MyMedR

Fulltext Risk factors of nonalcoholic fatty liver disease in lean body mass population: A systematic review and meta-analysis

Alam S, Eslam M, Skm Hasan N, Anam K, Chowdhury MAB, Khan MAS, et al.

JGH Open, 2021 Nov;5(11):1236-1249.

PMID: 34816009 DOI: 10.1002/jgh3.12658

The pathophysiology and risk factors of nonalcoholic fatty liver disease (NAFLD) among lean patients is poorly understood and therefore investigated. We performed a meta-analysis of observational studies. Of 1175 articles found through searching from Medline/PubMed, Banglajol, and Google Scholar by two independent investigators, 22 were selected. Data from lean (n = 6768) and obese (n = 9253) patients with NAFLD were analyzed; lean (n = 43 398) and obese (n = 9619) subjects without NAFLD served as controls. Age, body mass index, waist circumference, systolic blood pressure, and diastolic blood pressure (DBP) had significantly higher estimates in lean NAFLD patients than in lean non-NAFLD controls. Fasting blood sugar [MD(mean difference) 5.17 mg/dl, 95% CI(confidence interval) 4.14-6.16], HbA1c [MD 0.29%, 95% CI 0.11-0.48], and insulin resistance [HOMA-IR] [MD 0.49 U, 95% CI 0.29-0.68]) were higher in lean NAFLD patients than in lean non-NAFLD controls. All components of the lipid profile were raised significantly in the former group except high-density lipoprotein. An increased uric acid (UA) level was found to be associated with the presence of NAFLD among lean. Cardio-metabolic profiles of nonlean NAFLD patients significantly differs from the counter group. However, the magnitude of the difference of lipid and glycemic profile barely reached statistical significance when subjects were grouped according to lean and nonlean NAFLD. But DBP (slope: 0.19, P

Fulltext The challenges of implementing evidence-based therapy for irritable bowel syndrome in Asia

Chuah KH, Mahadeva S

JGH Open, 2021 Nov;5(11):1225-1226.

PMID: 34816007 DOI: 10.1002/jgh3.12665

Fulltext Endoscopic ultrasound-guided hepaticogastrostomy using a partially covered metal stent in patients with malignant biliary obstruction after failed Endoscopic retrograde cholangiopancreatography

Emmanuel J, Omar H, See LT

JGH Open, 2020 Dec;4(6):1059-1064.

PMID: 33319037 DOI: 10.1002/jgh3.12386

BACKGROUND AND AIM: The advent of endoscopic ultrasound-guided biliary drainage (EUS-BD) has provided an inimitable alternative for gaining biliary access in patients who fail conventional endoscopic drainage. The antimigratory features of the partially covered metal stent (PCMS), namely, the flange head and uncovered portion of the stent, makes it a valuable option in patients undergoing EUS-guided hepaticogastrostomy (EUS-HGS). The aim of the study is to evaluate the clinical outcome of EUS-BD via the hepaticogastrostomy approach using PCMS in patients with malignant biliary obstruction after failed ERCP.

METHODS: This is a single-center retrospective observational study of patients with malignant biliary obstruction undergoing EUS-HGS after failed ERCP between January 2018 and May 2019. The end-point of the study was to assess the technical and clinical success rate, as well as the stent- and procedure-related complications.

RESULTS: There were 20 subjects in this study. The average age was 71.8 ± 7.6 years. Most patients were male, 16 (80%). Inaccessible papillae was the most common indication for this procedure, 16 (80%). Technical success was achieved in all patients. The average procedural time was 39.9 ± 1.3 min. Mean preprocedural bilirubin levels were 348.6 ± 28.8 and subsequently decreased to 108.94 ± 37.1 μmol/L at 2 weeks postprocedure. The clinical success rate was 95% (19/20), with one patient requiring percutaneous transhepatic biliary drainage (PTBD). There were no stent- or procedure-related complications reported in this study.

CONCLUSION: EUS-HGS with PCMS is a feasible, effective, and safe alternative for biliary decompression in patients with failed endoscopic retrograde cholangiopancreatography (ERCP).

Editor's note

Goh KL

JGH Open, 2018 Dec;2(6):248.

PMID: 30619932 DOI: 10.1002/jgh3.12127

Editor's note

Goh KL

JGH Open, 2019 Aug;3(4):273.

PMID: 31406917 DOI: 10.1002/jgh3.12237

Fulltext History and development of gastroenterology in the Asia Pacific region with particular reference to the role of the Journal of Gastroenterology and Hepatology and the Journal of Gastroenterology and Hepatology Foundation

Goh KL

JGH Open, 2020 Dec;4(6):1027-1030.

PMID: 33319033 DOI: 10.1002/jgh3.12340

Editor's note

Goh KL

JGH Open, 2019 Apr;3(2):99.

PMID: 31061882 DOI: 10.1002/jgh3.12188

Fulltext JGH Open: 3 years on and growing stronger!

Goh KL

JGH Open, 2021 Jan;5(1):3.

PMID: 33490607 DOI: 10.1002/jgh3.12476

Consensus statements and recommendations on the management of mild-to-moderate gastroesophageal reflux disease in the Southeast Asian region

Goh KL, Lee YY, Leelakusolvong S, Makmun D, Maneerattanaporn M, Quach DT, et al.

JGH Open, 2021 Aug;5(8):855-863.

PMID: 34386592 DOI: 10.1002/jgh3.12602

This paper reports the proceedings from the first consensus meeting on the management of mild-to-moderate gastroesophageal reflux disease (GERD) in the Southeast Asian (SEA) region. Seventeen statements were drawn up by a steering committee that focused on epidemiology, mechanism of action, diagnostic investigations, and treatment. Voting on the recommendations used the Delphi method with two rounds of voting among the 10 panel members. The consensus panel agreed that GERD is mostly a mild disease in the SEA region with predominantly non-erosive reflux disease (NERD). Complicated GERD and Barrett's esophagus are infrequently seen. The panel recommended endoscopy in patients with alarm or refractory symptoms but cautioned that the incidence of gastric cancer is higher in SEA. pH and impedance measurements were not recommended for routine assessment. The acid pocket is recognized as an important pathogenic factor in GERD. Lifestyle measures such as weight reduction, avoidance of smoking, reduction of alcohol intake, and elevation of the head of the bed were recommended but strict avoidance of specific foods or drinks was not. Alginates was recommended as the first-line treatment for patients with mild-to-moderate GERD while recognizing that proton-pump inhibitors (PPIs) remained the mainstay of treatment of GERD. The use of alginates was also recommended as adjunctive therapy when GERD symptoms were only partially responsive to PPIs.

Ulcerative colltis in the older patient- a treatment conundrum

Goh KL

JGH Open, 2021 Aug;5(8):841.

PMID: 34386589 DOI: 10.1002/jgh3.12620

Editorial

Goh KL

JGH Open, 2017 Nov;1(3):81.

PMID: 30483540 DOI: 10.1002/jgh3.12030

Editor's note

Goh KL

JGH Open, 2018 Apr;2(2):33.

PMID: 30483560 DOI: 10.1002/jgh3.12050