There are five subspecialties. Dr Wan Jazilah Wan Ismail, who is also the Head, runs a paediatric nephrology unit. Dr Lim Chooi Bee who is a trained paediatric gastroenterologist takes care of the one and only Ministry of Health paediatric liver transplant services for the country. The Paediatric Rheumatology Unit is headed by Dr Tang Swee Ping and this the only paediatric rheumatology tertiary referral unit in Malaysia. Dr Hargeet Kaur heads the SCAN and adolescent unit. Dr Chee Seok Ching heads the Neonatal Unit.
The other paediatricians are Dr Suhaila Omar, Dr Annie Liau, Dr Noraini Mustafa, Dr Florence Wong. There are also paediatricians on subspeciality fellowship training and also junior paediatricians undergong specialist gazettement. These paediatricians are especially invaluable in their contributions to the running of the general paediatric and neonatal services.
(1)PAEDIATRIC RHEUMATOLOGY UNIT
The Paediatric Department, Hospital Selayang first started offering Paediatric Rheumatology services in October 2003. This service is the first and only Paediatric Rheumatology tertiary service in Malaysia to date. The unit is led by Dr Tang Swee Ping who is a consultant in paediatric rheumatology.
Since its inception, the Paediatric Rheumatology unit has expanded in terms of the services offered as well as the number of patients seen and has become a well established paediatric rheumatology tertiary referral center in Malaysia.
The Paediatric Rheumatology team consists of:
- Dr Tang Swee Ping – Consultant Paediatrician and Paediatric Rheumatologist
- Dr Lim Sern Chin – Consultant Paediatrician and Paediatric Rheumatologist
- Dr Cham Weng Tarng – Consultant Paediatrician and Paediatric Rheumatologist
- SN Fatimah Noor Abdollah – Paediatric Rheumatology nurse
- Doctors and nursing staff working in ward 8A
The Paediatric Rheumatology services provided include:
1) Outpatient clinics
The total outpatient visits has increased over the years resulting in expansion from one outpatient clinic per week in 2003 to two clinics per week in January 2006, and for 2012, a total of 1947 outpatient visits were recorded.
The specialised Paediatric Rheumatology outpatient clinics are located at the Paediatric Clinic, Level 3 , Hospital Selayang and are by appointment only. Please call the Paediatric Clinic if you require an appointment and please inform in events of cancellation. The clinics are held on :
a) Monday : 8.00 am – 1.00 pm.
b) Thursday : 8.00 am – 1.00 pm
2) Inpatient admissions
This unit also offers inpatient paediatric rheumatology care for investigation, treatment and management including rehabilitation of patients with various paediatric rheumatic diseases like systemic lupus erythematosus (SLE), juvenile idiopathic arthritis (JIA), juvenile dermatomyositis (JDM), vasculitis and scleroderma. Various infusion of specialised medications are also carried out in the ward on a day basis. Paediatric rheumatology patients are normally admitted to ward 8A.
3) Specialised procedures
Specialised procedures like joint aspiration and steroid injections for children with arthritis are also offered by this unit. Musculoskeletal ultrasound is also offered for selected patients.
This unit is committed to training doctors and allied health professionals in the field of paediatric rheumatology. This unit accepts paediatric medical officers from other hospitals for short term attachments in paediatric rheumatology and is the only recognised subspeciality training centre for paediatric rheumatology. The first paediatric rheumatology subspeciality fellow was accepted in September 2007.
The unit also actively educates doctors in paediatric rheumatology conditions but delivering lectures at paediatric rheumatology seminars and workshops, and through various academic and scientific conferences both national and regional levels.
This unit is also committed and actively involved in research in paediatric rheumatology and the following scientific papers have been presented at various conferences.
1. Recognising cutaneous signs and treatment in paediatric connective tissue disease. SP Tang. Malaysian Journal of Dermatology 2009; vol 22: 1-6
2. Handbook of Hospital Paediatrics 3rd edition by Thong Meow Keong, Wwong Chee Piau, Lee Way Seah. SPTang is the author of 2 chapters on Musculoskeletal pain in children and Juvenile Idiopathic arthritis.
