Browse publications by year: 2021

Fulltext Periodontal disease in seropositive rheumatoid arthritis: scoping review of the epidemiological evidence

Nik-Azis NM, Mohd N, Baharin B, Said MSM, Fadzilah FM, Haflah NHM

Germs, 2021 Jun;11(2):266-286.
PMID: 34422698 DOI: 10.18683/germs.2021.1263

The link between periodontal disease (PD) and rheumatoid arthritis (RA) has been hypothesized to lie in the anti-cyclic citrullinated protein antibody (ACPA) molecules present in seropositive RA. This review aimed to discuss how RA and specifically ACPA-positive RA link to PD, and appraise the epidemiological evidence on the relationship between ACPA-positive RA and PD. Articles were searched following the PRISMA guideline across the MEDLINE, Web of Science, Scopus and Cochrane Library databases. A total of 21 articles met the inclusion criteria of reporting the epidemiological data on the different ACPA status of the subjects with RA and PD (or periodontitis) parameters. A discrepancy is noted in the epidemiological evidence on the difference in the prevalence and severity of PD between ACPA-positive and ACPA-negative RA patients. Although the link between RA and PD is mostly discussed in terms of ACPA, reports on the different manifestations of PD between the two RA subsets remains inconclusive.
Fulltext Dual DNA Transfection Using 1,6-Hexanedithiol-Conjugated Maleimide-Functionalized PU-PEI600 For Gene Correction in a Patient iPSC-Derived Fabry Cardiomyopathy Model

Chien CS, Chien Y, Lin YY, Tsai PH, Chou SJ, Yarmishyn AA, et al.

Front Cell Dev Biol, 2021;9:634190.
PMID: 34422789 DOI: 10.3389/fcell.2021.634190

Non-viral gene delivery holds promises for treating inherited diseases. However, the limited cloning capacity of plasmids may hinder the co-delivery of distinct genes to the transfected cells. Previously, the conjugation of maleimide-functionalized polyurethane grafted with small molecular weight polyethylenimine (PU-PEI600-Mal) using 1,6-hexanedithiol (HDT) could promote the co-delivery and extensive co-expression of two different plasmids in target cells. Herein, we designed HDT-conjugated PU-PEI600-Mal for the simultaneous delivery of CRISPR/Cas9 components to achieve efficient gene correction in the induced pluripotent stem cell (iPSC)-derived model of Fabry cardiomyopathy (FC) harboring GLA IVS4 + 919 G > A mutation. This FC in vitro model recapitulated several clinical FC features, including cardiomyocyte hypertrophy and lysosomal globotriaosylceramide (Gb3) deposition. As evidenced by the expression of two reporter genes, GFP and mCherry, the addition of HDT conjugated two distinct PU-PEI600-Mal/DNA complexes and promoted the co-delivery of sgRNA/Cas9 and homology-directed repair DNA template into target cells to achieve an effective gene correction of IVS4 + 919 G > A mutation. PU-PEI600-Mal/DNA with or without HDT-mediated conjugation consistently showed neither the cytotoxicity nor an adverse effect on cardiac induction of transfected FC-iPSCs. After the gene correction and cardiac induction, disease features, including cardiomyocyte hypertrophy, the mis-regulated gene expressions, and Gb3 deposition, were remarkably rescued in the FC-iPSC-differentiated cardiomyocytes. Collectively, HDT-conjugated PU-PEI600-Mal-mediated dual DNA transfection system can be an ideal approach to improve the concurrent transfection of non-viral-based gene editing system in inherited diseases with specific mutations.
Fulltext Case Report: Young Adults With Breast Cancer: A Case Series of Fertility Preservation Management and Literature Review

Ahmad MF, Sugishita Y, Suzuki-Takahashi Y, Sawada S, Iwahata H, Shiraishi E, et al.

Front Med (Lausanne), 2021;8:670872.
PMID: 34422852 DOI: 10.3389/fmed.2021.670872

Breast cancer comprised at least 21.8% of the overall cancer among young adult (YA) women and became the leading cancer in this group in Japan, with 50% adolescent and YAs being diagnosed and 15-44-year-old women showing excellent 5-year survival. Surgical-chemoradiation therapy often results in excellent survivorship with an increased incidence of treatment-induced subfertility. Therefore, adding fertility preservation (FP) to the primary cancer treatment is necessary. Herein, we reported a series of cases of YA women with breast cancer who opted for FP, where their option was tailored accordingly. To date, the selection of oocytes, embryos and ovarian tissue is widely available as an FP treatment. PGT could reduce the risk of BRCA mutation transmission amongst BRCA carriers before pregnancy planning. Otherwise, gonadotropin-releasing hormone analog has no gonadoprotective effect and thus should not be considered as an FP option.
Fulltext What Elements of Sport and Exercise Science Should Primary Care Physicians Learn? An Interdisciplinary Discussion

Wattanapisit A, Poomiphak Na Nongkhai M, Hemarachatanon P, Huntula S, Amornsriwatanakul A, Paratthakonkun C, et al.

