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  1. Laidin AZ, Proehoeman R, Mohd Nor M
    Med J Malaysia, 1982 Dec;37(4):349-53.
    PMID: 7167088
    Sixty seven infants were admitted over a 10-year period from 1972 to 1981: 50 males and 17 females. A higher incidence of hypertrophic pyloric stenosis exists in West Malaysia than was previously recognised. However, it remains at less than one tenth of the Western figures. Among the three major races, the condition was commonest in Indians and least in Malays. Most cases presented between the ages of 3 to 8 weeks. Prolonged history of vomiting of more than 3 weeks occurred in 43.3 percent cases, usually among Malay and Indian patients. All patients were treated surgically with 1 death (1.5 percent). The usual postoperative complication was vomiting which occurred in 22.4 percent. Early presentation, adequate preoperative resuscitation and improved anaesthetic techniques can further reduce this mortality and morbidity.
    Matched MeSH terms: Peristalsis
  2. Shanmuganathan G, Ritz MA, Holloway RH, Di Matteo AC, Omari TI
    J Gastroenterol Hepatol, 2000 Dec;15(12):1362-9.
    PMID: 11197044
    BACKGROUND AND AIMS: Perfused miniature manometric assemblies with lumina of 0.4-0.5 mm i.d. have been developed. Reduced luminal size offers the advantages of reduced assembly bulk and increased assembly complexity with greater numbers of lumina and lower manometric infusion volumes because of a slower perfusion rate. This study investigated the recording fidelity of miniature manometric assemblies in the measurement of esophageal peristalsis.

    METHODS: Four miniature manometric assemblies, each containing manometric lumina of either 0.4 or 0.5 mm i.d., were evaluated at 100 and 180 cm lengths. The fidelity of miniature manometric luminal recordings were evaluated in vivo during esophageal peristalsis by using a simultaneous comparison with the standard lumina and an intraluminal strain gauge.

    RESULTS: During esophageal peristalsis, miniature manometric lumina recorded the peak amplitude of pressure waves, with an accuracy at perfusion rates of 0.04 mL/min (0.4 mm, i.d.) and 0.15 mL/min (0.5 mm, i.d.).

    CONCLUSION: Miniature manometric assemblies of lengths that are practical for use in humans are suitable for recording esophageal peristalsis.

