Displaying publications 1 - 20 of 50 in total

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  1. Praveen S, Razman J
    Med J Malaysia, 2008 Aug;63(3):259-60.
    PMID: 19248705
    An 80 year old lady presented with signs and symptoms of sub-acute intestinal obstruction which failed conservative management. CT scan abdomen revealed circumferential ileum thickening with proximal bowel dilatation. Laparotomy and segmental resection was done. Pathological findings were suggestive of chronic granulomatous ileits with differential of Crohn's disease and gastrointestinal tuberculosis. The patient was presumed to have gastrointestinal tuberculosis and commenced on anti tuberculosis treatment despite inconclusive evidence for confirmation and showed marked clinical improvement.
    Matched MeSH terms: Crohn Disease/diagnosis*; Crohn Disease/microbiology*; Crohn Disease/therapy
  2. Hilmi I, Tan YM, Goh KL
    World J Gastroenterol, 2006 Mar 07;12(9):1435-8.
    PMID: 16552816
    AIM: To determine the demography and clinical presentation of CD and secondly to determine any differences in the prevalence between the different ethnic groups in a multiracial Asian population.

    METHODS: Patients with CD who were seen in 2001-2003 in the University of Malaya Medical Centre (UMMC) were enrolled in this study. Prevalence of disease was calculated for the group as a whole and by race with hospital admissions per ethnic group as the denominator.

    RESULTS: Thirty-four patients were diagnosed to have CD. Basic demographic data of patients; male:female 17:17; mean age 29.1 years (+/-13.5 years); ethnic group: Malays 5 (14.7%), Chinese 12 (35.3%) and Indians 17 (50%).Twenty-six (76.5%) were diagnosed under the age of 40 and 8 (23.5%) were diagnosed over the age of 40. Location of the disease was as follows:ileocolonic 13 (38.2%), terminal ileum only 9 (26.5%), colon only 8 (23.5%), and upper gastrointestinal 4 (11.8%). Sixteen (47.1%) had penetrating disease, 9 (26.5%) had stricturing disease and 9 (26.5%) had non-penetrating and non-stricturing disease. The hospital admission prevalence of CD was 26.0 overall, Indians 52.6, Chinese 6.9, and Malays 9.3 per 10(5) admissions per ethnic group. The difference between Indians and Malays: [OR 5.67 (1.97, 17.53) P<0.001] was statistically significant but not between the Indians and the Chinese [OR 1.95 (0.89, 4.35) P=0.700]. The difference between the Chinese and the Malays was also not statistically significant. [OR 2.90 (0.95, 9.42) P=0.063].

    CONCLUSION: The clinical presentation of CD is similar to the Western experience. Although the overall prevalence is low,there appears to be a clear racial predominance among the Indians.

