Gastrointestinal manifestations in patient with Common Variable Immunodeficiency Syndrome (CVID): A Case Report
A 57 yo male with a background history of common variable Immunodeficiency syndrome (CVID) on Immunoglobulin Infusion (Kiovig) 40mg three weekly was referred for investigation of diarrhoea and follow up from previous history of colonic polyps. Colonoscopy showed an irregular looking ileocaecal valve (ICV) with an adjacent flat polyp (Paris IIa). Biopsies showed low grade dysplasia. There was also a duodenal polyp noted on gastroscopy and biopsy again showed low grade dysplasia. In light of the findings of upper and lower gastrointestinal tract polyps, a small bowel capsule endoscopy (SBCE) was arranged. This showed an irregular area of mucosa in the proximal small bowel with significant ulceration and inflammation (Figure 1). There were also multiple scattered lymphagiectasias and lymphoid hyperplasia in the distal small bowel (Figure 2). Anterograde double ballon enteroscopy (ADBE) was subsequently performed to the distal jejunum about 8 weeks after the SBCE. The duodenal polyp seen at gastroscopy was visualised during ADBE (Figure 3). In addition, two diminutive (
Efficacy Of Potassium-Competitive Acid Blocker vs Proton Pump Inhibitor as First-Line and Second-Line Treatment for Helicobacter Pylori Eradication
Introduction: Eradication of H. pylori reduced the risk of gastric cancer by 75%, thus, its therapy with high eradication rates is needed. Nowadays, the success rate of H.pylori eradication regimen (PPI-based) has dropped to less than 75% due to clarithromycin resistance and inadequate gastric acid suppression. Vonoprazan, a Potassium-competitive acid blocker (PCAB) was released for use in first-line and second-line treatment for H.pylori eradication. It shows better acid suppression effect in acid-related disease. Aim: The aim of this study was to compare the efficacy of PCAB and PPI as first-line and second-line treatment for H. pylori eradication. Method: We search the Medline, Google Scholar and Directory of Open Access Journals (DOAJ) databases in October 2019. The study selection process was plotted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram. Results: In studies assessing first-line therapy, 776 patient were using PPI and 965 patient were using PCAB. In first-line therapy, PCAB has higher ITT and PP compared to PPI. According to Sue et al, in PPI group, more patient complain of diarrhea (49 vs 25; p < 0.001). In studies assessing second-line therapy, 1,069 patient were using PPI and 605 patient were using PCAB. Two studies showed no significant differences between PCAB and PPI in second-line therapy, but one study showed PCAB superiority (ITT PPI vs PCAB 85% vs 90% p=0.045; PP PPI vs PCAB 91% vs 96% p=0.008). There is no difference in adverse event between PCAB and PPI. Conclusion: In conclusion, PCAB has higher eradication rate (ITT and PP) compared to PPI as first-line therapy for H.pylori eradication. Further study is still needed in comparing efficacy of PCAB and PPI as second-line therapy. Both therapies were safe and well tolerated.
Purpose: The aim of this reach is to identify how Artificial Intelligence (AI) could be used in enhancing forecasting to achieve more accurate outcomes. The research also explores the influence that forecasting has on global economy and the reasons why it needs to be accurate. Also, the research explains various pitfalls identified in forecasting. Method: This research implements two research approaches which are review of literature and formulation of hypotheses. Seven hypotheses are created. Findings: AI, when integrated with other technologies such as Machine Learning (ML) and when provided with the right computer power, yields much more accurate results than many other forecasting methods. The technology is costly, however, and it is prone to cyber-attacks. Conclusion: The future of business is highly reliant on forecasting, which directly impacts the global economy. But, not every business will have the power to own the forecasting technology due to the cost, and business will need to increase security to protect the forecasting systems.
Purpose: The aim of this research is to thoroughly analyze blockchain with respect to the role it plays in cybersecurity, and how this role may affect the future of blockchain and cybersecurity. Also, gaps are identified along with the shortcomings that cause these gaps. This research also identifies possible solutions to the gaps or issues. Method: the research approach used here is a review of the literature using the systematic-analysis technique. Other works that address various aspects of blockchain are analyzed in-depth to show its effectiveness. Results: there is a great possibility that blockchain is one of the future’s greatest cybersecurity solutions. Among the major issues include quantum computing, user habits, and conflicting interests. All these issues have various ways through which they can be addressed effectively in order to brighten the future of blockchain’s applicability in cybersecurity. Conclusion: blockchain, as it is, promotes fraud in cryptocurrency and therefore needs modification. Blockchain only needs reinforcement from technologies such as Artificial Intelligence and Machine learning to make it the future’s most dependable cybersecurity provider.
