MyMedR

Fulltext Intestinal geohelminthiasis and growth in pre-adolescent primary school children in Northeastern Peninsular Malaysia

Mahendra Raj S

Southeast Asian J. Trop. Med. Public Health, 1998 Mar;29(1):112-7.

PMID: 9740282

A cohort of one hundred 8-9 year old school children in Northeastern Peninsular Malaysia underwent stool examination, weight and height measurements. Seventy-three children were infected with Ascaris lumbricoides and/or Trichuris trichiura. All infected children were treated with albendazole at baseline, 6 months and 9 months. Measurements were repeated on all but 2 children at 1 year. Repeat stool examination (n = 94) at 1 year revealed a marked reduction in the level of Ascaris infection and a modest reduction in Trichuris infection. There was no difference in net growth between treated children and uninfected controls. Post-hoc analysis by gender however revealed that infected girls (n = 33) experienced significantly higher increments in weight, height and weight for age. Furthermore, children found to be infected at baseline level but worm free at follow-up, were observed to have experienced greater increments in height and height for age. The evidence suggests that periodic antihelminthic treatment may have a positive effect on the growth of subsets of pre-adolescent children but it is emphasised that further work is required to validate these findings.

Fulltext Prevalence of peptic ulcer in 82 Kelantanese Malaysians with non-alcoholic cirrhosis

Raj SM

Med J Malaysia, 1992 Sep;47(3):208-11.

PMID: 1491646

A review of 82 (68 male) Kelantanese patients with non-alcoholic cirrhosis who underwent gastroduodenal endoscopy revealed duodenal and gastric ulcers in 4.9% and 7.3% of patients respectively. Comparing with prevalence rates of peptic ulcer disease reported in the literature, there was no evidence to suggest that duodenal ulcers occur more frequently in patients with non-alcoholic cirrhosis. There is a suggestion, albeit a tenuous one, that non-alcoholic cirrhosis may be associated with gastric ulceration.

Fecal occult blood testing on Trichuris-infected primary school children in northeastern peninsular Malaysia

Raj SM

Am J Trop Med Hyg, 1999 Jan;60(1):165-6.

PMID: 9988342

Stool specimens of 104 primary schoolchildren (mean+/-SD age = 8.2+/-0.3 years) were examined for helminth eggs and for occult blood to investigate the possibility that trichuriasis causes occult intestinal bleeding in the absence of the overt Trichuris dysentery syndrome. A commercially available guaiac test was used to detect fecal occult blood. Sixty-one children had Trichuris infection, 11 of whom had heavy infections (> 10,000 eggs per gram of feces [epg]), and 53 had Ascaris infections. No hookworm infection was detected. Baseline screening yielded only one weakly positive occult blood test result in a child with a light (800 epg) Trichuris infection. Serial stool occult blood testing on the 11 subjects with heavy trichuriasis and 8 uninfected controls yielded a single weakly positive result in the control group. The results provide no evidence that trichuriasis predisposes to significant occult gastrointestinal bleeding in children in the absence of the dysenteric syndrome.

Fulltext Peptic ulcer disease in Kelantan: an underdiagnosed condition?

Raj SM

Med J Malaysia, 1991 Jun;46(2):183-6.

PMID: 1839424

A review of the records at a teaching hospital in Kelantan revealed that 175 new cases of peptic ulcer disease were diagnosed endoscopically over a period of 5 years. The ratio of duodenal to gastric ulcers was 2:1. Male patients outnumbered females by 2.7:1. There was a disproportionately high number of Chinese patients. A striking observation was that an unusually large proportion (45%) of patients had presented with acute gastrointestinal bleeding. The implication is that peptic ulcer disease in this region may be underdetected; the diagnosis often coming to light only after a serious complication has supervened.

A systematic review on factors associated with non-alcoholic fatty liver disease (NAFLD) among adolescents

Raj S V, Ismail M, Chan WK, Majid HA

Clin Nutr ESPEN, 2023 Oct;57:131-137.

PMID: 37739647 DOI: 10.1016/j.clnesp.2023.06.014

BACKGROUND & AIMS: Non-Alcoholic Fatty Liver Disease (NAFLD) is a global public health risk. The occurrence of adolescent NAFLD coincides with high rates of overweight and obesity, with an unhealthy lifestyle also playing a role. Data on prevalence and factors contributing to NAFLD among Asian adolescents is lacking as most studies focus on adults. This systematic review aims to determine the prevalence and factors contributing to NAFLD among adolescents.

