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Fulltext Factors associated with tuberculosis disease among children who are household contacts of tuberculosis cases in an urban setting in Malaysia

Azit NA, Ismail A, Ahmad N, Ismail R, Ishak S

BMC Public Health, 2019 Nov 01;19(1):1432.
PMID: 31675946 DOI: 10.1186/s12889-019-7814-x

BACKGROUND: With the rise in prevalence of childhood tuberculosis (TB) globally, contact tracing should be a powerful strategy for early diagnosis and management, especially in children who are household contacts of active TB cases. Here, we aimed to determine the prevalence and factors associated with TB disease in children who are household contacts of TB cases.
METHODS: We used a cross-sectional study with data from the Malaysian TB Information System (TBIS) recorded from 1 January 2014 to 31 December 2017. All children aged 0-14 years who were registered in the TBIS with at least one household contact of TB cases were included in the study. Multiple logistic regression analysis was performed to calculate the adjusted odds ratio (adj. OR) and for adjusting the confounding factors.
RESULTS: A total of 2793 children were included in the study. The prevalence of active TB was 1.5% (95% confidence interval [CI]: 1.31, 1.77%). Children aged 6 weeks [adj. OR 7.48 (95% CI: 2.88, 19.43), p
Fulltext The survival outcomes and prognostic factors of hepatocellular carcinoma among type 2 diabetes patients: a two-centre retrospective cohort study

Azit NA, Sahran S, Meng LV, Subramaniam MK, Mokhtar S, Nawi AM

Turk J Med Sci, 2022 Oct;52(5):1580-1590.
PMID: 36422484 DOI: 10.55730/1300-0144.5498

BACKGROUND: To determine the survival outcomes and prognostic factors associated with hepatocellular carcinoma (HCC) survival in type 2 diabetes (T2D) patients.
METHODS: This was a retrospective cohort study involving two hepatobiliary centres from January 1, 2012, to June 30, 2018. Medical records were analysed for sociodemographic, clinical characteristics, laboratory testing, and HCC treatment information. Survival outcomes were examined using the Kaplan-Meier and log-rank test. Prognostic factors were determined using multivariate Cox regression.
RESULTS: A total of 212 patients were included in the study. The median survival time was 22 months. The 1-, 3-, and 5-year survival rates were 64.2%, 34.2%, and 18.0%, respectively. Palliative treatment (adjusted hazard ratio [AHR] = 2.82, 95% confidence interval [CI] 1.75-4.52), tumour size ≥ 5 cm (AHR = 2.02, 95%CI: 1.45-2.82), traditional medication (AHR = 1.94, 95%CI: 1.27-2.98), raised alkaline phosphatase (AHR = 1.74, 95%CI: 1.25-2.42), and metformin (AHR = 1.44, 95%CI: 1.03-2.00) were significantly associated with poor prognosis for HCC survival. Antiviral hepatitis treatment (AHR = 0.54, 95% CI: 0.34-0.87), nonalcoholic fatty liver disease (NAFLD) (AHR = 0.50, 95% CI: 0.30-0.84), and family history of malignancies (AHR = 0.50, 95%CI: 0.26-0.96) were identified as good prognostic factors for HCC survival.
DISCUSSION: Traditional medication, metformin treatment, advanced stage and raised alkaline phosphatase were the poor prognostic factors, while antiviral hepatitis treatment, NAFLD, and family history of malignancies were the good prognostic factors for our HCC cases comorbid with T2D.
Fulltext Risk factors of hepatocellular carcinoma in type 2 diabetes patients: A two-centre study in a developing country

Azit NA, Sahran S, Voon Meng L, Subramaniam M, Mokhtar S, Mohammed Nawi A

PLoS One, 2021;16(12):e0260675.
PMID: 34882716 DOI: 10.1371/journal.pone.0260675

Type 2 diabetes mellitus (T2DM) is increasingly known as a risk factor of hepatocellular carcinoma (HCC). In this study, we determined the risk factors associated with HCC in T2DM patients. This was a matched case-control study conducted at two hepatobiliary referral centres in a developing country. Patients' sociodemographic, clinical, and biochemical characteristics between 1 January 2012 and 30 June 2018 were extracted from the electronic medical records and analysed using multivariate logistic regression analysis. A total of 212 case-control pairs were included. Significant risk factors included Chinese and Malay ethnicities that interacted with viral hepatitis (adjusted odds ratio [AOR] = 11.77, 95% confidence interval [CI]: 1.39-99.79) and (AOR = 37.94, 95% CI: 3.92-367.61) respectively, weight loss (AOR = 5.28, 95% CI: 2.29-12.19), abdominal pain/ discomfort (AOR = 6.73, 95% CI: 3.34-13.34), alcohol (AOR = 4.08, 95% CI: 1.81-9.22), fatty liver (AOR = 3.29, 95% CI: 1.40-7.76), low platelet (AOR = 4.03, 95% CI:1.90-8.55), raised alanine transaminase (AOR = 2.11, 95% CI: 1.16-3.86). and alkaline phosphatase (ALP) levels (AOR = 2.17, 95% CI: 1.17-4.00). Statins reduced the risk of HCC by 63% (AOR = 0.37, 95% CI: 0.21-0.65). The identification of these factors aids the risk stratification for HCC among T2DM patients for early detection and decision-making in patient management in the primary care setting.
Fulltext A systematic review on noncommunicable diseases among working women

Idris IB, Azit NA, Abdul Ghani SR, Syed Nor SF, Mohammed Nawi A

Ind Health, 2021 Aug 17;59(3):146-160.
PMID: 33551443 DOI: 10.2486/indhealth.2020-0204

The increasing involvement of women in the paid-labor market has led to multifactorial exposure towards the development of noncommunicable diseases (NCDs). This review aims to identify the prevalence of NCDs and the associated risk factors among working women. A systematic review was performed using PubMed and Scopus databases. Twelve articles published between 2015 and 2019 satisfied the inclusion and exclusion criteria and were selected for qualitative synthesis. Among working women, the prevalence of NCDs was as follows: coronary heart disease, 0.3%-5.9%; metabolic syndrome, 52.0%; diabetes mellitus, 8.9%-16.0%; hypertension, 16.6%-66.4%; non-skin cancer, 3.7%. The prevalence of NCD risk factors was as follows: overweight/obesity, 33.8%-77.0%; low physical activity, 51.0%; unhealthy diet, 44.9%-69.9%; dyslipidemia, 27.8%-44.0%. The factors associated with NCDs were long working hours, double work burden, and stress. NCD is an important burden of working women that will lead to reduced work quality and affect family well-being. Disease prevention approaches, such as the intervention of common workplace risk factors and specific work schedule design, are among the strategies for improving the situation.