SPA Reflective Essay

SPA Reflective Essay
Goals
I went to SPA with two goals, including: To know the criteria for type of anesthesia for each
procedure, and to know the most commonly performed procedure and whether any research had
been conducted to uncover the disease condition that warrants this procedure. According Dr.
Chopra, Kathryn, RN, and Katie, Charge nurse, severity of patient's problem and whether the
procedure will involve major tissues are some of the criteria used to decide on the type anesthesia
for each procedure. In addition, the charge nurse in person of Katie reported that
esophagogastroduodenoscopy (EGD) ranks highest among many procedures performed at SPA. I
was told that EGD is both diagnostic and therapeutic procedure, which makes it to be commonly
performed, ... Show more content on Helpwriting.net ...
My professor took walked me to SPA around 8 am, and I was introduced to the charge nurse of the
unit, who received me warmly. After this, I was assigned initially to Vaishali, RN who took me to
the first patient. With this patient, we did initial assessment before the procedure where plethora of
questions were asked to ensure patient's safety. Immediately after this, I was asked to follow one
patient to a procedure room for observation. I had the opportunity to see how the patient was
prepared for the procedure, the type of anesthesia, type of health professionals who make up the
SPA team for each procedure, and the patient is monitored throughout the process. After the
procedure, I was told to stay with the patient for 30 minutes in the recovery room, where the vital
signs are monitored every five minutes until patient fully comes around or better still, becomes fully
aware the environment. Furthermore, discharge teachings are given at recovery room, and what took
my interest was the language used in this area. One of the staff nurses said to patient that "You are
legally intoxicated for the next 24 hours, therefore, no driving, signing of legal documents, and no
operation of microwave." I like this statement because, it underscores patient safety. Thereafter, I
followed other patient, and the whole processes stated above were repeated. I learned how division
of labor brings efficiency. I will remember to utilize this in the nearest
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Brunner's Gland Hamartoma
Brunner's gland hamartoma is an uncommon benign lesion which is most commonly found in the
bulb of the duodenum. It is often a small lesion which is asymptomatic. Most are found incidentally
during upper gastrointestinal series or esophagogastroduodenoscopy. Symptoms are often
hemorrhage or duodenal obstructive symptoms which are mainly due to ulceration of the lesions.
Histologically, Brunner's gland hamartoma consists of components of Brunner's gland cells,
containing glandular, adipose and muscle cells. In this study we report a case of a 30–year–old man
presenting with upper gastrointestinal bleeding and obstructive symptoms due to a giant Brunner's
gland hamartoma in the duodenal bulb. The hamartoma was removed successfully by endoscopic
resection without significant complications. Microscopically, the lesion was found to be entirely
composed of variable Brunner's glands and adipocytes. Key Words: Brunner's gland, Hamartoma,
Gastrointestinal Bleeding Case report ... Show more content on Helpwriting.net ...
His background was hypertension, diabetes mellitus and hypercholesterolaemia. He was initially
seen in a primary clinic and underwent esophagogastroduodenoscopy where a duodenal
subepithelial lesion was found. He was diagnosed with lipoma by endoscopic ultrasonography. He
was treated conservatively and subsequent abdominal ultrasound and colonoscopy findings were
normal. The patient received 8 units of blood transfusion twice for iron deficiency anemia.
However, the patient did not improve over three months, and had ongoing dizziness and nausea. He
was then referred to this hospital for further investigation of gastrointestinal bleeding and known
duodenal lesion. The patient denied weight loss or use of non steroidal anti–inflammatory drugs
(NSAIDs). His height and weight were 180.9 cm and 145.8 kg, with a body mass index (BMI) of
44.5

A Case of a 62 Year Old with Epigastric Pain
Mr. A.M, a 62 year old man presented at the outpatient clinic with a two month history of epigastric
pain. He also reported that the pain was strongly correlated to meals. He also felt that his appetite
has decreased, however he did not lose any weight. He has a history of gastroesophageal reflux
disease (GERD), which dates back 5 years ago, which he took proton pump inhibitors for one
month. He is smoking for the last 40 years around one package a day, and does not consume any
alcohol. He had an appendectomy when he was 12 years old. Mr. A.M is married and just retired six
months ago from his former job as an accountant. He is currently on an ACE inhibitor for the
control of his hypertension. On examination, he appears comfortable and well. He has an abdominal
distention. Chest is clear on auscultation, his blood pressure is 125/75mmHg and pulse rate is
85/min. He is tender 2cm below the sternum when deep palpation is performed, no lumps are felt,
and the pain does not radiate. Liver is palpable 2cm below costal margins. There is no shifting
dullness or fluid thrill. 3. INVESTIGATIONS A referral to the cardiologist was made to exclude any
cardiac causes since the pain Mr. A.M felt was epigastric. Physical examination along with ECG as
the preferred test by the cardiologist did not reveille any abnormalities. CBC count and LFT's were
ordered. Mr. A.M was later on referred to a gastroenterologist for focused examination on the
gastrointestinal system.

Esophagogastroduodenoscopy Research Paper
Esophagogastroduodenoscopy Esophagogastroduodenoscopy (EGD) is a procedure to examine the
lining of the esophagus, stomach, and first part of the small intestine (duodenum). A long, flexible,
lighted tube with a camera attached (endoscope) is inserted down the throat to view these organs.
This procedure is done to detect problems or abnormalities, such as inflammation, bleeding, ulcers,
or growths, in order to treat them. The procedure lasts about 5–20 minutes. It is usually an
outpatient procedure, but it may need to be performed in emergency cases in the hospital. LET
YOUR CAREGIVER KNOW ABOUT: Allergies to food or medicine. All medicines you are taking,
including vitamins, herbs, eyedrops, and over–the–counter medicines and creams. Use ... Show
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However, as with any procedure, complications can occur. Possible complications include:
Infection. Bleeding. Tearing (perforation) of the esophagus, stomach, or duodenum. Difficulty
breathing or not being able to breath. Excessive sweating. Spasms of the larynx. Slowed heartbeat.
Low blood pressure. BEFORE THE PROCEDURE Do not eat or drink anything for 6–8 hours
before the procedure or as directed by your caregiver. Ask your caregiver about changing or
stopping your regular medicines. If you wear dentures, be prepared to remove them before the
procedure. Arrange for someone to drive you home after the procedure. PROCEDURE A vein will
be accessed to give medicines and fluids. A medicine to relax you (sedative) and a pain reliever will
be given through that access into the vein. A numbing medicine (local anesthetic) may be sprayed
on your throat for comfort and to stop you from gagging or coughing. A mouth guard may be placed
in your mouth to protect your teeth and to keep you from biting on the endoscope. You will be asked
to lie on your left side. The endoscope is inserted down your throat and into the esophagus, stomach,
and duodenum. Air is put through the endoscope to allow your caregiver to view the lining of your
esophagus

What Are The Advantages And Disadvantages Of Endoscopy
Abstract
Purpose Endoscopy is very important method to obtain exact information such as name of disease,
cause of disease and how to cure diseases. Also, surgery with endoscopy, called endoscopic surgery
is really useful tool for elaborate treatment. So, this paper accounts for a variety of endoscopy in
detail for people to know easily what endoscopy is.
Methods This review article explains the fundamental concept of endoscopy, difference between
optical & electronic endoscope, comparison rigid endoscope to flexible endoscope. Also, this paper
introduces past & present types of endoscopy and present & future types of endoscopy.
Conclusions
Keywords Endoscope, Endoscopy, Capsule endoscopy, NIR endoscopy, 3D endoscopy, Virtual
endoscopy
INTRODUCTION
Nowadays, Endoscopy has been very widely used. Endoscopy is a medical procedure done with an
instrument called an endoscope. The ... Show more content on Helpwriting.net ...
Doctors can even use the images to create a black and white image that looks like an actual
endoscopy.[29]
Virtual endoscopy has some advantages over standard endoscopy; nothing is put into the body and
no drugs are needed for the test and the doctor can change the angle or magnify the image, which
can help with diagnosis. However, there are some disadvantages, too. Virtual endoscopy shows
good detail, but it's not quite as good at showing fine surface detail as standard endoscopy such that
it can't show color differences. It also exposes the patient to about the same amount of radiation as a
standard CT. And because nothing is put into the body, the doctor can't take biopsy samples or
remove growths. If something abnormal is found, the patient may still need a standard endoscopy.
According to Pauriol–Lacaze, S. et al. [30] virtual endoscopy is a considerably new procedure, and
doctors aren't yet sure how best to use it. It will likely be used more in the future as the technology

