Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Clinical epidemiology of inflammatory bowel disease among adults in the South Asian region: A systematic review and meta-analysis(Elsevier Ltd, 2025-01) Niriella, M.A.; Martinus, C.K.; Withanage, M.Y.; Darshika, S.; Illangasinghe, M.; Perera, H.R.; Ediriweera, D.S.; De Silva, H.J.OBJECTIVES Inflammatory bowel disease (IBD) is an emerging disease in the South Asia. We conducted a systematic review to determine the characteristics and overall prevalence of IBD among South Asian adults.DESIGN We searched the PubMed database and included descriptive, epidemiological studies with satisfactory methodological quality, reporting the epidemiology of IBD with histological confirmation. The quality of the studies was assessed using Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies. Two authors screened and extracted data independently. A random-effects meta-analysis of characteristics and overall prevalence of IBD was performed.RESULTS This review analysed data from over 9000 IBD patients from 21 studies across multiple South Asian countries. It found a higher prevalence of ulcerative colitis (UC) compared to Crohn's disease (CD) (2:1). There was a male predominance and modest familial aggregation of IBD cases. Left-sided colitis was the most common disease extent for UC. Colonic involvement was more frequent than ileal involvement for CD. The non-stricturing, non-penetrating behaviour was dominant in CD cases. Joint manifestations were commonly reported in both UC and CD. Immunomodulators, such as azathioprine, were used in a significant proportion of patients, particularly for CD. The use of biological agents like infliximab was relatively low. Surgical intervention rates were lower than in Western cohorts but higher in CD compared to UC.CONCLUSIONS This study provides an epidemiological overview of adult IBD characteristics, phenotypes, and treatment patterns in the South Asian region. There were epidemiological, clinical, phenotypic and treatment differences compared to western IBD.Item Best practices on immunomodulators and biological agents for ulcerative colitis and Crohn's disease in Asia.(Taehan Chang Yŏn'gu Hakhoe, 2019) Ooi, C.J.; Hilmi, I.; Banerjee, R.; Chuah, S.W.; Ng, S.C.; Wei, S.C.; Makharia, G.K.; Pisespongsa, P.; Chen, M.H.; Ran, Z.H.; Ye, B.D.; Park, D.I.; Ling, K.L.; Ong, D.; Ahuja, V.; Goh, K.L.; Sollano, J.; K.Lim, W.C.; Leung, W.; Raja Ali, R.A.; Wu, D.C.; Ong, E.; Mustaffa, N.; Limsrivilai, J.; Hisamatsu, T.; Yang, S.K.; Ouyang, Q.; Geary, R.; de Silva, H.J.; Rerknimitr, R.; Simadibrata, M.; Abdullah, M.; Leong, R.W.L.; Asia Pacific Association of Gastroenterology (APAGE) Working Group on Inflammatory Bowel Disease and Asian Organization for Crohn's and ColitisABSTRACT: The Asia-Pacific Working Group on inflammatory bowel disease (IBD) was established in Cebu, Philippines, under the auspices of the Asian Pacific Association of Gastroenterology with the goal of improving IBD care in Asia. This consensus is carried out in collaboration with Asian Organization for Crohn's and Colitis. With biologic agents and biosimilars becoming more established, it is necessary to conduct a review on existing literature and establish a consensus on when and how to introduce biologic agents and biosimilars in the conjunction with conventional treatments for ulcerative colitis (UC) and Crohn's disease (CD) in Asia. These statements also address how pharmacogenetics influence the treatments of UC and CD and provide guidance on response monitoring and strategies to restore loss of response. Finally, the review includes statements on how to manage treatment alongside possible hepatitis B and tuberculosis infections, both common in Asia. These statements have been prepared and voted upon by members of IBD workgroup employing the modified Delphi process. These statements do not intend to be all-encompassing and future revisions are likely as new data continue to emerge.Item Acute Dermato-Lymphangio-Adenitis Following Administration of Infliximab for Crohn's Disease.(American College of Gastroenterology, 2019) Liyanage, I.K.; Niriella, M.A.; de Silva, A.P.; de Silva, N.; de Silva, H.J.Tumor necrosis factor-α inhibitor (TNF-α) is frequently used for Crohn's disease and other autoimmune conditions. Increased risk of infection is an accepted adverse effect of TNF-α, and routine screening for potential infections are carried out before initiation of therapy. We report the case of a patient who developed a localized painful swelling near the injection site, which was diagnosed as acute dermato-lymphangio-adenitis due to filarial infection. This adds to the limited number of case reports on parasitic complications following TNF-α therapyItem Best practices on immunomodulators and biological agents for ulcerative colitis and Crohn's disease in Asia.(Blackwell Scientific Publications, 2019) Ooi, C. J.; Hilmi, I.; Banerjee, R.; Chuah, S.W.; Ng, S.C; Wei, S.C.; Makharia, G.K.; Pisespongsa, P.; Chen, M.H.; Ran, Z.H.; Ye, B.D.; Park, D. I.; Ling, K. L.; Ong, D.; Ahuja, V.; Goh, K.L.; Sollano, J.; K.Lim, W.C.; Leung, W.; Raja Ali, R.A.; Wu, D.C.; Ong, E; Mustaffa, N.; Limsrivilai, J.; Hisamatsu, T.; Yang, S. K.; Ouyang, Q.; Geary, R.; de Silva, H.J.; Rerknimitr, R.; Simadibrata, M.; Abdullah, M.; Leong, R.W.L.; Asia Pacific Association of Gastroenterology (APAGE) Working Group on Inflammatory Bowel Disease and Asian Organization for Crohn's and ColitisThe Asia Pacific Working Group on Inflammatory Bowel Disease (IBD) was established in Cebu, Philippines, under the auspices of the Asian Pacific Association of Gastroenterology (APAGE) with the goal of improving IBD care in Asia. This consensus is carried out in collaboration with Asian Organization for Crohn's and Colitis (AOCC). With biological agents and biosimilars becoming more established, it is necessary to conduct a review on existing literature and establish a consensus on when and how to introduce biological agents and biosimilars in the conjunction with conventional treatments for ulcerative colitis (UC) and Crohn's disease (CD) in Asia. These statements also address how pharmacogenetics influence the treatments of UC and CD and provide guidance on response monitoring and strategies to restore loss of response. Finally, the review includes statements on how to manage treatment alongside possible Hepatitis B and tuberculosis infections, both common in Asia. These statements have been prepared and voted upon by members of IBD workgroup employing the modified Delphi process. These statements do not intend to be all-encompassing and future revisions are likely as new data continue to emerge.