Front Med (Lausanne), 2021;8:704403.
PMID: 34422861 DOI: 10.3389/fmed.2021.704403
Fulltext A Multiwalled Carbon Nanotube-Based Polyurethane Nanocomposite-Coated Sand/Proppant for Improved Mechanical Strength and Flowback Control in Hydraulic Fracturing Applications

Alzanam AAA, Ishtiaq U, Muhsan AS, Mohamed NM

ACS Omega, 2021 Aug 17;6(32):20768-20778.
PMID: 34423185 DOI: 10.1021/acsomega.1c01639

A novel resin-based nanocomposite-coated sand proppant is introduced to address the issue of proppant flowback in post-fracturing fluid flowback treatments and hydrocarbon production. Self-aggregation in the water environment is the most attractive aspect of these developed proppants. In this work, sand was sieve-coated with 0.1% multiwalled carbon nanotubes (MWCNTs) followed by optimized thin and uniform resin (polyurethane) spray coating in the concentration range of 2 to 10%. Quantitative and qualitative evaluations have been carried out to assess the self-aggregation capabilities of the proposed sand proppants where no flowback was witnessed at 4% polyurethane coating containing 0.1% MWCNTs. This applied resin incorporating MWCNT coating was characterized by field emission scanning electron microscopy, and energy-dispersive X-ray spectroscopy depicted the dispersed presence of MWCNTs into polyurethane resin corroborated by the presence of 38% elemental carbon on the sand substrate. Proppant crushing resistance tests were conducted, including proppant pack stress-strain response, compaction, and fines production. It was found that the proposed sand proppant decreased the proppant pack compaction by ∼25% compared to commonly used silica sand with the ability to withstand high closure stress as high as 55 MPa with less than 10 wt % fines production. The surface wettability was determined by the sessile drop method. The application of resin incorporating MWCNT coating layers changed the sand proppant wetting behavior to oil-wet with a contact angle of ∼124°. Thermogravimetric analyses revealed a significant increment in thermal stability, which reached up to 280 °C due to the addition of MWCNTs as reinforcing nanofillers.
COMPARISON OF RADIATION DOSE AND IMAGE QUALITY IN HEAD CT SCANS AMONG MULTIDETECTOR CT SCANNERS

Abuzaid MM, Elshami W, Tekin HO, Sulieman A, Bradley DA

Radiat Prot Dosimetry, 2021 Nov 03;196(1-2):10-16.
PMID: 34423365 DOI: 10.1093/rpd/ncab125

The present study compares three different multidetector CT (MDCT) scanners for routine brain imaging in terms of image quality and radiation doses. The volume CT dose index (CTDIvol), dose-length product (DLP), and effective dose (E) were calculated. Subjective image assessment was obtained based on a scale ranging from 1 (unacceptable) to 5 (optimum). All images scored 3.5 or over, with the 160-slice MDCT images being favoured. For the 4-, 16- and 160-slice MDCT scanners, the respective median values for CTDIvol were 57 mGy, 41 mGy, and 28 mGy; DLP values were 901 mGy.cm, 680 mGy.cm, and 551 mGy.cm; and effective doses were 2 mSv, 1.5 mSv, and 1 mSv, respectively. Compared to the 160-slice MDCT, the dose values for the 4- and 16-slice units were significantly greater. In practice, the CT modality used must be carefully selected to avoid elevated radiation doses and maintain image quality.

MeSH terms: Radiation Dosage; Tomography Scanners, X-Ray Computed; Cone-Beam Computed Tomography; Multidetector Computed Tomography*
Psychometric Evaluation of the Persian Version of Religious Orientation Scale in Iranian Patients with Cancer

Sharif Nia H, She L, Fomani FK, Kaur H, Sánchez-Teruel D, Froelicher ES, et al.

