Introduction: Leukemia is one of the most prevalent childhood cancers, accounting for 30% of paediatric cancers globally and 39.1% in Malaysia. This study assesses neuropsychological functioning in childhood Acute Lymphoblastic Leukemia (ALL) survivors, including executive functioning, attention span, working memory, problem solving, processing speed, cognitive flexibility, and inhibitory control. Methods: Twenty-seven childhood ALL survivors (12 males, 15 females), aged 8–26 years and in remission for at least one year, were recruited from Hospital Pakar Universiti Sains Malaysia. Participants completed the Wechsler Intelligence Scale: Digit Span and subtests from the Delis-Kaplan Executive Function System: Trail Making Test, Verbal Fluency, Colour-Word Interference, and Sorting Test. Results: Results revealed significant neuropsychological deficits compared to normative data. Working memory performance (Digit Span, M = 6.63) was significantly below the mean. Impairments in executive functioning were found in Trail Making Test scores, particularly in Visual Scanning (M = 6.78), Letter Sequencing (M = 4.30), and Number-Letter Sequencing (M = 4.70). Verbal Fluency deficits were most notable in Letter Fluency (M = 4.70). Cognitive flexibility challenges were indicated by Colour-Word Interference scores (Inhibition, M = 8.04; Inhibition/ Switching, M = 8.26). Sorting Test scores (M = 7.33) indicated categorization difficulties. Correlations showed that school and post-treatment duration positively affected task performance, while earlier diagnosis negatively affected cognitive flexibility. Conclusion: These findings highlight neuropsychological deficits in Malay childhood ALL survivors, emphasizing the need for tailored interventions and screening tools to improve their quality of life and address gaps in understanding long-term effects.

Objective: The study aims to determine the prevalence and risk factors for endocrine disorders in childhood brain tumour survivors. Methodology: 124 childhood brain tumour survivors aged 18 years old or younger with either stable disease or in remission, and had survived for at least 2 years after diagnosis were included in the study. Demographic data (age at diagnosis, gender, ethnicity, socioeconomic status), clinical clues for endocrine disorders, anthropometrics (weight, height, midparental height), pubertal staging, tumour-related characteristics, treatment modalities and endocrine laboratory measurements at diagnosis and during follow up were obtained. Logistic regression was applied to evaluate risk factors for endocrine disorders in childhood brain tumour survivors. Results: The prevalence of endocrine disorders in childhood brain tumour survivors was 62.1%. The risk factors were high BMI [adjusted odds ratio (OR) 1.29, 95% CI: 1.12 to 1.5], high-risk site [adjusted odds ratio (OR) 7.15, 95% CI: 1.41 to 36.3] and chemotherapy [adjusted odds ratio (OR) 0.18 , 95% CI: 0.05 to 0.62]. Conclusion The prevalence of endocrine disorders in childhood brain tumour survivors in our centre was 62.1%. The significant risk factors were high BMI, tumour location (suprasellar and intrasellar) and chemotherapy.
Risk Factors

Introduction: Anaemia is a common medical condition among children worldwide, yet a commonly overlooked health problem if not life-threatening. This study aimed to determine the prevalence of anaemia in hospitalized children and identify its associated risk factors. Methods: A retrospective study was conducted from January to December 2021 on 792 patients aged 6 months to less than 12 years old with acute illnesses, who were admitted to the general paediatric ward in Hospital Universiti Sains Malaysia. We analysed socioeconomic and demographic data, and risk factors associated with anaemia. Result: The overall prevalence of anaemia among children aged 6 months to less than 12 years old was 16.4%. The age group of 6 to 59 months has a significant association with anaemia with 3.73 odds compared to the age group of 5 to 11 years (Adj OR 3.73, 95% CI 2.53-5.49). Birth weight of more than 2.5kg has a significant association with anaemia with 1.80 odds compared to weight less than 2.5kg (Adj OR 1.79, 95% CI 1.12-2.88). Conclusion: The prevalence of anaemia in the studied population was considered as a mild public health problem according to WHO severity classification. Children aged 6 to 59 months and those with birth weight more than or equivalent to 2.5kg were more likely to be anaemic. Early iron supplementation should be taken into consideration to reduce anaemia in this population.

Introduction: The aim of the study is to determine the prevalence of burnout and correlation between burnout score and stressor domain score and to determine the association between sociodemographic and occupational related factors with overall burnout among nurses caring for children in Hospital Universiti Sains Malaysia (Hospital USM). Methods: This was a cross-sectional study using bilingual validated questionnaire; the General Stressor Questionnaire (GSQ) and Copenhagen Burnout Inventory (CBI) conducted among nurses providing medical service for children in Hospital USM particularly in wards and clinics. All 159 eligible nurses were recruited and 157 completed questionnaires were analysed. Pearson’s correlation analysis was applied to study the correlation while simple logistic regression and multiple logistic regressions were applied to study the association. Results: The prevalence of burnout among nurses caring for children in Hospital USM was 28.7% (95% CI = 21.6, 35.7) with the majority of them experienced personal burnout (49.7%, 95% CI = 41.9, 57.5). There was a significant moderate positive correlation between different stressor domain score with overall burnout score with p-value < 0.05. Work placement and bureaucratic constraints were identified as the main contributory factor leading to overall burnout. Conclusion: Burnout among nurses providing medical services for children in Hospital USM is of concern especially involving personal burnout. The main stressor related factors of burnout were work placement and bureaucratic constraints. Therefore, burnout among nurses providing care for children must be addressed in order to enhance their psychological well-being.