    Matched MeSH terms: Peristalsis/physiology*
  3. Hayat T, Abbasi F, Ahmad B, Alsaedi A
    Sains Malaysiana, 2014;43:1583-1590.
    This article concerns with a mixed convection peristaltic flow of an electrically conducting fluid in an inclined asymmetric channel. Analysis has been carried out in the presence of Joule heating. The fluid viscosity and thermal conductivity are assumed to vary as a linear function of temperature. A nonlinear coupled governing system is computed. Numerical results were presented for the velocity, pressure gradient, temperature and streamlines. Heat transfer rate at the wall is computed and analyzed. Graphs reflecting the contributions of embedded parameters were discussed.
    Matched MeSH terms: Peristalsis
  4. Mehmood OU, Norzie Mustapha, Sharidan Shafie, Hayat T
    Sains Malaysiana, 2014;43:1109-1118.
    This research looks at the effects of partial slip on heat and mass transfer of peristaltic transport. The magnetohydrodynamic (MHD) flow of viscous fluid in a porous asymmetric channel has been considered. The exact solutions for the stream function, longitudinal pressure gradient, longitudinal velocity, shear stress, temperature and concentration fields are derived by adopting long wavelength and small Reynolds number approximations. The results showed that peristaltic pumping and trapping are reduced with increasing velocity slip parameter. Furthermore, temperature increases with increasing thermal slip parameter. Moreover, the concentration profile decreases with increasing porosity parameter, Schmidt number and concentration slip parameter. Comparisons with published results are found to be in good agreement.
    Matched MeSH terms: Peristalsis
  5. Gundamaraju R, Vemuri R
    Euroasian J Hepatogastroenterol, 2014 Jan-Jun;4(1):51-54.
    PMID: 29264319 DOI: 10.5005/jp-journals-10018-1096
    Greedy colon which is a synonym of constipation is a serious condition in the human body which may lead to complications, like damage of the rectal tissue, cellular dehydration and colorectal cancer. Diabetes mellitus, although a systemic disease with diverse clinical symptoms, is also related with cellular dehydration. Understanding the pathophysiological aspects of diabetes mellitus and greedy colon may shed light in the management of either of these conditions. The main purpose of this article is to demonstrate an association of tissue dehydration during diabetes mellitus and constipation. The adverse side effects of atropine will be discussed due to its M3 blockage effect and reduction in peristalsis keeping in mind the importance of these facts in the context of public health importance, especially in geriatric health. How to cite this article: Gundamaraju R, Vemuri R. Pathophysiology of Greedy Colon and Diabetes: Role of Atropine in worsening of Diabetes. Euroasian J Hepato-Gastroenterol 2014;4(1):51-54.
    Matched MeSH terms: Peristalsis
  6. Raja J, Ng CT, Sujau I, Chin KF, Sockalingam S
    Clin Exp Rheumatol, 2016 Sep-Oct;34 Suppl 100(5):115-121.
    PMID: 26843456
    OBJECTIVES: To evaluate the associations between objectively measured gastroesophageal involvement using high-resolution manometry and 24- hour impedance-pH study, and clinical presentations in systemic sclerosis (SSc) patients.
    METHODS: This cross-sectional study was conducted in University of Malaya Medical Centre (UMMC) with 31 consecutive SSc patients recruited into this study. Clinical symptoms of gastroesophageal involvement, high-resolution impedance-manometry and 24-hour impedance-pH monitoring were assessed. Their associations with serological features and other organ involvement were evaluated.
    RESULTS: Twenty-five (80.6%) patients had gastroesophageal reflux disease (GORD) symptoms, mainly heartburn (45.1%), regurgitation (32.2%) and dysphagia (29%). Using manometry, oesophageal dysmotility was detected in 24 (88.9%) patients, while hypotensive lower oesophageal sphincter (LOS) was observed in 17 (63%) patients. 21 (84%) patients had GORD based on pH study. Hypotensive LOS was significantly associated with presence of digital ulcers. The main gastroesophageal symptoms were absent in majority of the SSc patients including in those with severe gastroesophageal manifestations demonstrating failed peristalsis >75%, hypotensive LOS, Demeester score >200 and acid reflux >200 per day. Demeester score >200 is associated with severity of GORD symptoms. Demeester score >200 was also associated with restrictive lung pattern (p=0.001). Significant association between GORD severity (daily number of acid reflux episodes >200) and pulmonary fibrosis was seen (p=0.030).
    CONCLUSIONS: The presence and severity of gastroesophageal symptoms may not accurately reflect the seriousness of oesophageal involvement. GORD severity is associated with presence of restrictive lung pattern and pulmonary fibrosis. Oesophageal manometry and 24-hour pH study should be considered more frequently in the assessment of SSc patients.
    Matched MeSH terms: Peristalsis
  7. Lai NM, Ahmad Kamar A, Choo YM, Kong JY, Ngim CF
    Cochrane Database Syst Rev, 2017 Aug 01;8(8):CD011891.
    PMID: 28762235 DOI: 10.1002/14651858.CD011891.pub2
    BACKGROUND: Neonatal hyperbilirubinaemia is a common problem which carries a risk of neurotoxicity. Certain infants who have hyperbilirubinaemia develop bilirubin encephalopathy and kernicterus which may lead to long-term disability. Phototherapy is currently the mainstay of treatment for neonatal hyperbilirubinaemia. Among the adjunctive measures to compliment the effects of phototherapy, fluid supplementation has been proposed to reduce serum bilirubin levels. The mechanism of action proposed includes direct dilutional effects of intravenous (IV) fluids, or enhancement of peristalsis to reduce enterohepatic circulation by oral fluid supplementation.

    OBJECTIVES: To assess the risks and benefits of fluid supplementation compared to standard fluid management in term and preterm newborn infants with unconjugated hyperbilirubinaemia who require phototherapy.

    SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 5), MEDLINE via PubMed (1966 to 7 June 2017), Embase (1980 to 7 June 2017), and CINAHL (1982 to 7 June 2017). We also searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials.

    SELECTION CRITERIA: We included randomised controlled trials that compared fluid supplementation against no fluid supplementation, or one form of fluid supplementation against another.

    DATA COLLECTION AND ANALYSIS: We extracted data using the standard methods of the Cochrane Neonatal Review Group using the Covidence platform. Two review authors independently assessed the eligibility and risk of bias of the retrieved records. We expressed our results using mean difference (MD), risk difference (RD), and risk ratio (RR) with 95% confidence intervals (CIs).

