MyMedR

Fulltext Vitamin D deficiency causing eosinophilic esophagogastroenteritis and ascites: a rare association

Qua CS, Peh KB, Saravannan K, Goh KL

BMJ Case Rep, 2021 Feb 04;14(2).

PMID: 33541947 DOI: 10.1136/bcr-2020-240039

A 54-year-old Chinese man presented with ascites for 2 weeks. He had a preceding 2-year history of intermittent dysphagia, lethargy and general malaise. Blood investigations revealed leucocytosis with eosinophilia of 26.5%, whereas paracentesis showed turbid fluid with high protein content (45 g/L) and a high white blood cell count of 5580/µL, predominantly eosinophils (90%). An incidental assay of vitamin D showed a very low level of 13.5 ng/mL. No other cause of ascites was found. Gastroscopy was normal except for duodenitis. However, biopsies from lower oesophagus confirmed the presence of eosinophilic infiltration. Following vitamin D replacement, the patient experienced marked improvement in symptoms of dysphagia within 2 weeks and no recurrence of ascites after 3 months. The reason for the patient's vitamin D deficiency remains unclear. The marked improvement in the patient's health indicates a causative role of vitamin D deficiency in causing eosinophilic esophagogastroenteritis and associated eosinophilic ascites.

Adolescent tobacco use and its determinants: evidence from Global Youth Tobacco Survey, Bangladesh 2007

Kabir MA, Goh KL, Khan MM

Asia Pac J Public Health, 2015 Mar;27(2):NP1578-90.

PMID: 23359868 DOI: 10.1177/1010539512472357

Adolescent tobacco use (ATU) is on the rise worldwide and the problem is particularly severe in developing countries. Based on nationally representative data, this study aims to investigate the association between ATU and its possible correlates for Bangladesh, where the prevalence rate of ATU is high. The data set is extracted from the Global Youth Tobacco Survey for Bangladesh conducted in 2007. The survey collected information from a total of 3113 students from 52 schools, with a response rate of 100% at the school level, while a response rate of 88.9% was achieved from the students. Students covered in the survey were in grades 7, 8, 9, and 10, with age ranging from 11 to 17 years. The prevalence rate of ATU at the time of the survey was 8.4%, while 35.6% of the students had used at least a type of tobacco products before. Logistic regressions were used to obtain the odds ratios (ORs) in favor of ATU for each of the possible determinants and the confidence intervals (CIs) of these ratios. Use of tobacco among friends (OR = 3.46; CI = 2.37-5.05), the experience of seeing others smoking at home (OR = 2.10; CI = 1.36-3.22) or other places (OR = 1.6; CI = 1.02-2.57), receiving pocket money (OR = 7.6; CI = 4.59-13.28), receiving free tobacco from vendors (OR = 2.3; CI = 1.44-3.78), and exposure to advertisements and promotions of tobacco products (OR = 1.83; CI = 1.23-2.79) were associated with a higher likelihood of ATU. Increased awareness of health hazards of tobacco use through education in schools helped mitigate the problem of ATU. The findings of this study have ramifications for tobacco control prevention strategies in Bangladesh.

Liver cancer in Malaysia: epidemiology and clinical presentation in a multiracial Asian population

Goh KL, Razlan H, Hartono JL, Qua CS, Yoong BK, Koh PS, et al.

J Dig Dis, 2015 Mar;16(3):152-8.

PMID: 25512092 DOI: 10.1111/1751-2980.12223

Hepatocellular carcinoma (HCC) is an important cancer in Malaysia. This study aimed to determine the epidemiological characteristics and clinical presentations of patients in a multiracial population consisting of three major Asian races: Malays, Chinese and Indians.

A first study on the incidence and prevalence of IBD in Malaysia--results from the Kinta Valley IBD Epidemiology Study

Hilmi I, Jaya F, Chua A, Heng WC, Singh H, Goh KL

J Crohns Colitis, 2015 May;9(5):404-9.

PMID: 25744112 DOI: 10.1093/ecco-jcc/jjv039

Inflammatory bowel disease [IBD] is known to be rare in the Asia Pacific region but epidemiological studies are scarce.

