Ida Hilmi - Academia.edu (original) (raw)

Papers by Ida Hilmi

Digestive Diseases

Background: The differentiation between intestinal tuberculosis (ITB) and Crohn’s disease (CD) re... more Background: The differentiation between intestinal tuberculosis (ITB) and Crohn’s disease (CD) remains a challenge, particularly in areas where tuberculosis is highly prevalent. Previous studies have identified features that favour one diagnosis over the other. The aim of the study was to determine the accuracy of a standardized protocol in the initial diagnosis of CD versus ITB. Methods: All patients with suspected ITB or CD were prospectively recruited. A standardized protocol was applied, and the diagnosis was made accordingly. The protocol consists of history and examination, ileocolonoscopy with biopsies, and tuberculosis workup. The diagnosis of probable ITB was made based on at least one positive finding. All other patients were diagnosed as probable CD. Patients were treated either with anti-tubercular therapy or steroids. Reassessment was then carried out clinically, biochemically, and endoscopically. In patients with suboptimal response, the treatment was either switched o...

Intestinal Research, 2020

Hydroxyurea is an antimetabolite drug that is commonly used in many hematological disorders. Ulce... more Hydroxyurea is an antimetabolite drug that is commonly used in many hematological disorders. Ulcer formation in the gastrointestinal tract is a rare phenomenon associated with this drug. We report a case of a 73-year-old woman who was found to have an isolated ileocecal valve ulcer while on hydroxyurea 1 g daily for essential thrombocythemia. A comprehensive evaluation ruled out all other causes. The cytoreductive therapy was switched to anagrelide and the endoscopic evaluation 6 months later showed complete healing of the ulcer. However, the hydroxyurea was resumed due to increasing platelet counts and intolerance to dose increments of the anagrelide. Subsequently, the patient was found to have a recurrence of the ulcer. Apart from oral ulcers, there have also been reports of ulcers involving the small bowel and the colon associated with the use of hydroxyurea. The pathophysiology of the non-oral gastrointestinal ulceration in relation to this drug is unclear. Withdrawal of the dru...

BMC Gastroenterology

Background Inflammatory bowel disease is an uncommon disease in developing nations whereby patien... more Background Inflammatory bowel disease is an uncommon disease in developing nations whereby patient’s knowledge on the disease may be limited. The CCKNOW questionnaire, a widely known questionnaire to assess patient’s knowledge on the disease, may be too complex to comprehend for patients in developing countries. The aim of this study is to develop a new tool known as AIBDKQ questionnaire to evaluate the local inflammatory bowel disease patient’s knowledge. Methods This was a prospective study carried out in four phases. In phase 1, three gastroenterologists with expertise in IBD generated a total of 21 questions related to the general knowledge of the disease in the English language. Phase 2 involved content and face validity whereby the questions were further validated by other gastroenterologists. In phase 3, the validated questions were translated into three languages namely Malay, Mandarin and Tamil which are commonly used in Malaysia. In phase 4 (statistical validity), administ...

Journal of Gastrointestinal and Liver Diseases

Buried bumper syndrome: incidence study and clinical characterization of a rare complication of p... more Buried bumper syndrome: incidence study and clinical characterization of a rare complication of percutaneous endoscopic gastrostomy To the Editor, Buried bumper syndrome (BBS) is a rare complication of percutaneous endoscopic gastrostomy (PEG), in which the internal fixation device migrates alongside the tract of the stoma outside the stomach, with an incidence of approximately 1% [1]. Although rare, it can be associated with severe complications including gastrointestinal bleeding, perforation or abscess and, considering the increasing number of patients requiring PEG for enteral nutrition, it may become a significant clinical problem [2]. We retrospectively analyzed every patient who performed PEG between

Journal of Visualized Experiments, Mar 26, 2022

JGH Open

The COVID-19 pandemic, secondary to SARS-CoV-2, has resulted in high mortality and morbidity worl... more The COVID-19 pandemic, secondary to SARS-CoV-2, has resulted in high mortality and morbidity worldwide. As inflammatory bowel disease (IBD) is a chronic disease, and most patients are on long-term immunosuppressive agents, there is understandable concern, particularly in terms of therapy. In view of this, experts in IBD across the Asia Pacific region were invited to put together recommendations based on their experience and the currently available data. In general, most IBD therapies (with a few exceptions) can be continued safely, and the general consensus is that maintaining disease control should remain the main principle of management. In addition, social distancing measures and the appropriate use of personal protective equipment should be strictly adhered to. During the current pandemic, face-to-face clinic follow ups and non-urgent procedures should be kept to a minimum.

