Electrolytes are minerals which are present in the blood and body tissues and are essential for metabolism, for proper nerve and muscle functioning, for maintenance of proper water balance, and proper blood pH (acid-base balance). The serum electrolyte test includes a group of tests to measure the following electrolytes: Sodium (Na+), Potassium (K+) and Chloride (Cl-).
Reference: https://www.1mg.com/labs/test/serum-electrolyte-1761
It is fluid which is present in the pleural cavity of
lungs b/w parietal pleura n visceral pleura.
The pleural cavity is a potential space lined by
mesothelium of the visceral n parietal pleura.
Electrolytes are minerals which are present in the blood and body tissues and are essential for metabolism, for proper nerve and muscle functioning, for maintenance of proper water balance, and proper blood pH (acid-base balance). The serum electrolyte test includes a group of tests to measure the following electrolytes: Sodium (Na+), Potassium (K+) and Chloride (Cl-).
Reference: https://www.1mg.com/labs/test/serum-electrolyte-1761
It is fluid which is present in the pleural cavity of
lungs b/w parietal pleura n visceral pleura.
The pleural cavity is a potential space lined by
mesothelium of the visceral n parietal pleura.
The Urine Culture Test is performed to detect and diagnose a microbial infection of the urinary tract.
For more information, visit https://www.1mg.com/labs/test/culture-urine-2232
Estimation of Blood Urea Nitrogen by Dr. TehmasTehmas Ahmad
Lecture/Demonstration of Biochemistry Practical of Blood Urea Nitrogen estimation in serum Delivered on 11-04-2018 to 2nd year MBBS students of Bannu Medical College, Bannu.
KFT are used for evaluating kidney functions. there are several routine tests such as urea, creatinine and uric acid. Calculation of eGFR is recommended by national kidney organization whenever creatinine serum is measured.
Pathological analysis of body fluids with lab investigations,
Including Amniotic fluid, Semen analysis, Synovial fluid, Gastric fluid
Other body fluids: Sweat,saliva,tear
The slides show the gastric and pancreatic function test along with the significance of these tests and the conditions in which the values of which increase.
The Urine Culture Test is performed to detect and diagnose a microbial infection of the urinary tract.
For more information, visit https://www.1mg.com/labs/test/culture-urine-2232
Estimation of Blood Urea Nitrogen by Dr. TehmasTehmas Ahmad
Lecture/Demonstration of Biochemistry Practical of Blood Urea Nitrogen estimation in serum Delivered on 11-04-2018 to 2nd year MBBS students of Bannu Medical College, Bannu.
KFT are used for evaluating kidney functions. there are several routine tests such as urea, creatinine and uric acid. Calculation of eGFR is recommended by national kidney organization whenever creatinine serum is measured.
Pathological analysis of body fluids with lab investigations,
Including Amniotic fluid, Semen analysis, Synovial fluid, Gastric fluid
Other body fluids: Sweat,saliva,tear
The slides show the gastric and pancreatic function test along with the significance of these tests and the conditions in which the values of which increase.
This power point presentation include the definition of the peptic ulcer, formation of peptic ulcer, regulation of gastric acid secreation, sign and symptomes, etiology of chronic ulceration, acid- pepsin vs mucosal resistance, gastric hyper secreation, disease complication, infection and obstruction, different factors related to acid secreation, classification of drugs used in peptic ulcer animal models in experimental peptic ulcer in both in-vivo and in- vitro
Screening models for evaluation of anti ulcer activitySIVASWAROOP YARASI
A sore that develops on the lining of the oesophagus, stomach or small intestine.
Ulcers occur when stomach acid damages the lining of the digestive tract. Common causes include the bacteria H. Pylori and anti-inflammatory pain relievers including aspirin.
Upper abdominal pain is a common symptom.
Treatment usually includes medication to decrease stomach acid production. If it is caused by bacteria, antibiotics may be required.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
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.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
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
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
2. INTRODUCTION
IT CONSIST OF QUANTITATION OF GASTRIC ACID PRODUCED BY STOMACH.
GASTRIC JUICE IS COLLECTED BY NASOGASTRIC TUBE AND GASTRIC ACID IS
QUANTITATED BY TITRATION WITH SODIUM HYDROXIDE SOLUTION.
ANATOMY OF STOMACH:
HAVE FOUR DIFFERENT PARTS:
1) CARDIA
2) FUNDUS
3) BODY
4) PYLORIC
3. Cont...
1) CARDIAC ZONE: LINED BY MUCUS SECRETING EPITHELIUM
2) FUNDUS AND BODY:
i) MUCUS SECRETING CELLS: WHICH PROTECT GASTRIC MUCOSA FROM SELF
DIGESTION BY FORMING AN OVERLYING THICK LAYER OF MUCUS.
ii) PARIETAL CELLS: SECRET HCL AND IF(INTRINSIC FACTOR)
iii) PEPTIC AND CHIEF CELLS: SECRET PROTEOLYTIC ENZYME CALLED PEPSINOGEN.