J Relig Health, 2021 Oct;60(5):3658-3674.
PMID: 34423379 DOI: 10.1007/s10943-021-01384-6

This paper reports on the psychometric properties of the Religious Orientation Scale (ROS) with a sample of 311 Iranian patients who were suffering from cancer between September and December 2020. A cross-sectional study design was used, and convenience sampling was employed. Reliability was evaluated by internal consistency Cronbach's alpha, McDonald's omega, and average inter-item correlation. The exploratory factor analysis showed that the ROS had 15 items and two factors (religious identity and personal identity) that explained 43.2% of the total variance of religious orientation in Iranian patients with cancer. Construct validity was assessed by means of confirmatory factor analysis. The internal consistency and composite reliability were acceptable. The results indicate that the ROS can produce reliable and valid data on religious orientation in a sample of Iranian patient with cancer.

MeSH terms: Cross-Sectional Studies; Humans; Iran; Neoplasms*; Psychometrics; Surveys and Questionnaires; Reproducibility of Results
Outcome of Eustachian Tube Balloon Dilation in Children: A Systematic Review

Saniasiaya J, Kulasegarah J, Narayanan P

Ann Otol Rhinol Laryngol, 2021 Aug 22.
PMID: 34423675 DOI: 10.1177/00034894211041340

OBJECTIVE: Eustachian tube dysfunction (ETD) is a chronic entity that has been historically managed with adenoidectomy and ventilation tube insertion. Recently, balloon dilation of the eustachian tube has shown promising results in recalcitrant eustachian tube dysfunction. We reviewed the literature to determine the outcome of eustachian tube balloon dilation in children.
METHODS: A literature search was conducted for the period from 1990 to 2020 by searching several databases over a 1-month period (January 2021) according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Cochrane Handbook for Systematic Reviews for Interventions. Primary outcome was defined as the success of the intervention determined by the resolution of symptoms, and secondary outcome was determined by revisions surgery and presence of complications.
RESULTS: Only 7 articles were identified based on our objectives and selection criteria. All studies included are retrospective cohort case series (Level IV) and 1 cohort of matched controls (Level III). A total of 284 patients were included in this review, with a mean age of 7.8 years. A total of 463 balloon dilation were performed either bilaterally or unilaterally. The most common finding of ETD is middle ear effusion in 5 studies. Balloon dilation of eustachian tube was second-line treatment in 6 studies and first-line treatment in 1 study. Improvement of symptoms was identified in all studies through various assessments performed. Revision surgery was performed in 1 study with no major complications reported.
CONCLUSIONS: Balloon dilation of the eustachian tube may be considered as an alternative procedure following failed standard treatment in children. The quality of evidence is inadequate to recommend widespread use of the technique until a better-quality study has been completed. Future randomized controlled studies with a large sample size are warranted to determine the efficacy of this procedure amongst children.
Polyvinyl chloride (PVC) and peritoneal dialysis (PD): Trivialisation of reality?

Goh BL, Shanmuganathan M, Ang KL

Perit Dial Int, 2021 11;41(6):587.
PMID: 34423706 DOI: 10.1177/08968608211040361
MeSH terms: Humans; Peritoneal Dialysis, Continuous Ambulatory*; Polyvinyl Chloride
Carbon and polymer-based magnetic nanocomposites for oil-spill remediation-a comprehensive review

Mehmood A, Khan FSA, Mubarak NM, Mazari SA, Jatoi AS, Khalid M, et al.

Environ Sci Pollut Res Int, 2021 Oct;28(39):54477-54496.
PMID: 34424475 DOI: 10.1007/s11356-021-16045-0

Oil spills are a major contributor to water contamination, which sets off a significant impact on the environment, biodiversity, and economy. Efficient removal of oil spills is needed for the protection of marine species as well as the environment. Conventional approaches are not efficient enough for oil-water separation; therefore, effective strategies and efficient removal techniques (and materials) must be developed to restore the contaminated marine to its normal ecology. Several research studies have shown that nanotechnology provides efficient features to clean up these oil spills from the water using magnetic nanomaterials, particularly carbon/polymer-based magnetic nanocomposites. Surface modification of these nanomaterials via different techniques render them with salient innovative features. The present review discusses the advantages and limitations of conventional and advanced techniques for the oil spills removal from wastewater. Furthermore, the synthesis of magnetic nanocomposites, their utilization in oil-water separation, and adsorption mechanisms are discussed. Finally, the advancement and future perspectives of magnetic nanocomposites (particularly of carbon and polymer-based magnetic nanocomposites) in environmental remediation are presented.

