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Biomedical subjects

I Yap

Publications and source records attributed to I Yap.

At least 19 recordsLinked to original sources
PubMed1995

Chili--protective factor against peptic ulcer?

The aim of the present study was to determine the frequency and amount of chili taken by peptic ulcer patients and control subjects. One hundred three Chinese patients with peptic ulcer and 87 control patients were interviewed using a standard questionnaire. Those subjects who deliberately avoided chili use because of symptoms or advice from friends or medical practitioners were excluded. The median number of times of chili use per month was eight in the ulcer group (25-75% quartiles 1-30) compared to 24 (8-56) in the control group (P < 0.001). The median amount of chili used per month was 312 units (25-75% quartiles 38-899) in the ulcer group compared to 834 units (274-1892) in the control group (P < 0.001). The odds ratio of having peptic ulcer disease, adjusted for age, sex, analgesic use, and smoking by multiple logistic regression, was 0.47 (95% confidence intervals: 0.25-0.89) for subjects who had a higher intake of chili both in terms of frequency as well as amount used compared to those who took less chili. Our data support the hypothesis that chili use has a protective effect against peptic ulcer disease.

Adult↗
PubMed1995

Chili protects against aspirin-induced gastroduodenal mucosal injury in humans.

Capsaicin, the pungent ingredient of chili, has a gastroprotective effect against experimental gastric mucosal injury in animals. Such an effect has not, however, been documented in humans to date. Eighteen healthy volunteers with normal index endoscopies underwent two studies four weeks apart. Each subject took 20 g chili orally with 200 ml water in one study and 200 ml water in another study. In each case this was followed half an hour later by 600 mg aspirin BP with 200 ml water. Endoscopy was repeated 6 hr later. Gastroduodenal mucosal damage was assessed by a previously validated scoring system. The median gastric injury score after chili was 1.5 compared to 4 in the control group (P < 0.05), demonstrating a gastroprotective effect of chili in human subjects.

Adult↗
PubMed1995

Treatment of hepatitis B surface antigen carriers in the early stage of the infection using recombinant alpha-interferon with steroid priming.

BACKGROUND: Alpha-interferon has been found to inhibit hepatitis B virus (HBV) replication in Chinese patients with chronic HBV infection although a sustained effect was rarely achieved in those with normal pretreatment serum alanine amino transferase (ALT) levels. Prednisolone priming has been found to be beneficial over treatment with interferon alone in these subjects. We studied the effect of steroid pre-treatment followed by recombinant interferon alpha-2a in the treatment of asymptomatic HBV carriers with positive hepatitis Be antigen (HBeAg), hepatitis B viral DNA (HBV-DNA) and minimal changes in liver histology. METHODS: The treatment regimen included a 6-week prednisolone priming, a 2 week rest followed by 14 weeks of three times weekly 9 mega units of interferon alpha-2a injection and 52 weeks of follow-up. There were seven patients in the treatment group and seven controls. RESULTS: The mean age, pre-treatment ALT (normal in all except for one in each of the treatment and control groups), HBV-DNA levels and histological scores were similar in the two groups. Serum HBV-DNA levels fell in six patients during treatment and became undetectable in two of them by the end. During follow-up, serum HBV-DNA returned to pre-treatment levels in all patients. None of the treated patients had HBeAg sero-conversion and none of the controls had spontaneous clearance of HBV-DNA or sero-conversion of HBeAg. No improvement of liver histology was observed in any of the treated patients. There were only mild flu-like side-effects noted and interferon alpha-2a was well tolerated at the doses given among treated patients. CONCLUSION: Prednisolone priming followed by interferon alpha-2a treatment has no beneficial effect on HBV carriers in the early stages of chronic hepatitis B infection.

Adult↗
PubMed1995

Immunogenicity and safety of an inactivated hepatitis A vaccine amongst Singaporeans.

