MyMedR

Predictors of recurrent abdominal pain among 9 to 15-year-old urban school-children in Malaysia

Boey CC, Goh KL

Acta Paediatr, 2001 Mar;90(3):353-5.

A cross-sectional survey of school-children aged from 9 to 15 y was performed in the city of Petaling Jaya to look for predictors of recurrent abdominal pain. A sample of 1488 children was randomly chosen, of whom 143 (9.6%) had recurrent abdominal pain according to Apley's criteria.

Fulltext Commentary: rabeprazole improves symptoms in patients with functional dyspepsia in Japan

Yap PR, Mahadeva S, Goh KL

Aliment Pharmacol Ther, 2013 Nov;38(10):1321-2.

PMID: 24134501 DOI: 10.1111/apt.12497

Fulltext Commentary: changing aetiology of peptic ulcers

Goh KL, Chan WK

Aliment Pharmacol Ther, 2012 Aug;36(3):291-2; discussion 292-3.

PMID: 22747451 DOI: 10.1111/j.1365-2036.2012.05164.x

Fulltext High-dose rabeprazole-amoxicillin dual therapy and rabeprazole triple therapy with amoxicillin and levofloxacin for 2 weeks as first and second line rescue therapies for Helicobacter pylori treatment failures

Goh KL, Manikam J, Qua CS

Aliment Pharmacol Ther, 2012 May;35(9):1097-102.

PMID: 22404486 DOI: 10.1111/j.1365-2036.2012.05054.x

BACKGROUND:
H. pylori eradication failures are difficult to treat and rescue therapies often consist of complex treatment regimens.

AIM:
To determine an effective and practical rescue therapeutic strategy for H. pylori treatment failures using two consecutive regimens: first rescue therapy - rabeprazole 20 mg t.d.s. and amoxicillin 1 g t.d.s. for 2 weeks and for failures a further second rescue therapy - rabeprazole 20 mg b.d., levofloxacin 500 mg b.d., amoxicillin 1 g b.d. for a further 2 weeks.

METHODS:
Consecutive patients who failed the proton pump inhibitor (PPI) 1-week triple therapy were recruited for the study. H. pylori status was determined by a C(13) urea breath test.

RESULTS:
One hundred and forty-nine patients received the first rescue therapy. Seven were not compliant to medication/defaulted follow-up. Eradication success- first rescue therapy: per protocol (PP) analysis-107/142 (75.4%) (95% CI (68.3-82.4%) and intention to treat (ITT) analysis-107/149 (71.8%) 95% CI (64.6-79.0%). Thirty-one of 35 patients who failed the first rescue therapy received the second rescue therapy. All were compliant with medications. Eradication success- PP and ITT was 28/31 (90.3%) 95% CI (74.2-98.0%). The cumulative eradication rate using both rescue therapies: PP analysis- 135/138 (97.8%) 95% CI: (93.8-99.6%), ITT analysis- 135/149 (90.6%) 95% CI: (84.7-94.8%).

CONCLUSIONS:
A 2-week high dose PPI-amoxicillin dual therapy followed by a PPI-amoxicillin-levofloxacin triple therapy were highly successful in achieving eradication in H. pylori treatment failures.

Fulltext Ethnic variation, epidemiological factors and quality of life impairment associated with dyspepsia in urban Malaysia

Mahadeva S, Yadav H, Rampal S, Everett SM, Goh KL

Aliment Pharmacol Ther, 2010 May;31(10):1141-51.

PMID: 20175766 DOI: 10.1111/j.1365-2036.2010.04270.x

The role of ethnicity in the development of dyspepsia remains uncertain.

Fulltext Time trends in peptic ulcer, erosive reflux oesophagitis, gastric and oesophageal cancers in a multiracial Asian population

Goh KL, Wong HT, Lim CH, Rosaida MS

Aliment Pharmacol Ther, 2009 Apr 1;29(7):774-80.

PMID: 19183160 DOI: 10.1111/j.1365-2036.2009.03930.x

Dramatic changes in the prevalence and pattern of gastrointestinal disease has taken place in Asia in recent years.

Gastro-oesophageal reflux disease in chronic laryngitis: prevalence and response to acid-suppressive therapy

Qua CS, Wong CH, Gopala K, Goh KL

Aliment Pharmacol Ther, 2007 Feb 1;25(3):287-95.

PMID: 17269990

Gastro-oesophageal reflux is thought to cause chronic laryngitis through laryngopharyngeal reflux. Response of laryngitis to treatment with acid-suppressive therapy supports this causal link.

Fulltext Gastro-oesophageal reflux disease in 'difficult-to-control' asthma: prevalence and response to treatment with acid suppressive therapy

Wong CH, Chua CJ, Liam CK, Goh KL

Aliment Pharmacol Ther, 2006 May 1;23(9):1321-7.

