Displaying publications 41 - 55 of 55 in total

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  1. Emmanuel J, Omar H, See LT
    JGH Open, 2020 Dec;4(6):1059-1064.
    PMID: 33319037 DOI: 10.1002/jgh3.12386
    BACKGROUND AND AIM: The advent of endoscopic ultrasound-guided biliary drainage (EUS-BD) has provided an inimitable alternative for gaining biliary access in patients who fail conventional endoscopic drainage. The antimigratory features of the partially covered metal stent (PCMS), namely, the flange head and uncovered portion of the stent, makes it a valuable option in patients undergoing EUS-guided hepaticogastrostomy (EUS-HGS). The aim of the study is to evaluate the clinical outcome of EUS-BD via the hepaticogastrostomy approach using PCMS in patients with malignant biliary obstruction after failed ERCP.

    METHODS: This is a single-center retrospective observational study of patients with malignant biliary obstruction undergoing EUS-HGS after failed ERCP between January 2018 and May 2019. The end-point of the study was to assess the technical and clinical success rate, as well as the stent- and procedure-related complications.

    RESULTS: There were 20 subjects in this study. The average age was 71.8 ± 7.6 years. Most patients were male, 16 (80%). Inaccessible papillae was the most common indication for this procedure, 16 (80%). Technical success was achieved in all patients. The average procedural time was 39.9 ± 1.3 min. Mean preprocedural bilirubin levels were 348.6 ± 28.8 and subsequently decreased to 108.94 ± 37.1 μmol/L at 2 weeks postprocedure. The clinical success rate was 95% (19/20), with one patient requiring percutaneous transhepatic biliary drainage (PTBD). There were no stent- or procedure-related complications reported in this study.

    CONCLUSION: EUS-HGS with PCMS is a feasible, effective, and safe alternative for biliary decompression in patients with failed endoscopic retrograde cholangiopancreatography (ERCP).

  2. Ling KL, Hilmi I, Raja Ali RA, Leong RWL, Leung WK, Ng SC, et al.
    JGH Open, 2020 Jun;4(3):320-323.
    PMID: 32514431 DOI: 10.1002/jgh3.12362
    The COVID-19 pandemic, secondary to SARS-CoV-2, has resulted in high mortality and morbidity worldwide. As inflammatory bowel disease (IBD) is a chronic disease, and most patients are on long-term immunosuppressive agents, there is understandable concern, particularly in terms of therapy. In view of this, experts in IBD across the Asia Pacific region were invited to put together recommendations based on their experience and the currently available data. In general, most IBD therapies (with a few exceptions) can be continued safely, and the general consensus is that maintaining disease control should remain the main principle of management. In addition, social distancing measures and the appropriate use of personal protective equipment should be strictly adhered to. During the current pandemic, face-to-face clinic follow ups and non-urgent procedures should be kept to a minimum.
  3. Alam S, Eslam M, Skm Hasan N, Anam K, Chowdhury MAB, Khan MAS, et al.
    JGH Open, 2021 Nov;5(11):1236-1249.
    PMID: 34816009 DOI: 10.1002/jgh3.12658
    The pathophysiology and risk factors of nonalcoholic fatty liver disease (NAFLD) among lean patients is poorly understood and therefore investigated. We performed a meta-analysis of observational studies. Of 1175 articles found through searching from Medline/PubMed, Banglajol, and Google Scholar by two independent investigators, 22 were selected. Data from lean (n = 6768) and obese (n = 9253) patients with NAFLD were analyzed; lean (n = 43 398) and obese (n = 9619) subjects without NAFLD served as controls. Age, body mass index, waist circumference, systolic blood pressure, and diastolic blood pressure (DBP) had significantly higher estimates in lean NAFLD patients than in lean non-NAFLD controls. Fasting blood sugar [MD(mean difference) 5.17 mg/dl, 95% CI(confidence interval) 4.14-6.16], HbA1c [MD 0.29%, 95% CI 0.11-0.48], and insulin resistance [HOMA-IR] [MD 0.49 U, 95% CI 0.29-0.68]) were higher in lean NAFLD patients than in lean non-NAFLD controls. All components of the lipid profile were raised significantly in the former group except high-density lipoprotein. An increased uric acid (UA) level was found to be associated with the presence of NAFLD among lean. Cardio-metabolic profiles of nonlean NAFLD patients significantly differs from the counter group. However, the magnitude of the difference of lipid and glycemic profile barely reached statistical significance when subjects were grouped according to lean and nonlean NAFLD. But DBP (slope: 0.19, P 
  4. Zhang Y, Ma ZF, Zhang H, Pan B, Li Y, Majid HA, et al.
    JGH Open, 2019 Apr;3(2):173-178.
    PMID: 31061894 DOI: 10.1002/jgh3.12125
    Functional bowel disorders, including irritable bowel syndrome (IBS), are a chronic condition that can significantly reduce patients' quality of life. Therefore, this paper will review the roles of a low fermentable oligosaccharides, disaccharides, monosaccharides, and polypols (FODMAP) diet in treating IBS, particularly in an Asian setting. About 20% of the general population is diagnosed with IBS. However, there are limited effective medical therapies available for treating IBS. Therefore, IBS presents a major challenge to the health-care providers. Recently, there is an increasing interest in the use of a diet low in FODMAP for the treatment of IBS. A low FODMAP diet can decrease the delivery of readily fermentable substrates to the small intestine and colon, thereby improving functional gastrointestinal symptoms.
  5. Devi J, Chantarojanasiri T, Hang DV, Lui R, Ali RAR, Butt AS, et al.
    JGH Open, 2025 Jan;9(1):e70080.
    PMID: 39791011 DOI: 10.1002/jgh3.70080
    OBJECTIVES: Despite progress in promoting gender equality, gender bias remains a significant obstacle for women and hinders their academic advancement. We aim to survey and critically analyze women's representation in conferences and changes over time in various regions of Asian countries.

