This document provides an index and introduction to a presentation on Barrett's esophagus. Some key points:
- Barrett's esophagus is a condition where the lining of the lower esophagus is replaced by abnormal columnar epithelium cells due to chronic acid reflux.
- It increases the risk of developing esophageal adenocarcinoma. The progression from Barrett's esophagus to cancer occurs through the stages of metaplasia, dysplasia, and eventually cancer.
- Diagnosis is done through endoscopy with biopsy to examine the cell types. Management depends on the stage, ranging from lifestyle changes, medications, endoscopic treatments, to surgery.
- Ayurveda
This document discusses classifications and clinical relevance of oral epithelial dysplasia in assessing risk of oral potentially malignant disorders. It describes various classification systems for grading dysplasia including WHO and Ljubljana systems. Key histopathological features of dysplasia are loss of maturation and increased nuclear-cytoplasmic ratio. Higher risk of malignant transformation is seen with factors like female gender, long standing lesions, location on tongue/floor of mouth, large size and presence of dysplasia. Accurate grading helps determine prognosis and clinical management.
This document defines oral cancer and discusses its pathogenesis, risk factors, incidence and prevalence in Pakistan. It states that over 90% of oral cancers are squamous cell carcinomas. Risk factors include tobacco and betel quid chewing which have a high prevalence in Pakistan. Early diagnosis is important due to the poor prognosis. The document also describes screening techniques, levels of prevention and references used.
Neural tube defects are congenital malformations affecting the brain, meninges, and skull that occur early in development. The most common defects involve the spinal cord and range from spina bifida occulta to more severe myelomeningocele. Preventing neural tube defects involves ensuring adequate folate intake during the first trimester of pregnancy. Infections of the nervous system can involve the meninges (meningitis) or brain parenchyma. Acute bacterial meningitis presents with neutrophils in CSF and requires prompt antibiotic treatment. Brain tumors include gliomas arising from glial cells and neuronal tumors. The most common pediatric brain tumor is medulloblastoma, an aggressive, poorly differentiated neoplasm in the
This document provides information about erythroplakia, including its definition, clinical features, pathogenesis, histopathology, diagnosis, management, and malignant potential. Erythroplakia is defined as a solitary red lesion that cannot be characterized clinically or pathologically as any other condition. It has a high risk of malignant transformation, ranging from 14-50%. Diagnosis involves clinical examination and biopsy. Management includes removing causative factors, chemoprevention with antioxidants, and surgical excision with long-term follow-up due to the high recurrence risk.
Kawasaki disease is a self-limited vasculitis that predominantly affects children under 5 years old. It is characterized by prolonged fever and changes in the mouth, hands and feet, skin rash, and conjunctival injection. Left untreated, it can lead to coronary artery aneurysms in up to 25% of cases. Treatment involves intravenous immunoglobulin and aspirin to reduce inflammation and prevent aneurysm formation. While most children recover fully, timely diagnosis and treatment are important to prevent rare but serious cardiac complications.
This document discusses endometrial cancer, including risk factors, types, clinical features, and histology. It notes that endometrial cancer risk is highest in developed countries and associated with factors like obesity, diabetes, and hormone therapy. There are two main types - Type 1 occurs in younger women, is estrogen-dependent and differentiated, while Type 2 occurs later, is estrogen-independent and undifferentiated. Clinical features include abnormal bleeding, while histology shows grades ranging from well to poorly differentiated adenocarcinoma.
This document provides information on endometrial carcinoma, including epidemiology, risk factors, types, staging, treatment, and prognosis. It notes that endometrial carcinoma is the most common gynecologic malignancy in developed countries, with incidence increasing with age. Risk factors include nulliparity, obesity, diabetes, and exposure to unopposed estrogen. Treatment involves hysterectomy, with or without lymphadenectomy, depending on tumor characteristics. Prognosis depends on histologic grade and extent of disease, with younger age and less aggressive histologic subtypes conferring a better outlook.
The document discusses several problems with asthma management in Pakistan, including lack of knowledge about the disease among patients and doctors, poor compliance with treatment, misdiagnosis, misuse of medications like steroids, and high treatment costs. It notes that while asthma prevalence is high in Pakistan, the magnitude of the problem is not clearly known. Guidelines for asthma treatment exist but are not always followed in practice.
This document discusses classifications and clinical relevance of oral epithelial dysplasia in assessing risk of oral potentially malignant disorders. It describes various classification systems for grading dysplasia including WHO and Ljubljana systems. Key histopathological features of dysplasia are loss of maturation and increased nuclear-cytoplasmic ratio. Higher risk of malignant transformation is seen with factors like female gender, long standing lesions, location on tongue/floor of mouth, large size and presence of dysplasia. Accurate grading helps determine prognosis and clinical management.
This document defines oral cancer and discusses its pathogenesis, risk factors, incidence and prevalence in Pakistan. It states that over 90% of oral cancers are squamous cell carcinomas. Risk factors include tobacco and betel quid chewing which have a high prevalence in Pakistan. Early diagnosis is important due to the poor prognosis. The document also describes screening techniques, levels of prevention and references used.
Neural tube defects are congenital malformations affecting the brain, meninges, and skull that occur early in development. The most common defects involve the spinal cord and range from spina bifida occulta to more severe myelomeningocele. Preventing neural tube defects involves ensuring adequate folate intake during the first trimester of pregnancy. Infections of the nervous system can involve the meninges (meningitis) or brain parenchyma. Acute bacterial meningitis presents with neutrophils in CSF and requires prompt antibiotic treatment. Brain tumors include gliomas arising from glial cells and neuronal tumors. The most common pediatric brain tumor is medulloblastoma, an aggressive, poorly differentiated neoplasm in the
This document provides information about erythroplakia, including its definition, clinical features, pathogenesis, histopathology, diagnosis, management, and malignant potential. Erythroplakia is defined as a solitary red lesion that cannot be characterized clinically or pathologically as any other condition. It has a high risk of malignant transformation, ranging from 14-50%. Diagnosis involves clinical examination and biopsy. Management includes removing causative factors, chemoprevention with antioxidants, and surgical excision with long-term follow-up due to the high recurrence risk.
