Unstable Angina Case Study

Unstable Angina Case Study
Current Treatment and Consideration of Evidence Base: Upon admission, patient was most–likely suspected of having ACS (acute coronary syndrome)
because of CHD (coronary heart disease) (NICE, 2014c). Troponin T High Sensitivity Test was carried out to distinguish whether chest pains were
because of NSTEMI or unstable angina (NICE, 2014b). This led to diagnosis of unstable angina. His current treatment with regards to drug interactions
is okay, except that enoxaparin has a clinically significant interaction with aspirin (2015, p. 1199). This can be discounted for due to his condition.
Patient has a CVD (cardiovascular disease); can be exacerbated by having high cholesterol (could be the cause of his angina). Therefore, atorvastatin
80 mg was initiated for secondary prevention of CV ... Show more content on Helpwriting.net ...
Mention important benefits of quitting such as if patient quits smoking for 5 years or more, risk of heart attack decreases by 50 to 70 percent (2012).
Refer patient to NHS Stop smoking Service to further help quitting. Emphasize important of exercise and diet on CVD progression. Explain how
active lifestyle reduces heart attack risk by 45% (2012). 2 hours and 30 minutes of moderate–intensity aerobic activity every week is ideal, for example,
walking fast or pushing a lawn mower (NHS, 2014). Counsel patient on returning to normal day to day activities; ideal to wait 2 months after
CABG before doing strenuous activities (RCS, 2014). Emphasize importance of diet on CVD progression. Mention important benefits such as that
for every percent his serum cholesterol is reduced, chance of having a heart attack is reduced by 2 percent. Patient should be counselled to reduce
salt intake to less than six grams a day, avoid caffeinated drinks, eat at least 5 portions of fruits and vegetables a day, 2 portions of fish a week, and 4–5
portions of unsalted nuts, seed and legumes per
... Get more on HelpWriting.net ...

Gastroesophageal Reflux Research Paper
Gastroesophageal reflux What is Gastroesophageal reflux? Gastroesophageal reflux is a medical condition characterized by reflux of acidic juices into
the esophagus, resulting in symptoms of regurgitation (sour taste in mouth) and reflux (burning in the chest). This is an extremely common condition
in the United States. Factors such as obesity, alcohol use, tobacco use, certain medications, and various diets and lifestyle decisions increase your risk
of developing gastroesophageal reflux. Long term disease can lead to a precancerous condition called Barrett esophagus. Other serious complications
include esophageal adhesions, constrictions, and cancer. Some patients may ultimately develop difficulty swallowing and weight loss – which may...
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How common is gastroesophageal reflux? What are the symptoms and signs of gastroesophageal reflux? How is gastroesophageal reflux diagnosed?
How is gastroesophageal reflux treated? What causes Gastroesophageal reflux? Gastroesophageal reflux is caused by the reflux of acidic juices from
the stomach into the esophagus. This results in irritation of the esophageal lining – leading to chest burning and discomfort. Acid can also reach the
throat resulting in the sensation of a sour taste in the mouth (regurgitation). Symptoms often occur after meals and may be associated other features of
dyspepsia such as bloating and mild abdominal discomfort. Long term inflammation in the lower esophagus can lead to cellular changes that are
precancerous if the problem is not corrected or reversed – Barrett esophagus. Eventually chronic irritation can lead to adenocarcinoma of the lower
esophagus. Conditions that lead to acid reflux generally occur as a result of abnormal anatomic or pathophysiologic processes. Often times it is causes
by increased intraabdominal pressure, which facilitates acid backflow from the stomach to the esophagus. Some of these can include: Obesity
Pregnancy Abdominal

Memory Loss : Common Causes Of Memory And Memory
Problem
Memory loss has been around since the dawn of time. Isn't it frustrating when you can't find your keys or forgot someone's name? There have been
a lot of natural and medical ways to help increase memory loss. memory loss has always been around and there are some cases where it is harder to
control for like Alzheimer's but it is possible to try and improve memory. According to Harvard Health Page there are a few common causes ofmemory
loss and how to improve it.
It is commonly shown that lack of sleep, depression, anxiety, stress, certain medications, and alcohol are all common causes of memory loss. The most
important thing to do here is to sleep well, and be happy. If using medications and it is shown that memory is decreasing ask about changing
medications.
There are other causes of memory loss like Alzheimer's that can be more difficult to treat. Alzheimer's was first discovered in the 50's when Auguste
Duarte was having strong dementia. When asked for her husband's name she would respond with her own name or if she was eating pork and asked
what she was eating she would reply with salad.
Dependent Variable
Sleep, alcohol, medications
Independent variable
Memory loss, how to improve dementia, and how to stabilize/ improve Alzheimer's
Hypothesis
If I change the problems that might be affecting my memory, then my memory will increase
Solutions to this problem may be sleeping early, playing memory games to strengthen your memory, exercise, eat healthier,

How Does Proton Pump Acid Affects The Body
Nutrition and lifestyle can change the body's response to drugs; conversely, a nutrient–drug interaction also affects the nutritional content in the body.
Drugs may also change food absorption and metabolism in the body. Some drugs can increase GI motility, increasing or decreasing food digestion.
Other drugs decrease GI motility. Some drugs are better tolerated if taken with food.1
Proton pump inhibitors (PPIs) are one of the most important drugs in order to treat gastrointestinal diseases. Proton pump inhibitors are a group of
drugs whose main action is reduction of stomach acid production. 2
Iron is an essential mineral in the body and there is iron in all cells in the body. It is the mineral that should be in our diet, it is necessary for
transport of oxygen through hemoglobin. Iron is also vital for oxidation by cell.3 Dietary iron consist of two forms: heme or organic iron is found
in animal product such as meat and fish which attached to proteins called heme proteins. None heme iron is found in vegetable such as bean and
spinach. Heme iron is typically absorbed at a higher rate (20%) rather than non heme iron (2%).4 Hydrochloride (HCl) secretes in order to help
digestion of the food at beginning of a meal and help to keep low the ph of the stomach. Hydrochloride (HCl) breakdowns protein to amino ... Show
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Study performed with 98 people who met inclusion criteria and 98 controls. In the group of people who used PPI, 34.7% used omeprazole, 32.7%
esomeprazole, 15.3% lansoprazole, 13.3% pantoprazole, and 4.1% rabeprazole. All hematologic factors like hemoglobin (–0.19 g/dL, P = 0.03),
hematocrit (–0.63%, P = 0.02) and mean corpus cular volume (–0.49 fL, P = 0.05) decrease significantly among patient who used