    METHODS: An international survey was conducted with representatives from East Asia (Hong Kong, China, and Japan), South Asia (India and Pakistan), and Southeast Asia (Vietnam and Thailand). The survey collected data on faculty members serving as chairpersons, moderators, speakers, and organizing committee members of annual scientific meetings held between 2018 and 2022.

    RESULTS: A total of 33 conferences were held between 2018 and 2022: 24 in gastroenterology, 5 in hepatology, and 4 in endoscopy across East, South, and Southeast Asia, respectively. The total number of invited faculty members was 4106. Out of 4106, the number of women involved as chairperson, moderator, speakers, and organizing committee was 105, 78, 290, and 146, respectively. The representation of women faculty ranged from 3.8% to 25% in East Asia, 9.2% to 13.5% in South Asia, and 11.8% to 34.3% in Southeast Asia. Overall, the increase in women's participation was minor and statistically non-significant. However, there was an increase of women's participation as chairpersons, moderators, speakers, and organizing committee members from 14.1% in 2018 to 15.2% in 2022.

    CONCLUSION: Participation of women in Asian annual conferences in the capacity of chairperson, moderator, speaker, and/or organizing committee member was significantly under-represented. This under-representation necessitates targeted measures to enhance women's roles in these meetings, thereby supporting their career advancement.