GI Endoscopy Biopsy (EGD)
43239 Upper GI endoscopy biopsy (Esophagogastroduodenoscopy, flexible, transoral; with biopsy,
single or multiple). The beneficiary underwent an esophagogastroduodenoscopy (EGD) and was
diagnosed with "unspecified disorder of the stomach and duodenum" (537.9), which is not covered
by the Local Coverage Determination Policy L29167. The documentation did not include prior
physician progress notes to support the medical necessity for the EGD procedure. There was no
indication of symptoms of physical findings that would support the medical necessity of the
procedure in accordance with Medicare guidelines. The beneficiary was a 65 year old woman who
had been diagnosed with mild gastritis. She complained of abdominal pain for approximately 5 ...
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The provider submitted a copy of the claim and medical records. The provider also indicated that a
corrected claim had been submitted with the diagnosis code 537.89. On March 09, 2014, the QIC
sent a letter to the provider stating that the payment was "denied due to the lack of medical
necessity/invalid diagnosis." The claim was billed with the diagnosis 537.9 (the incorrect code) not
covered within the LCD. However, the provider had already submitted the appeal with the correct
diagnosis twice. Was that information taken into account at the time of the QIC's determination? The
QIC also indicated that the documentation submitted did "not include any prior physician progress
notes from the billing physician/PCP to substantiate medical necessity for the procedure billed."
How would the progress notes have changed the determination? The claimant was evaluated in the
ER; the ER doctor discussed the case with the billing provider while the claimant was still in the
ER. Per the ER documentation "6:46 PM Discussed case with Dr. Selub (GI) states for the PT to call
his office at 9 AM and he will be able to F/U with the Pt in 1

Ferritin Case Study
K. Pagana, T. Pagana, and Pike–MacDonald (2013) state "the normal values of ferritin as:
Male: 12–30 mcg/L Female: 10–150 mcg/L
Child/Adolescent:
Newborn: 25–200 mcg/L 2–5 months: 50–200 mcg/L
≤1 month: 200–600 mcg/L 6 months to 15 years: 7–142 mcg/L
1 mcg/L of serum ferritin corresponds to approximately 8 mg of stored iron" (p. 264).
All ages; both sexes who may be experiencing:
– unexplained fatigue, weakness, dizziness, headaches, pallor, pica (iron deficiency)
– unexplained joints pain, fatigue, weakness, weight loss, energy decrease, pain in abdomen,
decreased libido, hair loss, or heart issues such as congestive heart failure (iron overload)
– blood loss (specifically female teens/women with heavy menses), trauma patients
– blood in stool/rectal bleeding or positive fecal occult blood (FOB)
– malnutrition
Or patients:
– with iron overload disorders or family disposition for hemochromatosis, hemosiderosis; or at risk
for iron overload from iron poisoning, or recent blood transfusions
– with chronic diseases such as cancer, alcoholism, uremia, collagen diseases, chronic liver diseases
such as hepatitis, or patients with chronic renal failure to monitor iron stores
– with already diagnosed anemia – all types (to monitor treatment)
– who are pregnant or post delivery
Information collected from: Dunning III & Fischbach (2011), Pagana et al., (2013), Lab Tests
Online (n.d.) and Juravinski Cancer Centre (JCC) personal

Essay On Ulcerative Colitis
T–CELL RESPONSE:
This disease have a TH2 profile, but the concentrations of IL–4 and IL–5, which are normally
increased in TH2 responses, have been variable in ulcerative colitis tissues.
From studies of the oxazalone colitis model, one of the few models to exhibit a TH2 profile,
ulcerative colitis has an atypical TH2 response, mediated by natural killer T cells that secrete IL–13.
These natural killer T cells are activated by APCs that express the nonclassical major
histocompatibility
MHC molecule, CD1d, which presents lipid instead of protein antigens to T cells. will require
blockade of IL–13 could provide an exciting new approach to ulcerative colitis treatment.
T–cell subsets are stimulated by APCs, most notably dendritic ... Show more content on
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Inflammation occurs in rectum and sigmoid colon. Symptoms include bloody diarrhea, abdominal
cramps and pain.
Left–sided colitis. Inflammation spread from the rectum up through the sigmoid and descending
colon. Symptoms include bloody diarrhea, abdominal cramping left side pain, and weight loss.
Pancolitis. Affects the entire colon and causes severe bloody diarrhea, abdominal cramps and pain,
fatigue, and significant weight loss.
Acute severe ulcerative colitis. Rare form of colitis affects the entire colon and causes severe pain,
diarrhea, bleeding, fever and inability to eat.and increase risk of colon cancer 70–80%. And usually
doctor suggest to remove the part of colon or whole colon.
SYMPTOMS: According to inflammation and site, symptoms can be different depend on the type of
colitis. Diarrhea or internal bleeding, risk of causing anemia followed by bloody stool, fever, weight
loss due to low appetites, fatigue, stomach pain and cramping some other complication occur like
pore in the colon, loss of water and blood from the body, loss of calcium and damage the bone
osteoporosis, high risk of colon cancer,sorness and abscess in mouth, stiffness, lung embolism
,blood coagulation in deep vein

DIAGNOSIS:
Diagnosis occurs on the basis of medical history of the patient related to gastrointestinal symptoms
and physical examination for the GI tract, dermatologic, optical system. Looking for any condition
among crohn's, ischemic, infections and

The Tuberculosis ( Mtb )
Mycobacterium tuberculosis (MTB) is an infection that about one–third of the population has.
MTB, which is an airborne infection, can infect nearly any organ of the body. Human
immunodeficiency virus or HIV also has an impact on the world. In 2011, it was estimated that
around 34 million people were living with HIV. This virus is contracted by the exchange of blood or
bodily fluids whether it be from sexual contact or sharing needles or syringes used for drugs. In
addition, HIV is a retrovirus specifically attacking the CD4 T lymphocytes. Acquired
immunodeficiency syndrome (AIDS) is the disease caused by already having the HIV infection. The
possibility of having both diseases has gradually diminished due to the improvements made in ...
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The rest of her examinations deemed normal. He white blood cell count was 7500/µL (normal range
being 4,800–10,800/µL with seventy–five percent neutrophils. Her hematocrit test (the volume of
red blood cells to the total volume of blood) was thirty–four point three percent. Along with her
urinalysis, serum electrolytes, and liver function tests, the patient was ruled completely normal.
Treatments that were provided during her stay were empiric intravenous vancomycin and
piperacillin/tazobactam, along with oral fluconazole, which was added due to oral candidiasis.
Azithromycin 1200mg weekly was added for MAC prophylaxis and since she was at a lower risk
for the nosocomial pathogens, the antibiotics given were reduced to amoxicillin instead.
The patient had tests ran such as an esophagogastroduodenoscopy (EGD) which stated the
esophagus was estimated average. No granuloma or acid–fast bacilli(AFB) were seen, her
duodenum was normal, but atrophic gastric mucosa was seen and enlarged folds with friable mucosa
with lacy reticular pattern was found in gastric fundus. Therefore, an upper endoscopic ultrasound
(EUS) was conducted. This showed that the patient had a 3.1cm x 1.8 cm heterogeneous mass lesion
coming from the submucosa in the fundus with small anechoic spaces. Viscous serosanguinous
liquid was obtained by fine needle aspiration. A gram stain confirmed negative of aspirate yet the
AFB showed an excess