    Matched MeSH terms: Crohn Disease/ethnology*; Crohn Disease/epidemiology; Crohn Disease/pathology*; Crohn Disease/surgery
  3. Lee YY, Yu S, Khurana S, Rao SS
    Gastroenterology, 2014 Apr;146(4):1133-4.
    PMID: 24576735 DOI: 10.1053/j.gastro.2013.12.043
    Matched MeSH terms: Crohn Disease/epidemiology*
  4. Chua KH, Hilmi I, Lian LH, Patmanathan SN, Hoe SZ, Lee WS, et al.
    J Dig Dis, 2012 Sep;13(9):459-65.
    PMID: 22908971 DOI: 10.1111/j.1751-2980.2012.00617.x
    This study was aimed to investigate the possible association of Crohn's disease (CD) with inflammatory bowel disease gene 5 (IBD5) IGR2198a_1 (rs11739135), IGR2096a_1 (rs12521868) and interleukin-23 receptor (IL23R) genetic variant (rs1004819) in the Malaysian population.
    Matched MeSH terms: Crohn Disease/genetics*
  5. Goh K, Xiao SD
    J Dig Dis, 2009 Feb;10(1):1-6.
    PMID: 19236540 DOI: 10.1111/j.1751-2980.2008.00355.x
    Inflammatory bowel disease (IBD) has long been considered a disease that affects predominantly a Western population. The incidence and prevalence rates from Asian populations are much lower in comparison. More recent data, however, have shown significantly higher rates in Asians and time trend studies have shown an increase in the incidence of ulcerative colitis (UC) and a similar but lower rise in Crohn's disease (CD). The epidemiological changes that are taking place mirror that of the Western experience seen 50 years previously and seem to occur in parallel with the rapid socioeconomic development taking place in Asia. It appears that certain racial groups are more prone than others to develop IBD. For instance, Indians in South-East Asia have higher rates compared to Chinese and Malays. While there is host genetic predisposition, environmental factor(s) may be responsible for this difference. Migrant studies of South Asians in the UK, where second-generation immigrants have assumed incidence rates as high as the indigenous whites and Asian Jews who develop high incidence rates comparable to Jews from Europe or North America in Israel point to the role of environmental factors. It is unclear which specific factors are responsible. Studies have suggested a change in diet to a more Westernized one may underlie this epidemiological change in the Asian population. It is likely that there are racial groups amongst Asians who are more susceptible to IBD and who will demonstrate a higher frequency of IBD when exposed to putative environmental factors.
    Matched MeSH terms: Crohn Disease/ethnology; Crohn Disease/epidemiology*
  6. Kum CK, Sim EK, Ngoi SS, Goh P, Sinniah R
    Med J Malaysia, 1992 Dec;47(4):323-7.
    PMID: 1303488
    Crohn's disease is extremely rare among Asians. Resection of strictures causing obstruction has traditionally been the accepted choice in surgical therapy. This may lead to problems such as iatrogenic short bowel syndrome and its sequelae. Stricturoplasty is an acceptable and safe alternative. We report a case where combined stricturoplasty and resection was performed safely and advocate its use.
    Matched MeSH terms: Crohn Disease/complications*; Crohn Disease/pathology
  7. Ti TK
    Aust N Z J Surg, 1979 Aug;49(4):428-31.
    PMID: 115452
    A 10-year experience in the diagnosis and treatment of 92 patients with inflammatory bowel diseases in Kuala Lumpur is described. Tuberculosis (34 cases) was the most common inflammatory bowel disease of surgical importance. The clinical presentation of tuberculous enteritis and Crohn's disease is similar, though tuberculosis is strongly suggested by associated pulmonary disease and radiological evidence of caecal involvement. The finding of 10 cases each of Crohn's disease and ulcerative colitis is in keeping with an increased awareness of these conditions in a developing urban society where facilities exist for thorough investigation of diarrhoeal diseases. Amoebiasis sometimes causes a granulomatous lesion simulating carcinoma. Diverticular disease of the colon as known in the West is of very rare occurrence.
    Matched MeSH terms: Crohn Disease/diagnosis; Crohn Disease/pathology
  8. Ooi CJ, Hilmi I, Banerjee R, Chuah SW, Ng SC, Wei SC, et al.
    J Gastroenterol Hepatol, 2019 Aug;34(8):1296-1315.
    PMID: 30848854 DOI: 10.1111/jgh.14648
    The Asia-Pacific Working Group on Inflammatory Bowel Disease was established in Cebu, Philippines, under the auspices of the Asia-Pacific Association of Gastroenterology with the goal of improving inflammatory bowel disease care in Asia. This consensus is carried out in collaboration with Asian Organization for Crohn's and Colitis. With biologic agents and biosimilars becoming more established, it is necessary to conduct a review on existing literature and establish a consensus on when and how to introduce biologic agents and biosimilars in conjunction with conventional treatments for ulcerative colitis and Crohn's disease in Asia. These statements also address how pharmacogenetics influences the treatments of ulcerative colitis and Crohn's disease and provides guidance on response monitoring and strategies to restore loss of response. Finally, the review includes statements on how to manage treatment alongside possible hepatitis B and tuberculosis infections, both common in Asia. These statements have been prepared and voted upon by members of inflammatory bowel disease workgroup employing the modified Delphi process. These statements do not intend to be all-encompassing, and future revisions are likely as new data continue to emerge.
    Matched MeSH terms: Crohn Disease/diagnosis; Crohn Disease/drug therapy*; Crohn Disease/immunology; Crohn Disease/epidemiology
  9. Bergmann MM, Hernandez V, Bernigau W, Boeing H, Chan SS, Luben R, et al.
    Eur J Clin Nutr, 2017 04;71(4):512-518.
    PMID: 28120853 DOI: 10.1038/ejcn.2016.271
    BACKGROUND/OBJECTIVES: The role of long-term alcohol consumption for the risk of developing ulcerative colitis (UC) and Crohn's disease (CD) is unclear. For the first time, to prospectively assess the role of pre-disease alcohol consumption on the risk of developing UC or CD.

