Isgtncon 2015 sessions (1) 1
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The document lists the sponsors for various academic sessions and panels about gastrointestinal topics such as constipation, obscure GI bleeding, liver fibrosis assessment, Crohn's disease, cirrhosis, and acute pancreatitis. Each session listing includes the name of the session and the company supporting it as a pharmaceutical maker of various drugs.
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Formulation and Evaluation of Colon Targeted Suppository of Mesalazine
The aim of the present investigation was to formulate and evaluate of Colon Targeted Suppository of Mesalazine. The attempts have been made to increase the dissolution of BCS class IV drug Mesalazine using Cocoa butter, Polyethylene Glycol 6000, Polyethylene Glycol 9000 as base which was prepared by Fusion Method. Base combinations was prepared. Total three formulations of each combinations of base Cocoa butter Polyethylene Glycol 6000 and Cocoa butter Polyethylene Glycol 9000 were prepared in the ratio of 1 9 to 9 1.Cocoa butter was taken alone and used as standard. These base combinations were evaluated for optimization of base using parameters like melting point and liquefaction time. The optimized base Cocoa butter Polyethylene Glycol 6000 with ratio of1 9 and Cocoa butter Polyethylene Glycol 9000 with ratio of1 9 was then formulated into Colon Targeted Suppository of Mesalazine. Polyethylene glycol 400 was added in combination of bases which was used as plasticizer to increase its flexibility which was added in the concentration of 15, 30 and 45 . Displacement value was then calculated to formulate suppository. These formulated colon targeted Mesalazine suppository were evaluated with parameters such as weight variation, hardness, melting point, liquefaction time, content uniformity, and dissolution test. The F3 batch was selected as optimized formulation and was found superior. The F3 formulation shows high drug release of 94.31 and less dissolution time of 30 minutes from six formulation batches Hence showing better results than other formulations. When F3 formulation was compared with marketed formulation, it gives highest percent drug release than marketed formulation. The results of stability studies showed that F3 has no significant change in drug content, melting point, hardness, liquefaction time and dissolution profile of suppositories after storing them for 90 days at refrigeration temperature. Shrutika S. Kamble | Mrs. Trusha P. Shangrapawar | Dr. Ashok Bhosale "Formulation and Evaluation of Colon Targeted Suppository of Mesalazine" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-6 | Issue-5 , August 2022, URL: https://www.ijtsrd.com/papers/ijtsrd50411.pdf Paper URL: https://www.ijtsrd.com/pharmacy/pharmaceutics/50411/formulation-and-evaluation-of-colon-targeted-suppository-of-mesalazine/shrutika-s-kamble
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This document discusses probiotics and their role in managing diarrhea. It defines probiotics as live microbes that provide health benefits when consumed in adequate amounts. Common probiotic strains include Lactobacillus, Bifidobacterium, and Saccharomyces boulardii. Probiotics can help treat digestive disorders, allergies, and lower cholesterol. They are found naturally in foods like yogurt. Clinical studies show certain probiotic strains like L. rhamnosus GG and a mix of bacterial strains can significantly shorten the duration of acute diarrhea in children. The document also outlines guidelines for classifying and treating diarrhea based on dehydration signs, recommending oral rehydration, zinc and probiotic supplements,
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This document summarizes a presentation on decoding embryo culture. It discusses how in vitro culture aims to mimic the in vivo environment by balancing nutrients, temperature, pH, oxygen tension, and preventing contaminants. It describes the in vivo conditions in the oviduct and uterus and how culture media and protocols try to replicate these. Key aspects of embryo culture systems like media, gas phase, incubators, and embryologists are outlined. Different culture media compositions and the expectations and history of development are summarized. Various culture protocols like single step, sequential, group and individual culture are compared. Factors like pH, temperature, oxygen tension and their optimal levels are highlighted.
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Gastric bypass surgery
Gastric bypass surgery restructures the stomach and intestines to promote weight loss. It creates a small pouch at the top of the stomach and connects it directly to the small intestine, bypassing part of the stomach and duodenum. This allows food to pass quickly through the digestive system so fewer calories are absorbed. While risks include infection and blood clots, typical gastric bypass surgery results in 60-80% excess weight loss within 2-3 years for most patients.
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Formulation Approaches For Gastro Retentive Drug Delivery
1) Gastroretentive drug delivery systems are formulations designed to remain in the stomach for an extended period of time in order to allow drugs to be released over a prolonged period.