Background M2 pyruvate kinase (M2PK) is an oncoprotein secreted by colorectal cancers in stools. ... more Background M2 pyruvate kinase (M2PK) is an oncoprotein secreted by colorectal cancers in stools. This the first report on the accuracy of a rapid stool test in the detection of colorectal cancer (CRC). Objective To determine the sensitivity, specificity and positive and negative predictive value of a rapid, point of care stool test M2 PK- the M2PK Quick. Methods Consecutive cases of endoscopically diagnosed and histological proven CRC were recruited. Stools were collected by patients and tested with the immunochromatographic M2PK Quick Test (Schebo Biotech AC, Giessen, Germany). Controls were consecutively chosen from patients without any significant colorectal or gastrointestinal disease undergo-ing colonoscopy. CRC was staged according to the AJCC staging manual (7th Edition) and location of tumor defined as proximal or distal. Results The sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy were: 93%, 97.5%, 94.9%, 96.5 % and 96.0 % ...

Clinical Gastroenterology and Hepatology, 2015

$Research paper thumbnail of Endoscopic Ultrasound-Guided Biliary Drainage Performed for Refractory Bile Duct Stenosis Due to Chronic Pancreatitis: A Case Report$

Digestive Endoscopy, 2012

We report a case of the patient who underwent endoscopic ultrasound-guided biliary drainage (EUS-... more We report a case of the patient who underwent endoscopic ultrasound-guided biliary drainage (EUS-BD) for refractory bile duct stenosis due to chronic pancreatitis. The patient had repeatedly undergone endoscopic biliary stenting for bile duct stenosis due to chronic pancreatitis. Because of repeated relapses of cholangitis and jaundice, transpapillary treatment was judged to have reached its limits. Surgical bypass was attempted but had to be abandoned due to adhesions. Thus, EUS-BD was performed. The procedure was successful, and placement of a covered expandable metallic stent (C-EMS) relieved cholangitis. Two months after placement, the C-EMS was removed, and the patient became stent-free but closure of the fistula subsequently occurred.

Inflammatory Bowel Diseases, 2021

Journal of Gastroenterology and Hepatology, 2022

Background and aims Inflammatory bowel disease (IBD) is emerging in the newly industrialized coun... more Background and aims Inflammatory bowel disease (IBD) is emerging in the newly industrialized countries of South Asia, South East Asia and the Middle East, yet epidemiological data are scarce. METHODS We performed a cross-sectional study of IBD demographics, disease phenotype and treatment across 38 centers in 15 countries of South Asia, South-East Asia and Middle East. Intergroup comparisons included gross national income (GNI) per capita. RESULTS Among 10,400 patients, ulcerative colitis (UC) was twice as common as Crohn's disease (CD), with a male predominance (UC 6678, CD 3495, IBD-Unclassified 227, 58% male). Peak age of onset was in the third decade, with a low proportion of elderly onset IBD (5% age >60). Familial IBD was rare (5%). The extent of UC was predominantly distal (proctitis/left sided 67%), with most being treated with mesalamine (94%), steroids (54%), or immunomodulators (31%). Ileocolic CD (43%) was commonest, with low rates of perianal disease (8%) and only 6% smokers. Diagnostic delay for CD was common (median 12 months; IQR 5-30). Treatment of CD included mesalamine, steroids and immunomodulator (61%, 51% and 56% respectively), but a fifth received empirical anti-tubercular therapy. Treatment with biologics was uncommon (4% UC,13% CD) which increased in countries with higher GNI per capita. Surgery rates were 0.1 (UC) and 2 (CD)/100 patient/years. CONCLUSIONS The IBD-ENC cohort provides insight into IBD in South-East Asia and the Middle East, but is not yet population-based. UC is twice as common as CD, familial disease uncommon and rates of surgery are low. Biologic use correlates with per capita GNI.

