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  1. Chee NM, Sinnanaidu RP, Chan WK
    J Gastroenterol Hepatol, 2024 Dec;39(12):2545-2554.
    PMID: 39150005 DOI: 10.1111/jgh.16723
    BACKGROUND AND AIM: Multiple clinical trials have been conducted to study the potential benefits of vitamin E for the treatment of metabolic dysfunction-associated steatotic liver disease (MASLD). Despite available evidence, vitamin E is not widely used. This study aimed to assess the effect of vitamin E on serum markers of liver inflammation, specifically serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, and histology, including resolution of metabolic dysfunction-associated steatohepatitis (MASH), in adult patients with MASLD.

    METHODS: A systematic literature search on randomized controlled trials published in English was conducted using electronic databases. Standardized mean difference (SMD) and mean difference (MD) were used for continuous outcomes, while risk ratio (RR) was used for dichotomous outcomes, with corresponding 95% confidence interval (CI).

    RESULTS: A total of eight studies were included in the qualitative synthesis while seven studies were included in the meta-analysis. Vitamin E significantly reduced serum ALT and AST levels with SMD of -0.82 (95% CI, -1.13 to -0.51) and -0.68 (95% CI, -0.94 to -0.41), respectively. Vitamin E significantly reduced steatosis, lobular inflammation, and hepatocyte ballooning with a MD of -0.60 (95% CI, -0.83 to -0.37), -0.34 (95% CI, -0.53 to -0.16), -0.32 (95% CI, -0.53 to -0.12), and increased MASH resolution with a RR of 1.9 (95%CI, 1.20 to 3.02). However, vitamin E did not reduce fibrosis, with a MD of -0.23 (95% CI, -0.51 to 0.05).

    CONCLUSION: Vitamin E resulted in significant improvement in serum markers of liver inflammation and histology in patients with MASLD.

  2. 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.

  3. Lim CE, Sinnanaidu RP, Ng XT, Teh JY, Khamis F, Vijayananthan A, et al.
    PLoS One, 2026;21(11):e0359831.
    PMID: 42986898 DOI: 10.1371/journal.pone.0359831
    BACKGROUND: There are limited studies comparing Hepatus (HP), a novel visual transient elastography device with Fibroscan (FS), one of the most studied and validated non-invasive tests in the field of hepatology.

    METHODOLOGY: HP and FS examinations were performed on patients with chronic liver disease by two operators, healthcare providers from different background, twice on each patient, at two different time points, independent of each other.

    RESULTS: The data for 158 patients with 1264 examinations was analysed. There was moderate to strong correlation for attenuation parameter (Spearman's rho 0.67, p S0, > S1 and >S2 and substantial agreement for diagnosis of unlikely and likely compensated advanced chronic liver disease. The interquartile range (IQR) for attenuation parameter and IQR/median for LSM were lower for HP compared with FS (12 dB/m vs 33 dB/m, p 

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