Dr Peter Chweyah Case Summary
An attending physician statement completed by Dr. Peter Chweyah (Internal Medicine), dated
06/16/2016, indicated that the claimant presented with complaints of lower extremity weakness,
neuropathy, weight loss, acute renal failure, and gout, as well as anemia. Objective findings showed
an extreme weakness of the legs and pain in the feet. He also had diabetes mellitus type 2, chronic
kidney disease, and hypertension. It was noted that the claimant was totally disabled from
05/30/2017 through 06/15/2017 and 05/23/2017 – 05/26/2017 secondary to gout.
A progress note from Dr. Chweyah, dated 06/26/2017, indicated that the claimant presented for
follow–up of gout, muscle weakness, and weight loss. He had ongoing weakness of the legs with
knee pain. He stated that her weight drop had stopped. His current weight was 210 pounds.
Objective findings showed a pulse rate of 105 with a blood pressure of 92/60. His BMI was 28.56.
He was diagnosed with an acute pain in both knees, muscle weakness in the legs, chronic gout, and
weight loss. A referral to neurology and medications were recommended. ... Show more content on
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Chweyah, dated 08/11/2017, indicated that the claimant presented for a follow–up visit after his
discharge from the hospital on 08/08/2017. He was admitted on 08/04/2017 due to normocytic
anemia, pain in both knees, starvation ketoacidosis, hypertension, gout with tophus, and duodenitis.
The esophagogastroduodenoscopy revealed erythematous duodenopathy, erythematous mucosa in
the antrum, and small hiatal hernia. He had a colonoscopy which revealed internal hemorrhoids.
Objective findings showed blood pressure of 112/86 with a pulse of 105. He was diagnosed with
quadriceps weakness, pain in both knees, normocytic anemia, type 2 diabetes mellitus,
hypertension, stable chronic kidney disease stage III, and bilateral impacted cerumen. It was noted
that he can return to work on 08/16/2017 with limitations of not standing for more than 10 minutes
at a time for 1

Clinical Overview : Esophageal Varices
CLINICAL OVERVIEW – Esophageal Varices
TERMINOLOGY
CLINICAL CLARIFICATION o Esophageal varices are abnormal, enlarged veins in the lower part
of the esophagus. Esophageal varices develop when normal blood flow to the liver is obstructed by
scar tissue in the liver or a clot. Seeking a way around the blockages, blood flows into smaller blood
vessels that are not designed to carry large volumes of blood. The vessels may leak blood or even
rupture, causing life–threatening bleeding. CLASSIFICATION
Small varices and no hemorrhage
Hepatic venous pressure gradient ≥ 10mmHg
Varices development rate 8% per year
Large varices and no hemorrhage
Hyper dynamic circulation
Progression from small to large 8% per year
Variceal hemorrhage
Pressure > Variceal wall tension
Esophageal hemorrhage 5–15% per year
Bleeding in patients with gastric varices is reports in 25% of patients in 2 years
Recurrent hemorrhage
Persistence of portal pressure and variceal status
DIAGNOSIS
CLINICAL PRESENTATION History
Patients are usually asymptomatic unless they bleed
Symptoms of bleeding esophageal varices include:
Vomiting blood
Black, tarry or bloody stools Physical Examination
If varices are related to liver disease, may see any of the following: Shock (in severe cases)
Yellow coloration of your skin and eyes (jaundice)
A cluster of tiny blood vessels on the skin, shaped like a spider (spider nevi)
Reddening of the skin on the palm of hands (palmar

Clinical Rotation At Florida Hospital
This is one of the biggest hospitals in Florida and I feel really fortunate to work here as an observer
in the Department of Nephrology. The morning rounds with the attending physician are very
informative as they are enabling me to learn many new concepts like indications of renal biopsy and
management of post–transplant patients. Observing management of patients before, during and after
the dialysis is a routine over here. Since there was a training course regarding the EPIC software of
electronic medical records before the start of the rotation, the advantage of having access to patient
records will go a long way in consolidating my grip on patient notes and charting.
During my clinical rotation at Florida Hospital, Tampa, I got the opportunity of doing retrospective
analysis on EKOS Catheter and Angiovac Cannula Systems. Study of EKOS Catheter is mainly
focused on the effect of ultrasound–guided localized release of tPA within the pulmonary artery on
pulmonary artery pressures while Angiovac study deals with catheter assisted decrease in systemic
thrombus load and its benefits and complications. While working on data collection, I have gained a
considerable command on CERNER software of EMRs. The foresight, precision and patience I am
learning as a researcher will help me better understand a disease from its origin and enable me to
become a better clinician.
Three week rotation in Internal Medicine at Florida Hospital, Tampa was thrilling as it is one of the
biggest

Barium Swallow : Patient Clinical Details
Barium swallow Patient clinical details The patient was referred to the Radiologist from his GP,
because of ongoing pain and difficulty when swallowing. The patient was 45years old male,
consumed alcohol regularly and a heavy smoker. Due to the clinical details the radiologist decided
to perform a barium swallow this allows for the best visualisation of the internal structures, mainly
the upper gastrointestinal tract and the stomach. Barium swallows show any strictures or narrowing
's in this region which would account for the patients clinical details. Esophageal carcinomas are
able to be diagnosed from: Barium swallow Chest MRI or thoracic CT Endoscopic ultrasound
Esophagogastroduodenoscopy (EGD) and biopsy PET scan Because barium swallows are non–
invasive and clearly outline the shape of the esophagus, the radiologist decided this form of imaging
was best suited to the patient and his clinical details which strongly suggested cancer to be the cause
of the clinical details. Esophageal cancers usually present with the following symptoms: Difficulty
swallowing (dysphagia) Backwards movement of food through the esophagus and possibly mouth
(regurgitation) Chest pain not related to eating Weight loss without trying Worsening indigestion or
heartburn Coughing or hoarseness But early esophageal cancers typically causes no symptoms and
have no apparent signs. Barium Swallow A barium swallow is a procedure of the upper
gastrointestinal tract,

Signet-Ring Cell Adenocarcinoma Case Summary
A Case of Signet Ring Cell Adenocarcinoma–Unique presentation with Concurrent Non–
gastrointestinal Malignancy.
Authors: Sandar Linn1, Hernan A. Lopez–Morra1, Sofia Nigar1, Juan Tejada1, Nami S Haeri1,Shah
Giashuddin2,Jonathan Chow2, Mahesh K. Krishniah1, Sury Anand1.
1 Division of Gastroenterology, Department of Internal Medicine, the Brooklyn Hospital Center,
Brooklyn, NY.
2 Department of Pathology, the Brooklyn Hospital Center, Brooklyn, NY.
Abstract:
Background: Signet–ring cell adenocarcinoma (SRCC), the histological variant of ampullary
carcinoma, is an extremely uncommon malignancy. To our knowledge, this report is the first case of
SRCC with concurrent non–gastrointestinal malignancies.
Case Report: A 66 year old male with history of prostate cancer, anglioblastoma multiforme
presented with jaundice and abdominal pain. Endoscopic retrograde cholangiopancreatography
(ERCP) and Endoscopic Ultrasound (EUS) suggested a duodenal tumor at ... Show more content on
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90% of SRCC take place in the stomach [1]. SRCC is extremely uncommon in the ampulla of Vater,
and only 32 previous cases have been described in the literature [3].
Because of its uncommon entity, the histological genesis of SRCC is still mysterious. While
previous authors suggested that the tumor came from the ectopic gastric mucosa located at the
ampullary region since most of SRCC are found in stomach [9, 10], others declared that SRCC
occurs from the gastric–type metaplastic epithelium [1] which appeared possibly due to the elevated
acidity since the metaplastic changes were are usually observed at the duodenal bulb in peptic ulcer
patients [10]. However, Our case did not support both theories like the other case because it did not
show any gastric mucosa around the tumor nor peptic ulcer found in EGD

