Displaying publications 221 - 240 of 383 in total

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  1. Fulltext Helicobacter pylori infection--a boon or a bane: lessons from studies in a low-prevalence population
    Lee YY, Mahendra Raj S, Graham DY
    Helicobacter, 2013 Oct;18(5):338-46.
    PMID: 23607896 DOI: 10.1111/hel.12058
    Helicobacter pylori (H. pylori) infection is etiologically associated with gastric cancer and peptic ulcer diseases which are both important public health burdens which could be largely eliminated by H. pylori eradication. However, some investigators urge caution based on the hypothesis that eradication of H. pylori may result in an increase in the incidence of gastroesophageal reflux disease, esophageal adenocarcinoma, and childhood asthma. The ethnic Malays of northeastern Peninsular Malaysia have long had a low prevalence of H. pylori infection and, as expected, the incidence of gastric cancer and its precursor lesions is exceptionally low. The availability of a population with a low H. pylori prevalence and generally poor sanitation allows separation of H. pylori from the hygiene hypothesis and direct testing of whether absence of H. pylori is associated with untoward consequence. Contrary to predictions, in Malays, erosive esophagitis, Barrett's esophagus, distal esophageal cancers, and childhood asthma are all of low incidence. This suggests that H. pylori is not protective rather the presence of H. pylori infection is likely a surrogate for poor hygiene and not an important source of antigens involved in the hygiene hypothesis. Helicobacter pylori in Malays is related to transmission from H. pylori-infected non-Malay immigrants. The factors responsible for low H. pylori acquisition, transmission, and burden of H. pylori infection in Malays remain unclear and likely involves a combination of environmental, host (gene polymorphisms), and strain virulence factors. Based on evidence from this population, absence of H. pylori infection is more likely to be boon than a bane.
    Matched MeSH terms: Peptic Ulcer/epidemiology*
  2. Fulltext Commentary: changing aetiology of peptic ulcers
    Goh KL, Chan WK
    Aliment Pharmacol Ther, 2012 Aug;36(3):291-2; discussion 292-3.
    PMID: 22747451 DOI: 10.1111/j.1365-2036.2012.05164.x
    Matched MeSH terms: Peptic Ulcer/epidemiology*
  3. Fulltext Time trends in peptic ulcer, erosive reflux oesophagitis, gastric and oesophageal cancers in a multiracial Asian population
    Goh KL, Wong HT, Lim CH, Rosaida MS
    Aliment Pharmacol Ther, 2009 Apr 1;29(7):774-80.
    PMID: 19183160 DOI: 10.1111/j.1365-2036.2009.03930.x
    Dramatic changes in the prevalence and pattern of gastrointestinal disease has taken place in Asia in recent years.
    Matched MeSH terms: Peptic Ulcer/epidemiology*
  4. Changing epidemiology of Helicobacter pylori in Asia
    Tan HJ, Goh KL
    J Dig Dis, 2008 Nov;9(4):186-9.
    PMID: 18959588 DOI: 10.1111/j.1751-2980.2008.00344.x
    As in developed societies, the prevalence of Helicobacter pylori has declined rapidly in Asia. This has been shown in both seroprevalence-based and endoscopy-based studies. While the decline in the incidence of gastric cancer has now been observed, a decrease in peptic ulcer disease has not been so clearly evident. This apparent paradox can be explained by an increase in non-H. pylori associated ulcers - such as those related to non-steroidal anti-inflammatory drugs or idiopathic ulcers. The increase of gastroesophageal reflux disease in Asia has been widely observed and commented on and its relationship to the decline in H. pylori speculated upon. However there have been few conclusive studies from Asia on this subject. While the improved diagnosis and elimination of H. pylori has contributed to its decline, a more basic change involving large segments of the Asian population must be responsible. An improvement in hygiene and living conditions that results from more affluent Asian societies is thought to be a possible cause.
    Matched MeSH terms: Peptic Ulcer/epidemiology*
  5. Further evidence of ethnic and gender differences for Helicobacter pylori infection among endoscoped patients
    Sasidharan S, Uyub AM, Azlan AA
    Trans R Soc Trop Med Hyg, 2008 Dec;102(12):1226-32.
    PMID: 18586289 DOI: 10.1016/j.trstmh.2008.05.006
