Displaying publications 1 - 20 of 40 in total

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  1. Goh KL, Yoon BK
    J Dig Dis, 2012 Aug;13(8):389-92.
    PMID: 22788923 DOI: 10.1111/j.1751-2980.2012.00609.x
    Pancreatic cancer is notoriously difficult to diagnose until a late stage when curative options are no longer available. Owing to its relatively low incidence and the lack of sensitivity of current diagnostic tool, screening of pancreatic cancer in the general population is not recommended. However, in high-risk individuals, especially those with well-described genetic syndromes and a strong family history of pancreatic cancer, screening can be carried out. Detection of a lesion of the diameter 
  2. Goh K, Xiao SD
    J Dig Dis, 2009 Feb;10(1):1-6.
    PMID: 19236540 DOI: 10.1111/j.1751-2980.2008.00355.x
    Inflammatory bowel disease (IBD) has long been considered a disease that affects predominantly a Western population. The incidence and prevalence rates from Asian populations are much lower in comparison. More recent data, however, have shown significantly higher rates in Asians and time trend studies have shown an increase in the incidence of ulcerative colitis (UC) and a similar but lower rise in Crohn's disease (CD). The epidemiological changes that are taking place mirror that of the Western experience seen 50 years previously and seem to occur in parallel with the rapid socioeconomic development taking place in Asia. It appears that certain racial groups are more prone than others to develop IBD. For instance, Indians in South-East Asia have higher rates compared to Chinese and Malays. While there is host genetic predisposition, environmental factor(s) may be responsible for this difference. Migrant studies of South Asians in the UK, where second-generation immigrants have assumed incidence rates as high as the indigenous whites and Asian Jews who develop high incidence rates comparable to Jews from Europe or North America in Israel point to the role of environmental factors. It is unclear which specific factors are responsible. Studies have suggested a change in diet to a more Westernized one may underlie this epidemiological change in the Asian population. It is likely that there are racial groups amongst Asians who are more susceptible to IBD and who will demonstrate a higher frequency of IBD when exposed to putative environmental factors.
  3. Goh KL, Cheah PL, Navaratnam P, Chin SC, Xiao SD
    J Dig Dis, 2007 Aug;8(3):139-42.
    PMID: 17650225
    The gastric biopsy urease test is an accurate and robust diagnostic test for Helicobacter pylori infection. Large endoscopy units use their own homemade unbuffered ultra-rapid urease test for diagnosis of H. pylori infection but several commercial rapid urease tests are available.
  4. Tan HJ
    J Dig Dis, 2010 Dec;11(6):334-42.
    PMID: 21091895 DOI: 10.1111/j.1751-2980.2010.00466.x
    A proton pump inhibitor (PPI) is often co-prescribed with clopidogrel to reduce the gastrointestinal risk of bleeding ulcers in patients following acute coronary syndrome or a stent implant. However, the safety issue of such practice has been scrutinized after some studies reporting an increased incidence of cardiovascular events and mortality, although there have also been contrary research reports. This has lead to a warning statement from the US Food and Drug Administration cautioning the concomitant use of PPI and clopidogrel. This review examines the evidence of PPI as gastroprotective agent, histamine H(2) antagonists as an alternative therapy, the influence of PPI on the antiplatelet effect of clopidogrel, and the controversies of various studies.
  5. Tan HJ, Mahadeva S, Menon J, Ng WK, Zainal Abidin I, Chan FK, et al.
    J Dig Dis, 2013 Jan;14(1):1-10.
    PMID: 23134105 DOI: 10.1111/1751-2980.12000
    The working party statements aim to provide evidence and guidelines to practising doctors on the use of antiplatelet therapy and proton pump inhibitors (PPIs) in patients with cardiovascular risk as well as those at risk of gastrointestinal (GI) bleeding. Balancing the GI and cardiovascular risk and benefits of antiplatelet therapy and PPIs may sometimes pose a significant challenge to doctors. Concomitant use of anti-secretory medications has been shown to reduce the risk of GI bleeding but concerns have been raised on the potential interaction of PPIs and clopidogrel. Many new data have emerged on this topic but some can be confusing and at times controversial. These statements examined the supporting evidence in four main areas: rationale for antiplatelet therapy, risk factors of GI bleeding, PPI-clopidogrel interactions and timing for recommencing antiplatelet therapy after GI bleeding, and made appropriate recommendations.
  6. Leow HR, Ching SM, Sujarita R, Yap CF, Chia YC, Ho SH, et al.
    J Dig Dis, 2014 Nov;15(11):591-6.
    PMID: 25139629 DOI: 10.1111/1751-2980.12183
    OBJECTIVE:
    To develop and validate a Mandarin version of the Leeds Dyspepsia Questionnaire (M-LDQ) in Asian patients with dyspepsia.

