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Clinical and economic implications of upper gastrointestinal adverse events in Asian rheumatological patients on long-term non-steroidal anti-inflammatory drugs

Pok LSL, Shabaruddin FH, Dahlui M, Sockalingam S, Mohamed Said MS, Rosman A, et al.

Int J Rheum Dis, 2018 May;21(5):943-951.
PMID: 29314744 DOI: 10.1111/1756-185X.13256

AIM: To determine the incidence and direct costs of NSAID-induced upper GI adverse events in Malaysian rheumatology patients.
METHODS: A retrospective, multi-centre, cohort study of rheumatology patients on long-term NSAIDs was conducted. Clinical data of patients treated between 2010 and 2013 were collected for a 24-month follow-up period. The costs of managing upper GI adverse events were based on patient level resource use data.
RESULTS: Six hundred and thirty-four patients met the inclusion criteria: mean age 53.4 years, 89.9% female, diagnosis of rheumatoid arthritis (RA; 59.3%), osteoarthritis (OA; 10.3%) and both RA and OA (30.3%). Three hundred and seventy-one (58.5%) patients were prescribed non-selective NSAIDs and 263 (41.5%) had cyclo-oxygenase-2 inhibitors. Eighty-four upper GI adverse events occurred, translating into a risk of 13.2% and an incidence rate of 66.2 per 1000 person-years. GI adverse events comprised: dyspepsia n = 78 (12.3%), peptic ulcer disease (PUD) n = 5 (0.79%) and upper GI bleeding (UGIB) n = 1 (0.16%). The total direct healthcare cost of managing adverse events was Malaysian Ringgit (MR) 37 352 (US dollars [USD] 11 419) with a mean cost of MR 446.81 ± 534.56 (USD 136.60 ± 163.42) per patient, consisting mainly of GI pharmacotherapy (33.8%), oesophagoduodenoscopies (23.1%) and outpatient clinic visits (18.2%). Mean cost per patient by GI events were: dyspepsia, MR 408.98 ± 513.29 (USD125.03 ± 156.92); PUD, MR 805.93 ± 578.80 (USD 246.39 ± 176.95); UGIB, MR 1601.94 (USD 489.74, n = 1).
CONCLUSION: The economic burden of GI adverse events due to long-term NSAIDs use in Malaysian patients with chronic rheumatic diseases is modest.
Study site: Rheumatology clinics, Hospital Putrajaya, Hospital Selayang, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Gastrointestinal Diseases/chemically induced*; Gastrointestinal Diseases/economics*; Gastrointestinal Diseases/ethnology; Gastrointestinal Diseases/therapy
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) Induced Dyspepsia

Yap PR, Goh KL

Curr Pharm Des, 2015;21(35):5073-81.
PMID: 26369685

Non-steroidal anti-inflammatory drugs (NSAIDs) are the most prescribed group of drugs in the world. They are used primarily for pain relief in chronic inflammatory joint disease and act by inhibiting enzymes COX1 and COX2 and ultimately preventing the production of active prostanoids which are required for the innate inflammatory pathway. The use of NSAIDs have been associated with the development of gastrointestinal (GI) symptoms ranging from simple dyspepsia to life threatening GI bleeds and perforations. The definition of dyspepsia has evolved over the years and this has hampered accurate studies on the prevalence of dyspepsia as different studies used varying criteria to define dyspepsia. It is now known that NSAIDs significantly increase the risk of dyspepsia.The risk of developing peptic ulcer disease vary with specific NSAIDs and dosages but there is no correlation between the symptoms of dyspepsia and underlying peptic ulcers. The pathogenesis of dyspepsia with NSAIDs is not completely understood. Peptic ulceration alone is not able to account for the majority of dyspepsia symptoms encountered by NSAIDs users. Erosive oesophagitis secondary to NSAIDs may be contributing factor to the prevalence of dyspepsia in NSAIDs users. Altered gut permeability and changes in gastric mechanosensory function due to NSAIDs may also be a contributory factor. Management of NSAID induced dyspepsia is involves a multipronged approach. Drug avoidance if possible would be ideal. Other options include using the lowest effective dose, changing to an NSAIDs with a safer GI risk profile, avoiding concurrent use with other NSAIDs or if the patient has a previous history of peptic ulcer disease, and co-prescribing with anti-secretory medications such as proton pump inhibitors. Eradication of Helicobacter pylori has a protective role against developing peptic ulcers and may also improve symptoms of NSAIDs induced dyspepsia.