    HeIicobacter pylori infection rate was determined in 697 consecutive patients with ulcer, gastritis, duodenitis and non-ulcer dyspepsia by endoscopy at a Malaysian hospital in 1999-2002. Biopsies of the gastric antrum and body were subjected to the urease test, Gram staining of impression smears and culture examination. Infection was defined as a positive result in at least one test. The infection rates were 32.1, 10.4, 20.0 and 16.2% in ulcer, gastritis, duodenitis and non-ulcer dyspepsia patients, respectively. Overall, the prevalence of H. pylori infection was 14.6%, with the rate among the Indian (21.7%), Chinese (19.2%) and Bangladeshi foreign worker (23.1%) groups significantly higher (P<0.05) than that of the Malays (5.8%). Generally, the prevalence rate among males (18.9%) was significantly higher (P<0.001) than that among females (9.0%), but for a particular ethnic group, such trend and significant differences (P<0.05) were observed only among the Malays. In terms of gender, the prevalence rates of Malay males and females were also significantly lower (P<0.05) than those of Chinese and Indians. In conclusion, there is a significant difference in H. pylori infection prevalence rates among ethnic groups (highest in Indians, then Chinese and unusually low in Malays) and gender groups (highest in males) in Malaysia.
    Matched MeSH terms: Stomach Ulcer/microbiology*
  6. Nurses' perceptions of standardised assessment and prevention of complications in an ICU
    Soh KL, Davidson PM, Leslie G, DiGiacomo M, Soh KG
    J Clin Nurs, 2013 Mar;22(5-6):856-65.
    PMID: 23398314 DOI: 10.1111/jocn.12017
    To describe nurses' perceptions of evidence-based recommendations to prevent complications in a Malaysian intensive care unit.
    Matched MeSH terms: Pressure Ulcer/prevention & control*
  7. Recurrent abdominal pain in Malaysian children: clinical profiles and outcome
    Boey CC, Goh KL
    Dig Liver Dis, 2001 4 17;33(1):83-4.
    PMID: 11303982
    Matched MeSH terms: Duodenal Ulcer/diagnosis
  8. Fulltext Oxygen-derived free radical scavengers: a new approach to the problem of refractory peptic ulceration
    Salim AS
    Med J Malaysia, 1993 Dec;48(4):392-6.
    PMID: 8183161
    Refractory peptic ulceration refers to ulcers which are slow to heal despite active treatment for at least three months. Oxygen-derived free radicals are cytotoxic and promote tissue injury. Twelve consecutive patients with refractory peptic ulceration (eight with duodenal ulcers and four with solitary pre-pyloric gastric ulcers) were treated using the radical scavengers allopurinol or dimethyl sulphoxide. This treatment was well tolerated by all patients and produced no adverse effects. Endoscopic examination four weeks later demonstrated complete healing (an intact gastric or duodenal mucosa without any breaches) in all patients. The results suggest that oxygen-derived free radicals perpetuate the process of peptic ulceration and exert an adverse effect on healing. Scavengers of these radicals stimulate the healing of refractory gastric and duodenal ulceration.
    Matched MeSH terms: Peptic Ulcer/drug therapy*
  9. Prevention of duodenal ulcer relapse with omeprazole 20 mg daily: a randomized double-blind, placebo-controlled study
    Goh KL, Boonyapisit S, Lai KH, Chang R, Kang JY, Lam SK
    J Gastroenterol Hepatol, 1995 1 1;10(1):92-7.
    PMID: 7620115
    We report the first double-blind, placebo-controlled study that assesses the efficacy and safety of omeprazole 20 mg daily in the maintenance treatment of duodenal ulcer. For the healing phase, 128 patients with endoscopically proven active duodenal ulcer and a history of three or more relapses during the 2 years prior to the study were treated until healing with omeprazole 40 mg daily for 2 and up to 8 weeks. One hundred and twenty-three patients whose ulcers were healed were randomized to receive omeprazole 20 mg daily (n = 60) or placebo (n = 63) for 12 months as maintenance treatment. Patients were interviewed at 3, 6, 9 and 12 months, and endoscopy was performed at 3, 6 and 12 months and whenever symptoms recurred. The healing rates of the 124 patients completing the healing phase were 84, 98 and 100% at 2, 4 and 8 weeks, respectively. During the maintenance phase, eight and four patients discontinued treatment from the omeprazole and placebo groups, respectively. The proportion of patients in remission in the omeprazole group and placebo group after 12 months were 94 and 9% respectively (life table estimates, P < 0.0001). No significant clinical or laboratory changes were observed in patients on therapy with omeprazole. Patients with a history of frequent relapses thus continued to have a very high relapse rate without prophylactic treatment. Omeprazole 20 mg daily was effective and safe in maintaining such patients in remission.
