Purpose: This study aimed to estimate the prevalence and predictors of portopulmonary hypertension (POPH) in children with portal hypertension. Methods: We recruited children of both sexes aged 3–15 years with portal hypertension that was clinically suspected and confirmed by the presence of varices on esophagogastroduodenoscopy (EGD). The participants underwent clinical examination, 6-min walk distance (6-MWD), and echocardiography. Results: We enrolled 94 children with portal hypertension: 26.6% with pre-hepatic causes and 73.4% secondary to chronic liver disease. Among our participants, 13.8% had one or more cardiac manifestations, such as exercise intolerance, dyspnea on exertion, cyanosis, or orthopnea, whereas 86.2% were asymptomatic. EGD examination revealed grade I varices in 54.3% of cases, grade II–III in 43.6%, and grade IV in 2.1%. Pulmonary hypertension (>35 mmHg) was detected in 30.9% of cases using echocardiography; two of them were >45 mmHg. Patients with POPH had significantly more frequent dyspnea on exertion, lower O 2 saturation, and more severe variceal grades than those with normal pulmonary artery pressure. Five (6.9%) cases had <300 m 6-MWD, with no significant difference between patients with normal and those with elevated pulmonary artery pressure. The duration of portal hypertension and 6-MWD were correlated significantly with the echocardiographic measures. High-grade varices (p=0.04) and low O 2 saturation (p=0.03) were identified as risk factors for POPH. Conclusion POPH was detected in 30.9% of our study group. High-grade varices and low O 2 saturation are predictors of POPH. Echocardiography screening is crucial for the early detection of cases.

The transition of young patients with inflammatory bowel disease (IBD) from pediatric to adult-centered healthcare presents a significant challenge, particularly in regions like Oman, where transfer occurs as early as 14 years old. Although both pediatric and adult patients require multidisciplinary management, key differences in disease characteristics, vaccination needs, growth considerations, and treatment approaches necessitate a carefully structured transition process. Effective communication between pediatric and adult gastroenterologists is crucial for ensuring optimal management for these young patients. This mini-review explores the complexities involved in transitioning young patients with IBD to adult healthcare services.

Introduction: Health insurance plays a crucial role in healthcare and financial protection. Nonetheless, a considerable portion of Malaysia's low-income population lacks health insurance. This study aimed to investigate the relationship between health insurance and out-of-pocket health expenditure (OOPHE) among the low-income group (B40 households) in Malaysia. Materials and methods: The current study used data from the National Health and Morbidity Surveys (NHMS) conducted in 2015 and consisted of 18,616 B40 respondents. Ordinary least squares (OLS) regression and a two-part model were employed for data analysis purposes. The two-part model encompassed a logit regression in the first part and a generalised linear model (GLM) in the second. Results: Most B40 households are underinsured, with only 13.81% having insurance. The results also found that insured households (0.44, 95% confidence interval [CI]: 0.01%, 0.0.87%), those over 65 years old (1.00, 95% CI: 0.41%, 1.60%), utilisation of inpatient care (2.62, 95% CI: 2.24%, 2.99%), women (0.28, 95% CI: 0.20%, 0.35%), higher education (0.27, 95% CI: 0.13%, 0.42%) and retirees (1.18, 95% CI: -0.01%, 2.37%) significantly spent more on OOPHE. In comparison, private workers (-0.32, 95% CI: -0.50%, -0.14%) and self-employed individuals (-0.27, 95% CI: -0.46%, -0.08%) significantly spent less on OOPHE. Conclusion: The findings confirm that health insurance significantly increases the OOPHE among B40 households. This highlights the necessity of a national health insurance (NHI) program that is managed by the government and provides a comprehensive benefits package. NHI will achieve much better results in controlling healthcare expenditures and reducing the prevalence of catastrophic OOPHE