Matched MeSH terms: Gastrointestinal Diseases/chemically induced*; Gastrointestinal Diseases/physiopathology
Fulltext Sustained benefit from intravenous immunoglobulin therapy for gastrointestinal involvement in systemic sclerosis

Raja J, Nihtyanova SI, Murray CD, Denton CP, Ong VH

Rheumatology (Oxford), 2016 Jan;55(1):115-9.
PMID: 26320139 DOI: 10.1093/rheumatology/kev318

OBJECTIVE: IVIG is known to confer significant benefit in rheumatologic conditions, including inflammatory myopathy. This study aimed to assess the efficacy of IVIG across different aspects of internal organ involvement in refractory active SSc, particularly the gastrointestinal (GI) system.
METHODS: SSc patients with overlap polymyositis who remained active and unresponsive to conventional disease-modifying agents and who subsequently received IVIG were identified. GI symptoms were assessed using validated questionnaires. The Medical Research Council Sum Score for muscle strength and modified Rodnan skin score (mRSS) were assessed. Serial measurements were undertaken at baseline prior to the first IVIG treatment and post-treatment in the most recent assessment.
RESULTS: Fifteen SSc patients were consecutively recruited into this observational study. The mean duration of IVIG treatment was 2.3 years, with treatment frequency ranging from every 6 weeks to 4 months. Compared with baseline, there was a significant reduction in gastro-oesophageal reflux frequency and intensity mean scores (P = 0.006 and P = 0.013, respectively). Significant improvement in the Gastrointestinal Tract (GIT) 2.0 score from a baseline mean score of 1.07 (s.d. 0.67) to 0.60 (0.46) (P = 0.002) was observed. There was regression in the markers of muscle disease with a reduction in the mean (s.d.) Medical Research Council sum score and the median creatine kinase level (P = 0.001 and P = 0.025, respectively). Significant amelioration of the mean basal modified Rodnan skin score from 21.5 (s.d. 13.8) to 10 (10.6) (P = 0.005) was observed.
CONCLUSION: IVIG may be a helpful adjunctive therapy in the amelioration of some key clinical aspects in refractory SSc. Sustained benefit from IVIG suggests a specific immunomodulatory effect on those with established SSc GI complications.
Study site: Royal Free Hospital, United Kingdom

Matched MeSH terms: Gastrointestinal Diseases/drug therapy*; Gastrointestinal Diseases/etiology
Fulltext Honey, Propolis, and Royal Jelly: A Comprehensive Review of Their Biological Actions and Health Benefits

Pasupuleti VR, Sammugam L, Ramesh N, Gan SH

Oxid Med Cell Longev, 2017;2017:1259510.
PMID: 28814983 DOI: 10.1155/2017/1259510

BACKGROUND: There are several health benefits that honeybee products such as honey, propolis, and royal jelly claim toward various types of diseases in addition to being food.
SCOPE AND APPROACH: In this paper, the effects of honey, propolis, and royal jelly on different metabolic diseases, cancers, and other diseases have been reviewed. The modes of actions of these products have also been illustrated for purposes of better understanding.
KEY FINDINGS AND CONCLUSIONS: An overview of honey, propolis, and royal jelly and their biological potentials was highlighted. The potential health benefits of honey, such as microbial inhibition, wound healing, and its effects on other diseases, are described. Propolis has been reported to have various health benefits related to gastrointestinal disorders, allergies, and gynecological, oral, and dermatological problems. Royal jelly is well known for its protective effects on reproductive health, neurodegenerative disorders, wound healing, and aging. Nevertheless, the exact mechanisms of action of honey, propolis, and royal jelly on the abovementioned diseases and activities have not been not fully elucidated, and further research is warranted to explain their exact contributions.