PMID: 16629937 DOI: 10.1111/j.1365-2036.2006.02888.x

BACKGROUND: The causal association between gastro-oesophageal reflux disease (GERD) and difficult-to-control asthma is unclear.
AIM: To determine the prevalence of GERD and response to proton pump inhibitor therapy in patients with difficult-to-control asthma.
METHODS: Consecutive patients with difficult-to-control asthma as defined by persistent and recurrent symptoms despite on optimal asthmatic medications were recruited for the study. GERD was diagnosed by symptoms, gastroscopy and 24-h oesophageal pH monitoring. All patients were prescribed a course of lansoprazole 30 mg daily for 8 weeks. Improvement to treatment was assessed by a change in pulmonary symptom score and also by patient's subjective assessment of improvement.
RESULTS: Seventeen of 30 (56.7%) patients with difficult-to-control asthma were diagnosed with GERD. Pulmonary symptom score improved significantly only in patients with GERD (35.0 to 21.0; P = 0.002). Twelve of 16 (75%) patients with GERD reported an improvement in asthma symptoms; 1 of 11 (9.1%) without GERD reported mild symptom improvement. There was no significant change in peak expiratory flow rate and forced expiratory volume.
CONCLUSIONS: More than half of patients with difficult-to-control asthma were diagnosed with GERD. In these patients the severity of asthma improved significantly with potent acid suppression therapy. This underlines the critical role of acid reflux in this subset of patients with difficult-to-control asthma.
Study site: Respiratory clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Fulltext Commentary: adherence and detection rates in colorectal cancer screening

Hilmi I, Goh KL

Aliment Pharmacol Ther, 2013 Jan;37(1):156-7; discussion 157-8.

PMID: 23205475 DOI: 10.1111/apt.12122

Gastro-oesophageal reflux is more prevalent in Western dyspeptics: a prospective comparison of British and South-East Asian patients with dyspepsia

Mahadeva S, Raman MC, Ford AC, Follows M, Axon AT, Goh KL, et al.

Aliment Pharmacol Ther, 2005 Jun 15;21(12):1483-90.

PMID: 15948816

There is a paucity of data directly comparing dyspepsia in Western and Eastern populations.

Colorectal cancer in Asians: a demographic and anatomic survey in Malaysian patients undergoing colonoscopy

Goh KL, Quek KF, Yeo GT, Hilmi IN, Lee CK, Hasnida N, et al.

Aliment Pharmacol Ther, 2005 Nov 1;22(9):859-64.

PMID: 16225496

Colorectal cancer is one of the most common forms of gastrointestinal cancer in the world today. In the Asia-Pacific area, it is the fastest emerging gastrointestinal cancer.

Human leucocyte antigen determinants of susceptibility to Barrett's oesophagus in Asians--a preliminary study

Rajendra S, Ackroyd R, Murad S, Mohan C, Ho JJ, Goh KL, et al.

Aliment Pharmacol Ther, 2005 Jun 1;21(11):1377-83.

PMID: 15932368

Characteristic immune profiles have been demonstrated in gastro-oesophageal reflux disease. However, the genetic basis of gastro-oesophageal reflux disease remains unclear.

Time trends in upper gastrointestinal diseases and Helicobacter pylori infection in a multiracial Asian population--a 20-year experience over three time periods

Leow AH, Lim YY, Liew WC, Goh KL

Aliment Pharmacol Ther, 2016 Apr;43(7):831-7.

PMID: 26847417 DOI: 10.1111/apt.13550

Marked epidemiological changes in upper gastrointestinal diseases and Helicobacter pylori infection have taken place in the Asian Pacific region. In particular, differences with respect to race in the multiracial Asian population in Malaysia have been important and interesting.

Letter: prompt endoscopy in Asians with uninvestigated dyspepsia

Mahadeva S, Goh KL

Aliment Pharmacol Ther, 2015 Apr;41(8):792.

PMID: 25781046 DOI: 10.1111/apt.13120

Comparison of two 1-week low-dose omeprazole triple therapies--optimal treatment for Helicobacter pylori infection?

Goh KL, Parasakthi N, Chuah SY, Cheah PL, Lo YL, Chin SC

Aliment Pharmacol Ther, 1997 Dec;11(6):1115-8.

PMID: 9663838

OBJECTIVES: To determine and compare the efficacy and tolerability of two 1-week regimen comprising omeprazole, clarithromycin and amoxycillin or metronidazole in the eradication of Helicobacter pylori, and to determine the influence of bacterial resistance to metronidazole and clarithromycin on the outcome of treatment.

