Inflammatory Bowel Disease ( Pathogensis & Steps of Diagnosis and Management) For Resident at Gastroenterology and Hepatology department at Kafrelsheikh by Dr/ Mohammed Hussien ( Assistant Lecturer).
This is comprehensive Presentation about IBD, its Classification, major subtypes, eitology, genetics, presentation, diagnosis and treatment.
it Includes Both Crohn's Disease And Ulcerative Colitis in detail
Pathology, Diagnosis, Medical Therapy, Surgical Management of Both the diseases are described
Inflammatory Bowel Disease ( Pathogensis & Steps of Diagnosis and Management) For Resident at Gastroenterology and Hepatology department at Kafrelsheikh by Dr/ Mohammed Hussien ( Assistant Lecturer).
This is comprehensive Presentation about IBD, its Classification, major subtypes, eitology, genetics, presentation, diagnosis and treatment.
it Includes Both Crohn's Disease And Ulcerative Colitis in detail
Pathology, Diagnosis, Medical Therapy, Surgical Management of Both the diseases are described
Ulcerative colitis explanation, management and therapyYuliaDjatiwardani2
A chronic, inflammatory bowel disease that causes inflammation in the digestive tract.
Ulcerative colitis is usually only in the innermost lining of the large intestine (colon) and rectum. Forms range from mild to severe. Having ulcerative colitis puts a patient at increased risk of developing colon cancer.
Symptoms include rectal bleeding, bloody diarrhoea, abdominal cramps and pain.
Treatment includes medication and surgery.
UC is an idiopathic IBD that affects the colonic mucosa.
Hallmark of UC is bloody diarrhea often with prominent symptoms of rectal urgency and tenesmus.
The clinical course is marked by exacerbations and remissions.
The diagnosis of UC is suspected on clinical grounds and supported by the appropriate findings on
Proctosigmoidoscopy or colonoscopy
Biopsy
By negative stool examination for infectious causes
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
- 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
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.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
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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.
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
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
1. Ulcerative colitis
Ulcerative colitis (UC)
Idiopathic inflammatory disease of the mucosa of colon and rectum
characterized by severe ulcerative lesion, going on with remissions and
exacerbations.
usually involves the rectum and extends proximally to involve all or
part of the colon.
Approximately 40 to 50% of patients have disease limited to the
rectum and rectosigmoid, 30 to 40% have disease extending beyond the
sigmoid but not involving the whole colon, and 20% have a total colitis.
EPIDEMIOLOGY
The incidence of UC varies within different geographic areas.
Northern countries, such as the United States, United Kingdom, Norway,
and Sweden, have the highest rates.
•
The incidence rate is 4 - 20 cases per 100 000 year,
•
The male to female ratio for UC is 1:1
•
The peak age of onset of UC is between 15 and 30 years. A second
peak occurs between the ages of 60 and 80.
•
ETIOLOGY
Although UC has been described as a clinical entity for over 100 years, its
etiology and pathogenesis have not been definitively elaborated.
•
Genetic considerations
•
Changes in the diet
•
Infection
•
Autoimmune inflammation
Clinical presentation.
Specific:
•
Rectal bleeding;
•
diarrhea with blood, pus and mucus ,
•
Bowel movements 4 – 20 day ;
•
Tenesmus or urgency with a feeling of incomplete evacuation ;
2. crampy abdominal pain
General:
•
Fever;
•
Dicreased appetitis;
•
Weight loss.
Extraintestinal manifestations (20% cases):
•
Joints - mono- or oligoarthritis, Ankylosing spondylitis
•
Eyes - iritis, uveitis, conjunctivitis, episcleritis;
•
Skin - Erythema nodosum, Pyoderma gangrenosum;
•
Oral cavity - mouth ulcers;
•
liver - Hepatic steatosis, Primary sclerosing cholangitis.
•
kidneys -glomerulonephritis
•
N.B. In some cases those lesions may precede the appearance of GI
symptoms.
Classification
By localization:
•
Proctitis(distal colitis)and proctosigmoiditis
•
Left-sided colitis
•
Extensive colitis
•
Pancolitis
By course:
•
Acute ulcerative colitis
•
Chronic ulcerative colitis
•
Recurring ulcerative colitis
By severity of status:
Mild
Moderate
severe
Diagnosis.
1)Rectal exam :
3. perianal abscesses ,
Anal fistulas,
anal fissures ,
Spasm of sphincter, granular surface and thickening of mucosa,
Rigid wall,
Presence of blood, mucus, pus.
2)Sigmoidoscopy Proctoscopy
•
With mild inflammation, the mucosa is erythematous and has a fine
granular surface that looks like sandpaper. In more severe disease, the
mucosa is hemorrhagic, edematous, and ulcerated .
•
mucosal granularity ;
•
Significant amount of blood, mucus, pus;
•
Edema and hyperemia of sigmoid and rectal mucosa;
•
Loss of haustration ;
•
superficial erosions and ulcers , covered with pus and fibrin;
•
Edema and excessive epithelial regeneration with pseudopolyps
formation.
3)Endoscopy
Minimal activity, (granular)
Moderate activity, (ulcerative).
Moderatesevere activity, (ulcerative).