3)PYLORIC PART: LINED BY MUCUS SECRETING CELLS AND G-CELLS (GASTRIN
SECRETING NEUROENDOCRINE CELLS)
4. PHYSIOLOGY OF STOMACH
• FOOD INGESTED GET CONVERTED IN CHYME BY MECHANICAL AND CHEMICAL
BREAKDOWN
• CHYME PASSED TO DUODENUM ONCE PYLORIC SPHINCTER IS RELAXED.
GASTRIC ACID SECRETION HAPPEN IN 3 PHASE.
i) CEPHALIC/ NEUROGENIC PHASE
ii) GASTRIC PHASE
iii) INTESTINAL PHASE
5. Cont..
i) CEPHALIC/NEUROGENIC PHASE:
ACTIVATED BY SIGHT, SMELL, TASTE OR THOUGHT OF FOOD THAT CAUSES
STIMULATION OF VAGAL NUCLEI IN THE BRAIN
VAGUS NERVE ACT ON PARIETAL CELLS AND SECRET HCL AND ACT ON G-CELLS
WHICH HELPS IN SECRETION OF GASTRIN.
ii) GASTRIC PHASE:
ENTRY OF SWALLOWED FOOD INTO STOMACH CAUSE GASTRIC DISTENTION AND
INDUCE GASTRIC PHASE.
Distension of antrum and increase in ph to neutralize acid when food reach
stomach activate G cells which secrete gastrin.
6. Cont..
iii) INTESTINAL PHASE:
ENTRY OF DIGESTED PROTEIN INTO DUODENUM CAUSES AN INCREASE IN ACID
OUTPUT FORM THE STOMACH.
CERTAIN HORMONES AND ABSORBED AMINO ACIDS STIMULATE PARIETAL CELLS TO
SECRET ACID.
7. Composition of Gastric juice:
HCL(Parietal cells):
Secretion is stimulated by histamine, acetylcholine(ACH), gastrin and
Inhibited by somatostatin (D cells of pancrease)
INTRINSIC FACTOR (Parietal cells):
HELPS IN ABOSORPTION OF VITAMIN B12 IN TERMINAL ILEUM
Pepsin (Chief cells):
SECRETION IS STIMULATED BY VAGUS NERVE..
HELPS IN DIGESTION OF PROTEIN LEAD TO FORMATION OF LARGE POLYPEPTIDE
MOLECULE.
Mucus
8. INDICATIONS OF GASTRIC ANALYSIS
• AMOUNT OF ACID SECRETED BY THE STOMACH IS DETERMINED ON GASTRIC
JUICE SAMPLE
• GASTRIC ACID OUTPUT IS ESTIMATED BEFORE AND AFTER STIMULATION OF
PARIETAL CELLS.( BASAL , PEAK ACID OUTPUT)
• USE TO RULE OUT PEPTIC ULCERS.
1) To determine recurrent peptic ulcer disease
i) DETECT ZOLLINGER-ELLISON SYNDROME:
RARE DISEASE IN WHICH MULTIPLE MUCOSAL ULCERS DEVELOPS IN THE
STOMACH, DUODENUM AND UPPER JEJUNUM DUE TO GROSS HYPERSECRETION OF
ACIDS IN STOMACH
EXCESSIVE ACID PRODUCTION IS BECAUSE OF GASTRIN PRODUCING TUMOR OF
PANCREASE.
9. Cont..
ii) DETERMINE THE CAUSE OF RAISED FASTING SERUM GASTRIN LEVEL:
Hypergastrinemia can be seen in
• ACHLORHYDRIA
• Z-E SYNDROME
• ANTRAL G-CELL HYPERPLASIA
iii) TO SUPPORT DIAGNOSIS OF PERNICIOUS ANAEMIA(PA):
• FAILURE OF SYNTHESIS IN INTRINSIC FACTOR RESULT DEFICIENT DEFECTIVE
ABSORPTION OF VITAMIN B12.
• GASTRIC ANALYSIS CAN BE DONE IN ABSENCE OF SCHLLING TEST.
iv) DISTINGUISH BETWEEN BENIGN AND MALIGNANT ULCER:
• HYPERSECRETION OF ACID LEADS TO DUODENAL PEPTIC ULCER.
• ACHLORHYDRIA—GASTRIC CARCINOMA
10. v) TO DECIDE THE TYPE OF SURGERY TO BE PREPARED IN A PATIENT WITH PEPTIC
ULCER
• GASTRECTOMY
• VAGOTOMY
vi) DYSPEPSIA (DIGESTIVE DYSFUNCTION).
