INTRODUCTIONComplementary and alternative medicine (CAM) is garnering increasing interest and acceptance among the general population. Although usage is thought to be widespread among paediatric cancer patients, local studies have not been done. We aimed to investigate the prevalence and predictors of CAM usage in paediatric cancer patients in a single institution.

MATERIALS AND METHODSParents of 73 paediatric cancer patients treated at KK Women's & Children's Hospital completed an interviewer-administered questionnaire. Data about the types of CAM therapies used, motivations for use, adverse effects, costs and discussion of usage with the patient's physician were obtained. General perceptions towards CAM and conventional medicine were explored. A subsequent telephone survey enquired about spirituality, benefits of CAM use and overall satisfaction with the therapies.

RESULTSTwo-thirds of patients used at least 1 CAM treatment, mainly as supportive adjuncts to conventional cancer treatment. Dietary changes, health supplements, herbal tea and bird's nest were the most common therapies used. Few patients (8.1%) consulted a CAM practitioner. Positive predictors of CAM usage included being of Chinese race, the practice of Buddhism or Taoism, the use of CAM prior to diagnosis, perception of CAM effectiveness and dissatisfaction with conventional treatment. Significantly, 55.1% of the parents had not discussed their CAM usage with their child's physician.

CONCLUSIONSA substantial proportion of paediatric cancer patients utilises CAM therapies, often without their physician's knowledge. Healthcare providers need to remain cognisant of the potential implications of CAM usage in order to proactively counsel patients. This would ensure that conventional therapy remains uncompromised.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Medical Oncology ; methods ; Medicine, Chinese Traditional ; Neoplasms ; epidemiology ; therapy ; Patient Satisfaction ; Pediatrics ; methods ; Prevalence ; Singapore ; epidemiology

INTRODUCTIONChronic bacterial, viral and parasitic infections contribute to the morbidity and mortality associated with human immunodeficiency virus (HIV) infection. This study investigated risk factors and time-trends of the seroprevalence of cytomegalovirus (CMV), toxoplasmosis and hepatitis A total antibody; and co-infection with syphilis, hepatitis B and hepatitis C among newly diagnosed HIV individuals in Singapore.

MATERIALS AND METHODSThis was a cross-sectional study. A random sample of 50% of HIV infected patients who visited the Communicable Disease Centre (CDC), Singapore for first-time care from January 2006 to December 2011 were analysed.

RESULTSAmong the 793 study subjects, 93.4% were male; 77.9% of them were of Chinese ethnicity; mean age at HIV diagnosis was 41.4 years; and the mean baseline CD4+ T-cell count was 222 cells/mm³. The prevalence of sero-reactivity for CMV was 96.8%; hepatitis A: 40.9%; and toxoplasmosis: 23.7%. Co-infection with syphilis was identified in 12.3%; hepatitis B: 8.1%; and hepatitis C: 2%. Among those co-infected with hepatitis C, 73.3% of them were intravenous drug user (IVDU). Syphilis co-infection was significantly more common among men who have sex with men (MSM) (multivariate OR: 2.53, 95% CI, 1.31 to 4.90, P = 0.006).

CONCLUSIONThis study described the baseline rates of HIV co-infection with syphilis, hepatitis B and C in Singapore, and sero-reactivity to CMV, toxoplasmosis and hepatitis A. The increased rates compared to the general population may have important consequences for disease progression, response to antiretroviral treatment and long-term general health.

Adult ; Coinfection ; epidemiology ; Cross-Sectional Studies ; Cytomegalovirus ; isolation & purification ; Cytomegalovirus Infections ; blood ; epidemiology ; Female ; HIV Infections ; epidemiology ; Hepacivirus ; isolation & purification ; Hepatitis, Viral, Human ; blood ; epidemiology ; Humans ; Male ; Odds Ratio ; Risk Factors ; Seroepidemiologic Studies ; Singapore ; epidemiology ; Syphilis ; blood ; epidemiology ; Time Factors ; Toxoplasmosis ; blood ; epidemiology

We investigated the protective effects of chlorogenic acid (CGA), a polyphenol compound, on oxidative damage induced by UVB exposure on human HaCaT cells. In a cell-free system, CGA scavenged 1,1-diphenyl-2-picrylhydrazyl radicals, superoxide anions, hydroxyl radicals, and intracellular reactive oxygen species (ROS) generated by hydrogen peroxide and ultraviolet B (UVB). Furthermore, CGA absorbed electromagnetic radiation in the UVB range (280-320 nm). UVB exposure resulted in damage to cellular DNA, as demonstrated in a comet assay; pre-treatment of cells with CGA prior to UVB irradiation prevented DNA damage and increased cell viability. Furthermore, CGA pre-treatment prevented or ameliorated apoptosis-related changes in UVB-exposed cells, including the formation of apoptotic bodies, disruption of mitochondrial membrane potential, and alterations in the levels of the apoptosis-related proteins Bcl-2, Bax, and caspase-3. Our findings suggest that CGA protects cells from oxidative stress induced by UVB radiation.
Apoptosis ; Caspase 3 ; Cell Survival ; Cell-Free System ; Chlorogenic Acid* ; Comet Assay ; DNA ; DNA Damage ; Electromagnetic Radiation ; Humans ; Hydrogen Peroxide ; Keratinocytes* ; Membrane Potential, Mitochondrial ; Oxidative Stress* ; Reactive Oxygen Species ; Superoxides