    SUBJECTS/METHODS: Nested within the European Prospective Investigation into Cancer and Nutrition (EPIC-IBD), incident UC and CD cases and matched controls where included. At recruitment, participants completed validated food frequency and lifestyle questionnaires. Alcohol consumption was classified as either: non-use, former, light (⩽0.5 and 1 drink per week), below the recommended limits (BRL) (⩽1 and 2 drinks per day), moderate (⩽2.5 and 5 drinks per day), or heavy use (>2.5 and >5 drinks per day) for women and men, respectively; and was expressed as consumption at enrolment and during lifetime. Conditional logistic regression was applied adjusting for smoking and education, taking light users as the reference.

    RESULTS: Out of 262 451 participants in six countries, 198 UC incident cases/792 controls and 84 CD cases/336 controls were included. At enrolment, 8%/27%/32%/23%/11% UC cases and 7%/29%/40%/19%/5% CD cases were: non-users, light, BRL, moderate and heavy users, respectively. The corresponding figures for lifetime non-use, former, light, BRL, moderate and heavy use were: 3%/5%/23%/44%/19%/6% and 5%/2%/25%/44%/23%/1% for UC and CD cases, respectively. There were no associations between any categories of alcohol consumption and risk of UC or CD in the unadjusted and adjusted odds ratios.

    CONCLUSION: There was no evidence of associations between alcohol use and the odds of developing either UC or CD.

    Matched MeSH terms: Crohn Disease/etiology*; Crohn Disease/epidemiology
  10. Racine A, Carbonnel F, Chan SS, Hart AR, Bueno-de-Mesquita HB, Oldenburg B, et al.
    Inflamm Bowel Dis, 2016 Feb;22(2):345-54.
    PMID: 26717318 DOI: 10.1097/MIB.0000000000000638
    BACKGROUND: Specific nutrients or foods have been inconsistently associated with ulcerative colitis (UC) or Crohn's disease (CD) risks. Thus, we investigated associations between diet as a whole, as dietary patterns, and UC and CD risks.

    METHODS: Within the prospective EPIC (European Prospective Investigation into Cancer) study, we set up a nested matched case-control study among 366,351 participants with inflammatory bowel disease data, including 256 incident cases of UC and 117 of CD, and 4 matched controls per case. Dietary intake was recorded at baseline from validated food frequency questionnaires. Incidence rate ratios of developing UC and CD were calculated for quintiles of the Mediterranean diet score and a posteriori dietary patterns produced by factor analysis.

    RESULTS: No dietary pattern was associated with either UC or CD risks. However, when excluding cases occurring within the first 2 years after dietary assessment, there was a positive association between a "high sugar and soft drinks" pattern and UC risk (incidence rate ratios for the fifth versus first quintile, 1.68 [1.00-2.82]; Ptrend = 0.02). When considering the foods most associated with the pattern, high consumers of sugar and soft drinks were at higher UC risk only if they had low vegetables intakes.

    CONCLUSIONS: A diet imbalance with high consumption of sugar and soft drinks and low consumption of vegetables was associated with UC risk. Further studies are needed to investigate whether microbiota alterations or other mechanisms mediate this association.