    METHODS:
    The M-LDQ was developed according to standardized methods. The validity, internal consistency, test-retest reliability and responsiveness of the instrument were evaluated in both primary and secondary care patients.

    RESULTS:
    A total of 184 patients (mean age 54.0 ± 15.8 years, of whom 59% were women and 72.3% of whom had at least secondary level education) were recruited between August 2012 and March 2013, from both primary (n = 100) and secondary care clinics (n = 84). Both the internal consistency of all components of the M-LDQ (Cronbach's α 0.79) and test-retest reliability (Spearman's correlation coefficient 0.78) were good. The M-LDQ was valid in diagnosing dyspepsia in primary care (area under the receiver operating characteristics curve 0.84) and was able to discriminate between secondary and primary care patients (median cumulative LDQ score 13.0 vs 3.0, P < 0.0001). Among eight patients with organic dyspepsia, the median M-LDQ score reduced significantly from 21.0 (pretreatment) to 9.5 (4 weeks post-treatment) (P < 0.0001).

    CONCLUSION:
    The M-LDQ is a valid and responsive instrument for assessing ethnic Chinese adults with dyspepsia.

    KEYWORDS:
    Mandarin; ethnic Chinese; functional dyspepsia; outcome measure; questionnaire; validation
  7. Chan WK, Roslani AC, Law CW, Goh KL, Mahadeva S
    J Dig Dis, 2013 Dec;14(12):670-5.
    PMID: 23981291 DOI: 10.1111/1751-2980.12097
    To compare the outcomes and costs of endoluminal clipping and surgery in the management of iatrogenic colonic perforation.
  8. Koh PS, Yoong BK, Vijayananthan A, Nawawi O, Mahadeva S
    J Dig Dis, 2013 Aug;14(8):451-4.
    PMID: 23324023 DOI: 10.1111/1751-2980.12036
    Hemobilia with jaundice as a result of cholestasis and bleeding from choledochal cyst is uncommon. Ascertaining the diagnosis is often challenging and delayed diagnosis can lead to significant consequences due to hemodynamic instability, particularly in elderly patients. Although surgery remains the definitive treatment modality, interventional radiology for hemostasis has been increasingly recognized as an option. In this manuscript, we described two Malaysian cases of jaundice and hemobilia associated with choledochal cysts and the challenges related with clinical diagnosis and management.
  9. Chuah KH, Beh KH, Mahamad Rappek NA, Mahadeva S
    J Dig Dis, 2021 Mar;22(3):159-166.
    PMID: 33595169 DOI: 10.1111/1751-2980.12975
    OBJECTIVE: To explore the differences in frequency and epidemiology of functional gastrointestinal disorders (FGIDs) in a primary care setting, and to examine the health-related quality of life (HRQOL) and healthcare utilization of FGID patients based on the Rome III and Rome IV criteria.

    METHODS: A cross-sectional study of consecutive adults in a primary healthcare setting was conducted. Differences in epidemiology, and HRQOL of common FGIDs (functional dyspepsia [FD], irritable bowel syndrome [IBS], functional diarrhea, functional constipation [FC]) between the Rome III and IV criteria were explored.

    RESULTS: Among a total of 1002 subjects recruited, the frequency of common FGIDs was 20.7% and 20.9% among subjects based on the Rome III and Rome IV criteria, respectively. The frequency of IBS reduced from 4.0% (Rome III) to 0.8% (Rome IV), while that of functional diarrhea increased from 1.2% (Rome III) to 3.3% (Rome IV). In contrast, there was no significant change in the frequency of FD (7.5% [Rome III] vs 7.6% [Rome IV]) and FC (10.5% [Rome III] vs 11.7% [Rome IV]). Most of the Rome III IBS subjects (52.5%, n = 21) who did not meet Rome IV IBS criteria, fulfilled the criteria for FC, functional diarrhea, FD, or overlap syndrome. Subjects with all FGIDs, regardless of criteria, had more healthcare utilization and lower HRQOL compared to non-FGID controls.