Purpose: This study aimed to estimate the prevalence and predictors of portopulmonary hypertension (POPH) in children with portal hypertension. Methods: We recruited children of both sexes aged 3–15 years with portal hypertension that was clinically suspected and confirmed by the presence of varices on esophagogastroduodenoscopy (EGD). The participants underwent clinical examination, 6-min walk distance (6-MWD), and echocardiography. Results: We enrolled 94 children with portal hypertension: 26.6% with pre-hepatic causes and 73.4% secondary to chronic liver disease. Among our participants, 13.8% had one or more cardiac manifestations, such as exercise intolerance, dyspnea on exertion, cyanosis, or orthopnea, whereas 86.2% were asymptomatic. EGD examination revealed grade I varices in 54.3% of cases, grade II–III in 43.6%, and grade IV in 2.1%. Pulmonary hypertension (>35 mmHg) was detected in 30.9% of cases using echocardiography; two of them were >45 mmHg. Patients with POPH had significantly more frequent dyspnea on exertion, lower O 2 saturation, and more severe variceal grades than those with normal pulmonary artery pressure. Five (6.9%) cases had <300 m 6-MWD, with no significant difference between patients with normal and those with elevated pulmonary artery pressure. The duration of portal hypertension and 6-MWD were correlated significantly with the echocardiographic measures. High-grade varices (p=0.04) and low O 2 saturation (p=0.03) were identified as risk factors for POPH. Conclusion POPH was detected in 30.9% of our study group. High-grade varices and low O 2 saturation are predictors of POPH. Echocardiography screening is crucial for the early detection of cases.

The transition of young patients with inflammatory bowel disease (IBD) from pediatric to adult-centered healthcare presents a significant challenge, particularly in regions like Oman, where transfer occurs as early as 14 years old. Although both pediatric and adult patients require multidisciplinary management, key differences in disease characteristics, vaccination needs, growth considerations, and treatment approaches necessitate a carefully structured transition process. Effective communication between pediatric and adult gastroenterologists is crucial for ensuring optimal management for these young patients. This mini-review explores the complexities involved in transitioning young patients with IBD to adult healthcare services.

Purpose: This study aimed to estimate the prevalence and predictors of portopulmonary hypertension (POPH) in children with portal hypertension. Methods: We recruited children of both sexes aged 3–15 years with portal hypertension that was clinically suspected and confirmed by the presence of varices on esophagogastroduodenoscopy (EGD). The participants underwent clinical examination, 6-min walk distance (6-MWD), and echocardiography. Results: We enrolled 94 children with portal hypertension: 26.6% with pre-hepatic causes and 73.4% secondary to chronic liver disease. Among our participants, 13.8% had one or more cardiac manifestations, such as exercise intolerance, dyspnea on exertion, cyanosis, or orthopnea, whereas 86.2% were asymptomatic. EGD examination revealed grade I varices in 54.3% of cases, grade II–III in 43.6%, and grade IV in 2.1%. Pulmonary hypertension (>35 mmHg) was detected in 30.9% of cases using echocardiography; two of them were >45 mmHg. Patients with POPH had significantly more frequent dyspnea on exertion, lower O 2 saturation, and more severe variceal grades than those with normal pulmonary artery pressure. Five (6.9%) cases had <300 m 6-MWD, with no significant difference between patients with normal and those with elevated pulmonary artery pressure. The duration of portal hypertension and 6-MWD were correlated significantly with the echocardiographic measures. High-grade varices (p=0.04) and low O 2 saturation (p=0.03) were identified as risk factors for POPH. Conclusion POPH was detected in 30.9% of our study group. High-grade varices and low O 2 saturation are predictors of POPH. Echocardiography screening is crucial for the early detection of cases.

The transition of young patients with inflammatory bowel disease (IBD) from pediatric to adult-centered healthcare presents a significant challenge, particularly in regions like Oman, where transfer occurs as early as 14 years old. Although both pediatric and adult patients require multidisciplinary management, key differences in disease characteristics, vaccination needs, growth considerations, and treatment approaches necessitate a carefully structured transition process. Effective communication between pediatric and adult gastroenterologists is crucial for ensuring optimal management for these young patients. This mini-review explores the complexities involved in transitioning young patients with IBD to adult healthcare services.