Autophagy in Helicobacter pylori Infection and Related Gastric Cancer

Castaño-Rodríguez N, Kaakoush NO, Goh KL, Fock KM, Mitchell HM

Helicobacter, 2015 Oct;20(5):353-69.

PMID: 25664588 DOI: 10.1111/hel.12211

Autophagy, a degradation pathway in which cytoplasmic content is engulfed and degraded by lysosomal hydrolases, plays a pivotal role in infection and inflammation. Given that defects in autophagy lead to increased susceptibility to infection, we investigated the role of autophagy in Helicobacter pylori-related gastric cancer (GC).

Fulltext Peptic ulcer diseases: genetics, mechanism, and therapies

Chuah SK, Wu DC, Suzuki H, Goh KL, Kao J, Ren JL

Biomed Res Int, 2014;2014:898349.

PMID: 25610875 DOI: 10.1155/2014/898349

Association between genetic polymorphisms in interferon regulatory factor 5 (IRF5) gene and Malaysian patients with Crohn's disease

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.

Internal radiation dosimetry of orally administered radiotracers for the assessment of gastrointestinal motility

Yeong CH, Ng KH, Abdullah BJJ, Chung LY, Goh KL, Perkins AC

Appl Radiat Isot, 2014 Dec;94:216-220.

PMID: 25222875 DOI: 10.1016/j.apradiso.2014.08.009

Radionuclide imaging using (111)In, (99m)Tc and (153)Sm is commonly undertaken for the clinical investigation of gastric emptying, intestinal motility and whole gut transit. However the documented evidence concerning internal radiation dosimetry for such studies is not readily available. This communication documents the internal radiation dosimetry for whole gastrointestinal transit studies using (111)In, (99m)Tc and (153)Sm labeled formulations. The findings were compared to the diagnostic reference levels recommended by the United Kingdom Administration of Radioactive Substances Advisory Committee, for gastrointestinal transit studies.

Fulltext Association between EGF and VEGF functional polymorphisms and sporadic colorectal cancer in the Malaysian population

Lau TP, Roslani AC, Lian LH, Lee PC, Hilmi I, Goh KL, et al.

Genet. Mol. Res., 2014;13(3):5555-61.

PMID: 25117311 DOI: 10.4238/2014.July.25.9

Growth factors are polypeptides that are critical for the initiation, progression, and metastasis of cancer. Most tumor cells are capable of synthesizing particular growth factors leading to constitutive pathway activation in these cells through autocrine signaling. Epidermal growth factor (EGF) is a potent mitogenic peptide that exerts direct effects on the proliferation and differentiation of tumor cells in carcinogenesis. By contrast, vascular endothelial growth factor (VEGF) is vital for the invasion and metastasis of neoplasms through the formation of new blood vessels from mature endothelial cells. In this study, we investigated the association between functional polymorphisms of both the EGF and VEGF genes and colorectal cancer (CRC) susceptibility. A total of 130 CRC patients and 212 healthy controls were recruited for this case-control study. Genotyping of genetic variants was conducted via real-time polymerase chain reaction (PCR) amplification with allele-specific TaqMan probes. None of the genotypes of the EGF +61 A>G and VEGF +936 C>T variants was significantly associated with CRC susceptibility among the Malaysian subjects evaluated (P > 0.05). The observed frequency distributions of the EGF +61 A>G polymorphism genotypes showed ethnic heterogeneity, which was not the case for the VEGF +936 C>T genotypes. In conclusion, no positive correlation between these functional polymorphisms and CRC risk was found in this Malaysian population. Studies of the EGF and VEGF genes and CRC susceptibility are scarce, and the results reported thus far differ from one population to another. Hence, more replication studies are warranted before any firm conclusions can be made.

Genetic polymorphisms in the Toll-like receptor signalling pathway in Helicobacter pylori infection and related gastric cancer

Castaño-Rodríguez N, Kaakoush NO, Pardo AL, Goh KL, Fock KM, Mitchell HM

Hum Immunol, 2014 Aug;75(8):808-15.