Essay On Cirrhosis
P.P.I therapy is often used in patients with cirrhosis, sometimes, in the absence of a specific indication (e.g.: acid related diseases), there are
conflicting reports for their use in cirrhotic patients. The dosage of most PPIs should be reduced in cirrhotic as they are metabolized by the liver and
associated with adverse effects of prolonged use.
Keywords
Proton pump inhibitors, liver cirrhosis, peptic ulcer, H. pylori, esophageal band ligation.
Abbreviations
P.P.I: proton pump inhibitors.
EVS: esophageal variceal Sclerotherapy.
EVL: esophageal variceal ligation.
HE: hepatic encephalopathy.
SBP: spontaneous bacterial peritonitis.
CDI: Clostridium difficile infection.
PHG: portal hypertensive gastropathy.
GERD: gastroesophageal ... Show more content on Helpwriting.net ...
However, high–dose infusion (e.g., pantoprazole 8 mg/h) and prolonged use in the absence of endoscopic procedures is not supported by the literature
and should be discouraged until evidence of benefit becomes available. (8)
GERD
Functional studies showed decreased LES function with low amplitude of acid clearance and primary esophageal peristalsis in cirrhotic patients
with large varices [9]. These phenomena could be due to a mechanical effect of the varices. Cirrhotic patients without EV have also esophageal
motor disorders and mixed acid and bile reflux as the main pattern, whereas the cirrhosis itself is an important causative factor. It is unclear whether
this might contribute to bleeding from varices [8]. Data on management of GERD in cirrhosis are few, however, the indications of use for PPIs may
remain exactly the same in patient with cirrhosis of the liver as general population for the treatment of erosive esophagitis, or in general the pathology
secondary to gastroesophageal reflux of acid (10)
Peptic ulcer and H. pylori infection
Prevalence of duodenal and gastric ulcers in patients with liver cirrhosis increases as the disease progress[11] and this prevalence becomes higher in
decompensated cirrhosis than in compensated cirrhosis [12]. Currently, PPIs are the mainstay treatment option of peptic ulcers in the general
population [13]. Helicobacter pylori infection contributes to the development of hyperammonemia [14] and subsequent episodes of

Pathophysiology Case Studies
A.Demographics:
a)Age: Infant (1 month – 1 year)
b)Sex: Male
c)Race: Hispanic
B.Drug Allergies: No known drug allergies
C.Chief Complaint:
a)Congenital Tracheomalacia
b)Respiratory depression
c)Shortness of breath
d)Decreased food intake
e)Cough
D.History of Present Illness: The patient was presented with a one day history of shortness of breath (SOB), respiratory distress, decreased food
intake and occasional cough. According to his mother, he was in his usual state of health until the night before he got to the hospital nearby their
house. She noted him to be working hard to breathe with retractions and wheezing, also noted him to refusing to eat and occasional coughing. His
mother stated that she took him to his PCP for his immunizations; from there he developed a fever after the vaccine, which was resolved after a day.
Mother denies any skin contact, any diarrhea, constipation, vomiting or any other signs or symptoms. After that, she took him to an emergency room
(ER) at Southwest where he received multiple DuoNebs, NS bolus, Racemic Epinephrine and was ... Show more content on Helpwriting.net ...
The normal range of WBC is 6.0–17.0 10*3/ВµL; his WBC count was normal. The normal range of RBC is 2.70–4.9 10*6/ВµL; his RBC count was
normal. The normal range of HGB is 9.0–15 g/dL; his hemoglobin level was low. Normal HCT is 28–42 %; his hematocrit level was low. The reason
for such low hemoglobin and hematocrit level could be because of decreased food intake that can cause iron deficiency (part of hemoglobin structure
where oxygen is bind to hemoglobin). Normal platelet range is 150–495 10*3/ВµL; his platelet count was normal. Normal Na is 135–145 mmol/L,
normal potassium is 3.5–5.0 mmol/L, normal chloride is 98–108 mmol/L, normal BUN is 7–23 mg/dL, normal creatinine is 0.50–1.04 mg/dL, and
normal calcium is 8.6–10.6 mg/dL. All of his metabolic labs were within normal

Anemia Research Paper
Anemia
What is anemia?
Anemia is a medical condition characterized by low red blood cell count or mass (hemoglobin). This can be caused by blood loss, decreased
production of red blood cells, or increased red cell destruction. Some common forms of anemia include iron deficiency, vitamin B12 deficiency,
thyroid disease, and liver disease. Patients with certain blood or bone marrow cancers may also develop anemia. Individuals with anemia often develop
symptoms of when their hemoglobin is very low or there is a rapid drop in hemoglobin.
Symptoms typically fatigue, low energy, exertional shortness of breath, and pale skin. Severe anemia due to hemorrhage may lead to death, particularly
in elderly individuals with chronic heart or lung disease. ... Show more content on Helpwriting.net ...
The diagnosis of anemia is suggested based on symptoms and physical examination, but is typically confirmed with a CBC (complete blood cell
count). Your doctor will also usually order a CMP (comprehensive metabolic panel), thyroid function (TSH, free T4), vitamin B12, iron studies (ferritin,
iron saturation, total iron binding capacity), and coagulation studies (PT/INR, PTT).
Other tests may include a urinalysis, heme occult stool study, reticulocyte count, haptoglobin level, SPEP and UPEP (serum and urine protein
electrophoresis), and peripheral blood smear
If you are over age 50 and have evidence of iron deficiency anemia, your doctor will likely refer you to a gastroenterologist to undergo an upper
endoscopy and colonoscopy. These tests are done in order to rule out gastrointestinal cancer.
If you are having chest pain or difficulty breathing, you doctor may obtain a chest x–ray, EKG (electrocardiogram), and ultrasound of the heart
(echocardiogram).
How is anemia treated?
The treatment of anemia is based on its severity. Severe anemia due to blood loss often requires blood transfusion with packed red blood cells. Less
urgent forms of anemia may be treated with a variety of therapies depending on their

