Paediatric ultrasound – developmental hip dysplasia

12th May 2024, NIA Diagnostic Imaging

Developmental dysplasia of the hip (DDH) stands out as one of the most prevalent musculoskeletal disorders manifesting in neonates and infants (Charlton et al., 2017). Owing to the dynamic potential for hip remodelling, hip dysplasia at birth may either resolve spontaneously or progress as the child grows (Loh & Wollett, 2021). DDH encompasses a spectrum of hip conditions, including abnormal acetabular development and hip dislocation causing disruption to the typical alignment of the femoral head and acetabulum as a stable ball-and-socket joint (Landes, 2011).…

Omega-3 supplements in pregnancy for leaner kids?

11th May 2024, A/Prof Chee L Khoo

Omega-3 supplements?

I recall reading somewhere that increasing fish intake during pregnancy results in leaner offsprings. It all makes sense as we know that ω-3 fatty acid (ω-3 FA) is beneficial for adults (also read somewhere). It must be good for babies then. Is there data on those claims? Well, sort of. We shall look into them.…

Familial hypercholesterolaemia – is it really that rare?

9th April 2023, Dr Chee L Khoo

Familial Hypercholesterolaemia

One of the most important contributor to atherosclerosis is elevated cholesterol levels. Familial hypercholesterolaemia (FH) is a genetic disease that manifests as a disorder of cholesterol metabolism by mutations in hereditary genes usually in an autosomal dominant manner.  Data suggest that 1 in 200 Caucasians are heterozygous for FH and that 1 in 160,000–300,000 are homozygous, which are much higher prevalence than those estimated a decade earlier (1).…

Myopia – can we prevent it?

12th March 2023, Dr Chee L Khoo

Myopia, especially high myopia is associated with increased risk of irreversible blinding conditions, including myopic retinopathy, retinal detachment, choroidal neovascularisation, and glaucoma (1-4) leading to a heavy cost burden on individuals and communities (5). So, it makes sense to see whether we could prevent or delay the onset of myopia or at least slow its progression.…

The tale of two cysts

24th February 2022, Spectrum Medical Imaging

Case 1

7-year-old girl has 3-week history of headache, lethargy and vomiting.Woke up in the morning with headache and vomiting, presented to hospital casualty. Urgent CT brain showed acute hydrocephalus with raised intracranial pressure requiring urgent operative insertion of ventricular drain to reduce ventricular pressure. What is the cause of the obstruction?

Case 2

6 ½ year old girl.…

Covid-19 and newborn – scary stuff?

25th October 2020, Dr Chee L Khoo

Covid-19 and newborn

Although our numbers of new Covid-19 infections and community transmission is pretty good in comparison with most other countries in the world, it isn’t zero. This is as good as it gets for at least the next 12 months. One of the scariest things is transmission of the virus to the newborn if the pregnant mother has the Covid-19 infection.…

Anti-depressants in pregnancy – which agent is less bad?

14th August 2020, Dr Chee L Khoo

Most women would prefer not to take any medications during the pregnancy for fear of any potential teratogenic effects on the foetus. However, for some women, the use of anti-depressants is necessary. Managing these mental disorders during pregnancy and the post-partum period can be challenging (1-2) but effective management can maintain maternal and infant health (3), improve maternal prenatal health care practices (4) and improve maternal-infant attachment (5).…

Paediatric Radiology – the tale of two cysts

28th April, Spectrum Radiology

This month’s radiology series is brought to you by Dr Chee Chung Hiew, a Paediatric Radiologist at Spectrum Medical Imaging.

In Case 1, we have a 7 year-old girl with a 3 week history of headache, lethargy and vomiting. She woke up one morning with severe vomiting and presented to ED.

In Case 2, a 6.5 year-old girl had headaches for 2 months.…

Paediatric Acute-Onset Neuropsychiatric Syndrome (PANS) – Is it real?

25th December 2019, Dr Chee L Khoo

They used to call it “Paediatric Infection Triggered Autoimmune Neuropsychiatric Disorders” (PITANDS)(1). Sounds terrible, doesn’t it? They were referring to children with obsessive-compulsive disorder (OCD) who had a sudden onset of their psychiatric symptoms, typically following infection with a variety of agents, including group A streptococcus (pyogenes), varicella and mycoplasma pneumoniae. The subgroup specifically associated with group A streptococcus (GAS) was called “Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections” (PANDAS).…

Acid suppression in infants – 2 questions to ponder before prescribing

13th July 2019, Dr Chee L Khoo

Gastroesophageal acid reflux disease in babies is a common presentation in general practice. Crying, frequent vomiting or regurgitation and sometimes poor weight gain can transform a lovely and cute baby into a monster. Acid suppressants, including proton pump inhibitors (PPIs) and histamine H2-receptor antagonists (H2RAs) are increasingly being prescribed for this debilitating (to both baby and parents) condition.…

Montelukast and neuropsychiatric events in kids with asthma – is there a link?

10th June 2019, Dr Chee L Khoo

Children with moderate to severe asthma often needs more than the usual bronchodilators. Even the newer long acting beta agonists (LABA) or long acting muscarinic antagonists (LAMA) may not be enough to control the symptoms and reduce exacerbations and inhaled corticosteroids (ICS) are often needed. But we are careful to keep the total daily dose of corticosteroids to a minimum.…