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| 1 | Efficacy of small-volume simethicone given at least 30 min before gastroscopy显示文摘AIM To evaluate the efficacy of 5 m L simethicone solution in decreasing gastric foam if given at least 30 min before gastroscopy.METHODS This was a randomized, placebo controlled, endoscopist blinded study performed at Changi General Hospital. Patients were at least 21 years old, had no prior sur-gical resection of the upper gastrointestinal tract, and scheduled for elective diagnostic gastroscopies. The primary outcome was the total mucosal visibility score(TMVS) which was evaluated using Mc Nally score. The sample size was calculated to be 24 per group(SD 2.4, 80% power, P < 0.05, 2-sample t test). RESULTS Fifty-four patients were randomised to receive either simethicone [1 m L liquid simethicone(100 mg) in 5 m L of water] or placebo(5 m L of water) at least 30 min before their gastroscopy. Six accredited consultants conductedthe gastroscopy, and the interobserver agreement of scoring TMVS was good with a Kappa statistic of 0.73. The simethicone group had significantly better mean TMVS compared to placebo(5.78 ± SD 1.65 vs 8.89 ± SD 1.97, P < 0.001). The improvement was statistically significant for the duodenum and the gastric antrum, angularis, body, and fundus. Percent 51.9 of patients in the simethicone group had a TMVS of 4(no bubbles at all) to 5(only 1 area with minimal bubbles), while in the placebo group 3.7% of patients had TMVS of 4 or 5. The number needed to treat was 2.1 to avoid a TMVS of 6 and more. The simethicone group also had a significantly shorter procedure time with less volume of additional flushes required during gastroscopy to clear away obscuring gastric foam.CONCLUSION With a premedication time of at least 30 min, 5 m L simethicone can significantly decrease gastric foam, decrease the volume of additional flushes, and shorten gastroscopy time. | Mingjun Song Andrew Boon Eu Kwek Ngai Moh Law Jeannie Peng Lan Ong Jessica Yi-Lyn Tan Prem Harichander Thurairajah Daphne Shih Wen Ang Tiing Leong Ang | 2016 | World Journal of Gastrointestinal Pharmacology and Therapeutics2016，7，4： | 10 |
| 2 | Proton pump inhibitor use increases mortality and hepatic decompensation in liver cirrhosis显示文摘BACKGROUND Proton pump inhibitors(PPIs)are widely prescribed,often without clear indications.There are conflicting data on its association with mortality risk and hepatic decompensation in cirrhotic patients.Furthermore,PPI users and PPI exposure in some studies have been poorly defined with many confounding factors.AIM To examine if PPI use increases mortality and hepatic decompensation and the impact of cumulative PPI dose exposure.METHODS Data from patients with decompensated liver cirrhosis were extracted from a hospital database between 2013 to 2017.PPI users were defined as cumulative defined daily dose(cDDD)≥28 within a landmark period,after hospitalisation for hepatic decompensation.Cox regression analysis for comparison was done after propensity score adjustment.Further risk of hepatic decompensation was analysed by Poisson regression.RESULTS Among 295 decompensated cirrhosis patients,238 were PPI users and 57 were non-users.PPI users had higher mortality compared to non-users[adjusted HR=2.10,(1.20-3.67);P=0.009].Longer PPI use with cDDD>90 was associated with higher mortality,compared to non-users[aHR=2.27,(1.10-5.14);P=0.038].PPI users had a higher incidence of hospitalization for hepatic decompensation[aRR=1.61,(1.30-2.11);P<0.001].CONCLUSION PPI use in decompensated cirrhosis is associated with increased risk of mortality and hepatic decompensation.Longer PPI exposure with cDDD>90 increases the risk of mortality. | Marianne Anastasia De Roza Lim Kai Jia Wen Kam Yiong Huak Chan Andrew Kwek Tiing Leong Ang John Chen Hsiang | 2019 | World Journal of Gastroenterology2019，25，33： | 6 |
| 3 | Safety of endovascular therapy for symptomatic intracranial artery stenosis:a national prospective registry显示文摘Introduction The safety outcomes of endovascular therapy for intracranial artery stenosis in a real-world stetting are largely unknown.The Clinical Registration Trial of Intracranial Stenting for Patients with Symptomatic Intracranial Artery Stenosis(CRTICAS)was a prospective,multicentre,real-world registry designed to assess these outcomes and the impact of centre experience.Methods 1140 severe,symptomatic intracranial arterial stenosis(ICAS)patients treated with endovascular therapy were included from 26 centres,further divided into three groups according to the annual centre volume of intracranial angioplasty and stent placement procedures over 2 years:(1)high volume for≥25 cases/year;(2)moderate volume for 10–25 cases/year and(3)low volume for<10 cases/year.Results The rate of 30-day stroke,transient ischaemic attack or death was 9.7%(111),with 5.4%,21.1%and 9.7%in high-volume,moderate-volume and low-volume centres,respectively(p<0.05).Multivariable logistic regression confirmed high-volume centres had a significantly lower primary endpoint compared with moderate-volume centres(OR=0.187,95%CI:0.056 to 0.627;p≤0.0001),while moderate-volume and low-volume centres showed no significant difference(p=0.8456).Conclusion Compared with the preceding randomised controlled trials,this real-world,prospective,multicentre registry shows a lower complication rate of endovascular treatment for symptomatic ICAS.Non-uniform utilisation in endovascular technology,institutional experience and patient selection in different volumes of centres may have an impact on overall safety of this treatment. | Yabing Wang Tao Wang Adam Andrew Dmytriw Kun Yang Liqun Jiao Huaizhang Shi Jie Lu Tianxiao Li Yujie Huang Zhenwei Zhao Wei Wu Jieqing Wan Qinjian Sun Bo Hong Yongli Li Liyong Zhang Jianfeng Chu Qiong Cheng Yiling Cai Pengfei Wang Qi Luo Hua Yang Baijing Dong Yang Zhang Jun Zhao Zuoquan Chen Wei Li Xiaoxin Bai Weiwen He Xueli Cai Maimai Ti Osama O Zaidat | 2022 | Stroke & Vascular Neurology2022，7，2： | 3 |
| 4 | Ten‐day triple therapy versus sequential therapy versus concomitant therapy as first‐line treatment for H elicobacter pylori infection显示文摘 | Tiing Leong Ang Kwong Ming Fock Mingjun Song Daphne Ang Andrew Boon Eu Kwek Jeannie Ong Jessica Tan Eng Kiong Teo Subbiah Dhamodaran | 2015 | J Gastroenterol Hepatol2015，，7： | 2 |
| 5 | An analysis of the efficacy and safety of a strategy of early precut for biliary access during difficult endoscopic retrograde cholangiopancreatography in a general hospital显示文摘 | Tiing LeongANG Andrew Boon EuKWEK Kieron Boon LengLIM Eng KiongTEO Kwong MingFOCK | 2010 | Journal of Digestive Diseases2010，，5： | 1 |
| 6 | Reverse obliquity fractures of the intertrochanteric region of the femur显示文摘 | George JH Andrew TI Daniel JB | 2001 | J Bone Joint Surg(Am)2001，83，5： | 1 |
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