MeSH terms: Carbon; Polymers; Nanocomposites*; Petroleum Pollution*; Magnetic Phenomena
Fulltext The expectations and acceptability of a smart nursing home model among Chinese elderly people: A mixed methods study protocol

Zhao Y, Sazlina SG, Rokhani FZ, Su J, Chew BH

PLoS One, 2021;16(8):e0255865.
PMID: 34424931 DOI: 10.1371/journal.pone.0255865

Nursing homes integrated with smart information such as the Internet of Things, cloud computing, artificial intelligence, and digital health could improve not only the quality of care but also benefit the residents and health professionals by providing effective care and efficient medical services. However, a clear concept of a smart nursing home, the expectations and acceptability from the perspectives of the elderly people and their family members are still unclear. In addition, instruments to measure the expectations and acceptability of a smart nursing home are also lacking. The study aims to explore and determine the levels of these expectations, acceptability and the associated sociodemographic factors. This exploratory sequential mixed methods study comprises a qualitative study which will be conducted through a semi-structured interview to explore the expectations and acceptability of a smart nursing home among Chinese elderly people and their family members (Phase I). Next, a questionnaire will be developed and validated based on the results of a qualitative study in Phase I and a preceding scoping review on smart nursing homes by the same authors (Phase II). Lastly, a nationwide survey will be carried out to examine the levels of expectations and acceptability, and the associated sociodemographic factors with the different categories of expectations and acceptability (Phase III). With a better understanding of the Chinese elderly people's expectations and acceptability of smart technologies in nursing homes, a feasible smart nursing home model that incorporates appropriate technologies, integrates needed medical services and business concepts could be formulated and tested as a solution for the rapidly ageing societies in many developed and developing countries.

MeSH terms: Aged; China; Family/psychology; Female; Humans; Interviews as Topic; Male; Middle Aged; Surveys and Questionnaires; Models, Nursing*
In Vitro Antiaging Evaluation of Sunscreen Formulated from Nanostructured Lipid Carrier and Tocotrienol-Rich Fraction

Chu CC, Hasan ZABA, Tan CP, Nyam KL

J Pharm Sci, 2021 Dec;110(12):3929-3936.
PMID: 34425132 DOI: 10.1016/j.xphs.2021.08.020

Chronic exposure to ultraviolet (UV) radiation leads to photoaging. There is a tremendous rise in products having a dual activity of photoprotection and antiaging. In vitro analysis in dermal fibroblasts and their biological mechanisms involved are critical to determine antiaging potential. The study aimed to investigate the antiaging potential of sunscreen formulated from nanostructured lipid carrier and tocotrienol-rich fraction (NLC-TRF sunscreen). The antioxidant activity of the NLC-TRF sunscreen was evaluated by radical scavenging and hydrogen peroxide inhibition properties. Also, collagenase, elastase and matrix metalloproteinase-1 (MMP-1) inhibition activities, and type I collagen and elastin protein expression were studied. Quantitative real-time polymerase chain reaction (qPCR) was used to evaluate the mRNA expression of fibroblast growth factor (FGF), vascular endothelial growth factor (VEGF), transforming growth factor-β1 (TGF-β1), type I collagen (COL1A1), elastin (ELN), MMP-1, MMP-2, and tissue inhibitor matrix metalloproteinase-1 (TIMP-1). The results suggested that NLC-TRF sunscreen is effective in radical, anti-hydrogen peroxide, and collagenase, elastase and MMP-1 inhibition activities. Besides, a significant increase for type I collagen (3.47-fold) and elastin (2.16-fold) protein and fibroblast regeneration genes (FGF (2.12-fold), VEGF (1.91-fold), TGF-β1 (2.84-fold), TIMP-1 (1.42-fold), ELN (2.13-fold)) were observed after sample treatment. These findings support the therapeutic potential of NLC-TRF sunscreen in antiaging.
Potential biodegradation of Tapis Light Crude Petroleum Oil, using palm oil mill effluent final discharge as biostimulant for isolated halotolerant Bacillus strains

Sayed K, Baloo L, Kutty SRBM, Makba F

Mar Pollut Bull, 2021 Nov;172:112863.
PMID: 34425365 DOI: 10.1016/j.marpolbul.2021.112863

