MyMedR

Lee YY, Medford AR, Halim AS

J R Coll Physicians Edinb, 2015;45(2):104-7.

PMID: 26181523 DOI: 10.4997/JRCPE.2015.203

Increasing numbers of doctors are experiencing burnout now more than ever before and the worrying part is that what we see is just the tip of the iceberg. Burnout, a state of mental exhaustion caused by the doctor's professional life, is characterised by emotional exhaustion, depersonalisation and a reduced sense of accomplishment or success. Burnout has been largely ignored or under-recognised previously. This paper provides a perspective on burnout among doctors, including an overview of symptoms, the scale of the problem, the implications and causes of burnout and, finally, a strategic framework to provide a basis for managing it. Most importantly, professional bodies are urged to start taking steps to help troubled doctors. Medical Colleges should provide essential assistance, support and guidance as well as ensuring fair management and promotion policies.

Diagnosis and management of fatty liver

Tan PO, Mustaffa N, Tan SS, Lee YY

J R Coll Physicians Edinb, 2020 Sep;50(3):256-261.

PMID: 32936098 DOI: 10.4997/JRCPE.2020.308

Globally, the prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing rapidly and constitutes a significant healthcare burden due to associated complications including hepatic (cirrhosis and hepatocellular cancer) and non-hepatic (cardiovascular deaths) disorders. It is closely linked to insulin resistance and metabolic syndrome but moderate alcohol consumption frequently coexists. Recently, genetic polymorphisms were implicated in the development of non-obese NAFLD. Apart from liver biopsy, in order to assess for steatosis, fibrosis and non-alcoholic steatohepatitis (NASH), advances in non-invasive serum tests and elastography have provided similarly accurate, more accessible and safer alternatives for risk stratification. As for treatment in 2020, weight loss and lifestyle modification remain the central strategy. Unfortunately, no pharmacological agents have been approved thus far, but there are a number of potential therapies in the pipeline for fibrosis and NASH. Treatment of underlying metabolic disorders is important. While the term NAFLD was coined in the 1980s, more recent understanding may support a change in nomenclature highlighting its strong metabolic roots.

Communication breakdown between physicians and IBS sufferers: what is the conundrum and how to overcome it?

Jayaraman T, Wong RK, Drossman DA, Lee YY

J R Coll Physicians Edinb, 2017 Jun;47(2):138-141.

PMID: 28675183 DOI: 10.4997/JRCPE.2017.206

Irritable bowel syndrome is a disorder of gut-brain interaction that leads to a significant healthcare burden worldwide. A good physician-patient relationship is fundamental in managing patients who suffer from this poorly understood chronic disease. We highlight possible reasons for breakdown in communication between physicians and irritable bowel syndrome sufferers and suggest possible ways to overcome such pitfalls.

Is tenofovir the answer to further preventing mother-to-child transmission of hepatitis B?

Abdul Hafidz MI, Tan SS, Lee YY

J R Coll Physicians Edinb, 2016 12;46(4):248-250.

PMID: 28504780 DOI: 10.4997/JRCPE.2016.409

Management of refractory heartburn: are we convinced that surgery is better than medical treatment?

Jalil MABM, Wong Z, Ali RAR, Lee YY

J R Coll Physicians Edinb, 2020 Mar;50(1):51-53.

PMID: 32539039 DOI: 10.4997/JRCPE.2020.114

Have we found the panacea to COVID-19 with remdesivir, an old but newly packaged drug?

Thalha AMM, Lee YY, Besari A, Omar SFS

J R Coll Physicians Edinb, 2020 06;50(2):159-161.

PMID: 32568289 DOI: 10.4997/JRCPE.2020.217

Addressing unmet needs for patients with previous upper gastrointestinal bleed requiring concomitant aspirin and non-steroidal anti-inflammatory drugs

Jayaraman T, Wong MS, Mustaffa N, Lee YY

J R Coll Physicians Edinb, 2017 12;47(4):356-358.