Journal of Gastroenterology and Hepatology, 2010

Inflammatory bowel disease (IBD) is increasing in many parts of the Asia-Pacific region. There is... more Inflammatory bowel disease (IBD) is increasing in many parts of the Asia-Pacific region. There is a need to improve the awareness of IBD and develop diagnostic and management recommendations relevant to the region. This evidence-based consensus focuses on the definition, epidemiology and management of ulcerative colitis (UC) in Asia. A multi-disciplinary group developed the consensus statements, reviewed the relevant literature, and voted on them anonymously using the Delphi method. The finalized statements were reviewed to determine the level of consensus, evidence quality and strength of recommendation. Infectious colitis must be excluded prior to diagnosing UC. Typical histology and macroscopic extent of the disease seen in the West is found in the Asia-Pacific region. Ulcerative colitis is increasing in many parts of Asia with gender distribution and age of diagnosis similar to the West. Extra-intestinal manifestations including primary sclerosing cholangitis are rarer than in t...

American Journal of Gastroenterology, 2013

Purpose: Standard treatment dose of infl iximab (IFX) is ineff ective in some Crohn's disease (CD... more Purpose: Standard treatment dose of infl iximab (IFX) is ineff ective in some Crohn's disease (CD) patients, requiring intensifi cation by either increasing the dosage or shortening the interval of treatment. To evaluate safety and effi cacy of high-dose (HD) IFX (>10 mg/kg every (q) eight weeks or equivalent) in CD and characterize predictors of response to IFX dose intensifi cation. Methods: Electronic medical records (EMRs) were queried for CD patients who received HD IFX (10 mg/kg q7weeks-20 mg/kg q4 weeks) during 2010-2012. EMRs fulfi lling criteria were reviewed for history, medications, and laboratory data. Safety and effi cacy of dose intensifi cation was analyzed. Results: Three hundred nineteen patients with CD were identified; 87 received HD IFX. Of the HD IFX patients, median age at diagnosis and initiation of HD IFX were 16.5 and 28.5 years, respectively. Ninety-three percent met criteria for moderate-severe or severe-fulminant disease activity; 55% had history of penetrating disease; 58% had ileocolonic involvement. Twenty-nine percent failed at least one other biologic therapy. Sixty-nine percent received HD IFX doses between 10 mg/kg q7 weeks and 10 mg/kg q4 weeks; 31% received doses between 15 mg/kg q8 weeks and 20 mg/kg q4 weeks. Forty-six percent of patients initiated HD IFX therapy with an immunomodulator. At 4, 24, and 52 weeks of therapy, 20%, 28%, and 18% of patients experienced a full response, and 46%, 30%, and 23% experienced a partial response, respectively. In a subset of 58 patients on HD IFX, CRP was reduced from a median of 21.9 mg/L before initiation of HD IFX therapy to 4.7 mg/L at a median of 16.5 weeks (p<0.001). Patients who responded fully or partially at 4 weeks had a higher median baseline CRP than those who did not respond (24.9 vs. 3.5 mg/L, p=0.04). Forty-four percent remained on HD IFX at the end of follow-up (median 103.5 weeks). The median length of treatment before discontinuation was 30.5 weeks. Eleven cases of infection required hospitalization (7.4 events/100 patient-years); none were mycobacterial. Three of these were in patients receiving combination immunosuppressant therapy. Two patients developed melanoma, and one developed squamous cell carcinoma of the skin. Reasons for discontinuation of HD IFX: infection (n=1), infusion reaction (n=2), autoimmune disease (n=2), relocating, insurance (n=16), inadequate response (n=22), and successful de-escalation to standard treatment dose of IFX after a full response to HD IFX (n=6). Conclusion: HD IFX therapy may off er a therapeutic benefi t to CD patients who have failed to achieve a response with standard treatment doses, or to patients who have failed other therapies. Safety of HD IFX therapy appears to be consistent with the known side eff ect profi le of anti-TNF therapy. Baseline CRP value may be a predictor for clinical response to IFX dose intensifi cation.