The Visualization Of The Small Bowel
Abstract The visualization of the small bowel has posed a challenge to gastroenterologists due to the
difficulty of physically reaching more distal regions of the small bowel anatomically. As the small
bowel can often be a source of pathology, endoscopy of the small bowel can be a useful diagnostic
and therapeutic technique. Over the last few years' enteroscopies has been introduced and being
used widely. Various types of enteroscopies are being used; among them the most commonly used
are double balloon, single balloon and spiral enteroscopies. In this dissertation, I am focusing and
comparing among the three to find which one is having highest diagnostic and therapeutic benefits.
Objective: To assess the invasive enteroscopic technique with maximum diagnostic and therapeutic
yield, for common small bowel diseases like OGIB, small bowel crohn 's and polyps. Methods:
Online electronic search of databases– Medline, CIHNAL, EMBASE, citation searching, the
relevant literatures, carefully selected keywords (enteroscopy, Single balloon enteroscopy, double
balloon enteroscopy, spiral enteroscopy) and its appropriate combinations were used. Further the
citation searching was done to identify more relevant literatures. Results: From the 1035 articles,
selected from 2001 to 2015, six articles were selected after excluding the relevant criteria's and
those were critically apprised and compared to get comprehensive results. Conclusion: The various
enteroscopic procedures have

Diagnosis And Treatment Of Cancer Essay
Cancer is very large throughout the U.S. and Canada, it is said that one and a half million people
will receive a new diagnosis of cancer each year (Ignatavicius & Workman, 2013).Many years back
a diagnosis of cancer had a very poor outcome and you were basically considered dead. Technology
and research have been focusing on cancer, and how to prevent it. This paper will review the
diagnosis of cancer as well as the staging of cancer, as well as possible treatment options and side
effects related and how to deal with the psychological burden that cancer patients deal with.
Diagnosis and Staging of Cancer The body consists of millions of tissues and cells that are grown
from conception to adulthood. Cancer cells are cells that are not normal and have the capability of
infinite replication, they are harmful to the normal cells and serve no benefit to the body
(Ignatavicius & Workman, 2013).Cancer cells are also defined as malignant cells; they tend to start
in one spot which is called the primary location. They may break from the primary location and
spread to other locations to establish more colonies. When the cancer spreads it is known as
metastasis. There are several tests that are needed to be done prior to confirming a cancer diagnosis.
Depending on the cancer suspected, different tests may be done. It is very common to take a biopsy
of the infected area and wait for pathologists to evaluate the specimen. Blood work is also very
important for

Gastric Ulcer Research Paper
Gastric ulcers are a large problem now a days in the medical community. It has the attention of all
the core measure directors of every hospital in the country. That is because a gastric ulcer is
preventable in the hospital setting. Since the gastric ulcer is considered preventable, new diagnosed
ulcers, once being an inpatient, would not be permitted to seek reimbursement for any care
provided. You could see why it has their attention.
In the past it was believed that gastric ulcers were caused by life style modifiable risk factors. The
biggest culprit now is Helicobacter pylori (H. pylori). H. Pyloris is a bacterium commonly found in
the gut. The bacteria breaks down the lining of the stomach. Then the stomach acid further breaks
down the lining which causes the ulcer. This is the reason, unless contraindicated, most patient
receives either a Histamine–2 Receptor Antagonist or a proton pump inhibitor in the hospital. The
GI symptoms that are present with gastric ulcers would decrease the appetite of the patient.
Therefore the patient would encounter a digestion problem. ... Show more content on
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The vessels inside the lining also break down causing the patient to bleed. Depending where the
ulcer is will the patient present with Hematemesis or Hematochezia. Another complication could be
perforation of the stomach. This allows gastric contents to release into the sterile portion of the
abdominal cavity. This could cause a severe infection and often requires surgical repair. The third
major complication could be obstruction. Often if a ulcer presents in the narrow part of the distal
stomach, an obstruction can occur. That is because scar tissue grows back often occluding the path
of gastric contents. Surgical repair would also be necessary in this

Renal Failure: A Case Study
On February 4th and 5th of 2015, I provided care in the Cardiovascular Intensive Care Unit
(CVICU) at Jefferson Regional Medical Center to a 77 year old white female, M. H. She came to
the Emergency Room (ER) on January 26, 2015 with a chief complaint of shortness of breath and
hypoxia. She has a history of chronic obstructive pulmonary disease (COPD), diabetes mellitus
(DM), hypertension (HTN), congestive heart failure (CHF), and coronary artery disease (CAD). She
was admitted the Medical–Surgical floor on the same day. After her initial lab workups, she was
given medical diagnosis of renal failure. Renal failure is a condition in which the kidneys fail to
adequately filter waste products form the blood. The two main forms are acute kidney injury and
chronic kidney ... Show more content on Helpwriting.net ...
Some causes include impaired blood flow to the kidneys, damage to the kidneys, and urine blockage
in the kidneys. Signs and symptoms include vomiting, diarrhea, dehydration, muscle cramps,
hyperkalemia, weakness, dizziness, swelling in the hands and feet, difficulty sleeping, and abnormal
heart rhythms. Diagnostic tests and procedures include glomerular filtration rate (GFR), blood urea
nitrogen (BUN), creatinine, and computed tomography (CT) scans to observe kidneys, kidney tissue
sampling, and urine output measurements. Treatment includes treating the underlying cause of
kidney failure, balancing fluids in your blood, controlling your potassium, restoring calcium levels,
and dialysis to remove toxins from the blood. On January 28, 2015, M.H. participated in an
esophagogastroduodenoscopy (EGD). Upon examination, there was gastrointestinal bleeding from
noted ulcerations as well as gastroesophageal reflux disease (GERD), gastritis,

Deadly Disease : Kaposi Sarcoma
The deadly disease, known as Kaposi Sarcoma, was first discovered by Moritz Kaposi and later
named after the discoverer himself. Moritz Kaposi was a Hungarian physician and dermatologist
and he first discovered the disease in 1872 describing it as an idiopathic multiple pigmented
sarcoma of the skin. He studied the affliction on five elderly male patients. Moritz continued to
describe the various characteristics of the disease including nodules developing on the skin, mainly
on the hands and feet, tinted in either blue–red or brown–red forms. Moritz continued to describe
the behavior of the nodules by describing two scenarios. One in which the nodules remain isolate
and begin to protrude growing in a spherical shape. Another scenario involves the nodules
multiplying in number but remaining flat in the skin. Generally the nodules begin to form on the
instep of the foot and soon after develop on the hands. As the disease progresses, the formations
tend to group around several areas including the arms, legs, face, and trunk except they cluster in
irregular patterns and in smaller numbers as well. Moritz Kaposi continues describe the affliction
throughout its stages as some of the nodules have been observed in a state or atrophy or regression
seeming to only ulcerate at a later point, gangrene (refers to the death of body tissue due to a lack of
blood flow or a bacterial infection) usually taking the place of the degenerating nodules. Further into
kaposi sarcoma, the patient