11. METHODS OF GASTRIC ANALYSIS
• TO ASSESS THE GASTRIC ACID SECRETION IN FASTING STATE AND AFTER INJECTING
PENTAGASTRIN ( DRUG STIMULATING GASTRIC ACID SECRETION)
i) BA0 (BASAL ACID OUTPUT): AMOUNT OF HCL SECRETED WITHOUT ANY
EXTERNAL STIMULI (VISUAL, OLFACTORY AND AUDITORY)
ii) MAO (MAXIMUM ACID OUTPUT): MAXIMUM AMOUNT OF HCL SECRETED BY
STOMACH FOLLOWING STIMULATION OF PENTAGASTRIN. FIRST FOUR SAMPLE IN
GAP OF 15 MINUTES ARE ANALYSED AFTER SITMULATION
iii) PAO (PEAK ACID OUTPUT): CALCULATED FROM FIRST FOUR 15 MINUTES
SAMPLES, INDICATES GREATEST POSSIBLE ACID SECRETORY CAPACITY AND IS
PREFERRED OVER MAO.
12. COLLECTION OF SAMPLES:
Patient preparation:
DRUGS AFFECTING ACID SECRETION SHOULD BE AVOIDED FOR 24HRS.
(Eg: ANTACIDS, ANTIHISTAMINE, ANTIDEPRESSENTS, TANQUILIZERS)
PROTEIN PUMP INHIBITORS (E.g: Pentaprazole) SHOULD BE STOPPED PRIOR 5 DAYS
TO THE TEST.
PATIENTS SHOULD BE RELAXED AND FREE FROM ALL SOURCE OF SENSORY
STIMULATION.
SHOULD BE OVERNIGHT FASTING
SAMPLE CAN BE ASPIRATED ORALLY OR BY NASOGASTRIC TUBE(PVC, SILICONE) OR BY
ENDOSCOPY PROCEDURE..
MOST COMMONLY USED METHOD IS ORAL OR NASOGASTRIC SECRETION..
13. PROCEDURE:
• INSERTED ORALLY OR BY NOSE
• IT IS A FLEXIBLE TUBE HAVING A SMALL DIAMETER AND BULBOUS END WHICH IS
MADE HEAVY BY A SMALL WEIGHT OF LEAD.
• END IS PERFORATED WITH SMALL HOLES TO ALLOW ENTRY OF GASTRIC JUICE
INTO TUBE
• END OF TUBES ARE RADIOPAQUE AND HELP IN POSITIONING UNDER
FLUROSCOPE OR X-RAY GUIDANCE
• THE PATIENT IS EITHER SITTING OR RECLINING ON LEFT SIDE
• TUBE HAVE MARKING ON IT
40CM= TIP TO ESOPHAGEAL JUNCTION
50CM= BODY OF STOMACH
57CM= PYLORIC ANTRUM
65CM= DUODENUM
15. Continue…
• POSITION CAN BE VERIFIED BY FLUROSCOPE OR BY WATER RECOVERY TEST.
• WATER RECOVERY TEST: 50ML OF WATER IS INSERTED INSIDE PATIENT BODY, IF
90% OR MORE WATER IS RECOVERED BACK IT IS BELIEVED THAT NASOGASTRIC
TUBE IS PLACED PROPERLY.
FOR ESTIMATION OF BAO(BASAL ACID OUTPUT):
FASTING 12HRS- OVERNIGHT SECRETION IS ASPIRATED AND DISCARDED
FOLLOWED BY ASPIRATION OF GASTRIC JUICE SECRETION AT 15 MINUTES
(INTERVAL OF 1HR – 4 SAMPLES ARE REQUIRED)
CENTRIFUGE AND REMOVE PARTICULATE MATTER,
EACH SAMPLE IS ANALYSED FOR VOLUME,PH, ACIDITY
ACID OUTPUT OF ALL SAMPLES IS SUMMED UP AND RESULT IS EXPRESSED IN
mmol/hr
16. Cont..….
AFTER BAO,
• PENTAGASTRIN (6mg/kg body weight) injected to patient subcutaneously/
intramuscular
• IMMEDIATELY AFTER 15 MINUTES 4 SAMPLES ARE COLLECTED WITH GAP OF 15
MINUTES TILL 1HR FOR ESTIMATION OF MAO & PAO.
• MAO IS CALCULATED FROM THE FIRST FOUR 15 MINUTES SAMPLE AFTER
STIMULATION.
• PAO IS CALCULATED FROM TWO CONSECUTIVE 15 MINUTES SAMPLES SHOWING
HIGHEST ACIDITY.
17. CONTRAINDICATIONS TO GASTRIC ANALYSIS
NOT COMMONY PERFORMED BECAUSE
i) IT IS AN INVASIVE PROCEDURE THAT IS TARUMATIC AND UNPLEASENT FOR
THE PATIENTS.
ii) INFORMATION OBTAINED IS NOT DIAGNOSTIC IN ITSELF.
