Post Operative (Gastro-Jejunostomy) Efferent Loop Obstruction due to Recurren...Hriday Ranjan Roy
A gastric operation (no documentation) was done in 1982 by an inexpert surgeon. This patient developed severe vomiting. Here the description to evaluate the case and its management.
Post Operative (Gastro-Jejunostomy) Efferent Loop Obstruction due to Recurren...Hriday Ranjan Roy
A gastric operation (no documentation) was done in 1982 by an inexpert surgeon. This patient developed severe vomiting. Here the description to evaluate the case and its management.
COMPOSITE GRAFT: ANTROPYLORUS TRANSPOSITION AND GLUTEUS MAXIMUS WRAPDr Amit Dangi
THIS PRESENTATION DESCRIBES THE NOVEL SURGICAL TECHNIQUE OF TOTAL ANORECTAL RECONSTRUCTION WITH ANTROPYLORUS TRANSPOSITION AND GLUTEOPLASTY AND ITS RESULTS.
Colon cancer is one of the most common reasons for colonic obstruction. This presentation focusing on benign as well as malignant diseases with its management.
https://drdhavalmangukiya.com/
http://www.youtube.com/c/DrDhavalMangukiyaGastrosurgeonSurat
https://gastrosurgerysurat.blogspot.com/
PEG tubes are becoming increasingly in demand for alternative enteral feeding options. Thus, BBS is a common complication that one should be aware of and how to manage it. Hope this helps..
Guidelines for the nursing management of peg pejMario Antonini
Enteral nutrition (EN) is the introduction of nutrients into the gastrointestinal tract through a tube placed in a natural or artifi cial stoma. Tubes may be passed into the stomach (gastrostomy) or the jejunum (jejunostomy) in patients who cannot obtain adequate nourishing via oral feeding. Following placement, nurses are typically responsible for management of gastrostomy or other enteral tube devices in both the acute and home care settings.
COMPOSITE GRAFT: ANTROPYLORUS TRANSPOSITION AND GLUTEUS MAXIMUS WRAPDr Amit Dangi
THIS PRESENTATION DESCRIBES THE NOVEL SURGICAL TECHNIQUE OF TOTAL ANORECTAL RECONSTRUCTION WITH ANTROPYLORUS TRANSPOSITION AND GLUTEOPLASTY AND ITS RESULTS.
Colon cancer is one of the most common reasons for colonic obstruction. This presentation focusing on benign as well as malignant diseases with its management.
https://drdhavalmangukiya.com/
http://www.youtube.com/c/DrDhavalMangukiyaGastrosurgeonSurat
https://gastrosurgerysurat.blogspot.com/
PEG tubes are becoming increasingly in demand for alternative enteral feeding options. Thus, BBS is a common complication that one should be aware of and how to manage it. Hope this helps..
Guidelines for the nursing management of peg pejMario Antonini
Enteral nutrition (EN) is the introduction of nutrients into the gastrointestinal tract through a tube placed in a natural or artifi cial stoma. Tubes may be passed into the stomach (gastrostomy) or the jejunum (jejunostomy) in patients who cannot obtain adequate nourishing via oral feeding. Following placement, nurses are typically responsible for management of gastrostomy or other enteral tube devices in both the acute and home care settings.
gastric resection, reconstruction and post gastrectomy syndromessanyal1981
discussion regarding history of gastrectomy, types of gastrectomy, billroth I, billroth II and roux en y gastrojejunostomy........discussion of post gastrectomy syndromes
Laparoscopic Management Of Pseudocyst Pancreas.pptxVarunraju9
The treatment focus of psedo pancreatic cyst is shifting slowly in to minimally invasive procedures and the scientific data is assuring it's long standing future with good results.
53 year old female patient presented for severe abdominal pain, associated with nausea and vomiting
diagnosed to have bowel obstruction due to incarcerated inguinal femoral hernia
Gastrointestinal Cancer: Research & Therapy is an open access, peer reviewed, scholarly journal dedicated to publish articles covering all areas of Gastrointestinal Cancer.
