scholarly journals Eosinophilic Esophagitis in a Developing Country: Is It Different from Developed Countries?

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Abdulrahman Al-Hussaini ◽  
Toufic Semaan ◽  
Imad El Hag
Keyword(s):  
Saudi Arabia ◽  
Developing Country ◽  
Eosinophilic Esophagitis ◽  
Failure To Thrive ◽  
Developed Countries ◽  
Response To Therapy ◽  
Dietary Manipulation ◽  
Older Children ◽  
Allergy Testing ◽  
Food Sensitization

Background and Objective. Despite the extensive reporting of eosinophilic esophagitis (EoE) from industrialized developed countries, reports from developing countries are rare. The aim of our study was to determine the epidemiological, clinical, and endoscopic features of EoE and response to therapy in children and adults from a developing country, Saudi Arabia.Methods. We identified patients diagnosed with EoE in our center from 2004 to 2011. EoE was defined as esophageal mucosal infiltration with a peak eosinophil count ≥15 eosinophils/high-powered field.Results. Forty-five patients were diagnosed with EoE (37 children and 8 adults; 36 males; median age 10.5 years, range from 1–37 years). Feeding difficulty, vomiting/regurgitation, and failure to thrive predominated in young children, whereas dysphagia and food impactions predominated in older children and adults. Allergy testing revealed food sensitization in 12 of 15 patients (80%); 3 responded to elemental formula, while 8 failed to respond to dietary manipulation after the allergy testing. Thirty-nine patients achieved remission by swallowed inhaled fluticasone. The majority of patients experienced a recurrence of symptoms upon the discontinuation of fluticasone.Conclusion. Our data indicate that EoE is increasingly recognized in Saudi Arabia and show many similarities to data from North America and Europe.

scholarly journals Current trends of adenotonsillar hypertrophy presentation in a developing country, Nigeria

2017 ◽  
Vol 3 (3) ◽  
pp. 501 ◽  
Author(s):  
Waheed A. Adegbiji ◽  
Shuaib Kayode Aremu ◽  
Clement C. Nwawolo ◽  
Chinyere N. Asoegwu
Keyword(s):  
Developing Country ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Failure To Thrive ◽  
Developed Countries ◽  
Predisposing Factors ◽  
Upper Respiratory Tract ◽  
Female Ratio ◽  
Adenotonsillar Hypertrophy ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> Adenotonsillar hypertrophy is a common paediatric disorder in Otorhinolaryngological practice worldwide. The prevalence, clinical manifestations and predisposing factors are well documented in developed countries. However, available data shows differences between the various studies. There is paucity of data from developing countries. <span lang="EN-IN">Thus, this study is aimed at assessing the age group distribution, predisposing factors, clinical manifestation and complications of adenotonsillar hypertrophy in a developing country. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">It is a prospective study of children under 10 years over a period of 24 months. Interviewer assisted questionnaire was administered. Data obtained were statistically analysed using SPSS version 18.  </span></p><p class="abstract"><strong>Results:</strong> Two hundred and fifty three, 253 subjects were enrolled into the study. Adenotonsillar hypertrophy affected all age groups studied. A high incidence was noted among the under 2 year olds. The Male: Female ratio was 2:1. Chronic cases constituted 55.7% of our study population. Common predisposing factors were atopy (73.9%), familial history (67.3%) and recurrent upper respiratory tract infection (58.2%). <span lang="EN-IN">The Commonest clinical features were snoring, noisy breathing, tonsillar enlargement and narrowing of postnasal space air column. Failure to thrive, otitis media and rhinosinusitis were the commonly associated complications observed. No death was recorded. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Adenotonsillar hypertrophy is common in our environment. It is important for all primary health care physicians, paediatricians and otorhinolaryngologists to have a clear knowledge on this ailment. Prevention or reduction in incidence is possible.</span></p>

Eosinophilic Esophagitis in Children and Adolescents

2017 ◽  
Author(s):  
Elizabeth J Hait
Keyword(s):  
Eosinophilic Esophagitis ◽  
Failure To Thrive ◽  
Inflammatory Disorder ◽  
Esophageal Mucosa ◽  
Older Children ◽  
High Power Field ◽  
Interleukin 5 ◽  
Adolescents And Adults ◽  
History Of ◽  
Seasonal Allergies