Background: The literature on complementary and alternative (CAM) therapies in South East Asia is limited. The objective of the study was to evaluate the frequencies of CAM therapies in the Malaysian patients with migraine and tension-type headache (TTH). We also assessed the reasons for CAM use. Methods: This was a cross-sectional study. The study was conducted in a tertiary hospital in Malaysia. Consecutive patients presenting with migraine and TTH to the neurology clinic were recruited. Demographic characteristics were documented. Data on CAM use, including frequency and the reasons was collected. Results: Six hundred and eighty five patients (365 TTH and 320 migraine) were recruited. They consisted of 305 (44.5%) Malay, 174 (25.4%) Chinese, 169 (24.7%) Indian and 37 (5.4%) patients from other ethnic groups. A total of 478 (69.8%) patients, comprising 266 (55.6%) patients with TTH and 212 (44.4%) patients with migraine used CAM therapies. The most commonly used CAM therapies were medicated oil (355 patients, 51.8%) and massage (246 patients, 35.9%). The most common reasons for CAM use were reduction of pain (47.7 %), stress reduction (34.9%), and “cooling” effect (27.4%). Thirteen (4.1%) patients with migraine practiced reflexology, whereas 5 (1.4%) patients with TTH practiced reflexology (p=0.032). Twenty three (7.2%) patients with migraine took vitamin supplements compared to 13 (3.6%) patients with TTH (p=0.039). On univariate analysis, CAM use was significantly associated with ethnic groups (p=0.014), gender (p<0.0001), age (p=0.004), salary (p=0.014), educational level (p=0.003), and headache subtypes (p= 0.067). On logistic regression, married women were more likely to use CAM (OR=1.864, 95% CI 1.216-2.858, p=0.004). Conclusion: A large number of Malaysian headache patients used CAM. The most common reasons were reduction of pain, stress and “heatiness”. Medicated oil was most commonly used, followed by massage. Married women were more likely to use CAM, and this was the only determinant in this study.

OBJECTIVES: This study aimed to develop susceptible-exposed-infectious-recovered-vaccinated (SEIRV) models to examine the effects of vaccination on coronavirus disease 2019 (COVID-19) case trends in Malaysia during Phase 3 of the National COVID-19 Immunization Program amidst the Delta outbreak. METHODS: SEIRV models were developed and validated using COVID-19 case and vaccination data from the Ministry of Health, Malaysia, from June 21, 2021 to July 21, 2021 to generate forecasts of COVID-19 cases from July 22, 2021 to December 31, 2021. Three scenarios were examined to measure the effects of vaccination on COVID-19 case trends. Scenarios 1 and 2 represented the trends taking into account the earliest and latest possible times of achieving full vaccination for 80% of the adult population by October 31, 2021 and December 31, 2021, respectively. Scenario 3 described a scenario without vaccination for comparison. RESULTS: In scenario 1, forecasted cases peaked on August 28, 2021, which was close to the peak of observed cases on August 26, 2021. The observed peak was 20.27% higher than in scenario 1 and 10.37% lower than in scenario 2. The cumulative observed cases from July 22, 2021 to December 31, 2021 were 13.29% higher than in scenario 1 and 55.19% lower than in scenario 2. The daily COVID-19 case trends closely mirrored the forecast of COVID-19 cases in scenario 1 (best-case scenario). CONCLUSIONS Our study demonstrated that COVID-19 vaccination reduced COVID-19 case trends during the Delta outbreak. The compartmental models developed assisted in the management and control of the COVID-19 pandemic in Malaysia.

Objective: Bariatric surgery effectively treats non-alcoholic fatty liver disease (NAFLD). The glutamate-serine-glycine (GSG) index has emerged as a non-invasive diagnostic marker for NAFLD, but its ability to monitor treatment response remains unclear. This study investigates the GSG index's ability to monitor NAFLD's response to bariatric surgery. Methodology: Ten NAFLD participants were studied at baseline and 6 months post-bariatric surgery. Blood samples were collected for serum biomarkers and metabolomic profiling. Hepatic steatosis [proton density fat fraction (PDFF)] and fibroinflammation (cT1) were quantified with multiparametric magnetic resonance imaging (mpMRI), and hepatic stiffness with magnetic resonance elastography (MRE). Amino acids and acylcarnitines were measured with mass spectrometry. Statistical analyses included paired Student’s t-test, Wilcoxon-signed rank test, and Pearson’s correlation. Results: Eight participants provided complete data. At baseline, all had hepatic steatosis (BMI 39.3 ± 5.6 kg/m2, PDFF ≥ 5%). Post-surgery reductions in PDFF (from 12.4 ± 6.7% to 6.2 ± 2.8%, p = 0.013) and cT1 (from 823.3 ± 85.4ms to 757.5 ± 41.6ms, p = 0.039) were significant, along with the GSG index (from 0.272 ± 0.03 to 0.157 ± 0.05, p = 0.001). Conclusion The GSG index can potentially be developed as a marker for monitoring the response of patients with NAFLD to bariatric surgery.
Non-alcoholic Fatty Liver Disease ; Amino Acids ; Metabolomics