GERD is the commonest GI problem afflicting the mankind. The cause is lax LES which is just opposite to Achalasia cadia. That is why GERD is also known as Chalasia cardia.
GERD is the commonest GI problem afflicting the mankind. The cause is lax LES which is just opposite to Achalasia cadia. That is why GERD is also known as Chalasia cardia.
This presentation is to help readers to be equipped with knowledge on predisposing factor to peptic ulcer disease and how it can be managed in the clinical/hospital setup.
Different esophageal disorders are discussed in this lecture. The learning objectives are to understand:
The anatomy and physiology of the oesophagus and their relationship to disease.
The clinical features, investigations, and treatment of benign and malignant disease with particular reference to the common adult disorders.
Topics include: Surgical anatomy, Physiology, Symptoms, Investigations, Congenital lesions: TOF and Atresia, Benign tumours, Cancer of oesophagus, Foreign bodies,Oesophageal perforation, Gastro-oesophageal reflux diease, Hiatal hernia,
Oesophageal motility disorders: achalasia and diffuse spasm, Oesophgeal diverticula.
and Others.
This presentation is to help readers to be equipped with knowledge on predisposing factor to peptic ulcer disease and how it can be managed in the clinical/hospital setup.
Different esophageal disorders are discussed in this lecture. The learning objectives are to understand:
The anatomy and physiology of the oesophagus and their relationship to disease.
The clinical features, investigations, and treatment of benign and malignant disease with particular reference to the common adult disorders.
Topics include: Surgical anatomy, Physiology, Symptoms, Investigations, Congenital lesions: TOF and Atresia, Benign tumours, Cancer of oesophagus, Foreign bodies,Oesophageal perforation, Gastro-oesophageal reflux diease, Hiatal hernia,
Oesophageal motility disorders: achalasia and diffuse spasm, Oesophgeal diverticula.
and Others.
Benigne diseases of stomach are one of the serious conditions of our world.... so here u get littlebit information about these diseases...hope it will help you for your future study about these diseases... thank you.
Gastroparesis in Chronic Kidney DiseaseVishal Bagchi
· Identify the common causes of gastroparesis in CKD · Overview of gut physiology
· Differentiate gastroparesis vs. other GI issues and their symptoms "· Provide comparison of gastroparesis & other common GI issues in CKD
· Testing and findings"
· Compare and contrast various evidence-based treatments for gastroparesis "· Review efficacy of current treatments in CKD for gastroparesis
· Cite what providers can safely advise patients to reduce symptoms"
Gastroesophageal reflux disease in children.Indian Society of Pediatric Gast...Vijitha A S
Gastroesophageal reflux disease in children.Indian Society of Pediatric Gastroenterology, Hepatology and Nutrition (ISPGHAN) 2022 update
DR VIJITHA A S
Surgical management of gastroesophageal reflux disease (GERD) and hiatal hernia is an approach used when conservative treatments fail to provide adequate relief or in cases where complications arise. GERD is a condition characterized by the backward flow of stomach acid and contents into the esophagus, leading to symptoms such as heartburn, regurgitation, and chest pain. Hiatal hernia, on the other hand, occurs when a portion of the stomach protrudes through the diaphragm into the chest cavity.
The surgical treatment of GERD and hiatal hernia aims to reinforce the lower esophageal sphincter (LES) and repair the anatomical defect in the diaphragm. This is typically achieved through a procedure called fundoplication, which involves wrapping a portion of the upper stomach (fundus) around the lower esophagus to create a new valve-like mechanism. This reinforces the LES and helps prevent the backflow of stomach acid into the esophagus.
There are different surgical techniques available for fundoplication, including open surgery and minimally invasive procedures such as laparoscopic or robotic-assisted surgery. Laparoscopic surgery involves making small incisions in the abdomen and using specialized instruments and a tiny camera to perform the procedure. Robotic-assisted surgery utilizes robotic arms controlled by the surgeon to perform precise movements during the operation.
The advantages of minimally invasive techniques over traditional open surgery include smaller incisions, reduced postoperative pain, faster recovery, and shorter hospital stays. However, the choice of surgical approach depends on various factors, including the patient's overall health, the size of the hiatal hernia, and the surgeon's expertise.