3. Hydroxychloroquine-induced ototoxicity in a child with systemic lupus erythematosus. Letter to Editor. SCLim and SPTang. International Journal of Rheumatic Diseases 2011;14:e1-e2
4. NOMID : The radiographic and MRI features and review of the literature. Faizah Mohd Zaki, Radhika Sridharan, Tan Sook Pei, Sharaf Ibrahim, Tang Swee Ping
b) Oral presentations
1. Outcome of Juvenile Systemic Lupus Erythematosus. SP Tang, C Pilkington, P Woo. - 26th Annual Congress of Malaysian Paediatric Association and the 2nd ACPID meeting in Sabah, September 2004.
2. "Cries from the Joints": Musculoskeletal Assessment amongst Malaysian Pediatric Trainees. SP Tang - 27th Annual Congress of Malaysian Paediatric Association and the APPSGHN meeting in Kuala Lumpur, 2005. Selected to be presented as one of the finalist for the 'Young Investigator Award'
3. Clinical features of Juvenile Dermatomyositis at Diagnosis. Tang Swee Ping, Lingesh A/L Sivanesan, Mathan Raj A/L Nadarajan, Primus John, Amirtha Vahini Chinnadurai, Tang Swee Fong . - 30th Annual Malaysian Paediatric Association congress in Malacca, August 2008
4. Long term complications of Juvenile Dermatomyositis. Tang Swee Ping, Amirtha Vahini Chinnadurai, Primus John, Lingesh A/L Sivanesan, Mathan Raj A/L Nadarajan, Tang Swee Fong .- 30th Annual Malaysian Paediatric Association congress in Malacca, August 2008
5. Perception of Paediatric Pain amongst Paediatric Nurses in a General Hospital. Tang Swee Ping, Fatimah Noor Abdullah, Haidah Basiran. -30th Annual Malaysian Paediatric Association congress in Malacca, August 2008
6. Clinical and laboratory features of Juvenile Systemic Lupus Erythematosus at Initial Presentation. Hii King Ching, Tang Swee Ping - 30th Annual Malaysian Paediatric Association congress in Malacca, August 2008
7. Juvenile Idiopathic Arthritis in Malaysia : The Selayang experience. Cham Weng Tarng, Tang Swee Ping.- This free paper was awarded the Young Investigator Award at the 32nd Malaysian Paediatric Association Annual Congress 2010
c) Poster presentations
1. Intravenous Immunoglobulin for Resistant Skin disease in Juvenile Dermatomyositis. SP Tang, SC Lim - 27th Annual Congress of Malaysian Paediatric Association and the APPSGHN meeting in Kuala Lumpur, 2005
2. Infections amongst Malaysian patients with Juvenile Idiopathic Arthritis on long term Methotrexate. SP Tang, SC Lim - 12th APLAR conference, Kuala Lumpur in August 2006
3. Antiphospholipid-related cerebral sinovenous thrombosis with Evans syndrome as presenting manifestation of juvenile systemic lupus erythematosus. SP Tang, MS Faridah - 12th APLAR conference, Kuala Lumpur in August 2006
4. Nystagmus as an unusual presentation of acute post-streptococcal glomerulonephritis (APSGN). Lim Sern Chin, Tang Swee Ping, - 30th Annual Malaysian Paediatric Association congress in Malacca, August 2008
5. Case report : Nimetazepam (Erimin 5) poisoning in children. Lim Sern Chin, Koh Lee Min, Tang Swee Ping - 30th Annual Malaysian Paediatric Association congress in Malacca, August 2008 – won third prize for the "best poster" category
6. Peripheral neuropathy in juvenile systemic lupus erythematosus : a case series. WT Cham, SP Tang.- Ten Topics Asia 2010 in Singapore, August 2010.
