Current Concepts in Management of Outlet Obstruction
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COVID-19 Mrna Pfizer- Biontech Vaccine Analysis Print
COVID-19 mRNA Pfizer- BioNTech Vaccine Analysis Print All UK spontaneous reports received between 9/12/20 and 22/09/21 for mRNA Pfizer/BioNTech vaccine. A report of a suspected ADR to the Yellow Card scheme does not necessarily mean that it was caused by the vaccine, only that the reporter has a suspicion it may have. Underlying or previously undiagnosed illness unrelated to vaccination can also be factors in such reports. The relative number and nature of reports should therefore not be used to compare the safety of the different vaccines. All reports are kept under continual review in order to identify possible new risks. Report Run Date: 24-Sep-2021, Page 1 Case Series Drug Analysis Print Name: COVID-19 mRNA Pfizer- BioNTech vaccine analysis print Report Run Date: 24-Sep-2021 Data Lock Date: 22-Sep-2021 18:30:09 MedDRA Version: MedDRA 24.0 Reaction Name Total Fatal Blood disorders Anaemia deficiencies Anaemia folate deficiency 1 0 Anaemia vitamin B12 deficiency 2 0 Deficiency anaemia 1 0 Iron deficiency anaemia 6 0 Anaemias NEC Anaemia 97 0 Anaemia macrocytic 1 0 Anaemia megaloblastic 1 0 Autoimmune anaemia 2 0 Blood loss anaemia 1 0 Microcytic anaemia 1 0 Anaemias haemolytic NEC Coombs negative haemolytic anaemia 1 0 Haemolytic anaemia 6 0 Anaemias haemolytic immune Autoimmune haemolytic anaemia 9 0 Anaemias haemolytic mechanical factor Microangiopathic haemolytic anaemia 1 0 Bleeding tendencies Haemorrhagic diathesis 1 0 Increased tendency to bruise 35 0 Spontaneous haematoma 2 0 Coagulation factor deficiencies Acquired haemophilia -
Post-Operative Clinical, Manometric, and Defecographic Findings in Patients Undergoing Unsuccessful STARR Operation for Obstructed Defecation
International Journal of Colorectal Disease (2019) 34:837–842 https://doi.org/10.1007/s00384-019-03263-9 ORIGINAL ARTICLE Post-operative clinical, manometric, and defecographic findings in patients undergoing unsuccessful STARR operation for obstructed defecation A. Picciariello1 & V. Papagni1 & G. Martines1 & M. De Fazio1 & R. Digennaro1 & D. F. Altomare1 Accepted: 6 February 2019 /Published online: 19 February 2019 # Springer-Verlag GmbH Germany, part of Springer Nature 2019 Abstract Aim To evaluate the reason for failure of STARR (stapled transanal rectal resection) operation for obstructed defecation. Methods A retrospective study (June 2012–December 2017) was performed using a prospectively maintained database of patients who underwent STARR operation for ODS (obstructed defecation syndrome), complaining of persisting or de novo occurrence of pelvic floor dysfunctions. Postoperative St Mark’s and ODS scores were evaluated. AVASwas used to score pelvic pain. Patients’ satisfaction was estimated administering the CPGAS (clinical patient grading assessment scale) questionnaire. Objective evaluation was performed by dynamic proctography and anorectal manometry. Results Ninety patients (83.3% females) operated for ODS using STARR technique were evaluated. Median ODS score was 19 while 20 patients (22%) reported de novo fecal urgency and 4 patients a worsening of their preoperative fecal incontinence. Dynamic proctography performed in 54/90 patients showed a significant (> 3.0 cm) rectocele in 19 patients, recto-rectal intussusception in 10 patients incomplete emptying in 24 patients. When compared with internal normal standards, anorectal manometry showed decreased rectal compliance and maximum tolerable volume in patients with urgency. Nine patients reported a persistent postoperative pelvic pain (median VAS score 6). Conclusion Failure of STARR to treat ODS, documented by persisting ODS symptoms, fecal urgency, or chronic pelvic pain, is often justified by the persistence or de novo onset of alteration of the anorectal anatomy at defecation. -
Endoscopic Characteristics and Causes of Misdiagnosis of Intestinal Schistosomiasis
MOLECULAR MEDICINE REPORTS 8: 1089-1093, 2013 Endoscopic characteristics and causes of misdiagnosis of intestinal schistosomiasis CHUNCUI YE, SHIYUN TAN, LIN JIANG, MING LI, PENG SUN, LEI SHEN and HESHENG LUO Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China Received February 21, 2013; Accepted July 27, 2013 DOI: 10.3892/mmr.2013.1648 Abstract. The aim of this study was to determine the clinical Introduction and endoscopic manifestations, and pathological character- istics of intestinal schistosomiasis in China, in order to raise Schistosomiasis is one of the most widespread parasitic infec- awareness of intestinal schistosomiasis and prevent misdi- tions worldwide. The three predominant schistosome species