18. TITRATION:
• GASTRIC ACIDITY IS ESTIMATED BY TITRATION WITH END POINT BEING
DETERMINED EITHER BY NOTING THE CHANGE IN COLOR OF INDICATOR
SOLUTION OR TILL THE DESIRED PH IS REACHED.
• EXPRESSED IN mmol/ltr.
19. Cont..
FREE ACIDITY:
• Refer to the concentration of HCL present in a free or uncombined form in
a solution.
• Alkali +gastric acid (Topfer’s reagent added as a indicator) Or ph when
reach 3.5 measure free acidity
COMBINED ACIDITY:
• AMOUNT OF HCL COMBINE WITH PROTEIN AND MUCIN WITH OTHER WEAK
ACIDS PRESENT IN THE GASTRIC JUICE..
TOTAL ACIDITY:
• SUM OF COMBINED AND FREE ACIDITY IS TOTAL ACIDITY.
• ALKALI IS ADDED TO ACID WHICH CHANGE COLOR AND MEASURE TOTAL ACIDITY.
20. INTERPRETATION OF RESULT:
i) VOLUME:
Normal: 20-100 ( usually less than 50 ml)
Cause of increase volume of acids:
Delayed emptying of stomach pyloric stenosis (narrowing).
Increase gastric secretion duodenal ulcer and ZE syndrome
ii) Colour:
Normal colourless with faint pungent odour.
Red: fresh blood in seen in trauma, bleeding from ulcer/ cancer.
Brown: old haemorrhage
Yellowish green: Bile regurgitation
21. Cont….
iii) pH: normal (1.5-3.5)
More than 7 pH indicate Achlorhydria.
iv) BAO: normal upto 5mEq/hr
Duodenal ulcer: 5-15 mEq/hr
ZE syndrome: more than 20 mEq/hr
Normal BAO seen in gastric ulcer and in some patients with duodenal ulcer.
v) PAO: normal: 1-20 mEq/hr
Duodenal ulcer: 20-60 mEq/hr
ZE syndrome: >60 mEq/hr
Achlorhydria: 0 mEq/hr
Normal PAO seen in gastric ulcer and gastric carcinoma.
22. Other test for gastric analysis:
i) Hollander’s test ( insulin hypoglycemia test):
DONE FOR THE CONFIRMATION OR COMPLETENESS OF VAGOTOMY.
HYPOGLYCEMIA IS A POTENT STIMULUS FOR GASTRIC JUICE SECRETION AND IS
MEDIATED BY VAGUS NERVE.
PROCEDURE:
0.15-0.2 UNITS/KG OF INSULIN IS ADMINSTERED INTRAVENOUSLY
AND ACID OUTPUT IS ESTIMATED EVERY 15 MINUTES UPTO 2HRS ( 8 SAMPLES WILL
BE COLLECTED.
VAGOTOMY IS COMPLETE WHEN BLOOD GLUCOSE IS <45mg/dl ( which is insulin
induced hypoglycemia).
23. Cont…
DISADVANTAGE OF HOLLANDER TEST:
CHANCES OF HAVING:
MYOCARDIAL INFARCTION,
SHOCK AND
DEATH
ii) FRACTIONAL TEST MEAL:
In past test, test meal (e.g. Oat meal, alcohol) were administered orally to
stimulate secretion of gastric juice and determine MAO or PAO
Currently PENTAGASTRIN is used to stimulate gastric juice secretion.
24. iii) TUBELESS GASTRIC ANALYSIS:
CATION EXCHANGE RESIN WITH AZURE DYE IS GIVEN ORALLY TO PATIENT.
ONCE THE BODY START METABOLISING THAT IS TAKEN TO BLOOD STREAM AND
REACHES KIDNEY.
EXCRETED URINE IS MEASURED PHOTOMETRICALLY.
DISADVANTAGE:
IT WILL SHOW FALSE RESULT WHEN KIDNEY AND LIVER FUNCTION IS IMPARIED.
25. iv) SPOT CHECK OF GASTRIC pH:
FASTING PATIENTS NASOGASTRIC SECRETION WILL TAKEN AND ph IS MEASURED .
Ph more than five (>5.0) HYPOCHLORHYDRIA IN MALE
Ph more than seven (>7.0) HYPOCHOLORHYDRIA IN FEMALE
v) CONGO RED TEST DURING ESOPHAGO-GASTRO-DUODENO-SCOPY:
• DONE FOR THE COMPLETENESS OF VAGOTOMY.
• DYE CONGO RED IS SPRAYED IN THE STOMACH DURING THE
ESOPHAGOGASTRODUODENOSCOPY.
• IF IT TURNS RED INDICATE PRESENCE OF FUNCTIONAL PARIETAL CELLS IN
STOMACH WITH CAPACITY OF PRODUCING ACID.