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Fulltext Behavioural outcome in children with congenital adrenal hyperplasia: experience of a single centre

Idris AN, Chandran V, Syed Zakaria SZ, Rasat R

Int J Endocrinol, 2014;2014:483718.
PMID: 24799898 DOI: 10.1155/2014/483718

The aim of this study was to determine the behavioral outcome in children with CAH and to identify the risk factors that may influence it. Participants (aged 6-18 years) included 29 girls and 20 boys with CAH and unaffected siblings (25 girls and 17 boys). Psychological adjustment was assessed with parent reports on the Child Behavior Checklist (CBCL). Information about disease characteristics was obtained from medical records. Our study reveals that there was higher incidence of parent-reported problem of anxious/depressed and withdrawn/depressed behaviours, somatic complaints, social, thought, and attention problems, and rule-breaking, aggressive, internalizing, and externalizing behaviour among children with CAH compared to controls. The prevalence of internalizing behaviour problems was higher in CAH boys compared with that of controls. Psychosocial adjustment of girls with CAH was found to be similar to unaffected female controls and was within the normal population range. Family income may be associated with behavioral outcome. Glucocorticoid dose may reflect disease severity which may be associated with behavioral outcome. We conclude that internalizing behavioral problem was prevalent among boys with CAH reflecting maladaptive adjustment in coping with chronic illness. This highlighted the importance of psychological and social support for the patients and their families.
Fulltext Behavioural and Emotional Problems in Malaysian Children and Adolescents with Type 1 Diabetes Mellitus: A Cross-sectional Study in a Single Centre

Ching WL, Idris AN, Nor NK, Giok LP

J ASEAN Fed Endocr Soc, 2023;38(2):13-19.
PMID: 38045679 DOI: 10.15605/jafes.038.02.10

INTRODUCTION: Type 1 diabetes mellitus (T1DM) is an autoimmune disorder that requires a lifelong treatment regimen which may affect psychosocial development.
OBJECTIVE: To identify behavioural and emotional problems in children and adolescents with T1DM.
METHODOLOGY: A cross-sectional study using the Child Behaviour Check List (CBCL) was conducted among all T1DM patients receiving treatment at the Paediatric Endocrine Unit, Hospital Tunku Azizah Kuala Lumpur, Malaysia.
RESULTS: Forty T1DM patients were included. The mean age of the participants was 12.4 years (SD = 2.69), with 52.5% males, and 75% Malay. The average duration of illness was 4.8 years, 9 were pre-pubertal, while mean HbA1c was 9.4%. Thirty-five percent of the respondents had parent-reported internalizing problems and 17.5% had parent-reported externalizing problems. Those >12 years old had more internalizing problems (p = 0.004) compared to those ≤12 years old. The differences were in the anxious/depressed syndrome subscale (p = 0.001) and withdrawn/depressed syndrome subscale (p = 0.015). There were no statistically significant differences in the 3 main global scores by gender, glycaemic control, duration of illness and pubertal status by univariate analysis.
CONCLUSION: T1DM patients >12 years old were at higher risk of developing psychosocial difficulties. This highlighted the benefit of screening of behavioural and emotional issues in children and adolescents with T1DM.
Tracing sewage contamination based on sterols and stanols markers within the mainland aquatic ecosystem: a case study of Linggi catchment, Malaysia

Abdul Zali M, Juahir H, Ismail A, Retnam A, Idris AN, Sefie A, et al.

Environ Sci Pollut Res Int, 2021 Apr;28(16):20717-20736.
PMID: 33405159 DOI: 10.1007/s11356-020-11680-5

Sewage contamination is a principal concern in water quality management as pathogens in sewage can cause diseases and lead to detrimental health effects in humans. This study examines the distribution of seven sterol compounds, namely coprostanol, epi-coprostanol, cholesterol, cholestanol, stigmasterol, campesterol, and β-sitosterol in filtered and particulate phases of sewage treatment plants (STPs), groundwater, and river water. For filtered samples, solid-phase extraction (SPE) was employed while for particulate samples were sonicated. Quantification was done by using gas chromatography-mass spectrometer (GC-MS). Faecal stanols (coprostanol and epi-coprostanol) and β-sitosterol were dominant in most STP samples. Groundwater samples were influenced by natural/biogenic sterol, while river water samples were characterized by a mixture of sources. Factor loadings from principal component analysis (PCA) defined fresh input of biogenic sterol and vascular plants (positive varimax factor (VF)1), aged/treated sewage sources (negative VF1), fresh- and less-treated sewage and domestic sources (positive VF2), biological sewage effluents (negative VF2), and fresh-treated sewage sources (VF3) in the samples. Association of VF loadings and factor score values illustrated the correlation of STP effluents and the input of biogenic and plant sterol sources in river and groundwater samples of Linggi. This study focuses on sterol distribution and its potential sources; these findings will aid in sewage assessment in the aquatic environment.
Thyroid autoimmunity and autoimmune thyroid disease in Malaysian girls with Turner syndrome: An understudied population

Lee YL, Zaini AA, Idris AN, Abdullah RA, Wong JS, Hong JS, et al.

J Paediatr Child Health, 2023 Jul;59(7):879-884.
PMID: 37066819 DOI: 10.1111/jpc.16405

AIMS: Knowledge on the spectrum of thyroid disorders amongst Turner syndrome (TS) patients in Southeast Asia is limited. This study aimed to evaluate the prevalence of thyroid autoimmunity, the spectrum of autoimmune thyroid disease and association with age and karyotype amongst Malaysian TS girls.
METHODS: A cross-sectional study was conducted at 11 paediatric endocrine units in Malaysia. Blood samples for antithyroglobulin antibodies, antithyroid peroxidase antibodies and thyroid function test were obtained. In patients with pre-existing thyroid disease, information on clinical and biochemical thyroid status was obtained from medical records.
RESULTS: Ninety-seven TS patients with a mean age of 13.4 ± 4.8 years were recruited. Thyroid autoimmunity was found in 43.8% of TS patients. Nineteen per cent of those with thyroid autoimmunity had autoimmune thyroid disease (Hashimoto thyroiditis in 7.3% and hyperthyroidism in 1% of total population). Patients with isochromosome X and patients with 45,X mosaicism or other X chromosomal abnormalities were more prone to have thyroid autoimmunity compared to those with 45,X karyotype (OR 5.09, 95% CI 1.54-16.88, P = 0.008 and OR 3.41, 95% CI 1.32-8.82, P = 0.01 respectively). The prevalence of thyroid autoimmunity increased with age (33.3% for age 0-9.9 years; 46.8% for age 10-19.9 years and 57.1% age for 20-29.9 years) with autoimmune thyroid disease detected in 14.3% during adulthood.
CONCLUSION: Thyroid autoimmunity was significantly associated with the non 45,X karyotype group, particularly isochromosome X. Annual screening of thyroid function should be carried out upon diagnosis of TS until adulthood with more frequent monitoring recommended in the presence of thyroid autoimmunity.