The immunogenicity and reactogenicity of an inactivated hepatitis A virus (HAV) vaccine was studied in healthy Singaporean adult volunteers. One hundred and forty healthy volunteers with normal alanine (ALT) and aspartate (AST) transaminases and no previous exposure to HAV, received three 1 ml doses (720 ELISA units) of an inactivated HAV vaccine (Smithkline Beechams Biologicals) following a 0, 1, 6 months vaccination schedule. All subjects were asked to record and grade the severity of any reactions for three consecutive days after each dose. Serum ALT and AST as well as anti-HAV were measured at 0, 1, 2, 6 and 7 months after the first vaccine dose. Anti-HAV seroconversion occurred when levels rose above 40 mIU/ml. Eighty-five percent of vaccinees seroconverted after the first innoculation and 99% after the second injection. All vaccinees seroconverted after the third dose. Geometric mean anti-HAV titers (GMTs) were, respectively, 119, 391, 4406 mIU/ml one month after each of the three doses. The most common side effect was transient pain and tenderness at the vaccination site. No elevation of ALT or AST levels were noted during the study period. The inactivated hepatitis A vaccine used in this study is safe and highly immunogenic in the local adult population. Two doses one month apart appeared to give adequate protection.

Adult↗
PubMed1994

The colonic air insufflation test indicates a colonic cause of abdominal pain. An aid in the management of irritable bowel syndrome.

We evaluated a standardized colonic air insufflation test in patients investigated for abdominal pain; 195 patients were evaluable. Of 164 patients with functional abdominal pain, 100 of the 128 (78%) with irritable bowel syndrome diagnosed on the basis of two or more Manning criteria (group A) had positive tests, compared with 19 of the 36 (53%) with functional abdominal pain not satisfying the diagnostic criteria for irritable bowel syndrome (group B). Eight of the 10 patients (80%) with structural colonic disease had positive tests (group C), and 3 of the 21 patients (14%) with structural noncolonic causes of abdominal pain (group D) had positive tests (group A vs. B, A vs. D, and C vs. D, p < 0.01). The air insufflation test had a sensitivity of 78% for the diagnosis of colonic pain and a specificity of 61%. The positive predictive value was 83% and the negative predictive value 54%. Sequential tests by two independent observers on 26 consecutive patients showed no interobserrer variation. The colonic air insufflation test warrants further evaluation as an adjunct to the Manning criteria in the diagnosis of irritable bowel syndrome. It can also serve as an investigative tool to define a subset of patients with functional abdominal pain who do not fulfill the current criteria for irritable bowel syndrome yet whose pain actually originates from the colon.

Abdominal Pain↗
PubMed1993

Low frequency of endoscopic esophagitis in Asian patients.

The aim of this study was to determine the frequency of endoscopic esophagitis in patients seen for upper gastrointestinal complaints in an Asian center. We studied a consecutive series of 11,943 patients undergoing diagnostic esophagogastroduodenoscopy at our unit over a 10-year period. Three hundred and eighty-nine patients (3.3%) had endoscopic esophagitis with no other significant lesion (primary esophagitis), whereas 143 (1.2%) had esophagitis associated with peptic ulcer or gastric or duodenal malignancy (secondary esophagitis). In contrast, peptic ulcer was diagnosed in 2,787 patients (23.3%) and gastric carcinoma in 286 (2.4%). The reported frequency of endoscopic esophagitis among patients undergoing endoscopy in Western countries varied from 9 to 23%. Our data therefore show that endoscopic esophagitis is much less common in Singaporean patients.

Adult↗
PubMed1993

Short report: prednisolone withdrawal followed by lymphoblastoid interferon in the therapy of adult patients with presumed childhood-acquired chronic hepatitis B virus infection.

Eighteen patients with presumed childhood acquisition of chronic hepatitis B virus infection were initially entered into this randomized controlled trial. Twelve were treated with prednisolone for 4 weeks followed, after a 2-week gap, by thrice weekly lymphoblastoid alpha-interferon for 12 weeks. Two of these had previously acted as untreated controls. Three of the 12 patients (25%) [who were initially hepatitis B virus (HBV) surface antigen (HBsAg), 'e' antigen (HBeAg) and HBV-DNA positive] became HBeAg and HBV-DNA negative during therapy and remained so after 12 months post-therapy follow-up. One of these also lost HBsAg. A further two patients lost HBeAg and HBV-DNA during therapy but relapsed 6 and 9 months later. Two additional patients were HBV-DNA negative but HBeAg positive at the end of follow-up. None of the eight untreated control patients seroconverted during an identical follow-up period. Two further patients were HBsAg and HBeAg positive but HBV-DNA negative at the start of therapy. These were omitted from the final analysis: both subsequently lost HBeAg. The treatment response was associated with a rise in aspartate aminotransferase, peaking 2-6 weeks after prednisolone withdrawal, loss of HBV-DNA 0-8 weeks later and subsequent normalization of liver function tests. Treatment was well tolerated.

