MyMedR

Fulltext Epiphrenic pulsion diverticulum: an uncommon cause of dysphagia and heartburn

Qua CS, Saravannan K, Goh KL

BMJ Case Rep, 2021 Apr 07;14(4).

PMID: 33827890 DOI: 10.1136/bcr-2021-242920

Fulltext Factors influencing dyspepsia-related consultation: differences between a rural and an urban population

Mahadeva S, Yadav H, Everett SM, Goh KL

Neurogastroenterol Motil, 2011 Sep;23(9):846-53.

PMID: 21740483 DOI: 10.1111/j.1365-2982.2011.01746.x

BACKGROUND:
Dyspepsia is a common, chronic condition but medical consultation rates for symptoms remain variable. We aimed to examine two populations with varied health-care provision to determine predictive factors for dyspepsia-related consultation.

METHODS:
A cross-sectional, population-based study in both an urban and a rural community within a single Asian country was conducted. Details on dyspepsia-related consultation rates over a fixed period and independent factors influencing them were identified.

KEY RESULTS:
A total of 4039/5370 (75.2%) adults from representative rural and urban areas in this country agreed to participate in the study. Although mean ages of respondents were similar (40.4years), the demographics of both populations varied in terms of gender (62.7% female, rural vs 55.7% female, urban, P<0.0001), marital status (75.4% rural vs 70.5% urban, P=0.002), ethnicity, (79% Malay rural vs 45.3% Malays urban, P<0.0001) and socio-economic status (professional occupation 7.1% rural vs 47.3% urban, P<0.0001). Dyspepsia-related consultation rates were found to be higher among rural compared to urban adults (41.4%vs 28.7%, P<0.0001). Over-the-counter medication consumption was higher among urban compared to rural dyspepsia sufferers (n=157 vs n=35, P<0.0001). Following logistic regression, rural population (OR 3.14, 95% CI=1.65-6.0), low quality of life (OR 1.90, 95% CI=1.17-3.10), and self-medication (OR 0.40, 95% CI=0.25-0.62) were found to independently predict dyspepsia-related consultation.

CONCLUSIONS & INFERENCES:
Dyspepsia-related consultation varied significantly between urban and rural communities. Factors within the rural population, self-medication practices, and a low quality of life independently influenced dyspepsia-related consultation.

Fulltext A second case of diphyllobothriasis in Malaysia

Rohela M, Jamaiah I, Goh KL, Nissapatorn V

Southeast Asian J Trop Med Public Health, 2006 Sep;37(5):896-8.

PMID: 17333730

Diphyllobothriasis was first reported in Malaysia in 2002. We are reporting a second case of diphyllobothriasis in Malaysia. The patient was a 37-year-old Chinese male seen at the outpatient clinic with a complaint of passing strands of white color flat worm in his stool. He had no other abdominal complaints. Laboratory and physical examinations were normal. Diphyllobothrium latum was confirmed by examination of the gravid proglottids passed out and the typical operculated eggs expelled from the ruptured proglottids. The patient had a history of eating raw fish. He was treated with a single dose of praziquantel.
Study site: Outpatient clinic, University Malaya Specialist Center (UMSC), Kuala Lumpur, Malaysia

Fulltext A cross-country comparison of tobacco consumption among youths from selected South-Asian countries

Kabir MA, Goh KL, Khan MH

BMC Public Health, 2013 Apr 23;13:379.

PMID: 23617464 DOI: 10.1186/1471-2458-13-379

BACKGROUND: Tobacco consumption (TC) among youths poses significant public health problem in developing countries. This study utilized the data of Global Youth Tobacco Survey (GYTS), 2007 to examine and compare youth TC behavior in Bangladesh, Nepal and Sri Lanka.

METHODS: The GYTS covered a total of 2,242 Bangladeshi, 1,444 Nepalese and 1,377 Sri-Lankan youths aged 13-15 years. They represented response rates of 88.9%, 94.6%, and 85.0% for the three countries, respectively. Socioeconomic, environmental, motivating, and programmatic predictors of TC were examined using cross tabulations and logistic regressions.