Wireless Capsule Endoscopy : Past And Present
ELEC5031M Industry Dissertation
Wireless Capsule Endoscopy
Etinosa Ekomwenrenren
Student ID: 200990550
The University of Leeds
School of Electronic and Electrical Engineering
April 2017
Table of Contents
Abstract iii
List of Abbreviations iv
List of Figures v
List of Tables vi
Chapter 1 Introduction 1
Chapter 2 Wireless capsule endoscopy: past and present 2
2.1 History of wireless capsule endoscopy 2
2.2 Current wireless capsule endoscope systems 4
2.3 Clinical utility of wireless capsule endoscopy 7
2.3.1 Small bowel diseases 7
2.3.1.1 Obscure gastrointestinal bleeding 7
2.3.1.2 Crohn's disease 7
2.3.1.3 Celiac disease 7
2.3.1.4 Polyposis syndrome and other small bowel disorders 8
2.3.2 Oesophageal diseases 8
2.3.2.1 ... Show more content on Helpwriting.net ...
It involves swallowing a capsule that's able to wirelessly transmit images of the gastrointestinal tract
– the pathway from the mouth through the oesophagus, stomach, small, and large intestines [2].
The capsule is the size of a large pill that leaves the body naturally through defecation [2]. Typically,
It has a CMOS chip video camera that captures video images (at two frames per second) that are
transmitted by video telemetry to aerials secured to the patient's body [3]. These images are stored
in a digital recorder worn around the patient's waist [3].

Although presently an effective method of assessing small bowel diseases, such as obscure
gastrointestinal bleeding and Celiac disease [3], this technology provides an opportunity to develop
low–cost screening techniques that can save lives of people at risk of gastric and oesophageal
cancers, which are prevalent in low–income

Bariatric Procedure Yields
6/12/2016 www.generalsurgerynews.com/Article/PrintArticle?articleID=34020
http://www.generalsurgerynews.com/Article/PrintArticle?articleID=34020 1/6 In the News
OCTOBER 22, 2015
New Bariatric Procedure Yields Exciting Results
Preliminary Data Strong For Modi䐣ጀed Duodenal Switch
By Christina Frangou
A pair of U.S. surgeons has developed a new bariatric procedure, a modi䐣ጀed version of a
duodenal switch, which may be technically easier to perform and results in weight loss on par with
the most effective bariatric operations.
"The weight loss is impressive and, based on historical comparison, greater than vertical sleeve
gastrectomy," reported study author Mitchell Roslin, MD, chief of bariatric surgery at Lenox Hill
Hospital, in New York City. ... Show more content on Helpwriting.net ...
"I don't think anybody has enough experience with this yet to say anything for sure regarding the
long–term need for revision, or the best way to revise it if there is a problem."
He added that surgeons who start performing new procedures must study them carefully, follow
their patients, and publish and report their data so that surgeons can make informed decisions about
whether to continue with the procedure.
"The biggest challenge is selecting the right patient for the operation, and maintaining good, really
close follow–up on the patients because that's critical if this procedure is to become mainstream."
Richard M. Peterson, MD, MPH, director of UT Medicine Center for Bariatric and Metabolic
Surgery at UT San Antonio, said
SIPS could be ideally suited for super–obese patients who need something more than a sleeve or a
gastric bypass. "But I need to know long term that the results carry more weight loss than a bypass
and are as durable, or close to it, and I need to know6/12/2016
www.generalsurgerynews.com/Article/PrintArticle?articleID=34020
http://www.generalsurgerynews.com/Article/PrintArticle?articleID=34020

S. R.: A Nursing Case Study
S.R. is a 63–year–old Caucasian female currently working as an operating room nurse. She has a
significant past medical history consisting of Breast Cancer, Depression, Fall, Diverticulitis of the
Colon, Follicular Lymphoma (stage 3), Irritable Bowel Syndrome, Osteoarthritis and Sciatica.
Currently S.R. is going through chemo with Rituximab for recurring lymphoma, gastritis and atrial
fibrillation. S.R came to the emergency department presenting with shortness of breath and dizzy
from having intractable nausea and coffee ground emesis overnight. Her chief complaint was of
feeling dizzy and weak at home after vomiting with chills and sweating. The client knows her
history and the fact that she needs to be on proton pump inhibitors twice a day, ... Show more
content on Helpwriting.net ...
773). This is the first step in problem solving and promotes creative problem solving. The client was
able to open up with nurse about her current stress. Once that was completed, teaching the client
how to evaluate methods of coping that worked or just partially successful. According to Cox, Hinz,
& Newfield (2007), "it strengthens the effective coping methods and elimination of ineffective
ones" (pg.

Research Paper On Heel Pain
Heel Pain
Definition and Overview
Heel pain is a common medical problem. A number of conditions can produce heel pain, including
injuries or disorders of the bones, muscles, tendons and nerves of the foot, among others. Heel pain
is typically felt either underneath the heel or behind the heel. Although the causes of heel pain are
not life–threatening, persistent heel pain can be debilitating, and if not adequately addressed, may
interfere with exercise and even activities of daily living.
Over 2 million people in the United States alone experience heel pain every year.
Cause of Condition
A variety of diseases can present with heel pain. Heel pain is usually due to overuse. Majority of an
individual's weight is absorbed by the heel. Running places an even greater pressure on it, and thus,
athletes tend to be at risk for this condition. This soreness may be attributed to repetitive stress and
pressure. The pain is typically mild, and gets better with rest.
One of the most common causes of heel pain is plantar fasciitis, both in athletes and in normal
individuals. The plantar fascia is a fibrous band located on the underside of the foot, from the
forefoot to the heel. This fascia serves to ... Show more content on Helpwriting.net ...
A gastroenterologist will be able to evaluate you thoroughly, and can request for various
examinations to diagnose your condition. If you are suspected of having stomach cancer, you will
have to undergo an esophagogastroduodenoscopy, or EGD. A scope with a camera is inserted into
your mouth down to your stomach to check for any masses. A biopsy can be done in the same
sitting, in order to determine the presence of cancer cells. You may also have to undergo imaging
tests, such as a CT scan, to determine the extent of the disease. If you are indeed discovered to have
stomach cancer, your gastroenterologist may refer you to several other specialists, such as a general
surgeon, a medical oncologist and a radiation

Mallory-Weiss Syndrome Research Paper
Mallory–Weiss syndrome
Overview:
Mallory–Weiss disorder or gastro–esophageal cut disorder alludes to seeping from tears (a Mallory–
Weiss tear) in the mucosa at the intersection of the stomach and throat, normally brought about by
severe alcoholism, coughing, vomiting, and retching.
Causes:
The most widely known causes for MWS is prolonged or severe vomiting. While this sort of
vomiting is connected with disease, it additionally much of the time happens because of unending
liquor abuse or bulimia.
Albeit incessant heaving commonly causes MWS, different conditions can bring about a gash of the
throat, including:
1. Trauma to the midsection or guts
2. Severe or delayed hiccups
3. Intense hacking
4. Intense wheezing
5. Heavy lifting ... Show more content on Helpwriting.net ...
Abdominal agony 2. Severe regurgitating 3. Vomiting blood (a condition called "hematemesis") 4.
Bloody stool 5. Involuntary regurgitating
Diagnosis:
Diagnosis of Mallory–Weiss syndrome is made by your specialist amid a complete physical exam.
Your specialist will get some information about any therapeutic issues, including day by day liquor
admission and late sicknesses, to distinguish the fundamental reason for your side effects.