The journal aims to promote research communications and provide a forum for doctors, researchers, physicians and healthcare professionals to find most recent advances in all areas of Gastrointestinal Cancer. Gastrointestinal Cancer: Research & Therapy accepts original research articles, reviews, mini reviews, case reports and rapid communication covering all aspects of Gastrointestinal Cancer.
Gastrointestinal Cancer: Research & Therapy strongly supports the scientific up gradation and fortification in related scientific research community by enhancing access to peer reviewed scientific literary works. Austin Publishing Group also brings universally peer reviewed journals under one roof thereby promoting knowledge sharing, mutual promotion of multidisciplinary science.
Gastrointestinal Cancer: Research & Therapy is an open access, peer reviewed, scholarly journal dedicated to publish articles covering all areas of Gastrointestinal Cancer.
The journal aims to promote research communications and provide a forum for doctors, researchers, physicians and healthcare professionals to find most recent advances in all areas of Gastrointestinal Cancer. Gastrointestinal Cancer: Research & Therapy accepts original research articles, reviews, mini reviews, case reports and rapid communication covering all aspects of Gastrointestinal Cancer.
Gastrointestinal Cancer: Research & Therapy strongly supports the scientific up gradation and fortification in related scientific research community by enhancing access to peer reviewed scientific literary works. Austin Publishing Group also brings universally peer reviewed journals under one roof thereby promoting knowledge sharing, mutual promotion of multidisciplinary science.
The Skinny on he Role of Endoscopy in Bariatric SurgeryPatricia Raymond
Obesity epidemic; so where does endoscopy fit in with current bariatric surgery in preoperative assessment and management of complications, and what's under development for primary endoscopic bariatric techniques-- get the skinny here!
In cases of Nulliparous prolapse or even patients deserving child bearing uterus preserving surgeries are done.
Recently even for prolapse if women want to preserve uterus for variety of reasons ,with newer minimally invasive methods it is now gaining popularity.Larger studies and longer followup is required.
Flyer for one day seminar for surgeons and gastroenterologists showcasing innovative technologies in endosurgery and robotic surgery
Sept 19, 2011 New Delhi
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
- 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
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
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
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Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
1. Case Study
Endoscopic plication and revision (EPR) of
gastric pouch for patients who have regained
weight after gastric bypass surgery
Written by:
Chiranjiv S Virk, MD
I Michael Leitman, MD
Elliot R Goodman, MD
2. ABSTRACT
10-40% of Roux-en-Y gastric bypass (RYGB) patients regain significant weight after
Roux-en-Y gastric bypass surgery due to dilation of the pouch and/or the
gastrojejunal (GJ) anastomosis. Traditional revisional surgery is associated with
significant morbidity (e.g. a 6% incidence of post-anastomotic GJ leak): less invasive
endoluminal procedures may represent safer alternatives. The present article reports a
case of the safe and successful use of endoluminal gastric pouch plication using the
StomaphyX® device to correct both a dilated gastric pouch and a dilated
gastrojejunostomy in a post-GB patient who regained significant weight.
INTRODUCTION:
RYGB surgery remains the gold-standard operation worldwide for weight loss. Many
studies report excess percentage weight loss of 50-80% over a 24-month period.
However weight regain has been reported to be as high as 25-30% of initial excess
weight loss. Weight regain after gastric bypass is multifactorial. Anatomic causes
such as gastric pouch and GJ dilation are common: gastro-gastric fistula is much less
common. Up to 12% of patients will have some type of surgical revision following
gastric bypass surgery due to weight gain or post-operative symptoms such as
intractable dumping related to stomal dilation. Revisional gastric bypass surgery is
associated with a much higher morbidity and mortality than primary gastric bypass
procedure. Newer technologies such as transoral endoscopic plication have recently
been employed to minimize post-operative morbidity. The present case study
highlights such an endoluminal revision.