    Matched MeSH terms: Duodenal Ulcer/prevention & control*
  10. Fulltext Twice daily cimetidine in the initial treatment of chronic gastric ulcer--a double-blind placebo-controlled trial
    Tay HH, Yap I, Guan R, Koh PS, LaBrooy SJ, Kang JY
    Med J Malaysia, 1988 Jun;43(2):181-5.
    PMID: 3070309
    Thirty-one patients with endoscopically proven chronic gastric ulcer completed a randomised double-blind trial comparing the effects of cimetidine and placebo on ulcer healing. Seventeen patients received cimetidine 400 mg bid and 14 patients received placebo. Repeat endoscopy at six weeks showed that the ulcer had healed in 12 patients (71%) receiving cimetidine and in four patients (29%) receiving placebo (p=O.032). Non-smokers healed their ulcers better than smokers (83% vs 35%, p=O.023). The use of cimetidine was not associated with any adverse effects.
    Matched MeSH terms: Stomach Ulcer/drug therapy*
  11. Fulltext Effect of ethanol on gastric secretion of thromboxane B2
    Fung WP, Mahoney D, Beilin LJ
    Med J Malaysia, 1984 Jun;39(2):131-4.
    PMID: 6513851
    The effects of ethanol on gastric thromboxane B2 was studied in man. A single dose of 20 ml 15% ethanol significantly inhibited the gastric secretion of thromboxane B2 whereas 20 mls of 5% ethanol were without effect. It was concluded that ethanol can suppress gastric secretion of thromboxane B2 psychosis.
    Matched MeSH terms: Peptic Ulcer/metabolism
  12. Fulltext Upper gastrointestinal endoscopy as an initial investigation in dyspepsia--a Malaysian experience
    Kudva MV, Thein-Htut
    Med J Malaysia, 1988 Dec;43(4):311-7.
    PMID: 3241596
    Matched MeSH terms: Peptic Ulcer/diagnosis*
  13. Fulltext Discriminant value of dyspeptic symptoms in peptic ulcer and non-ulcer dyspepsia
    Kudva MV, Zawawi M, Rafee N, Ismail O, Muda JR
    Med J Malaysia, 1989 Sep;44(3):236-42.
    PMID: 2626138
    The objective of the study was to determine whether discriminant analysis of characteristics of dyspepsia can differentiate peptic ulcer from non-ulcer dyspepsia in a Malaysian population. Two hundred and twenty six patients with dyspepsia were interviewed using a standard history questionnaire before undergoing upper gastrointestinal endoscopy. Forty seven patients had peptic ulcer while 149 others were classified as having non-ulcer dyspepsia. Stepwise logistic regression analysis was done on 25 variables. The study showed that only five of these variables could differentiate peptic ulcer from non-ulcer dyspepsia, namely, nocturnal pain, pain before meals or when hungry, absence of nausea, age and sex. A scoring system was devised based on these discriminant symptoms. At a sensitivity of 51%, the specificity for peptic ulcer was 83%, but only prospective studies will determine if this scoring system is of actual clinical value.
    Matched MeSH terms: Peptic Ulcer/diagnosis*
  14. Fulltext Glossodynia and glossopyrosis - a discussion of the aetiology and management
    Yaacob HB, Ling BC
    Med J Malaysia, 1981 Sep;36(3):177-80.
    PMID: 7329376
    Fifty patients with temporomandibular pain dysfunction syndrome were examined. Seventy-eight percent and 32 percent were female and male respectively. The white collar workers were more frequently affected. Emotional stress, dental malocclusion and a history of trauma were the main causes. Treatment consists of reassurance, relaxed jaw movements and exercises, anxiolytic drugs, thermotherapy, biting appliance, occlusal adjustments and restoration of lost dental units.
    Matched MeSH terms: Ulcer/complications
  15. Skin ulceration as a complication from unexpected extravasation injury: A case report
    Chong HC, Fong KK, Hayati F
    Ann Med Surg (Lond), 2021 Apr;64:102267.
    PMID: 33889406 DOI: 10.1016/j.amsu.2021.102267
    Background: Extravasation injury (EVI) is common, yet it is always underestimated and underreported. Severity varies ranging from thrombophlebitis up to disability. Unrecognised EVI is a potential medicolegal case in medicine.