    Matched MeSH terms: Crohn Disease/etiology*; Crohn Disease/epidemiology
  11. Ooi CJ, Makharia GK, Hilmi I, Gibson PR, Fock KM, Ahuja V, et al.
    J Gastroenterol Hepatol, 2016 Jan;31(1):56-68.
    PMID: 25819311 DOI: 10.1111/jgh.12958
    The Asia Pacific Working Group on Inflammatory Bowel Disease was established in Cebu, Philippines, at the Asia Pacific Digestive Week conference in 2006 under the auspices of the Asian Pacific Association of Gastroenterology (APAGE) with the goal of developing best management practices, coordinating research and raising awareness of IBD in the region. The consensus group previously published recommendations for the diagnosis and management of ulcerative colitis (UC) with specific relevance to the Asia-Pacific region. The present consensus statements were developed following a similar process to address the epidemiology, diagnosis and management of Crohn's disease (CD). The goals of these statements are to pool the pertinent literature specifically highlighting relevant data and conditions in the Asia-Pacific region relating to the economy, health systems, background infectious diseases, differential diagnoses and treatment availability. It does not intend to be all-comprehensive and future revisions are likely to be required in this ever-changing field.
    Matched MeSH terms: Crohn Disease
  12. Hilmi I, Kobayashi T
    Intest Res, 2020 Jul;18(3):265-274.
    PMID: 32623876 DOI: 10.5217/ir.2019.09165
    Capsule endoscopy (CE) is emerging as an important investigation in inflammatory bowel disease (IBD); common types include the standard small bowel CE and colon CE. More recently, the pan-enteric CE was developed to assess the large and small bowel in patients with Crohn's disease (CD). Emerging indications include noninvasive assessment for mucosal healing (both in the small bowel and the colon) and detection of postoperative recurrence in patients with CD. Given the increasing adoption, several CE scoring systems have been specifically developed for IBD. The greatest concern with performing CE, particularly in CD, is capsule retention, but this can be overcome by performing cross-sectional imaging such as magnetic resonance enterography and using patency capsules before performing the procedure. The development of software for automated detection of mucosal abnormalities typically seen in IBD may further increase its adoption.
    Matched MeSH terms: Crohn Disease
  13. Chuah KH, Raja Ali RA, Hilmi IN
    Indian J Gastroenterol, 2020 06;39(3):261-267.
    PMID: 32613522 DOI: 10.1007/s12664-020-01044-9
    BACKGROUND: Alteration in the natural history of Crohn's disease (CD) since the advent of biologic therapy remains to be proven. Our aim was to look at the intestinal surgical rates and the association with biologic therapy over the last two decades.

    METHODS: This was a retrospective study in which all CD patients seen in two tertiary referral hospitals in Malaysia were recruited. Patients were stratified into two cohorts; cohort 1 was patients diagnosed from year 1991 to 2000 and cohort 2 was patients diagnosed from year 2001 to 2010. These time cohorts were selected based on initial availability of biologic agents in Malaysia in year 2000. Details of demography, disease location, medications and cumulative surgical rates over 7 years were recorded.

    RESULTS: A total of 207 patients were recruited: 70 from cohort 1 and 137 from cohort 2. Differences seen in terms of disease location, phenotype, and use of immunomodulatory therapy between the two cohorts were not significant. Patients who were ever exposed to biologics were significantly different between the two cohorts, approximately two times higher at 35.8% (n = 49) in cohort 2, and 18.6% (n = 13) in cohort 1, p = 0.011. There was a significant reduction in the 7-year cumulative intestinal surgical rates between cohort 1 and cohort 2, from 21.4% (n = 15) to 10.2% (n = 14), p = 0.028. However, there was no statistically significant difference in biologic exposure between those who underwent surgery and those who did not.

    CONCLUSIONS: There has been a significant reduction in intestinal surgical rates for Crohn's disease over the last two decades but does not appear to be associated with the increased use of biologics.

    Matched MeSH terms: Crohn Disease/drug therapy; Crohn Disease/epidemiology; Crohn Disease/surgery*
  14. Pang P, Ng YS, Sidhu J, Kok M
    Med J Malaysia, 2018 04;73(2):86-89.
    PMID: 29703871 MyJurnal
    AIM: To record the incidence and prevalence of inflammatory bowel disease (IBD), its social demographics, clinical characteristics and treatment, in the state of Johor, Malaysia.

    METHODS: Hospital Sultanah Aminah, Johor Bahru, is the only public hospital in Johor with a Gastroenterology service. Data on all existing and new IBD patients managed by the Gastroenterology Unit in 2016 were collected. Incidence and prevalence of IBD in 2016 were then calculated based on the estimated population of Johor and Johor Bahru.

    RESULTS: Twenty-five new cases of IBD were diagnosed in 2016. Among the 25 cases, 13 cases were Crohn's disease (CD), 10 were ulcerative colitis (UC) and two were IBD Unclassified (IBDU). The crude incidence of IBD, CD, UC and IBDU were 0.68, 0.36, 0.27, and 0.05 per 100,000 population respectively. Ethnic Indians had the highest incidence of IBD at 4.21 followed by Malays and Chinese at 0.56 and 0.18 per 100,000 population respectively. A total of 156 IBD cases were captured. Amongst them, 85 cases were UC, 68 cases were CD and three cases were IBDU, hence the prevalence of IBD, UC, CD and IBDU were 4.27, 2.33, 1.86 and 0.08 per 100,000 population respectively. Similarly, Indians had the highest prevalence at 16.84, followed by Chinese at 4.06 and Malays at 3.44 per 100,000 population.

