Publications by authors named "Keith Zhi Xian Toh"

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used for anti-obesity indications. However, little is known of the comparative effect of GLP-1 RAs and their glycemic impact across the different routes of administration, diabetic statuses and durations of prescription. PubMed, EMBASE and CENTRAL were searched from inception to 13 February 2024.

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Introduction: Glucagon-like peptide-1 receptor agonists are novel medications with proven efficacy in treating type 2 diabetes mellitus, and are increasingly being used for weight loss. They may potentially have benefit in treating metabolic disorders; however, evidence is sparse with regards to treating high blood pressure (BP). We performed a systematic review, meta-analysis and meta-regression investigating the efficacy of GLP-1 RAs in lowering BP in obese or overweight patients.

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Article Synopsis
  • The study investigates the effectiveness and safety of using stent retrievers (SR) versus aspiration catheters (AC) in treating acute ischaemic stroke caused by distal medium vessel occlusion (AIS-DMVO).
  • A systematic review of 13 studies involving 1881 patients found that the combination of SR and primary combined techniques resulted in higher rates of functional independence and lower mortality compared to AC alone.
  • While both methods had similar outcomes for successful recanalisation and safety concerns, SR alone showed a significantly higher odds of successful recanalisation compared to AC, indicating possible advantages for SR/PC techniques.
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Article Synopsis
  • EVT (Endovascular therapy) for distal medium vessel occlusions (DMVOs) is being studied as a potential treatment for acute ischemic stroke (AIS) but its effectiveness compared to best medical therapy (BMT) is still unclear.
  • A systematic review analyzed 16 studies with over 2400 patients, finding that EVT offered significantly better chances of functional independence after 90 days, although there were no major differences in overall excellent outcomes or mortality rates between the two treatments.
  • While EVT appears effective, especially in certain groups, the study notes a higher risk of symptomatic intracranial hemorrhage in mild strokes treated with EVT, highlighting the need for more randomized controlled trials to better understand the risks and benefits.
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Introduction: A patent foramen ovale (PFO) may coexist with other potential embolic sources (PESs) in patients with embolic stroke of undetermined source (ESUS), leading to difficulty in attributing the stroke to either the PFO or other PESs. We aimed to investigate the prevalence and predictors of concomitant PESs in ESUS patients with PFOs.

Methods: A retrospective cohort study was conducted in a tertiary stroke centre.

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Background And Aims: Patients with Moyamoya disease (MMD) can present with ischaemic or haemorrhagic stroke. There is no good evidence for treatment strategies in MMD-associated acute ischaemic stroke (AIS), particularly for treatments like intravenous thrombolysis (IVT) and endovascular thrombectomy (ET). As the intracranial vessels are friable in MMD, and the risk of bleeding is high, the use of IVT and ET is controversial.

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