Cardiology, 2010

Objectives: The objective of this study is to identify possible genetic polymorphisms of the reni... more Objectives: The objective of this study is to identify possible genetic polymorphisms of the renin-angiotensin system (RAS) in systolic heart failure (sHF). Methods: A total of 509 patients were enrolled into this study. A non-parsimonious multivariable logistic regression model that incorporated potential risk factors was applied to calculate the propensity score for developing sHF. A 1:1 case-control selection process was made according to the rank of propensity. The six genetic polymorphisms of angiotensinogen (AGT), including T174M, M235T, G-6A, A-20C, G-152A, and G-217A, and angiotensin-converting enzyme (ACE) gene I/D polymorphism were typed by polymerase chain reaction and DNA sequencing technique. Results: The CC genotype at T174M was positively associated with sHF (OR 2.81, 95% CI 1.20–6.61, p = 0.018). The GG genotype at G-152A was also positively associated with the presence of sHF (OR 6.25, 95% CI 1.54–25.4, p = 0.010). OR of the ACE DD genotype for sHF, as compared with...

New England Journal of Medicine, 2013

Placebo-Controlled, Blinded, Multicenter Study of the Induction and Maintenance of Clinical Respo... more Placebo-Controlled, Blinded, Multicenter Study of the Induction and Maintenance of Clinical Response and Remission by Vedolizumab (MLN0002) in Patients with Moderate to Severe Crohn's Disease (GEMINI 2) study group are listed in the Supplementary Appendix, available at NEJM.org.

Digestive Diseases, 2021

Introduction: Clinical practice guidelines recommend periodic colonoscopy surveillance following ... more Introduction: Clinical practice guidelines recommend periodic colonoscopy surveillance following colorectal adenoma excision. Inappropriate use of post-polypectomy surveillance (PPS) is common and lead to improper resource utilization. The aim of this review was to identify structured interventions which can affect PPS practises and to evaluate the effectiveness of these various interventions in improving clinician adherence to PPS guidelines. Methods: A computerized search was performed to identify relevant studies between 1997 and November 2020. Two investigators identified eligible studies and extracted data independently. The quality of the included studies was assessed by the Newcastle-Ottawa risk of assessment scoring system. Results: The search identified 5,602 citations. Forty-one articles were retrieved for full-text analysis and 7 studies met the inclusion criteria. Compliance to PPS guidelines was higher following interventions which included medical education, specialist...

American Journal of Gastroenterology, 2017

Hong Kong Journal of Emergency Medicine, 2010

Background Willingness to donate organs is affected by socio-cultural and religious values. The M... more Background Willingness to donate organs is affected by socio-cultural and religious values. The Malaysian society is made up of three ethnic groups: Malay, Chinese, and Indian, with Islam, Buddhism and Hinduism as their religions respectively. This study examined the knowledge and perception towards organ donation for each group. Methods This study was conducted at University Malaya Medical Centre, Kuala Lumpur, Malaysia. Relatives of patients awaiting treatment at the emergency department answered a questionnaire on knowledge and attitude on organ transplantation. Results A total of 904 questionnaires were completed; 90.6% would accept organs, 43.6% would donate, and 4.0% carried donor cards. The reasons for reluctance to donate included: fear of organs being used for research (18.8%), desire to be buried whole (18.0%), fear of less active treatment if patient is known to be a donor (12.8%). Malays were less willing to accept organs from a different race (63.5%) compared to Chinese...

The Medical journal of Malaysia, 2012

Endoscopic injection of N-Butyl-2-cyanoacrylate is a widely accepted treatment for esophagogastri... more Endoscopic injection of N-Butyl-2-cyanoacrylate is a widely accepted treatment for esophagogastric varices. This procedure is commonly associated with minor complications which include transient pyrexia and abdominal discomfort. Serious vascular complications secondary to systemic embolization of cyanoacrylate have rarely been reported. We describe the CT findings of extensive splenic infarction in a patient following cyanoacrylate injection for gastric varices.