Azmi Mohd Tamil

Prevalence and parental perceptions of complementary and alternative medicine use by children with cancer in a multi-ethnic Southeast Asian population

The purpose of the current study was to determine the prevalence of use of complementary and alternative medicine (CAM) by children with cancer and to compare the characteristics of CAM users and CAM nonusers.

Health-related quality of life (HRQOL) among pediatric leukemia patients in Malaysia†

Health‐Related Quality of Life (HRQOL) in pediatric leukemia patients in Malaysia has not been studied before. This was mainly due to a lack of databases on patients in the past. Many patients abandoned treatment or were lost to follow up. With more children now fully compliant and completing treatment nowadays, with higher cure rate, HRQOL has become important for our patients. The purpose of the current study was to determine the HRQOL scores in children with acute leukemia and to compare the scores for those on maintenance chemotherapy with those off‐treatment as well as to determine factors which might affect HRQOL.

A pilot study to determine whether progestogen supplementation using dydrogesterone during the first trimester will reduce the incidence of gestational hypertension in primigravidae

Abstract Background: Gestational hypertension (GH) remains one of the main causes of high maternal and perinatal morbidity and mortality worldwide with the highest incidence among primigravidae of about 10%–15%. However, it was noted that the incidence of GH in primigravidae who conceived following assisted reproductive technique (ART) or intrauterine insemination (IUI) supplemented with dydrogesterone during the first trimester was low. Aim: To determine whether dydrogesterone supplementation during the first trimester can reduce the incidence of GH among primigravidae. Method: A prospective cross-sectional comparative study was undertaken in 2010 on 116 primigravidae (study group) who conceived following ART or IUI and supplemented with dydrogesterone up to 16 weeks gestation. They were matched for age and race at 16 weeks gestation with a control patient from the early pregnancy clinic who were primigravidae (n = 116) who conceived spontaneously without dydrogesterone supplementation. Findings: The incidence of GH in the study group was significantly lower than the control group (1.7% versus 12.9%, p = 0.001). The incidence of fetal distress was also significantly lower in the study group compared to the control group (4.3% versus 18.1%, p = 0.001). Interpretation: Dydrogesterone supplementation during the first trimester significantly reduced the incidence of GH and fetal distress in primigravidae.

Case control study on risk factors associated with esophageal cancer in Yemen

Background Esophageal cancer is the seventh most common malignancy worldwide and the fifth in the developing countries. Its incidence is rising more rapidly than any other cancer. The risk of developing esophageal cancer between countries may be influenced by diversity of cultures and customs. One of the unique customs in Yemen is chewing khat, therefore the aim of this study was to determine the risk factors associated with esophageal cancer in Yemen, including chewing khat.

The negative impact of living environment on intelligence quotient of primary school children in Baghdad City, Iraq: a cross-sectional study

BackgroundEnvironmental factors play a very important role in the child development process, especially in a situation like that of Iraq. Thirteen years of economic sanctions followed by the 2003 war and 8 years of unstable security have affected the daily life of Iraqi families and children. The objective of this study was to assess the associations between living environment domains and child intelligence quotient (IQ) score.MethodsA cross-sectional survey was conducted among 529 children aged 7–8 years from five primary schools in Baghdad during September–October, 2011. The five schools represent people living a range of conditions, and include of both high and low socio-economic groups. Living environment was assessed by 13 questionnaire items, consists of three domains: physical safety , mental stress and public services. While IQ was assessed by Raven Colored progressive matrices.ResultsAmong the participants, 22% were of low intelligence versus 77% of high intelligence and 19% lived in a poor environment. There were significant associations between the mental stress and service living environment domains and child IQ (p = 0.009 and p = 0.001, respectively).ConclusionIn Iraq, child IQ was found to be associated with the mental stress and service domains of the living environment. This study findings will help authorities in their efforts to improve living environment.

Predictors of postpartum weight retention among urban Malaysian mothers: A prospective cohort study

BACKGROUND Women of childbearing age are predisposed to becoming overweight or obese. This study determines the mean, prevalence and factors associated with 6 months postpartum weight retention among urban Malaysian mothers. METHODS A prospective cohort study was conducted at baseline (after delivery), 2, 4 and 6 months postpartum. From 638 eligible mothers initially recruited, 420 completed until 6 months. Dependent variable was weight retention, defined as difference between weight at 6 months postpartum and pre-pregnancy weight, and weight retention ≥5kg was considered excessive. Independent variables included socio-demographic, history of pregnancy and delivery, lifestyle, practices and traditional postpartum practices. RESULTS Average age was 29.61±4.71years, majority (83.3%) were Malays, 58.8% (low education), 70.0% (employed), 65.2% (middle income family), 33.8% (primiparous) and 66.7% (normal/instrumental delivery). Average gestational weight gain was 12.90±5.18kg. Mean postpartum weight retention was 3.12±4.76kg, 33.8% retaining ≥5kg. Bivariable analysis showed low income, primiparity, gestational weight gain ≥12kg, less active physically, higher energy, protein, carbohydrate and fat intake in diet, never using hot stone compression and not continuing breastfeeding were significantly associated with higher 6 months postpartum weight retention. From multivariable linear regression analysis, less active physically, higher energy intake in diet, gestational weight gain ≥12kg, not continuing breastfeeding 6 months postpartum and never using hot stone compression could explain 55.1% variation in 6 months postpartum weight retention. CONCLUSION Women need to control gestational weight gain, remain physically active, reduce energy intake, breastfeed for at least 6 months and use hot stone compression to prevent high postpartum weight retention.

