Peptic ulcer disease is caused by defects in the stomach or duodenal mucosa that extend through the inner lining. Common causes include Helicobacter pylori bacteria, nonsteroidal anti-inflammatory drugs, stress, and smoking. Patients experience gnawing or burning pain that is relieved by food and worsens with fasting. Diagnosis involves imaging tests like barium X-rays or endoscopy with biopsy. Treatment includes antibiotics to kill H. pylori, proton pump inhibitors to reduce acid, and surgery for complications like bleeding or perforation. Goals of treatment are to heal ulcers and prevent future recurrence.
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 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.
Gastroparesis is a condition in which a human stomach cannot empty itself of food in a normal manner. Gastroparesis disorder is also known as delayed gastric emptying.
Seminar present the Upper Gastrointestinal Bleeding problems
Edited by : Dr. Inzar Yassen & Dr. Ammar L. Aldwaf
in Hawler Medical Uni. collage of medicine in 14/01/2014
Iraq - Kurdistan - Erbil
Acute pancreatitis means inflammation of the pancreas that develops quickly. The main symptom is tummy (abdominal) pain. It usually settles in a few days but sometimes it becomes severe and very serious. The most common causes of acute pancreatitis are gallstones and drinking a lot of alcohol.
Gastroparesis is a condition in which a human stomach cannot empty itself of food in a normal manner. Gastroparesis disorder is also known as delayed gastric emptying.
Seminar present the Upper Gastrointestinal Bleeding problems
Edited by : Dr. Inzar Yassen & Dr. Ammar L. Aldwaf
in Hawler Medical Uni. collage of medicine in 14/01/2014
Iraq - Kurdistan - Erbil
Acute pancreatitis means inflammation of the pancreas that develops quickly. The main symptom is tummy (abdominal) pain. It usually settles in a few days but sometimes it becomes severe and very serious. The most common causes of acute pancreatitis are gallstones and drinking a lot of alcohol.
Acid peptic disease /certified fixed orthodontic courses by Indian dental aca...Indian dental academy
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Carotid artery disease is commonly seen in association with atherosclerosis and complicate the situation. clearcut guidelines with necessary surgical details are provided in presentations.
This presentation is about peptic ulcer disease , including:Pathomorphology,etiology,symptoms,complications,diagnosis and pharmacotherapy,asurgical intervention and prevention...
This topic helps you , how to approach a patient having peptic ulcer disease and how to diagnose finally how to end up with treatment. Peptic ulcer disease a chronic disease of stomach and duodenum where the protective layer of stomach and duodenum weakens by many factors most common is H Pylori infection. Infection of H Pylori cause ulcer over time.
A localized loss of gastric as well as duodenal mucosa leads to the formation of peptic ulcer.
A peptic ulcer is a sore on the lining of your stomach, small intestine or esophagus. A peptic ulcer in the stomach is called a gastric ulcer. A duodenal ulcer is a peptic ulcer that develops in the first part of the small intestine (duodenum). An esophageal ulcer occurs in the lower part of your esophagus.
Peptic ulcer arises when the normal mucosal defense mechanisms (mucus blood flow formation of HCO3- PGE2 ) are impaired or overpowered by damaging factors (acids pepsin pylori)
Ulcers occur 5 times more commonly in the duodenum and 95% of them are found in pyloric channel
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
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 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
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
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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.
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
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
9. Helicobacter Pylori
• H. pylori is the etiologic factor in most patients with peptic
ulcer disease
• The method of H. pylori transmission is unclear, but seems to
be person-to-person spread via a fecal-oral route.
• • Live in deeper parts under lumen where PH is 7.4
• • Producing Urease which reduce the acidity of stomach
• • Protease – Mucous break down.
10.
11. A duodenal ulcer caused by H.pylori A gastric ulcer caused by H.pylori
12. Symptoms
*Pain is the most common-Gnawing or Burning midepigastric pain.
Duodenal ulcer pain develops many hours after a meal when the
bulb is empty. Relieved by food and alkali & occurs in the early hours
of the morning.
In contrast, gastric ulcer pain is exacerbated with eating.
Non-specific symptoms include:
*Anorexia
*Nausea
*Fatty food intolerance
*Bloating
*Belching
18. Urea breath test(UBT)
Urea labelled with non radioactive isotope 13C,or a
very small dose of radioactive 14C,is drunk by the
patient.If H.pylori is present in the stomach,its
powerful urease catalyses hydrolysis of urea,and
labelled carbon dioxide can be detected in breath
samples.
19. Urease test
The Urease Test consists of a twin well cartridge containing
urea, phenol red and buffer salts when reconstituted, and a
buffer. If the urease enzyme of Helicobacter pylori is present
in a biopsy specimen, the rise in pH associated with the
hydrolysis of urea causes a change in colour from yellow to
pink/red. The colour change indicates a positive reaction
and confirms the presence of Helicobacter pylori.
