Zaleha Md Isa

Dietary Patterns and Risk of Colorectal Cancer: A Systematic Review of Cohort Studies (2000-2011)

OBJECTIVES This systematic review of cohort studies aimed to identify any association between specific dietary patterns and risk of colorectal cancer (CRC). Dietary patterns involve complex interactions of food and nutrients summarizing the total diet or key aspects of the diet for a population under study. METHODS AND MATERIALS This review involves 6 cohort studies of dietary patterns and their association with colorectal cancer. An exploratory or a posteriori approach and a hypothesis-oriented or a priori approach were employed to identify dietary patterns. RESULTS The dietary pattern identified to be protective against CRC was healthy, prudent, fruits and vegetables, fat reduced/diet foods, vegetables/fish/poultry, fruit/wholegrain/dairy, healthy eating index 2005, alternate healthy eating index, Mediterranean score and recommended food score. An elevated risk of CRC was associated with Western diet, pork processed meat, potatoes, traditional meat eating, and refined grain pattern. CONCLUSION The Western dietary pattern which mainly consists of red and processed meat and refined grains is associated with an elevated risk of development of CRC. Protective factors against CRC include a healthy or prudent diet, consisting of vegetables, fruits, fish and poultry.

Urban vs. Rural Factors That Affect Adult Asthma

In this review, our aim was to examine the influence of geographic variations on asthma prevalence and morbidity among adults, which is important for improving our understanding, identifying the burden, and for developing and implementing interventions aimed at reducing asthma morbidity. Asthma is a complex inflammatory disease of multifactorial origin, and is influenced by both environmental and genetic factors. The disparities in asthma prevalence and morbidity among the worlds geographic locations are more likely to be associated with environmental exposures than genetic differences. In writing this article, we found that the indoor factors most consistently associated with asthma and asthma-related symptoms in adults included fuel combustion, mold growth, and environmental tobacco smoke in both urban and rural areas. Asthma and asthma-related symptoms occurred more frequently in urban than in rural areas, and that difference correlated with environmental risk exposures, SES, and healthcare access. Environmental risk factors to which urban adults were more frequently exposed than rural adults were dust mites,high levels of vehicle emissions, and a westernized lifestyle.Exposure to indoor biological contaminants in the urban environment is common.The main risk factors for developing asthma in urban areas are atopy and allergy to house dust mites, followed by allergens from animal dander. House dust mite exposure may potentially explain differences in diagnosis of asthma prevalence and morbidity among adults in urban vs. rural areas. In addition, the prevalence of asthma morbidity increases with urbanization. High levels of vehicle emissions,Western lifestyles and degree of urbanization itself, may affect outdoor and thereby indoor air quality. In urban areas, biomass fuels have been widely replaced by cleaner energy sources at home, such as gas and electricity, but in most developing countries, coal is still a major source of fuel for cooking and heating, particularly in winter. Moreover, exposure to ETS is common at home or at work in urban areas.There is evidence that asthma prevalence and morbidity is less common in rural than in urban areas. The possible reasons are that rural residents are exposed early in life to stables and to farm milk production, and such exposures are protective against developing asthma morbidity. Even so, asthma morbidity is disproportionately high among poor inner-city residents and in rural populations. A higher proportion of adult residents of nonmetropolitan areas were characterized as follows:aged 55 years or older, no previous college admission, low household income, no health insurance coverage, and could not see a doctor due to healthcare service availability, etc. In rural areas, biomass fuels meet more than 70% of the rural energy needs. Progress in adopting modern energy sources in rural areas has been slow. The most direct health impact comes from household energy use among the poor, who depend almost entirely on burning biomass fuels in simple cooking devices that are placed in inadequately ventilated spaces. Prospective studies are needed to assess the long-term effects of biomass smoke on lung health among adults in rural areas.Geographic differences in asthma susceptibility exist around the world. The reason for the differences in asthma prevalence in rural and urban areas may be due to the fact that populations have different lifestyles and cultures, as well as different environmental exposures and different genetic backgrounds. Identifying geographic disparities in asthma hospitalizations is critical to implementing prevention strategies,reducing morbidity, and improving healthcare financing for clinical asthma treatment. Although evidence shows that differences in the prevalence of asthma do exist between urban and rural dwellers in many parts of the world, including in developed countries, data are inadequate to evaluate the extent to which different pollutant exposures contribute to asthma morbidity and severity of asthma between urban and rural areas.

Do indoor environments influence asthma and asthma-related symptoms among adults in homes? A review of the literature

This review summarizes the results of epidemiological studies focusing on the detrimental effects of home environmental factors on asthma morbidity in adults. We reviewed the literature on indoor air quality (IAQ), physical and sociodemographic factors, and asthma morbidity in homes, and identified commonly reported asthma, allergic, and respiratory symptoms involving the home environment. Reported IAQ and asthma morbidity data strongly indicated positive associations between indoor air pollution and adverse health effects in most studies. Indoor factors most consistently associated with asthma and asthma-related symptoms in adults included fuel combustion, mold growth, and environmental tobacco smoke. Environmental exposure may increase an adults risk of developing asthma and also may increase the risk of asthma exacerbations. Evaluation of present IAQ levels, exposure characteristics, and the role of exposure to these factors in relation to asthma morbidity is important for improving our understanding, identifying the burden, and for developing and implementing interventions aimed at reducing asthma morbidity.