RESULTS: Prevalence of TC was 6.9% (9.1% in males, 5.1% in females) in Bangladesh, 9.4% (13.2% in males, 5.3% in females) in Nepal and 9.1% (12.4% in males, 5.8% in females) in Sri Lanka. The average tobacco initiation age was 9.6, 10.24 and 8.61 years, respectively. Cross tabulations showed that gender, smoking among parents and friends, exposure to smoking at home and public places, availability of free tobacco were significantly (P < 0.001) associated with TC in all three countries. The multivariable analysis [odds ratio (95% confidence interval)] indicated that the common significant predictors for TC in the three countries were TC among friends [1.9 (1.30-2.89) for Bangladesh, 4.10 (2.64-6.38) for Nepal, 2.34 (1.36-4.02) for Sri Lanka], exposure to smoking at home [1.7 (1.02-2.81) for Bangladesh, 1.81 (1.08-2.79) for Nepal, 3.96 (1.82-8.62) for Sri Lanka], exposure to smoking at other places [2.67 (1.59-4.47) for Bangladesh, 5.22 (2.76-9.85) for Nepal, 1.76 (1.05-2.88) for Sri Lanka], and the teaching of smoking hazards in schools [0.56 (0.38-0.84) for Bangladesh, 0.60 (0.41-0.89) for Nepal, 0.58 (0.35-0.94) for Sri Lanka].

CONCLUSIONS: An understanding of the influencing factors of youth TC provides helpful insights for the formulation of tobacco control policies in the South-Asian region.

Fulltext Streptococcus mitis induces conversion of Helicobacter pylori to coccoid cells during co-culture in vitro

Khosravi Y, Dieye Y, Loke MF, Goh KL, Vadivelu J

PLoS One, 2014;9(11):e112214.

PMID: 25386948 DOI: 10.1371/journal.pone.0112214

Helicobacter pylori (H. pylori) is a major gastric pathogen that has been associated with humans for more than 60,000 years. H. pylori causes different gastric diseases including dyspepsia, ulcers and gastric cancers. Disease development depends on several factors including the infecting H. pylori strain, environmental and host factors. Another factor that might influence H. pylori colonization and diseases is the gastric microbiota that was overlooked for long because of the belief that human stomach was a hostile environment that cannot support microbial life. Once established, H. pylori mainly resides in the gastric mucosa and interacts with the resident bacteria. How these interactions impact on H. pylori-caused diseases has been poorly studied in human. In this study, we analyzed the interactions between H. pylori and two bacteria, Streptococcus mitis and Lactobacillus fermentum that are present in the stomach of both healthy and gastric disease human patients. We have found that S. mitis produced and released one or more diffusible factors that induce growth inhibition and coccoid conversion of H. pylori cells. In contrast, both H. pylori and L. fermentum secreted factors that promote survival of S. mitis during the stationary phase of growth. Using a metabolomics approach, we identified compounds that might be responsible for the conversion of H. pylori from spiral to coccoid cells. This study provide evidences that gastric bacteria influences H. pylori physiology and therefore possibly the diseases this bacterium causes.

Fulltext Endoscopic ablation therapy for biliopancreatic malignancies

Roque J, Ho SH, Reddy N, Goh KL

Clin Endosc, 2015 Jan;48(1):15-9.

PMID: 25674521 DOI: 10.5946/ce.2015.48.1.15

Biliopancreatic malignancies such as cholangiocarcinoma (CCA) has notoriously been diagnosed late. As such most therapy have been palliative in nature. Cholangioscopy allows for an earlier diagnosis to be made. Brachytherapy with the insertion of catheter with iridium-132 seeds, percutaneously or through endoscopic retrograde cholangiopancreatography (ERCP) was the earliest ablative techniques used. It has been shown to have a beneficial effect only in prolonging survival. Photodynamic therapy (PDT) has also been used for several years. stenting with PDT versus stenting alone for unresectable CCA showed a marked survival benefit with the addition of PDT. However the most exciting endoscopic ablative modality appears to be intraductal radiofrequency ablation using the Habib catheter and device. Several case series have shown the effectiveness of this technique in ablating tumors. This technique is evolving and coupled with early diagnosis of CCA through cholangioscopy will allow for a curative therapy. The crux to the effective treatment of early cancerous lesions in the bile or pancreatic duct is the early diagnosis of such lesions. Effective endoscopic ablative therapy is now available with the advent of radiofrequency ablation probes that can be passed through the duodenoscope via ERCP.