    CONCLUSIONS: The incidence of IBD in Johor is comparable to that of a previous study in northern Peninsular Malaysia. The ethnicity preponderance is similar to the previous studies conducted in Malaysia.

    Matched MeSH terms: Crohn Disease
  15. Hilmi I, Jaya F, Chua A, Heng WC, Singh H, Goh KL
    J Crohns Colitis, 2015 May;9(5):404-9.
    PMID: 25744112 DOI: 10.1093/ecco-jcc/jjv039
    Inflammatory bowel disease [IBD] is known to be rare in the Asia Pacific region but epidemiological studies are scarce.
    Matched MeSH terms: Crohn Disease/ethnology*
  16. 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.
    Matched MeSH terms: Crohn Disease/genetics*
  17. Chua KH, Hilmi I, Ng CC, Eng TL, Palaniappan S, Lee WS, et al.
    J Dig Dis, 2009 May;10(2):124-30.
    PMID: 19426395 DOI: 10.1111/j.1751-2980.2009.00374.x
    The NOD2/CARD15 gene has been identified as an important susceptibility gene for Crohn's disease (CD) but the three common disease predisposing mutations (DPM) found in developed countries have not been identified in Asian populations. The aim of our study was to look for the DPM in our multiracial population and to discover whether there were any differences in the three major ethnic groups; Malay, Chinese and Indian.
    Matched MeSH terms: Crohn Disease/genetics*
  18. Lian LH, Lau TP, Lee VL, Lee WS, Hilmi I, Goh KL, et al.
    Genet. Mol. Res., 2013;12(1):167-74.
    PMID: 23408403 DOI: 10.4238/2013.January.24.9
    This study aimed to investigate the potential association of TYK2 and STAT3 genes with the susceptibility to Crohn's disease (CD) among Malaysians. DNA samples were obtained from 80 CD patients and 100 healthy controls. Polymerase chain reaction-restriction fragment length polymorphism methods were employed for genotyping, followed by statistical analysis. In our current study, none of the single nucleotide polymorphisms of either TYK2 or STAT3 was statistically associated with the susceptibility to CD in our local population (P > 0.05). In contrast, there was a statistically significant association between the G/G homozygotes of the STAT3 rs2293152 and the healthy control group (χ(2) = 6.229, P < 0.05). In conclusion, our study does not support the role of the TYK2 and STAT3 genes influencing CD susceptibility.
    Matched MeSH terms: Crohn Disease/genetics*
  19. Lee YM, Fock K, See SJ, Ng TM, Khor C, Teo EK
    J Gastroenterol Hepatol, 2000 Jun;15(6):622-5.
    PMID: 10921415
    BACKGROUND: The aim of this study was to determine the prevalence rates of inflammatory bowel disease in the different races in Singapore.

    METHODS: The patients studied consisted of 58 people with an established diagnosis of ulcerative colitis (UC) and Crohn's disease (CD) as determined by a combination of clinical, radiological, endoscopic and histological criteria. The patients were residents of a well-defined geographical area in the northern part of Singapore and had been referred to the single regional hospital. Epidemiological data including sex, age, ethnicity, family history and disease type and extent were collected from case records and patient interviews.

    RESULTS: There were 37 UC and 21 CD patients. Of the patients with UC, 67.5% were Chinese, 13.5% were Malay and 19% were Indian. The CD group consisted of 81% Chinese, 9.5% Malay and 9.5% Indian patients. The study population from which the patients were drawn was approximately 0.5 million in size.

    CONCLUSIONS: The overall prevalence of UC was 6 per 100,000 and of CD was 3.6 per 100,000 in Singapore. There were disproportionately more Indians suffering from UC, with a prevalence of 16.2 per 100,000 in comparison with six per 100,000 for Chinese and seven per 100 000 for Malays. The relative risk of UC in Indians is 2.9-fold greater than for the Chinese (CI= 1.25-6.7) which was statistically significant. This trend was not seen for CD.

    Matched MeSH terms: Crohn Disease/ethnology*
  20. Lee WS
    Pediatr Int, 2004 Apr;46(2):198-201.
    PMID: 15056252
    Matched MeSH terms: Crohn Disease/drug therapy*
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