Factors predicting screen time related to physical and behavioural complaints in primary school children

@#problems from extended usage of electronic devices areissues among primary school children. This study is aimedto investigate the prevalence of physical and behaviouralcomplaints arising from the electronic device usage and toidentify the potential factors that predicted the complaints.Methods: This was a primary school-based cross-sectionalstudy using multistage cluster sampling, conducted at Baudistrict in Sarawak, Malaysia in 40 primary schools. Aquestionnaire was used to collect information of usagepattern in insufficient lighting, timing and position. Thephysical and behavioural complaints were traced. Dataanalysis was performed using SPSS version 22. A p-value <0.05 with 95% CI was considered as statistically significant. Results: About 52.8% of the 569 students used digitaldevices in a bright room, 69.8% in the day time and 54.4% insitting position. The physical complaints were headache(32.9%), neck, shoulder and back pain (32.9%) followed by byeye strain (31.8%). Regarding behavioural problems, 25.7% ofthe students had loss of interest in study and outdooractivities (20.7%), skipped meals (19.0%) andarguments/disagreements with parents (17.9%). After logisticregression analysis, the lying position (OR=1.71, 95% CI:1.096, 2.688) and darkroom lighting (OR=2.323 95% CI: 1.138,4.744) appeared to be potential predictors of the complaint.Conclusion: One-quarter of the students studiedexperienced physical complaints, and one-fifth hadbehavioural problems associated with the use of electronicdevices. Lying position and darkroom lighting are thepotential predictors of complaints. Therefore, we suggestthat the children should use electronic devices in the sittingposition with adequate room lighting.

Vision loss in an immunocompetent child post varicella infection: A case report

@#Chickenpox may lead to several neurological complications. Optic neuritis is one of the complications which has rarely been described, especially in immunocompetent individuals. We report a case of an 11-year-old immunocompetent girl who presented with sudden onset bilateral vision loss three weeks after varicella eruption. Ophthalmic examination revealed bilateral optic disc edema. Diagnosis of bilateral optic neuritis secondary to varicella was established based upon the preceding medical history, supported with clinical and radiological fndings.

Diagnostic dilemma of kimura disease of eyelids

@#Kimura disease (KD) is a rare benign chronic inflammatory disease that presents as a nodule mostly involving deep subcutaneous tissue of the head and neck region with frequent regional lymphadenopathy and peripheral blood eosinophilia. KD shares some clinical and histopathological similarity with angiolymphoid hyperplasia with eosinophilia (ALHE). Consequently, KD and ALHE were once considered variants of the same disease spectrum. We present here rare cases of Kimura disease and ALHE involving the eyelid and lacrimal gland and discuss their differential features.

Myxopapillary ependymoma of cauda equina presented with communicating hydrocephalus and papilloedema: A case report

@#We reported a case of cauda equina myxopapillary ependymoma in a patient who presented with atypical history of progressive blurring of vision. Ophthalmology examination revealed relative afferent pupillary defect, binasal hemianopia and papilloedema. This case report serves as a reminder that the intraspinal tumour could be a cause of papilloedema, despite rare, should be considered in a hydrocephalus patient who presented with no intracranial pathology and minimal spinal symptoms.

Factors determining the outcome of paediatric exotropia surgery

@#Objective: To determine the socio-demographic and clinical profile of exotropia surgery outcomes amongst paediatric patients. Methods: This is a descriptive, retrospective, clinical study of surgeries performed between 2014 and 2016 at the Sarawak Heart Centre, Malaysia. Medical records of patients with primary and secondary exotropia were reviewed. The following factors that affected the surgical outcomes were collected: onset age of squint, age at the time of surgery, the interval between diagnosis and surgery, the type of exotropia, visual acuity, presence of amblyopia, previous patching, anisometropia, refractive error, type of surgery, preoperative and postoperative deviation, pre-existing ocular comorbidity and systemic illness. Result: A total of 15 patients were studied with more than two thirds being females. Seven patients had primary exotropia while eight patients had secondary exotropia. Average interval between diagnosis and surgery was 1.3 years (±0.82) for primary exotropia and 1.2 years (±0.84) for secondary exotropia. Average pre-operative angle for primary exotropia was 50.57PD (±10.83) whereas secondary exotropia was 39.38PD (±8.63). Seven patients had successful surgical outcomes of within 10 prism dioptres, five for primary exotropia and two for secondary exotropia. The response to surgery was 3.0PD/mm (±0.59) for primary exotropia and 2.2PD/mm (±0.74) for secondary exotropia. Conclusion: In our study, primary exotropia had larger preoperative angle than secondary exotropia. The response to surgery was positively correlated with the preoperative angle of deviation. Primary exotropia showed better surgical outcome.