Esophageal cancer in Bobo-Dioulasso (Burkina Faso): epidemiological, clinical, endoscopic and anatomopathological aspects
Introduction. Our study aims to strengthen the literature on esophageal cancer in Burkina Faso by assessing its endoscopic frequency and describing its epidemiological, anatomical-clinical and endoscopic characteristics. Patients and Methods: This was a descriptive cross-sectional study conducted from January 1, 2015 to June 30, 2018. Included in this study were all patients who had upper gastrointestinal fibroscopy (UGIF) with biopsy, and in whom esophageal cancer was confirmed histologically. The variables studied were: age, sex, main circumstance of diagnosis, endoscopic appearance, and histological type, as well as risk factors. Results: During the study period, 29 cases of esophageal cancer were diagnosed, with an average endoscopic incidence of 8.3 cases/year. The average age was 58.34 years. There were 17 (58.6%) males, or a sex ratio of 1.5. The definite risk factors of alcohol consumption and active smoking were present in 31.0% of patients. The average duration of consultation was 65.8 days, and the main symptom at diagnosis was dysphagia (72.4%). The preferred location was the lower third for nearly three-quarters of tumors; and the budding form was dominant (56.3%). At histology, squamous cell carcinoma was the dominant type (65.5%). Conclusion: This study shows us an increase in the average annual incidence of esophageal cancer in Bobo-Dioulasso. It mainly affects males from the age of 50, with clinical, endoscopic and histological characteristics similar to those found in the literature. The great delay in diagnosis limits the therapeutic options for this cancer with a formidable prognosis.
The mucocutaneous manifestations are, with the osteo-articular attacks, the most frequent of the extradigestive attacks of the Crohn’s disease. While some of these events evolve alongside the digestive disease, others evolve on their own. Sometimes they can even precede the appearance of intestinal manifestations by several months, which then poses diagnostic problems. Recto-vaginal fistulas and ovarian involvement in Crohn’s disease have been widely reported in the literature (1; 2). However, there are few series in the literature reporting the genital complications of CD, let alone regarding vulvar lesion. We report a new case of vulvar lesion in Crohn’s disease.
Objective: Describe the situation of vitamin D deficiency in children aged 6 – 11 years at Vietnam National Children’s Hospital. Method: Cross-sectional study. Results: In 155 healthy children in the study, vitamin D deficiency (25(OH)D serum level < 50 nmol/l) was 23.9%. Common clinical symptoms of vitamin D deficiency were long bone pain (32%) and low ionized calcium level (83.8%). There was inverse linear correlation between vitamin D level, weight-for-age z score (WAZ) (r= –0.266 and p
Dietary intakes, nutrition status and micronutrient deficiency in picky eating children under 5 years old in the Vietnam National Hospital of Pediatrics
Background: Recently, picky eating behaviors have become more and more common in Vietnam. Early identification of nutritional deficiencies through assessment of nutritional status and dietary intake is important to be able to intervene in time to help children optimum in growing physically and cognitively. Objective: The aim of this study was to evaluate dietary intake of under five years old children with picky eating behavior and the consequences of these diets on their nutrition status. Methods: Dietary intake was assessed using 24-hour dietary recall for 124 under five years old who presented with picky eating behavior at Vietnam National Hospital of Pediatrics. Nutrients intakes were calculated using validated dietary analysis software and compared with age-appropriate Vietnam Recommended(Recommended Nutrient Intakes- RNI). Nutrition status was assessment follow WHO guideline 2009, micronutrients deficiency was evaluated based on laboratory tests. Results:84.7% of the children had an unbalanced diets, lacking in overall energy intake(70-90% of RNI:48 and ≤ 50%: 19%). Prevalence of stunting (32.3%), under weight (28.2%), wasting (13.7%) and micronutrients deficiency was high. Conclusions: Children with picky eating behavior had high prevalence of inadequate diet, malnutrition and micronutrient deficiencies. Early identification and treatment of picky eating behavior in children is needed to prevent malnutrition.
Rate monotonic scheduling algorithm (abbr. RM) is one of the main algorithms in real-time systems, but its operation efficiency is low relatively. In this paper, two-level scheduling method is used to improve the operational efficiency of RM algorithm, and the basic principle of computer processor in real-time system is analyzed, and the RM scheduling algorithm is implemented concretely. Considering the shortcoming of RM algorithm, a modified RM algorithm based two-level scheduling strategy is proposed. As a result, the performance and reliability of real-time system is increased, and the applicability of the method is widened.
To study the grouting anchor cable, high strength anchor cable, constant resistance, large deformation of anchor supporting of coal roadway surrounding rock different control effect, first using drilling into instrument detecting roof inner fracture of surrounding rock and loose circle development situation, again USES the anchor dynamometer, the roof abscission layer meter, convergence rule of surrounding rock of roadway convergence deformation and stress monitoring and supporting artifacts related to data processing and analysis between the drivage and stoping different anchor rope supporting of roadway surrounding rock under the condition of deformation and stress change rule anchor rope.Through the above steps, the grouting anchor cable is found to be the best supporting method.