Autism Spectrum Disorder (ASD) is a neurodevelopmental childhood disorder associated with cognitive and language impairments. Previous research found that children with developmental disorders increase parenting stress but parents of children with ASD, specifically have recorded higher parenting stress than any other developmental disabilities. Hence, this study investigates the difference in parenting stress levels among parents of children with ASD compared to a typical development (TD) control group. Parenting Stress Index, 3rd Edition Short Form was used to assess the parenting stress levels of 30 parents of children with ASD and 36 parents of TD children. Parents of children with ASD were sampled at Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Tangkak Hospital and National Autism Society of Malaysia (NASOM) in Muar and Segamat. Parents of children with ASD recorded significantly higher levels of parenting stress compared to the TD group (p<0.001). Parents of male children of ASD recorded significantly higher levels of parenting stress compared to the parents of male children of TD group (p<0.001). Parents of female children of ASD also recorded significantly higher levels of parenting stress compared to parents of female children of TD group (p<0.001). Intervention towards ASD children should not only focus on minimizing the core symptoms but should also pay attention to the family’s mental health as well.
Autism Spectrum Disorder ; Parenting

Background/Aims: Nonalcoholic fatty liver disease (NAFLD) is associated with a multitude of adverse outcomes. We aimed to estimate the pooled incidence of NAFLD-related adverse events. Methods: We performed a systematic review and meta-analysis of cohort studies of adults with NAFLD to evaluate the pooled incidence of adverse events. Results: 19,406 articles were screened, 409 full-text articles reviewed, and 79 eligible studies (1,377,466 persons) were included. Mean age was 51.47 years and body mass index 28.90 kg/m2. Baseline comorbidities included metabolic syndrome (41.73%), cardiovascular disease (CVD) (16.83%), cirrhosis (21.97%), and nonalcoholic steatohepatitis (NASH) (58.85%). Incidence rate per 1,000 person-years for mortality included: all-cause (14.6), CVD-related (4.53), non-liver cancer-related (4.53), and liver-related (3.10). Incidence for liver-related events included overall (24.3), fibrosis progression (49.0), cirrhosis (10.9), liver transplant (12.0), and hepatocellular carcinoma (HCC) (3.39). Incidence for non-liver events included metabolic syndrome (25.4), hypertension (25.8), dyslipidemia (26.4), diabetes (19.0), CVD (24.77), renal impairment (30.3), depression/anxiety (29.1), and non-liver cancer (10.5). Biopsy-proven NASH had higher incidence of HCC (P=0.043) compared to non-NASH. Higher rates of CVD and mortality were observed in North America and Europe, hypertension and non-liver cancer in North America, and HCC in Western Pacific/Southeast Asia (P<0.05). No significant differences were observed by sex. Time-period analyses showed decreasing rates of cardiovascular and non-liver cancer mortality and increasing rates of decompensated cirrhosis (P<0.05). Conclusions People with NAFLD have high incidence of liver and non-liver adverse clinical events, varying by NASH, geographic region, and time-period, but not sex.