Progression of liver disease in non-alcoholic fatty liver disease: a prospective clinicopathological follow-up study

Chan WK, Ida NH, Cheah PL, Goh KL

J Dig Dis, 2014 Oct;15(10):545-52.

PMID: 25060399 DOI: 10.1111/1751-2980.12175

To perform a follow-up study on non-alcoholic fatty liver disease (NAFLD) patients in our previous study using paired liver biopsy.

Fulltext Helicobacter pylori and Systemic Disease

Kuo CH, Chen YH, Goh KL, Chang LL

Gastroenterol Res Pract, 2014;2014:358494.

PMID: 24772167 DOI: 10.1155/2014/358494

Fulltext Tobacco smoking and its association with illicit drug use among young men aged 15-24 years living in urban slums of Bangladesh

Kabir MA, Goh KL, Kamal SM, Khan MM

PLoS One, 2013;8(7):e68728.

PMID: 23935885 DOI: 10.1371/journal.pone.0068728

Tobacco smoking (TS) and illicit drug use (IDU) are of public health concerns especially in developing countries, including Bangladesh. This paper aims to (i) identify the determinants of TS and IDU, and (ii) examine the association of TS with IDU among young slum dwellers in Bangladesh.

Fulltext Low prevalence of 'classical' microscopic colitis but evidence of microscopic inflammation in Asian irritable bowel syndrome patients with diarrhoea

Hilmi I, Hartono JL, Pailoor J, Mahadeva S, Goh KL

BMC Gastroenterol, 2013;13:80.

PMID: 23651739 DOI: 10.1186/1471-230X-13-80

There is increasing evidence for the role of microscopic inflammation in patients with IBS. We aimed to examine the prevalence of microscopic colitis and inflammation in Malaysian IBS patients with diarrhoea (IBS-D).

Tobacco consumption and illegal drug use among Bangladeshi males: association and determinants

Kabir MA, Goh KL, Khan MM

Am J Mens Health, 2013 Mar;7(2):128-37.

PMID: 23065136 DOI: 10.1177/1557988312462737

This article aimed to identify the determinants of tobacco consumption and illegal drug use (IDU) as well as to examine the association between these two variables using a representative sample of 3,771 Bangladeshi males aged 15 to 54 years. Data were collected through Bangladesh Demographic and Health Survey 2007. To identify the determinants, the patterns of tobacco consumption and IDU were analyzed by age, education and occupation, residence, mass media, premarital sex, wealth, and sexually transmitted infections (STIs). Prevalence of smoking cigarette and bidi was roughly 60%. However, the prevalence of IDU was 3.4%, and this proportion is statistically significant (Z = 11.32, p = .000). After bivariate analysis, almost all variables except STIs were significantly associated with tobacco consumption. Similarly, all variables except residence and mass media were associated with IDU. Based on multivariable adjusted logistic regression analysis, the likelihood of using IDU was approximately twofold (odds ratio [OR] = 1.8, 95% confidence interval [CI] = 1.23-2.53) among bidi smokers and fourfold (OR = 3.8, 95% CI = 2.62-5.56) among cigarette smokers as compared with nonsmokers.

Co-inheritance of variants/mutations in Malaysian patients with Crohn's disease

Chua KH, Ng CC, Hilmi I, Goh KL

Genet. Mol. Res., 2012;11(3):3115-21.

PMID: 23007989

Crohn's disease is a chronic, relapsing inflammatory bowel disease; it affects the mucosa and deeper layers of the digestive wall. Two Crohn's disease patients who carried the JW1 variant and two patients who carried the SNP5 variant were investigated for other co-inherited polymorphisms that could influence Crohn's disease development. Based on the sequencing results, a homozygous 5'-UTR-59 G to A variant in exon 1 (SNP6) was observed in a patient who carried SNP5, while a heterozygous SNP6 variant was detected in the other patient who carried SNP5. No other associated mutations or polymorphisms were detected in the two patients who carried the JW1 variant of the CARD15/NOD2 gene.

Tumour Lysis Syndrome: a Rare Complication of Trans-Arterial Chemo-Embolisation with Doxorubicin Beads for Hepatocellular Carcinoma

Katiman D, Manikam J, Goh KL, Abdullah BJ, Mahadeva S

J Gastrointest Cancer, 2012 Sep;43 Suppl 1:S187-90.