PMID: 29537408 DOI: 10.4997/JRCPE.2017.411

Growth reduction among primary schoolchildren with light trichuriasis in Malaysia treated with albendazole

Tee MH, Lee YY, Majid NA, Noori NM, Raj SM

Southeast Asian J. Trop. Med. Public Health, 2013 Jan;44(1):19-24.

PMID: 23682433

We studied asymptomatic primary schoolchildren in northeastern Malaysia with light to moderate trichuriasis to determine the effect of albendazole treatment on growth rates and TNF-alpha levels. Thirty-seven schoolchildren aged 6-7 years with stool samples positive for Trichuris trichiura and negative for other geohelminths and protozoa were randomized to receive albendazole 400 mg or a placebo daily for 2 days. Anthropometric parameters at baseline, 3, 6 and 12 months were compared between the 2 groups. The placebo group had a significantly greater increase in height (p = 0.04) than the albendazole treatment group. There were no significant differences in urinary TNF-alpha levels (p = 0.8) between the 2 groups and no significant changes between baseline and 1 month post-treatment levels. Further studies are needed to determine the etiology of this apparent association between the albendazole treatment group and the delay in growth rate at 6 months post-treatment.

Cullen and Grey Turner signs in abdominal pain

Chuah YY, Lee YY

Med J Aust, 2021 03;214(4):164.

PMID: 33458825 DOI: 10.5694/mja2.50924

A Critical Appraisal of COVID-19 in Malaysia and Beyond

Abdullah JM, Wan Ismail WFN, Mohamad I, Ab Razak A, Harun A, Musa KI, et al.

Malays J Med Sci, 2020 Mar;27(2):1-9.

PMID: 32308536 DOI: 10.21315/mjms2020.27.2.1

When the first report of COVID-19 appeared in December 2019 from Wuhan, China, the world unknowingly perceived this as another flu-like illness. Many were surprised at the extreme steps that China had subsequently taken to seal Wuhan from the rest of the world. However, by February 2020, the SARS-CoV-2 virus, which causes COVID-19, had spread so quickly across the globe that the World Health Organization officially declared COVID-19 a pandemic. COVID-19 is not the first pandemic the world has seen, so what makes it so unique in Malaysia, is discussed to avoid a future coronacoma.

Fulltext Microplastic Pollution and Health and Relevance to the Malaysia's Roadmap to Zero Single-Use Plastics 2018-2030

Ma ZF, Ibrahim YS, Lee YY

Malays J Med Sci, 2020 May;27(3):1-6.

PMID: 32684801 DOI: 10.21315/mjms2020.27.3.1

Microplastic pollution is an emerging environmental and public health threat worldwide including Malaysia. Microplastics are widespread in drinking water, but also food products especially seafood, an important dietary source for the Malaysians. Potential health hazards may be a result of chemicals, physical properties and microbial disturbance associated with microplastic exposure. However, most studies were performed in animals rather than in human. Nevertheless, in recognition of rising threat from microplastics, in 2018, the Malaysia's Roadmap to Zero Single-use Plastics 2018-2030 has been released. In this editorial, we firstly discussed the potential impact of microplastics on human health, followed by the strategies or limitations highlighted in the Malaysia's Roadmap.

Why do we still have Helicobacter Pylori in our Stomachs

Abadi AT, Ierardi E, Lee YY

Malays J Med Sci, 2015 Sep;22(5):70-75.

PMID: 28239271

The existence of any infectious agent in a highly acidic human stomach is contentious, but the chance finding of Helicobacter pylori is by no means an accident. Once H. pylori colonises the gastric mucosa, it can persist for a lifetime, and it is intriguing why our immune system is able to tolerate its existence. Some conditions favour the persistence of H. pylori in the stomach, but other conditions oppose the colonisation of this bacterium. Populations with high and extremely low prevalence of H. pylori provide useful insights on the clinical outcomes that are associated with this type of infection. Adverse clinical outcomes including peptic ulcer disease and gastric cancer depend on a delicate balance between a harmless inflammation and a more severe kind of inflammation. Is the only good H. pylori really a dead H. pylori? The jury is still out.