Adolescent↗
PubMed1993

Uncommon presentation of typhoid fever: a case report.

A 24-year-old Chinese woman was admitted for cholestatic jaundice following a short history of fever associated with headache and diarrhoea. She had mild hepatomegaly. Initial laboratory investigations were non-contributory. A percutaneous liver biopsy revealed inflammatory changes more in keeping with a systemic infection than a primary hepatitic problem. Repeat blood and stool cultures finally grew salmonella typhi. Jaundice is a rare manifestation of typhoid fever; it occurs in less than one-third of patients with hepatomegaly. Such a presentation may mimic primary hepatic infections. Awareness of this rare occurrence in typhoid fever would help in early diagnosis and therapy.

Adult↗
PubMed1993

Augmentin-induced cholestatic jaundice--a case report.

A case of cholestatic jaundice following treatment with Augmentin is reported. The awareness of hepatotoxicity due to drug should help to avoid unnecessary invasive procedures in the evaluation of this reversible condition.

Acute Disease↗
PubMed1993

Pill-induced esophageal ulcer.

We describe nine cases of esophageal injury associated with the ingestion of prescribed medications. Antibiotics were the most commonly implicated drugs. Odynophagia, retrosternal chest pain and dysphagia were the usual presenting symptoms. The typical endoscopic finding was that of discrete ulcers in the mid-esophagus. All patients recovered uneventfully with discontinuation of the offending drug and symptomatic treatment. Drug induced esophageal injury should be considered in patients presenting acutely with the above mentioned symptoms and having discrete esophageal ulcers on endoscopy.

Administration, Oral↗
PubMed1993

Peliosis hepatis: a case report.

A 54-year-old man who presented with marked hepatomegaly and a liver scan suggestive of an infiltrative malignancy was found to have peliosis hepatis caused by androgenic steroids. A detailed and repeated drug history is necessary for making the correct diagnosis. Withdrawal of the offending drug is indicated and may result in reversal of this serious form of hepatic toxicity.

Androgens↗
PubMed1992

Recombinant DNA hepatitis B vaccine containing Pre-S components of the HBV coat protein--a preliminary study on immunogenicity.

A novel recombinant hepatitis B vaccine, trademarked Sci-B-Vac, was evaluated for safety, tolerability and immunogenicity in an open label trial performed in Singapore. The experimental vaccine, derived from Chinese hamster ovary (CHO) cells, consists of hepatitis B surface antigen (HBsAg) particles harbouring all three viral envelope polypeptides, the major S protein and the minor Pre-S2 and Pre-S1, in their glycosylated and non-glycosylated forms. The vaccine was administered intramuscularly at 0, 1 and 6 months. No unexpected adverse effects were observed. A high level anti-HBs response to Sci-B-Vac was indicative of its immunogenicity. Subsequent to the third injection, 100% and 92% of the 10 micrograms and 5 micrograms dose recipients, respectively, were seroprotected (anti-HBs titres greater than or equal to 10 mIU ml-1). Moreover, the geometric mean titres (GMT) of the anti-HBs response were very high: 2687 and 1473 mIU ml-1, respectively. An immunogenic advantage of Sci-B-Vac was also suggested by the rapid onset of antibody response: 96% of the 10 micrograms dose recipients were seroprotected with a GMT of 159 mIU ml-1, prior to the third injection.

Adolescent↗
PubMed1991

Acid and gastric ulcer pain.

We have shown previously that acid is one factor, although not the only one, in the pathogenesis of duodenal ulcer pain. In the present study patients with gastric ulcer were endoscoped without sedation or premedication. Under direct vision the ulcer craters were infused sequentially with 0.1 N HCl and normal saline, the sequence of infusion being randomized and double blind. Typical ulcer pain occurred in seven of 19 patients during acid infusion compared with one with saline (p = 0.023). Two patients who developed pain on acid were rechallenged after their pain disappeared, and typical pain recurred in both. Acid therefore has a definite role in the pathogenesis of gastric ulcer pain.

Female↗