a
CASE PRESENTATION:
This 47-year-old man underwent a RYGB with a 30cc
pouch, a 12mm circular stapled GJ and a 150cm long
Roux limb in 2005. He lost 75kg with a reduction of
BMI of 23.3 (63.7->40.4, achieving his lowest weight
3.25 years after his RYGB. The patient started
experiencing dumping syndrome and regained 7kg in
weight over the next 11 months up to a BMI of 42.5. A
preoperative upper GI series x-ray showed an enlarged b
gastric pouch. An EGD showed a dilated GJ with loss
of restriction. As an alternative to an open or
laparoscopic revision, the patient elected to undergo
endoluminal surgery using the StomaphyX device. The
patient was taken to the operating room and placed
under general anesthesia. An upper endoscopy was Figure 1. General view of the
StomaphyX device (a) and its shaft with
performed to identify the anatomical landmarks of the
a SerosaFuse fastener; (b)
3. pouch. The pouch length was noted to be 7 cm.
The GJ was again observed to be widely dilated.
The endoscope was then inserted through the
shaft of the StomaphyX device, and the device
and endoscope were introduced in tandem
through the patient’s mouth into the pouch
under continuous visualization. Once inside the
pouch, vacuum was employed to draw large
folds of gastric pouch wall tissue into the lumen
of the device. With the gastric pouch wall on
suction, the pouch wall was circumferentially
plicated with serial firings of 6mm 3-0 polypropylene fasteners. This plication was
performed at two levels, one at 1 cm above the GJ anastomosis and one at 1 cm below
the GE junction. In total, 22 fasteners were delivered. A completion endoscopy was
performed after the plication which showed that the 7-cm pouch had been reduced to
3 cm in length. The luminal diameter as well as the width of the GJ anastomosis was
also significantly narrowed. The procedure took 40 minutes to perform. There were
no perioperative or postoperative complications. The patient was discharged home the
next day. 6 weeks after the procedure, the patient had lost 12kg in weight and no
longer complained of any dumping syndrome. An upper GI series x-ray obtained 2
months after the pouch plication procedure revealed reduction in the size of the
gastric pouch and a delay in emptying of contrast from the gastric pouch to the
jejunum.
DISCUSSION:
The case presented in this article demonstrates a successful reduction in gastric pouch
length, luminal diameter and GJ anastomotic width using the StomaphyX device.
Gastric pouch emptying into the jejunum was also slowed down after the procedure,
correlating with the patient’s subjective observation of earlier satiety since the
plication. EPR with the StomaphyX device is fast and safe. It eliminates the risk of
post-operative bleeding, GJ leak, wound infection and incisional hernia. This natural
orifice technique is an effective treatment for refractory dumping syndrome and
gastro-esophageal reflux after RYGB without the need to perform open or
laparoscopic revision. A recent retrospective analysis of 124 patients from three
centres at a median 6 months follow up after EPR demonstrated a mean 43% reloss of
regained excess body weight (unpublished data from author). While early results look
promising, long-term randomized prospective studies need to be carried out in order
to validate the effectiveness, safety and durability of EPR with StomaphyX.
REFERENCES:
Thompson CC, Slattery J, Bundga ME, Lautz DB. Peroral endoscopic reduction of
dilated gastrojejunal anastomosis after Roux-en-Y gastric bypass: a possible new
4. option for patients with weight regain. Surg Endosc. 2006 Nov;20(11):1744-8. Epub
2006 Oct 5.
Overcash WT, Natural orifice surgery (NOS) using StomaphyX for repair of gastric
leaks after bariatric revisions. Obes Surg. 2008 Jul;18(7):882-5. Epub 2008 Apr 26.
Mikami D, Needleman B, Narula V, Durant J, Melvin WS, Natural orifice surgery:
initial US experience utilizing the StomaphyX(TM) device to reduce gastric pouches
after Roux-en-Y gastric bypass. Surg Endosc. 2009 Jul 25. [Epub ahead of print].