Kawasaki disease is a self-limited vasculitis that predominantly affects children under 5 years old. It is characterized by prolonged fever and changes in the mouth, hands and feet, skin rash, and conjunctival injection. Left untreated, it can lead to coronary artery aneurysms in up to 25% of cases. Treatment involves intravenous immunoglobulin and aspirin to reduce inflammation and prevent aneurysm formation. While most children recover fully, timely diagnosis and treatment are important to prevent rare but serious cardiac complications.
This document discusses endometrial cancer, including risk factors, types, clinical features, and histology. It notes that endometrial cancer risk is highest in developed countries and associated with factors like obesity, diabetes, and hormone therapy. There are two main types - Type 1 occurs in younger women, is estrogen-dependent and differentiated, while Type 2 occurs later, is estrogen-independent and undifferentiated. Clinical features include abnormal bleeding, while histology shows grades ranging from well to poorly differentiated adenocarcinoma.
This document provides information on endometrial carcinoma, including epidemiology, risk factors, types, staging, treatment, and prognosis. It notes that endometrial carcinoma is the most common gynecologic malignancy in developed countries, with incidence increasing with age. Risk factors include nulliparity, obesity, diabetes, and exposure to unopposed estrogen. Treatment involves hysterectomy, with or without lymphadenectomy, depending on tumor characteristics. Prognosis depends on histologic grade and extent of disease, with younger age and less aggressive histologic subtypes conferring a better outlook.
The document discusses several problems with asthma management in Pakistan, including lack of knowledge about the disease among patients and doctors, poor compliance with treatment, misdiagnosis, misuse of medications like steroids, and high treatment costs. It notes that while asthma prevalence is high in Pakistan, the magnitude of the problem is not clearly known. Guidelines for asthma treatment exist but are not always followed in practice.
This document discusses renal preservation, acute renal failure (ARF) and its management. It defines ARF as a sudden decrease in renal function resulting in the kidney's inability to excrete wastes. ARF is commonly caused by ischemic insult and occurs in high-risk surgical patients exposed to nephrotoxic drugs. It describes various patient factors, high-risk surgical procedures, nephrotoxins, and strategies to optimize patients pre-operatively and prevent ARF, including pharmacological strategies like calcium channel blockers, prostaglandins, atrial natriuretic peptide analogues, dopamine-1 agonists, modulation of the complement system, and 21-amino steroids. Low-dose dopamine has been used but
The document discusses the radiological pathology of astrocytomas. It begins by explaining that astrocytomas are tumors composed of astrocytes and can be graded from II to IV. Grade II astrocytomas are called low grade diffuse astrocytomas. Grade III are called anaplastic astrocytomas. Grade IV are glioblastoma multiforme. The document then goes on to compare the features of focal grade I astrocytomas versus diffuse grade II-IV astrocytomas and lists their differences. It also discusses imaging and pathology characteristics of different grades of astrocytomas.
This document provides an overview of the ciliary ganglion:
1. The ciliary ganglion is located in the posterior orbit between the lateral rectus muscle and optic nerve. It receives sensory, parasympathetic, and sympathetic nerve fibers.
2. The ganglion gives rise to short ciliary nerves that innervate the iris, ciliary body, and cornea. Damage to the ganglion or its nerves can result in tonic pupil.
3. Tonic pupil is characterized by poor constriction to light with better constriction to accommodation. It is caused by aberrant regeneration after damage to the ciliary ganglion or nerves.
1362465129 diabetic foot syndrome an indian perspectivedfsimedia
This document discusses diabetic foot syndrome from an Indian perspective. It covers topics such as the classification of diabetic foot types, clinical evaluation of high-risk feet, appropriate technology for diagnosis and management, and solutions for common problems in India. The author emphasizes that clinical evaluation is most important and recommends inspecting the feet of all diabetic patients. Affordable technologies for India include Doppler ultrasound to measure ankle-brachial index and tests of autonomic function like heart rate response to standing.
Dr. Bharat Maheshwari presented on chondro-osteodystrophy, also known as Morquio syndrome, a rare genetic disorder caused by the deficiency of enzymes involved in breaking down long chains of sugar molecules. It is characterized by short stature, skeletal abnormalities like dysplasia of joints and vertebrae, and neurological symptoms. While there is currently no cure, enzyme replacement therapy and bone marrow transplants can help reduce symptoms and delay complications, with the goal of improving quality of life through medical care, physical therapy, and exercise.
Dr. Bharat Maheshwari presented on chondro-osteodystrophy, also known as Morquio syndrome, a rare genetic disorder caused by the deficiency of enzymes involved in breaking down long chains of sugar molecules. It is characterized by short stature, skeletal abnormalities like dysplasia of joints and vertebrae, and neurological symptoms. While there is currently no cure, enzyme replacement therapy and bone marrow transplants can help reduce symptoms and delay complications, with the goal of improving quality of life through medical care, physical therapy, and exercise.
This document discusses cervical cancer, which is the most common cancer affecting women in India. It accounts for 1/4 of all cervical cancer cases worldwide and 74,000 deaths annually in India alone. The anatomy of the cervix and adjacent structures are described, along with the histology of the normal ectocervix and endocervix. The squamocolumnar junction and transformation zone are identified as the origins for most precancerous lesions and cancers. Risk factors for cervical cancer include HPV infection and smoking. The Pap smear is the main diagnostic test, with clinically visible lesions also examined by colposcopy.
case presentation on post kala azar dermal leishmaniasis (PKDL)ChristyThomas37
This document presents a case study of post-kala azar dermal leishmaniasis (PKDL) in a 13-year old female patient who was previously treated for kala azar at age 6. Examinations found papular and nodular lesions on her face and macular lesions on her body. Diagnostic tests confirmed Leishmania parasites. She was diagnosed with PKDL and treated with liposomal amphotericin B and miltefosine. PKDL is usually a sequel of visceral leishmaniasis occurring months to years after treatment, characterized by skin lesions, and requires treatment to prevent further spread.
This document defines breast cancer and discusses its types, risk factors, pathogenesis, signs and symptoms, diagnosis, management and prevention. Some key points include:
- Breast cancer is an uncontrolled growth of cells in the breast, commonly occurring in women over age 45. It is the second leading cause of cancer deaths in women.
- There are four main breast cancer subtypes driven by hormone receptors and HER2 expression. Risk factors include family history, obesity, alcohol, hormone use, radiation exposure.
