1.Efficacy of Amitriptyline in Irritable Bowel Syndrome:A Systematic Review and Meta-analysis
Minahil IQBAL ; Sara HIRA ; Humza SAEED ; Sufyan SHAHID ; Suha T BUTT ; Kamran RASHID ; Mohammad AHMAD ; Hammad HUSSAIN ; Anzalna MUGHAL ; Gabriel P A COSTA ; Fernanda GUSHKEN ; Neil NERO ; Shreya SENGUPTA ; Akhil ANAND
Journal of Neurogastroenterology and Motility 2025;31(1):28-37
Background/Aims:
Amitriptyline is prescribed off-label for irritable bowel syndrome (IBS). We conducted a meta-analysis to assess its efficacy.
Methods:
A systematic literature review was conducted until November 10, 2023, using MEDLINE, Embase, Cochrane Library, and Web of Science to study the efficacy of amitriptyline in patients with IBS. We included all randomized controlled trials that compared amitriptyline to placebo. Revised Cochrane risk-of-bias tool was used to assess the quality of studies. Meta-analyses were performed using a bivariate random-effects model. Statistical analyses were performed using R Software 4.2.3 and heterogeneity was assessed with I 2 statistics.
Results:
Seven trials were included with 796 patients (61% female). Amitriptyline was associated with better treatment response (OR, 5.30; 95% CI, 2.47 to 11.39; P < 0.001), reduced Irritable Bowel Syndrome Symptom Severity Scores (MD, –50.72; 95% CI, –94.23 to –7.20; P = 0.020) and improved diarrhea (OR, 10.55; 95% CI, 2.90 to 38.41; P < 0.001). No significant difference between the 2 groups regarding the adverse effects was observed. Three trials showed an overall low risk of bias, 2 trials showed an overall high risk of bias due to randomization and missing data, and 2 trials had some concerns regarding missing data.
Conclusions
Amitriptyline was found to be well-tolerated and effective in treating IBS compared to placebo. These findings support the use of amitriptyline for the management of IBS, particularly among patients with the IBS diarrhea subtype. Future research should focus on the dose-dependent effects of amitriptyline in IBS to better guide clinicians in personalized titration regimens.
2.The Effects of Subjective Socioeconomic Status and Social Capital on Self-rated Health and Perceived Quality of Life: A Cross-sectional Survey-based Study in a Minority Group in Iran
Rashid AHMADIFAR ; Nader RAJABI-GILAN ; Shirzad ROSTAMIZADEH ; Nsrolah NADIMI ; Parviz SOBHANI ; Adel IRANKHAH
Journal of Preventive Medicine and Public Health 2025;58(1):11-20
Objectives:
The purpose of this study is to examine the impact of subjective socioeconomic status and social capital on self-rated health and quality of life among a minority group in Iran.
Methods:
This cross-sectional study involved 800 individuals from a minority group in Iran. The sampling method was clustering, and data collection was conducted using a questionnaire. Data analysis was performed using SPSS version 18 and Stata version 8.
Results:
The results of logistic regression analysis revealed that subjective socioeconomic status (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.34 to 1.61), belonging and empathy (OR, 1.09; 95% CI, 1.03 to 1.15), and trust (OR, 1.06; 95% CI, 1.00 to 1.13) significantly impacted the quality of life. Additionally, the logistic regression analysis for factors influencing self–rated health demonstrated significant effects for the age group of 31-50 years (OR, 0.59; 95% CI, 0.38 to 0.91), gender (OR, 0.65; 95% CI, 0.46 to 0.92), academic education (OR, 2.00; 95% CI, 1.22 to 3.26), subjective socioeconomic status (OR, 1.27; 95% CI, 1.16 to 1.38), chronic disease (OR, 4.52; 95% CI, 2.49 to 8.19), belonging and empathy (OR, 1.06; 95% CI, 1.01 to 1.11), and participation (OR, 1.12; 95% CI, 1.00 to 1.24).
Conclusions
The findings indicate that bonding social capital significantly influences health levels and quality of life. Focusing on delegating local responsibilities to community members and striving to promote participation in health programs, along with increasing the socioeconomic status of minority groups, can effectively improve their health and quality of life.