22. TREATMENT
• The principles of medical treatment are :
(i) withdrawal of ulcerogenic drugs - aspirin,
phenylbutazone, corticosteroids, etc.;
(ii) stop smoking and alcohol, and restrict
intake of tea or coffee to two cups a day;
(iii) adequate physical and mental rest;
(iv) diet;
(v) antacids and
(vi) other drugs.
23. Medical Therapy
The goal of medical therapy for peptic ulcer disease is to relieve
symptoms, heal craters, prevent recurrences, and prevent
complications.
1.Antacids-Magnesium hydroxide neutralize gastric acid.It is to
be taken in relatively large doses 1 and 3 hours after meals
and at bedtime.
2.Histamine H2-receptor antagonists-cimetidine, ranitidine,
famotidine and nizatidine reduce gastric acid production by
blocking the H2 receptor on the parietal cell.
3.Proton Pump inhibitors, or PPIs -omeprazole, lansoprazole,
pantoprazole, rabeprazole, and esomeprazole inactivates the
parietal cell hydrogen-potassium ATPase and this reduce acid
secretion.
4. Sucralfate forms a barrier or coating over the ulcer crater,
stimulates prostaglandin synthesis, and binds to noxious
agents such as bile salts.Stimulates prostaglandins, which
promote improved mucosal integrity and enhance epithelial
regeneration.
5.Misoprostol is a protaglandin E1 analog that increases mucosal
resistance and inhibits acid secretion to a minor degree.
25. Surgical Therapy
• Failure of the ulcer to completely heal
after an adequate trial of medical or
endoscopic therapy.
• Complications such as *
*Hemorrhage
*Perforation
*Penetration
*Gastric outlet obstruction
remain the major indications for
surgical intervention.
26. Surgical Procedures
* Vagotomy
-Truncal vagotomy with drainage
-Selective vagotomy with drainage
-Proximal gastric vagotomy without a drainage procedure
*Vagotomy with antrectomy
*Subtotal gastrectomy
31. • Injection therapy is performed with epinephrine in a
1:10,000 dilution or with absolute alcohol.
• Thermal endoscopic therapy is performed with a
heater probe, bipolar circumactive probe, or gold
probe. Pressure is applied to cause coagulation of
the underlying artery (coaptive coagulation).
• Combination therapy with epinephrine injection
followed by thermal coagulation appears to be more
effective than monotherapy for ulcers with a visible
vessel, active hemorrhage, or adherent clot.
• Hemoclips have been used successfully to treat an
acutely bleeding ulcer by approximating 2 folds and
clipping them together. Several clips may need to be
deployed to approximate the gastric ulcer folds. In
treating high-risk bleeding ulcers, combined therapy
with epinephrine and hemoclips seems to be more
efficacious than injection alone.
32. A, Endoscopic view of an actively bleeding
ulcer; B, cross-section of the stomach wall.
33. Thermally Active Methods
• Heating leads to edema, coagulation
of tissue proteins, and contraction of
arteries.
• Heat may be produced by tissue
absorbtion of laser light energy,
passage of electrical current through
tissue, or heat diffusion from another
source.
37. Injection Therapy
• A sclerotherapy catheter with a small retractable
needle is passed through the biopsy channel of
the endoscope. Non-bleeding visible vessels are
treated by the injection of a solution at three or
four surrounding sites about 1-3 mm from the
vessel. Subsequently, the visible vessel is injected.
In cases of bleeding vessels, injections are made
around the bleeding point until hemostasis is
achieved. This is followed by injection into the
vessel
38. Mechanical Therapy
• Endoscopic hemoclips have recently been
developed and made their way to the scene
of endoscopic therapy for peptic ulcer
disease.
40. Complications of Peptic Ulcers
• The major complications of peptic
ulcer disease include
1. Bleeding,
2. Perforation,
3. Penetration,
4. Gastric outlet obstruction.
41. Perforation
• Approximately 5–10% of patients with peptic ulcers.
• Two types of perforation of the stomach
and duodenum have been observed.
*Free perforation occurs when duodenal or gastric
contents spill into the abdominal cavity with
peritoneal contamination by gastric, pancreatic and
biliary juices. Clinically this produces an acute
abdomen.
*Contained perforation occurs when the ulcer
produces a full-thickness hole in the duodenum or
stomach, but the omentum or other adjacent organs
prevent peritoneal contamination.
42. Penetration
5 to 10% of perforating ulcers may erode
through the entire thickness of the gastric
or duodenal wall into adjacent abdominal
organs. Such penetration can involve
the pancreas, bile ducts,liver, and the small
or large intestine. The pancreas is the most
common site of penetration
43. Gastric Outlet Obstruction
• Fewer than 5% of patients develop gastric outlet
obstruction from pyloric stenosis. Duodenal ulcers
give rise to pyloric stenosis more often
than gastric ulcers. Peptic ulcer disease may be
accompanied by varying degrees of obstruction
caused by inflammatory swelling of the pyloric
channel or chronic scarring associated with fibrosis.