- Symptoms may include breast lumps, nipple discharge, skin changes. Diagnosis involves biopsy, mammography and other imaging tests. Treatment includes surgery, chemotherapy, radiation, and hormone therapy.
- Prevention
This document discusses the clinical approach to diagnosing congenital heart disease. It provides statistics on the incidence of CHD and notes it can be diagnosed through applied logic and accurate observations. The document outlines a clinical classification system for CHD and lists the basic questions to consider in diagnosis, including whether the patient is acyanotic or cyanotic, the direction of blood flow, site of malformation and more. A thorough history, physical exam including precordial exam, chest x-ray and ECG are important diagnostic tools.
Clinical approach to congenital heart disease diagnosisikramdr01
This document discusses the clinical approach to diagnosing congenital heart disease. It provides statistics on the incidence of CHD and notes it occurs in 6 per 1000 live births for moderate/severe forms. A clinical diagnosis of CHD requires accurate observations and logical inferences. CHD is classified based on whether cyanosis is present, pulmonary blood flow, the side of the heart affected, and whether pulmonary hypertension is present. The diagnosis involves considering the patient's history, physical exam findings, chest x-ray, and ECG.
Role of parasites in neoplastic disordersdranjansarma
This document discusses the role of parasites in neoplastic disorders and cancer. It provides details on various parasites that are classified as carcinogenic, including species of Schistosoma and liver flukes. Schistosomiasis caused by blood flukes like S. haematobium can lead to urinary bladder cancer through chronic inflammation. Parasitic infections have also been associated with cancers like cholangiocarcinoma, Burkitt's lymphoma, and HTLV-1 induced lymphomas through mechanisms involving inflammation, oxidative stress, and stimulation of viral replication. The life cycles and clinical manifestations of various parasite species are described.
This document discusses short gut syndrome (SGS), a condition that results from extensive resection of the small intestine, leaving the patient with a short bowel. It notes that SGS is a management challenge. The causes of SGS include intestinal atresia, midgut volvulus, necrotizing enterocolitis, and others. Factors affecting severity include the extent of resection, site of resection, state of residual gut, and adaptive capacity. Management involves addressing fluid and electrolyte balance, nutrition, and long-term complications like malnutrition and liver dysfunction. The role of surgery, including restoration of intestinal continuity and procedures to slow intestinal transit time, is also discussed.
This document discusses 18 common myths about breast cancer and mammography. It aims to dispel these myths by providing facts based on medical research. Some key myths addressed include that an abnormal mammogram always means cancer, mammograms are unsafe, and family history is required to get breast cancer. The facts emphasize that screening mammograms can find cancer early and that most women who develop breast cancer do not have a family history of the disease. Overall, the document encourages women to get regular mammograms as the best way to detect breast cancer at its earliest and most treatable stages.
This document discusses Rapunzel's Syndrome, a rare variant of trichobezoar where a mass of tangled hair extends from the stomach into the small intestine. It presents a case study of a young female patient who underwent surgery to remove a large trichobezoar. Rapunzel's Syndrome is associated with psychiatric disorders like trichotillomania and trichophagia. Open laparotomy is usually required to remove the complex mass. Post-operative psychiatric counseling is important to prevent recurrence by treating the underlying conditions.
The document discusses the etiology and classifications of malocclusion. It describes Moyer's classification which includes factors like heredity, development defects, trauma, physical agents, habits, diseases, and malnutrition. It also describes Graber's classification which separates factors into general factors like heredity, congenital defects, environment, metabolic diseases, dietary problems, habits, and trauma. Local factors include anomalies in tooth number, size, shape, frenum, eruption, and caries. The document provides details on each of these classifications and factors that can contribute to malocclusion.
A PRESENTATION ON THE BASIC ASPECTS OF PERITONITIS, ITS TYPES AND MANAGEMENT. IT IS DIRECTED TOWARDS THE BEGINNER IN SURGERY - MEDICAL STUDENT AND THE SURGERY RESIDENT.
Abruptio placenta including nursing management.akshaya r nair
This document discusses abruption placentae, which is premature separation of a normally situated placenta, causing bleeding. It has an incidence of about 1 in 200 deliveries. It can be revealed, concealed, or mixed. Risk factors include high birth order, advancing age, hypertension, and trauma. Clinical features depend on whether it is revealed, concealed, or mixed. Diagnosis is mainly clinical with ultrasound and labs. Management includes prevention, emergency measures like IV fluids and blood, and either immediate delivery, managing complications, or expectant management depending on the situation. Nursing interventions address pain management, fluid volume deficit, ineffective tissue perfusion, risk of anemia and infection, and fetal hypoxia.
Achalasia is a motility disorder of the esophagus characterized by lack of esophageal peristalsis and failure of the lower esophageal sphincter to relax when swallowing. This causes food to get stuck in the esophagus. It is caused by degeneration of the myenteric plexus which normally coordinates relaxation of the sphincter and contractions. Symptoms include difficulty swallowing, chest pain, regurgitation of food, and weight loss. Diagnosis involves barium swallow, endoscopy and manometry. Treatment options are medications, balloon dilation of the sphincter, botulinum toxin injections, or Heller myotomy surgery.
LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UPRAHUL
This Dissertation explores the particular circumstances of Mirzapur, a region located in the
core of India. Mirzapur, with its varied terrains and abundant biodiversity, offers an optimal
environment for investigating the changes in vegetation cover dynamics. Our study utilizes
advanced technologies such as GIS (Geographic Information Systems) and Remote sensing to
analyze the transformations that have taken place over the course of a decade.
The complex relationship between human activities and the environment has been the focus
of extensive research and worry. As the global community grapples with swift urbanization,
population expansion, and economic progress, the effects on natural ecosystems are becoming
more evident. A crucial element of this impact is the alteration of vegetation cover, which plays a
significant role in maintaining the ecological equilibrium of our planet.Land serves as the foundation for all human activities and provides the necessary materials for
these activities. As the most crucial natural resource, its utilization by humans results in different
'Land uses,' which are determined by both human activities and the physical characteristics of the
land.
The utilization of land is impacted by human needs and environmental factors. In countries
like India, rapid population growth and the emphasis on extensive resource exploitation can lead
to significant land degradation, adversely affecting the region's land cover.