    CONCLUSIONS: The Rome IV criteria alter the frequency of IBS and functional diarrhea, but not FD and FC, when compared to the Rome III criteria. Regardless of criteria, FGIDs had a significant impact on healthcare burden and HRQOL.

  10. Lee HL, Chua SS, Mahadeva S
    J Dig Dis, 2018 Jun;19(6):342-349.
    PMID: 29732728 DOI: 10.1111/1751-2980.12607
    OBJECTIVE: To evaluate regular non-steroidal anti-inflammatory drug (NSAID) users for dyspepsia, as well as to assess the effect of preventive measures, and the reasons for non-adherence to gastroprotective agents (GPA) from a real-world perspective.
    METHODS: A prospective longitudinal study was conducted among outpatients with regular NSAID usage. The presence of dyspepsia was assessed by locally validated versions of the Leeds dyspepsia questionnaire (LDQ), GPA and the participants' adherence to the drugs were assessed at recruitment and 2 weeks later. GPA was defined as the use of antisecretory medications or cyclooxygenase-2 inhibitors.
    RESULTS: Initially, 409 participants (mean age 52.3 ± 14.6 years, 60.6% females, 48.4% treated for musculoskeletal pain) were recruited. At recruitment, 50.9% of the participants had at least one upper gastrointestinal symptom. Complete data for follow-up analysis were collected from 158 participants who were naive NSAID users, had no prior gastrointestinal medication and who could be contacted. At 2-week follow-up there was no significant difference in the LDQ score change between NSAID users treated with GPA and those did not. However, there was a greater reduction in abdominal pain/discomfort (8.8% vs 5.0%, P 
  11. Chuah KH, Cheong SY, Lim SZ, Mahadeva S
    J Dig Dis, 2022 Jan 20.
    PMID: 35050547 DOI: 10.1111/1751-2980.13082
    OBJECTIVE: Functional gastrointestinal disorders (FGIDs) are known to have a significant impact on patients' quality of life and lead to a greater healthcare burden. In this study we aimed to investigate whether this healthcare burden differs among various types of FGIDs in secondary care.

    METHODS: A retrospective study of consecutive adults with luminal gastrointestinal (GI) diseases in a secondary healthcare gastroenterology clinic was conducted. The frequency of FGIDs and differences in healthcare utilization among different types of FGIDs were explored.

    RESULTS: Among 1206 patients with luminal GI disease, 442 (36.7%) had FGIDs. FGIDs patients were older (67 y vs 62 y, P 

  12. Chuah KH, Hian WX, Lim SZ, Beh KH, Mahadeva S
    J Dig Dis, 2023 Mar;24(3):194-202.
    PMID: 37200005 DOI: 10.1111/1751-2980.13189
    OBJECTIVE: To explore the factors associated with small intestinal bacterial overgrowth (SIBO), and to further evaluate the impact of SIBO on irritable bowel syndrome (IBS) in terms of symptom severity and health-related quality of life (HRQoL).

    METHODS: A cross-sectional study of consecutive adult patients who underwent glucose hydrogen breath test was conducted. Factors associated with SIBO were evaluated. Symptom severity and HRQoL of IBS patients with and without SIBO were compared. The independent factors associated with severe IBS were explored.

    RESULTS: A total of 160 patients were included (median age 40 years, males 31.3%). IBS was present among 53.8% of subjects, with 33.8% having diarrhea-predominant IBS (IBS-D). SIBO was diagnosed in 22.5% of the study population. Patients with SIBO were more commonly diagnosed with IBS-D than those without (50.0% vs 29.0%, P = 0.019). Severe IBS was associated with SIBO (36.4% vs 15.6%, P = 0.043). SIBO was associated with poorer HRQoL (Euroqol five-dimensional utility score: 0.73 vs 0.80, P = 0.024). SIBO (44.4% vs 20.6%, P = 0.043), anxiety (77.8% vs. 39.7%, P = 0.004), and depression (50.0% vs 19.1%, P = 0.011) were associated with severe IBS in the univariate analysis. However, SIBO was the only independent factor associated with severe IBS in the multivariate analysis (adjusted odds ratio 3.83, 95% confidence interval CI 1.02-14.34, P = 0.046).