Eosinophilic esophagitis (EoE) is an inflammatory disorder of the esophagus characterized by symptoms of esophageal dysfunction in association with histologic evidence of eosinophilic infiltration of the esophageal mucosa. The diagnosis is based on esophageal biopsies showing more than 15 eosinophils per high-power field in the absence of pathologic gastroesophageal reflux. It can present with a wide array of upper gastrointestinal tract symptoms. Babies and toddlers typically present with feeding intolerance or refusal, vomiting, and failure to thrive. Older children often present with abdominal pain and reflux symptoms, whereas adolescents and adults typically present with solid-food dysphagia and/or food impaction. Diagnosis is also supported by a family history of EoE and other allergy-based disorders, such as asthma, seasonal allergies, and atopy. Topical corticosteroids and dietary elimination are acceptable first-line treatment approaches. This review contains 7 figures, 5 tables, and 51 references. Key words: dysphagia, elimination diets, endoscopic dilation, eosinophilic esophagitis, eotaxin-3, feeding dysfunction, interleukin-5, proton pump inhibitor–responsive esophageal eosinophilia, swallowed fluticasone, viscous budesonide

Eosinophilic Esophagitis in Children and Adolescents

2017 ◽  
Author(s):  
Elizabeth J Hait
Keyword(s):  
Eosinophilic Esophagitis ◽  
Failure To Thrive ◽  
Inflammatory Disorder ◽  
Esophageal Mucosa ◽  
Older Children ◽  
High Power Field ◽  
Interleukin 5 ◽  
Adolescents And Adults ◽  
History Of ◽  
Seasonal Allergies

Eosinophilic esophagitis (EoE) is an inflammatory disorder of the esophagus characterized by symptoms of esophageal dysfunction in association with histologic evidence of eosinophilic infiltration of the esophageal mucosa. The diagnosis is based on esophageal biopsies showing more than 15 eosinophils per high-power field in the absence of pathologic gastroesophageal reflux. It can present with a wide array of upper gastrointestinal tract symptoms. Babies and toddlers typically present with feeding intolerance or refusal, vomiting, and failure to thrive. Older children often present with abdominal pain and reflux symptoms, whereas adolescents and adults typically present with solid-food dysphagia and/or food impaction. Diagnosis is also supported by a family history of EoE and other allergy-based disorders, such as asthma, seasonal allergies, and atopy. Topical corticosteroids and dietary elimination are acceptable first-line treatment approaches. This review contains 7 figures, 5 tables, and 51 references. Key words: dysphagia, elimination diets, endoscopic dilation, eosinophilic esophagitis, eotaxin-3, feeding dysfunction, interleukin-5, proton pump inhibitor–responsive esophageal eosinophilia, swallowed fluticasone, viscous budesonide

The Worrying Trend of Diabetes Mellitus in Saudi Arabia: An Urgent Call to Action

2020 ◽  
Vol 16 (3) ◽  
pp. 204-210 ◽  
Author(s):  
Asirvatham A. Robert ◽  
Mohamed A. Al Dawish
Keyword(s):  
Diabetes Mellitus ◽  
Saudi Arabia ◽  
Present Report ◽  
Adult Population ◽  
Current Trend ◽  
Fold Increase ◽  
Developed Countries ◽  
Evidence Base ◽  
Small Sample ◽  
Cross Sectional

From last few years, the pervasiveness of diabetes mellitus (DM), in Saudi Arabia, is growing at a frightening rate. Overall, one-fourth of the adult population is affected by DM, which is further predicted to rise to more than double by the year 2030. The most alarming is possibly the escalation propensity of diabetes, in recent years, where a nearly ten-fold increase has been witnessed over the past thirty years in Saudi Arabia. However, the number of research arbitrations on the prevalence and incidence of DM is woefully inadequate, as compared to developed countries. Apart from this, most of the existing research data carried out in Saudi Arabia is cross-sectional, with small sample sizes, which most often involve only certain parts of the country. Consequently, the present scenario demands more multidimensional and multisectoral research to strengthen the evidence base and to accumulate greater knowledge as a basis for measures and programmes to confront diabetes and its complications. Thus, the present report makes an attempt to depict the current trend of diabetes as well as intends to put forward essential measures for controlling diabetes in Saudi Arabia.

scholarly journals A14 WIDE VARIATION IN CLINICAL MANAGEMENT OF PAEDIATRIC EOSINOPHILIC ESOPHAGITIS: A CANADIAN EXPERIENCE.