Therefore, human intervention has significantly influenced land use patterns over many
centuries, evolving its structure over time and space. In the present era, these changes have
accelerated due to factors such as agriculture and urbanization. Information regarding land use and
cover is essential for various planning and management tasks related to the Earth's surface,
providing crucial environmental data for scientific, resource management, policy purposes, and
diverse human activities.
Accurate understanding of land use and cover is imperative for the development planning
of any area. Consequently, a wide range of professionals, including earth system scientists, land
and water managers, and urban planners, are interested in obtaining data on land use and cover
changes, conversion trends, and other related patterns. The spatial dimensions of land use and
cover support policymakers and scientists in making well-informed decisions, as alterations in
these patterns indicate shifts in economic and social conditions. Monitoring such changes with the
help of Advanced technologies like Remote Sensing and Geographic Information Systems is
crucial for coordinated efforts across different administrative levels. Advanced technologies like
Remote Sensing and Geographic Information Systems
9
Changes in vegetation cover refer to variations in the distribution, composition, and overall
structure of plant communities across different temporal and spatial scales. These changes can
occur natural.
This document discusses renal preservation, acute renal failure (ARF) and its management. It defines ARF as a sudden decrease in renal function resulting in the kidney's inability to excrete wastes. ARF is commonly caused by ischemic insult and occurs in high-risk surgical patients exposed to nephrotoxic drugs. It describes various patient factors, high-risk surgical procedures, nephrotoxins, and strategies to optimize patients pre-operatively and prevent ARF, including pharmacological strategies like calcium channel blockers, prostaglandins, atrial natriuretic peptide analogues, dopamine-1 agonists, modulation of the complement system, and 21-amino steroids. Low-dose dopamine has been used but
The document discusses the radiological pathology of astrocytomas. It begins by explaining that astrocytomas are tumors composed of astrocytes and can be graded from II to IV. Grade II astrocytomas are called low grade diffuse astrocytomas. Grade III are called anaplastic astrocytomas. Grade IV are glioblastoma multiforme. The document then goes on to compare the features of focal grade I astrocytomas versus diffuse grade II-IV astrocytomas and lists their differences. It also discusses imaging and pathology characteristics of different grades of astrocytomas.
This document provides an overview of the ciliary ganglion:
1. The ciliary ganglion is located in the posterior orbit between the lateral rectus muscle and optic nerve. It receives sensory, parasympathetic, and sympathetic nerve fibers.
2. The ganglion gives rise to short ciliary nerves that innervate the iris, ciliary body, and cornea. Damage to the ganglion or its nerves can result in tonic pupil.
3. Tonic pupil is characterized by poor constriction to light with better constriction to accommodation. It is caused by aberrant regeneration after damage to the ciliary ganglion or nerves.
1362465129 diabetic foot syndrome an indian perspectivedfsimedia
This document discusses diabetic foot syndrome from an Indian perspective. It covers topics such as the classification of diabetic foot types, clinical evaluation of high-risk feet, appropriate technology for diagnosis and management, and solutions for common problems in India. The author emphasizes that clinical evaluation is most important and recommends inspecting the feet of all diabetic patients. Affordable technologies for India include Doppler ultrasound to measure ankle-brachial index and tests of autonomic function like heart rate response to standing.
Dr. Bharat Maheshwari presented on chondro-osteodystrophy, also known as Morquio syndrome, a rare genetic disorder caused by the deficiency of enzymes involved in breaking down long chains of sugar molecules. It is characterized by short stature, skeletal abnormalities like dysplasia of joints and vertebrae, and neurological symptoms. While there is currently no cure, enzyme replacement therapy and bone marrow transplants can help reduce symptoms and delay complications, with the goal of improving quality of life through medical care, physical therapy, and exercise.
Dr. Bharat Maheshwari presented on chondro-osteodystrophy, also known as Morquio syndrome, a rare genetic disorder caused by the deficiency of enzymes involved in breaking down long chains of sugar molecules. It is characterized by short stature, skeletal abnormalities like dysplasia of joints and vertebrae, and neurological symptoms. While there is currently no cure, enzyme replacement therapy and bone marrow transplants can help reduce symptoms and delay complications, with the goal of improving quality of life through medical care, physical therapy, and exercise.
This document discusses cervical cancer, which is the most common cancer affecting women in India. It accounts for 1/4 of all cervical cancer cases worldwide and 74,000 deaths annually in India alone. The anatomy of the cervix and adjacent structures are described, along with the histology of the normal ectocervix and endocervix. The squamocolumnar junction and transformation zone are identified as the origins for most precancerous lesions and cancers. Risk factors for cervical cancer include HPV infection and smoking. The Pap smear is the main diagnostic test, with clinically visible lesions also examined by colposcopy.
case presentation on post kala azar dermal leishmaniasis (PKDL)ChristyThomas37
This document presents a case study of post-kala azar dermal leishmaniasis (PKDL) in a 13-year old female patient who was previously treated for kala azar at age 6. Examinations found papular and nodular lesions on her face and macular lesions on her body. Diagnostic tests confirmed Leishmania parasites. She was diagnosed with PKDL and treated with liposomal amphotericin B and miltefosine. PKDL is usually a sequel of visceral leishmaniasis occurring months to years after treatment, characterized by skin lesions, and requires treatment to prevent further spread.
This document defines breast cancer and discusses its types, risk factors, pathogenesis, signs and symptoms, diagnosis, management and prevention. Some key points include:
- Breast cancer is an uncontrolled growth of cells in the breast, commonly occurring in women over age 45. It is the second leading cause of cancer deaths in women.
- There are four main breast cancer subtypes driven by hormone receptors and HER2 expression. Risk factors include family history, obesity, alcohol, hormone use, radiation exposure.
- Symptoms may include breast lumps, nipple discharge, skin changes. Diagnosis involves biopsy, mammography and other imaging tests. Treatment includes surgery, chemotherapy, radiation, and hormone therapy.
- Prevention
This document discusses the clinical approach to diagnosing congenital heart disease. It provides statistics on the incidence of CHD and notes it can be diagnosed through applied logic and accurate observations. The document outlines a clinical classification system for CHD and lists the basic questions to consider in diagnosis, including whether the patient is acyanotic or cyanotic, the direction of blood flow, site of malformation and more. A thorough history, physical exam including precordial exam, chest x-ray and ECG are important diagnostic tools.
