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  1. A preliminary study of the original TIBSIT and its cultural adaptation in Malaysia
    Kevin SD, Govindaraju R, Danaee M, Shahrizal TA, Prepageran N
    Med J Malaysia, 2021 08;76(Suppl 4):3-8.
    PMID: 34558549
    BACKGROUND: A simple and self-administered 'scratch & sniff' test kit like the TIBSIT smell kit based on the Taiwan Smell Identification Test (TWSIT), provides a safe and quick assessment of olfaction. The original TIBSIT has been validated for use in Taiwan with age specific scores for different age groups and diagnosis. The main aim of this study is to examine if TIBSIT can be applicable for the Malaysian population and perform cultural adaptation as necessary to allow a more accurate assessment using this tool.

    METHOD AND MATERIAL: A preliminary study of the original TIBSIT (Phase 1) followed by cultural adaption (Phase 2) were carried out on volunteers from various neighbourhoods in Klang Valley, Malaysia comprising of age group 16-80 years. A total of 150 test subjects and 50 test subjects were recruited for Phase 1 and Phase 2 respectively. Cultural adaptation was done with changes to the distractors that were found to be confusing. In addition, modifications included added language translation and visual reinforcement with images of the odour's substance of origin.

    RESULTS: 109 out of the 150 responses were accepted for Phase 1. A detection rate of less than 75% was found in three of the odours with the remaining showing an average rate of 87.2% to 97.7%. These three odours were culturally adapted for Phase 2. All 50 responses for Phase 2 were accepted; two of the odours' detection rates improved to 98% but the plum odour was only detected 53% of the time.

    CONCLUSION: TIBSIT provides a quick office-based olfaction testing. The culturally adapted test kit is a potentially useful screening test for the Malaysian population. It is also safe and excludes the need of the clinician to carry out the test. This becomes especially useful in testing any dysosmia (hyposmia/anosmia) cases suspected of SARS-COV-2 virus infection (COVID-19).

  2. Isolated extramedullary plasmacytoma of the middle turbinate
    Shahrizal TA, Prepageran N, Rahmat O, Mun KS, Looi LM
    Ear Nose Throat J, 2009 Feb;88(2):786-9.
    PMID: 19224479
    Extramedullary plasmacytoma is a rare plasma cell proliferative disorder with a predilection for the head and neck region. Occasionally, it presents as a solitary lesion in the nasal cavity. We report a case of an isolated lesion in the middle turbinate of the right nasal cavity. The lesion was completely excised via an endoscopic approach. We also review the pathology and management of plasmacytomas in general.
  3. Fulltext Cell-mediated immunity in nasopharyngeal carcinoma and allergic rhinitis: a controlled study
    Wong HT, Shahrizal TA, Prepageran N, Lim WK, Raman R
    Ear Nose Throat J, 2007 May;86(5):292-4.
    PMID: 17580811
    We conducted a prospective study of 60 patients in a tertiary care referral center to ascertain the status of cell-mediated immunity as determined by delayed hypersensitivity reactions in patients with nasopharyngeal carcinoma (NPC) or allergic rhinitis. Delayed hypersensitivity as detected by Mantoux testing is generally accepted as a reflection of the level of cell-mediated immunoactivity-the less hypersensitivity reaction that occurs, the lower the level of immunoactivity is, and vice versa. Our study population was made up of three groups: 20 newly diagnosed patients with NPC (pretreatment), 20 age- and sex-matched patients with allergic rhinitis, and 20 matched controls without either disease. A negative Mantoux test (0- to 5-mm induration) was seen in 13 patients with NPC (65.0%), in 17 patients with allergic rhinitis (85.0%), and in 16 controls (80.0%); none of these differences was statistically significant. However, it is interesting that while the NPC group had the lowest percentage of negative Mantoux results overall, it had the highest percentage of patients who had no reaction at all (i.e., 0-mm induration); a complete absence of any reaction was seen in 7 of the 13 Mantoux-negative NPC patients (53.8%), compared with 2 of the 17 Mantoux-negative allergic rhinitis patients (11.8%) and 3 of the 16 Mantoux-negative controls (18.8%). An absence of a reaction generally indicates a very limited degree of cell-mediated immunoactivity. Therefore, we conclude that patients with NPC appear to have significantly less cell-mediated immunity than do patients with allergic rhinitis and normal controls; no statistically significant difference was noted between the latter two groups.
    Study site: ENT clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
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