MyMedR

Fulltext A new paradigm in medicine: genome wide association studies

S, MARAN, LEE, Y. Y., ZILFALIL BA, NOORIZAN AM

Buletin Persatuan Genetik Malaysia, 2011;18(1):3-6.

MyJurnal

Genome Wide Association (GWA) Studies of complex diseases represents a new paradigm in the
post-genomic era. Since then, the eld of human genetics has been revolutionized by the GWA Studies approach (Yang and Hibberd 2009). Adding to this, the completion of human genome sequence had enabled a systemic identi cation of genetic loci that determines
the etiology of complex diseases.

Disruption of the gastroesophageal junction by central obesity and waist belt: role of raised intra-abdominal pressure

Lee YY, McColl KE

Dis Esophagus, 2015 May-Jun;28(4):318-25.

PMID: 24575877 DOI: 10.1111/dote.12202

Obesity is a major reason for the recent increase in incidence of reflux disease and cancers at the distal esophagus and gastroesophageal junction (GOJ) and is mediated through a rise in the intra-abdominal pressure (IAP) but the exact mechanisms are unclear. Raised IAP from obesity and with application of waist belt produces mechanical distortion of the GOJ through formation of partial hiatus hernia. Even though there is no trans-sphincteric acid reflux, there is increased ingress of acid into the lower sphincter (intra-sphincteric reflux) as a consequence of raised IAP. In addition, short segment acid reflux is more evident in obese subjects with a belt on. Acid pocket is also enlarged in hiatus hernia, and acts as a reservoir of acid available to reflux whenever the sphincter fails. Above mechanisms may explain the common occurrence of cardiac lengthening and inflammation found in asymptomatic obese subjects. The inflamed cardia is also immunohistochemically similar to non-intestinal Barrett's mucosa, which is of etiological importance for cancers at the GOJ. Interventions that can reduce the mechanical distortion and acid exposure at the GOJ, including diet, exercise, drugs, sphincter augmentation therapy, and surgery, are clinically relevant in the treatment of gastroesophageal reflux disease but more data are needed whether if these strategies are also effective in preventing cancer. As a conclusion, raised IAP produces silent mechanical disruption of the GOJ, which may explain the high occurrence of cancers in this region and it is potentially reversible with early interventions.

Trio H's (Hyperglycemia, Hypertension, Hyperlipidemia): Undiagnosed Modifiable Risk Factors In Malaysia Rural Community

Lee YY, Lee L, Hong L, Welluppillai V, Kamarudin A

Value Health, 2015 Nov;18(7):A620-1.

PMID: 26533482 DOI: 10.1016/j.jval.2015.09.2172

Addressing unmet needs for patients with previous upper gastrointestinal bleed requiring concomitant aspirin and non-steroidal anti-inflammatory drugs

Jayaraman T, Wong MS, Mustaffa N, Lee YY

J R Coll Physicians Edinb, 2017 12;47(4):356-358.

PMID: 29537408 DOI: 10.4997/JRCPE.2017.411

Burnout in physicians

Lee YY, Medford AR, Halim AS

J R Coll Physicians Edinb, 2015;45(2):104-7.

PMID: 26181523 DOI: 10.4997/JRCPE.2015.203

Increasing numbers of doctors are experiencing burnout now more than ever before and the worrying part is that what we see is just the tip of the iceberg. Burnout, a state of mental exhaustion caused by the doctor's professional life, is characterised by emotional exhaustion, depersonalisation and a reduced sense of accomplishment or success. Burnout has been largely ignored or under-recognised previously. This paper provides a perspective on burnout among doctors, including an overview of symptoms, the scale of the problem, the implications and causes of burnout and, finally, a strategic framework to provide a basis for managing it. Most importantly, professional bodies are urged to start taking steps to help troubled doctors. Medical Colleges should provide essential assistance, support and guidance as well as ensuring fair management and promotion policies.

HLA-B27 polymorphism in the Malays

Dhaliwal JS, Too CL, Lisut M, Lee YY, Murad S

Tissue Antigens, 2003 Oct;62(4):330-2.

PMID: 12974801

The frequency of HLA-B27 and its subtypes was determined in 878 Malay subjects. Thirty-five of the subjects typed for HLA-A, -B and -DR were found to be positive for HLA-B27. The frequency of this allele in the Malay population was found to be 3.99%. The subtypes observed and their frequencies are: HLA-B*2704 (19.4%), HLA-B*2705 (5.6%), HLA-B*2706 (72.2%) and HLA-B*2707 (2.8%).

Fatal anaphylaxis of ranitidine injection : have we not learnt the lesson yet?

Chuah YY, Lee YY, Lin LF, Kuo CJ

Acta Gastroenterol Belg, 2019 10 1;82(3):449-450.

PMID: 31566338

Fulltext Dietary practices among overweight and obese Chinese children in Kota Bharu, Kelantan

Soo KL, Wan AM, Abdul MH, Lee YY

Malays J Nutr, 2011 Apr;17(1):87-95.