3.Integrating virtual reality to enhance remote teaching of anatomy during unprecedented times
Thomas BOILLAT ; Ivan James PRITHISHKUMAR ; Dineshwary SURESH ; Nerissa NAIDOO
Anatomy & Cell Biology 2025;58(1):112-121
The COVID-19 pandemic necessitated a global paradigm shift in the teaching of human anatomy. Most institutions successfully transitioned from traditional in-person teaching methods, to various distance-learning strategies.Since virtual reality (VR) offers immersive three-dimensional (3D) experiences, this study investigated students’ experiences regarding the capacity of VR to support distance-learning of anatomy. Using the VR application, 3D Organon Virtual Reality Anatomy, anatomy instructors pre-recorded learning content as 360-degree videos with live voice-over and integrated it into the teaching material of the MBBS first-year abdomen, pelvis, and perineum-structure and function course. A 19-item 5-point Likert scale questionnaire, comprising of two major categories, “VR experience in anatomy lessons” and “VR in anatomy lessons vs. traditional cadaveric dissection” was disseminated. Post-evaluation analysis revealed a response rate of 63.5%. Almost 70% of students agreed that VR was instrumental in solidifying their theoretical understanding and improved spatial awareness with better retention of anatomical relationships. Approximately 50% wanted to continue using VR even if instruction becomes onsite. Though 72% of participants agree that VR addressed the session learning objectives only 24% agree that it is similar or better than cadaveric dissection, thus preferring cadaveric dissection to VR. Only 12.1% agree that VR is more beneficial to cadaveric dissection. Our exploration into the integration of VR technology in anatomy teaching has revealed promising opportunities. While VR can augment traditional teaching methods in unprecedented times such as war, floods or global pandemic, it should not replace hands-on cadaveric learning entirely, but rather complement existing approaches.
4.Integrating virtual reality to enhance remote teaching of anatomy during unprecedented times
Thomas BOILLAT ; Ivan James PRITHISHKUMAR ; Dineshwary SURESH ; Nerissa NAIDOO
Anatomy & Cell Biology 2025;58(1):112-121
The COVID-19 pandemic necessitated a global paradigm shift in the teaching of human anatomy. Most institutions successfully transitioned from traditional in-person teaching methods, to various distance-learning strategies.Since virtual reality (VR) offers immersive three-dimensional (3D) experiences, this study investigated students’ experiences regarding the capacity of VR to support distance-learning of anatomy. Using the VR application, 3D Organon Virtual Reality Anatomy, anatomy instructors pre-recorded learning content as 360-degree videos with live voice-over and integrated it into the teaching material of the MBBS first-year abdomen, pelvis, and perineum-structure and function course. A 19-item 5-point Likert scale questionnaire, comprising of two major categories, “VR experience in anatomy lessons” and “VR in anatomy lessons vs. traditional cadaveric dissection” was disseminated. Post-evaluation analysis revealed a response rate of 63.5%. Almost 70% of students agreed that VR was instrumental in solidifying their theoretical understanding and improved spatial awareness with better retention of anatomical relationships. Approximately 50% wanted to continue using VR even if instruction becomes onsite. Though 72% of participants agree that VR addressed the session learning objectives only 24% agree that it is similar or better than cadaveric dissection, thus preferring cadaveric dissection to VR. Only 12.1% agree that VR is more beneficial to cadaveric dissection. Our exploration into the integration of VR technology in anatomy teaching has revealed promising opportunities. While VR can augment traditional teaching methods in unprecedented times such as war, floods or global pandemic, it should not replace hands-on cadaveric learning entirely, but rather complement existing approaches.
5.Integrating virtual reality to enhance remote teaching of anatomy during unprecedented times
Thomas BOILLAT ; Ivan James PRITHISHKUMAR ; Dineshwary SURESH ; Nerissa NAIDOO
Anatomy & Cell Biology 2025;58(1):112-121
The COVID-19 pandemic necessitated a global paradigm shift in the teaching of human anatomy. Most institutions successfully transitioned from traditional in-person teaching methods, to various distance-learning strategies.Since virtual reality (VR) offers immersive three-dimensional (3D) experiences, this study investigated students’ experiences regarding the capacity of VR to support distance-learning of anatomy. Using the VR application, 3D Organon Virtual Reality Anatomy, anatomy instructors pre-recorded learning content as 360-degree videos with live voice-over and integrated it into the teaching material of the MBBS first-year abdomen, pelvis, and perineum-structure and function course. A 19-item 5-point Likert scale questionnaire, comprising of two major categories, “VR experience in anatomy lessons” and “VR in anatomy lessons vs. traditional cadaveric dissection” was disseminated. Post-evaluation analysis revealed a response rate of 63.5%. Almost 70% of students agreed that VR was instrumental in solidifying their theoretical understanding and improved spatial awareness with better retention of anatomical relationships. Approximately 50% wanted to continue using VR even if instruction becomes onsite. Though 72% of participants agree that VR addressed the session learning objectives only 24% agree that it is similar or better than cadaveric dissection, thus preferring cadaveric dissection to VR. Only 12.1% agree that VR is more beneficial to cadaveric dissection. Our exploration into the integration of VR technology in anatomy teaching has revealed promising opportunities. While VR can augment traditional teaching methods in unprecedented times such as war, floods or global pandemic, it should not replace hands-on cadaveric learning entirely, but rather complement existing approaches.