PMID: 24929142 DOI: 10.1016/j.humimm.2014.06.001

Gastric cancer (GC) is a progressive process initiated by Helicobacter pylori-induced inflammation. Initial recognition of H. pylori involves Toll-like receptors (TLRs), central molecules in the host inflammatory response. Here, we investigated the association between novel polymorphisms in genes involved in the TLR signalling pathway, including TLR2, TLR4, LBP, MD-2, CD14 and TIRAP, and risk of H. pylori infection and related GC.

Fulltext Culturable bacterial microbiota of the stomach of Helicobacter pylori positive and negative gastric disease patients

Khosravi Y, Dieye Y, Poh BH, Ng CG, Loke MF, Goh KL, et al.

ScientificWorldJournal, 2014;2014:610421.

PMID: 25105162 DOI: 10.1155/2014/610421

Human stomach is the only known natural habitat of Helicobacter pylori (Hp), a major bacterial pathogen that causes different gastroduodenal diseases. Despite this, the impact of Hp on the diversity and the composition of the gastric microbiota has been poorly studied. In this study, we have analyzed the culturable gastric microbiota of 215 Malaysian patients, including 131 Hp positive and 84 Hp negative individuals that were affected by different gastric diseases. Non-Hp bacteria isolated from biopsy samples were identified by matrix assisted laser desorption ionization-time of flight mass spectrometry based biotyping and 16SrRNA sequencing. The presence of Hp did not significantly modify the diversity of the gastric microbiota. However, correlation was observed between the isolation of Streptococci and peptic ulcer disease. In addition, as a first report, Burkholderia pseudomallei was also isolated from the gastric samples of the local population. This study suggested that there may be geographical variations in the diversity of the human gastric microbiome. Geographically linked diversity in the gastric microbiome and possible interactions between Hp and other bacterial species from stomach microbiota in pathogenesis are proposed for further investigations.

Fulltext Functional and molecular surveillance of Helicobacter pylori antibiotic resistance in Kuala Lumpur

Teh X, Khosravi Y, Lee WC, Leow AH, Loke MF, Vadivelu J, et al.

PLoS One, 2014;9(7):e101481.

PMID: 25003707 DOI: 10.1371/journal.pone.0101481

Helicobacter pylori is the etiological agent for diseases ranging from chronic gastritis and peptic ulcer disease to gastric adenocarcinoma and primary gastric B-cell lymphoma. Emergence of resistance to antibiotics possesses a challenge to the effort to eradicate H. pylori using conventional antibiotic-based therapies. The molecular mechanisms that contribute to the resistance of these strains have yet to be identified and are important for understanding the evolutional pattern and selective pressure imposed by the environment.

Fulltext Novel use of a self-expandable metal stent with an anti-migration system for palliative drainage of a pancreatic cystic neoplasm

Paramasivam RK, Ho SH, Abdullah BJ, Goh KL, Hilmi I

JOP, 2014 Sep;15(5):508-11.

PMID: 25262723 DOI: 10.6092/1590-8577/2802

There is scanty data on endoscopic palliative management of pancreatic cystic lesions that cause gastric outlet obstruction (GOO). This is the first case report that illustrates the use of a covered self-expandable metal stent (CSEMS) with an anti-migration system in the management of a symptomatic neoplastic cystic pancreatic lesion.

Fulltext The NOD-like receptor signalling pathway in Helicobacter pylori infection and related gastric cancer: a case-control study and gene expression analyses

Castaño-Rodríguez N, Kaakoush NO, Goh KL, Fock KM, Mitchell HM

PLoS One, 2014;9(6):e98899.

PMID: 24901306 DOI: 10.1371/journal.pone.0098899

Currently, it is well established that cancer arises in chronically inflamed tissue. A number of NOD-like receptors (NLRs) form inflammasomes, intracellular multiprotein complexes critical for generating mature pro-inflammatory cytokines (IL-1β and IL-18). As chronic inflammation of the gastric mucosa is a consequence of Helicobacter pylori infection, we investigated the role of genetic polymorphisms and expression of genes involved in the NLR signalling pathway in H. pylori infection and related gastric cancer (GC).