2) There are several approaches to gastric retention including floating systems, expandable systems, and bioadhesive systems. Floating systems have a lower density than gastric fluids while expandable systems swell upon contact with gastric fluid.
3) Gastroretentive systems provide benefits like improved drug absorption, reduced dosing, and site-specific drug delivery to the stomach. However, challenges include dose dumping and poor correlation between in vitro tests and in vivo performance.
Endoscopic Management Of Obesity-Endobariatrics
This document discusses endoscopic management of obesity, known as endobariatrics. It can be used as primary therapy, bridging therapy before surgery, or revisional therapy after surgery. Primary endoscopic therapies include intragastric balloons, tissue apposition techniques, and nutrient diverting therapies. Secondary endoscopic therapies include transoral outlet reduction, revision obesity surgery procedures, and argon plasma coagulation. Several studies on intragastric balloons and other primary therapies show promising results with 20-50% excess weight loss. Endobariatrics aims to bridge the gap between medical and surgical obesity treatment.
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Probiotics are used to help get your gut working properly, and different probiotics may serve different functions. There is a reason for the constipation, and while probiotics might not cure constipation, it can certainly help relieve it as long as you can find the underlying issues.
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• Understand that certain nutrients are poorly absorbed by the body
• Understand that the Vesisorb delivery system can provide a means by which absorption of certain nutrients can be enhanced
• Understand that liquid-filled two-piece capsules are one means by which nutrients can be delivered using Vesisorb technology
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This document summarizes a presentation on probiotics and their potential role in treating gastrointestinal issues in dialysis patients. It begins by providing background on the human gut microbiome and how imbalances can influence health and disease. It then discusses what probiotics are and how they may act to improve gut barrier function, modulate immune function and alter metabolism. The document reviews evidence that kidney disease can induce a gut dysbiosis and how probiotics may help by reducing toxic metabolite production and improving gut health. Finally, it outlines some clinical trial results investigating probiotic therapies for outcomes like serum indoxyl sulfate and quality of life in dialysis patients, though notes larger and more rigorous studies are still needed.
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2.3 human digestive system
1. The digestive system begins in the mouth and includes the esophagus, stomach, and small and large intestines.
2. In the mouth, food is chewed and saliva containing the enzyme amylase begins breaking down carbohydrates.
3. The esophagus transports food to the stomach through peristalsis. No digestion occurs in the esophagus.
4. In the stomach, proteins begin digesting due to the enzyme pepsin and hydrochloric acid breaks down food and kills bacteria.
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Cirrhosis can be reversible to some degree depending on the severity and persistence of the underlying disease. While uncommon, regression of fibrosis and scarring can occur, especially in early-stage cirrhosis diagnosed on histology. Complete reversal is not seen in clinical or decompensated cirrhosis, as the vascular changes do not regress. Histological cirrhosis may reverse without full reversal of clinical cirrhosis, suggesting there is a "point of no return" where cirrhosis becomes irreversible.
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The document discusses the use of biologicals such as infliximab and adalimumab in treating Crohn's disease. It provides details on their indications, administration protocols, effectiveness, safety considerations like risks of tuberculosis and autoimmune reactions, and constraints to their use like cost and lack of insurance coverage. Special precautions are needed with biologicals regarding vaccinations, screening for latent infections, and monitoring for adverse effects. Overall, biologicals are effective for inducing and maintaining remission in severe Crohn's disease and fistulizing disease when conventional treatments have failed or are not tolerated.
Role of surgeon dr.p.radhakrishan
Surgery is often required in the treatment of Crohn's disease to address complications such as strictures, fistulae, inflammatory masses, and perforations. Approximately 50% of Crohn's patients develop strictures or fistulae within 20 years of diagnosis. Immunomodulators and anti-TNF therapies have reduced the need for surgery. When surgery is needed, non-resectional techniques like strictureplasty may be used to avoid excessive intestine removal, while resectional techniques remove only the severely affected portions. The document discusses various surgical procedures for different areas affected by Crohn's disease including the small bowel, colon, and perianal region. A multidisciplinary approach is emphasized for optimal Crohn's disease
Crohn vs tb 2015 03 22 tnisgcon
Crohn's disease and tuberculosis can be difficult to differentiate based on clinical features alone. Key factors that may help include disease duration, family history, presence of extraintestinal manifestations, and endoscopic and histological findings on biopsies. Radiological imaging findings can also provide clues but often overlap between the two conditions. A high index of suspicion is needed and further investigations including microbiological tests may be required in uncertain cases to arrive at the correct diagnosis and avoid unnecessary double treatment.