Fulltext Placebo Controlled Trials: Interests of Subjects versus Interests of Drug Regulators

Sasongko TH, Othman NH, Hussain NHN, Lee YY, Abdullah S, Husin A, et al.

Malays J Med Sci, 2017 Aug;24(4):1-4.

PMID: 28951684 DOI: 10.21315/mjms2017.24.4.1

The use of placebo-controlled trials in situations where established therapies are available is considered ethically problematic since the patients randomised to the placebo group are deprived of the beneficial treatment. The pharmaceutical industry and drug regulators seem to argue that placebo-controlled trials with extensive precautions and control measures in place should still be allowed since they provide necessary scientific evidence for the efficacy and safety of new drugs. On the other hand, the scientific value and usefulness for clinical decision-making may be much higher if the new drug is compared directly to existing therapies. As such, it may still be unethical to impose the burden and risk of placebo-controlled trials on patients even if extensive precautions are taken. A few exceptions do exist. The use of placebo-controlled trials in situations where an established, effective and safe therapy exists remains largely controversial.

Fulltext What is obesity doing to your gut?

Lee YY

Malays J Med Sci, 2015 Jan-Feb;22(1):1-3.

PMID: 25892944

Obesity is a fast-emerging epidemic in the Asia-Pacific region, with numbers paralleling the rising global prevalence within the past 30 years. The landscape of gut diseases in Asia has been drastically changed by obesity. In addition to more non-specific abdominal symptoms, obesity is the cause of gastro-oesophageal reflux disease, various gastrointestinal cancers (colorectal cancer, hepatocellular carcinoma, oesophageal adenocarcinoma, gastric cardia adenocarcinoma, pancreatic cancer and gallbladder cancer) and non-alcoholic fatty liver disease. Abnormal cross-talk between the gut microbiome and the obese host seems to play a central role in the pathogenesis, but more studies are needed.

Fulltext The deadly ebola threat in the midst of an overwhelming dengue epidemic

Besari AM, Md Noor SS, Lee YY

Malays J Med Sci, 2014 Nov-Dec;21(6):9-13.

PMID: 25897277 MyJurnal

The recent death tolls and morbidities associated with two deadly viral haemorrhagic fevers (VHFs), i.e., Ebola and dengue, are simply shocking. By the end of August 2014, 65 672 people were afflicted with dengue fever (DF) in Malaysia, with 9505 from Kelantan, and there were 128 reported deaths. More astounding are the death tolls associated with Ebola: 3091 deaths from 6574 reported cases so far. It is not difficult to imagine the potential disaster if Ebola spreads beyond Africa. VHFs are characterised by an acute onset of fever, vascular disruption and a rapid progression to shock and death. The revised World Health Organization (WHO) 2012 classification (dengue with and without warning signs and severe dengue) is more clinically relevant and allows more streamlined admission. With good administrative support and public health and governmental efforts, the dengue epidemic in Malaysia is now more contained. However, there should be no laxity with the imminent lethal Ebola threat. Human-to-human transmission is an important mechanism for the spread of Ebola, and this calls for strict precautions regarding contact with any suspected cases. In contrast, the control and elimination of dengue would require successful control of the vectors and their breeding sites.

Fulltext A Theory Planned Behaviour of Study on Improving Abdominal Bloating among the Malays Population: A Qualitative Study

Abdullah N, Kueh YC, Kuan G, Yahaya FH, Lee YY

Malays J Med Sci, 2022 Dec;29(6):77-88.

PMID: 36818903 DOI: 10.21315/mjms2022.29.6.8

BACKGROUND: Abdominal bloating (AB) is a common medical complaint known to diminish patients' quality of life. However, lifestyle and behavioural changes could mitigate its expression and severity. This study sought to explore the health beliefs, intentions and health-promoting behaviours among people with AB in Kelantan, Malaysia.

METHODS: The theory of planned behaviour (TPB) was employed to explore the factors that influence the management of adults with AB, namely health beliefs and intentions. An interview guide was developed by adapting the TPB and the findings of prior studies concerning the factors associated with AB management. All eligible participants took part in in-depth interviews.