METHODS: A systematic search was conducted using five (Goh et al., 2013) [5] databases: Cochrane, PubMed, Scopus, Science Direct, EBSCO and grey literature. Two reviewers independently screened studies using predefined inclusion and exclusion criteria and performed data extraction. Assessment of methodological quality was completed using the Newcastle-Ottawa checklist.

RESULTS: The quality of most studies were of high quality, with the majority reporting no association between lifestyle factors and NAFLD. A total of 6 studies were included in this systematic review. The prevalence of NAFLD among adolescents varied between 8.0% (Fraser et al., 2007) in a study on 5586 adolescents aged 12-19 and 16.0% (Chen et al., 2009) in another survey of 1724 adolescents aged 12-13 years old. Snacking habits and lack of physical activity had potential associations with adolescent NAFLD. Current evidence shows that lifestyle factor (Western dietary pattern) is associated with a higher risk of developing NAFLD among adolescents.

CONCLUSIONS: Lifestyle factors, including snacking habits and lack of physical activity, were associated with a higher risk of developing NAFLD among adolescents from high-income countries. The difference in the prevalence of NAFLD between countries with different incomes requires further investigation.

Fulltext Trichuris Dysentery Syndrome: evidence that it may be underdiagnosed in Kelantan

Noorizan AM, Mahendra Raj S

Med J Malaysia, 2001 Mar;56(1):53-7.

PMID: 11503297

The prevalence rate of trichuriasis in children in certain areas of Kelantan is high. However the Trichuris Dysentery Syndrome (TDS), a condition in children characterized by chronic diarrhoea, stunting and anaemia is said to be rare. A recent change in policy at our institution to lower the threshold for undertaking colonoscopy in children with chronic diarrhoea resulted in the detection of 6 cases of TDS in less than a year. The median age was 7 years (range 3-13) and the median duration of symptoms before diagnosis was 2 years (range 1-8). The insidious nature of TDS and the low level of awareness of this condition even among health care workers may result in considerable underdiagnosis.

2-(Nitromethylene)-1,3-dithietane

Shanmuga Sundara Raj S, Surya Prakash Rao H, Sakthikumar L, Fun HK

Acta Crystallogr C, 2000 Sep;56 (Pt 9):1113-4.

PMID: 10986500

In the crystal structure of the title compound, C(3)H(3)NO(2)S(2), the four-membered C(2)S(2) ring is planar, as is the whole molecule. The short intramolecular S.O distance of 2.687 (2) A shows the five-atom system to be conjugated. The molecules pack as a two-dimensional network in the (010) plane through short intermolecular S.O [2.900 (2) and 3.077 (2) A] interactions.

Fulltext Treatment of bleeding gastroesophageal varices

Kyaw K, Raj SM

Med J Malaysia, 1993 Sep;48(3):377-8.

PMID: 8183158

Intestinal helminthiasis and abdominal symptoms in adults

Mahendra Raj S, Sivakumaran S, Vijayakumari S

Trop Gastroenterol, 1991 Jan-Mar;12(1):21-4.

PMID: 2058006

In a study to test the association between soil transmitted intestinal helminthiasis and abdominal symptoms in a non-paediatric age group, 242 randomly selected patients (137 males, 105 females, median age 45 years) were asked specific questions pertaining to abdominal symptoms at the time of admission to the adult medical wards. Stool examination on all patients revealed a round worm prevalence rate of 21%. A larger proportion of stool positive female patients were symptomatic than stool negative females (68% vs 30%, p = 0.04). There was no significant difference in symptoms between stool positive and stool negative male patients (34.6% vs 31%, p = 0.91). The results suggested an association between intestinal nematode infection and abdominal symptoms in females but not in males.

Fulltext Systemic lupus erythematosus and miliary tuberculosis in a prepubertal girl--a case report

Raj SM, Hunt J

Med J Malaysia, 1990 Dec;45(4):347-8.