Clinical approach to congenital heart disease diagnosisikramdr01
This document discusses the clinical approach to diagnosing congenital heart disease. It provides statistics on the incidence of CHD and notes it occurs in 6 per 1000 live births for moderate/severe forms. A clinical diagnosis of CHD requires accurate observations and logical inferences. CHD is classified based on whether cyanosis is present, pulmonary blood flow, the side of the heart affected, and whether pulmonary hypertension is present. The diagnosis involves considering the patient's history, physical exam findings, chest x-ray, and ECG.
Role of parasites in neoplastic disordersdranjansarma
This document discusses the role of parasites in neoplastic disorders and cancer. It provides details on various parasites that are classified as carcinogenic, including species of Schistosoma and liver flukes. Schistosomiasis caused by blood flukes like S. haematobium can lead to urinary bladder cancer through chronic inflammation. Parasitic infections have also been associated with cancers like cholangiocarcinoma, Burkitt's lymphoma, and HTLV-1 induced lymphomas through mechanisms involving inflammation, oxidative stress, and stimulation of viral replication. The life cycles and clinical manifestations of various parasite species are described.
This document discusses short gut syndrome (SGS), a condition that results from extensive resection of the small intestine, leaving the patient with a short bowel. It notes that SGS is a management challenge. The causes of SGS include intestinal atresia, midgut volvulus, necrotizing enterocolitis, and others. Factors affecting severity include the extent of resection, site of resection, state of residual gut, and adaptive capacity. Management involves addressing fluid and electrolyte balance, nutrition, and long-term complications like malnutrition and liver dysfunction. The role of surgery, including restoration of intestinal continuity and procedures to slow intestinal transit time, is also discussed.
This document discusses 18 common myths about breast cancer and mammography. It aims to dispel these myths by providing facts based on medical research. Some key myths addressed include that an abnormal mammogram always means cancer, mammograms are unsafe, and family history is required to get breast cancer. The facts emphasize that screening mammograms can find cancer early and that most women who develop breast cancer do not have a family history of the disease. Overall, the document encourages women to get regular mammograms as the best way to detect breast cancer at its earliest and most treatable stages.
This document discusses Rapunzel's Syndrome, a rare variant of trichobezoar where a mass of tangled hair extends from the stomach into the small intestine. It presents a case study of a young female patient who underwent surgery to remove a large trichobezoar. Rapunzel's Syndrome is associated with psychiatric disorders like trichotillomania and trichophagia. Open laparotomy is usually required to remove the complex mass. Post-operative psychiatric counseling is important to prevent recurrence by treating the underlying conditions.
The document discusses the etiology and classifications of malocclusion. It describes Moyer's classification which includes factors like heredity, development defects, trauma, physical agents, habits, diseases, and malnutrition. It also describes Graber's classification which separates factors into general factors like heredity, congenital defects, environment, metabolic diseases, dietary problems, habits, and trauma. Local factors include anomalies in tooth number, size, shape, frenum, eruption, and caries. The document provides details on each of these classifications and factors that can contribute to malocclusion.
A PRESENTATION ON THE BASIC ASPECTS OF PERITONITIS, ITS TYPES AND MANAGEMENT. IT IS DIRECTED TOWARDS THE BEGINNER IN SURGERY - MEDICAL STUDENT AND THE SURGERY RESIDENT.
Abruptio placenta including nursing management.akshaya r nair
This document discusses abruption placentae, which is premature separation of a normally situated placenta, causing bleeding. It has an incidence of about 1 in 200 deliveries. It can be revealed, concealed, or mixed. Risk factors include high birth order, advancing age, hypertension, and trauma. Clinical features depend on whether it is revealed, concealed, or mixed. Diagnosis is mainly clinical with ultrasound and labs. Management includes prevention, emergency measures like IV fluids and blood, and either immediate delivery, managing complications, or expectant management depending on the situation. Nursing interventions address pain management, fluid volume deficit, ineffective tissue perfusion, risk of anemia and infection, and fetal hypoxia.
Achalasia is a motility disorder of the esophagus characterized by lack of esophageal peristalsis and failure of the lower esophageal sphincter to relax when swallowing. This causes food to get stuck in the esophagus. It is caused by degeneration of the myenteric plexus which normally coordinates relaxation of the sphincter and contractions. Symptoms include difficulty swallowing, chest pain, regurgitation of food, and weight loss. Diagnosis involves barium swallow, endoscopy and manometry. Treatment options are medications, balloon dilation of the sphincter, botulinum toxin injections, or Heller myotomy surgery.
LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UPRAHUL
This Dissertation explores the particular circumstances of Mirzapur, a region located in the
core of India. Mirzapur, with its varied terrains and abundant biodiversity, offers an optimal
environment for investigating the changes in vegetation cover dynamics. Our study utilizes
advanced technologies such as GIS (Geographic Information Systems) and Remote sensing to
analyze the transformations that have taken place over the course of a decade.
The complex relationship between human activities and the environment has been the focus
of extensive research and worry. As the global community grapples with swift urbanization,
population expansion, and economic progress, the effects on natural ecosystems are becoming
more evident. A crucial element of this impact is the alteration of vegetation cover, which plays a
significant role in maintaining the ecological equilibrium of our planet.Land serves as the foundation for all human activities and provides the necessary materials for
these activities. As the most crucial natural resource, its utilization by humans results in different
'Land uses,' which are determined by both human activities and the physical characteristics of the
land.
The utilization of land is impacted by human needs and environmental factors. In countries
like India, rapid population growth and the emphasis on extensive resource exploitation can lead
to significant land degradation, adversely affecting the region's land cover.
Therefore, human intervention has significantly influenced land use patterns over many
centuries, evolving its structure over time and space. In the present era, these changes have
accelerated due to factors such as agriculture and urbanization. Information regarding land use and
cover is essential for various planning and management tasks related to the Earth's surface,
providing crucial environmental data for scientific, resource management, policy purposes, and
diverse human activities.
Accurate understanding of land use and cover is imperative for the development planning
of any area. Consequently, a wide range of professionals, including earth system scientists, land
and water managers, and urban planners, are interested in obtaining data on land use and cover
changes, conversion trends, and other related patterns. The spatial dimensions of land use and
cover support policymakers and scientists in making well-informed decisions, as alterations in
these patterns indicate shifts in economic and social conditions. Monitoring such changes with the
help of Advanced technologies like Remote Sensing and Geographic Information Systems is
crucial for coordinated efforts across different administrative levels. Advanced technologies like
Remote Sensing and Geographic Information Systems
9
Changes in vegetation cover refer to variations in the distribution, composition, and overall
structure of plant communities across different temporal and spatial scales. These changes can
occur natural.