Petroleum hydrocarbon pollution in marine waters has been an extremely significant environmental and health issue worldwide. This study aims at constructing an efficient indigenous bacterial consortium to biodegrade Tapis Light Crude Petroleum Oil (TLCO). The local agro-industrial wastewater of palm oil mill effluent final discharge (POME FD) was used as biostimulant to enhance the biodegradation efficiency. In this study, three TLCO degrading bacteria were isolated from seawater samples collected. Molecular identification using 16S rRNA genes sequencing was done and results show that these isolated strains belong to: Bacillus tropicus, Bacillus licheniformis and Bacillus subtilis. Bacterial consortium tested using four different concentrations of POME FD (0.1, 0.25, 0.5, and 1%) as biostimulant and TLCO (0.5 and 1.0%) degradation capability was investigated. The residual TLCO in culture medium after 40 days was analysed. The results confirmed that POME FD dosage of 0.25% is optimum for the bacterial consortium and can degrade 99.85% of TLCO at 0.5%. However, TLCO degradation with POME FD dosage (0.25%) in TLCO (1.0%) was found optimum, with biodegradation reaching up to 95.23% in 40 days. This study is a beginning for the future development of a consortium of petroleum hydrocarbon degrading bacteria to mitigate oil spills in the Malaysian shoreline.
Fulltext The Effects of Market Orientation, Product Innovation and Marketing Ethics on Firm Performance: A Theoretical Framework

Moad Hamod M Saleh, Adi Anuar Azmin, Ummi Naiemah Saraih

International Journal of Innovation and Industrial Revolution, 2021;3(7):31-47.
MyJurnal

In the contemporary business environment, market orientation has become a widely discussed topic in the business community and academics. Since the market environment has become more competitive, developing and improving one's internal resources is now an absolute necessity. Despite the influence these topics have on the performance of microenterprises, a significant number of market orientation studies haven't empirically connected them. According to this perspective, this study established a theoretical link between market orientation and SME performance via a literature review. Additionally, a new framework for experimental evidence was developed. This study makes significant contributions to the understanding of the relationship between market orientation and SME performance but also sheds light on the critical role of product innovation as a mediator. Furthermore, the conceptual model explains the impact of marketing ethics as a moderator on small- and medium-sized enterprise (SMEs) performance.
Fulltext Sago Starch Compressing Machine: Increasing the Productivity with New Concept

Farihana A.Rahman, Syarfadila Ezurida Shaari, Brenda Anak Norbert Rabar

International Journal of Innovation and Industrial Revolution, 2021;3(7):10-18.
MyJurnal

Sago is the staple food of Melanau in Sarawak. Sago is sourced from Pokok Rumbia or known as Pokok Sagu which is widely found in the interior of the forest. Pokok Rumbia is a kind of palm tree found in Malaysia and Indonesia forests. Among the products of sago trees is wet sago starch or ‘Lemantak’. Wet sago starch is still traditionally produced by Small and Medium Enterprises (SMEs). By utilizing the compressed air produced using the single-acting cylinder from a pneumatic system, the sago starch is compressed with 1.5 horsepower. Through careful selections of concepts, the final selected concept was fabricated and analysed. Machine efficiency analysis is determined by taking into account the compressor pressure factor, the time taken for compression, the height of wet sago starch, and the rate of production at a given time. It is proven that with the implementation of the process through the new machine concept, the productivity of ‘Lemantak’ has increased by 68% compared to the conventional method of production.
Fulltext Enhancing Vitamin C Content in Soap Production via Subsequent Amount of Extract from Phyllanthus Amblica and Cosnicium Bluemeanum

Ruhana Wati Iran, Surina Nordin, Dayang Kamariah Tajul Maulok

International Journal of Innovation and Industrial Revolution, 2021;3(7):1-9.
MyJurnal

The demand for cosmetic products is rapidly growing, despite the majority of them is high in chemical substances and may harm the skin. Nowadays, there are other alternatives that may help to prevent the use of chemical substances in cosmetic products. For example, fruit contains its own nutrient. Furthermore, there are some fruits that contains high in vitamins and also good for the skin. Researchers noticed that Phyllantus amblica (Melaka fruits) has an unpleasant odor but it higher with contains 30 times more vitamin C compared to orange while Cosnicium blumeanem (mengkunyit) helps raise the level of vitamins C in the body. Therefore, looking at potential and benefits, research has been conducted to produce a bar soap (Amblica Soap) from Phyllantus amblica and Cosnicium blumeanem. Analyze has been done to determine the vitamin C, antioxidant level, and perception level of respondents towards Amblica Soap. Likert Scale and High-Performance Liquid Chromatography (HPLC) was used as the quantitative instrument. A number of 30 respondents were selected based on their locality. Descriptive analysis was used to analyses collected using SPSS version 25.0. Resulting confirming that is Amblica Soap not contain in vitamin C and shows the perception level of respondents towards Amblica Soap is highly positive. In conclusion, Amblica Soap accepted optimistically.
Fulltext Dialogical reflexivity towards collective action to transform global health

