controlled trial involved 160 term newborns with severe neonatal...

Objectives: Caring for children with disabilities brings about a significant impact on the parents and families. The purposes of this study were to determine the impact of having children with disabilities on parents' health-related quality of life (HRQOL), family functioning, and total family impact and to identify the associated factors. Method...

Introduction: Apprenticeship has been recently introduced as new teaching model at Paediatric Department, USM. The pur-pose is for the students to take an active role during the clinical attachment with thorough understanding of emerging issues on the patients. It is hoped that the learning experience will be modeled by the senior doctors in a cond...

Background and objectives: Population with disabilities are susceptible to malnutrition and limited data has been documented especially for those with low socio-economic background. A cross-sectional study was conducted to assess the nutritional status of persons with disabilities (PWD) in Kelantan, Malaysia; and to identify the malnutrition risk f...

Intrahospital variations in antimicrobial profiles may be related to many factors. This study compared causative agents of nosocomial bloodstream infections between a neonatal intensive care unit (NICU) that adopted a ward-tailored antibiotic policy and adult intensive care units (ICUs). Data on organisms from blood cultures obtained from the respe...

Introduction: Persons with disabilities (PWD) are susceptible to malnutrition. Caregivers or teachers in rehabilitation centres may not be adequately trained in nutrition management of PWD. The aims of this study were (i) to assess the nutrition knowledge, attitude and practice among teachers in community-based rehabilitation centres for PWD; and...

Introduction: Neonatal hyperbilirubinemia is a common condition appearing in the first week of life. This condition is caused by several factors such as hematological factors, breast feeding and mutations in genes like the bilirubin-uridine diphosphate glucuronosyltransferase gene (UGT1A1). The objectives of this study were to determine and compare...

We conducted a before and after study to determine whether an educational intervention to build capacity in the understanding and implementation of evidence could result in improved outcomes for mothers and babies in obstetric and neonatal units of two Malaysian hospitals. Twelve practices and thirteen associated outcomes were selected based on cle...

No previous study has assessed the impact of childhood disability on parents and family in the context of Malaysia, and no instrument to measure this impact has previously been available. The objective of this cross-sectional study was to determine the reliability of a Malay version of the PedsQL™ Family Impact Module that measures the impact of ch...

1), Wan Pauzi Wan Ibrahim (2), Mohd Ismail Ibrahim (1), Azizah Othman (2), Aniza Abd Aziz (3), Sakinah Harith (4), Normastura Abd Rahman (5), Hans Van Rostenberghe (2) (1) Department of Community Medicine, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan Malaysia (2) Department of Pediatrics, Universiti Sains Malaysia, Malaysia (3) Biostati...

Introduction: Little is known about the quality of life of children with disabilities (CWD). To the best of our knowledge, there is no validated instrument to measure the quality of life of CWD in Malaysia. Objective: The objective of this cross sectional study was to determine the reliability of the Malay version of the Quality of Life Inventory ™...

The addition of glutamine to parenteral nutrition (PN) in neonates has not shown significant benefits as compared to adults thus far. This study aimed to determine the potential benefits of the addition of glutamine to neonatal PN in a tertiary hospital in a middle-income country. This was a double-blinded randomised controlled trial. Babies who we...

To determine the rate, causes and risk factors of non-attendance to the paediatric clinic in a tertiary hospital in Malaysia and to determine the efficacy of one telephone call to confirm a new appointment. For all non-attending patients, during a 2-month period, a pro forma was filled up based on patients' records. During a phone call, additional...

Delays in transporting blood samples may cause inaccurate results. Samples may be exposed to light or heat during delays, resulting in the degradation of analytes, for example, bilirubin. This study was done to determine the effect of delays in the transportation of blood samples on serum bilirubin test results. Samples taken from neonates admitted...

The uridine diphosphoglucuronate-glucuronosyltransferase 1A1 (UGT1A1) gene encodes the enzyme responsible for bilirubin glucuronidation. To evaluate the contribution of UGT1A1 promoter mutations to neonatal jaundice, we determined the genotypes of c.-3279T>G, c.-3156G>A, and A(TA)7TAA in Malay infants with neonatal jaundice (patients) and in infant...

The benefits of human milk for both infants and mothers have been well established. Especially preterm infants benefit from breast milk. However barriers to breast milk expression in mothers with preterm babies result in a relatively low availability of human milk for these particularly vulnerable infants. To overcome this problem, human milk banks...

Evidence-based medicine has become increasingly important over the years. Getting research evidence into practice is a necessity in current practice. It has to be kept in mind that every patient population has its own special characteristics and this may make the best available research evidence sometimes not the best option for that particular pop...

Neonatal jaundice is very common in newborn infants. Although it is often a natural and transitional condition, some infants develop severe hyperbilirubinemia, in which unconjugated bilirubin in the serum may cross the blood-brain-barrier and cause bilirubin encephalopathy (acute bilirubin intoxication) or kernicterus (chronic bilirubin intoxicatio...