Cirrhotic Essay
Abstract P.P.I therapy is often used in patients with cirrhosis, sometimes, in the absence of a specific indication (e.g.: acid related diseases), there are
conflicting reports for their use in cirrhotic patients. The dosage of most PPIs should be reduced in cirrhotic as they are metabolized by the liver and
associated with adverse effects of prolonged use. We aimed to review strict indications and adverse effects for their use in this group of patients.
Keywords Proton pump inhibitors, liver cirrhosis, peptic ulcer, H. pylori, esophageal band ligation. Abbreviations P.P.I: proton pump inhibitors. EVS:
esophageal variceal Sclerotherapy. EVL: esophageal variceal ligation. HE: hepatic encephalopathy. SBP: spontaneous bacterial... Show more content on
Helpwriting.net ...
A short course for 10 days post–EVL may be reasonable if we concern for ulcer healing. However, high–dose infusion (e.g., pantoprazole 8 mg/h) and
prolonged use in the absence of endoscopic procedures is not supported by the literature and should be discouraged until evidence of benefit
becomes available. (8) GERD Functional studies showed decreased LES function with a low amplitude of acid clearance and primary esophageal
peristalsis in cirrhotics with large varices [9]. These phenomena could also be due to a mechanical effect of the varices. Cirrhotic patients without
EV have also esophageal motor disorders and mixed acid and bile reflux as the main pattern whereas the cirrhosis itself was an important causative
factor. It is unclear whether this might contribute to bleeding from varices [8]. Data on management of GERD in cirrhosis are few, however, the
indications of use for PPIs may remain exactly the same also in patient with cirrhosis of the liver as general population for the treatment of erosive
esophagitis or in general the pathology secondary to gastroesophageal reflux acid (10) Peptic ulcer and H. pylori infection Prevalence of duodenal and
gastric ulcers in patients with liver cirrhosis increases as the disease progress[11] and this prevalence becomes higher in decompensated cirrhosis than
in compensated cirrhosis [12]. Currently, PPIs are the mainstay treatment option of peptic ulcers in the

Proton Pump Inhibitors
According to Proton Pump inhibitors (PPIs) decrease the generation of acid by hindering the enzyme in the mass of the stomach that produces the acid.
Acid is vital for the arrangement of most ulcers in the esophagus, stomach, and duodenum, and the decrease of acid with PPIs avoids ulcers and permits
any ulcer that exists in the throat, stomach, and duodenum to mend. According to medicinenet.com (), proton pump inhibitors are used for the
prevention and treatment of acid–related conditions such as: Gastroesophageal reflux disease (GERD) NSAID–associated ulcer Zollinger–Ellison
syndrome Esophageal duodenal and stomach ulcers Ulcers There are many different drugs that are associated with the use of PPIs such as
Lansoprazole (Prevacid, Prevacid IV, Prevacid 24–hour), Rabeprazole (Aciphex), Omerprazole (Nexium, Nexium IV, Nexium 24–hour), aspirin and
omeprazole (yosprala), omeprazole/sodium bicarbonate (Zegerid, Zegerid OTC),... Show more content on Helpwriting.net ...
However, many individuals don't feel the symptoms, or they can manage them. It is best to ask a pharmacist the possible side effects that come with
any medication you take. The most widely recognized side effects of proton pump inhibitors are nausea, diarrhea, abdominal pain, vomiting, headache,
rash, constipation, fever, and flatulence. The more serious side effects of proton pump inhibitors (PPIs) are erythema multiforme, serious allergic
reactions, reduced liver function, Stevens–Johnson syndrome, pancreatitis, toxic epidermal necrolysis and reduced kidney function. If a woman is
pregnant, they should not take any prescriptions unless a doctor says that it is ok. A few prescriptions can hurt the baby. This includes medicines sold
over–the–counter, herbs, vitamins, and supplements. Furthermore, it is very important that a woman who is pregnant informs a doctor that they are
indeed pregnant, currently breastfeeding, or intending to get

Roles Of The Registered Nurse
Introduction
In 2010 and 2011 inclusive, approximately 2.4 million hospitalisations within Australia were for the purpose of surgery. Of the approximated 2.4
million, 1.9 million of these were classified as elective admissions (Australian Institute of Health and Welfare 2010–11). Australia is shown to have an
ageing population, (Australian Bureau of Statistics. 2006) which indicates an increasing percentage of patients undertaking surgery are elderly with
numerous comorbidities. In considering these it pre–operative assessment as a means of risk management prior to surgery seeks to reduce the potential
probability of perioperative complications.
The Role of the Registered Nurse in Pre–operative Assessment
The role of the registered nurse in Preoperative assessment is fundamentally to undertake a clinical risk assessment where the health of a patient is
evaluated to determine if a person is fit to undergo the anaesthetic for a planned operation. Preoperative patient assessment is essential in identifying
patient risk factors, provision of information and education, as well as the facilitation of any required measurements or laboratory studies, such as blood
tests or electrocardiographs (Hines, Munday, & Kynoch, 2013). A well–designed pre–operative framework will decrease the likelihood of failure to
advance to surgery owing to communication and/or administration errors (Rai & Pandit, 2003). Considering the role of the registered nurse in terms of
pre–operative assessment it

H. Pylori Research Paper
Over half of human stomachs in the world are colonized by H. pylori. This bacterium is the culprit for almost 80% of all gastric adenocarcinoma
cases and upwards of 90% of all duodenal peptic ulcer cases making it the second most common bacterial infection worldwide (6). Those colonized
with H. pylori have a two to six times increased risk of forming gastric cancer or ulcers. Because of this, H. pylori has since been classified as a class
I carcinogen. There are currently two completely sequenced genomes of H. pylori (strain 26695 and strain J99) which have been revolutionary in the
research and understanding of its genetic diversity and pathogenic mechanisms. H. pylori are gram–negative, spiral shaped, adorned with three to five
polar ... Show more content on Helpwriting.net ...
pylori's expression of a Type IV secretion system suggests it utilizes horizontal gene transfer to uptake DNA to and from host cells or other bacterial
cells in its environment. H. pylori uses its T4SS to inject the highly pathogenic cagA protein into the gastric epithelial cells of the human host which
then phosphorylates and interferes with human host signaling cascades related to cell differentiation, proliferation, motility and cytoskeletal
rearrangement causing H. pylori induced proinflammatory responses via IL–8 activation and NF–ОєB stimulation. This sequence of events results in
the elongation of infected host epithelial cells, characteristic of H. pylori illness, termed the "hummingbird phenotype (2)." It has been shown that
almost 100% of all Eastern Asian strains express the cagA protein while only about 60–70% of the Western strains express a functional cagA protein. It
is clear to see that geographical regions have dramatic differences in virulence and pathogenicity of H. pylori strains further proving the vast
diversity in the genetics of the bacteria. The H. pylori T4SS can be assessed in three different clusters of genes. The first is the protein type IV
secretion system (pT4SS) whose primary function is to translocate the cagA protein. The cag pathogenicity island uses 18 out of its 27 genes to
translocate cagA into the host cells and 14 genes are used in