PMID: 2152059

A 13 year old girl presented with miliary tuberculosis and active systemic lupus erythematosus (S.L.E.). She responded to a combination of antituberculous drugs and systemic steroids. This case illustrates the fact that S.L.E. presenting in childhood may be rare but not unknown and exemplifies the need for vigilance in detecting life threatening infections in this group of patients.

Should postpapillotomy screening for Ascaris lumbricoides infection be routine in communities endemic for ascariasis?

Raj SM, Radzi M

Am J Gastroenterol, 1999 Aug;94(8):2329.

PMID: 10445590

Fulltext A study of the concordance between endoscopic gastritis and histological gastritis in an area with a low background prevalence of Helicobacter pylori infection

Kaur G, Raj SM

Singapore Med J, 2002 Feb;43(2):090-2.

PMID: 11993896

The concordance between endoscopic and histological gastritis was determined in 52 patients referred for upper gastrointestinal endoscopy. The study was conducted in Northeastern Peninsular Malaysia, an area with a low background prevalence of H. pylori infection. Endoscopic and histological gastritis were assessed in accordance with the Sydney System. The results showed poor concordance between endoscopic and histological gastritis even after reclassifying mild endoscopic gastritis as normal. The low prevalence of H. pylori was validated in this study.

Fulltext Preliminary study suggests low incidence of gastric carcinoma in kelantan relates to low rate of helicobacter pylori infection

Kaur G, Raj SM

Malays J Med Sci, 2001 Jan;8(1):31-3.

PMID: 22973153 MyJurnal

Helicobacter pylori-associated gastric carcinoma is generally more common in the antrum/body and is of the intestinal type. The aim of this study was to determine the pattern of gastric carcinoma in an area known to have a low prevalence of H. pylori. Pathology records of gastric carcinoma diagnosed at Hospital University Sains Malaysia between 1995 and 1999 were retrieved and studied. There were a total of 23 cases. The median age was 60 years. Eighteen patients were Malay and 5 were Chinese. The most common location of the tumour was the cardia/gastrooesophageal junction (61%, 14/23 patients). The majority was of the intestinal type (69.6%, 16/23). The frequency of gastric carcinoma appears to be exceptionally low in the area of study. The Chinese population was over-represented. The higher frequency of tumour in the cardia/gastro-oesophageal junction as compared to the antrum and body is in sharp contrast to most other studies. This reaffirms the notion that Helicobacter pylori infection is a causative agent for non-cardia gastric carcinomas.

Fulltext Concern about the efficacy of clarithromycin containing standard triple therapy in the eradication of Helicobacter pylori infection in Malaysia

Raj JM, Raj SM

Med J Malaysia, 2012 Oct;67(5):547.

PMID: 23770883

Fulltext Ascariasis, trichuriasis, and growth of schoolchildren in Northeastern Peninsular Malaysia

Raj SM, Naing NN

Southeast Asian J. Trop. Med. Public Health, 1998 Dec;29(4):729-34.

PMID: 10772554

A study to determine the effect of antihelminthic treatment on growth and nutritional status was undertaken on 103 children in the second grade of primary school, 71 of whom were found to be infected with Ascaris lumbricoides or Trichuris trichiura. The median Ascaris and Trichuris intensities in the infected group were 19,600 (range; 0-488,000) and 2,800 (range; 0-84,600) eggs per gram of feces respectively. Forty-three children harbored both types of worm. Fourteen weeks after two 400 mg doses of albendazole were administered to infected children, the increases in weight, height, weight for age, height for age and weight for height were significantly higher among infected children than controls who were uninfected at baseline. The observed gains were independent of sex and socioeconomic status. Decrease in log transformed Trichuris intensity correlated with increases in weight (r=0.24; p=0.02) and weight for age (r=0.20; p=0.06) but decrease in Ascaris intensity did not correlate with increases in any of the anthropometric parameters. The results suggest that antihelminthic treatment has beneficial short-term effects on growth and nutritional status of a modest magnitude among early primary schoolchildren in the area.

Fulltext Helicobacter pylori infection--a boon or a bane: lessons from studies in a low-prevalence population

Lee YY, Mahendra Raj S, Graham DY

Helicobacter, 2013 Oct;18(5):338-46.

