Estimated Premium a rough estimate that can be tweaked to reflect the scope of coverage supplied under a specific contract.
Whats the full meaning of EPI?
In May 1974, the World Health Organization (WHO) launched the Expanded Program on Immunization (EPI) with the goal of vaccinating children all throughout the world.
The WHO produced a consistent immunization schedule for the first EPI vaccines, Bacillus Calmette-Guérin (BCG), diphtheria-tetanus-pertussis (DTP), oral polio, and measles, ten years later, in 1984. New vaccines were developed as a result of increased knowledge of disease immunologic factors, and they were added to the EPI’s list of recommended vaccines: Hepatitis B (HepB), yellow fever in countries where the disease is endemic, and Haemophilus influenzae meningitis (Hib) conjugate vaccine in countries where the disease is endemic.
The Global Alliance for Vaccines and Immunization (GAVI) was founded in 1999 with the express goal of improving child health in the world’s poorest countries by expanding the EPI’s coverage. The GAVI coalition included UN agencies and institutions (WHO, UNICEF, the World Bank), public health institutes, donor and implementing countries, the Bill and Melinda Gates Foundation and The Rockefeller Foundation, the vaccination industry, non-governmental organizations (NGOs), and many others. The GAVI initiative has helped to rekindle interest in vaccines and retain their importance in combating the world’s high burden of infectious illnesses.
- to ensure that all children under the age of one year are fully immunized in every district,
- to reduce the prevalence of maternal and neonatal tetanus to fewer than one case per 1,000 births by 2005
- to lower the number of measles-related deaths in half from 1999 levels, and
- All new vaccines and preventative health initiatives should be made available to children in all districts around the world.
Furthermore, the GAVI has established specific milestones for achieving the EPI goals: by 2010, all countries will have routine immunization coverage of 90% of their child population, HepB will be introduced in 80% of all countries by 2007, and 50% of the poorest countries will have Hib vaccine by 2005.
What is EPI accounting?
- A consumer visits the merchant’s website. This could be an online retail site, an online vacation booking site, or any other website where a customer must make a payment to a business.
- The customer arrives at the page on the merchant’s website where he must choose a payment method. The customer picks bank account as the payment method and the bank.
If no account number is provided by default, the customer can choose which account the funds will be debited from and then complete the transaction.
- The customer is taken to the merchant’s website, where the transaction’s status is displayed.
Does EPI mean above?
Prefixes are important morphemes that begin words in English. Epi-, which meaning “over” or “upon,” is found in a large variety of English vocabulary words, including epidermis and epitaph. You may know that the prefix epi- means “upon” from the noun epidemic, which refers to a widespread disease that strikes people; you may also recall that epi- means “over” from the word epidermis, which refers to the outer layer of skin that rests “over” the lower layers of skin.
What can you do for EPI?
When the pancreas does not produce enough digesting enzymes, exocrine pancreatic insufficiency ensues. As a result, food is not adequately digested, and the body does not get the nutrition it requires.
Abdominal discomfort, bloating, unintended weight loss, diarrhea, and greasy stool are all symptoms of EPI.
Malnutrition and vitamin and trace element deficits result if not treated.
This can lead to weakening or fragile bones (osteopenia or osteoporosis) over time, which can have a major impact on a person’s life.
EPI is frequent in people with pancreatic illness, although it is underdiagnosed and undertreated.
Acute and chronic pancreatitis, pancreatic cancer, cystic fibrosis, diabetes, and those undergoing pancreatic surgery to remove benign or malignant tumors can all cause EPI.
EPI is seen in up to 62 percent of patients hospitalized for acute pancreatitis, and 33 percent at follow-up sessions after discharge.
EPI develops 5 to 10 years after the onset of chronic pancreatitis in adults with chronic pancreatitis and is found in 30-90 percent of patients.
There are a few EPI tests available, but they are typically inconvenient and painful.
A stool test termed fecal elastase-1 is the most often utilized EPI test.
Unfortunately, EPI’s ambiguous early symptoms can make diagnosis difficult and cause delays.
According to studies, not all individuals at high risk for EPI are now examined, and those who are tested and diagnosed with EPI are not given enough EPI drug dosages.
EPI is treated with a combination of a better diet, less drinking and smoking, and a drug called PERT (pancreatic enzyme replacement therapy).
PERT is a digestive enzyme supplement that is given by mouth during a meal.
PERT aids in fat digestion and absorption, as well as the absorption of vitamins that require lipids to be digested (vitamins A, D, E, and K).
PERT treatment for EPI not only improves symptoms, but also reduces the risk of osteopenia and osteoporosis.
Patients with pancreatic cancer, those undergoing pancreatic surgery for CP, and those with cystic fibrosis may all benefit from PERT.
PERT improved bodily discomfort, vitality, and mental health in persons with chronic pancreatitis and EPI in a 51-week study, in addition to general health improvements.
EPI is caused by a mix of genetic and environmental factors, including the use of alcohol and tobacco.
Genetic variations can potentially cause or raise the likelihood of developing diseases that lead to EPI.
Genetic variations, for example, play a role in the risk of chronic pancreatitis, cystic fibrosis, pancreatic cancer, and diabetes.
The severity of EPI is determined on the genetic variant discovered.
EPI is one of the symptoms of Shwachman-Diamond syndrome, which is caused by mutations in the gene SBDS.