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 16-18
Author(s):  
K A Bortolin ◽  
D Ashok ◽  
V Avinashi ◽  
J Barkey ◽  
D Burnett ◽  
...  
Keyword(s):  
Maintenance Therapy ◽  
Eosinophilic Esophagitis ◽  
Online Survey ◽  
Treatment Algorithm ◽  
Elimination Diet ◽  
Practice Variation ◽  
Initial Diagnosis ◽  
Response To Therapy ◽  
Topical Steroids ◽  
Repeat Endoscopy

Abstract Background Eosinophilic esophagitis (EoE) is a chronic disorder treated by food elimination diet (FED), topical steroids and/or proton-pump inhibitors (PPI). Serial endoscopies and biopsies assess response to therapy. EoE management has evolved as guidelines are updated. Aims To identify practice variation among Canadian paediatric gastroenterologists (PG) who care for children with EoE. Methods An online survey using REDCap about decision-making in children with EoE was distributed to PG in Canada in November 2020. Results 62 PG completed the survey (response rate 69%, 62/94). The majority work in academic centres (92%). 3 centers indicated an accrual of &gt;50 new patients per year; 9/16 centres have &gt;100 patients in follow-up. An EoE Clinic is present in 5 centres. Diagnosis: Familiarity with the 2018 AGREE and 2020 AGA EoE guidelines was found to be 57% and 67% respectively. Criteria required to diagnose EoE according to current guidelines were correctly indicated by 42% of PG. (Figure 1). Endoscopy: The majority of PG (95%) adhere to guidelines in terms of required number and location of biopsies for the initial diagnosis. Ideal timing of repeat endoscopy after change in therapy in patients who are not in histological remission was 8–12 weeks by 67% of PG, timing in stable patients on maintenance therapy varied (33% only if patient is symptomatic). 25% used the EREFS Score in reporting endoscopic findings. Therapy: Improvement of symptoms was the highest ranked goal (64%), followed by remission of histologic findings (30%). A treatment algorithm was in place in 4 centers. The majority routinely assess adherence to therapy (73%) and consult a dietitian for FED (77%). Most (87%) do not consult an allergist for initial management. Preferred choices of 1st-line therapy varied among PG (Figure 2). When FED was selected, 32% of PG started with 1 food, 32% started with 2 foods, most frequently excluding dairy, followed by wheat. 14 (26%) start with ≥6 FED. Prescription of budesonide slurry was consistent among PG with doses of 1 and 2 mg/day in children &lt;10 and &gt;10 years, respectively. Conclusions The is the first Canadian study to assess the variation in management of children with EoE by PG. Overall, PG demonstrated good adherence to the guidelines in terms of initial diagnosis, but differences in maintenance therapy choice and timing of endoscopies. The results highlight a need for standardized management algorithms to deliver uniform care to this growing group. Grounding these guidelines in evidence will warrant a significant investment in further paediatric EoE research. Funding Agencies None

scholarly journals Globalization Impact on Multinational Enterprises

World ◽  
2021 ◽  
Vol 2 (2) ◽  
pp. 216-230
Author(s):  
Justine Kyove ◽  
Katerina Streltsova ◽  
Ufuoma Odibo ◽  
Giuseppe T. Cirella
Keyword(s):  
Developing Country ◽  
Multinational Enterprises ◽  
Developed Countries ◽  
Global Market ◽  
Data Availability ◽  
Negative Effects ◽  
Developed Country ◽  
Excellent Starting Point ◽  
Starting Point ◽  
The Impact