Introduction: Caring for children who have chronic kidney disease (CKD) is challenging. The goal of this study was to find out the prevalence of burnout and what factors contribute to it. We also want to know the correlation between caretaker’s strain and burnout. Methods: This was a cross-sectional study that involved caretakers of children with CKD. They were recruited from a university hospital in Kelantan, Malaysia. Self-administered questionnaire in Malay language comprised of Demographic Information Form, Copenhagen Burnout Inventory (CBI-M) and Caregiver Strain Index (CSI-M) was used. Results: Eighty-eight caretakers were involved in this study. The mean age of caretakers was 42 years old, majority were female (72.4%), Malay (99.0%) and Muslim (99.0%). The mean age of children with CKD was 11 years old, most of them were on medication (69.3%) and mean duration of illness was 4.6 years. The prevalence of burnout in all domains (personal, work-related, client-related) among the caretakers was 5.7%. Eight caretakers had personal burnout (9.1%) while five (5.7%) had client-related and work-related burnout respectively. Multiple linear regression showed positive association of duration since the initial diagnosis and total ward admission within six months with total burnout score. Pearson correlation revealed a positive and fair correlation between strain and burnout. Conclusion: Prevalence of burnout among caretakers was generally low, but personal burnout outnumbered other domains. Children with CKD with longer duration of illness and more frequent ward admission are the important factors leading to burnout among caretakers. A high number of caretakers having significant strain indicated that there were possibilities of developing burnout later on.

Teratomatous tumours of the head are rather uncommon. We report a 3-month-old child who presented with acute signs of raised intracranial pressure, needing craniectomy and subtotal tumour removal. The patient was diagnosed as intracranial immature teratoma grade 3, from the pathological study and elevated alpha-fetoprotein (AFP). Managing brain teratoma posed a challenge to the managing team due to the location of the tumour, the unavailability of standardized chemotherapy protocol and the dilemma of commencing adjuvant chemotherapy in a very young infant. The tumour was partially removed due to its critical location. And chemotherapy was delayed until the patient achieved 7 months of age. After four rounds of chemotherapy, the patient remained in remission for more than three years follow up.

INTRODUCTIONStrongyloidiasis is one of the most commonly neglected but clinically important parasitic infections worldwide, especially among immunocompromised patients. Evidence of infection among immunocompromised patients in Malaysia is, however, lacking. In this study, microscopy, real-time polymerase chain reaction (PCR) and enzyme-linked immunosorbent assays (ELISAs) were used to detect Strongyloides stercoralis (S. stercoralis) infection among cancer patients in a Malaysian hospital.

METHODSA total of 192 stool and serum samples were collected from cancer patients who were receiving chemotherapy with or without steroid treatment at a hospital in northeastern Malaysia. Stool samples were examined for S. stercoralis using parasitological methods and real-time PCR. Serology by ELISA was performed to detect parasite-specific immunoglobulin G (IgG), IgG4 and immunoglobulin E (IgE) antibodies. For comparison, IgG4- and IgG-ELISAs were also performed on the sera of 150 healthy individuals from the same area.

RESULTSOf the 192 samples examined, 1 (0.5%) sample was positive for S. stercoralis by microscopy, 3 (1.6%) by real-time PCR, 8 (4.2%) by IgG-ELISA, 6 (3.1%) by IgG4-ELISA, and none was positive by IgE-ELISA. In comparison, healthy blood donors had significantly lower prevalence of parasite-specific IgG (2.67%, p < 0.05) and IgG4 (2.67%, p < 0.05) responses.

CONCLUSIONThis study showed that laboratory testing may be considered as a diagnostic investigation for S. stercoralis among immunocompromised cancer patients.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Animals ; Antibodies, Helminth ; blood ; Child ; Child, Preschool ; Cross-Sectional Studies ; Enzyme-Linked Immunosorbent Assay ; Female ; Healthy Volunteers ; Hospitalization ; Humans ; Immunocompromised Host ; Immunoglobulin E ; blood ; Immunoglobulin G ; blood ; Malaysia ; Male ; Middle Aged ; Neoplasms ; complications ; parasitology ; Real-Time Polymerase Chain Reaction ; Strongyloides stercoralis ; Strongyloidiasis ; blood ; complications ; diagnosis ; Young Adult

Strongyloidiasis is an infection caused by the intestinal nematode Strongyloides stercoralis. Infected healthy individuals are usually asymptomatic, however it is potentially fatal in immunocompromised hosts due to its capacity to cause an overwhelming hyperinfection. Strongyloidiasis could be missed during routine screening because of low and intermittent larval output in stool and variable manifestations of the symptoms. We present two cases of strongyloidiasis occurring in children with solid organ malignancies suspected to have the infection based on their clinical conditions and treatment history for cancer. Both patients were diagnosed by molecular and serological tests and were successfully treated. Thus, strongyloidiasis in patients undergoing intensive treatment for malignancies should be suspected, properly investigated and treated accordingly.

Background: No previous study has assessed the impact of childhood disability on parents and family in the context of Malaysia, and no instrument to measure this impact has previously been available. The objective of this cross-sectional study was to determine the reliability of a Malay version of the PedsQL™ Family Impact Module that measures the impact of children with disabilities (CWD) on their parents and family in a Malaysian context. Methods: The study was conducted in 2009. The questionnaire was translated forward and backward before it was administered to 44 caregivers of CWD to determine the internal consistency reliability. The test for Cronbach’s alpha was performed. Results: The internal consistency reliability was good. The Cronbach’s alpha for all domains was above 0.7, ranging from 0.73 to 0.895. Conclusion: The Malay version of the PedsQL™ Family Impact Module showed evidence of good internal consistency reliability. However, future studies with a larger sample size are necessary before the module can be recommended as a tool to measure the impact of disability on Malay-speaking Malaysian families.