    Case presentation: We experience a 47-year-old lady who developed an unrecognised EVI after being admitted for sepsis. The EVI turned out to be a huge and sloughy skin ulcer. A series of wound debridement with vacuum dressing were conducted until the wound was able to be closed.

    Discussion: The EVI can be categorised according to Amjad EVI grading and Loth and Eversmann's EVI classification. Adult EVI tends to be overlooked, especially during critical care because patients cannot complain upon sedation and ventilation. In order to prevent EVI, firstly prevention is better than cure. Secondly, if EVI is recognised early, infusion should be stopped immediately. Thirdly, analgesia is mandatory. Finally, the plastic team needs to be engaged if it is deemed required.

    Conclusion: Prevention and early intervention before the occurrence of progressive tissue damage is the key to treatment. Early radical wound debridement and immediate or delayed wound coverage with skin graft or skin flap are indicated in full thickness skin necrosis, persistent pain, and chronic ulcer.

    Matched MeSH terms: Skin Ulcer; Ulcer
  16. Fulltext A community based study on tropical phagedenic ulcers in Shah Alam, Malaysia: knowledge, attitude and practice
    Asdren Zajmi, Nur Atikah Adam, Mohammed Abdelfatah Alhoot
    Malaysian Journal of Medicine and Health Sciences, 2020;16(101):112-117.
    MyJurnal
    Introduction: Tropical phagedenic ulcer is a skin disease caused by a cocktail of bacteria. This painful ulcer forms over the lower limbs. It is also associated with necrotic slough and foul-smelling discharge that eventually lead to amputation and permanent disabilities. Tropical phagedenic ulcer in Malaysia has not been given much attention. In light of this situation, this research was conducted to assess the knowledge, attitude and practice regarding tropical phagedenic ulcer among the public in Shah Alam, Selangor. Methods: The total respondents were 384, consisting of 164 males and 220 females who were randomly selected. Data were obtained qualitatively through structured questionnaires and analysed using the chi-square test to study the association between the dependent variables and demographic factors. Results: The collected data showed that the respondents (67.2%) had poor knowledge of trop- ical phagedenic ulcer; merely 65.4% considered it to be a health problem, whereas 29.7% believed it is contagious. Also, the data revealed an association between age (χ2=13.587, p =0.004), marital status (χ2=15.435, p=0.001), time spent in community (χ2=6.438, p=0.04) and knowledge of the local name of tropical phagedenic ulcer. About 74.7% of the respondents did not know the cause of tropical phagedenic ulcer. Only 22.1% of the respondents had encoun- tered tropical phagedenic ulcer patients and an association was found between the variable with gender (χ2=4.672, p =0.031), age (χ2=24.134, p =0.000) and marital status (χ2=17.143, p =0.001). Conclusion: This study reveals mis- conceptions about the aetiology and transmission of tropical phagedenic ulcer which greatly influence the attitude of community members towards tropical phagedenic ulcer patients.
    Matched MeSH terms: Skin Ulcer; Ulcer
  17. Efficacy of Rebamipide in Organic and Functional Dyspepsia: A Systematic Review and Meta-Analysis
    Jaafar MH, Safi SZ, Tan MP, Rampal S, Mahadeva S
    Dig Dis Sci, 2018 05;63(5):1250-1260.
    PMID: 29192375 DOI: 10.1007/s10620-017-4871-9
    OBJECTIVE: The role of gastritis in dyspepsia remains controversial. We aimed to examine the efficacy of rebamipide, a gastric mucosal protective agent, in both organic and functional dyspepsia.

    DESIGN: A systematic review and meta-analysis was performed. The following databases were searched using the keywords ("rebamipide" OR "gastroprotective agent*" OR "mucosta") AND ("dyspepsia" OR "indigestion" OR "gastrointestinal symptoms"): PubMed, Wed of Science, Embase, CINAHL, Cochrane Clinical Trials Register. The primary outcome was dyspepsia or upper GI symptom score improvement. Pooled analysis of the main outcome data were presented as risk ratio (RR) for dichotomous data and standardized mean difference (SMD) for continuous data.