6.Health-related quality of life in Singapore: Population norms for the EQ-5D-5L and EORTC QLQ-C30.
Jaclyn TAN ; Mervyn Jr LIM ; Ravindran KANESVARAN ; Richard NORMAN ; Wen Yee CHAY ; Mohamad Farid Bin HARUNAL RASHID ; Mihir GANDHI ; Madeleine KING ; Nan LUO
Annals of the Academy of Medicine, Singapore 2025;54(3):147-159
INTRODUCTION:
Comparison of patient health-related quality of life (HRQOL) scores to a reference group is needed to quantify the HRQOL impact of disease or treatment. This study aimed to establish population norms for 2 HRQOL questionnaires-EuroQol 5-dimension 5-level questionnaire (EQ-5D-5L) and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core Question-naire 30 (EORTC QLQ-C30) according to age, sex and ethnicity-and to explore relationships between the EQ-5D-5L, EORTC QLQ-C30 and sociodemographic characteristics. We used a representative sample of adult Singapore residents aged 21 years and above.
METHOD:
This study used data collected from a cross-sectional household survey in which 600 adult Singaporeans completed questions on sociodemo-graphic characteristics-the EQ-5D-5L and the EORTC QLQ-C30. Multiple linear regression analyses were conducted to explore associations between sociodemographic characteristics, the EQ-5D-5L scores and the EORTC QLQ-C30 scores. Regression-based population norms were computed for each subgroup using a post-stratification method.
RESULTS:
In multiple linear regression analysis, age was significantly associated with EQ-5D-5L index and visual analogue scale (VAS) scores, while no sociodemographic characteristics were significantly associated with EORTC QLQ-C30 summary scores. The normative EQ-5D-5L index and VAS scores decreased in adults aged 65 years and above, and EQ-5D-5L index scores were slightly lower in females than males and in non-Chinese than Chinese. The normative EORTC QLQ-C30 summary scores were slightly higher in Chinese than in the non-Chinese group and in the 45-64 age group than other age groups.
CONCLUSION
This study provides population norms for the EQ-5D-5L and EORTC QLQ-C30 for the general adult population in Singapore. Future studies of patient populations in Singapore using EQ-5D-5L or QLQ-C30 can use these normative data to interpret the HRQOL data collected.
Humans
;
Quality of Life
;
Singapore
;
Male
;
Female
;
Middle Aged
;
Adult
;
Cross-Sectional Studies
;
Aged
;
Surveys and Questionnaires
;
Young Adult
;
Health Status
;
Age Factors
;
Linear Models
;
Aged, 80 and over
7.Integrating virtual reality to enhance remote teaching of anatomy during unprecedented times
Thomas BOILLAT ; Ivan James PRITHISHKUMAR ; Dineshwary SURESH ; Nerissa NAIDOO
Anatomy & Cell Biology 2025;58(1):112-121
The COVID-19 pandemic necessitated a global paradigm shift in the teaching of human anatomy. Most institutions successfully transitioned from traditional in-person teaching methods, to various distance-learning strategies.Since virtual reality (VR) offers immersive three-dimensional (3D) experiences, this study investigated students’ experiences regarding the capacity of VR to support distance-learning of anatomy. Using the VR application, 3D Organon Virtual Reality Anatomy, anatomy instructors pre-recorded learning content as 360-degree videos with live voice-over and integrated it into the teaching material of the MBBS first-year abdomen, pelvis, and perineum-structure and function course. A 19-item 5-point Likert scale questionnaire, comprising of two major categories, “VR experience in anatomy lessons” and “VR in anatomy lessons vs. traditional cadaveric dissection” was disseminated. Post-evaluation analysis revealed a response rate of 63.5%. Almost 70% of students agreed that VR was instrumental in solidifying their theoretical understanding and improved spatial awareness with better retention of anatomical relationships. Approximately 50% wanted to continue using VR even if instruction becomes onsite. Though 72% of participants agree that VR addressed the session learning objectives only 24% agree that it is similar or better than cadaveric dissection, thus preferring cadaveric dissection to VR. Only 12.1% agree that VR is more beneficial to cadaveric dissection. Our exploration into the integration of VR technology in anatomy teaching has revealed promising opportunities. While VR can augment traditional teaching methods in unprecedented times such as war, floods or global pandemic, it should not replace hands-on cadaveric learning entirely, but rather complement existing approaches.