Matched MeSH terms: Gastrointestinal Diseases/pathology; Gastrointestinal Diseases/prevention & control
Fulltext Indication of acid suppression therapy and predictors for the prophylactic use of protonpump inhibitors vs. histamine-2 receptor antagonists in a Malaysian tertiary hospital

Oh AL, Tan AG, Phan HS, Lee BC, Jumaat N, Chew SP, et al.

Pharm Pract (Granada), 2015 Apr-Jun;13(3):633.
PMID: 26445624 DOI: 10.18549/PharmPract.2015.03.633

Proton-pump inhibitors (PPI) and histamine-2 receptor antagonists (H2RA) are common acid suppressants used in gastrointestinal disorders. The trend of usage in Malaysia has changed from predominantly H2RA to PPI from 2007 to 2008, 3.46 versus 2.87 and 2.99 versus 3.24 DDD (Defined Daily Dose)/1000 population/day respectively. This raises concerns as PPI overutilization amounts to higher cost expenditure and are associated with various untoward consequences such as Clostridium difficile-associated diarrhea, pneumonia, and osteoporosis.

Matched MeSH terms: Gastrointestinal Diseases
Time trends in upper gastrointestinal diseases and Helicobacter pylori infection in a multiracial Asian population--a 20-year experience over three time periods

Leow AH, Lim YY, Liew WC, Goh KL

Aliment Pharmacol Ther, 2016 Apr;43(7):831-7.
PMID: 26847417 DOI: 10.1111/apt.13550

Marked epidemiological changes in upper gastrointestinal diseases and Helicobacter pylori infection have taken place in the Asian Pacific region. In particular, differences with respect to race in the multiracial Asian population in Malaysia have been important and interesting.

Matched MeSH terms: Gastrointestinal Diseases/diagnosis*; Gastrointestinal Diseases/ethnology*; Gastrointestinal Diseases/microbiology
Fulltext Effect of psyllium and gum Arabic biopolymers on the survival rate and storage stability in yogurt of Enterococcus duransIW3 encapsulated in alginate

Nami Y, Haghshenas B, Yari Khosroushahi A

Food Sci Nutr, 2017 05;5(3):554-563.
PMID: 28572941 DOI: 10.1002/fsn3.430

Different herbal biopolymers were used to encapsulate Enterococcus durans IW3 to enhance its storage stability in yogurt and subsequently its endurance in gastrointestinal condition. Nine formulations of encapsulation were performed using alginate (ALG), ALG-psyllium (PSY), and ALG-gum Arabic (GA) blends. The encapsulation efficiency of all formulations, tolerance of encapsulated E. durans IW3 against low pH/high bile salt concentration, storage lifetime, and release profile of cells in natural condition of yogurt were evaluated. Result revealed 98.6% encapsulation efficiency and 76% survival rate for all formulation compared with the unencapsulated formulation cells (43%). The ALG-PSY and ALG-GA formulations have slightly higher survival rates at low pH and bile salt condition (i.e., 76-93% and 81-95%, respectively) compared with the ALG formulation. All encapsulated E. durans IW3 was released from the prepared beads of ALG after 90 min, whereas both probiotics encapsulated in ALG-GA and ALG-PSY were released after 60 min. Enterococcus durans IW3 was successfully encapsulated in ALG, ALG-GA, and ALG-PSY beads prepared by extrusion method. ALG-GA and ALG-PSY beads are suitable delivery carriers for the oral administration of bioactive compounds like probiotics. The GA and PSY gels exhibited better potential for encapsulation of probiotic bacteria cells because of the amendment of ALG difficulties and utilization of therapeutic and prebiotic potentials of these herbal biopolymers.