PATIENTS AND METHODS: Patients with unequivocal evidence of H. pylori infection based on culture, histology and rapid urease test of both antrum and corpus biopsies were recruited for the study. The study was a randomized, investigator-blind, comparative study. Patients received either omeprazole 20 mg o.m., clarithromycin 250 mg b.d. and amoxycillin 500 mg b.d. (OAC) or omeprazole 20 mg o.m., metronidazole 400 mg b.d. and clarithromycin 250 mg b.d. (OMC) for 1 week. Patients were assessed for successful eradication, which was defined as absence of bacteria in all tests (culture, histology and urease test on both antral and corpus biopsies), at least 4 weeks after completion of therapy.

RESULTS: Eighty-two patients were recruited for the study. Eradication rates on intention-to-treat analysis were--OAC: 36/41 (87.8%, 95% CI: 73.8, 95.9); OMC: 33/41 (80.5%, 95% CI: 65.1, 91.2). On per protocol analysis were--OAC: 36/40 (90%, 95% CI: 76.3, 97.2); OMC: 32/38 (84.2%, 95% CI: 68.7, 94.0). All side-effects encountered were mild and no patient discontinued treatment because of intolerance to medications. The most common side-effects were altered taste (OAC 31.7%, OMC 53.7%) and lethargy (OAC 14.6%, OMC 19.5%). Pre-treatment metronidazole resistance was encountered in 34/63 (54.0%) patients. No bacterial strains were found with primary resistance to clarithromycin. Metronidazole resistance did not significantly affect eradication rates. Emergence of resistance to clarithromycin was not seen post-therapy.

CONCLUSIONS: Both the OAC and the OMC regimens were convenient and well-tolerated treatments for H. pylori. However, eradication rates were lower than anticipated.

Clinical features and treatment of nonalcoholic fatty liver disease across the Asia Pacific region-the GO ASIA initiative

Chan WK, Treeprasertsuk S, Imajo K, Nakajima A, Seki Y, Kasama K, et al.

Aliment Pharmacol Ther, 2018 Mar;47(6):816-825.

PMID: 29333610 DOI: 10.1111/apt.14506

BACKGROUND: The Gut and Obesity Asia (GO ASIA) workgroup was formed to study the relationships between obesity and gastrointestinal diseases in the Asia Pacific region.

AIM: To study factors associated with nonalcoholic steatohepatitis (NASH) and advanced fibrosis, and medical treatment of biopsy-proven nonalcoholic fatty liver disease (NAFLD) patients.

METHODS: Retrospective study of biopsy-proven NAFLD patients from centres in the GO ASIA Workgroup. Independent factors associated with NASH and with advanced fibrosis on binary logistic regression analyses in a training cohort were used for the development of their corresponding risk score, which were validated in a validation cohort.

RESULTS: We included 1008 patients from nine centres across eight countries (NASH 62.9%, advanced fibrosis 17.2%). Independent predictors of NASH were body mass index ≥30 kg/m2 , diabetes mellitus, dyslipidaemia, alanine aminotransferase ≥88 U/L and aspartate aminotransferase ≥38 U/L, constituting the Asia Pacific NASH risk score. A high score has a positive predictive value of 80%-83% for NASH. Independent predictors of advanced fibrosis were age ≥55 years, diabetes mellitus and platelet count <150 × 109 /L, constituting the Asia-Pacific NAFLD advanced fibrosis risk score. A low score has a negative predictive value of 95%-96% for advanced fibrosis. Only 1.7% of patients were referred for structured lifestyle program, 4.2% were on vitamin E, and 2.4% were on pioglitazone.

CONCLUSIONS: More severe liver disease can be suspected or ruled out based on factors identified in this study. Utilisation of structured lifestyle program, vitamin E and pioglitazone was limited despite this being a cohort of biopsy-proven NAFLD patients with majority of patients having NASH.

Tobacco consumption and illegal drug use among Bangladeshi males: association and determinants

Kabir MA, Goh KL, Khan MM

Am J Mens Health, 2013 Mar;7(2):128-37.

PMID: 23065136 DOI: 10.1177/1557988312462737

This article aimed to identify the determinants of tobacco consumption and illegal drug use (IDU) as well as to examine the association between these two variables using a representative sample of 3,771 Bangladeshi males aged 15 to 54 years. Data were collected through Bangladesh Demographic and Health Survey 2007. To identify the determinants, the patterns of tobacco consumption and IDU were analyzed by age, education and occupation, residence, mass media, premarital sex, wealth, and sexually transmitted infections (STIs). Prevalence of smoking cigarette and bidi was roughly 60%. However, the prevalence of IDU was 3.4%, and this proportion is statistically significant (Z = 11.32, p = .000). After bivariate analysis, almost all variables except STIs were significantly associated with tobacco consumption. Similarly, all variables except residence and mass media were associated with IDU. Based on multivariable adjusted logistic regression analysis, the likelihood of using IDU was approximately twofold (odds ratio [OR] = 1.8, 95% confidence interval [CI] = 1.23-2.53) among bidi smokers and fourfold (OR = 3.8, 95% CI = 2.62-5.56) among cigarette smokers as compared with nonsmokers.