8.Integrating virtual reality to enhance remote teaching of anatomy during unprecedented times
Thomas BOILLAT ; Ivan James PRITHISHKUMAR ; Dineshwary SURESH ; Nerissa NAIDOO
Anatomy & Cell Biology 2025;58(1):112-121
The COVID-19 pandemic necessitated a global paradigm shift in the teaching of human anatomy. Most institutions successfully transitioned from traditional in-person teaching methods, to various distance-learning strategies.Since virtual reality (VR) offers immersive three-dimensional (3D) experiences, this study investigated students’ experiences regarding the capacity of VR to support distance-learning of anatomy. Using the VR application, 3D Organon Virtual Reality Anatomy, anatomy instructors pre-recorded learning content as 360-degree videos with live voice-over and integrated it into the teaching material of the MBBS first-year abdomen, pelvis, and perineum-structure and function course. A 19-item 5-point Likert scale questionnaire, comprising of two major categories, “VR experience in anatomy lessons” and “VR in anatomy lessons vs. traditional cadaveric dissection” was disseminated. Post-evaluation analysis revealed a response rate of 63.5%. Almost 70% of students agreed that VR was instrumental in solidifying their theoretical understanding and improved spatial awareness with better retention of anatomical relationships. Approximately 50% wanted to continue using VR even if instruction becomes onsite. Though 72% of participants agree that VR addressed the session learning objectives only 24% agree that it is similar or better than cadaveric dissection, thus preferring cadaveric dissection to VR. Only 12.1% agree that VR is more beneficial to cadaveric dissection. Our exploration into the integration of VR technology in anatomy teaching has revealed promising opportunities. While VR can augment traditional teaching methods in unprecedented times such as war, floods or global pandemic, it should not replace hands-on cadaveric learning entirely, but rather complement existing approaches.
10.Efficacy of Amitriptyline in Irritable Bowel Syndrome:A Systematic Review and Meta-analysis
Minahil IQBAL ; Sara HIRA ; Humza SAEED ; Sufyan SHAHID ; Suha T BUTT ; Kamran RASHID ; Mohammad AHMAD ; Hammad HUSSAIN ; Anzalna MUGHAL ; Gabriel P A COSTA ; Fernanda GUSHKEN ; Neil NERO ; Shreya SENGUPTA ; Akhil ANAND
Journal of Neurogastroenterology and Motility 2025;31(1):28-37
Background/Aims:
Amitriptyline is prescribed off-label for irritable bowel syndrome (IBS). We conducted a meta-analysis to assess its efficacy.
Methods:
A systematic literature review was conducted until November 10, 2023, using MEDLINE, Embase, Cochrane Library, and Web of Science to study the efficacy of amitriptyline in patients with IBS. We included all randomized controlled trials that compared amitriptyline to placebo. Revised Cochrane risk-of-bias tool was used to assess the quality of studies. Meta-analyses were performed using a bivariate random-effects model. Statistical analyses were performed using R Software 4.2.3 and heterogeneity was assessed with I 2 statistics.
Results:
Seven trials were included with 796 patients (61% female). Amitriptyline was associated with better treatment response (OR, 5.30; 95% CI, 2.47 to 11.39; P < 0.001), reduced Irritable Bowel Syndrome Symptom Severity Scores (MD, –50.72; 95% CI, –94.23 to –7.20; P = 0.020) and improved diarrhea (OR, 10.55; 95% CI, 2.90 to 38.41; P < 0.001). No significant difference between the 2 groups regarding the adverse effects was observed. Three trials showed an overall low risk of bias, 2 trials showed an overall high risk of bias due to randomization and missing data, and 2 trials had some concerns regarding missing data.
Conclusions
Amitriptyline was found to be well-tolerated and effective in treating IBS compared to placebo. These findings support the use of amitriptyline for the management of IBS, particularly among patients with the IBS diarrhea subtype. Future research should focus on the dose-dependent effects of amitriptyline in IBS to better guide clinicians in personalized titration regimens.

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