Introduction The epidemiology of hepatitis, which is apparently endemic in Asia, is still poorly documented in Malaysia. Available statistics are modelled estimates based on expert input or estimated from small studies on special populations. We therefore determined the prevalence of chronic hepatitis B and C in Malaysia based on a large sample data from a screening campaign. Methods A total of 10,914 subjects participated in the hepatitis screening campaign in 2018 and 2019. A low-cost Point-of-care test, which has previously been validated, was used to screen for HBsAg and anti-HCV. All screen positive subjects were recalled to undergo confirmatory serology tests and nucleic acid tests. Results We estimated 1.17% or 238,971 Malaysian adults aged 20 or older had chronic HBV, while only 0.74% or 151,144 adults had chronic HCV. Young adults below age 30 years had very low prevalence of HBV (0.09%). Women had lower prevalence of HBV and HCV, Chinese had the highest prevalence of HBV while Malay had the highest prevalence of HCV. Conclusion Young adults seems to be protected from HBV perhaps owing to the introduction of universal HBV vaccination since 1989. Chronic HBV however remains prevalent in older adults especially among the Chinese. Chronic HCV is uncommon in Malaysia.

Introduction: For patients with acute upper non-variceal gastrointestinal bleeding (AUNVB), various guidelines and meta-analysis have shown that combination endoscopic treatment is superior to a single treatment modality (injection or thermal coagulation) as an endoscopic haemostatic technique. This study aim to assess the adherence to ‘best practice’ standards (an emphasis on endoscopic treatment modalities) for patients with non-variceal upper gastrointestinal bleeding with high risk stigmata on endoscopic findings. Methods: Between January 2015 and March 2016, consecutive charts of patients hospitalized for acute upper gastrointestinal bleeding in Hospital Tengku Ampuan Afzan, Kuantan were reviewed. Data regarding initial presentation, endoscopic findings and management were collected. The inclusion criteria were patients with peptic ulcer disease and high risk stigmata on endoscopic findings. Results: Eighty one patients were included in the final analysis. There were 62 males and 19 females patients with mean age of 62.5 ± 1.5. Although the statistical analysis was not significant, more than half of the patients (60.5%) were given a single treatment modality to achieve haemostasis. Only 33.3% and 6.2% patients received a combination of two and three treatment modalities respectively. Conclusions: There was marked variability between the process of care and ‘best practice’ in AUNVB. Certain patient and situational characteristics may influence guideline adherence. Further studies are needed to delineate the underlying causes.

Thiopurine exposure from inflammatory bowel disease (IBD) treatment had been associated with a higher risk of lymphoproliferative disorders namely peripheral T-cell lymphoma, as early as 2 years after its initiation. We report a rare case of classical or type 1 enteropathy-associated T-cell lymphoma (EATL) with liver metastasis in a long-standing Crohn’s disease 61-year-old patient treated with azathioprine monotherapy. He presented with acute, severe abdominal pain with cholestatic jaundice and pancytopenia. Colonoscopy showed multiple small, superficial ulcers at the terminal ileum and the biopsy taken was reported as classical EATL, an uncommon gastrointestinal non-Hodgkin’s lymphoma with CD2, CD 3, CD 30, and CD 56 positivity and more than 90% Ki67 proliferative index. Computed tomography (CT) 3-phase liver scan suggested liver metastasis. This case highlights the unusual presentation of classical EATL in non-celiac disease patients and its risk association with thiopurine therapy in IBD.