Malaysian joint societies' consensus recommendations on diagnosis and management of disorders of esophagogastric junction outflow.

Disorders of esophagogastric junction (EGJ) outflow, including achalasia and EGJ outflow obstruction, are motility disorders characterized by inadequate relaxation of lower esophageal sphincter with or without impaired esophageal peristalsis. Current guidelines are technical and less practical in the Asia-Pacific region, and there are still massive challenges in timely diagnosis and managing these disorders effectively. Therefore, a Malaysian joint societies' task force has developed a consensus on disorders of EGJ outflow based on the latest evidence, while taking into consideration the practical relevance of local and regional context and resources. Twenty-one statements were established after a series of meetings and extensive review of literatures. The Delphi method was used in the consensus voting process. This consensus focuses on the definition, diagnostic investigations, the aims of treatment outcome, non-surgical or surgical treatment options, management of treatment failure or relapse, and the management of complications. This consensus advocates the use of high-resolution esophageal manometry for diagnosis of disorders of EGJ outflow. Myotomy, via either endoscopy or laparoscopy, is the preferred treatment option, while pneumatic dilatation can serve as a secondary option. Evaluation and management of complications including post-procedural reflux and cancer surveillance are recommended.

Complementary alternative medicine use among patients with dengue fever in the hospital setting: a cross-sectional study in Malaysia.

BACKGROUND: In Malaysia, the number of reported cases of dengue fever demonstrates an increasing trend. Since dengue fever has no vaccine or antiviral treatment available, it has become a burden. Complementary and alternative medicine (CAM) has become one of the good alternatives to treat the patients with dengue fever. There is limited study on the use of CAM among patients with dengue fever, particularly in hospital settings. This study aims to determine the prevalence, types, reasons, expenditure, and resource of information on CAM use among patients with dengue fever. METHODS: This is a descriptive, cross-sectional study of 306 patients with dengue fever, which was carried out at the dengue clinic of three hospitals. Data were analysed using IBM SPSS Statistics version 21.0 and logistic regression analysis was used to determine the factors associated with CAM use. RESULTS: The prevalence of CAM use was 85.3% among patients with dengue fever. The most popular CAMs were isotonic drinks (85.8%), crab soup (46.7%) and papaya leaf extract (22.2%). The most common reason for CAM use was a good impression of CAM from other CAM users (33.3%). The main resource of information on CAM use among patients with dengue fever was family (54.8%). In multiple logistic regression analysis, dengue fever patients with a tertiary level are more likely to use CAM 5.8 (95% confidence interval (CI 1.62-20.45) and 3.8 (95% CI 1.12-12.93) times than secondary level and primary and below respectively. CONCLUSION: CAM was commonly used by patients with dengue fever. The predictor of CAM use was a higher level of education.

Mixed Neuroendocrine - Nonneuroendocrine Neoplasm Arising in Barrett's Esophagus.

Barrett's esophagus, which results from chronic gastroesophageal reflux disease, is a known precursor to dysplasia and ultimately esophageal adenocarcinoma. Mixed neuroendocrine - nonneuroendocrine neoplasm (MiNEN) is a rare and heterogenous group of neoplasm with aggressive clinical behavior in general. There have been rare reports of MiNEN arising in Barrett's esophagus, and its pathogenesis remains unclear. Surgical resection with lymph node dissection remains the most effective treatment of MiNEN of the esophagus to date, although the evidence on its optimal treatment is scant. How to cite this article: Lee SL, Ng CY, Gew LT, et al. Mixed Neuroendocrine - Nonneuroendocrine Neoplasm Arising in Barrett's Esophagus. Euroasian J Hepato-Gastroenterol 2022;12(1):57-59.

Bat species diversity trend along an elevation gradient: A study in Crocker Range Park, Sabah, Borneo.

Bats (Order: Chiroptera) is a recognised group of bioindicators due to their sensitivity towards alterations in their immediate surroundings. With the threats of climate change becoming more severe on a daily basis, it is reasonable to collect data on how bat diversity is influenced by elevation. This will be useful to predict and monitor possible upslope shifting of bat species due to increase in surrounding temperature or anthropogenic pressure. Hence, this study aims to uncover the bat diversity trend at different elevations in Crocker Range Park (CRP), Sabah, Malaysia. Bat trappings were conducted in four substations within this park, covering an elevation spectrum from 450 to 1900 m a.s.l. The overall sampling managed to capture 133 individuals of bats, predominantly Pteropodidae, with the addition of two new species locality records for CRP, Murinapeninsularis and Hypsugovondermanni. Simple linear regression analyses revealed that both bat diversity and richness have an inverse linear relationship with elevation. Likewise, the Pearson's correlation value, associating bat diversity with elevation, also shows that they have a negative relationship at r = -0.852. Heterogeneity of habitats explain this trend, as in the lower counterpart of CRP, lowland forests, which are richer in fruit and insect resources persist. Besides, lower land forests have better niche assortment, due to the distinctive layers stratification, allowing bats utilising different guilds to thrive in the same vegetation profile. This study further emphasises the role of CRP to protect most of the bat species found in Borneo, as well as serving as the baseline data for the future studies that look into the impact of temperature increment towards the upslope shifting of the bat population in CRP.

High-density SNP screen of sodium channel genes by haplotype tagging and DNA pooling for association with idiopathic generalized epilepsy.

We have investigated seven voltage-gated sodium channel genes for association with idiopathic generalized epilepsy (IGE). Probands and control DNA were grouped into pools and used to screen 85 single-nucleotide polymorphisms (SNPs), mostly HapMap SNPs tagging the common variation in these genes. Twelve SNPs exhibiting an allele frequency difference between pools were genotyped individually in our sample of 232 probands, 313 controls, and 95 parent-proband trios. Two SNPs, in SCN1A and SCN8A, were associated by allele and genotype at nominal level of significance, but were not significant after Bonferroni correction. Two SCN2A SNPs (rs3943809 and rs16850331) were associated by case-control with a subgroup with IGE and history of febrile seizures and also by transmission disequilibrium test (TDT) in parent-proband trios. Both SNPs are part of a linkage disequilibrium (LD) cluster of 38 SNPs, but none are obvious functional variants. The association of rs3943809 with the febrile seizure subgroup (p = 0.0004) remains significant after the conservative Bonferroni correction for multiple testing.

No association of single nucleotide polymorphisms in the micro-opioid receptor subunit gene with idiopathic generalized epilepsy.

We have investigated the reported association (p = 0.019) between the A118G single nucleotide polymorphism (SNP) of the opioid receptor micro subunit gene (OPRM1) and idiopathic absence epilepsy (IAE). Five SNPs, including A118G, were investigated by association studies in a sample of 240 probands with idiopathic generalized epilepsy (IGE), including 110 with IAE, and 257 controls. No significant association was found for A118G with IGE or IAE. The difference between the two studies was in the control samples that had significantly different allele frequencies (p = 0.00005), suggesting that population stratification may explain the earlier significant association with IAE. In the current study, none of the other four SNPs was significantly associated with IGE or IAE. Our results provide no support for association of A118G with either IAE or IGE and also exclude association in our sample of a small-to-moderate gene effect with IGE from a large part of OPRM1.