We described an intracranial immature teratoma in a 13 year old Malay boy who presented with history of chronic headache and blurring of vision. Physical findings revealed bilateral papilloedema but no other localizing sign. A Magnetic Resonance Imaging of the brain revealed a suprasellar well defined lobulated midline heterogenous mass which was intraoperatively described as mainly solid tumour with multiple small cystic component filled with yellowish jelly like material. Histopathological finding confirmed the case as immature teratoma. Molecular genetic analysis of p53 and p27 genes revealed substitution of nucleotide G to C at location nucleotide 12139, exon 4 of gene p53. No alteration was detected at exon 5-6 and 8 of p53 gene and exon 1 and 2 of p27 gene. This is the first case report of an intracranial immature teratoma with genetic mutation occuring in a Malay boy.

Purpose::Malnutrition is a common problem among hospitalized patients, especially among traumatic brain injury (TBI) patients. It is developed from hypermetabolism and the condition may worsen under the circumstance of underfeeding or incompatible dietary management. However, the data of nutrient intake especially calorie and protein among TBI patients were scarce. Hence, this study aimed to determine the calorie and protein intake among acute and sub-acute TBI patients receiving medical nutrition therapy in hospital Sultanah Nur Zahirah, Terengganu.Methods::This observational study involved 50 patients recruited from the neurosurgical ward. Method of 24 h dietary recall was utilized and combined with self-administered food diaries for 2-8 days. Food consumptions including calorie intake and protein intake were analyzed using Nutritionist PRO? (Woodinville, USA) and manual calculation based on the Malaysian food composition database (2015).Results::Patients consisted of 56% males and 44% females with the median age of 28.0 (IQR = 22.8-36.5) years, of which 92% were diagnosed as mild TBI and the remaining (8%) as moderate TBI. The Glasgow coma scale (GCS) was adopted to classify TBI severity with the score 13-15 being mild and 9-12 being moderate. The median length of hospital stay was 2 (IQR = 2.0-3.3) days. Calorie and protein intake improved significantly from day 1 to discharge day. However, the intake during discharge day was still considered as suboptimal, i.e. 75% of calorie requirement, whilst the median protein intake was only 61.3% relative to protein requirement. Moreover, the average percentages of calorie and protein intakes throughout hospitalization were remarkably lower, i.e. 52.2% and 41.0%, respectively.Conclusion::Although the calorie and protein intakes had increased from baseline, hospitalized TBI patients were still at a risk to develop malnutrition as the average intakes were considerably low as compared to their requirements. Optimum nutrient intakes especially calorie and protein are crucial to ensure optimum recovery process as well as to minimize risks of infection and complications.

patients, families as well as the surrounding communities,especially the healthcare services. It can be classified intoeither a benign slow growing tumour (non-cancerous) andmalignant tumour (cancerous). The purpose of this studywas to determine the incidence and pattern of brain tumouradmitted to the Neurosurgery Department in HospitalSultanah Nurzahirah (HSNZ), Terengganu, Malaysia.Methods: This is a retrospective study of incidence andpattern of BT admitted to the Neurosurgery Department inHSNZ. Data was collected from the yearly census of BTregistered from 2013 to 2018.Results: A total number of 386 new cases of primary BT wereregistered. The number of cases of BT was found to belowest among children (0 to 10 years old) with only 4.4% butat peak among elderly aged between 51 to 60 years old(26.2%). As for gender, males constituted about 44.5%(n=172) whereas females accounted for 55.5% (n= 214) of thecases. In total, meningioma was found to have the highestincidence (27.2%) followed by metastases brain tumour(18.1%) and glioma (17.4%). Conclusions: This study has shown that the incidence of BTwas led by meningioma which had a high prevalence amongthe elderly population, followed by metastasis BT andgliomas.