PMID: 22692948 DOI: 10.1007/s12029-012-9373-6

Fulltext Epidemiology of Helicobacter pylori infection and public health implications

Goh KL, Chan WK, Shiota S, Yamaoka Y

Helicobacter, 2011 Sep;16 Suppl 1:1-9.

PMID: 21896079 DOI: 10.1111/j.1523-5378.2011.00874.x

This review summarizes studies on the epidemiology and public health implications of Helicobacter pylori published in peer-reviewed journals from April 2010 through March 2011. Prevalence rates vary widely between different geographical regions and ethnic groups. An interesting study from the USA identified the degree of African ancestry as an independent predictor of H. pylori infection. Two studies have demonstrated early childhood as the period of transmission of infection and identified an infected sibling as an important risk factor. An oral-oral route of spread has been substantiated with several studies showing the presence of H. pylori in the oral cavity. Studies have shown the presence of H. pylori in drinking water and the role of poor living conditions and sanitation in H. pylori infection, supporting an oral-fecal route of spread. Screening for H. pylori as a gastric cancer pre-screening strategy has been described in Japan, and the importance of H. pylori eradication as a gastric cancer-prevention strategy has now been further emphasized in Japanese guidelines. Two studies have shown a decrease in the burden of dyspepsia and peptic ulcer disease with H. pylori eradication.

Fulltext Appointment waiting times and education level influence the quality of bowel preparation in adult patients undergoing colonoscopy

Chan WK, Saravanan A, Manikam J, Goh KL, Mahadeva S

BMC Gastroenterol, 2011;11:86.

PMID: 21798022 DOI: 10.1186/1471-230X-11-86

Risk factors for poor bowel preparation are recognized to be independent of the type of bowel preparation method used. Patient and administrative factors influencing bowel preparation are known to vary in different healthcare systems.

Validation study of the Leeds Dyspepsia Questionnaire in a multi-ethnic Asian population

Mahadeva S, Chan WK, Mohazmi M, Sujarita R, Goh KL

J Gastroenterol Hepatol, 2011 Nov;26(11):1669-76.

PMID: 21649731 DOI: 10.1111/j.1440-1746.2011.06806.x

BACKGROUND AND AIM:
Outcome measures for clinical trials in dyspepsia require an assessment of symptom response. There is a lack of validated instruments assessing dyspepsia symptoms in the Asian region. We aimed to translate and validate the Leeds Dyspepsia Questionnaire (LDQ) in a multi-ethnic Asian population.

METHODS:
A Malay and culturally adapted English version of the LDQ were developed according to established protocols. Psychometric evaluation was performed by assessing the validity, internal consistency, test-retest reliability and responsiveness of the instruments in both primary and secondary care patients.

RESULTS:
Between April and September 2010, both Malay (n=166) and Malaysian English (n=154) versions were assessed in primary and secondary care patients. Both language versions were found to be reliable (internal consistency was 0.80 and 0.74 (Cronbach's α) for Malay and English, respectively; spearman's correlation coefficient for test-retest reliability was 0.98 for both versions), valid (area under receiver operating curve for accuracy of diagnosing dyspepsia was 0.71 and 0.77 for Malay and English versions, respectively), discriminative (median LDQ score discriminated between primary and secondary care patients in Malay (11.0 vs 20.0, P<0.0001) and English (10.0 vs 14.0, P=0.001), and responsive (median LDQ score reduced after treatment in Malay (17.0 to 14.0, P=0.08) and English (18.0 to 11.0, P=0.008) to dyspepsia.

CONCLUSIONS:
The Malaysian versions of the LDQ are valid, reliable and responsive instruments for assessing symptoms in a multi-ethnic Asian population with dyspepsia.

Effects of frozen storage temperature on the elasticity of tendons from a small murine model

Goh KL, Chen Y, Chou SM, Listrat A, Bechet D, Wess TJ

Animal, 2010 Sep;4(9):1613-7.