7. Clinical features and predictors of renal disease in Juvenile Systemic Lupus Erythematosus. Lim Sern Chin, Tang Swee Ping, Wan Jazilah Wan Ismail. - 32nd Malaysian Paediatric Association Annual Congress 2010 – was awarded third prize for best poster competition.
8. Infliximab therapy in severe refractory Kawasaki Disease. Tang Swee Ping, Hung Liang Choo.- 32nd Malaysian Paediatric Association Annual Congress 2010
9. Chronic Pain syndromes : A missed or misdiagnosis ? Tang Swee Ping - 32nd Malaysian Paediatric Association Annual Congress 2010
10. "Nutrient drinks" and hepatic impairment in children : A case report. Cham Weng Tarng, Tang Swee Ping, Lim Sern Chin.- 32nd Malaysian Paediatric Association Annual Congress 2010
11. Atypical Presentation of Childhood Leukaemia. Florence Wong, Grace Chow Kam Yoke, Tang Swee Ping, Cham Weng Tarng - 32nd Malaysian Paediatric Association Annual Congress 2010
12. Iv Immunoglobulin in Influenza A H1N1 associated acute necrotising encephalopathy : A case report. Koh Lee Min, Tang Swee Ping, Lim Sern Chin, Cham Weng Tarng - 32nd Malaysian Paediatric Association Annual Congress 2010
13. Polyarteritis Nodosa – A rare presentation (Case Report): Tina Sivalal, Soo Min Hong, Tang Swee Ping, Cham Weng Tarng. - 32nd Malaysian Paediatric Association Annual Congress, Kuala Lumpur 2010
14. The effectiveness of iv Tocilizumab in severe Systemic Juvenile Idiopathic Arthritis. Tang Swee Ping, Cham Weng Tarng - 34th Malaysian Paediatric Association Annual Congress 2012, Kuching.
15. Outcome of the first Home Based Self Administration of subcutaneous Methotrexate (HoSAM) programme in Malaysia. Tang Swee Ping, Norliza Mat Ariffin, Elain Liew, Chuah Ching Ching, Rosminah Mohd Din, Lim Sern Chin, Cham Weng Tarng. - 34th Malaysian Paediatric Association Annual Congress 2012, Kuching
16. Case series : Calcinosis in Juvenile Dermatomyositis. Lim Sern Chin, Tang Swee Ping
6) Patient and public education
This unit is also committed towards promoting the awareness of some of these childhood rheumatological conditions to the public. To date, multiple articles on Juvenile Idiopathic Arthritis has been published in mainstream English and Malay newspapers. Two interviews on childhood lupus were also carried out live over national television in conjunction with the World Lupus Day in 2009.
The paediatric rheumatology unit also has a close liason with the Arthritis Foundation Malaysia (AFM), and Dr Tang was the founding member and the current chairman of the AFM Junior Club which is a patient support group for children and young people with arthritis. Through the AFM Junior Club, many paediatric patients from Selayang Hospital have benefited its activities which included JIA family day trips to Bread Town Museum, Shah Alam in 2005, Colmar Tropicale, Bukit Tinggi in 2006 where the highlight was an introduction to therapeutic horse riding for children, Kuala Gandah Elephant Sanctuary in 2009 and Sungai Klah Hot Springs, Sungkai in 2011. In November 2006, the unit under the auspices of AFM also organized the first ever 'Independence Camp" for 16 teenagers with arthritis which was held in Genting Highlands and aimed towards empowering teenagers with arthritis to be responsible for their own disease and its management. In 2008, another 25 teenagers benefited when an Independence camp was held in Kuala Selangor National Park. In 2012, 25 children and teenagers attended the 3rd Independence Camp in Klana Resort, Seremban.
Independence Camps :
|Teaching the use of orthosis||Sharing and learning together||Physical empowerment|
7) Future plans
The future plans for this unit include setting up multidisciplinary clinics to enhance patient care as well as having specific dedicated allied health professional members in the team. It is hoped that the unit will continue to train many more paediatric rheumatologist for the country in the future.