ABSTRACT
The aim of this study was to assess the knowledge of medical staff [physicians] at different levels about insertion or placement of nasogastric tube [NGT] in a normal newborn before discharge. It was a survey-based, observational study conducted at King Khalid University Hospital. A total of 103 doctors were sent text message; among those 81 [78.6%] responded. Among the respondents, 27, 16, 11 and 27 were neonatologists, general physicians, obstetricians/ ENT/pediatric surgeons, and senior registrars neonatology [SRN], respectively. Majority of physicians, 57 [70.3%] rejected the idea of insertion of NGT in a normal newborn but in 24 [29.6%]; answer was to insert NGT in all the newborns before discharge to check the patency of nasal cavities. Regarding the position, region of doctors and their response, majority from Center said 'No' [not in favour of insertion] but from South, 17/18 [94.4%] said 'Yes' [in favour of insertion]. Regarding other specialties, majority of them showed rejection of this idea. In conclusion, most of the healthcare professionals, directly involved with neonatal care, rejected the idea of routine insertion of NGT in normal newborn examination before discharge; rather, some non-invasive technique could be opted
ABSTRACT
To investigate the incidence and diagnostic features of eosinophilic esophagitis [EoE] in a group of children with dysphagia and gastroesophageal reflux disease. This study was designed as a retrospective case analysis of 229 patients who underwent upper gastrointestinal endoscopy between January 2009 and January 2012 at a private tertiary care hospital in Riyadh, Saudi Arabia to ascertain the proportion of patients with eosinophilic esophagitis. Out of 229 children, 14 children were diagnosed as EoE [esophageal eosinophil count more than 15/high power field on esophageal biopsies], but 3 children were excluded because of other associated conditions. There were 8 males and 3 females with a mean age of 8.4 years [<18 years]. The major presentation was dysphagia followed by vomiting and epigastric pain. History of allergy and bronchial asthma was present in 40-50% of children. Peripheral eosinophilia was present in 36.3% [range 7-28%]. Barium contrast was abnormal in 3 children. Typical ringed [circular] appearance of esophagus was found in 3, linear furrowing in 2, and moderate to severe esophagitis in 8 children. All the patients were managed with swallowed inhaled steroids, except 2 patients who were initially given systemic steroids. Eosinophilic esophagitis is not an uncommon manifestation in children with dysphagia, and should be considered as one of the top differential diagnoses in patients with reflux esophagitis
ABSTRACT
To investigate the presenting features of childhood-onset inflammatory bowel disease [IBD] in the central region of Riyadh, Saudi Arabia and to compare with those reported in the literature. This is a retrospective review of medical records of children below 18 years of age at onset of symptoms with confirmed diagnosis of IBD for age, gender, family history, presenting clinical and laboratory findings in the Divisions of Pediatric and Adult Gastroenterology, King Khalid University Hospital [which provides free health care] and the Department of Gastroenterology Al Mofarreh Poly Clinic, Riyadh, Saudi Arabia, between January 1993 and December 2010. Two hundred and eighteen children diagnosed with IBD with predominance of males in Crohn's disease [CD] [56%] and females in ulcerative colitis [UC] [59%]. There was no significant difference between UC and CD regarding age of onset of symptoms [p=0.347]; however, the difference in the age at presentation and age at final diagnosis were significant [p=0.027 and p=0.008]. There was a significant increase of IBD diagnosis from the period 1993-2001 to 2002-2010 [p<0.0001]. The family history was positive in 15.3%. The presenting clinical features and laboratory abnormalities are similar to those reported in other populations. Further studies are needed to establish the incidence and prevalence