Peptic ulcer disease is caused by an imbalance between acid-pepsin secretion and mucosal defense. Major causes include Helicobacter pylori infection, NSAID use, and smoking. Common symptoms are epigastric pain, vomiting, and bleeding. Diagnosis involves endoscopy and biopsy to detect ulcers and test for H. pylori. Treatment involves acid suppression, antibiotics to eradicate H. pylori, and surgery for complications like perforation or bleeding. Goals of treatment are pain relief, H. pylori eradication, ulcer healing, and prevention of recurrence.
This presentation is about peptic ulcer disease , including:Pathomorphology,etiology,symptoms,complications,diagnosis and pharmacotherapy,asurgical intervention and prevention...
This presentation is to help readers to be equipped with knowledge on predisposing factor to peptic ulcer disease and how it can be managed in the clinical/hospital setup.
This presentation is about peptic ulcer disease , including:Pathomorphology,etiology,symptoms,complications,diagnosis and pharmacotherapy,asurgical intervention and prevention...
This presentation is to help readers to be equipped with knowledge on predisposing factor to peptic ulcer disease and how it can be managed in the clinical/hospital setup.
Acid peptic disease /certified fixed orthodontic courses by Indian dental aca...Indian dental academy
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An eroded lesion in either the esophageal, gastric, or duodenal mucosare sulting fromt heaction of gastric secretions and typically H.pulori bacterial inflammation. For online medical resources visit at http://gisurgery.info
'Photographing Change' - The Picture Press talk at American CenterThe Picture Press
With the end of the war in Sri Lanka, rapid changes are taking place in the country. Society, economy, culture, people, livelihoods, and the environment - they are all changing. Development, which already means so many different things to different people, is reshaping Sri Lanka swiftly and sometimes silently. How can this change be captured? How can we visually preserve the present, for the future? This is what The Picture Press set out to do, and was the focus of a recent presentation we made at the American Center in Colombo (May 21st 2014). The Picture Press (TPP) presentation looked at TPP’s work since its launch in December 2012, why we started the site, and why we do what we do. TPP's presentation was made by 2 of 3 of its co-curators (Iromi Perera and Anushka Wijesinha). We recommend that you read this written overview of the presentation, accompanying these slides - http://www.slideshare.net/thepicturepress/overview-of-the-picture-press-presentation-at-american-center
A short overview of one of the biggest digital printing houses in Poland.
PrintXL have more than 1,400 clients across Europe and prints over 1 mln sq meters of various types of materials each year.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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).
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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.
Best Ayurvedic medicine for Gas and IndigestionSwastikAyurveda
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
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
3. Peptic ulcer
Definition
A mucosal defect equal to or greater than 0.5 cm that
extent to or beyond muscularis mucosa. These ulcers are
caused by increased acid/ pepsin secretion or diminished
mucosal defense.
5. Gastric / duoedenal ulcer
Prevalance
H2 receptor inhibitors
Proton pump inhibitors
Effective treatment against H Pylori
• Overall risk , 10%
• More common in males
• Duodenal ulcer 4 times more common than gastric
ulcer
• Slight increase in GU due to wide spread use of
NSAIDs
11. Aetiology
1. Helicobacter pylori
• urease– urea- ammonia- hypergastrinaemia-
increased acid secretion
• H. pylori- reduces the gastric mucosal resistance
against acid and pepsin. Enzymes, cytotoxins
• Local inflammatory response due to cytotoxins
• 90% in DU
• 70% in GU
12. 2. Non steroidal anti inflammatory drugs( NSAIDs)
• 30% in GU and smaller percentage in DU
• More commonly associated with complications
• Inhibit cyclooxygenase (COX,1,2) & reduce mucosal
protective prostaglandins
13. Risk factors for NSAIDs induced ulcers
• Age > 60 years
• Past history of peptic ulcer
• Additional steroids
• Multiple NSAIDs,
• High dose
• Individual NSAIDs. Piroxicam, ibuprufen
14. 3. Heriditary
• Positive family history in DU
• Blood group O
• Increased level of serum pepsinogen 1
15. 4. Smoking
• More prone to develop gastric ulcer than DU
• Ulcer less likely to heal and prone to haemorrhage and
perforation
5. Stress
Burns,
Head injury
on ventilators
17. Summary (aetiology)
(Acid pepsin versus mucosal barrier)
• Increased acid and pepsin secretion.