Matched MeSH terms: Gastrointestinal Diseases
Fulltext Survival study and haemolysin activity of Escherichia coli in raw and pasteurized milk produced in Negeri Sembilan

Farra Amira Mohamed, Aimi Nadia Ramli,, Noorlis Ahmad

Journal of Academia Universiti Teknologi MARA Negeri Sembilan, 2020;8(1):66-77.
MyJurnal

Demand for milk has increased in Malaysia due to the increased in awareness of healthy foods consumption.
Hence, research of milk is crucial to ensure that it is not contaminated with Escherichia coli. This study
evaluated the survival of Escherichia coli at different temperature and haemolysin activity of Escherichia
coli on blood agar. A total of 8 samples of raw fresh and pasteurized milk were collected from nearby farm
and market in Negeri Sembilan, Malaysia. After an overnight exposure to four different temperatures of
0
0C, 280C, 350C and 450C, the bacteriological test of milk was evaluated for the presence of Escherichia
coli. Overall, all raw fresh milk sampled exceeded the acceptable limit of bacterial count of 1 x 105 CFU/ml.
Raw fresh milk recorded the highest count at 35oC with 4.4 x 107 CFU/ml and the lowest at 0oC with 8.3 x
104 CFU/ml. The presence of Escherichia coli was detected in 7/20(35%) of the total raw fresh milk
samples. All pasteurized milk showed no presence of Escherichia coli due to the effectiveness of heat
treatment. Haemolysin test showed no haemolytic activity. Milk contaminated with Escherichia coli can
cause diarrheal, gastrointestinal diseases and urinary infection. Hence, it is important to study the survival
rate of Escherichia coli and its pathogenicity in milk to ensure public safety.

Matched MeSH terms: Gastrointestinal Diseases
Fulltext Effects of Different Types of Plant-Based Milk and Animal-Based Milk Delivery Vehicle on Growth of Lactobacillus Plantarum

Nurhazirah Salehen, Nurzafirah Mazlan, Oon, Chuah Li, Siti Marwanis Anua,, Young, Thung Tze

Journal of Management & Science, 2018;16(2):67-73.
MyJurnal

Probiotics has been discovered long time ago for its beneficial effect on health when consumed especially to the people who had allergy and gastrointestinal disease. This preliminary study was conducted to find out which vehicles can allow better growth of probiotic. Lactobacillus plantarum was used in this study as choice of probiotic to be cultured in the four types of milk. The pH value was recorded for determination of growths and metabolic activity of the probiotic. Results showed that L. plantarum in soy milk can grow and had a better metabolic activity in the cultured soy milk with pH 3.46 compared to others. The highest growth was recorded at optical density of 1.137 in soy milk at 560nm. This result showed that L. plantarum in soy milk multiply rapidly compared to other milks. As conclusion, soy milk has better development of probiotic as delivery vehicles compare to cow milk, goat milk and coconut milk.

Matched MeSH terms: Gastrointestinal Diseases
Relapsing retroperitoenal abscess secondary to juvenile dermatomyositis: Complexity in management

Jothinathan M, Lau KS, Vanusha D

Med J Malaysia, 2020 03;75(2):178-180.
PMID: 32281605

Juvenile dermatomyositis (JDM) is a systemic autoimmune condition with myopathy. Gastrointestinal and pulmonary manifestations are rare presentation of JDM. Gastrointestinal perforation incidence in JDM is associated with vasculopathy and ischaemia. There are only few reported case of management of JDM with gastrointestinal complication. Management of such condition is challenging. We present a 21-year-old man with spontaneous descending colon perforation undergoing Hartmann's procedure. He subsequently presented with recurrent retroperitoneal abscess at five and 30 months following the initial presentation which was treated with percutaneous drainage. A high index of suspicion is necessary in JDM patients presenting with acute abdomen.