Carbonated drinks, chips intake and their relation to Intelligence Quotient (IQ) among primary school children in Baghdad city, Iraq.

Background The revolution in children’s lifestyle and dietary habits which has occurred over the last thirty years can be largely attributed to changes in the family environment and in the social environment in general. Fast food is a diet high in processed foods and soft drinks. Children consuming more junk food are likely to have a lower intake of vitamins, minerals and essential fatty acids. The aim of this study was to assess the relationship between carbonated drinks, chips intake and intelligence quotient of primary school children.

Prevalence of asthma and level of fractional exhaled nitrogen oxide among Malaysian school children

Materials and methods The use of FeNO measurements in clinical practice has been increasingly accepted based on a number of theoretical and practical factors. It is not only a user friendly, portable and non-invasive assessment tool, but is also able to detect inflammatory airway changes in children exposed to atmospheric pollutions. The study respondents were randomly selected from secondary school students in Terengganu, Malaysia. A questionnaire with previously tested questions was used to obtain information on the respondents’ living conditions, school environment, asthmatic symptoms and allergies. FeNo measurement was conducted using a NIOX-MINO (50 ml/min flow) instrument.

Epidemiological pattern of acute respiratory infection among under-fives in Almazar Aljanoubi District -South Jordan

Background Acute respiratory diseases are the most common international human illnesses. Acute respiratory infection (ARI) in under five year old children represent the most common health problem in paediatric practice all over the world. It is reported that all children under five years suffer from 6-8 respiratory infections annually, which represent about 50% of all preschooler illnesses. The aim of the present study was to assess the epidemiological pattern of ARI and to estimate the prevalence of ARI and the six monthly incidences (person & spells) of ARI among under-five year’s old children in Almazar Aljanoubi district –South Jordan.

The practice of traditional and complementary medicine and factors associated with it among the medical staff in Malaysia

A total of 46.3% of the medical staff had ever used T&CM in their life and 32.5% of them used T&CM in the last one year, while 48.6% of the medical staff had ever referred T&CM to their patients or families in their life, and 25.2% of them referred T&CM in the last one year. Knowledge regarding T&CM was poor but positive perception regarding education in T&CM was high. Knowledge regarding T&CM was significantly higher in Hospital Duchess of Kent (52%, p = 0.001), among non-Malays (44%, p = 0.047), and pharmacists (47.2%, p = 0.03). Positive perception regarding education in T&CM among medical staff was higher among females (88.1%, p = 0.002) and pharmacists (93.7%, p < 0.001). There was no significant association between practice of T&CM and perception of education in T&CM. Conclusions Many medical staff had not been exposed to T&CM education, however most of them had positive perception about health education/training in T&CM. The provision of information on T&CM practice and its associated factors among medical staff may help to integrate T&CM into the mainstream medicine.

Relationship Between Vehicle Count and Particulate Air Pollution in Amman, Jordan

The main objective of this cross-sectional comparative study is to observe the relationship between traffic-related air pollutants, particularly particulate matter (PM) of total suspended particulate (TSP) and PM of size 10 µm (PM10), and vehicle traffic in Amman, Jordan. Two study areas were chosen randomly as a high-polluted area (HPA) and low-polluted area (LPA). The findings indicate that TSP and PM10 were still significantly correlated with traffic count even after controlling for confounding factors (temperature, relative humidity, and wind speed): TSP, r = 0.726, P < .001; PM10, r = 0.719, P < .001). There was a significant positive relationship between traffic count and PM level: TSP, P < .001; PM10, P < .001. Moreover, there was a significant negative relationship between temperature and PM10 level (P = .018). Traffic volume contributed greatly to high concentrations of TSP and PM10 in areas with high traffic count, in addition to the effect of temperature.

Economic Impact of Pneumococcal Protein-D Conjugate Vaccine (PHiD-CV) on the Malaysian National Immunization Programme

OBJECTIVE To assess the cost-effectiveness of introducing pneumococcal polysaccharide and nontypeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) in the National Immunization Programme of Malaysia. This study compared introducing PHiD-CV (10 valent vaccine) with current no vaccination, as well as against the alternative 13-valent pneumococcal conjugate vaccine (PCV13). METHODS A lifetime Markov cohort model was adapted using national estimates of disease burden, outcomes of pneumococcal disease, and treatment costs of disease manifestations including pneumonia, acute otitis media, septicemia, and meningitis for a hypothetical birth cohort of 550,000 infants. Clinical information was obtained by review of medical records from four public hospitals in Malaysia from the year 2008 to 2009. Inpatient cost from the four study hospitals was obtained from a diagnostic-related group-based costing system. Outpatient cost was estimated using clinical pathways developed by an expert panel. The perspective assessed was that of the Ministry of Health, Malaysia. RESULTS The estimated disease incidence was 1.2, 3.7, 70, and 6.9 per 100,000 population for meningitis, bacteremia, pneumonia, and acute otitis media, respectively. The Markov model predicted medical costs of Malaysian ringgit (RM) 4.86 billion (US

Perceptions of Malaysian Colorectal Cancer Patients Regarding Dietary Intake: A Qualitative Exploration

1.51 billion) in the absence of vaccination. Vaccination with PHiD-CV would be highly cost-effective against no vaccination at RM30,290 (US