In the event that your side effects show dynamic seeping in the throat, your specialist may do an
esophagogastroduodenoscopy (EGD). Prior to this methodology, you will be given a narcotic and a
painkiller to keep any inconvenience. An endoscope (little, adaptable tube with a camera joined to
it) will be embedded through the throat and into the stomach. This can help your specialist see the
throat and recognize the area of the tear.
A complete blood check (CBC) might likewise be requested to affirm low hematocrit (number of
red platelets). Your red platelet check may be low in the event that you have seeping in the throat.
Taking into account the discoveries from these tests, your specialist will have the capacity to figure
out whether you have MWS.
Treatment:

Crohn'S Disease . .. .. .. .. .. .. .. .. . By: Elizabeth
Crohn 's Disease
By: Elizabeth Nazginov 8G1
Due: April 5th 2017
Crohn 's disease is one of two conditions referred to by the term "Inflammatory Bowel Disease"
(IBD). The other condition that is referred to as an IBD is called Ulcerative Colitis. Both Crohn's
and Ulcerative Colitis are conditions that cause recurring or persistent inflammation in one or more
sections of the intestine. The literal definition of "inflammation" is "being set on fire". It is a
protective reaction that happens when tissue is injured or destroyed. There are two types of
inflammations. The first is acute inflammation, which is defined by heat, redness, pain and swelling.
The ... Show more content on Helpwriting.net ...
There is approximately a fifteen to twenty five percent chance of Inflammatory Bowel Disease in
the extended family of someone who has Crohn 's. However in this situation, ulcerative colitis
would be less likely than Crohn 's. The risk of Inflammatory Bowel Disease occurring if both of a
child 's parents having an IBD begins at least around fifty percent. According to Mayoclinic.org,
open quote "As many as 1 in 5 people with Crohn 's disease has a family member with the disease"
closed quote. Crohn 's Disease is most commonly found in advanced areas like in Scandinavia,
North America, the United Kingdom and Western Europe. Crohn 's Disease affects Ashkenazi Jews
and Caucasians more than any other racial groups. Another reason that supports the theory of
genetics being a cause of Crohn 's can also be found on page eleven in the same book as the book in
the first reason. On page eleven it is written: open quote "While little has been accomplished so far
in ulcerative colitis, mutations in a gene known as NOD2, located on chromosome 16, have been
shown to predispose some people to Crohn 's in the Ileum, especially the form of the disease that
causes a lot of scarring and narrowing" closed quote. In other words, there has been mutations in a
gene found on chromosome sixteen that have been proved to cause some people to get Crohn 's in
the Ileum (which

Peptic Ulcer Research Paper
Peptic ulcer disease – PUD is one of the most common disease, affecting millions of Americans
(Jill, 2015). Furthermore, peptic ulcers are a recurrent problem; unless patient is preventing
recurrence.
Many people with peptic ulcer have no symptoms or present pain in the upper abdomen, which can
be worsening with food or sometimes makes pain better. Some other symptoms associated with
peptic ulcer are nausea, vomiting, feeling bloated or full. The most serious presentation is bleeding,
which if unnoticed can be life–threatening hemorrhage and individual can become anemic with
symptoms such as fatigue, shortness of breath with exercise, feeling lightheaded, and pale skin
(Caufield and Schafer, 2012).
Causes of ulcer can be associated with a

An Autosomal Dominant Disorder
Recurrent epistaxis is one of the diagnostic criteria for Hereditary Hemorrhagic Telangiectasia
(HHT). HHT is an autosomal–dominant disorder that is also depicted by skin and mucosal
telangiectasias. Feared complications of HHT include rupture of pulmonary or cerebral
arteriovenous malformations (AVM). The etiology of HHT is most often due to genetic mutations
that impair normal angiogenesis. We report a case of suspected HHT in a 49–year–old female, with
a first–degree relative with HHT, and a history of recurrent epistaxis status post coiling of left and
right internal maxillary arteries. Of special note, her initial hemoglobin level was 1.7, but she was
alert and walking at triage. Her presentation was consistent with multiple prior admissions in the
past three years. Patients with suspected hereditary telangiectasia should receive a comprehensive
work up, including serum studies, imaging, and possibly genetic testing. Treatment should focus on
both acute management of the bleed and prevention of future complications.
Introduction:
Hereditary Hemorrhagic Telangiectasia, or Osler–Weber–Rendu syndrome, is an autosomal
dominant disorder characterized by recurrent epistaxis and small arteriovenous malformations
known as telangiectasias . Telangiectasias can rupture with minimal or no trauma, and resultant
bleeds can be difficult to manage. The epistaxis can lead to chronic anemia in a small set of afflicted
patients. The estimated prevalence of HTT is estimated to be one

Gastritis Case Study Hypertension
This patient is a 62–year–old male who required inpatient hospitalization due to: Mr. C had a
spiculated nodule in his right middle lobe identified on screening lung computerized tomography
scan. It was hypermetabolic on positron emission tomography and suspicious for carcinoma and
deep for wedge biopsy. Additionally, he had a hypermetabolic findings in his stomach without
complaints of gastritis or heartburn. He was brought to Mary San Juan Operating room for elective
surgery for right middle lobe mass. His medical history was significant for hypertension, lung mass
and a smoker. Upon presentation, he was NPO for more than six hours with outpatient laboratory
finding of platelets 139 and PT of 10.4.
Mr. C was admitted to the hospital for ... Show more content on Helpwriting.net ...
Two right chest tubes at the right lung base were inserted and secured with surgical sutures. He was
transferred to ICU after he was discharge from anesthesia care. Post–operatively despite chest tubes,
he continued to have a worsening crepitus. Chest x–ray was done revealing right pneumothorax
with subcutaneous emphysema, right middle lobe spiculated lesion and positive lesion in stomach.
He was transferred to the floor for some time, but was returned back to ICU after he developed an
increased in subcutaneous air in face and neck for which a 3rd chest tube was placed through a prior
surgical incision. During his hospitalization, his vital signs worsened with blood pressure of 104/56
mmHg, oxygen saturation of 80% on room air, respiratory rate of 38 breaths per minutes and a
temperature of 35.6 °Celsius. After two of the three right chest tubes have been removed, he was
advised of needing to go home with chest tube or heimlich valve. Then, he was given specific
discharge instructions including chest tube and pleurevac care, wound care, activity, diet, and meds.
He verbalized understanding and agrees with plan after he was advised to follow up in the office this
week with the probability of removing the chest and to return to Emergency Department if his
symptoms

Helicobacter Peptic Ulcer Disease
As there are many causes of peptic ulcer disease, the number one causative agent is a Helicobacter
pylori infection. This spiral shaped bacterium was known as far back as 1875. It was discovered that
this bacteria inhabited the lining of the human stomach by German scientists. Unfortunately it was
impossible to culture at the time so it fell by the wayside and was forgotten ( Hardy, J ). It wasn't
until 1979 that an Australian pathologist Robin Warren noticed that many of his patients who were
suffering from gastric ulcers had mysterious bacteria clinging to the tissues of his biopsy specimens.
He alongside with his associate physician Barry Marshall, worked endlessly to culture what they
saw under the microscope. It was by accident in 1982 that they left their cultures incubating over a
five day span and what they discovered upon returning was a turning point in the treatment of peptic
ulcer disease. There were growing colonies of what ... Show more content on Helpwriting.net ...
This was an amazing discovery but it was unfortunately met with a lot of skepticism in the medical
community as it was believed that no bacteria could survive the hostile environment of the stomach.
Discouraged, Dr. Marshall actually drank a beaker full of the H. pylori in a broth solution. He
became very ill days later and via endoscopy ten days after inoculation he was noted to have
gastritis with the presence of H. pylori in his stomach. This marked the beginning of the belief that
peptic ulcer disease is an infectious disease. Doctors Marshall and Warren went on to prove that
antibiotics are an effective treatment in the management of PUD. It wasn't until 2005 that Warren
and Marshall were awarded the Noble Prize in Medicine for their work on H. pylori (Hardy,

