The purpose of this study was to determine the timing and sequence of emergence of the first 28 permanent teeth in a cross-section of Malay children in the district of Kota Bharu, in northeastern Peninsula Malaysia. The sample consists of 478 boys and 908 girls of Malay descent aged between 5-19 years. The criterion for tooth emergence was the appearance of the tooth through the gingivae. Descriptive statistics were calculated and probit regression analysis performed to determine the mean age of emergence of the permanent dentition. The mean age at emergence was found to conform to general trends, with emergence seen earlier in girls than in boys. Comparisons were made with the Chinese (Hong Kong) and the Punjabi (Chandigarh) profiles, which showed earlier emergence timings in those ethnic groups. The emergence timing in Malays, however, was earlier than in Thais (Central Thailand). The sequence of emergence was determined by referring to the mean age of tooth emergence of individual teeth and conforms to the general trend seen in other studies.
Tooth ; Malaysia ; Age, NOS ; trends ; Central brand of multivitamin with minerals

Twin reverse arterial perfusion sequence occurs in approximately one percent of monochorionic twins. This condition is always fatal for the recipient twin and carries a high mortality rate for the pump twin. Various treatment options are described, but management is continually evolving with the publication of new data. We report an acardiac acephalic monochorionic twin who was diagnosed at 31 weeks gestation. Serial ultrasonographical examinations of the normal pump twin showed intrauterine growth restriction but with no evidence of heart failure. A healthy pump twin was delivered by caesarean section at 34 weeks.
Abnormalities, Multiple ; diagnostic imaging ; Cesarean Section ; Female ; Fetofetal Transfusion ; diagnostic imaging ; Follow-Up Studies ; Gestational Age ; Heart Defects, Congenital ; diagnostic imaging ; Humans ; Infant, Newborn ; Pregnancy ; Pregnancy Outcome ; Pregnancy Reduction, Multifetal ; methods ; Pregnancy, Multiple ; Twins, Monozygotic ; Ultrasonography, Prenatal

Infective endocarditis (IE) is a relatively uncommon disease, but has been challenging to diagnose over the years. With the increasing incidence, variety of causative agents and the resistance of microorganisms towards antibiotics, there is still an occurrence of sudden death due to undiagnosed IE. The most common microorganism causing IE is Staphylococcus aureus. However, there is increasing prevalence of other microorganisms causing IE. This case report highlights a case of sudden death due to IE caused by a rare pathogen, Streptococcus constellatus which belongs to the Streptococcus anginosus group (Milleri group). A study noted the crude incidence of IE in 6 world regions ranged between 1.5 and 11.6 cases per 100,000 people. To date, there has been no previous report on sudden death due to IE caused by Streptococcus constellatus in Malaysia, neither in the forensic nor clinical setting. This case report underlined the characteristics and pathological features of this microorganism. The increasing incidence and variety of causative organisms in IE are important public health issues. It is vital for future studies to examine the risk factors of IE related to Streptococcus constellatus, to enhance better understanding, insight and awareness regarding the course of this disease. This in turn may facilitate preventive measures to avoid morbidity and mortality from this condition.