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
How to Make a Field Mandatory in Odoo 17Celine George
In Odoo, making a field required can be done through both Python code and XML views. When you set the required attribute to True in Python code, it makes the field required across all views where it's used. Conversely, when you set the required attribute in XML views, it makes the field required only in the context of that particular view.
How to Build a Module in Odoo 17 Using the Scaffold MethodCeline George
Odoo provides an option for creating a module by using a single line command. By using this command the user can make a whole structure of a module. It is very easy for a beginner to make a module. There is no need to make each file manually. This slide will show how to create a module using the scaffold method.
How to Setup Warehouse & Location in Odoo 17 InventoryCeline George
In this slide, we'll explore how to set up warehouses and locations in Odoo 17 Inventory. This will help us manage our stock effectively, track inventory levels, and streamline warehouse operations.
This presentation was provided by Steph Pollock of The American Psychological Association’s Journals Program, and Damita Snow, of The American Society of Civil Engineers (ASCE), for the initial session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session One: 'Setting Expectations: a DEIA Primer,' was held June 6, 2024.
The simplified electron and muon model, Oscillating Spacetime: The Foundation...RitikBhardwaj56
Discover the Simplified Electron and Muon Model: A New Wave-Based Approach to Understanding Particles delves into a groundbreaking theory that presents electrons and muons as rotating soliton waves within oscillating spacetime. Geared towards students, researchers, and science buffs, this book breaks down complex ideas into simple explanations. It covers topics such as electron waves, temporal dynamics, and the implications of this model on particle physics. With clear illustrations and easy-to-follow explanations, readers will gain a new outlook on the universe's fundamental nature.
Main Java[All of the Base Concepts}.docxadhitya5119
This is part 1 of my Java Learning Journey. This Contains Custom methods, classes, constructors, packages, multithreading , try- catch block, finally block and more.
How to Fix the Import Error in the Odoo 17Celine George
An import error occurs when a program fails to import a module or library, disrupting its execution. In languages like Python, this issue arises when the specified module cannot be found or accessed, hindering the program's functionality. Resolving import errors is crucial for maintaining smooth software operation and uninterrupted development processes.
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Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
International FDP on Fundamentals of Research in Social Sciences
at Integral University, Lucknow, 06.06.2024
By Dr. Vinod Kumar Kanvaria
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1. PRESENTING BY
DIVYANGNA B. PATEL
B.A.M.S
2nd PG SCHOLAR,DEPT. OF KAYA CHIKITSA
GOVT. AKHANDANAND AYURVED COLLEGE, AHMEDABAD.
GUIDED BY
DR. SURENDRA A. SONI
M.D, PhD
PROF. & HEAD, PG DEPT. OF KAYA CHIKITSA
GOVT. AKHANDANAND AYURVED COLLEGE, AHMEDABAD, GUJARAT, INDIA.
2. INDEX TOPIC NAME:
1.INTRODUCTION 12.EPITHELIAL DYSPLASIA
2.DEFINATION 13.NEOPLASIA
3.PREVALANCE 14.MANAGEMENT
4.CAUSATIVE FACTOR 15.AYURVEDIC CONCEPT
5.SIGN AND SYMTOMS 16.AYURVEDIC PHYSIOLOGICAL
ASPECT
6.PATHOPHYSIOLOGY 17.ASSOSIATED DISEASE ACCORDING
TO AYURVEDA
7.DIAGNOSIS 18. INVOLVEMENT OF RASADI SAPTA
DHATU IN AMLAPITTA
8.EARLY DIAGNOSIS 19.UNDERSTANDING THE PROGRESS
OF AMLAPITTA AS BASED ON
SHADVIDHA KRIYA KALA.
9.METAPLASIA 20.SAMPRAPTI GHATAK
10.HYPERPLASIA 21.CHIKITSA SUTRA
11.DYSPLASIA 22.PATHYA-APATHYA, CONCLUSION
3. A CONDITION IS NAMED AFTER
SURGEON “NORMAN BARRETT”.
THIS CONDITON IS GENERALLY
DISCRIBED BY “PHILIP
RAWLANDALLISON” IN 1946.
IT IS ALSO CALLED AS BARRETT‘S
OESOPHAGUS AND “COLUMNAR
EPHITHELIUM LINED LOWER
OESOPHAGUS”(CELLO).
INTRODUCTION:
4. DEFINATION:
DAMAGE (DYSPLASIA) TO THE LOWER
PORTION OF THE OESOPHAGUS THAT
CONNECTS THE MOUTH AND
STOMACH.
IT IS THE RESULT OF REPEATED
EXPOSURE OF STOMACH ACID AND
ALSO RESULT OF “GERD” (GASTRO
ESOPHAGEAL REFLUX DIESASE).
SYNONYMS: ALLISON-JOHNSTONE
ANOMALY.
5. ONLY 10% -15% CHANCE IN GERD WILL
DEVELOPE “BARRETT SYNDROME”.
BARRETT SYNDROME IS A SERIOUS
COMPLICATION OF GERD.
IT INCREASE THE RISK OF DEVELOPING
OESOPHAGEAL ADENOCARCINOMA WHICH IS
SEVERE POTENTIALLY FATAL CANCER OF
ESOPHAGUS.
IF BARRETT OESOPHAGUS TURN INTO CANCER IT
WILL TAKES SEVERAL YEARS.
IN “LOW RISK” CASES BARRETT OESOPHAGUS
TISSUE WILL TAKE 2 TO 8 WEEKS FOR HEAL.
PREVELANCE:
6. CAUSATIVE FACTORS:
LONG STANDING “GERD”.
NO MORE HARDWORK.
OBESITY (FAT AROUND ABDOMEN
MAY INCREASE
POSSIBILITY)
SPICY FOOD, IRREGULAR FOOD
HABITS.
EXCESSIVE SMOKING.
INDIGESTION
7. SIGN AND SYMPTOMS:
HEMATEMESIS: DUE TO GASTRIC
REFLUX.