Matched MeSH terms: Gastrointestinal Diseases
Fulltext Effects of xiang sha yang wei wan on ethanol-induced gastric ulcer in Sprague Dawley rats: a histological study

A.M.S. Al-Qaraghuli, E.M.N. Abdel Wahab, I.M. Al-Ani

International Medical Journal Malaysia, 2013;12(2):3-10.
MyJurnal

Xiang Sha Yang Wei Wan (XSYWW) is a Chinese traditional medicine that is used for gastrointestinal disorders, specifically gastric ulcer in many countries of South-East Asia. The aim of the study was to evaluate the potential effects of XSYWW on ethanol-induced gastric ulcer in rats by means of histological Study. On a similar basis of treatment, ranitidine, a conventional medication was used as gold standard. Methods: Fifty five male Sprague-Dawley rats (250-300 gm) were divided into four groups. Group I (ethanol treated group) was the control group and gastric ulcers were induced by administering 100% ethanol (1 ml/200 g). Group II (Pre-treatment group) was divided into two subgroups; they were orally fed with 1.0 gm/kg and 2.0 gm/kg respectively of XSYWW solution. Thirty minutes later they were administered with absolute ethanol as in group I. Group III, was given an oral dose of 2gm/kg of XSYWW solution after one hour of ethanol administration. Group IV was given an oral dose of 200mg/kg ranitidine solution after one hour of ethanol administration. Five rats from groups I, III and IV were sacrificed on day 1, 2 and 3 while the animals of group II were sacrificed one hour after ethanol administration. Results: Histological study of the stomachs from ethanol treated rats showed multiple ulcers of various depths that reached the muscularis and the serosa. Conclusion: Pre or post-treated rats with XSYWW showed that XSYWW has protective effect against ethanol-induced gastric mucosal lesion. However, there was a faster and more complete healing process in the ranitidine treated group when compared to the XSYWW treated subjects.

Matched MeSH terms: Gastrointestinal Diseases
Fulltext Gastrointestinal involvement in Henoch Schonlein purpura: a case report

Siti Kamariah CM, Rohaizan Y

International Medical Journal Malaysia, 2009;8(2):37-38.
MyJurnal

Henoch-Schonlein purpura or anaphylactoid purpura is a systemic vasculitis of unknown cause that affects small vessels and mainly involves the skin, joints, gastrointestinal tract and kidneys. Gastrointestinal involvement occurs in more than half of patients and is thought to be related to edema and intramural haemorrhage. Radiologically the gastrointestinal findings are mainly those of bowel ischemia with thumbprinting and bowel wall oedema. Although this disease is usually treated conservatively, aggressive intervention is occasionally performed because of acute abdominal symptoms due to complications, such as perforation, intussusception and obstruction. This report illustrates a case of Henoch-Schonlein purpura with acute abdominal symptoms due to intussusception.

Matched MeSH terms: Gastrointestinal Diseases
Fulltext Choledochal cyst in pregnancy

Koh KS, Bickle I, Mathew VV, Chong VH

Malays Fam Physician, 2016;11(2-3):27-29.
PMID: 28491243

INTRODUCTION: Biliary diseases during pregnancy are not uncommon and are frequently due to cholelithiasis. Choledochal cyst during pregnancy is rare. The management of biliary pathologies during pregnancy poses a challenge as the window of opportunity to carry out any interventions with minimal risk is small.

CASE REPORT: We report the case of a lady who was diagnosed with a large type I choledochal cyst during the second trimester of pregnancy. Due to increasing symptoms and recurrent cholangitis, she was managed with antibiotics and surgical resection. She remained well and delivered a healthy baby boy.

CONCLUSION: Clinicians need to consider choledochal cyst as a differential in pregnant patients presenting with upper abdominal fullness.