– Gastrin, Histamine, acetylcholine, cholecystokinine
• Reduced mucosal barrier
– H. Pyelori
– NSAIDs
– Smoking
– Decreased bicarbonate production
– Decreased protective prostaglandins
18. Pathology Duodenal ulcer
–First part of duodenum
–50% on anterior duodenal wall, 50% on posterior
wall
–Anterior ulcers tend to perforate while posterior
tend to bleed
–Usually single but can be more than one
–Fibrosis – pyloric stenosis
–All benign
19. Pathology
Gastric ulcer
–Usually single, 2-4 cm, smooth base perpendicular
walls
–Located on lesser curve but can occur anywhere
–Larger than duodenal ulcer
–Fibrosis can lead to Hour glass deformity.
–Can penetrate into transverse colon, pancreas.
–All stomach ulcers are not benign. (4% malignant)
20.
21. Malignancy in gastric ulcer
• Benign ulcers becoming malignant.?
• Malignant to start with
• All stomach ulcers are considered malignant until
proved benign on biopsy & follow up
• Always, always take a biopsy of stomach ulcer
• 10 well targeted biopsies
22. Clinical features
• Pain abdomen
– Epigastrium, may radiate to back
– Relation with meals- hunger pain
• Periodicity
– Episodic- lasting for several weeks (periodicity)
• Vomiting
• Alteration in weight
23. • Bleeding
– Chronic
– Acute
• Other symptoms
– Dyspepsia, heartburn, epigastric fullness, loss of appetite
• Silent
– Anaemia
– Haemetemesis
– Perforation
26. • Esophagogastrduodenoscopy (EGD)
• Urea breath test
•
• Direct detection of urease activity/ H pylori in biopsy
specimen
• Biopsy of any stomach ulcer
28. Medical treatment
General measures
• Cessation of smoking
• Avoidance of spicy foods
• Avoid NSAIDs if possible
• Antacids. Aluminum hydroxide, Magnesium hydroxide
30. Eradication of H. pylori
• One of the proton pump inhibitors x 02 weeks. Duration
may vary
• Combination of two antibiotics x 02 weeks
– Amoxycillin
– Clithromycin
– Metronidazole
– Tetracycline
• Bismuth added
32. • Maintenance of treatment
– Usually not required in majority after eradication therapy
for H. Pylori
– Lowest effective dose of proton pump inhibitors for
prolonged period
33. • Surgical treatment
• Indications
• Perforation
• Haemorrhage
• Gastric outlet obstruction
• Interactable disease
– Delayed healing. Ulcer persists despite 3 months of active
treatment
– Ulcer recurrence with in one year of initial healing despite
maintenance therapy
34. Surgical treatment for uncomplicated duodenal ulcer
Aim
• Diversion of acid from the duodenum
• Reducing the acid/ pepsin secretion
• Both of the above
35. Options
• Truncal vagotomy and drainage
• Truncal vagatomy and antrectomy
• Highly selective vagotomy. First choice
• Lparoscopic
• Billroth 1 gastrectomy
• Billroth 11 gastrectomy
• Gastrojejunostomy
36.
37.
38.
39.
40.
41.
42. Operation for gastric ulcer
Goal
• To excise the ulcer
• To reduce the acid/ pepsin output
• To minimize the bile reflux and gastric stasis
• Options
• Billroth 1 gastrectomy. (Ulcerated part included)
• Billroth II gastrectomy (Ulcerated part included)
• T.Vagotomy, Drinage and ulcer excision
• Proximal gastrectomy
43.
44.
45. Complications of ulcer surgery
• Recurrent ulcerations
• Small stomach syndrome
• Bile vomiting
• Early and late dumping
• Post vagotomy diarrhoea
• Malignant transformation
• Nutritional cosequences
• Gall stones