Mitochondrial DNA Mutations in Grade II and III Glioma Cell Lines Are Associated with Significant Mitochondrial Dysfunction and Higher Oxidative Stress

The role of mitochondria in tumorigenesis has regained much attention as it could dysregulate cellular energetics, oxidative stress and apoptosis. However, the role of mitochondria in different grade gliomasis still unknown. This study aimed to identify mitochondrial DNA (mtDNA) sequence variations that could possibly affect the mitochondrial functions and also the oxidative stress status. Three different grades of human glioma cell lines and a normal human astrocyte cell line were cultured in-vitro and tested for oxidative stress biomarkers. Relative oxidative stress level, mitochondria activity, and mitochondrial mass were determined by live cell imaging with confocal laser scanning microscope using CM-H2DCFDA, MitoTracker Green, and MitoTracker Orange stains. The entire mitochondrial genome was sequenced using the AffymetrixGeneChip Human Mitochondrial Resequencing Array 2.0. The mitochondrial sequence variations were subjected to phylogenetic haplogroup assessment and pathogenicity of the mutations were predicted using pMUT and PolyPhen2. The Grade II astrocytoma cells showed increased oxidative stress wherea high level of 8-OHdG and oxidative stress indicator were observed. Simultaneously, Grade II and III glioma cells showed relatively poor mitochondria functions and increased number of mutations in the coding region of the mtDNA which could be due to high levels of oxidative stress in these cells. These non-synonymous mtDNA sequence variations were predicted to be pathogenic and could possibly lead to protein dysfunction, leading to oxidative phosphorylation (OXPHOS) impairment, mitochondria dysfunction and could create a vicious cycle of oxidative stress. The Grade IV cells had no missense mutation but preserved intact mitochondria and excellent antioxidant defense mechanisms thus ensuring better survival. In conclusion, Grade II and III glioma cells demonstrated coding region mtDNA mutations, leading to mitochondrial dysfunction and higher oxidative stress.

Serum pepsinogen and gastrin‑17 as potential biomarkers for pre‑malignant lesions in the gastric corpus

There is a lack of non-invasive screening modalities to diagnose chronic atrophic gastritis (CAG) and intestinal metaplasia (IM). Thus, the aim of the present study was to determine the sensitivity and specificity of serum pepsinogen I (PGI), PGI:II, the PGI:II ratio and gastrin-17 (G-17) in diagnosing CAG and IM, and the correlations between these serum biomarkers and pre-malignant gastric lesions. A cross-sectional study of 72 patients (82% of the calculated sample size) who underwent oesophageal-gastro-duodenoscopy for dyspepsia was performed in the present study. The mean age of the participants was 56.2±16.2 years. Serum PGI:I, PGI:II, G-17 and Helicobacter pylori antibody levels were measured by enzyme-linked immunosorbent assay. Median levels of PGI:I, PGI:II, the PGI:II ratio and G-17 for were 129.9 µg/l, 10.3 µg/l, 14.7 and 4.4 pmol/l, respectively. Subjects with corpus CAG/IM exhibited a significantly lower PGI:II ratio (7.2) compared with the control group (15.7; P<0.001). Histological CAG and IM correlated well with the serum PGI:II ratio (r=-0.417; P<0.001). The cut-off value of the PGI:II ratio of ≤10.0 demonstrated high sensitivity (83.3%), specificity (77.9%) and area under the receiver operating characteristic curve of 0.902 in detecting the two conditions. However, the sensitivity was particularly low at a ratio of ≤3.0. The serum PGI:II ratio is a sensitive and specific marker to diagnose corpus CAG/IM, but at a high cut-off value. This ratio may potentially be used as an outpatient, non-invasive biomarker for detecting corpus CAG/IM.

Parental reports of behavioural outcome among paediatric leukaemia survivors in Malaysia: a single institution experience.

To determine the behavioural impact of chemotherapy in survivors of acute lymphoblastic leukaemia (ALL) treated with chemotherapy only and to identify treatment‐related or sociodemography‐related factors that might be associated with behavioural outcome.