    RESULTS: From an initial 248 records, 17 randomised controlled trial (RCT) publications involving 2170 subjects (1224 rebamipide, 946 placebo/control) were included in the final analysis. Twelve RCTs were conducted in subjects with organic dyspepsia (peptic ulcer disease, reflux esophagitis or NSAID-induced gastropathy) and five RCTs were conducted in patients with functional dyspepsia (FD). Overall, dyspepsia symptom improvement was significantly better with rebamipide compared to placebo/control drug (RR 0.77, 95% CI = 0.64-0.93; SMD -0.46, 95% CI = -0.83 to -0.09). Significant symptom improvement was observed both in pooled RR and SMD in subjects with organic dyspepsia (RR 0.72, 95% CI = 0.61-0.86; SMD -0.23, 95% CI = -0.4 to -0.07), while symptom improvement in FD was observed in pooled SMD but not RR (SMD -0.62, 95% CI = -1.16 to -0.08; RR 1.01, 95% CI = 0.71-1.45).

    CONCLUSION: Rebamipide is effective in organic dyspepsia and may improve symptoms in functional dyspepsia.

    Matched MeSH terms: Anti-Ulcer Agents/therapeutic use*
  18. Fulltext Helicobacter pylori and gastric cancer: Indian enigma
    Misra V, Pandey R, Misra SP, Dwivedi M
    World J Gastroenterol, 2014 Feb 14;20(6):1503-9.
    PMID: 24587625 DOI: 10.3748/wjg.v20.i6.1503
    Helicobacter pylori (H. pylori) is a gram negative microaerophilic bacterium which resides in the mucous linings of the stomach. It has been implicated in the causation of various gastric disorders including gastric cancer. The geographical distribution and etiology of gastric cancer differ widely in different geographical regions and H. pylori, despite being labeled as a grade I carcinogen, has not been found to be associated with gastric cancer in many areas. Studies in Asian countries such as Thailand, India, Bangladesh, Pakistan, Iran, Saudi Arabian countries, Israel and Malaysia, have reported a high frequency of H. pylori infection co-existing with a low incidence of gastric cancer. In India, a difference in the prevalence of H. pylori infection and gastric cancer has been noted even in different regions of the country leading to a puzzle when attempting to find the causes of these variations. This puzzle of H. pylori distribution and gastric cancer epidemiology is known as the Indian enigma. In this review we have attempted to explain the Indian enigma using evidence from various Indian studies and from around the globe. This review covers aspects of epidemiology, the various biological strains present in different parts of the country and within individuals, the status of different H. pylori-related diseases and the molecular pathogenesis of the bacterium.
    Matched MeSH terms: Peptic Ulcer/microbiology
  19. An immunodiffusion analysis of strains of Mycobacterium ulcerans isolated in Australia, Malaya, Mexico, Uganda and Zaire
    Stanford JL
    J Med Microbiol, 1973 Aug;6(3):405-8.
    PMID: 4199273
    Matched MeSH terms: Ulcer/immunology
  20. Effectiveness of hyaluronic acid and its derivatives on chronic wounds: a systematic review
    Shaharudin A, Aziz Z
    J Wound Care, 2016 Oct 02;25(10):585-592.
    PMID: 27681589 DOI: 10.12968/jowc.2016.25.10.585
    OBJECTIVE: Hyaluronic acid (HA) and its derivatives are used for chronic wounds, but evidence of their effectiveness remains unclear. The aim of this study was to provide more updated evidence for the effectiveness of HA (or its derivatives) compared with placebo or other agents for promoting healing in chronic wounds.
    METHOD: The Cochrane Central Register of Controlled Trials, MEDLINE via Ovid Online, CINAHL and the EMBASE via EBSCO host databases were searched. Drug companies and experts in wounds were also contacted. Randomised controlled trials of HA (or its derivatives) compared with control were eligible for inclusion.
    RESULTS: We identified nine randomised controlled trials involving 865 participants with chronic wounds were included in the review. The reporting for mixed arterial and venous ulcers seems to be better quality than that for venous leg ulcers (VLUs) and diabetic foot ulcers (DFUs). Studies provided little evidence regarding the claimed effects of HA or its derivaties on healing of chronic wounds. However, there is some evidence on their effectiveness for reducing pain intensity for mixed arterial and venous ulcers, which involved 255 patients (MD=-6.78 [95% CI: -11.10 to -2.46]).
    CONCLUSION: Evidence to guide decisions regarding the use of HA or its derivatives to promote wound healing is still limited. More good-quality randomised controlled trials are warranted.
    KEYWORDS: assessment bias; chronic ulcers; hyaluronan; meta-analysis
    Matched MeSH terms: Varicose Ulcer/drug therapy*
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