Fulltext NOD2/CARD15 variants in Malaysian patients with sporadic colorectal cancer

Lau TP, Roslani AC, Lian LH, Lee PC, Hilmi I, Goh KL, et al.

Genet. Mol. Res., 2014;13(3):7079-85.

PMID: 24682985 DOI: 10.4238/2014.March.19.3

Colorectal cancer (CRC) is one of the most common types of cancer in both developed and developing countries. This disease is triggered by and progresses via the sequential accumulation of multiple genetic alterations. In addition, the interaction between low-penetrance genes and environmental factors can also increase the risk of developing CRC. Since inflammatory bowel diseases (IBDs) are one of the predisposing factors for CRC, IBD-related genes might, to a certain extent, be associated with cancer initiation. The nucleotide oligomerization domain 2/caspase activating recruitment domain 15 gene (NOD2/CARD15) is the most well-established gene to be associated with increased susceptibility to Crohn's disease. Thus, various studies have been performed to investigate the potential contribution of this gene to CRC risk. In this study, we aimed to determine the frequency of the Arg702Trp, Gly908Arg, 3020insC, Pro268Ser, and JW1 variants of NOD2/CARD15, and to investigate their association with CRC susceptibility. A total of 130 CRC patients and 212 healthy controls were recruited for this study. Subsequently, real-time polymerase chain reaction with TaqMan was performed for the genotyping of these NOD2/ CARD15 variants. None of the NOD2/CARD15 variants was statistically associated to CRC susceptibility in our Malaysian population. Our findings were remarkably similar to those of other Asian cohorts, which indicated that these NOD2/CARD15 variants exhibit genetic heterogeneity between Caucasian and Asian populations.

Ultrasonography-diagnosed non-alcoholic fatty liver disease is not associated with prevalent ischemic heart disease among diabetics in a multiracial Asian hospital clinic population

Chan WK, Tan AT, Vethakkan SR, Tah PC, Vijayananthan A, Goh KL

Clin Res Hepatol Gastroenterol, 2014 Jun;38(3):284-91.

PMID: 24736032 DOI: 10.1016/j.clinre.2014.02.009

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) and cardiovascular diseases are both common among patients with diabetes mellitus.
OBJECTIVE: The aim of this study is to determine if ultrasonography-diagnosed NAFLD is associated with prevalent ischemic heart disease (IHD) among patients with diabetes mellitus.
METHODS: This is a cross-sectional study on consecutive patients seen at the Diabetic Clinic, University of Malaya Medical Centre. The medical record for each patient was reviewed for documented IHD. Patients without documented IHD but had symptoms and/or electrocardiographic changes suggestive of IHD were referred for cardiac evaluation.
RESULTS: Data for 399 patients were analyzed. Mean age was 62.8±10.5 years with 43.1% male. NAFLD and IHD were present in 49.6 and 26.6%, respectively. The prevalence of IHD among patients with and without NAFLD was 24.7 and 28.4%, respectively (P=0.414). The prevalence of IHD was highest among the Indians (34.1%) followed by the Malays (29.2%) and the Chinese (20.1%). No association was found between NAFLD and IHD when analyzed according to ethnicity. On multivariate analysis, independent factors associated with IHD were older age, lower levels of physical activity, greater waist circumference and higher serum glycated hemoglobin level.
CONCLUSIONS: Ultrasonography-diagnosed NAFLD was not associated with prevalent IHD among patients with diabetes mellitus in a multiracial Asian hospital clinic population.

Study site: Diabetic clinc, University Malaya Medical Centre (UMMC)

Non-alcoholic fatty liver disease in a young multiracial Asian population: a worrying ethnic predilection in Malay and Indian males

Chan WK, Bahar N, Razlan H, Vijayananthan A, Sithaneshwar P, Goh KL

Hepatol Int, 2014 Jan;8(1):121-7.