Childhood Obesity : An Epidemic
Introduction Childhood obesity is rising worldwide in an alarming rate. New Zealand Health Survey
results in 2012/2013 showed that one out of nine children (2–14 years) was obese and it was 11 per
cent of the total children population1. Obese children are more prone to have cardiovascular disease,
psychological morbidity, asthma, Type 1 diabetes, and early mortality2 sooner or later in their life.
Adverse effects of childhood obesity not only affect the current or later health status of children but
also the country's productivity and economy. Therefore it is very important to break the obesity
viscous cycle in order to have a healthy nation. Various factors involve in the development of this
multifaceted condition – "Obesity" such as individual's genetics, environment and behaviour2. The
major causes for childhood obesity in New Zealand include less physical activity, inadequate sleep3,
unhealthy dietary patterns such as skipping breakfast4 and consumption of unhealthy snack food5.
There are various preventive strategies for childhood obesity. The conventional treatments include
promoting healthy dietary and behaviour practises and physical activities; however, these seem to be
not having positive impacts in some situations. Moreover, some studies also have shown that
different diet and physical activity intervention studies had failed to have a positive effect on BMI
and obesity of children2. Likewise, some existing evidence reflects that traditional obesity
prevention

Medical Terminology: A Case Study
CYANOTIC: A patient who has cyanosis, or a slight bluish discoloration of the skin due to the
presence of abnormal amounts of reduced hemoglobin in the blood JAUNDICE: A yellow
discoloration of the skin GASTROSCOPY: A scope for inspecting the stomach COLONOSCOPY:
An endoscope to inspect the colon (large intestines) ANGIOSCOPE: Views the heart and major
vessels VASCULAR ENDOSCOPE: Views that interior or small vessels BRONCHOSCOPY: An
endoscope to inspect the bronchial tree LARYNGOSCOPY: An endoscope to inspect the larynx
LAPAROSCOPY:Views the abdominal organs THORACOSCOPY: Views the organs of the thoracic
cavity VENTRICULOSCOPY: Views the ventricles of the brain CYSTOSCOPE: Passed through
the urethra and into the bladder to examine the interior ... Show more content on Helpwriting.net ...
When the veins around the anus swell, we call them hemorrhoids. Colon cancer is a condition in
which polyps form in the lining of the colon (large intestine). Crohn's disease is a chronic
inflammatory granulomatous lesion involving the terminal ileum. Irritable bowel syndrome (IBS) is
sometimes called a functional disorder because there is no sign of disease in the colon. Case Study:
Robert Johnson noticed blood in his stool. For several months , he had experienced pain in his
abdomen and diarrhea. What endoscopic procedure will his physician order? –Robert Johnson's
physician would order a Pillcam Endoscopic procedure. Mr. Johnson has the precise reasons for the
order of the Pillcam, The Pillcam evaluates unexplained rectal bleeding, intermittent abdominal
pain, and diarrhea. A Pillcam is different from the various other endoscopic procedures, it is a
vitamin sized vitamin that a patient swallows. The pill then travels throughout the body providing
the physician with images of Mr. Johnson's internal organs. This procedure will most likely be all
that is needed to find the source of the bleeding and the reason for the abdominal pain and

Personal Writing : A Personaltive Of Personal Narrative
Personal Narrative
"I don't want to do this! Please don't make me! I'm scared!" I stammered and cried at the same time.
"OH MY!" I gasped. Then everything went as black as the dead of night. ...
One day earlier The warm, windy August night before my critical day, my Mom took me out to
Spiros Pizza. When I walked through the enormous, fancy glass doors to Spiros, the aroma of Italian
pizza dough filled the air. When my hot, melty, sizzling pizza arrived, I began gobbling it like a
turkey. The pizza was a greasy mess that lathered my face from chin to forehead; I'm surprised I
didn't break out all over my face. Unfortunately for me, I didn't know it was the last time I would
ever be able to eat there.
"I'm scared for tomorrow," I murmured as I was stuffing pizza in my mouth. "Don't worry, you'll be
fine. It's just going to be like short nap. Probably 20 minutes," my mom said. My mom is a kind
hearted woman who thinks about other people before herself.
"I know but it's like...You know...um."
"Fear of the unexpected?" My mom questioned.
"Yea," I replied. Unlike my mom, I am an outgoing daredevil that loves adventures.
"It's normal to be nervous," she explained.
"Ok," I resigned. The next morning
The next morning I woke up to a mouth as dry as

Dysphagia
The fluoroscopy and the upper gastrointestinal endoscopy are different, but remarkable diagnostic
methods used for the people suffering from dysphagia. Dysphagia is a medical term that means
difficulty swallowing due to abnormal contractions of the esophageal muscles. It is important to find
a quick evaluation that will lead to a better diagnosis and recovery with lesser complications. This
research paper will discuss the appropriate diagnostic method by comparing between the
fluoroscopic unit, and the UGI endoscopy. Data will be collected from King Abdul Aziz University
hospital, the sample will be a large diverse patients with dysphagia as the main complaint.
Dysphagia is a common indication that needs functional and anatomical assessment. ... Show more
Images were obtained for the oropharynx, the whole length of the esophagus including the proximal
and distal ends, and the gastroesophageal junction ( GEJ ) for any present pathology, with single and
double contrast studies for mucosal relief. The images were taken while the patients were in the
supine position. For upper GI endoscopy, a complete preparation was done for the patients including
nothing per oral ( NPO ) for at least four hours before the start of the examination, under local
anesthesia. The complications and risks of the procedure were also explained to the patients prior
the exam. The patients were positioned on their left side, and to prevent them from biting on the
endoscope, a mouth guard was placed between the teeth. The endoscope was moved over the tongue
into the oropharynx under vision, the endoscope was guided into the esophagus with fast and gentle
manipulation, noting any pathology while the endoscope was gradually advanced down the
esophagus. If necessary, a biopsy was taken immediately. The result of the study was ten of the
patients ( 83.34% ) were diagnosed with videofluoroscopy, and five patients ( 41% ) were diagnosed
with upper GI endoscopy, however; eight of the examined patients, no problems were found on both
videofluoroscopy, or upper GI endoscopy. The results showed That in comparison with the upper GI
endoscopy, videofluoroscopy can accurately diagnose a large number of positive causes of
dysphagia. Also, videofluoroscopy was readily done, and it did not require a previous work up of
the

ED Summary
A study by McGuire (2012) explored the statistical occurrence of ED in the veteran population and
it relation to mental illness, specifically PTSD. The study consisted of 135 male participants with
ages ranging from 18 to 35. Although military branch specificity was not a criterion, majority of the
study group make–up contained Marines, which was 98 percent of the participants. The U.S. Navy
made up 8 percent of the group. Researchers used four assessment tools; State–trait inventory,
PTSD Checklist–Military, Patient Health questionnaire and the Pediatric Anesthesia Emergence
Delirium to assess anxiety, symptomatology, depression and behavior observed during periods of
ED, respectively. Results of the study indicated ED had a 20 percent occurrence ... Show more
In a study by Wilson (2013) the perception of ED by anesthesia providers was evaluated. The survey
group, consisting of 254 practitioners, was administered a questionnaire regarding their experience
with ED and perceived dangerous behavior, such as violence toward staff, vandalism and agitation.
Of those having been surveyed, 78 percent reported a personal experience with ED. In regards to
violent emergence, 68 percent reported witnessing various types of aggressive behavior and feeling
there was imminent or actual danger (See Table 1). Thirty–three percent of those surveyed felt that
ED was a significant problem. An addendum made after publication noted that ED was seen in
higher rates among patients with PTSD (Wilson, 2013). Again, practitioners must understand the
possibly dangers that can occur with ED. Furthermore, even if ED is non–violent it can be very
disconcerting for the