Remission: pseudopolyps
•
•
•
•
•
•
Lab tests:
•
Increased ESR,
•
Leukocytosis ,
•
Increased platelet count ,
•
Hypochromic anemia,
•
Hypokalemia,
•
Hypo- and dysproteinemia
Diagnosis
Microbiology.
•
dicreased Lactobacillus bifidus to 61% (normally to 98%);
•
Significant increasing of colibacilli and Enterococci;
•
Growth of pathogenic Staphilococci (more than 60 times than norm);
4. •
Dyslocation of intestinal microflora up to the stomach.
Complications .
•
Perianal lesions: anal fissures, perianal abscesses, or hemorrhoids (430%).
•
Obstructions (benign stricture; one-third of the strictures occurring in
the rectum ). (3-19 %)
•
Perforation of the colon (3-5%)
•
Massive hemorrhage . (1-3%)
•
Toxic megacolon (Acute toxic dilation of the colon) (3-5%)
•
Malignancy. Patients with pancolitis have a 10% incidence of colon
cancer at 10-20 years with an additional 10% incidence for every decade
thereafter.
Goals of treatment
•
Improvement of quality of life;
•
Diminish the severity of symptoms;
•
Prophylaxis of relapses.
Diet ( № 4)
To exclude:
•
Milk and all dairy products;
•
Fresh bread, bakery, sweets;
•
Vegetable oil;
•
cereals;
•
All vegetables and fruits;
•
Pickled food, marinades, spices;
•
Fried food
Glucocorticosteroids
Prednisone 60 mg/day
Hydrocortisone 100 mg/day (enema )
Beclometasone 200 – 1600 µg/day,
Budesonide 200 – 800 µg/day
Fluticasone 100 – 500 µgday
5. Sulfasalazine-(anti-inflam act)
(sulfapyridine + 5-aminosalicylic acid )
Sulfasalazine 4-6 gday
Side effects (dose > 4g /d):
•
nausea,
•
Abdominal pain,
•
anorexia ,
•
rash ,
•
diarrhea,
•
weakness,
•
Agranulocytosis,
•
allergic reactions .
5-aminosalicylic acid (5-ASA)
•
In tablets (1,5-4 g)
•
In suppositories (0,5 - 1,5 g/d)
•
In enemas (4 g),
Аntibiotics
Despite numerous trials, antibiotics have no role in the treatment of active
or quiescent UC. However, pouchitis, which occurs in about a third of UC
patients after colectomy and ileal pouch-anal anastamosis, usually responds
to treatment with metronidazole or ciprofloxacin.
Immunosupressors
Cyclosporine 4 mg/kg IV or 10 mg/kg PO.
Azathioprine ,
6-Mercaptopurine
Newer Medical Therapies
5-lipooxygenase inhibitor (Cyleiton).
Infliximab 10 mg/kg IV (chimeric mouse-human monoclonal
antibody against TNF )
6. Maintenance Therapy
Glucocorticoids play no role in maintenance therapy
•
Sulfasalazine 2 gday
•
5-АSA 0,75 - 1 gday PO
•
Rectal forms of sulfasalazine and 5-ASA
•
6-MP or azathioprine
Medical Management of Ulcerative Colitis: Active Disease
Indications for Surgery
•
Intractable disease
•
Fulminant disease
•
Toxic megacolon
•
Colonic perforation
•
Massive colonic hemorrhage
•
Extracolonic disease
•
Colonic obstruction
•
Colon cancer prophylaxis
•
Colon dysplasia or cancer
Treatment of toxic megacolon:
1.Absolute cancellation of oral and rectal drugs intake, total parenteral
nutrition. Nothing by mouth.
2. Glucocorticosteroids (100 mg q6h), broad-spectrum antibiotics
(metronidazole or ciprofloxacin) IV.
3. Nasogastric suction.
4. Persistent follow-up (fever, abdominal pain, tension of abdominal wall,
diuresis, leukocytosis).
5. Radiographic control after colon dilation.
6. Indications to urgent operation: GI bleeding, perforation, uneffective
conservative treatment (during 1–3 days).
7.Anticholinergic and opioid drugs should not be used because they can
precipitate or aggravate toxic megacolon.
7. Maintenance Therapy
Glucocorticoids play no role in maintenance therapy
•
Sulfasalazine 2 gday
•
5-АSA 0,75 - 1 gday PO
•
Rectal forms of sulfasalazine and 5-ASA
•
6-MP or azathioprine
Medical Management of Ulcerative Colitis: Active Disease
Indications for Surgery
•
Intractable disease
•
Fulminant disease
•
Toxic megacolon
•
Colonic perforation
•
Massive colonic hemorrhage
•
Extracolonic disease
•
Colonic obstruction
•
Colon cancer prophylaxis
•
Colon dysplasia or cancer
Treatment of toxic megacolon:
1.Absolute cancellation of oral and rectal drugs intake, total parenteral
nutrition. Nothing by mouth.
2. Glucocorticosteroids (100 mg q6h), broad-spectrum antibiotics
(metronidazole or ciprofloxacin) IV.
3. Nasogastric suction.
4. Persistent follow-up (fever, abdominal pain, tension of abdominal wall,
diuresis, leukocytosis).
5. Radiographic control after colon dilation.
6. Indications to urgent operation: GI bleeding, perforation, uneffective
conservative treatment (during 1–3 days).
7.Anticholinergic and opioid drugs should not be used because they can
precipitate or aggravate toxic megacolon.