Purpose: This study aimed to estimate the prevalence and predictors of portopulmonary hypertension (POPH) in children with portal hypertension. Methods: We recruited children of both sexes aged 3–15 years with portal hypertension that was clinically suspected and confirmed by the presence of varices on esophagogastroduodenoscopy (EGD). The participants underwent clinical examination, 6-min walk distance (6-MWD), and echocardiography. Results: We enrolled 94 children with portal hypertension: 26.6% with pre-hepatic causes and 73.4% secondary to chronic liver disease. Among our participants, 13.8% had one or more cardiac manifestations, such as exercise intolerance, dyspnea on exertion, cyanosis, or orthopnea, whereas 86.2% were asymptomatic. EGD examination revealed grade I varices in 54.3% of cases, grade II–III in 43.6%, and grade IV in 2.1%. Pulmonary hypertension (>35 mmHg) was detected in 30.9% of cases using echocardiography; two of them were >45 mmHg. Patients with POPH had significantly more frequent dyspnea on exertion, lower O 2 saturation, and more severe variceal grades than those with normal pulmonary artery pressure. Five (6.9%) cases had <300 m 6-MWD, with no significant difference between patients with normal and those with elevated pulmonary artery pressure. The duration of portal hypertension and 6-MWD were correlated significantly with the echocardiographic measures. High-grade varices (p=0.04) and low O 2 saturation (p=0.03) were identified as risk factors for POPH. Conclusion POPH was detected in 30.9% of our study group. High-grade varices and low O 2 saturation are predictors of POPH. Echocardiography screening is crucial for the early detection of cases.

The transition of young patients with inflammatory bowel disease (IBD) from pediatric to adult-centered healthcare presents a significant challenge, particularly in regions like Oman, where transfer occurs as early as 14 years old. Although both pediatric and adult patients require multidisciplinary management, key differences in disease characteristics, vaccination needs, growth considerations, and treatment approaches necessitate a carefully structured transition process. Effective communication between pediatric and adult gastroenterologists is crucial for ensuring optimal management for these young patients. This mini-review explores the complexities involved in transitioning young patients with IBD to adult healthcare services.

Purpose: This study aimed to estimate the prevalence and predictors of portopulmonary hypertension (POPH) in children with portal hypertension. Methods: We recruited children of both sexes aged 3–15 years with portal hypertension that was clinically suspected and confirmed by the presence of varices on esophagogastroduodenoscopy (EGD). The participants underwent clinical examination, 6-min walk distance (6-MWD), and echocardiography. Results: We enrolled 94 children with portal hypertension: 26.6% with pre-hepatic causes and 73.4% secondary to chronic liver disease. Among our participants, 13.8% had one or more cardiac manifestations, such as exercise intolerance, dyspnea on exertion, cyanosis, or orthopnea, whereas 86.2% were asymptomatic. EGD examination revealed grade I varices in 54.3% of cases, grade II–III in 43.6%, and grade IV in 2.1%. Pulmonary hypertension (>35 mmHg) was detected in 30.9% of cases using echocardiography; two of them were >45 mmHg. Patients with POPH had significantly more frequent dyspnea on exertion, lower O 2 saturation, and more severe variceal grades than those with normal pulmonary artery pressure. Five (6.9%) cases had <300 m 6-MWD, with no significant difference between patients with normal and those with elevated pulmonary artery pressure. The duration of portal hypertension and 6-MWD were correlated significantly with the echocardiographic measures. High-grade varices (p=0.04) and low O 2 saturation (p=0.03) were identified as risk factors for POPH. Conclusion POPH was detected in 30.9% of our study group. High-grade varices and low O 2 saturation are predictors of POPH. Echocardiography screening is crucial for the early detection of cases.