PMID: 26202413 DOI: 10.1007/s12072-013-9510-8

PURPOSE: Previous studies on multiracial Malaysian populations found inordinately high prevalence of NAFLD among Malays and Indians. Whether the prevalence of NAFLD is different among young adults of different ethnic origins is not known. We aimed to determine racial differences in NAFLD in a young multiracial Malaysian population and associated factors.

METHODS: This was a cross-sectional study on medical students from the University of Malaya. Diagnosis of NAFLD was by transabdominal ultrasonography and following exclusion of significant alcohol intake and other causes of chronic liver disease.

RESULTS: Data of 469 subjects were analyzed (mean age 23.2 ± 2.4 years, 40.3 % male). The racial distribution was: Chinese 53.9 %, Malay 30.5 % and Indian 15.6 %. The overall prevalence of NAFLD was 7.9 %. Subjects with NAFLD were older, had greater BMI and WC, higher SBP and DBP, higher FBS, serum TG and LDL levels, and lower serum HDL level. The prevalence of NAFLD was higher among males compared to females (17.9 % vs. 3.3 %, p

Clinical outcomes and direct costings of endoluminal clipping compared to surgery in the management of iatrogenic colonic perforation

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.

Fulltext Hypericin-photodynamic therapy leads to interleukin-6 secretion by HepG2 cells and their apoptosis via recruitment of BH3 interacting-domain death agonist and caspases

Barathan M, Mariappan V, Shankar EM, Abdullah BJ, Goh KL, Vadivelu J

Cell Death Dis, 2013;4:e697.

PMID: 23807226 DOI: 10.1038/cddis.2013.219

Photodynamic therapy (PDT) has emerged as a capable therapeutic modality for the treatment of cancer. PDT is a targeted cancer therapy that reportedly leads to tumor cell apoptosis and/or necrosis by facilitating the secretion of certain pro-inflammatory cytokines and expression of multiple apoptotic mediators in the tumor microenvironment. In addition, PDT also triggers oxidative stress that directs tumor cell killing and activation of inflammatory responses. However, the cellular and molecular mechanisms underlying the role of PDT in facilitating tumor cell apoptosis remain ambiguous. Here, we investigated the ability of PDT in association with hypericin (HY) to induce tumor cell apoptosis by facilitating the induction of reactive oxygen species (ROS) and secretion of Th1/Th2/Th17 cytokines in human hepatocellular liver carcinoma cell line (HepG2) cells. To discover if any apoptotic mediators were implicated in the enhancement of cell death of HY-PDT-treated tumor cells, selected gene profiling in response to HY-PDT treatment was implemented. Experimental results showed that interleukin (IL)-6 was significantly increased in all HY-PDT-treated cells, especially in 1 μg/ml HY-PDT, resulting in cell death. In addition, quantitative real-time PCR analysis revealed that the expression of apoptotic genes, such as BH3-interacting-domain death agonist (BID), cytochrome complex (CYT-C) and caspases (CASP3, 6, 7, 8 and 9) was remarkably higher in HY-PDT-treated HepG2 cells than the untreated HepG2 cells, entailing that tumor destruction of immune-mediated cell death occurs only in PDT-treated tumor cells. Hence, we showed that HY-PDT treatment induces apoptosis in HepG2 cells by facilitating cytotoxic ROS, and potentially recruits IL-6 and apoptosis mediators, providing additional hints for the existence of alternative mechanisms of anti-tumor immunity in hepatocellular carcinoma, which contribute to long-term suppression of tumor growth following PDT.

Performance of transient elastography (TE) and factors associated with discordance in non-alcoholic fatty liver disease

Mahadeva S, Mahfudz AS, Vijayanathan A, Goh KL, Kulenthran A, Cheah PL

J Dig Dis, 2013 Nov;14(11):604-10.

PMID: 23859493 DOI: 10.1111/1751-2980.12088

To determine the accuracy of transient elastography (TE) and factors associated with discordance between TE and liver histology in patients with non-alcoholic fatty liver disease (NAFLD).

Displaying publications 181 - 200 of 334 in total