Advantages And Disadvantages Of Heterocyclic Moietie
Many naturally occurring medicines containing heterocyclic moieties in their basic structure such as antibiotics like cephalosporin (4), penicillin (5),
morphine (6) as analgesic, alkaloids like caffeine (7), nicotine (8) and quinine (9) as anti–malarial drug. On the other hand, novel heterocyclic
compounds have been synthesized by synthetic chemist due to their excellent pharmacological activities. These heterocyclic molecules are biological
active as antifungal [11], antidepressant [12–13] anticonvulsant [14–15], anti–inflammatory [16], antibacterial [17], antitumor [18] and more
(Figure–2). Figure–2: Biological active heterocyclic molecules
Heterocyclic compounds heaving other important commercial or industrial applications such as fungicides, optical ... Show more content on
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In complex (33) benzimidazolylmethyl–1,3–diaminepropane act as hexadentate ligand and make complex with Cu (II) ion. This complex (33)
possesses antitumor activity and has ability to add into the double helix of the DNA [85]. Another complex (34) of Cu (II) ion with
2–pyridinylbenzimidazole–5–carboxalic acid was studied for topoisomerase II inhibitory activity and found very active [86]. Some benzimidazole
complexes (35, 36) with Pt (II) ion were showed excellent activity against human breast cancer cell line (MCF–7) and HeLa cervix cancer cell line
[87–88]

Pharmaceutical Price Controls in the Oecd Countries
Pharmaceutical Price Controls in OECD Countries
Implications for U.S. Consumers, Pricing, Research and Development, and Innovation
U.S. Department of Commerce International Trade Administration
The International Trade Administration (ITA) has as its mission the creation of economic opportunity for U.S. workers and firms by promoting
international trade, opening foreign markets, ensuring compliance with trade laws and agreements, and supporting U.S. commercial interests at home
and abroad. To learn more about the ITA, write to: International Trade Administration, Office of Public Affairs, U.S. Department of Commerce,
Washington, DC 20230, or visit the ITA's Internet site at www.ita.doc.gov.
Pharmaceutical Price Controls in OECD ... Show more content on Helpwriting.net ...
Department of Commerce, International Trade Administration
Executive Summary
Improvements in health care and life sciences are an important source of gains in health and longevity globally. The development of innovative
pharmaceutical products plays a critical role in ensuring these continued gains. To encourage the continued development of new drugs, economic
incentives are essential. These incentives are principally provided through direct and indirect government funding, intellectual property laws, and other
policies that favor innovation. Without such incentives, private corporations, which bring to market the vast majority of new drugs, would be less able
to assume the risks and costs necessary to continue their research and development (R&D). In the United States, government action has focused on
creating the environment that would best encourage further innovation and yield a constant flow of new and innovative medicines to the market. The
goal has been to ensure that consumers would benefit both from technological breakthroughs and the competition that further innovation generates. The
United States also relies on a strong generic pharmaceutical industry to create added competitive pressure to lower drug prices. Recent action by the
Administration and Congress has accelerated the flow of generic medicines to the market for precisely that reason. By contrast, in the Organization for
Economic Cooperation and

A Brief Note On Atherosclerosis And Coronary Spasms
1. Ms. T sought medical attention mainly because of intolerable chest pain after climbing several flights of stairs; however, Ms. T has a history of
conditions such as atherosclerosis and coronary spasms. Atherosclerosis is the buildup of fatty material known as plaque, along the walls of arteries
causing the arteries to narrow (Taber's pg 224). Therefore, angina pectoris can result with exertion. Also, coronary spasms can potentially be caused
by plaque buildup and can occur in people who have high cholesterol such as Ms. T. Also, coronary spasms are known to cause angina pectoris in
people (Taber's pg 2171). Ms. T's history of these conditions explains why she experiences episodes of angina.
4. The two predominant types of angina are ... Show more content on Helpwriting.net ...
Propranolol HcL drug to drug interactions: general anesthesia, IV phenytoin, and verapamil may cause additive myocardial depression. Additive
bradycardia may occur with digoxin. Additive hypotension may occur with other antihypertensives, acute ingestion of alcohol, or nitrates. Levels may
be decreased with chronic alcohol use. Concurrent use with amphetamines, cocaine, ephedrine, epinephrine, norepinephrine, phenylephrine, or
pseudoephedrinemay result in unopposed alpha–adrenergic stimulation (excessive hypertension, bradycardia). Concurrent thyroid administration may
decrease effectiveness. May alter the effectiveness of insulin or oral hypoglycemics(dose adjustments may be necessary). May decrease effectiveness
of beta–adrenergic bronchodilatorsand theophylline. May decrease beneficial beta cardiovascular effects of dopamine or dobutamine. Use cautiously
within 14 days of MAO inhibitor therapy (may result in hypertension). Cimetidine may increase blood levels and toxicity. Concurrent NSAIDs may
decrease antihypertensive action. Smoking increases metabolism and decreases effects; smoking cessation may increase effects. May increase levels of
lidocaine and bupivacaine.
Nifedipine drug to drug interactions: Drug–Drug: Rifampin, rifabutin, phenobarbital, phenytoin, orcarbamazepine may significantly decrease levels and
effects; concurrent use is contraindicated. Ketoconazole, fluconazole, itraconazole,clarithromycin,

Mallory-Weiss Syndrome Research Paper
Mallory–Weiss syndrome
Overview:
Mallory–Weiss disorder or gastro–esophageal cut disorder alludes to seeping from tears (a Mallory–Weiss tear) in the mucosa at the intersection of the
stomach and throat, normally brought about by severe alcoholism, coughing, vomiting, and retching.
Causes:
The most widely known causes for MWS is prolonged or severe vomiting. While this sort of vomiting is connected with disease, it additionally much of
the time happens because of unending liquor abuse or bulimia.
Albeit incessant heaving commonly causes MWS, different conditions can bring about a gash of the throat, including:
1. Trauma to the midsection or guts
2. Severe or delayed hiccups
3. Intense hacking
4. Intense wheezing
5. Heavy lifting ... Show more content on Helpwriting.net ...
Abdominal agony 2. Severe regurgitating 3. Vomitingblood (a condition called "hematemesis") 4. Bloody stool 5. Involuntary regurgitating
Diagnosis:

Diagnosis of Mallory–Weiss syndrome is made by your specialist amid a complete physical exam. Your specialist will get some information about any
therapeutic issues, including day by day liquor admission and late sicknesses, to distinguish the fundamental reason for your side effects.
In the event that your side effects show dynamic seeping in the throat, your specialist may do an esophagogastroduodenoscopy (EGD). Prior to this
methodology, you will be given a narcotic and a painkiller to keep any inconvenience. An endoscope (little, adaptable tube with a camera joined to it)
will be embedded through the throat and into the stomach. This can help your specialist see the throat and recognize the area of the tear.
A complete blood check (CBC) might likewise be requested to affirm low hematocrit (number of red platelets). Your red platelet check may be low in
the event that you have seeping in the throat. Taking into account the discoveries from these tests, your specialist will have the capacity to figure out
whether you have MWS.
Treatment:

Barret's Esophagus: Gastro Esophageal Reflux Disease
Barret's Esophagus is a serious complication of GERD, in which stands for Gastro Esophageal Reflux Disease. With Barret's esophagus normal tissue
lining the esophagus; the tube that carries food from the mouth to the stomach changes to tissue that resembles the lining of the intestine, this process
is called intestinal metaplasia ("Barret's esophagus: Symptoms," 2005). Patients who are diagnosed with Barret's esophagus are at an increase risk of
developing esophageal adenocarcinoma, which is cancer of the esophagus and can be fatal. The cause of Barret's esophagus is unknown. Barret's
esophagus is very rare and affects only about 1%–6.8% of people. The average age of diagnose is around the age of 55, and more men develop Barret's
esophagus twice as often as women would ("Barret's esophagus– national," 2013). Also more Caucasian men get diagnosed more than men of other
races, and Barret's esophagus is not commonly seen in children. People who are diagnosed with GERD have a 5–10% chance to develop Barret's
esophagus. Researches did find that patients who are diagnosed with heartburn are 5–15% more likely to end up getting diagnosed with Barret's
esophagus, it is sometimes hard to diagnose for Barret's esophagus because it is rare. Most people with acid reflux don't develop Barret's esophagus.
Patients with frequent acid reflux; cells that are similar to cells in the intestine to become Barret's esophagus may eventually replace the normal cells in
the esophagus. The

Dementia And Its Effect On The Function Of The Brain
Dementia is a term used to describe the symptoms of a number of illnesses which effect the function of the brain. It is an umbrella term describing
the progressive decline in a person's cognitive ability. The type and severity of symptoms varies with each type of dementia and is usually has a
gradual onset, is progressive and irreversible. (1) Research conducted by the Australian government in 2011, estimated that 298,000 Australians have
been diagnosed with dementia and based on current projections, this number will exceed 400,000 by 2020. (1) Although forecast methods vary, the
number of people with dementia is expected to triple between 2011 and 2050 and is estimated to reach approximately 900,000 by 2050. (1) In
2013, 10,933 people died from dementia, making it the second leading underlying cause of death in Australians, accounting for 7.4% of deaths in that
year. This number has gradually increased by 32% since 2009. (2) Dementia does not only impact the people with symptoms and it also disturbs the
people who must care for the person. It is estimated that 1.2 million people are involved in the care of people with dementia. It has a financial burden
on the Australian economy $4.9 billion in 2009–10. (1) Globally, the World Health Organisation reports there are approximately 47.5 million people
who have been diagnosed with a form of dementia and there are 7.7 million new cases each year. The number of people effected internationally is
estimated to triple by 2050 to

Rheumatoid Arthritis Research Paper
Arthritis is one of the oldest and most chronic disease in the world. As the name suggests "arthr–" meaning joint and "–itis" meaning inflammation,
hence arthritis primarily affects joints, which are the places where bones meet and movement occurs. It is characterized by swelling, pain and stiffness
in the joints.
Almost 8 million adults who report an activity limitation due to arthritis also report of severe limitation in their ability to kneel, bend, or stoop and
about six million are not able walk 0.25 miles
About 31% of working adults with arthritis complain of limitations in work.
The impairment in ability of people with arthritis to perform essential daily tasks interferes with their work, their purpose in community, or the care ...
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One study found that people using an Ayurvedic formula of herbs and minerals with turmeric, winter cherry (Withinia somnifera), boswellia
(Boswellia serrata) and zinc relieved pain and decreased the risk of disability. But it's impossible to discern which herb or what combination was
responsible for this effect.
According to another group of researchers–Human clinical trials haven't found turmeric to be toxic when given at doses of 1–10g a day. In studies,
participants received doses of not only 1–1.5 g (approx.) a day but also up to 8 g a day.
Turmeric increases the effects of anticoagulants or antiplatelet drugs in laboratory studies conducted on animals and test tubes, but the effects on
antiplatelet drugs in humans have yet to be demonstrated.
Secondly, some studies have used an injectable form of curcumin, the active substance in turmeric, which might not be viable for humans.
Last but not the least, some of the studies show conflicting

A Case of a 62 Year Old with Epigastric Pain
Mr. A.M, a 62 year old man presented at the outpatient clinic with a two month history of epigastric pain. He also reported that the pain was
strongly correlated to meals. He also felt that his appetite has decreased, however he did not lose any weight. He has a history of gastroesophageal
reflux disease (GERD), which dates back 5 years ago, which he took proton pump inhibitors for one month. He is smoking for the last 40 years
around one package a day, and does not consume any alcohol. He had an appendectomy when he was 12 years old. Mr. A.M is married and just
retired six months ago from his former job as an accountant. He is currently on an ACE inhibitor for the control of his hypertension. On
examination, he appears comfortable and well. He has an abdominal distention. Chest is clear on auscultation, his blood pressure is 125/75mmHg
and pulse rate is 85/min. He is tender 2cm below the sternum when deep palpation is performed, no lumps are felt, and the pain does not radiate.
Liver is palpable 2cm below costal margins. There is no shifting dullness or fluid thrill. 3. INVESTIGATIONS A referral to the cardiologist was
made to exclude any cardiac causes since the pain Mr. A.M felt was epigastric. Physical examination along with ECG as the preferred test by the
cardiologist did not reveille any abnormalities. CBC count and LFT's were ordered. Mr. A.M was later on referred to a gastroenterologist for focused
examination on the gastrointestinal system.

Gi Pillars Research Paper
GI Pillars Patient Handbook
Introduction
Your digestive system is amazing–it is comprised of a complex network of organs that work together to provide you with the nutrients from the food
you eat, while eliminating harmful substances from your body. Unfortunately, the importance of digestive health is greatly underappreciated.
More Americans are afflicted with digestive disorders than the combined total of those suffering from heart disease, AIDS and cancer. Digestive
illnesses can range from occasional heartburn to terminal cancer. Next to the common cold, gastrointestinal (GI) discomfort is the most common
reason people seek medical advice or turn to over–the–counter remedies.
Like most body systems, the quality of your digestive health ... Show more content on Helpwriting.net ...
Next, the most common solution for digestive insufficiencies is to supplement with digestive aids. Digestive enzymes, bile or bile stimulators,
hydrochloric acid or a combination of these components are available as capsules or tablets. These products may be used as temporary aids to
overcome deficiencies while other therapies are pursued, or they may be used daily, before meals, to improve digestion. Some common digestive aids
are listed below. Be sure to ask your doctor what supplements are best for