Matched MeSH terms: Gastrointestinal Diseases
Fulltext Descriptive analysis of total medical admissions and common medical disorders in 1987 Kuantan General Hospital, using computerized in-patients' discharge record

Lim TO, Looi HW, Harun K, Marzida

Med J Malaysia, 1991 Sep;46(3):239-46.
PMID: 1839919

Using computerized in-patients' discharge records, a descriptive analysis was carried out of all medical admission in 1987 in a general hospital. The survey found that there were a total of 4053 admissions in 1987. A wide range of medical disorders were seen reflecting the lack of subspecialization. Cardiovascular disorders topped accounting for 25.6% of all admissions, followed by gastrointestinal and hepatobiliary disorders 12.8% and respiratory disorders 10.7%. The commonest specific medical disorders seen were hypertension 13.8%, diabetes mellitus 10.2%, ischaemic heart disease 7% and asthma 4.5%. The age, sex, ethnic and geographical distributions of the common medical disorders seen appear to conform to two broad pattern; hypertension, diabetes, ischaemic heart disease and cerebrovascular disease affected the older patients, had even ethic distribution and predominantly urban. Malaria, non-specific fever, viral hepatitis and acute gastroenteritis affected the younger patients, predominantly rural and Malay. Information from such surveys may be useful for planning and organization of medical services.

Matched MeSH terms: Gastrointestinal Diseases/epidemiology
Effects of Lugol's solution on thyroid function in normals and patients with untreated thyrotoxicosis

Tan TT, Morat P, Ng ML, Khalid BA

Clin Endocrinol (Oxf), 1989 Jun;30(6):645-9.
PMID: 2591064

Thirty-eight normal volunteers and 10 patients with untreated thyrotoxicosis were each given 0.5 ml of Lugol's solution daily for 10 days. On days 0, 5, 10, 15 and 20, serum levels of T4, free T4, T3 and TSH (by sensitive immunoradiometric assay) were measured. In normal subjects, the serum concentrations of free T4 declined significantly at day 10 while TSH levels were significantly increased at days 5, 10 and 15. Serum levels of T4 and T3 did not change significantly. All the observed changes took place within the limits of normal ranges for the hormones mentioned. In contrast, in the thyrotoxic subjects, both T4 and T3 were significantly decreased at days 5 and 10, while serum TSH remained below detection limit (0.14 mU/l) throughout the study. Short exposure to excessive iodide in normal subjects affects T4 and T3 release and this effect could be partially overcome by compensatory increase in TSH. In thyrotoxicosis, lack of compensatory increase in TSH results in rapid decreases in T4 and T3 levels. The integrity of the hypothalamo-pituitary-thyroidal axis may be effectively assessed by measuring TSH response to iodide suppression, using a highly sensitive immunoradiometric assay.

Matched MeSH terms: Gastrointestinal Diseases/chemically induced
To breast feed or not?

Nutr Rev, 1972 May;30(5):112-4.
PMID: 4554312
Matched MeSH terms: Gastrointestinal Diseases/etiology
Radiology and disease patterns in Malaysia

Wastie ML

Trop Geogr Med, 1975 Mar;27(1):17-24.
PMID: 1138449

The organisation of the radiological services in Malaysia is described and those diseases in which radiology plays an important part in diagnosis are discussed. As radiology embraces all specialities a pattern of diseases emerges which is different from that seen in the West. The control of infectious diseases, the general improvement in health care and the more sophisticated radiological investigations now available mean that in future radiology will play a much more important part in diagnosis and management of patients.

Matched MeSH terms: Gastrointestinal Diseases/radiography
Fulltext Preparation and characterization of a gastric floating dosage form of capecitabine

Taghizadeh Davoudi E, Ibrahim Noordin M, Kadivar A, Kamalidehghan B, Farjam AS, Akbari Javar H