PMID: 22444710 DOI: 10.1017/S1751731110000698

The basic mechanism of reinforcement in tendons addresses the transfer of stress, generated by the deforming proteoglycan (PG)-rich matrix, to the collagen fibrils. Regulating this mechanism involves the interactions of PGs on the fibril with those in the surrounding matrix and between PGs on adjacent fibrils. This understanding is key to establishing new insights on the biomechanics of tendon in various research domains. However, the experimental designs in many studies often involved long sample preparation time. To minimise biological degradation the tendons are usually stored by freezing. Here, we have investigated the effects of commonly used frozen storage temperatures on the mechanical properties of tendons from the tail of a murine model (C57BL6 mouse). Fresh (unfrozen) and thawed samples, frozen at temperatures of -20°C and -80°C, respectively, were stretched to rupture. Freezing at -20°C revealed no effect on the maximum stress (σ), stiffness (E), the corresponding strain (ε) at σ and strain energy densities up to ε (u) and from ε until complete rupture (up). On the other hand, freezing at -80°C led to higher σ, E and u; ε and up were unaffected. The results implicate changes in the long-range order of radially packed collagen molecules in fibrils, resulting in fibril rupture at higher stresses, and changes to the composition of extrafibrillar matrix, resulting in an increase in the interaction energy between fibrils via collagen-bound PGs.

Clarithromycin resistance and point mutations in the 23S rRNA gene in Helicobacter pylori isolates from Malaysia

Ho SL, Tan EL, Sam CK, Goh KL

J Dig Dis, 2010 Apr;11(2):101-5.

PMID: 20402836 DOI: 10.1111/j.1751-2980.2010.00423.x

To determine the prevalence of primary clarithromycin resistance amongst Helicobacter pylori (H. pylori) strains in Malaysian patients with gastroduodenal diseases, by using restriction fragment length polymorphism (RFLP) in domain V of 23S rRNA.

Fulltext Quality of life in South East Asian patients who consult for dyspepsia: validation of the short form Nepean Dyspepsia Index

Mahadeva S, Wee HL, Goh KL, Thumboo J

Health Qual Life Outcomes, 2009;7:45.

PMID: 19463190 DOI: 10.1186/1477-7525-7-45

BACKGROUND:
Treatment objectives for dyspepsia include improvements in both symptoms and health-related quality of life (HRQoL). There is a lack of disease-specific instruments measuring HRQoL in South East Asian dyspeptics.

OBJECTIVES:
To validate English and locally translated version of the Short-Form Nepean Dyspepsia Index (SF-NDI) in Malaysian patients who consult for dyspepsia.

METHODS:
The English version of the SF-NDI was culturally adapted locally and a Malay translation was developed using standard procedures. English and Malay versions of the SF-NDI were assessed against the SF-36 and the Leeds Dyspepsia Questionnaire (LDQ), examining internal consistency, test-retest reliability and construct validity.

RESULTS:
Pilot testing of the translated Malay and original English versions of the SF-NDI in twenty subjects did not identify any cross-cultural adaptation problems. 143 patients (86 English-speaking and 57 Malay speaking) with dyspepsia were interviewed and the overall response rate was 100% with nil missing data. The median total SF-NDI score for both languages were 72.5 and 60.0 respectively. Test-retest reliability was good with intraclass correlation coefficients of 0.90 (English) and 0.83 (Malay), while internal consistency of SF-NDI subscales revealed alpha values ranging from 0.83 - 0.88 (English) and 0.83 - 0.90 (Malay). In both languages, SF-NDI sub-scales and total score demonstrated lower values in patients with more severe symptoms and in patients with functional vs organic dyspepsia (known groups validity), although these were less marked in the Malay language version. There was moderate to good correlation (r = 0.3 - 0.6) between all SF-NDI sub-scales and various domains of the SF-36 (convergent validity).

CONCLUSION:
This study demonstrates that both English and Malay versions of the SF-NDI are reliable and probably valid instruments for measuring HRQoL in Malaysian patients with dyspepsia.

Fulltext Ethnic variation, epidemiological factors and quality of life impairment associated with dyspepsia in urban Malaysia

Mahadeva S, Yadav H, Rampal S, Everett SM, Goh KL

Aliment Pharmacol Ther, 2010 May;31(10):1141-51.

PMID: 20175766 DOI: 10.1111/j.1365-2036.2010.04270.x

The role of ethnicity in the development of dyspepsia remains uncertain.

Displaying publications 121 - 140 of 334 in total