    MAIN RESULTS: Out of 1449 articles screened, seven studies were included. Three articles were awaiting classification, among them, two completed trials identified from the trial registry appeared to be unpublished so far.There were two major comparisons: IV fluid supplementation versus no fluid supplementation (six studies) and IV fluid supplementation versus oral fluid supplementation (one study). A total of 494 term, healthy newborn infants with unconjugated hyperbilirubinaemia were evaluated. All studies were at high risk of bias for blinding of care personnel, five studies had unclear risk of bias for blinding of outcome assessors, and most studies had unclear risk of bias in allocation concealment. There was low- to moderate-quality evidence for all major outcomes.In the comparison between IV fluid supplementation and no supplementation, no infant in either group developed bilirubin encephalopathy in the one study that reported this outcome. Serum bilirubin was lower at four hours postintervention for infants who received IV fluid supplementation (MD -34.00 μmol/L (-1.99 mg/dL), 95% CI -52.29 (3.06) to -15.71 (0.92); participants = 67, study = 1) (low quality of evidence, downgraded one level for indirectness and one level for suspected publication bias). Beyond eight hours postintervention, serum bilirubin was similar between the two groups. Duration of phototherapy was significantly shorter for fluid-supplemented infants, but the estimate was affected by heterogeneity which was not clearly explained (MD -10.70 hours, 95% CI -15.55 to -5.85; participants = 218; studies = 3; I² = 67%). Fluid-supplemented infants were less likely to require exchange transfusion (RR 0.39, 95% CI 0.21 to 0.71; RD -0.01, 95% CI -0.04 to 0.02; participants = 462; studies = 6; I² = 72%) (low quality of evidence, downgraded one level due to inconsistency, and another level due to suspected publication bias), and the estimate was similarly affected by unexplained heterogeneity. The frequencies of breastfeeding were similar between the fluid-supplemented and non-supplemented infants in days one to three based on one study (estimate on day three: MD 0.90 feeds, 95% CI -0.40 to 2.20; participants = 60) (moderate quality of evidence, downgraded one level for imprecision).One study contributed to all outcome data in the comparison of IV versus oral fluid supplementation. In this comparison, no infant in either group developed abnormal neurological signs. Serum bilirubin, as well as the rate of change of serum bilirubin, were similar between the two groups at four hours after phototherapy (serum bilirubin: MD 11.00 μmol/L (0.64 mg/dL), 95% CI -21.58 (-1.26) to 43.58 (2.55); rate of change of serum bilirubin: MD 0.80 μmol/L/hour (0.05 mg/dL/hour), 95% CI -2.55 (-0.15) to 4.15 (0.24); participants = 54 in both outcomes) (moderate quality of evidence for both outcomes, downgraded one level for indirectness). The number of infants who required exchange transfusion was similar between the two groups (RR 1.60, 95% CI 0.60 to 4.27; RD 0.11, 95% CI -0.12 to 0.34; participants = 54). No infant in either group developed adverse effects including vomiting or abdominal distension.

    AUTHORS' CONCLUSIONS: There is no evidence that IV fluid supplementation affects important clinical outcomes such as bilirubin encephalopathy, kernicterus, or cerebral palsy in healthy, term newborn infants with unconjugated hyperbilirubinaemia requiring phototherapy. In this review, no infant developed these bilirubin-associated clinical complications. Low- to moderate-quality evidence shows that there are differences in total serum bilirubin levels between fluid-supplemented and control groups at some time points but not at others, the clinical significance of which is uncertain. There is no evidence of a difference between the effectiveness of IV and oral fluid supplementations in reducing serum bilirubin. Similarly, no infant developed adverse events or complications from fluid supplementation such as vomiting or abdominal distension. This suggests a need for future research to focus on different population groups with possibly higher baseline risks of bilirubin-related neurological complications, such as preterm or low birthweight infants, infants with haemolytic hyperbilirubinaemia, as well as infants with dehydration for comparison of different fluid supplementation regimen.

    Matched MeSH terms: Peristalsis
  8. Mohd Said MR, Wong Z, Abdul Rani R, Ngiu CS, Raja Ali RA, Lee YY
    J Gastroenterol Hepatol, 2021 May;36(5):1244-1252.
    PMID: 33002243 DOI: 10.1111/jgh.15284
    BACKGROUND AND AIM: Variations in the Chicago 3.0 normative metrics may exist with different postures and with different provocative swallow materials in a healthy Asian population.

    METHOD: Eligible healthy Malay volunteers were invited to undergo the high-resolution esophageal manometry (inSIGHT Ultima, Diversatek Healthcare, Milwaukee, WI, USA). In recumbent and standing positions, test swallows were performed using liquid, viscous, and solid materials. Metrics including integrated relaxation pressure 4 s (IRP-4 s, mmHg), distal contractile integral (DCI, mmHg s cm), distal latency (DL, s), and peristaltic break (PB, cm) were reported in median and 95th percentile.

    RESULTS: Fifty of 57 screened participants were recruited, and 586 saline, 265 viscous, and 261 solid swallows were analyzed. Per-patient wise, in the recumbent position, 95th percentile for IRP-4 s, DCI, DL, and PB were 16.5 mmHg, 2431 mmHg s cm, 8.5 s, and 7.2 cm, respectively. We observed that with each posture, the use of viscous swallows led to changes in DL, but the use of solid swallows led to more changes in the metrics including DCI and length of PB. Compared with a recumbent posture, anupright posture led to lower IRP-4 s and DCI values. Both per-patient analysis and per-swallow analyses yielded almost similar results when comparing the different postures and types of swallows. No major motility disorders were observed in this cohort of asymptomatic population. However, more motility disorders were reported in the upright position.

    CONCLUSIONS: Variations in metrics can be observed in different postures and with different provocative swallow materials in a healthy population. The normative Chicago 3.0 metrics are also determined for the Malay population.

    Matched MeSH terms: Peristalsis/physiology
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