Synthesis Synthesis Lab Report
Abstract: Synthesis of new compounds 2–(bis((1H–benzo[d]imidazol–2–yl)methylthio)methyl)–1H–benzo[d]imidazole (6a) and
2–((((1H–benzo[d]imidazol–2–yl)(((5–hydroxy–1H–benzo[d]imidazol–2–yl)methyl)sulfanyl)methyl)sulfanyl)methyl)–3H–benzo[d]imidazol–5–ol (6b)
were carried out under two different reaction conditions, namely the conventional method and microwave irradiation conditions. The compounds
(3a,b), (5a,b) and (6a,b) were synthesized by using microwave methods which showed decrease in the reaction time and increasing in the yield as
shown in Table (1). The structures of the synthesized compounds were confirmed by IR; NMR and elemental analysis. The antimicrobial activityof the
synthesized benzimidazolemethanethiol derivatives... Show more content on Helpwriting.net ...
HCl)33, respectively, with 2–mercaptoacetic acid (2) in the presence of 6M hydrochloric acid under reflux for 4 hours in 70% yield. 1H–NMR
spectrum of 3a , as an example, showed a singlet at 1.7 for SH, singlet at 3.8 for methylene group and benzimidazole protons at 7.4 and 7.6 ppm.
Compounds 3a and 3b were heated with 2,2–dichloroacetic acid (4) and potassium carbonate in absolute ethanol under reflux for 3 hours to give
2,2–bis(((1H–benzo[d]imidazol–2–yl)methyl)thio)acetic acid (5a) in 69% yield and 2,2`–bis(((5–hydroxy–1H–benzo[d]imidazolyl)methyl)thio)acetic
acid (5b) in 66% yield, respectively. Compounds 5a,b gave compatible spectroscopic data (Experimental). Condensation of o–phenylenediamine (1)
with each of 5a,b in the present of 6N hydrochloric acid give
2,2`–((((1H–benzo[d]imidazol–2–yl)methylene)bis(sulfane–diyl))bis–(methylene))bis–(1H–benzo[d]imidazole(6a) in 66% yield,
and2,2`–((((1H–benzo[d]imi–dazol–2–yl)bis(sulfane–diyl)bis(methylene))–bis(1H–benzo–d]imidazol–5–ol) (6b) in 61% yield; Scheme (1). 1H–NMR
of 6a showed a singlet signal at 4.2 ppm for two methylene group, a singlet at 5.1 ppm for CH, 7.4 and 7.7 ppm for aromatic protons. Its 13C–NMR
spectrum showed signal at 36.3 ppm for two methylene groups, 68.8 ppm for methine. 1H–NMR spectrum of (5b) showed a singlet at 4.3 ppm as four
protons for two methylene groups; singlet at 5.3 ppm as one proton for methine group, and 6 aromatic protons at 7.2, 7.4 and 7.6

Stress Related Mucosal Disease ( Srmd )
Stress–related mucosal disease (SRMD), an acute erosive gastritis that may potentially lead to stress ulcers and/or stress–related injuries, remain a
significant concern for patients within the critical care setting.1 The initiation of anti–secretory therapy (AST) for stress ulcer prophylaxis (SUP)
within the critical care setting has gained widespread use as it has been noted to protect against SRMD and clinically important gastrointestinal (GI)
bleeding.2 Although the use of these agents is well established in the critical care setting, several research studies have confirmed the extensive and
inappropriate use of AST in both intensive care unit (ICU) and non–ICU patients, based on current recommendations.3 Proton pump inhibitors, in most
hospital settings, have been the mainstay drug of choice for SUP. Since the introduction of the first proton pump inhibitor (PPI) in the late 1980s, the
use of PPIs has risen dramatically, with sharp increases noted up to 456% in the 1990s.4 As one of the world's most frequently prescribed
medications5, expenditures are estimated to surpass seven billion dollars annually,6 falling only second to HMG CoA reductase inhibitors. There is
strong evidence demonstrating that SUP can be an efficacious and effective preventative care measure. However, a perceived favorable safety profile
has contributed to the significant overutilization of PPIs. STRESS ULCER–RELATED RISK FACTORS Stress ulcers are either single or multiple
gastroduodenal

Helicobacter Pylori Report
Helicobacter pylori
Introduction
Helicobacter pylori, also known as H. pylori, is a spiral bacterium that lives inside the human stomach. H. pylori likes the acidic environment that the
stomach provides and evidence has linked it to a variety of minor gastrointestinal illnesses. H. pylori causes inflammation in the lining of the stomach
and is involved in 90% of stomach and intestinal ulcers. H. pylori also has an apparent cause to the development of adenocarcinoma, a common
stomach cancer. J. Robin Warren first detected H. pylori in the stomachs of ulcer patients in 1979. Warren then isolated the microbe in a culture and
tested it effects by swallowing some of the inoculum. A short–term case of gastritis (inflammation of the lining of the ... Show more content on
Helpwriting.net ...
pylori. One way to test for H. pylori is to do a Breath Test. When taking the breath test, the person has to stop taking antibiotics or Pepto–Bismol up to 2
weeks before the testing. During the test, the swallowing of a special substance that has urea is necessary. The body uses the urea to break down
protein and the urea used for the test is made harmlessly radioactive. If H. pylori is present, the bacteria convert the urea into CO2 which is then
detected and recorded in the persons exhale breath 10 minutes after. This test is very affective in determining whether a person has H. pylori or
not. The next test is a blood test which is used to measure antibodies to H. pylori. The test can only tell if a person has H. pylori antibodies but it
cannot tell if the person currently have the infection or how long they have had the infection. The blood test cannot be used to see if the infection
has been cured after treatment. The third type of test is the stool test that can detect traces of H. pylori in the feces. The stool test can be used to
diagnose the infection and confirm that it has been cured after the treatment. The fourth type of test is a biopsy (a tissue sample) that is taken from
the stomach lining and a biopsy is the most accurate way to tell if a person has H. pylori. To remove the tissue sample from the lining of the stomach
the person has to go through a procedure called an endoscopy and this procedure is done in the hospital. Reasons for needing an endoscopy include
diagnosing the ulcer, treating bleeding, or making sure there is no cancer (Tests for H. pylori,