WEIGHT LOSS: INDIGESTION
DYSPHAGIA: DUE TO GERD,
INFLAMMATION IN OESOPHAGUS.
HEART BURN: DUE TO GASRIC REFLUX.
PAIN IN STOMACH WHERE
OESOPHAGUS MEETS
STOMACH
IT MAY BE INCREASE THE RISK OF
CENTRAL OBESITY.
8.
9. PATHOPHYSIOLOGY:
IT’S CHRONIC INFLAMMATION.
IN THIS DISEASE STOMACH ACID, BILE, SMALL INTESTINE,
PANCREATIC CONTENTS DAMAGE THE CELL OF LOWER
OESOPHAGUS.
WHEN CHRONIC OR LONG TERM REFLUX OF STOMACH
CONTAIN UP INTO OESOPHAGUS DAMAGE THE NORMAL INNER
LINING OF OESOPHAGUS.THIS PROCESS TAKES MANY YEARS.
CELLULAR & DNA DAMAGE ALTERS THE DIFFERENTION
POTENTIAL OF PROLIFERATING EPITHELIAL CELLS.
REASERCHERS ARE UNABLE TO PREDICT WHY HEART BURN
DEVELOPE IN BARRETT’S OESOPHAGUS.
SOMETIMES SOME PEOPLE HAVE NO SYMTOMS OF HEART
BURN IN BARRETT’S OESOPHAGUS.
IT’S PRINCIPLE OF CHRONIC INFLAMMATION IN “GERD”.
13. DIAGNOSIS:
ENDOSCOPY (ESOPHAGOGASTRODEODENOSCOPY) IN WHICH FIBRE
OPTIC INSERTED IN MOUTH AND EXAMINE THE OESOPHAGUS,
STOMACH, DEODENUM.
BIOSCOPY
BOTH MACROSCOPIC AND MICROSCOPIC EXAMINATION.
COLUMNER EPITHALIAL CELL REPLACE THE NORMAL SQUAMOUS
EPITHALIAL CELL(METAPLASIA).
THEY INCREASE THE RISK OF ADENOCARCINOMA.
THE CELL OF BARRETT SYNDROME ARE CLASSIFIED IN 4 TYPES:
(1) NON DYSPLASTIC-CANCER CELL PRESENT, NO ABILITY
TO SPREAD.
(2)LOW GRADE DYSPLASIA-VERY EARLY FORM OF PRE CANCER
OF OESOPHAGUS. CELL LOOKS LIKE ABNORMAL CELL BUT NO
TO SPREAD.
(3)HIGH GRADE DYSPLASIA-PRE CANCEROUS CHANGE IN
OESOPHAGEAL CELL. LOOKS LIKE INTESTINAL CELL. ABNORMAL
CELL.
(4)FRANK CARCINOMA- SEVERE DYSPLASIA.
14. IN WESTERN COUNTRIES THEY
OESOPHAGECTOMY AS FIRST LINE OF TREAMENT
FOR “HGD”(HIGH GRADE DYSPLASIA) AND
ADENOCARCINOMA BUT HAS LOW SUCCESS
RATE.
ENDOSCOPIC TREATMENT IS SUGGESE IF
PATIENT IS UNFIT FOR SURGERY.
ENDOSCOPY IS MORE EFFECTIVE AND LESS
EXPANSIVE THAN SURGICAL TREATMENT.
AFTER ALL IT’S ALL DEPENT UPON DOCTOR
AND RATE OF SEVEARITY.
DIAGNOSIS:
15.
16. EARLY DIAGNOSIS ? :
IN THIS CONDITION 30 TO 50 FOLDS INCREASE THE
RISK OF ADENOCARCINOMA.
SURVIVAL RATE OF OESOPHAGEAL CANCER IS ONLY
9%.
70% PEOPLE DON’T PRESENT UNTIL THE DISEASE IS
STAGE III OR HIGHER.
B.O. IS IMPORTANT FACTOR FOR OESOPHAGEAL
CANCER. STAGE OF CANCER SURVIVAL RATE
I 80%
II 30%
III 18%
IV 4%
17. METAPLASIA:
IT IS THE TRANSFORMATION OF ONE
DIFFERENTIATED CELL TYPE TO ANOTHER
DIFFERENTIATED CELL TYPE.
IF ORIGINAL CELL ARE NOT ROBUST ENOUGH
TO WITHSTAND THEIR ENVIRONMENT,SO THEY
WILL TRANSFORM INTO ANOTHER TYPE BETTER
SUITED TO THEIR ENVIRONMENT.
IT IS EARLY PHASE OF CARCINOGENESIS,
SPECIFICALLY THOSE WHO HAS SUSPECTIBILITY
OF CANCER.
18. HYPERPLASIA:
THE ENLARGEMENT OF AN ORGAN OR TISSUE
CAUSED BY AN INCREASE IN THE
REPRODUCTION RATE OF IT’S CELLS.
MICROSCOPICALLY CELLS RESEMBLE NORMAL
BUT INCREASED IN NUMBERS.
SOMETIMES IT IS CONFUSED WITH BENING
NEOPLASIA OR BINIGN TUMOR.
19. DYSPLASIA:
THE PRESENCE OF CELLS OF AN ABNORMAL TYPE
WITHIN A TISSUE,WHICH MAY SIGNIFY A STAGE
PRECEDING THE DEVELOPEMENT OF CANCER.
IT IS AN ABNORMAN DEVELOPEMENT OR
EPITHELIAL ANOMALY OF GROWTH AND
DIFFERENTIATION.
20. EPITHELIAL DYSPLASIA:
AFTER DIAGNOSIS OF BARRETT’S SYNDROME IT MAY BE RISK TO
PROGRESSION TO CANCER DEVELOPEMENT OF EPITHELIAL
DYSPHAGIA.
IT’S SUM OF VARIABLE DISTURBANCE OF EPITHALIAL
PROLIFARATION AND DIFEERNTIATION AS MICROSCOPIC LEVEL.
SQAMOUS CELL WHICH IS FOUND ON TOP LAYER OF
OESOPHAGUS WHICH LOOK LIKE FISH SCALE WHEN VIEWED IN
MICROSCOPE.AND GOBLET CELLS NORMALLY LINED INTESTINE
NOT OESOPHAGUS .