Surgical management of GERD and hiatal hernia can provide long-term relief from symptoms and improve the quality of life for many patients. However, as with any surgery, there are potential risks and complications involved, such as infection, bleeding, difficulty swallowing, and gas-related discomfort. It is important for patients to discuss the potential benefits and risks with their healthcare provider and undergo a thorough evaluation before considering surgical intervention.
Overall, surgical management plays a crucial role in the treatment of GERD and hiatal hernia, particularly for individuals who do not respond well to medication or lifestyle modifications. It offers an effective solution to restore the normal functioning of the lower esophageal sphincter and repair the anatomical defect, providing relief from symptoms and reducing the risk of complications associated with these conditions.
Dysphagia is an important problem in surgical patients. I have discussed Introduction, Zenker's diverticulum, GERD, Achalasia Cardia and Carcinoma Esophagus. If you watch all these videos together, i assure you that you will become confident in managing a case of dysphagia.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
2. GERD
GERD is one of the most prevalent
gastrointestinal disorders
Population-based studies show that up to 15% of
individuals have heartburn and/or regurgitation
at least once a week, and 7% have symptoms
daily
2
DrShuaibAnsari
3. The normal antireflux mechanisms consist of
LES
crural diaphragm
anatomical location of the gastroesophageal junction below
the diaphragmatic hiatus.
3
DrShuaibAnsari
8. CLINICAL FEATURES
Heartburn: The burning is aggravated by bending, lifting
weight, straining or lying down and may be relieved by
antacids
Regurgitation of sour material into the mouth
Dysphagia due to esophageal spasm/stricture
Bleeding occurs due to mucosal erosions or Barrett's ulcer
Many patients with GERD remain asymptomatic
Extraesophageal manifestations of GERD :
chronic cough, laryngitis,pharyngitis, hoarseness
chronic bronchitis, asthma, pulmonary fibrosis, chronic
obstructive pulmonary disease, or pneumonia
Rapidly progressive dysphagia and weight loss may
indicate the development of adenocarcinoma in Barrett's
esophagus
8
DrShuaibAnsari
12. INVESTIGATIONS
1. Upper GI Endoscopy:
It is the investigation of choice
Done to see esophigitis, strictures
Barret’s mucosa can be confirmed by biopsy
2. Ambulatory 24-hour pH monitoring : Gold Standard for
diagnosis. It shows a sudden decrease in intraesophageal
pH from above to below 4.0
3. Barium swallow and meal : Hiatus hernia
4. Esophageal motility test (Esophageal Manometry)
5. Bernstein test: A test to find out if heartburn is caused by
acid in the esophagus. The test involves dripping a mild
acid, similar to stomach acid, through a tube placed in the
esophagus and see whether heartburn occurs or not.
6. EKG: to rule out CAD
12
DrShuaibAnsari
14. DrShuaibAnsari
14
Reflux oesophagitis. The
gullet is inflamed and
ulcerated (small arrows)
and there is early
stricturing (large arrow).
Barrett's oesophagus. Pink
columnar mucosa extends
up the gullet. Small
islands of squamous
mucosa remain (arrow).
15. MANAGEMENT
A. General measure:
Weight reduction
Cessation of smoking
Small volume frequent meals
Avoid alcohol, fatty food, caffeine
Avoid late night meals
Head end of bed should be eleveted to 15
degree angle
15
DrShuaibAnsari
16. B. Medical treatment:
1. Liquid antacid: 10-15 ml TID
2. H2 receptor antagonists like ranitidine 150mg orally
BD for 6-8 weeks
3. PPIs (Proton pump inhibitors): Omeprazole 20-40
mg/day; Lansoprazole 15-30mg/day; pantoprazole
40mg/day; Esomeprazole 40mg/day for 6-8 weeks
4. Metoclopramide or domperidone 10 mg TID
(increases lower gastroesophageal tone and
promotes gastric emptying)
5. Esophageal strictures: repeated esophageal
dilatations
6. Anemia: Oral iron, Blood transfusion
16
DrShuaibAnsari
18. I’m worried
and concerned
GI symptoms
bother me!
My whole life is
affected
Heartburn
disturbs my
sleep
I cannot eat and
drink whatever
I like
I cannot bend
over or exercise
LES forms normal barrier between positive pressure in stomach and negative pressure in chest created by increased pressure of LES and crural diaphragm which is attached to the esophagus by the phrenoesophageal ligament