Symptoms And Treatment Of Laryngopharyngeal Reflux ( Lpr )
Introduction
Laryngopharyngeal reflux (LPR) disease is defined as the backward flow of stomach content up to the throat. It has a wide variety of symptoms in the
paedi–atric population, and is usually associated with many otolaryngological problems such as laryngitis, pharyn–gitis, rhinosinusitis, eustachian tube
dysfunction, recur–
rent otitis media, and otitis media with effusion (OME).1–6
Tasker et al. demonstrated that pepsinogen and pepsin could be found in the middle–ear fluid of OME patients, indicating that LPR disease could be a
significant aetiological factor in the development of OME.7 Helicobacter pylori, a Gram–negative, micro–aerophilic bacterium that can cause infection
of the stomach, is likewise strongly linked to LPR ... Show more content on Helpwriting.net ...
The local ethics committee had approved the study.
Procedure
A pilot study was conducted, in which 10 children with OME, with positive H pylori stool antigen results, were subjected to ventilation tube insertion
under general anaesthesia. Middle–ear fluid was aspirated with a micro–aspiration cannula (blood contamination was entirely avoided; effusion
samples were collected under completely sterile conditions). Gastric lavage was performed with an orogastric Nelaton catheter. This was inserted into
the stomach, and 10 cc of saline solution was injected and subsequently aspirated back into the injector. All ear and gastric lavage samples were
processed within 4 hours of collection. They showed positive reactions for catalase, oxidase and urease. In addition, polymerase chain reaction
ana–lysis revealed that all were positive for H pylori infection.
For the main study, all stool samples of the 258 chil–dren diagnosed with bilateral OME were examined for H pylori using the H pylori stool antigen
test.12 In total, 124 children were negative for H pylori stool antigen and received standard OME therapy of amoxicillin–clavulanate (90 mg/kg/day)13
for 4 weeks. A total of 134 children were positive for H pylori stool antigen. The H pylori positive children were equally and ran–domly allocated either
to a control group or a study group, each with 67 children. The control group

Differential Diagnosis : How Asthma Should Be Considered...
Differential Diagnosis:
Several diseases that mimic asthma should be considered during the assessment of a child with severe or difficult asthma (Table 2). These include:
structural airway abnormality, Intrabronchial obstruction, aspiration, gastroesophageal reflux with/without recurrent microaspiration, cystic fibrosis,
ciliary dyskinesia, immune dysfunction, bronchiectasis, pulmonary edema, lung disease of prematurity, bronchiolitis obliterans syndrome,
hypersensitivity pneumonitis.
Laboratory, Pulmonary Function, Bronchoscopic Evaluation:
Assessment of a child with severe or difficult asthma may include physiological measurements such as pre– and post–bronchodilator spirometry and
body plethysmography. It can include assessment of airway inflammation such as FENO,, sputum eosinophils , bronchoscopy with bronchoalevolar
lavage and bronchial biopsy, and tests for allergic sensitization such as specific allergen IgE or aeroallergen skin prick tests or more evaluation for
comorbidities or diseases that mimic asthma(Table 2). Lastly, the coexistence of corticosteroid receptor and pharmacokinetic abnormalities has been
linked to a poor response to corticosteroids in children. Therefore, corticosteroid sensitivity testing done at specialized centers could be considered such
as a corticosteroid pharmacokinetic studies and corticosteroid lymphocyte stimulation assays. [54,55]ATS/ERS 2014 guidelines on severe asthma
suggested that chest CT scans be done only when atypical

My Plan Of Care Must Be Based On Patient Teaching And...
Our plan of care must be based on patient teaching and instruction to help resolve the persistent gastrointestinal conditions. This patient's treatment is
going to be divided in: non–pharmacological measures (lifestyle changes) and pharmacological measures.
Diet: The patient should stop eating food and beverage that can increase the acid production and irritation in the stomach such as: fast food, spicy food,
seasoning food, "too hot too cold" foods and beverage–containing caffeine, cocoa, chocolate, mint and citric. This patient can benefit from a balance
fiber rich: whole grains, fruits (no citric), vegetables and fat–free or low–fat dairy foods, low sodium, cereals, pasta, and brown rice. The patient should
select lean meats like chicken, turkey, and some types of fish, beans, eggs, and nuts. The rich diet in fruits and vegetables; apples, cranberries, onion,
garlic, celery, and tea have shown to prevent the development of Helicobacter Pylori. In addition, spicy foods, coffee, alcohol, and sodas can aggravate
the symptoms. We need to be very careful in this patient diet because he is suffering from hypertension, PUD (peptic ulcer disease) and gout. We
should provide the patient a list of these dietary instructions and if possible educative handouts and ask the patient to repeat the instructions provided
(Hinkle & Cheever, 2014). The patient can also benefits form the DASH diet (Diet for hypertensive patients). This diet is a balanced diet program
effective on reducing

Pathogram: Chronic Respiratory Failure Essays
Chronic Respiratory Failure Shelby Lynch Date of Care: 03/19/2013 Chamberlain College of Nursing NR 340: Critical Care |Assessment |Medical
/Nursing Diagnoses |Treatment | |Brief review of the patient |Medical Diagnoses: |Therapeutic Modalities | |Age: 86 years old |Admitting Diagnosis:
|–Continuous vital... Show more content on Helpwriting.net ...
These are common |–EKG monitoring– to monitor the electrical activity of the heart and dysrhythmias. | |right–sided CVA with left hemiparesis. He is
|manifestations of respiratory failure. |–Colostomy: to divert incontinent stools away from decubitus ulcer. | |nonverbal and is able to move only his
right arm| |–Wound VAC set at 125 mm Hg: to help wound healing by delivering negative pressure at the wound site| |and leg. |Febrile illness
– is a type
of illness characterized by a |to draw wound edges together, remove infectious materials and actively promote granulation. | |Course of current
hospitalization: |sudden onset of fever, which is an increase in internal |Routine Care | |The patient arrived at M Hospital 3/18/2013 with|body
temperature to levels above normal. Is usually caused |–ET feeding diet: due to inability to consume food by mouth as a result of inability to swallow |
|a chief complaint (from family) of worsening of |by the presence of a bacterial or viral infection. Febrile |secondary to CVA | |condition and
respiratory difficulty. The |illness can be an indicator

Fixed Drug Eruptions
A young male patient used the fixed dose combinations with of different fluoroquinolones and nitroimidazoles several times in the last few years for
self–treating repeated episodes of diarrhoea and loose motion, and each time experienced fixed drug eruptions that increased in number and severity on
subsequent occasions. Suspecting association between the drug and the rashes, the patient each time discontinued the treatment prematurely, and
preferred to switch to a similar formulation but with different molecules of fluoroquinolone (ciprofloxacin or ofloxacin) and nitroimidazole (tinidazole
or ornidazole) next time. The patient presented with multiple, round–to–oval, well–defined, hyperpigmented cutaneous patches of different dimensions,
present all over the body. He appeared to have run out of options and therefore consulted us seeking advice how he should treat himself next time he
suffered from diarrhoea. Causality assessment by Naranjo's algorithm revealed a definite relationship between the cutaneous adverse reaction and the
offending drug. He was counselled regarding medication in general and advised, in particular, to avoid the tendency to self–treat any future episode of
diarrhoea. Keywords: Self Medication, Drug Combinations, Drug Eruptions, Fluoroquinolones, Nitroimidazoles INTRODUCTION: Fixed drug
eruptions (FDE) are a distinct type of drug eruptions that appear as pruritic, well circumscribed, round or oval–shaped, erythematous macules or
edematous plaques,