Pharmacological closure of patent ductus arteriosus in pre-term infants with indomethacin has been applied since the late 1970s. However, because of complications, a search for a safer and efficacious alternative continues. In this review, we look at the available evidence in the literature for and against closure of the patent ductus arteriosus wi...

The aim of this study was to determine whether there was a difference in the pain indicators and effectiveness between venipuncture (VP) and heel prick (HP) for blood glucose monitoring in term neonates (recently, venipuncture was shown superior for the Guthrie test). 66 term neonates undergoing blood glucose monitoring underwent VP or HP. Primary...

We report the first case of a human Burkholderia tropica infection. The patient was a premature neonate who had necrotizing enterocolitis with bowel perforation requiring surgical intervention. The stoma care and difficulties in feeding were a chronic problem. At the age of almost 4 months he developed septicemia due to B. tropica. Three consecutiv...

To determine whether the addition of low-cost reflecting curtains to a standard phototherapy unit could increase effectiveness of phototherapy for neonatal jaundice. Randomised controlled clinical trial. Level-one nursery of the Hospital Universiti Sains Malaysia, Kelantan, Malayasia. Term newborns with uncomplicated neonatal jaundice presenting in...

Mutations in the gene encoding UDP-glucuronosyltransferase 1A1 (UGT1A1) may reduce the glucuronidation of estradiol, bilirubin, etc. In the present study, we used a liquid chromatography-tandem mass spectrometry (LC/MS/MS) method to assay the activities of recombinant mutated UGT1A1 toward 17beta-estradiol (E2), by determining its glucuronide (E2G)...

Pantoea infections are uncommon in humans. Most reports have involved adults or children after thorn injuries. There are only a few reports of systemic infections with Pantoea. This is the first report of the clinical picture of systemic Pantoea spp. infection in neonates as observed during an outbreak in a neonatal intensive care unit caused by in...

Gilbert syndrome is caused by defects in the uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1) gene. These mutations differ among different populations and many of them have been found to be genetic risk factors for the development of neonatal jaundice. The objective was to determine the frequencies of the following mutations in the UGT1A1 g...

Contaminated parenteral nutrition (PN) is an important source of infection in neonates. Many organisms have been reported to cause contamination that results in outbreaks in intensive care units. The objective of this study was to investigate an outbreak caused by Pantoea spp., which contaminates PN, in a neonatal intensive care unit (NICU). This w...

The objective of this study was to assess the efficacy and safety of oral 30% dextrose during venepuncture in neonates. Neonates admitted in the Special Care Nursery for jaundice from September 200 to January 2001 were recruited for this double-blind randomised controlled trial. The intervention consisted of administration of either 2 ml of oral 30...

The role of hemolysis in the pathophysiology of neonatal jaundice (NNJ) in patients with glucose 6-phosphate dehydrogenase (G6PD) deficiency has been questioned recently. The aim of the present study was to determine the contribution of hemolysis to the pathophysiology of jaundice in Malay neonates with G6PD deficiency and NNJ. Four groups of babie...

There are significant differences in the prevalence and severity of neonatal jaundice among various populations. Recently, it has been reported that a mutation of the UGT1A1 gene, glycine to arginine at codon 71 (G71R), is related to the development of neonatal jaundice in East Asian populations. However, whether the G71R mutation contributes to th...

Southeast Asian ovalocytosis (SAO) is a red blood cell abnormality common in malaria-endemic regions and caused by a 27 nt deletion of the band 3 protein gene. Since band 3 protein, also known as anion exchanger 1, is expressed in renal distal tubules, the incidence of SAO was examined in distal renal tubular acidosis (dRTA) in Malays in Kelantan,...

Multiplex polymerase chain reaction (PCR) using multiple tandem forward primers and a common reverse primer (MPTP) was recently established as a comprehensive screening method for mutations in X-linked recessive diseases. In the work reported here, MPTP was used to scan for mutations of the glucose-6-phosphate dehydrogenase (G6PD) gene. Mutations i...

We present an unusual neonatal fungal infection, Hansenula anomala in a very low birthweight infant who underwent abdominal surgery for an omphalocele. Despite treatment with adequate doses of amphotericin B, the yeast continued to grow from the blood culture, and was only eradicated with the use of oral ketoconazole.

A newborn boy presented within the first day of life with moaning, anemia, and thrombocytopenia. The clinical syndrome resulted from thrombosis of the posterior part of the superior sagittal sinus due to impression at birth of the tip of the occipital squama. Both computed tomography and ultrasound scans were valuable noninvasive tools for document...

Low creatine kinase (CK) activities in serum are associated with high fatality rates in intensive care patients. The underlying mechanisms for this phenomenon were investigated. No correlation was found with other biochemical markers of inflammation (CRP, alpha-1 acid glycoprotein, alpha-2 macroglobulin). In the patients' serum a factor is describe...

Background: The role of hemolysis in the pathophysiology of neonatal jaundice (NNJ) in patients with glucose 6-phosphate dehydrogenase (G6PD) deficiency has been questioned recently. The aim of the present study was to determine the contribution of hemolysis to the pathophysiology of jaundice in Malay neonates with G6PD deficiency and NNJ. Methods:...