RESULTS: The mean age of the participants was 32.5 years old (standard deviation [SD] = 14.19 years old) and the majority of participants were female (58.3%). The themes and sub-themes that emerged following the application of the TPB framework represented the qualitative results of this study, which indicated that the health beliefs, intentions and health-promoting behaviours observed among people with AB were closely related.

CONCLUSION: The findings of this study suggest that the adoption of a healthy lifestyle could be an effective means of improving AB. Thus, it is vital to implement a health education programme that promotes health-related beliefs and intentions in order to trigger health-promoting behaviour among people with AB.

Fulltext Is Gut Involvement a Cause or Effect of COVID-19?

Zulkifli KK, Tan PO, Mustaffa N, Chuah YY, Muthukaruppan R, Ma ZF, et al.

Malays J Med Sci, 2021 Dec;28(6):186-193.

PMID: 35002498 DOI: 10.21315/mjms2021.28.6.14

Digestive disorder symptoms in COVID-19 may be similar in form to post-infectious functional gastrointestinal disorder (PI-FGID). To cause clinical effects, SARS-CoV-2 must reach the bowels and gastric hypochlorhydria may facilitate such transit. Asian elderly are predisposed to greater infection rate and severity of COVID-19, and the high prevalence of gastric atrophy and intake of proton-pump inhibitor in this aged group might explain the risk. Persistence shedding of SARS-CoV-2 in stools indicates that faecal transmission should not be disregarded. Gut involvement in COVID-19 is mediated by angiotensin-converting enzyme 2 (ACE2) receptor, which serves as the entry point for SARS-CoV-2 in the small bowel. ACE2 dysregulation has an impact on the homeostasis of gut microbiota and altered inflammatory response. Liver injury is variable in COVID-19 and is likely a result of by-stander effects rather than actual viropathic process. Further research is needed to understand if gut involvement is a cause or effect of SARS-CoV-2.

Fulltext The Brain-Gut Clinic in Hospital Universiti Sains Malaysia: Pioneering New Service to Advance Neuro-Gastroenterology and Motility in Malaysia

Lee YY, Izham N, Mohd Zulkifly MF, Mohamed Mustafar MF, Ismail AK, Mohamed Shah NFFN, et al.

Malays J Med Sci, 2023 Jun;30(3):1-7.

PMID: 37425382 DOI: 10.21315/mjms2023.30.3.1

Neurogastroenterology and motility is a new but advanced subspecialty within gasteroenterology that cater to difficult, persistent and refractory gut-brain symptoms. Hospital USM has the country's first and new state-of-the art motility lab that was recently launched on the 25 May 2023, and is covered in nationwide media. Another first is the Brain-Gut Clinic, established on the 16 November 2022. The clinic is a new concept that builds on unique multiple disciplines in relation to the gut-brain axis. It is hoped that there will be more awareness on the existence of neurogastroenterology and motility among doctors and community, and that more research can be forthcoming to reduce the disease burden.

Fulltext Cat flea infestation in a hospital: a case report

Muthupalaniappen L, Norhayati M, Lee YY

Korean J Parasitol, 2012 Mar;50(1):79-82.

PMID: 22451739 DOI: 10.3347/kjp.2012.50.1.79

Cat flea bite in humans results in extremely pruritic skin lesions. It has been reported to occur among those living in domiciliary accommodation. However, nosocomial infestation with cat flea has not been reported. We hereby report a case of nosocomial infestation of cat flea in a hospital facility. Identification of the parasite, its appropriate eradication, and adequate medical management of the patients resulted in a satisfactory outcome.

Evidence against Helicobacter pylori being related to childhood asthma

Raj SM, Choo KE, Noorizan AM, Lee YY, Graham DY

J Infect Dis, 2009 Mar 15;199(6):914-5.

PMID: 19239342 DOI: 10.1086/597066

Displaying publications 21 - 40 of 245 in total