Effects of frozen storage temperature on the elasticity of tendons from a small murine model

Goh KL, Chen Y, Chou SM, Listrat A, Bechet D, Wess TJ

Animal, 2010 Sep;4(9):1613-7.

PMID: 22444710 DOI: 10.1017/S1751731110000698

The basic mechanism of reinforcement in tendons addresses the transfer of stress, generated by the deforming proteoglycan (PG)-rich matrix, to the collagen fibrils. Regulating this mechanism involves the interactions of PGs on the fibril with those in the surrounding matrix and between PGs on adjacent fibrils. This understanding is key to establishing new insights on the biomechanics of tendon in various research domains. However, the experimental designs in many studies often involved long sample preparation time. To minimise biological degradation the tendons are usually stored by freezing. Here, we have investigated the effects of commonly used frozen storage temperatures on the mechanical properties of tendons from the tail of a murine model (C57BL6 mouse). Fresh (unfrozen) and thawed samples, frozen at temperatures of -20°C and -80°C, respectively, were stretched to rupture. Freezing at -20°C revealed no effect on the maximum stress (σ), stiffness (E), the corresponding strain (ε) at σ and strain energy densities up to ε (u) and from ε until complete rupture (up). On the other hand, freezing at -80°C led to higher σ, E and u; ε and up were unaffected. The results implicate changes in the long-range order of radially packed collagen molecules in fibrils, resulting in fibril rupture at higher stresses, and changes to the composition of extrafibrillar matrix, resulting in an increase in the interaction energy between fibrils via collagen-bound PGs.

24th Seah Cheng Siang Lecture: Seeing better, doing better--evolution and application of gastrointestinal (GI) endoscopy

Goh KL

Ann Acad Med Singap, 2015 Jan;44(1):34-9.

PMID: 25703498

Gastrointestinal (GI) endoscopy has evolved tremendously from the early days when candlelight was used to illuminate scopes to the extent that it has now become an integral part of the practice of modern gastroenterology. The first gastroscope was a rigid scope first introduced by Adolf Kussmaul in 1868. However this scope suffered from the 2 drawbacks of poor illumination and high risk of instrumental perforation. Rudolf Schindler improved on this by inventing the semiflexible gastroscope in 1932. But it was Basil Hirschowitz, using the principle of light conduction in fibreoptics, who allowed us to "see well" for the first time when he invented the flexible gastroscopy in 1958. With amazing speed and innovation, instrument companies, chiefly Japanese, had improved on the Hirschowitz gastroscope and invented a flexible colonoscope. Walter McCune introduced the technique of endoscopic retrograde cholangiopancreatography (ERCP) in 1968 which has now evolved into a sophisticated procedure. The advent of the digital age in the 1980s saw the invention of the videoendoscope. Videoendoscopes have allowed us to start seeing the gastrointestinal tract (GIT) "better" with high magnification and resolution and optical/digital enhancements. Fusing confocal and light microscopy with endoscopy has allowed us to perform an "optical biopsy" of the GI mucosa. Development of endoscopic ultrasonography has allowed us to see "beyond" the GIT lumen. Seeing better has allowed us to do better. Endoscopists have ventured into newer procedures such as the resection of mucosal and submucosal tumours and the field of therapeutic GI endoscopy sees no end in sight.

Stage-directed individualized therapy in esophageal cancer

Goense L, van Rossum PS, Kandioler D, Ruurda JP, Goh KL, Luyer MD, et al.

Ann N Y Acad Sci, 2016 10;1381(1):50-65.

PMID: 27384385 DOI: 10.1111/nyas.13113

Esophageal cancer is the eighth most common cancer worldwide, and the incidence of esophageal carcinoma is rapidly increasing. With the advent of new staging and treatment techniques, esophageal cancer can now be managed through various strategies. A good understanding of the advances and limitations of new staging techniques and how these can guide in individualizing treatment is important to improve outcomes for esophageal cancer patients. This paper outlines the recent progress in staging and treatment of esophageal cancer, with particularly attention to endoscopic techniques for early-stage esophageal cancer, multimodality treatment for locally advanced esophageal cancer, assessment of response to neoadjuvant treatment, and the role of cervical lymph node dissection. Furthermore, advances in robot-assisted surgical techniques and postoperative recovery protocols that may further improve outcomes after esophagectomy are discussed.

Displaying publications 1 - 20 of 333 in total