Herpes simplex virus remains the commonest organism of sporadic encephalitis. Common presentations in herpes simplex encephalitis are seizures and behavioural changes apart from fever, lethargy and headache. Cardiac manifestations, nonetheless, are uncommon in herpes simplex infection. We presented an 8-year-old boy with clinical meningoencephalitis and bradycardia. The initial impression was typhoid meningitis due to severe bradycardia. He was managed in paediatric intensive care unit with transcutaneous cardiac pacemaker and infusion of low dose noradrenaline until the bradycardia resolved. A diagnosis of herpes simplex encephalitis was made based on clinical and specific right temporal and focal radiological findings including right insular ribbon involvement, focal changes over temporal and frontal electroencephalographic (EEG) inference and positive HSV IgM serological confirmation.

Introduction: Parents with autistic children are more susceptible of developing stress due to genuine challenges in treasuring them. During the world pandemic disaster of COVID-19 emergency, the challenge is far greater than expected as movement control order restricted them to seek for help and resources as the country adopting strict isolation measurement to restrain COVID-19 virus infection. This survey was conducted online to determine the prevalence of stress, independent predictor and assessing coping style that help to overcome them. Methods: This was a cross-sectional study using Facebook platform. The survey was posted into Autisme Malaysia group for 2 weeks duration from 17th June until 30th June 2020. Stress was measured using Malay version of Perceived Stress Scale (PSS-10) and coping style using Brief COPE questionnaire. Independent t-test was used to determine coping style associated with stress and multiple logistic regression for independent stress predictor. Results: The mean age of respondents was 38.9 years old with mean child’s age was 8.6 years old. Majority of respondents were female, Malay, and married couples with 83.1% of the caregivers were having stress. The independent predictor for stress were age of the caregivers and the level of education. The approach style of coping was significantly associated with stress. Conclusion: The pandemic has directly and indirectly contributed to stress prevalence among caregivers of children with autism. Hence, the right coping style should be embraced and empowered to parents for healthier stress therapy. Our findings recommended that coping style of informational support, behavioural disengagement, religion and acceptance as dynamic model of coping style.

To study the characteristics of paediatric patients admitted to two non-COVID-19 teaching hospitals before and during the implementation of the Movement Control Order (MCO) in Malaysia. The retrospective study was performed in two phases (before MCO between February to March 2020, and during MCO lockdown between March to April 2020) in two teaching hospitals on the East Coast of Peninsular Malaysia. Hospitalized children <18 years were included and those coming for elective procedures or oncology treatment were excluded. The clinical data were retrieved from both hospitals’ admission records. There was a total of 496 and 191 admissions to two teaching hospitals on the East Coast of Peninsular Malaysia, respectively. A significant reduction in the number of non-COVID-19 hospital admissions was seen in both hospitals. For Hospital Universiti Sains Malaysia, the daily hospital admissions were reduced with a mean of 10 (before MCO) to 7 (during MCO) admissions/day (95% CI 1.54,7.54, p=0.001). In Sultan Ahmad Shah Medical Centre, a reduction in hospital admission was seen from 5 (before MCO) to 3 (during MCO) admissions/day (95% CI 0.61, 3.15, p=0.005). Our study observed a general drop in non-COVID-related respiratory illnesses and infectious disease cases during the MCO period. There were significant differences in neurological (p=0.029) and accident (p = 0.001) cases admissions observed between the two periods. Public health social distancing has indirectly reduced the non-COVID-19 related cases in the hospital settings with an increase in accidental injuries among the children during the MCO period.
COVID-19