Liwanag HJ, Rhule E

BMJ Glob Health, 2021 Aug;6(8).
PMID: 34417275 DOI: 10.1136/bmjgh-2021-006825
MeSH terms: Humans; Global Health*
Fulltext Publisher Correction: Scale-up approach for supercritical fluid extraction with ethanol-water modified carbon dioxide on Phyllanthus niruri for safe enriched herbal extracts

Hassim N, Markom M, Rosli MI, Harun S

Sci Rep, 2021 Aug 20;11(1):17231.
PMID: 34417534 DOI: 10.1038/s41598-021-96669-x
Fulltext Low-wage migrant workers during coronavirus disease 2019: a social determinants analysis

Saparamadu AADNS, Sharpe A, Kim S, Barbosa BLFA, Pereira A

J Public Health Policy, 2021 Sep;42(3):452-464.
PMID: 34417557 DOI: 10.1057/s41271-021-00303-z

The severe acute respiratory syndrome coronavirus 2 pandemic has had disproportionate effects on economically and socially marginalized people. We explore the effects on low-wage migrant workers (migrant workers) in three countries: Singapore, South Korea and Brazil, through the lens of the social determinants of health. Our analysis shows that governments missed key opportunities to mitigate pandemic risks for migrant workers. Government measures demonstrate potential for effective and sustainable policy reform, including universal and equitable access to healthcare, social safety nets and labour rights for migrant workers-key concerns of the Global Compact for Migration. A whole-of-society and a whole-of-government approach with Health in All Policies, and migrant worker frameworks developed by the World Health Organization could be instrumental. The current situation indicates a need to frame public health crisis responses and policies in ways that recognize social determinants as fundamental to health.

MeSH terms: Brazil/epidemiology; Humans; Singapore/epidemiology; Transients and Migrants*; Republic of Korea/epidemiology; Policy; Social Determinants of Health*
Small Intestinal Bacterial Overgrowth In Various Functional Gastrointestinal Disorders: A Case-Control Study

Chuah KH, Wong MS, Tan PO, Lim SZ, Beh KH, Chong SCS, et al.

Dig Dis Sci, 2021 Aug 21.
PMID: 34417923 DOI: 10.1007/s10620-021-07227-4

INTRODUCTION: Small intestinal bacterial overgrowth (SIBO) is prevalent in irritable bowel syndrome (IBS), but its' association with other functional gastrointestinal disorders (FGIDs) is less certain. This study aimed to explore SIBO in a multi-racial Asian population with various FGIDs compared to non-FGID controls.
METHODOLOGY: Consecutive Asian adults with Rome III diagnosed common FGIDs (functional dyspepsia/FD, IBS and functional constipation/FC) and non-FGID controls were subjected to glucose breath testing, with hydrogen (H2) and methane (CH4) levels determined.
RESULTS: A total of 244 participants (FGIDs n = 186, controls n = 58, median age 45 years, males 36%, Malay ethnicity 76%) were recruited. FGIDs had a higher prevalence trend of SIBO compared to controls (16% FGIDs vs. 10% controls, p = 0.278) with 14% in FD, 18% in IBS and 17% in FC. Compared to controls, SIBO was associated with diarrhoea-predominant IBS (IBS-D) (24% vs. 10%, P = 0.050) but not with other types of FGIDs. IBS-D remained an independent predictor of SIBO (OR = 2.864, 95% CI 1.160-7.071, p = 0.023) but not PPI usage nor history of diabetes (both p > 0.050) at multivariate analysis. Compared to controls, SIBO in IBS-D was associated with an elevated H2 level (≥ 20 ppm from baseline) (18% vs. 3%, p = 0.017), but not CH4 levels (≥ 10 ppm) (9% vs. 7%, p = 0.493). In addition, no difference was found in the prevalence of methane-positive SIBO between chronic constipation (constipation-predominant IBS and FC) compared to controls (9% vs. 7%, P = 0.466).
CONCLUSION: SIBO is prevalent amongst multi-ethnic Asian adults with and without FGIDs. Amongst various FGIDs, only IBS-D is significantly associated with SIBO.

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