Streptococcus gallolyticus infection: A neglected marker for colorectal cancer?

BACKGROUND AND STUDY AIMS: Colorectal cancer (CRC) is the second most common cancer in Malaysia and mostly detected at advanced stages due to lack of awareness of CRC symptoms and signs. CRC pathogenesis is multifactorial, and there is ambiguous evidence on association of Streptococcus gallolyticus infection with CRC that needs further attention. Thus, a case-control study was conducted to determine whether S. gallolyticus infection is a predictor for CRC occurrence among patients attending Sultan Ahmad Shah Medical Centre@IIUM (SASMEC@IIUM). PATIENTS AND METHODS: A total of 33 stool samples from patients diagnosed with CRC and 80 from patients without CRC attending surgical clinic of SASMEC@IIUM were collected and analyzed with iFOBT test and PCR assay to detect S. gallolyticus. RESULTS: In this study, the proportion of S. gallolyticus infection was higher among patients with CRC (48.5%) compared with the control group (20%). Univariate analysis shows that occult blood in stool, S. gallolyticus infection and family history were significantly associated with the development of CRC (P < 0.05). Using the multivariate logistic regression model, positive stool PCR for S. gallolyticus had the lowest relative standard error and almost five times the odds of developing CRC after adjusting other factors (adjusted odds ratio = 4.7, 95% confidence interval = 1.7-12.6, relative standard error = 59.6%). CONCLUSION: This finding suggests that S. gallolyticus infection was the strongest predictor of CRC's development in our study and potentially serves as a predictive marker for early detection of disease progression.

Investigation of the impacts of climate change and rising temperature on food poisoning cases in Malaysia.

This study is an attempt to investigate climate-induced increases in morbidity rates of food poisoning cases. Monthly food poisoning cases, average monthly meteorological data, and population data from 2004 to 2014 were obtained from the Malaysian Ministry of Health, Malaysian Meteorological Department, and Department of Statistics Malaysia, respectively. Poisson generalised linear models were developed to assess the association between climatic parameters and the number of reported food poisoning cases. The findings revealed that the food poisoning incidence in Malaysia during the 11 years study period was 561 cases per 100 000 population for the whole country. Among the cases, females and the ethnic Malays most frequently experienced food poisoning with incidence rates of 313 cases per 100,000 and 438 cases per 100,000 population over the period of 11 years, respectively. Most of the cases occurred within the active age of 13 to 35 years old. Temperature gave a significant impact on the incidence of food poisoning cases in Selangor (95% CI: 1.033-1.479; p = 0.020), Melaka (95% CI: 1.046-2.080; p = 0.027), Kelantan (95% CI: 1.129-1.958; p = 0.005), and Sabah (95% CI: 1.127-2.690; p = 0.012) while rainfall was a protective factor in Terengganu (95% CI: 0.996-0.999; p = 0.034) at lag 0 month. For a 1.0°C increase in temperature, the excess risk of food poisoning in each state can increase up to 74.1%, whereas for every 50 mm increase in rainfall, the risk of getting food poisoning decreased by almost 10%. The study concludes that climate does affect the distribution of food poisoning cases in Selangor, Melaka, Kelantan, Sabah, and Terengganu. Food poisoning cases in other states are not directly associated with temperature but related to monthly trends and seasonality.

Development and Validation of a New Gadget Addiction Scale (Screen Dependency Scale) among Pre-School Children in Malaysia.

BACKGROUND: Excessive screen time in young children is associated with many harmful consequences including screen dependency. Research has shown a worrying prevalence of media-related dependency among adolescents and pre-school children. There are a few available questionnaires among adolescents but none for pre-school children. This study aimed to design and validate a questionnaire to assess screen dependency among pre-school children aged 4 to 6 years old. METHODOLOGY: A cross-sectional two-phase study was carried out to develop the scale. In phase 1, a preliminary parent-report measure questionnaire was developed in Bahasa Malaysia. Later, it was sent to four experts for content validity followed by face validity. In Phase 2, a total of 386 parents of pre-school children aged 4 to 6 years old, split into two samples, were involved in the field study for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). RESULT: Sample 1 was used to perform EFA to determine the factorial structure of the SDS. All items with a factor loading of >0.4 were included. Sample 2 was used to perform the CFA. RMSEA and CFI analysis showed that the SDS has a good fit and confirms the dimensional structure found via EFA. The final questionnaire consists of 15 items with a 4 factors' structure and has excellent internal consistency reliability. CONCLUSIONS: The Screen Dependency Scale (SDS) is a reliable and valid questionnaire to detect screen dependency among pre-school children aged 4 to 6 years old in Malaysia.

Effects of Betahistine on Vestibulo-Ocular Reflex in Normal Healthy Adults: A Randomized Double-Blind, Placebo-Controlled Trial.

Introduction Vertigo, or the perception of a spinning sensation, is a common symptom experienced by patients who are referred to Otorhinolaryngology clinics. Betahistine is a medication that has been widely used to treat vertigo and its accompanying symptoms. However, the effects of this medication on the vestibulo-ocular reflex (VOR) are still unknown. Initially, it was assumed that betahistine should be discontinued prior to any vestibular tests, particularly the video head impulse test (vHIT). Method Thirty young healthy adults were randomly divided into two equal groups for this randomized double-blind clinical study (betahistine 24 mg and placebo). Baseline pure-tone audiometry (PTA), tympanometry, and VOR measurements were taken, followed by experimental measurements at one hour, four hours, eight hours, and 24 hours after consumption. The video head impulse test (vHIT) was used to determine the VOR. Result Betahistine had no statistically significant effect on vestibulo-ocular reflex gain (F(4,140) = 0.601, p = 0.662). The gain variability across repetitive head impulses remained constant over time. Conclusions Betahistine has no effect on the vestibulo-ocular reflex. As a result, this medication can be taken prior to the vHIT procedure.