The impact of globalization on multinational enterprises was examined from the years 1980 to 2020. A scoping literature review was conducted for a total of 141 articles. Qualitative, quantitative, and mixed typologies were categorized and conclusions were drawn regarding the influence and performance (i.e., positive or negative effects) of globalization. Developed countries show more saturated markets than developing countries that favor developing country multinational enterprises to rely heavily on foreign sales for revenue growth. Developed country multinationals are likely to use more advanced factors of production to create revenue, whereas developing country multinationals are more likely to use less advanced forms. A number of common trends and issues showed corporate social responsibility, emerging markets, political issues, and economic matters as key to global market production. Recommendations signal a strong need for more research that addresses contributive effects in the different economies, starting with the emerging to the developed. Limitations of data availability and inconsistency posed a challenge for this review, yet the use of operationalization, techniques, and analyses from the business literature enabled this study to be an excellent starting point for additional work in the field.

scholarly journals Clinical profile and outcome of refractory convulsive status epilepticus in older children from a developing country

Seizure ◽  
2016 ◽  
Vol 36 ◽  
pp. 31-35 ◽  
Author(s):  
Lokesh Lingappa ◽  
Ramesh Konanki ◽  
Ravi Patel ◽  
Sudhindra Vooturi ◽  
Sita Jayalakshmi
Keyword(s):  
Status Epilepticus ◽  
Developing Country ◽  
Clinical Profile ◽  
Convulsive Status Epilepticus ◽  
Older Children

scholarly journals Early Warning Scores at time of ICU admission to Predict Mortality in critically ill COVID-19 Patients

2021 ◽  
pp. 1-15
Author(s):  
Asha Tyagi ◽  
Surbhi Tyagi ◽  
Ananya Agrawal ◽  
Aparna Mohan ◽  
Devansh Garg ◽  
...  
Keyword(s):  
Developing Country ◽  
Cox Regression ◽  
Vital Signs ◽  
Developed Countries ◽  
Operating Characteristics ◽  
Icu Mortality ◽  
Prospective Data ◽  
Icu Admission ◽  
Reactive Protein ◽  
Time Of Admission

Abstract Objective: To assess ability of NEWS2, SIRS, qSOFA and CRB-65 calculated at the time of Intensive Care Unit (ICU) admission for predicting ICU-mortality in patients of laboratory confirmed COVID-19 infection. Methods: This prospective data analysis was based on chart reviews for laboratory confirmed COVID-19 patients admitted to ICUs over a 1month period. The NEWS2, CURB-65, qSOFA and SIRS were calculated from the first recorded vital signs upon admission to ICU and assessed for predicting mortality. Results: Total of 140 patients aged between 18 to 95 years were included in the analysis of whom majority were >60 years (47.8%), with evidence of pre-existing comorbidities (67.1%). The commonest symptom at presentation was dyspnea (86.4%). Based upon the Receiver Operating Characteristics-Area Under Curve (AUC), the best discriminatory power to predict ICU mortality was for the CRB65 (AUC: 0.720 [95% CI: 0.630 – 0.811]) followed closely by NEWS2 (AUC: 0.712 [95% CI: 0.622 – 0.803]). Additionally, a multivariate cox regression model showed Glasgow Coma Score at time of admission [P < 0.001; adjusted Hazard Ratio = 0.808 (95% CI: 0.715-0.911)] to be the only significant predictor of ICU mortality. Conclusion: CRB65 and NEWS2 scores assessed at the time of ICU admission offer only a fair discriminatory value for predicting mortality. Further evaluation after adding laboratory markers such as C-reactive protein and D-dimer may yield a more useful prediction model. Much of the earlier data is from developed countries and uses scoring at time of hospital admission. This study was from a developing country, with the scores assessed at time of ICU admission, rather than the emergency department as with existing data from developed countries, for patients with moderate/severe COVID disease. Since the scores showed some utility for predicting ICU mortality even when measured at time of ICU admission, their use in allocation of limited ICU resources in a developing country merits further research.

scholarly journals Stroke in Young in India

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Manjari Tripathi ◽  
Deepti Vibha
Keyword(s):  
Developing Countries ◽  
Developing Country ◽  
Disease Burden ◽  
Developed Countries ◽  
Age Group ◽  
Special Significance ◽  
Stroke In Young

Stroke in young has special significance in developing countries. This is so because some etiologies like cardioembolic infections are more common than in developed countries, and the affection of economically productive group adds further to the overall disease burden. The paper discusses the burden of stroke in young and its implications in a developing country like India along with an approach to identifying different causes that are known to occur in this age group.

Sign in / Sign up

Export Citation Format

Share Document