Poem 03 15
This document summarizes the technique and outcomes of peroral endoscopic myotomy (POEM) based on the author's experience and literature. In 3 sentences:
POEM is a minimally invasive treatment for achalasia that involves cutting the esophageal muscle through an incision in the mouth using an endoscope, with benefits over laparoscopic surgery of being less invasive, allowing full control of the myotomy, and preserving the phrenoesophageal membrane. Studies show POEM provides over 90% treatment success based on the author's experience of 282 cases. While long-term data is still needed, POEM appears as effective as surgery with fewer side effects and shorter recovery time based on comparative studies.
Cbd stones
This document discusses biliary stone diseases and treatments. It defines difficult bile duct stones as those over 15mm or impacted. Standard treatment involves endoscopic retrograde cholangiopancreatography (ERC) but factors like stone size, number, and location; bile duct anatomy; and prior surgeries can make removal difficult. Methods for difficult stones include lithotripsy, balloon dilation, cholangioscopy, and dissolution, with the goal of decreasing stone size and increasing bile duct access. Complete stone removal can be achieved in most cases using various endoscopic techniques, but sometimes requires a multidisciplinary approach.
Esophstrictures chennai
1) The document provides information on the efficacy of different treatment modalities for esophageal strictures including dilation, stenting and intralesional steroid injections.
2) Data from studies show that fully covered self-expanding metal stents (SEMS) achieve clinical success in 30-66% of patients with refractory strictures, but have migration rates of 14-37%.
3) Biodegradable stents have a lower clinical success rate of 30-33% and require frequent reinterventions, but avoid issues of migration associated with metal stents.
Vgn cfhennai isg-2015_latest new final _
This document discusses the use of transient elastography (TE) or Fibroscan to assess liver fibrosis as an alternative to liver biopsy. TE uses ultrasound pulses to measure liver stiffness, with higher stiffness indicating more severe fibrosis. The document provides cutoff values for various fibrosis stages and notes TE has excellent accuracy and reproducibility. TE can detect significant fibrosis in many non-alcoholic fatty liver disease patients where ultrasound only detects fatty liver. Case studies demonstrate how TE scores decreased with treatment and abstinence from alcohol. While liver biopsy is still the reference standard, TE suffices in most cases to avoid invasive tests and is useful for screening and monitoring liver disease patients.
Crohns symposium mathew philps beyond biologicals
This document discusses potential new drugs for inflammatory bowel disease (IBD) beyond current biological therapies. It outlines several therapeutic pipelines targeting cytokines like TNF, IL-12/IL-23, IL-13 and IL-6. Anti-adhesion molecules targeting integrins and MadCAM-1 are also discussed. The document explores manipulating the microbiome through probiotics, antibiotics or fecal transplantation, as well as using prognostic genomics to predict treatment responses. Overall it concludes that future IBD treatment will be personalized based on biomarkers and tissue signatures to select therapies beyond TNF blockers.
5 Liver Fibrosis Assessment Dr. V.G. Mohanprasad
This document discusses the use of transient elastography (TE) or Fibroscan to assess liver fibrosis as an alternative to liver biopsy. TE uses ultrasound pulses to measure liver stiffness, which correlates with the stage of fibrosis. The document provides cutoff values for various stages of fibrosis. It also describes a study comparing TE to Philips shear wave elastography, finding a high correlation. TE detected significant fibrosis in 17.85% of patients where ultrasound only found fatty liver. The document concludes that while biopsy is still the gold standard, TE is a useful noninvasive tool for initial screening and monitoring of patients with liver diseases.
Prof.N. Madanagopalan Oration
This document summarizes the work of Dr. N Madanagopalan regarding Budd-Chiari syndrome (BCS) from 1978-1996. It highlights that Dr. Madanagopalan made major contributions to understanding the epidemiology, clinical presentation, investigations and management of BCS. Through angiographic and surgical studies conducted with collaborators, he helped establish the patterns and treatment of hepatic vein outflow tract obstruction in India. His work demonstrated differences from Western countries and identified congenital abnormalities as a major cause. This laid the foundation for endovascular treatments now used.