Biomed Res Int, 2013;2013:495319.
PMID: 24288681 DOI: 10.1155/2013/495319

Gastrointestinal disturbances, such as nausea and vomiting, are considered amongst the main adverse effects associated with oral anticancer drugs due to their fast release in the gastrointestinal tract (GIT). Sustained release formulations with proper release profiles can overcome some side effects of conventional formulations. The current study was designed to prepare sustained release tablets of Capecitabine, which is approved by the Food and Drug Administration (FDA) for the treatment of advanced breast cancer, using hydroxypropyl methylcellulose (HPMC), carbomer934P, sodium alginate, and sodium bicarbonate. Tablets were prepared using the wet granulation method and characterized such that floating lag time, total floating time, hardness, friability, drug content, weight uniformity, and in vitro drug release were investigated. The sustained release tablets showed good hardness and passed the friability test. The tablets' floating lag time was determined to be 30-200 seconds, and it floated more than 24 hours and released the drug for 24 hours. Then, the stability test was done and compared with the initial samples. In conclusion, by adjusting the right ratios of the excipients including release-retarding gel-forming polymers like HPMC K4M, Na alginate, carbomer934P, and sodium bicarbonate, sustained release Capecitabine floating tablet was formulated.

Matched MeSH terms: Gastrointestinal Diseases/chemically induced; Gastrointestinal Diseases/pathology
Fulltext Antioxidant capacities and total phenolic contents increase with gamma irradiation in two types of Malaysian honey

Hussein SZ, Yusoff KM, Makpol S, Yusof YA

Molecules, 2011 Jul 27;16(8):6378-95.
PMID: 21796076 DOI: 10.3390/molecules16066378

Two types of monofloral Malaysian honey (Gelam and Nenas) were analyzed to determine their antioxidant activities and total phenolic and flavonoid contents, with and without gamma irradiation. Our results showed that both types of honey can scavenge free radicals and exhibit high antioxidant-reducing power; however, Gelam honey exhibited higher antioxidant activity (p < 0.05) than Nenas honey, which is in good correlation (r = 0.9899) with its phenolic contents. Interestingly, we also noted that both irradiated honeys have higher antioxidant activities and total phenolic and flavonoid contents compared to nonirradiated honeys by Folin-Ciocalteu and UV-spectrophotometry methods, respectively. However, HPLC analysis for phenolic compounds showed insignificant increase between irradiated and nonirradiated honeys. The phenolic compounds such as: caffeic acid, chlorogenic acid, ellagic acid, p- coumaric acid, quercetin and hesperetin as indicated by HPLC method were found to be higher in Gelam honey versus Nenas honey. In conclusion, irradiation of honey causes enhanced antioxidant activities and flavonoid compounds.

Matched MeSH terms: Gastrointestinal Diseases/diet therapy*; Gastrointestinal Diseases/physiopathology
Fulltext Detailed assessment of nutritional status and eating patterns in children with gastrointestinal diseases attending an outpatients clinic and contemporary healthy controls

Tsiountsioura M, Wong JE, Upton J, McIntyre K, Dimakou D, Buchanan E, et al.

Eur J Clin Nutr, 2014 Jun;68(6):700-6.
PMID: 24424079 DOI: 10.1038/ejcn.2013.286

BACKGROUND/OBJECTIVES: In the era of modern multidisciplinary clinical management, very little is known about the prevalence and presentation of malnutrition in children with gastrointestinal disorders (GastroD) particularly employing composite, global measures of nutritional status.
SUBJECTS/METHODS: Anthropometry, body composition, dietary intake, eating habits and grip strength were assessed with bedside methods in 168 patients from outpatient gastroenterology clinics (n, median (IQR) years; Crohn's disease (CD): n=53, 14.2 (11.6:15.4); ulcerative colitis (UC): n=27, 12.2 (10.7:14.2); coeliac disease: n=31, 9.3 (7.5:13.6); other GastroD: n=57, 9.8 (7.2:13.8)) and compared with 62 contemporary healthy controls (n, median (IQR): 9.8 (6.9:13.8)) and the results of the recent UK, National Diet and Nutritional Survey (NDNS).
RESULTS: Children with CD had lower BMI z-scores than controls (median (IQR): -0.3 (-0.9:0.4) vs 0.3 (-0.6:1.4); P=0.02) but only 2% were classified as thin (BMI z-score

Matched MeSH terms: Gastrointestinal Diseases/complications*

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