PMID: 22135868 MyJurnal

INTRDUCTION: Obesity and chronic diseases have been increasing since the last few decades alongside rapid economic development in developed and developing countries. The alarming increase in the prevalence of childhood obesity had been shown by many epidemiological studies worldwide. The aims of this study were to determine the prevalence of overweight and obesity among Chinese school children in Kota Bharu, Kelantan, and to map the association between dietary practices and their nutritional status.
METHODS: A cross-sectional study was conducted on 278 school children aged 10 to 12 years old (144 boys and 134 girls) studying in a Chinese primary school in Kota Bharu.
RESULTS: The survey revealed that while only 1.4% (n=4) were overweight, 23.4% (n=65) of the children were obese. A total of 67.7% (n=44) of the obese children were boys. The overweight and obese children (n=70) were compared with a randomly selected group of normal weight children (n=70). Dietary assessment showed that protein, fat and total calorie intake were significantly higher among the overweight group (p<0.05). A significantly higher proportion of the normal weight children (85.7%) took breakfast daily or at least 4 days per week compared to the overweight groups (59.4%) (p<0.05).
CONCLUSION: The prevalence of obesity among school children in the study is a matter of concern. These findings may be useful in targeting programmes and strategies for prevention and intervention of childhood obesity.

Fulltext Overweight and obesity among Malay primary school children in Kota Bharu, Kelantan: parental beliefs, attitudes and child feeding practices

Wan AM, Norazawati AK, Lee YY

Malays J Nutr, 2012 Apr;18(1):27-36.

PMID: 23713227 MyJurnal

The increasing prevalence of overweight and obesity among children has become a major public health problem in Malaysia. Parents play an important role in child feeding especially among younger children.

Communication breakdown between physicians and IBS sufferers: what is the conundrum and how to overcome it?

Jayaraman T, Wong RK, Drossman DA, Lee YY

J R Coll Physicians Edinb, 2017 Jun;47(2):138-141.

PMID: 28675183 DOI: 10.4997/JRCPE.2017.206

Irritable bowel syndrome is a disorder of gut-brain interaction that leads to a significant healthcare burden worldwide. A good physician-patient relationship is fundamental in managing patients who suffer from this poorly understood chronic disease. We highlight possible reasons for breakdown in communication between physicians and irritable bowel syndrome sufferers and suggest possible ways to overcome such pitfalls.

Is tenofovir the answer to further preventing mother-to-child transmission of hepatitis B?

Abdul Hafidz MI, Tan SS, Lee YY

J R Coll Physicians Edinb, 2016 12;46(4):248-250.

PMID: 28504780 DOI: 10.4997/JRCPE.2016.409

Sengstaken-Blakemore tube malposition with esophageal rupture

Chuah YY, Lee YY, Chen WC, Kao SS

Acta Gastroenterol Belg, 2018 10 24;81(3):447-448.

PMID: 30350541

Enteropathy-associated T-cell Lymphoma (EATL) with intracranial metastasis : a rare and dismal condition

Chuah YY, Tashi T, Lee YY, Fu TY, Shih CA

Acta Gastroenterol Belg, 2020 4 2;83(1):77-80.

PMID: 32233276

Background: Enteropathy-associated T-cell lymphoma (EATL) is a rare type of gastrointestinal non-Hodgkin's Lymphoma. EATL with intracranial metastasis is even rarer. We report a case of EATL with intracranial metastasis.

Case Presentation: A 36-years old man presented with five weeks history of intractable diarrhea. Colonoscopy was normal, but abdominal computed tomography (CT) scan revealed mural thickening at duodenojejunal junction, and subsequent jejunofiberoscopy showed a circumferential ulceration at the jejunum. Histo-immunopathology confirmed the diagnosis of enteropathyassociated T-cell lymphoma (EATL) type II. His disease course proved to be aggressive and refractory to standard front-line chemotherapy, and eventually progressed through second-line salvage regimen with CNS and intracranial involvement. He died nine months after the initial diagnosis.

Conclusion: EATL with brain metastasis is a very rare occurrence with dismal prognosis.

Fulltext Thrombolytic failure with streptokinase in acute myocardial infarction using electrocardiogram criteria

Lee YY, Tee MH, Zurkurnai Y, Than W, Sapawi M, Suhairi I

Singapore Med J, 2008 Apr;49(4):304-10.

PMID: 18418522

This study was primarily aimed to determine the failure rate of thrombolysis with streptokinase in acute myocardial infarction using electrocardiogram criteria and its association between various independent variables and outcome parameters.

Plant-based milk: unravel the changes of the antioxidant index during processing and storage - a review

Tong SC, Siow LF, Tang TK, Lee YY

Crit Rev Food Sci Nutr, 2024;64(14):4603-4621.