    CONCLUSIONS: There was a significant association between IBS-D and SIBO. The coexistence of SIBO had a significant negative impact on IBS patients.

  13. Cheah PL, Koh CC, Khang TF, Goh KL, Lau PC, Chin KF, et al.
    J Dig Dis, 2018 May;19(5):272-278.
    PMID: 29722130 DOI: 10.1111/1751-2980.12605
    OBJECTIVE: With an age-standardized incidence rate of 2 per 100 000, esophageal cancer is not common among Malaysians, but they are nevertheless important due to its poor prognosis. The study is to clarify whether the human papillomavirus (HPV) is associated with esophageal cancer in Malaysians as there has been no report to date on this in Malaysians and other South East Asians.

    METHODS: Altogether 67 esophageal squamous cell carcinomas histologically diagnosed between 1 January 2004 and 31 December 2014 at the Department of Pathology, University of Malaya Medical Center, Malaysia were considered for HPV analysis using two commercially available methods, polymerase chain reaction with flow-through hybridization (21 HPV GenoArray Diagnostic Kit) and multiplex real-time polymerase chain reaction (Anyplex II HPV28 Detection). The DNA amplifiability of the formalin-fixed, paraffin-embedded tumor was checked by amplification of a 268 bp segment of the human β-globin gene (GH20/PC04) prior to HPV detection.

    RESULTS: HPV detection was finally carried out in 51 patients. HPV16 was detected in the moderately differentiated, stage IV lower esophageal tumor of a 32-year-old Malaysian-born Chinese woman by both methods. Except for a predilection for Indians, the clinical characteristics of esophageal squamous cell carcinomas in this Malaysian cohort were generally similar to those of other populations.

    CONCLUSION: It appears that HPV is rare and an unlikely oncovirus in esophageal squamous cell carcinomas of Malaysians.

  14. Chua KH, Lian LH, Khor WC, Lee WS, Hilmi I, Goh KL, et al.
    J Dig Dis, 2015 Apr;16(4):205-16.
    PMID: 25564941 DOI: 10.1111/1751-2980.12229
    The study aimed to investigate the association between the interferon regulatory factor 5 (IRF5) gene polymorphisms and the onset of Crohn's disease (CD) in a Malaysian cohort.
  15. Maran S, Lee YY, Xu SH, Raj MS, Abdul Majid N, Choo KE, et al.
    J Dig Dis, 2013 Apr;14(4):196-202.
    PMID: 23241512 DOI: 10.1111/1751-2980.12023
    To identify gene polymorphisms that differ between Malays, Han Chinese and South Indians, and to identify candidate genes for the investigation of their role in protecting Malays from Helicobacter pylori (H. pylori) infection.
  16. Chan WK, Ida NH, Cheah PL, Goh KL
    J Dig Dis, 2014 Oct;15(10):545-52.
    PMID: 25060399 DOI: 10.1111/1751-2980.12175
    To perform a follow-up study on non-alcoholic fatty liver disease (NAFLD) patients in our previous study using paired liver biopsy.
  17. Hartono JL, Mahadeva S, Goh KL
    J Dig Dis, 2012 May;13(5):252-7.
    PMID: 22500787 DOI: 10.1111/j.1751-2980.2012.00581.x
    To examine the differences in the prevalence and severity of anxiety and depression in patients with functional dyspepsia (FD), nonerosive reflux disease (NERD), irritable bowel syndrome (IBS) and healthy controls.
  18. Chua KH, Hilmi I, Lian LH, Patmanathan SN, Hoe SZ, Lee WS, et al.
    J Dig Dis, 2012 Sep;13(9):459-65.
    PMID: 22908971 DOI: 10.1111/j.1751-2980.2012.00617.x
    This study was aimed to investigate the possible association of Crohn's disease (CD) with inflammatory bowel disease gene 5 (IBD5) IGR2198a_1 (rs11739135), IGR2096a_1 (rs12521868) and interleukin-23 receptor (IL23R) genetic variant (rs1004819) in the Malaysian population.
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