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  1. Lim HM, Chia YC, Koay ZL
    Prim Care Diabetes, 2020 10;14(5):494-500.
    PMID: 32156516 DOI: 10.1016/j.pcd.2020.02.008
    AIMS: To evaluate the performance of FINDRISC and ModAsian FINDRISC for the screening of undiagnosed diabetes and dysglycaemia in primary care. To compare the performance of FINDRISC with the recommendations of the American Diabetes Association (ADA) and US Preventive Services Task Force (USPSTF) guidelines.

    METHODS: This cross-sectional study was carried out on 293 patients without a prior history of diabetes at a primary care clinic in Malaysia. Questions on body mass index and waist circumference were modified based on the Asian standard in ModAsian FINDRISC. Haemoglobin A1c of ≥6.5% (48 mmol/mol) was used to diagnose diabetes. Areas under the receiver operating curve (ROC-AUC) for FINDRISC and ModAsian FINDRISC were analyzed.

    RESULTS: The prevalence of undiagnosed diabetes was 7.5% and prediabetes was 32.8%. The ROC-AUC of FINDRISC was 0.76 (undiagnosed diabetes) and 0.79 (dysglycaemia). There was no statistical difference between FINDRISC and ModAsian FINDRISC. The recommended optimal FINDRISC cut-off point for undiagnosed diabetes was ≥11 (Sensitivity 86.4%, Specificity 48.7%). FINDRISC ≥11 point has higher sensitivity compared to USPSTF criteria (72.7%) and higher specificity compared to the ADA (9.6%).

    CONCLUSIONS: FINDRISC is a useful diabetes screening tool to identify those at risk of diabetes in primary care in Malaysia.

  2. Lee WS, Tee CW, Koay ZL, Wong TS, Zahraq F, Foo HW, et al.
    World J Gastroenterol, 2018 Mar 07;24(9):1013-1021.
    PMID: 29531465 DOI: 10.3748/wjg.v24.i9.1013
    AIM: To study implications of measuring quality indicators on training and trainees' performance in pediatric colonoscopy in a low-volume training center.

    METHODS: We reviewed retrospectively the performance of pediatric colonoscopies in a training center in Malaysia over 5 years (January 2010-December 2015), benchmarked against five quality indicators: appropriateness of indications, bowel preparations, cecum and ileal examination rates, and complications. The European Society of Gastrointestinal Endoscopy guideline for pediatric endoscopy and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition training guidelines were used as benchmarks.

    RESULTS: Median (± SD) age of 121 children [males = 74 (61.2%)] who had 177 colonoscopies was 7.0 (± 4.6) years. On average, 30 colonoscopies were performed each year (range: 19-58). Except for investigations of abdominal pain (21/177, 17%), indications for colonoscopies were appropriate in the remaining 83%. Bowel preparation was good in 87%. One patient (0.6%) with severe Crohn's disease had bowel perforation. Cecum examination and ileal intubation rate was 95% and 68.1%. Ileal intubation rate was significantly higher in diagnosing or assessing inflammatory bowel disease (IBD) than non-IBD (72.9% vs 50.0% P = 0.016). Performance of four trainees was consistent throughout the study period. Average cecum and ileal examination rate among trainees were 97% and 77%.

    CONCLUSION: Benchmarking against established guidelines helps units with a low-volume of colonoscopies to identify area for further improvement.

  3. Lee WS, Wong SY, Wong SY, Koay ZL, Safuan NSK, Sam ZH, et al.
    Ann Acad Med Singap, 2021 Jul;50(7):580-582.
    PMID: 34342340 DOI: 10.47102/annals-acadmedsg.2020586
  4. Chew KS, Em JM, Koay ZL, Jalaludin MY, Ng RT, Lum LCS, et al.
    Pediatr Neonatol, 2021 01;62(1):49-54.
    PMID: 32891528 DOI: 10.1016/j.pedneo.2020.08.009
    BACKGROUND: Functional gastrointestinal disorders (FGIDs) are common in children. The prevalence of FGIDs varies across the world but is unknown in Malaysia. We aimed to investigate the prevalence of FGIDs in healthy Malaysian infants.

    METHODS: This was a cross-sectional study involving healthy infants younger than 12 months of age who attended a well-baby clinic. A universal sampling method was adopted. Children with congenital disorders potentially affecting gastrointestinal functions, chronic debilitating diseases and hypothyroidism were excluded. Rome IV criteria were used to define FGIDs.

    RESULTS: Of the total 534 infants recruited (54% males), 92% were born at term; 85% had normal birth weight [range 2.5-4.0 kg], and the mean (±S.D.) age at interview was 6.8 (±3.4) months. Thirty-six percent were breastfed, 29% were formula-fed, and 35% had mixed feeding. Prevalence of infant regurgitation and rumination syndrome was 10.5% and 1.7%, respectively. Prevalence of infant colic was 1.9% (3/160) (infant 

  5. Ng RT, Chew KS, Choong CL, Song ZL, Teh JKL, Koay ZL, et al.
    Hepatol Int, 2022 Dec;16(6):1390-1397.
    PMID: 36131224 DOI: 10.1007/s12072-022-10417-5
    OBJECTIVE: Outcome of pediatric acute liver failure (PALF) in countries with limited availability of LT is not well described. We evaluated the outcome and prognostic indicators of PALF in Malaysia where emergency LT for ALF is limited.

    METHODS: In this retrospective review on children  452 μmol/L and peak GGT 

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