Prevention Of Gi Malignancy
This document discusses strategies for preventing gastrointestinal (GI) cancers. It outlines several key risk factors for GI cancers, including H. pylori infection for gastric cancer, obesity for pancreatic cancer, and family history for colon and gastric cancers. Prevention strategies discussed include H. pylori eradication, vaccination for hepatitis B, lifestyle modifications like diet and exercise, and cancer screening programs. The document emphasizes that while knowledge of risk factors is sound, interventions need improved implementation and awareness and education are critical to reducing the burden of GI cancers.
Post liver tx complication surgeon role
This document discusses surgical complications that can occur after liver transplantation. Immediate postoperative complications include bleeding, arterial complications like hepatic artery thrombosis, portal venous complications, and biliary complications like bile leaks. Long term complications include biliary strictures, which can develop due to technical issues or ischemia. Proper prevention through surgical technique and a multidisciplinary approach are important to address these complications after liver transplantation.
Isg chennai march 2015 rajasekar
This document summarizes key developments and the current state of cadaveric liver transplantation. It discusses:
1) Important milestones in transplantation history including the introduction of cyclosporine and advances in India.
2) Current transplant statistics in India showing high 1-year survival rates of 88-90% for liver transplants but an ongoing organ shortage.
3) Techniques for deceased and living donor liver transplants including recipient hepatectomy, implantation, and management of complications.
4) Efforts to expand the donor pool through use of marginal donors and grafts with steatosis, though these can increase risk of poor outcomes. Ongoing research aims to further improve long-term results
Dr lvk liver transplpantation l.venkatakrishan
The document discusses the evaluation process for patients being considered for liver transplantation. It covers the common indications for transplant including complications of cirrhosis and liver failure. The evaluation involves assessing cardiac, pulmonary, surgical, infectious disease, renal, neurological, laboratory and radiology factors. Scores like MELD are used to determine priority on transplant waiting lists. Certain conditions may qualify for MELD exceptions. The evaluation aims to ensure candidates are medically suitable and have necessary social support for transplant.
PHYSICIANS ROLE C.E.Eapen
1. Lifelong immunosuppression is needed after liver transplant to prevent graft rejection. Calcineurin inhibitors like cyclosporine and tacrolimus are the mainstay but require monitoring to avoid toxicity due to drug interactions.
2. Drug interactions are a major concern, as many drugs are metabolized by the CYP3A4 pathway which is inhibited or induced by calcineurin inhibitors. This can increase or decrease drug levels and impact outcomes.
3. Long term complications include chronic rejection, recurrence of original liver disease, infections, renal failure, and malignancy. Careful management is needed long term to monitor for issues and minimize immunosuppression when possible.
Acute Pancreatitis
The panel discussion summarized:
1) Serum amylase and lipase levels are reliable markers for acute pancreatitis during pregnancy.
2) MRCP is the best imaging modality for evaluating the bile duct for choledocholithiasis in pregnancy due to lack of radiation exposure, though EUS provides the highest accuracy.
3) Therapeutic ERCP can be performed safely in pregnancy with precautions to minimize radiation exposure to the fetus, and is safest during the second trimester.
Case Capsule
1. A 47-year-old male presented with abdominal pain, back pain, weight loss, and worsening diabetes. Imaging showed ill-defined masses in the pancreas. Differential considerations included pancreatic malignancy or autoimmune pancreatitis.
2. Endoscopic ultrasound-guided fine needle aspiration of the masses was nondiagnostic but showed no malignancy. Surgery found an infiltrative pancreatic mass but biopsy again showed no malignancy.
3. Follow up showed jaundice and imaging characteristics suggestive of autoimmune pancreatitis. Histopathology and elevated IgG4 supported a diagnosis of type 1 autoimmune pancreatitis. The patient was started
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Isgtncon 2015 sessions (1) 1
- 1. Welcome to
- 2. This academic session is supported by Bristol –Myers Squibb India Pvt Ltd
- 3. APPROACH TO CONSTIPATION This academic session is supported by Abbott India
- 4. OBSCURE GI BLEED – PANEL DISCUSSION This academic session is supported by Tablets India Ltd. Makers of Glutazene, Safelax, Bifilac HP
- 5. LIVER FIBROSIS ASSESSMENT This academic session is supported by Microlabs Makers of Udibon
- 6. ENDOSCOPY DIGEST This academic session is supported by Delvin Formulations Makers of Coloprep
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