  6. Goh LH, Manoharan M, Goh KL
    JGH Open, 2025 Jan;9(1):e70102.
    PMID: 39850090 DOI: 10.1002/jgh3.70102
    Primary intestinal lymphangiectasia (PIL) is a rare protein-losing gastroenteropathy characterized by diffuse or localized ectasia of the enteric lymphatics, which can be accompanied by lymphatic abnormalities in other parts of the body. This condition results in hypoalbuminemia, hypogammaglobulinemia, and lymphopenia due to the abnormal leakage of lymphatic fluid into the gastrointestinal tract. As there are no specific serological or radiological tests available, the gold standard for diagnosing intestinal lymphangiectasia is endoscopic examination with histopathological examination of intestinal biopsy specimens. We present a rare case of primary intestinal lymphangiectasia in a 62-year-old Chinese woman who presented with a six-month history of lethargy, persistent diarrhea, and progressive weight loss. Gastroscopy and colonoscopy were performed, and biopsies revealed dilated intestinal lymphatics with broadened villi in the small intestine. Secondary causes of intestinal lymphangiectasia were ruled out, confirming the diagnosis of PIL. The patient was treated with a high-protein, low-fat diet supplemented with medium-chain triglycerides, resulting in significant clinical improvement.
  7. Sinnanaidu RP, Poobalan K, Singh ASB, Nair K, Vijayananthan A, Mahadeva S
    JGH Open, 2025 Feb;9(2):e70111.
    PMID: 39959453 DOI: 10.1002/jgh3.70111
    INTRODUCTION: Ascites is a common condition seen by clinicians in secondary care. Data on the epidemiology of ascites in Asians is lacking.

    METHODOLOGY: A retrospective case record review was performed in this large, referral institution between January 2016 and December 2019. Clinical and epidemiological data of adult (age > 18 years) patients with ascites, identified from the Radiology database, were obtained from this institutions' electronic medical records.

    RESULTS: A total of 838 patients (median age 59.77 ± 14.46 years, 56% males, ethnicity: Chinese 41.9%, Malay 34.8%, Indian 22.7%) were included in the study. Malignancy (28.9%) and liver cirrhosis (27.9%) were the most common etiology of ascites. Most of the malignant etiology of ascites were due to female-related (breast and ovarian) and gastrointestinal (colon, liver, pancreatic, bile duct) cancer. Liver cirrhosis-related ascites was mostly due to metabolic-associated fatty liver disease (MASLD, 35.5%) and hepatitis B infection (20.5%). An increased age (> 40 years) was associated with all causes of ascites. The etiology of ascites varied with ethnicity as follows: the most common cause of ascites was malignancy (37.6%) among ethnic Chinese, heart failure (20.5%) in ethnic Malays and chronic liver disease (43.7%) in ethnic Indians.

    CONCLUSION: Malignancy and liver cirrhosis are the leading cause of ascites in a multi-ethnic Asian population. Demographic factors, particularly ethnicity, have a strong influence on the etiology of ascites.

  8. Gaonkar A, Zahiruddin QS, Shabil M, Menon SV, Kaur M, Kumari M, et al.
    JGH Open, 2025 Mar;9(3):e70128.
    PMID: 40130085 DOI: 10.1002/jgh3.70128
    BACKGROUND: Although Helicobacter pylori (H. pylori) infections are widespread throughout the world, it is yet unknown whether they are linked to systemic illnesses like dyslipidemia. The purpose of this systematic review and meta-analysis was to examine the connection between lipid metabolism and H. pylori infection, with a particular emphasis on how it affects dyslipidemia.

    METHODS: We conducted a thorough search up until October 10, 2024, across databases such as PubMed, Web of Science, and Embase. Studies that reported lipid profiles in both H. pylori-infected and non-infected patients were considered eligible. The primary outcomes were triglyceride, LDL-C, HDL-C, and total cholesterol levels, which were examined using a random-effects model in R software version 4.4.

    RESULTS: There were 17 studies with more than 150,000 participants from 681 screened publications. Higher levels of LDL (MD: 5.32 mg/dL; 95% CI: 1.315 to 9.319) and total cholesterol (MD: 6.28 mg/dL; 95% CI: 0.718 to 11.842), as well as lower levels of HDL (MD: -2.06 mg/dL; 95% CI: -3.212 to -0.915), were the results of the meta-analysis. Among those infected, triglyceride levels were likewise higher (MD: 7.93 mg/dL; 95% CI: 0.413 to 15.436), but the odds ratio (OR) did not show a significant increase in risk (OR: 1.002; 95% CI: 0.995 to 1.010).

    CONCLUSION: H. pylori infection is associated with significant dyslipidemia, suggesting a potential link between chronic bacterial infection and lipid metabolism. The findings emphasize the need for further research to explore the mechanisms and potential therapeutic interventions.

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