1.A Safe and Efficacious Alternative to Roux-en-Y Gastric Bypass for the Treatment of Morbid Obesity and Type 2 Diabetes - One Anastamosis / Mini Gastric Bypass.
Chun Hai TAN ; Young Suk PARK ; Dong Wook KIM ; Yoontaek LEE ; Sang Hoon AHN ; Do Joong PARK ; Hyung Ho KIM ; Anton CHENG
Journal of Metabolic and Bariatric Surgery 2016;5(2):45-52
Roux-en-y gastric bypass (RYGB) is currently used to treat obesity and metabolic syndrome. It is however technically challenging with a steep learning curve and long operating times. Laparoscopitc mini-gastric bypass (LMGB) is another surgical method that is acclaimed to achieve similar efficacy and yet safe with acceptable complication rates. We reviewedcurrent literature on LMGB on its efficacy and safety profile. Comprehensive search of available literature using a combination of key words was performed, looking out for efficacy and safety end points. Efficacy end points include excess weight loss, change in body mass index (BMI), resolution of metabolic syndrome or T2DM remission. Safety end points include mortality and morbidity rates, short and long term complications. 18 studies were selected with a total of 9392 patients. Follow up range was from 1 year to 6 years with majority of studies achieving 57%-92% excess weight loss (%EWL) within 1 year. Remission of T2DM rates were mostly more than 84%. Several studies reported better %EWL and T2DM remission when compared to SG and RYGB. Overall mortality rate was 0.152%. Morbidity rates vary from 2.7%-12.5%. Some studies reported lower mortality and complication rates in LMGB when compared to SG and RYGB. In summary, MGB is a safe and effective metabolic-bariatric procedure in treating morbid obesity and T2DM. It should be considered an alternative to standard RYGB. Risk of bile reflux, marginal ulcer and anemia needs to be explained to the patient when counselling for such procedure.
Anemia
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Bile Reflux
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Body Mass Index
;
Follow-Up Studies
;
Gastric Bypass*
;
Humans
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Learning Curve
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Methods
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Mortality
;
Obesity
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Obesity, Morbid*
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Peptic Ulcer
;
Weight Loss
2.Asthma control and asthma treatment adherence in primary care: results from the prospective, multicentre, non-interventional, observational cohort ASCOPE study in Malaysia
Nor Azila Mohd Isa ; Chang Li Cheng ; Nazrila Hairizan Nasir ; Viknesh Naidu ; Vieshal Raja Gopal ; Anton Kumar Alexander
The Medical Journal of Malaysia 2020;75(4):331-337
Introduction: As the first point of contact for those presenting
with asthma symptoms, primary healthcare plays a crucial role
in asthma management. This is a nationwide study of
assessment of asthma symptom control and adherence to
asthma medication among outpatients in public health clinics
in Malaysia.
Methods: This is a prospective, observational multicentre study
(ASCOPE; NCT03804632). Data on asthma control, assessment
of control symptoms, and adherence to treatment were
collected from medical records and interviews of patients. The
level of asthma control was assessed using the Global Initiative
for Asthma (GINA) Assessment of Symptom Control.
Adherence of patient to medication for asthma was assessed
through interview of patients using four questions adapted
from the Malaysian Medication Adherence Scale.
Results: Among the 1011 patients recruited, 416 (41%) had
well controlled asthma, 388 (38%) were partly controlled, and
207 (21%) had uncontrolled asthma. Majority (81%) had mild
asthma and all patients were on asthma medication. Most
patients did not have spirometry data (97%) but underwent
peak flow rate measurements (98%). Poor adherence occurred
at all levels of asthma control but was worst among those with
uncontrolled asthma. This was statistically significant across all
four questions on adherence (p<0.05). For example, more
patients with uncontrolled asthma forgot doses (56%) or
stopped treatment (39%) than those with well-controlled
asthma (44% and 27% respectively).
Conclusions: Among Malaysian primary care patients with
asthma, less than 50% had well-controlled asthma, and low
adherence to treatment was common. More effort is needed to
improve asthma control among patients in Malaysia, including
those with mild asthma.
3.An Integrated Systems Biology Approach Identifies the Proteasome as A Critical Host Machinery for ZIKV and DENV Replication
Song GUANG ; M.Lee EMILY ; Pan JIANBO ; Xu MIAO ; Rho HEE-SOOL ; Cheng YICHEN ; Whitt NADIA ; Yang SHU ; Kouznetsova JENNIFER ; Klumpp-Thomas CARLEEN ; G.Michael SAMUEL ; Moore CEDRIC ; Yoon KI-JUN ; M.Christian KIMBERLY ; Simeonov ANTON ; Huang WENWEI ; Xia MENGHANG ; Huang RUILI ; Lal-Nag MADHU ; Tang HENGLI ; Zheng WEI ; Qian JIANG ; Song HONGJUN ; Ming GUO-LI ; Zhu HENG
Genomics, Proteomics & Bioinformatics 2021;19(1):108-122
The Zika virus (ZIKV) and dengue virus (DENV) flaviviruses exhibit similar replicative processes but have distinct clinical outcomes. A systematic understanding of virus–host protein–pro-tein interaction networks can reveal cellular pathways critical to viral replication and disease patho-genesis. Here we employed three independent systems biology approaches toward this goal. First, protein array analysis of direct interactions between individual ZIKV/DENV viral proteins and 20,240 human proteins revealed multiple conserved cellular pathways and protein complexes, including proteasome complexes. Second, an RNAi screen of 10,415 druggable genes identified the host proteins required for ZIKV infection and uncovered that proteasome proteins were crucial in this process. Third, high-throughput screening of 6016 bioactive compounds for ZIKV inhibition yielded 134 effective compounds, including six proteasome inhibitors that suppress both ZIKV and DENV replication. Integrative analyses of these orthogonal datasets pinpoint proteasomes as crit-ical host machinery for ZIKV/DENV replication. Our study provides multi-omics datasets for fur-ther studies of flavivirus–host interactions, disease pathogenesis, and new drug targets.