PMID: 23607896 DOI: 10.1111/hel.12058

Helicobacter pylori (H. pylori) infection is etiologically associated with gastric cancer and peptic ulcer diseases which are both important public health burdens which could be largely eliminated by H. pylori eradication. However, some investigators urge caution based on the hypothesis that eradication of H. pylori may result in an increase in the incidence of gastroesophageal reflux disease, esophageal adenocarcinoma, and childhood asthma. The ethnic Malays of northeastern Peninsular Malaysia have long had a low prevalence of H. pylori infection and, as expected, the incidence of gastric cancer and its precursor lesions is exceptionally low. The availability of a population with a low H. pylori prevalence and generally poor sanitation allows separation of H. pylori from the hygiene hypothesis and direct testing of whether absence of H. pylori is associated with untoward consequence. Contrary to predictions, in Malays, erosive esophagitis, Barrett's esophagus, distal esophageal cancers, and childhood asthma are all of low incidence. This suggests that H. pylori is not protective rather the presence of H. pylori infection is likely a surrogate for poor hygiene and not an important source of antigens involved in the hygiene hypothesis. Helicobacter pylori in Malays is related to transmission from H. pylori-infected non-Malay immigrants. The factors responsible for low H. pylori acquisition, transmission, and burden of H. pylori infection in Malays remain unclear and likely involves a combination of environmental, host (gene polymorphisms), and strain virulence factors. Based on evidence from this population, absence of H. pylori infection is more likely to be boon than a bane.

Trichuriasis: localized inflammatory responses in the colon

Kaur G, Raj SM, Naing NN

Southeast Asian J. Trop. Med. Public Health, 2002 Jun;33(2):224-8.

PMID: 12236416

Most patients with trichuriasis have light worm burdens. Data regarding the inflammatory response to Trichuris worms in the colon of lightly infected persons are scant. Nine patients whose Trichuris infection was found by colonoscopy had biopsies taken from a site adjacent to visible worms and from a second site some 20 cm distally. The biopsies were studied by routine and immunohistochemical methods. None of the biopsies showed mucosal ulceration, significant congestion, fibrosis, gland distortion or goblet cell mucin depletion. There was no difference between worm and worm-free sites in terms of edema, lymphoid follicles or epithelial slough. Worm sites had higher numbers of eosinophils, neutrophils and total inflammatory cells and lower numbers of plasma cells. However there was no difference in lymphocyte, mast cell, and B- and T-cell counts between the two sites. This suggests that the T. trichiura worm incites a local inflammatory response involving eosinophils and neutrophils, even when the colon has only a light burden of worms.

4-(N-Hydroxyethyl-N-methylamino)benzaldehyde thiosemicarbazone

Shanmuga Sundara Raj S, Fun HK, Zhang XJ, Tian YP, Xie FX, Ma JL

Acta Crystallogr C, 2000 Oct;56 (Pt 10):1238-9.

PMID: 11025310

In the crystal structure of the title compound, C(11)H(16)N(4)OS, the phenyl ring and the thiosemicarbazone moiety from a dihedral angle of 7.7 (1) degrees. The crystal structure is governed by N-H.O and O-H.S hydrogen bonds leading to the formation of a two-dimensional network.

trans-cis S-benzyl dithiocarbazate

Shanmuga Sundara Raj S, Yamin BM, Yussof YA, Tarafder MT, Fun HK, Grouse KA

Acta Crystallogr C, 2000 Oct;56 (Pt 10):1236-7.

PMID: 11025309

In the crystal structure of the title compound, C(8)H(10)N(2)S(2), the molecules are linked by N-H.S hydrogen bonds between the imino group and the thione-S atoms to form a chain along the b axis. The dithiocarbazate moiety is rotated by 85.8 (2) degrees with respect to the phenyl ring.

4-Hydroxy-3-methoxybenzaldehyde 4,5-diazafluoren-9-ylidenehydrazone

Shanmuga Sundara Raj S, Fun HK, Lu ZL, Xiao W, Gong XY, Gen CM

Acta Crystallogr C, 2000 Aug;56 (Pt 8):1015-6.

PMID: 10944310

The whole molecule of the title compound, C(19)H(14)N(4)O(2), is essentially planar, with a highly conjugated pi system. In the crystal, the molecules are packed as chains along the [011] direction connected by O-H.N intermolecular hydrogen bonds.

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