WHEN GOBLET CELL TAKE PLACE IN OESOPHAGUS IT’S CALLED
INTESTINAL METAPLASIA.WHEN INTESTINAL METAPLASIA
REPLACES SQAMOUS MUCOSA IN OESOPHAGUS IT WILL CALLED
BARRETT OESOPHAGUS.
21. NEOPLASIA:
IT IS A TYPE OF ABNORMAL AND EXCEESIVE
GROWTH OF TISSUE.WHICH IS
UNCOORDINATED WITH NORMAL
SURROUNDING TISSUE AND GROWING
ABNORMALLY,EVEN IF ORIGINAL TRIGGER IS
REMOVED.
THIS ABNORMAL GROWTH USUALLY FORMS A
MASS.
22. MANAGEMENT:
HIGH GRADE DYSPLASIA: SURGICAL REMOVAL OF
OESOPHAGUS.
ENDOSCOPIC RESECTION OR REDIOFREQUENCY ABLATION.
LASER TREATMENT IN SEVERE DYSPLASIA.
MALIGNENANCY :SURGERY,RADIATION
THERAPY(CHEMOTHERAPY).
ENDOSCOPIC RESECTION KNOWN AS “NISSEN
FUNDOPLICATION” CAN REDUCE THE REFLUX OF ACID FROM
STOMACH IN TO OESOPHAGUS. REMOVAL OF MUCOSA AND
SUBMUCOSA LEAVING MUSCULARIS PROPIA EXPOSED AND
MAKE CONFIRM THAT CANCEROUS TISSUE HAS MARGINS
WITHIN THE RESECTED LESION.
THIS SURGERY IS USEFULL IN “LOW RISK” (CANCER TISSUE
LIMITED IN MUCOSAL LAYER. “ HIGHER RISK” PATIENT GIVEN
POOR RESULT.
ON OTHER SIDE “NSAIDS” DRUGS ALSO USED IN PREVENTION.
27. DHATUGATTVA OF AMLAPITTA-DHATUDUSTI OF
3 DHATU IN ANNA NALIKA .
BARRETT’S ESOPHAGUS IS A SPECIFIC ADVANCE
CONDITION OF AMLAPITTA PRESENTATION OF
AMLAPITTA PRESENTATION WITH PROGRESSIVE
DHATUGATTVA CAN COMPARE WITH MORE NEAR
TO VATADHIK AMLAPITTA, URDHVAG AMLAPITTA.
कम्पप्रलापमूच्छॉचिममचिममगात्रावसादशूलानि।
तमसो दशॅिववभ्रमववमोहहषॉण्यनिलकोपात ्।।9।।
MADHAV NIDAN UTTARDHA-51.
28. SHADVIDHA KRIYA KALA DISCRIPTION IS
EXCELLENT APPROCH TO UNDERSTAND ANY G.I.T.
DISORDER PROPERLY .
(1) SANCHAY
(2) PRAKOPA
(3) PRASAR
(4) STHAN SAMSHRAYA
(5) VYKTA
(6) BHEDA. 6 STAGES ARE FOR SHADVIDHA KRIYA
KALA.
29. CHARAKOKTA AMASHAYA IS MAIN SITE FOR
COUGH AND PITTA DOSHA, ANY
DISTURBANCE/IMBALANCE IN AMASHAYA MAY
INITIATE THE SHADVIDHA KRIYA KALA PATTERN
ACCUMULATION /VITIATION/PROGRESS OF
VATADI DOSHAS AS PER SHADVIDHA KRIYAKAL
PATTERN.HENCE BEING A MAIN ASHAY THAT
ACCEPTS THE FOOD INGESTED IS VERY
IMPORTANT. THIS IS THE REASON THAT SHAD
VIDHA KRIYAKALA HAS GREAT IMPORTANCE IN
UNDERSTANDING/ANALYSE ALL DISEASE
SPECIALLY G.I.T. DISEASE.
30. SHADVIDHA KRIYA
KALA
UNDERSTANDING THE PROGRESS OF AMLAPITTA AS
BASED ON SHADVIDHA KRIYA KALA. (SHUSHRUT
SAMHITA SUTRA STHAN 21/18,27,32,33,34)
SANCHAY PARIDAHA, OSHA –CHOSHA, AROCHAK, AVIPAKA,
ANGSADA
PRAKOPA KOSHTHA TODA, PARIDAHA, SARVATODAHA, AMLIKA,
ANNA DWESHA, HRADAYOTKLEDA.
PRASAR ATOP, ANGASADA, AVIPAKA, AROCHAKA, VAMAN,
KOSHTH TODA, SANCHARAN.
STHAN SANSHRAYA KUSHTHA, VISARPA
VYAKTA FULLY BLOWN SIGN AND SYMTOMS OF THE DISEASE
AS PER DOSHAJ DOMINANCE.
BHEDA PROGRESS OF THE DISEASE IN RASADI SAPTA DHATU
AS DISPLAYED IN TABLE NO 1.
37. CONCLUSION:
BARRETT’S OESOPHAGUS IS AN ADVANCE CHRONIC
CONDITION OF AMLAPITTA DISEASE WHERE PROGRESS OF
THE DISEASE REACHES MANSA DHATU CROSSING THE RAS
AND RAKTA DHATU AS PER THE PRINCIPLE OF
DHATUGATTVA PATTERN MENTION BY ACHARYA CHARAK.
REFLUXED PITTA FROM ADHO AMASHAY TO URDHVA
AMASHAY MAINLY CAUSES THE DAMAGE AT CARDIAC
ORIFIC OF STOMACH. MANAGEMENT IS SO SIMPLE THAT IT
CAN BE CHECKED VERY EASILY WITH ANULOMAN,
DIPAN/PACHAN(TIKTA RAS), SNEHAN, BHRIHAN ETC.
SUCH ALL VARIOUS G.I.T. CLINICAL PRESENTATION ARE
MAINLY BASED ON DOMINANCE OF VAYU/ INDIVIDUAL
DOSHA/ INVOLVEMENT OF EITHER RASADI DHATU ETC.
THE PATHOGENESIS OF ALL ABOVE CLINICAL
PRESENTATION MAINLY TAKES PLACE IN MAHASTROTAS
HENCE DIAGNOSIS IS USUALLY CONFIRED ON THE BASIS
OF DOMINANCE SIGN AND SYMPTOMS OF DOSHA, DHATU,
MALA.