PMID: 36377721 DOI: 10.1080/10408398.2022.2143477

As a nutrient rich emulsion extracted from plant materials, plant-based milk (PBM) has been the latest trend and hot topic in the food industry due to the growing awareness of consumers toward plant-based products in managing the environmental (carbon footprint and land utility), ethical (animal well-fare) and societal (health-conscious) issues. There have been extensive studies and reviews done to discuss the distinct perspective of PBM including its production, health effects and market acceptance. However, not much has been emphasized on the valuable antioxidants present in PBM which is one of the attributes making them stand apart from dairy milk. The amounts of antioxidants in PBM are important. They offered tremendous health benefits in maintaining optimum health and reducing the risk of various health disorders. Therefore, enhancing the extraction of antioxidants and preserving their activity during production and storage is important. However, there is a lack of a comprehensive review of how these antioxidants changes in response to different processing steps involved in PBM production. Presumably, antioxidants in PBM could be potentially lost due to thermal degradation, oxidation or leaching into processing water. Hence, this paper aims to fill the gaps by addressing an extensive review of how different production steps (germination, roasting, soaking, blanching, grinding and filtration, and microbial inactivation) affect the antioxidant content in PBM. In addition, the effect of different microbial inactivation treatments (thermal or non-thermal processing) on the alteration of antioxidant in PBM was also highlighted. This paper can provide useful insight for the industry that aims in selecting suitable processing steps to produce PBM products that carry with them a health declaration.

Possible underestimation of SIBO in IBS patients: is lack of Glucose Breath Test standardization responsible?

Erdogan A, Rao SS, Gulley D, Jacobs C, Lee YY, Badger C

Neurogastroenterol Motil, 2015 Aug;27(8):1192-3.

PMID: 26220649 DOI: 10.1111/nmo.12603

Hospital-acquired Clostridium difficile infection among patients with type 2 diabetes mellitus in acute medical wards

Hassan SA, Rahman RA, Huda N, Wan Bebakar WM, Lee YY

J R Coll Physicians Edinb, 2013;43(2):103-7.

PMID: 23734349 DOI: 10.4997/JRCPE.2013.203

Clostridum difficile (C. difficile) infection is increasingly seen among hospitalised patients with type 2 diabetes mellitus but its rate and associated risk factors are not known. We aimed to determine the rate and characteristics of hospital-acquired C. difficile infection in subjects with type 2 diabetes mellitus admitted into acute medical wards.

HLA polymorphism in three indigenous populations of Sabah and Sarawak

Dhaliwal JS, Shahnaz M, Azrena A, Irda YA, Salawati M, Too CL, et al.

Tissue Antigens, 2010 Feb;75(2):166-9.

PMID: 20196825 DOI: 10.1111/j.1399-0039.2009.01410.x

One hundred and fifty-eight Kadazan, Iban and Bidayuh individuals registered with the Malaysian Marrow Donor Registry were typed for human leukocyte antigen (HLA)-A, HLA-B and HLA-DR. Six, seven and eight HLA-A alleles as well as 13, 15 and 16 HLA-B alleles were detected in the Kadazan, Bidayuh and Iban, respectively. The most common HLA-A allele in all three groups was HLA-A*24 with a frequency of 0.456, 0.490 and 0.422 in the Kadazan, Bidayuh and Iban, respectively. The most common HLA-B allele detected in the Kadazan was HLA-B*40 with a frequency of 0.333; for the Bidayuh and the Iban it was HLA-B*15 with a frequency of 0.460 and 0.275, respectively. The HLA-DR allele with the highest frequency in the Kadazan was HLA-DR*1502 with a frequency of 0.500. In the Iban and the Bidayuh, HLA-DRB1*1202 was the most common DR allele with frequencies of 0.235 and 0.310, respectively. The two most common haplotypes for the Kadazan are A*34-B*38-DR*1502 and A*24-B*40-DR*0405, whereas for the Bidayuh they are A*24-B*15-DR*1602 and A*24-B*35-DR*1202 and for the Iban they are A*34-*B15-DR*1502 and A*24-B*15-DR*1202.

Further observations in an area with an exceptionally low prevalence of Helicobacter pylori infection

Raj SM, Lee YY, Choo KE, Noorizan AM, Zulkifli A, Radzi M, et al.

Trans R Soc Trop Med Hyg, 2008 Nov;102(11):1163-4.

PMID: 18678380 DOI: 10.1016/j.trstmh.2008.06.015

HLA-A, -B and -DR allele and haplotype frequencies in Malays

Dhaliwal JS, Shahnaz M, Too CL, Azrena A, Maiselamah L, Lee YY, et al.

Asian Pac J Allergy Immunol, 2007 Mar;25(1):47-51.

PMID: 17891921

One thousand four hundreds and forty-five Malays registered with the Malaysian Marrow Donor Registry were typed for HLA-A, HLA-B and HLA-DR. Fifteen HLA-A, twenty nine HLA-B and fourteen HLA-DR alleles were detected. The most common HLA-A alleles and their frequencies were HLA-A24 (0.35), HLA-A11 (0.21) and HLA-A2 (0.15). The most common HLA-B alleles were HLA-B15 (0.26), HLA-B35 (0.11) and HLA-B18 (0.10) while the most common HLA-DR alleles were HLA-DR15 (0.28), HLA-DR12 (0.27) and HLA-DR7 (0.10). A24-B15-DR12 (0.047), A24-B15-DR15 (0.03) and the A24-B35-DR12 (0.03) were the most frequent haplotypes. This data may be useful in determining the probability of finding a matched donor and for estimating the incidence of HLA associated diseases.

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