Advantages And Disadvantages Of Turmeric
TURMERIC, THE GOLDEN SPICE
INTRODUCTION:
Plants , Is their existence a miracle for healing the various loopholes in health occurring throughout history?
Plants have been the basis for the medical treatment of the most complicated health issues through much of human history ,and the traditional practices
have become a need and a boon to the society .
Natural plant products have been a part of human history for various purposes. The natural products are derived from nature billions of years old. Tens
of thousands of these products are produced in the form of secondary metabolites by higher plants and act as a natural defense mechanism against
disease and infection.
Turmeric ,a plant has a very long history of medicinal use, dating back nearly ... Show more content on Helpwriting.net ...
Cold Remedy – Turmeric boosts immune function, which is key when fighting a cold or other viral illness.
ADVANTAGES AND DISADVANTAGES:
The advantages of turmeric are endless in different forms to help in various ways with smallpox, shingles, chickenpox, scabies, tuberculosis, HIV
/AIDS, fibromyalgia, liver problems, kidney disorders, parasitic infections, expelling phlegm, eye infections, itchiness, worms, eczema, loss of appetite,
blood circulation, anemia, detoxing blood and organs, hemorrhage and anti–aging. Turmeric juice has been used for morning sickness in pregnancy,
scorpion stings, and snakebites. Turmeric oil has been used as a mosquito repellent.
Eating raw root or dried powder can help absorption easily when combined with essential oils.
Side Effects of Turmeric
Stomach problems: Turmeric taken in large quantities, for a long period of time can cause nausea, stomach upset and sweating in some people.
Even diarrhea is experienced by some people .
Bleeding: Studies conducted on animals have found that in some cases turmeric could result in excessive bleeding in those who are susceptible.
Blood pressure: High dosage of turmeric can lower blood pressure. Hence, it could react with medication taken for high blood

Lansoprazole
Introduction
The stomach naturally produces acid, which is mainly responsible for food digestion and destruction of any foreign pathogen or bacteria ingested with
food. Acid is secreted by stimulating the partial cells located in the inner lining of the stomach to release acid in response to a stimulant of food
ingested, sight of food, smell, or taste. This acid secretion renders the stomach pH to be very low, this strong acid is an irritant to the stomach. In
protection of the stomach, a mucus layer is present to shield the lining of the stomach from damage caused by the acid. When this protective mucus
layer is damaged, ulcers are formed and even to the point of perforation of stomach (hole that causes a bleed in the stomach).
This damage ... Show more content on Helpwriting.net ...
This is based on case control studies mentioned in the article on long–term use of PPIs. In other words, patients who are chronically using PPIs must
watch their intake of PPIs to prevent long–term adverse effects leading to osteoporosis causing bone fractures. The correlation was shown as a result
of a high variable effect of acid suppression on calcium absorption.
Researchers tried to investigate the difference between proton pump inhibitors and found consistent common pharmacology between all drugs in this
class4 (Omeprazole, Esosenoprazole, Lansoprazole, Pantorapzole, and Rabeprazole) that were compared in this study. In this article relating to the
clinical and pharmacological basis stated that Lansoprazole is equipotent to Omeprazole as well as Pantoprazole. This finding is still very consistent
with previous articles supporting the similar potencies and effectiveness of

What Is Peptic Ulcer Disease?
Peptic Ulcer Disease Rebecca Hang Id number Peptic ulcer disease also known as PUD, is a disease in which hydrochloric acid and pepsin comes
into contact with a tissue in the GI tract causing injury to that area. The area that peptic ulcer occur most is the first portion of the small intestine which
is called the duodenum. It occurs in the duodenum due to the acidic chyme that enters the small intestine. Another area for peptic ulcer is between the
stomach and the esophagus due to reflex of stomach content that contains acids. Other possible area is the stomach and the jejunum if surgery was use
to connect it together. Men that are in their middle age are more likely to have peptic ulcer disease. Peptic ulcer... Show more content on Helpwriting.net
...
The pain can follow 1 to 2 hours after eating and it can interfere with sleep. The pain may be reduce by eating food, because the food thins out the
stomach acids. Some client may present with back pain due to the ulcer affecting the pancreas. The first sign of ulcer, in about 20% of client is
bleeding (hemorrhage, hematemesis or melena). Later, weight loss and vomiting can

Gerd
LAPAROSOPIC SURGERY FOR GASTROESOPHAGEAL REFLUX DISEASE Gastroesophageal reflux is the most common gastrointestinal
disorder of the western world. Gallup poles have elucidated that approximately 44 % of the adult population in the U.S. has some abnormal reflux of
acidic gastric juices into the esophagus on a monthly basis. Roughly 10% of patients require daily acid suppression medication for relief of symptoms.
GERD accounts for over 1.0 million out patient visits to physicians every year! Gastroesophageal reflux disease, or GERD, occurs when the lower
esophageal sphincter (LES) does not close properly, and stomach contents splash back, or reflux, into the esophagus. The LES is a ring of muscle
located at the far end of the esophagus as ... Show more content on Helpwriting.net ...
The goals of therapy for GERD include: a) Symptomatic relief; b) Resolution of esophagitis (inflammatory changes of the esophagus as a result of
abnormal acid exposure); and c) Prevention of complications.
Lifestyle Changes
The first step in treating GERD includes lifestyle and diet modifications: And these are usually very effective.
1.Elevate the head the head of your bed. You must place blocks under the bed post. Pillows will not help. Patients with GERD tend to have more
frequent and longer episodes of reflux in the supine position than normal individuals.
2.Try to limit or avoid foods that can exacerbate GERD. This includes decreasing alcohol intake. Eat small meals.
3.DO NOT SMOKE. Aside from it's effect on LES and GERD, it can cause you a multitude of serious life and limb threatening problems. But you
already knew that. Right?!
4.If possible, lose weight. Excess weight can increase intra–abdominal pressure sufficient enough to overcome the resting pressure of the LES.
5.Avoid tight fitting clothes.
6.Avoid lying down for several hours after eating.
Medical Therapy
If at all possible, try to avoid medications that act to lower the LES pressure. (see above)
Antacids, such as ALKA–SELTZER, MAALOX, MYLANTA, PEPTO–BISMOL, ROLAIDS, and RIOPAN, are usually the first drugs recommended
to relieve heartburn and other mild GERD symptoms. Many brands on the market

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