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Fulltext Circulation of all dengue virus serotypes during dengue outbreak in Sandakan, Sabah, Malaysia (2016)

Gintarong TJ, Emran A, Sherin A, Thein TT, Aung TS

J Vector Borne Dis, 2018 10 4;55(2):168-171.
PMID: 30280717 DOI: 10.4103/0972-9062.242566
Fulltext A clinically silent tumour of adrenal myelolipoma: A case report

Azizan N, Myint O, Wynn AA, Thein TT, Hayati F, Nik Lah NAS

Int J Surg Case Rep, 2020;72:63-65.
PMID: 32506033 DOI: 10.1016/j.ijscr.2020.05.056

INTRODUCTION: Adrenal myelolipoma is a rare, non-functional, benign neoplasm which is constituted of mature haematopoietic elements and adipose tissues in various proportions. It is diagnosed accidentally and frequently with the widespread use of imaging modalities.
PRESENTATION OF CASE: We report a 63-year-old lady with incidental findings of adrenal tumour on computed tomography (CT) scan during a routine medical check-up. She underwent tumour resection in view of a large tumour of 7 cm in size.
DISCUSSION: CT scan is sensitive to diagnose adrenal myelolipoma in view of its fat-laden property and useful to monitor the tumour progress. Even previously she opted for conservative management; the decision for surgery was made in view of enlarging tumour and risk of surrounding tissue compression.
CONCLUSION: With increased awareness, the detection rate of this tumour is improving, hence able to prevent the complications of a large tumour such as compression, bleeding and tumour necrosis.
Re: Pneumoperitoneum due to ruptured tubo-ovarian abscess

Soe MZ, Hayati F, Yeap BT, Guad RM, Thein TT

ANZ J Surg, 2021 07;91(7-8):1635-1636.
PMID: 34402171 DOI: 10.1111/ans.16979
Serotyping of dengue virus in 2016-17 outbreak in Kudat, Sabah, Malaysia

Aung TS, Gintarong T, Balingi DB, Emran A, Thein TT, Chua TH

Trop Biomed, 2020 Mar 01;37(1):58-65.
PMID: 33612718

An outbreak of dengue in Kudat, northern Sabah in 2016-2017 provided an opportunity to investigate the circulating serotypes of dengue viruses of cases at Hospital Kudat. Between September 2016 and December 2017, a total of 156 dengue positive sera (tested positive by either NS1 antigen, or IgM and IgG antibody rapid test) were collected from dengue patients who had acute fever and showed signs and symptoms suggestive of dengue. RNA was extracted from the sera using QIAamp RNA Blood Mini Kit, and molecular amplification was performed using one-step RT-PCR kit, followed by nested PCR using HotStart Taq master mix kit with the primers of the dengue C-prM gene. There were 81 (52%) male and 75 (48%) female cases. The age group with the highest number of cases was the 10-19 years old, while the youngest infected was 8 months old and the oldest was 83 years old. RT-PCR results showed 88 sera dengue positive, 48 infected with a single serotype while another 40 with multiple serotypes. All four DENV serotypes were co-circulating during the outbreak period and DENV-1 was predominant. Molecular analysis also indicated 69.2%, 50.0%, 51.9% and 48.9% respectively of the NS1, IgM, IgG and IgM and IgG positive sera were RT-PCR positive for dengue. High number of cases were seen in December 2016, February and May 2017. The dengue outbreak might be related to switching of predominant serotype from DENV 4 to DENV 1.
Fulltext Forensic age estimation in living children: how accurate is the Greulich-Pyle method in Sabah, East Malaysia?

Nang KM, Ismail AJ, Tangaperumal A, Wynn AA, Thein TT, Hayati F, et al.

Front Pediatr, 2023;11:1137960.
PMID: 37397141 DOI: 10.3389/fped.2023.1137960

BACKGROUND: The Greulich and Pyle's Radiographic Atlas of Skeletal Development of the Hand and Wrist (GP Atlas) is the most widely used method of determining the bone age (BA) of a child. It is also a widely accepted method for forensic age determination. As there is limited local bone age data for forensic age estimation, the purpose of this study was to assess the accuracy of the GP Atlas for forensic age determination in living Sabahan children.
METHOD: This study recruited 182 children between the ages of 9 years to 18 years. BA estimation of the left-hand anteroposterior radiographs were performed by two experienced radiologists using the Greulich-Pyle method.
RESULTS: The BA estimates from two radiologists had very high interobserver reliability (ICC 0.937) and a strong positive interobserver correlation (r > 0.90). The GP method, significantly and consistently underestimated chronological age (CA) by 0.7, 0.6 and 0.7 years in overall children, boys and girls respectively with minimal errors. Mean absolute error and root of mean squared error for overall children was 1.5 and 2.2 years respectively, while mean absolute percentage error was 11.6%. This underestimation was consistent across all age groups but was statistically significant only at 13-13.9 and 17-18.9 years old age groups.
CONCLUSION: Despite high interobserver reliability of BA estimation using the GP Atlas, this method consistently underestimates the age of the child in all children to a significant degree, for both boys and girls across all age groups, with an acceptably low level of error metrics. Our findings suggest that locally validated GP Atlas or other type of assessments (artificial intelligence or machine learning) are needed for assessment of BA to accurately predict CA, since current GP Atlas standards significantly underestimated chronological age with minimal error for children in Sabah. A larger population-based study would be necessary for establishing a validated atlas of a bone age in Malaysia.