Endoscopy Essay
ENDOSCOPY EGD stands for an esophagogastroduodenoscopy. This procedure is used to visualize
the esophagus, stomach, and the duodenum. This is done via a lighted tube or endoscope to detect
abnormalities. Possible abnormalities are tumors, ulcerations, or an obstruction. The patient should
be NPO for 8 hours before the test. When the patient arrives medical history, consent forms,
explanation of test, and insertion of an IV are all completed. The patient is given preoperative
sedation and an IV sedation may also be given for the test. The throat is anesthetize with a local
spray or gargle. Each facility has different ways the patient is positioned for the test. The book states
that the patient lies on a table with head extended. GVMH has the patient sit and the endoscope is
introduced ... Show more content on Helpwriting.net ...
Polyps can be removed or biopsies taken during the procedure. Clear liquid diet should be 1–3 days
before the test. The patient should be NPO for 8 hours before the test. Laxatives are given for 1–3
days before the test and enemas the night before. GVMH has a different prep than the book. Their
prep consists of clear liquid diet, five Dulcolax in the am, and then at 3pm a 64oz of Gatorade with
Miralax the day before the test. When the patient arrives medical history, consent forms, explanation
of test, and insertion of an IV are all completed. The patient is given preoperative sedation and is
moderately sedated via IV for the test. The patient is positioned on their left side in bed. The length
of the procedure depends on the reason for the test. Most colonoscopies take 30 minutes to an hour
but some can take 1.5–2 hours if abnormalities are found. After the procedure is complete vital signs
should be monitored every 15–30 minutes or as ordered. Watch for increased temperature,
abdominal distention, or pain. This could be a possible complication known as perforation or rectal
bleeding

Crohn's Disease Analysis
Crohn's Disease is an Inflammatory Bowel Disease (IBD). It is a disease that causes inflammation
in the gastrointestinal tract. The gastrointestinal tract includes the oral cavity, esophagus, liver,
stomach, small intestine, terminal ileum, large intestine/colon, rectum, and anus. Crohn's Disease
affects thousands of people in America. Crohn's disease was first discovered in 1932 by three
doctors named Burrill Crohn, Leon Ginzberg, and Gordon D. Oppenheimer. The Crohn's & Colitis
Foundation of America (2014) declared "these doctors collected data from 14 patients with
symptoms of abdominal cramps, diarrhea, fever, and weight loss, which showed that the symptoms
were not the result of tuberculosis or any other known disease. They described a new disease entity,
which was first called regional ileitis, and later, Crohn's disease" (p. 7). Even though Crohn's
Disease was discovered over 80 years ago, there is no cure, but there is constantly more new
information being found out about this disease. There is no known cause of Crohn's Disease. Some
key factors in the development of Crohn's Disease are genes, the immune system, and
environmental ... Show more content on Helpwriting.net ...
This disease can be overwhelming physically, emotionally, and financially. Crohn's Disease is very
unpredictable so those who live with it have to be careful from day to day and make sure to listen
closely to their bodies. According to the Crohn's & Colitis Foundation of America (2014) "living
with this disease can also be very expensive. Direct medical costs include expenses for
hospitalizations, physician services, prescription drugs, over–the–counter drugs, skilled nursing
care, diagnostic procedures, and other healthcare services. Indirect costs are the value of lost
earnings or productivity. Indirect costs also include the value of leisure time lost" (p.19). However,
the good thing is that patients can still lead a happy and productive

Esophagogastroduodenoscopy (EGD) is the most widely used...
Esophagogastroduodenoscopy (EGD) is the most widely used method to investigate esophageal
diseases with excellent accuracy. Till date it has been considered the gold standard for the diagnosis
and surveillance of esophageal diseases including interventional procedures. It has mainly been used
for diagnosing barret's esophagus, reflux esophagitis, esophageal varices and esophageal cancers.
However the EGD is expansive and uncomfortable to the patient along with a small potential risk
for complications. It involves the risk of conscious sedation along with loss of productivity. It has
more complication rate in cases of cirrhosis. Next step was the development of a safer and more
comfortable method to view the mucosa of esophagus thus came ... Show more content on
Helpwriting.net ...
First the study was done on healthy volunteers which are themselves capsule endoscopists.
Subsequently study was done of patients with suspected esophageal disease to compare the
feasibility, efficacy, quality and patient discomfort between the two methods. Feasibility and the
quality of the test has been compares in al the four main diagnostic indications of EGD and this has
been shown the table format as well as compared with the pictures.
This article is on a very commonly performed procedure EGD, all over the world which has
changed its role from mainly diagnostic procedure in the early years to a therapeutic procedure.
Authors have presented the feasibility data compares to EGD. More than feasibility they have
emphasized that SSCE is more comfortable to the patient. It has less complication rate as compared
to EGD. It has equal quality of the images of the esophagus and rather better image quality than
EGD in certain diseases. Capsule endoscopy has shown moderate efficacy in lower end esophageal
images because of no control over the movement of the capsule. SSCE has overcome the difficulty
by attaching a string to the capsule with which up and down movement of the capsule can be
controlled ad lib to improve the focus on the area of interest. It has many other advantages:
It is a controlled method for esophagoscopy
No sleeve or string Was broken in the study
More comfortable to the patient

Gluten, Wheat And Grain Products
Gluten is made up of many different proteins and is often found in wheat and grain products. It is
used in foods to hold together ingredients. Some food sources that contain gluten are flour, wheat,
barley and rye. Some alternatives for people who cannot tolerate gluten are soy, chickpeas, flaxseed,
millet, potato, corn and buckwheat. Some common symptoms of celiac disease include gas,
bloating, fatigue, diarrhea and skin rashes. One way that celiac disease can be diagnosed is through
a blood test that tests for antibodies specialized to celiac disease. Another test that can be done to
diagnose celiac disease is a small intestinal biopsy which uses an EGD
(esophagogastroduodenoscopy) to collect samples of the small intestine. Doctors then use this to
look for signs of celiac disease. Lactose intolerance is caused by the large intestine's inability to
digest lactose, a type of sugar. When lactose is ingested, an enzyme called lactase in the large
intestine works to break down lactose, for people who are lactose intolerant have low levels of this
enzyme. People who are lactose intolerant may experience abdominal bloating, abdominal pain,
diarrhea, gas and nausea after ingesting lactose. Some non–dairy alternatives to lactose–containing
foods are almond milk, coconut milk, rice milk, lactose–free products and soya products. There are
many things that can trigger asthma, some of these things include dust mites, animals, cold air,
smoke, viral infections, certain air

What Is Peptic Ulcer Disease?
Peptic Ulcer Disease Rebecca Hang Id number Peptic ulcer disease also known as PUD, is a disease
in which hydrochloric acid and pepsin comes into contact with a tissue in the GI tract causing injury
to that area. The area that peptic ulcer occur most is the first portion of the small intestine which is
called the duodenum. It occurs in the duodenum due to the acidic chyme that enters the small
intestine. Another area for peptic ulcer is between the stomach and the esophagus due to reflex of
stomach content that contains acids. Other possible area is the stomach and the jejunum if surgery
was use to connect it together. Men that are in their middle age are more likely to have peptic ulcer
disease. Peptic ulcer ... Show more content on Helpwriting.net ...
The pain can follow 1 to 2 hours after eating and it can interfere with sleep. The pain may be reduce
by eating food, because the food thins out the stomach acids. Some client may present with back
pain due to the ulcer affecting the pancreas. The first sign of ulcer, in about 20% of client is bleeding
(hemorrhage, hematemesis or melena). Later, weight loss and vomiting can

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