1.Immature Brain Teratoma of An Infant In A University Hospital: A Case Report
Ariffin Nasir ; Fahisham Taib ; Nor Rosidah Ibrahim ; Abdul Rahman Izani Ghani ; Suria Emilia Suhana Othman Tan ; Norsarwany Mohamad
Malaysian Journal of Medicine and Health Sciences 2022;18(No.4):218-220
Teratomatous tumours of the head are rather uncommon. We report a 3-month-old child who presented with acute
signs of raised intracranial pressure, needing craniectomy and subtotal tumour removal. The patient was diagnosed
as intracranial immature teratoma grade 3, from the pathological study and elevated alpha-fetoprotein (AFP). Managing brain teratoma posed a challenge to the managing team due to the location of the tumour, the unavailability
of standardized chemotherapy protocol and the dilemma of commencing adjuvant chemotherapy in a very young
infant. The tumour was partially removed due to its critical location. And chemotherapy was delayed until the patient
achieved 7 months of age. After four rounds of chemotherapy, the patient remained in remission for more than three
years follow up.
2.Characteristics of Paediatric Death Cases at a Malaysian University Hospital
Nur Amirah Saulius ; Nor Rosidah Ibrahim ; Mohamad Ikram Ilias ; Fahisham Taib
Malaysian Journal of Medicine and Health Sciences 2023;19(No.6):201-207
Introduction: Auditing of paediatric deaths has rarely been evaluated in hospitals especially in low and middle-income countries. The aim of the study is to describe the characteristics of paediatric death in hospitalised children
and determine the predictors of death location in Hospital Universiti Sains Malaysia (USM). Method: Paediatric
mortality cases for children aged between 29 days and 18 years old at the time of death were analyzed. These were
documented cases between the year 2013 and 2020 at Hospital USM. Case notes were reviewed, and data were
captured retrospectively. Multiple Logistic Regression was used to assess predictors of the location of death especially in the ward setting.Results: Out of 841 paediatric deaths identified during the period of the study, 544 cases were
enrolled. The male gender has a higher proportion (1.4:1). The median age was 56 months, with infancy being the
predominant age group. The median length of hospital stay was 10.5 days. More than half of the cases (58.3%) had
underlying life-limiting illnesses. The majority of the patients had “Do Not Resuscitate” orders. A longer length of
stay (prevalence odds ratio (POR 0.99, 95% CI 0.98, 0.99), being on ventilator (POR 3.42,95% CI 1.95, 6.01), being
terminally ill (POR 0.40,95% CI 0.23, 0.70) and having underlying life limiting illness (POR 0.50, 95% CI 0.33, 0.75)
were the significant predictors for the ward death. Conclusion: Understanding the characteristics of child death and
the factors associated with death location is critical for improving paediatric care and treatment.