If you think you might have EPI, go to your doctor right away. Getting a diagnosis and starting treatment early might help you live a better life and avoid more catastrophic complications.
Pancreatic Enzyme Replacement Therapy: A Concise Review. JOP. 2019; 20(5):121-125. Brennan GT, Saif MW.
G. Capurso, M. Traini, M. Piciucchi, M. Signoretti, and P. G. Arcidiacono. Prevalence, diagnosis, and treatment of exocrine pancreatic insufficiency. 129-139 in Clin Exp Gastroenterol, 2019.
Contribution of pancreatic enzyme replacement treatment on survival and quality of life in patients with pancreatic exocrine insufficiency, Layer P, Kashirskaya N, Gubergrits N. 2019; 25(20):2430-2441 in World Journal of Gastroenterology.
Forsmark CE, Perbtani Y. Update on exocrine pancreatic insufficiency diagnosis and treatment. 2019; 8. F1000Res.
What causes EPI?
When your pancreas stops producing enough enzymes to enable normal digestion, EPI develops.
EPI can be caused by a multitude of illnesses or events that affect your pancreas. Pancreatitis, for example, causes EPI by directly destroying the pancreatic cells that produce digestive enzymes.
Chronic pancreatitis
Chronic pancreatitis is pancreas inflammation that does not go away with time. The most common cause of EPI in adults is this type of pancreatitis.
The cells that create digestive enzymes are damaged by your pancreas’ chronic inflammation. Exocrine insufficiency is common in persons who have chronic pancreatitis.
Acute pancreatitis
EPI is significantly less common in pancreatitis that comes and goes for brief periods of time than it is in chronic pancreatitis. Acute pancreatitis that is not treated can progress to chronic pancreatitis, increasing your chances of having EPI.
Autoimmune pancreatitis
When your immune system attacks your pancreas, this is a type of chronic pancreatitis. Steroid therapy may help persons with autoimmune pancreatitis produce more enzymes.
Diabetes
Diabetes patients are more likely to develop EPI. Researchers aren’t sure why this association exists, but it’s probably related to the chemical abnormalities that your pancreas goes through when you have diabetes.
Surgery
EPI is a typical side effect following pancreas or digestive tract surgery. According to some gastric surgery studies, up to 80% of persons who have undergone surgery on their pancreas, stomach, or upper small intestine will develop EPI.
When your pancreas is removed entirely or partially, it may produce less enzymes. EPI can also be caused by stomach, intestine, and pancreatic procedures that alter the way your digestive system works together.
Removing a portion of the stomach, for example, can disrupt the gut reflexes required to fully mix nutrition with pancreatic enzymes.
Genetic conditions
Cystic fibrosis is a hereditary condition in which the body produces an excessive amount of mucus. Mucus adheres to the lungs, digestive tract, and other organs.
Shwachman-Diamond syndrome is a genetic bone, bone marrow, and pancreas disorder. Early childhood is the most common onset of EPI in people with this syndrome. Children’s pancreatic function may improve as they get older.
Celiac disease
The inability to digest gluten is linked to Celiac disease. About 1% of adults in the United States have the condition.
People who have a gluten-free diet may nonetheless experience symptoms such as persistent diarrhea. The symptoms in this situation could be caused by EPI, which is linked to Celiac disease.
Pancreatic cancer
EPI is a pancreatic cancer complication. EPI can be caused by cancer cells replacing pancreatic cells. Enzymes may be prevented from entering the digestive tract by a tumor. EPI can potentially be a side effect of pancreatic cancer surgery.
Inflammatory bowel diseases
Inflammatory bowel illnesses such as Crohn’s disease and ulcerative colitis cause your immune system to assault and inflame your digestive tract.
EPI can affect patients who have Crohn’s disease or ulcerative colitis. The specific source of this link, however, has yet to be discovered by experts.
Zollinger-Ellison syndrome
This is an uncommon condition in which tumors in the pancreas or other parts of the gut create a lot of hormones. This causes an overabundance of stomach acid, which prevents your digestive enzymes from operating properly, resulting in EPI.
Can you gain weight with EPI?
Your overall goal should be to maintain your weight, even if you don’t return to your prior weight. Your doctor can assist you in determining a weight loss goal.
Even after finding a combination of foods that they can tolerate, few persons with EPI are likely to acquire too much weight. Focus on portion management if you acquire more weight than you need to, Lupu advises. If you’re aiming to gain or maintain a healthy weight, portion sizes are important to consider.
Your doctor will continue to monitor you for vitamin deficiencies even after you have reached a healthy weight. According to the NPF, your main worries are likely the fat-soluble vitamins A, D, E, and K. In contrast to water-soluble vitamins, which break down more easily during digestion, fat-soluble vitamins are broken down by lipids in the liver. You may need to take vitamin supplements in addition to your enzyme replacement therapy to replenish vitamins you can’t absorb.
An optimal diet combined with enzyme replacement treatment should improve your mood and allow you to eat enough to maintain a healthy weight.
What is EPI and what are the symptoms?
Undigested food travelling too quickly through the digestive tract might be a concern with EPI. Bloating and gas. People with EPI are unable to adequately digest their meals, resulting in unpleasant symptoms such as gas and bloating. Stomach ache. EPI-induced fat maldigestion can cause gas, bloating, and stomach pain.