agnosis and missed diagnosis. The retrospective analysis of identified to infect humans are Schistosoma haematobium clinical and endoscopic manifestations, and histopathological (endemic in Africa and the eastern Mediterranean), S. mansoni characteristics, were conducted for 96 patients with intestinal (endemic in Africa, the Middle East, the Caribbean and South schistosomiasis. Among these patients, 21 lived in areas that America) and S. japonicum (endemic mainly in China, Japan were not infected with Schistosoma and 25 (26%) had no history and the Philippines) (1). It is estimated that 843,007 individuals of schistosome infection or contact with infected water. These in China are infected with S. japonicum (2). Intestinal schis- patients were mainly hospitalized due to symptoms of diarrhea, tosomiasis is an acute or chronic, specific enteropathy caused mucus and bloody purulent stool. Sixteen cases were of the by the deposition of schistosome ovum on the colon and rectal acute enteritis type, and colonoscopy results determined hyper- walls. -
Seetha Kazhichal
A STUDY ON SEETHA KAZHICHAL Dissertation submitted to THE TAMILNADU DR. M.G.R MEDICAL UNIVERSITY Chennai-32 For the partial fulfillment of the requirements to the Degree of DOCTOR OF MEDICINE (SIDDHA) (Branch IV - Kuzhanthai Maruthuvam) Department of Kuzhanthai Maruthuvam GOVERNMENT SIDDHA MEDICAL COLLEGE PALAYAMKOTTAI – 627 002. MARCH 2008 CONTENTS Page. No INTRODUCTION 1 AIM AND OBJECTIVES 3 REVIEW OF SIDDHA LITERATURES 5 REVIEW OF MODERN LITERATURES 25 MATERIALS AND METHODS 44 RESULTS AND OBSERVATIONS 46 DISCUSSION 67 SUMMARY 73 CONCLUSION 75 ANNEXURES ¾ PREPARATION AND PROPERTIES OF TRIAL MEDICINE 76 ¾ BIOCHEMICAL ANALYSIS OF TRIAL MEDICINE 81 ¾ ANTI MICROBIAL STUDY OF TRIAL MEDICINE 84 ¾ PHARMACOLOGICAL ANALYSIS OF TRIAL MEDICINE 85 ¾ LABORATORY DIAGNOSIS OF SHIGELLA AND ENTAMOEBA HISTOLYTICA 97 ¾ PROFORMA OF CASE SHEET 102 BIBLIOGRAPHY 114 CERTIFICATE Certified that I have gone through the dissertation submitted by ------------------- a student of Final M.D.(s), Branch IV, Kuzhandhai Maruthuvam of this college and the dissertation does not represent or reproduce the dissertation submitted and approved earlier. Place: Palayamkottai Date: Professor and Head of the Department, (PG) Br IV, Kuzhanthai Maruthuvam, Govt. Siddha Medical College, Palayamkottai. ACKNOWLEDGEMENT First of all, I thank God for his blessings to complete my dissertation work successfully. My foremost thanks to The Vice Chancellor, The Tamil Nadu Dr.M.G.R.Medical University-Chennai , for giving permission to undertake this dissertation. I contribute my thanks to Dr.M.Thinakaran M.D(s)., The Principal,Govt. Siddha Medical College, Palayamkottai for granting permission and facilities to complete this dissertation. I owe a deep sense of gratitude to Dr.R.Patrayan M.D (s)., The Head of the department , Dr.N.Chandra Mohan M.D (s)., Lecturer, Department of Kuzhanthai Maruthuvam , Govt.Siddha Medical College, Palaymkottai for their encouragements , valuable suggestions and necessary guidance during this study. -
Bacillus Cereus
PHR 250 4/25/07, 6p Bacillus cereus Mehrdad Tajkarimi Materials from Maha Hajmeer Introduction: Bacillus cereus is a Gram-positive, spore-forming microorganism capable of causing foodborne disease At present three enterotoxins, able to cause the diarrheal syndrome, have been described: hemolysin BL (HBL), nonhemolytic enterotoxin (NHE) and cytotoxin K. HBL and NHE are three-component proteins, whereas cytotoxin K is a single protein toxin. Symptoms caused by the latter toxin are more severe and may even involve necrosis. In general, the onset of symptoms is within 6 to 24 h after consumption of the incriminated food. B. cereus food poisoning is underestimated probably because of the short duration of the illness (~24 h). History In 1887, Bacillus cereus isolated from air in a cowshed by Frankland and Frankland. Since 1950, many outbreaks from a variety of foods including meat and vegetable soups, cooked meat and poultry, fish, milk and ice cream were described in Europe. In 1969, the first well-characterized B. cereus outbreak in the USA was documented. Since 1971, a number of B. cereus poisonings of a different type, called the vomiting type, were reported. This type of poisoning was characterized by an acute attack of nausea and vomiting 1–5 h after consumption of the incriminated meal. Sometimes, the incubation time was as short as 15–30 min or as long as 6–12 h. Almost all the vomiting type outbreaks were associated with consumption of cooked rice. This type of poisoning resembled staphylococcal food poisoning. B. Cereus in the US Table 1: Best estimates of the annual cases and deaths caused by B. -
Speed Dating with a Palliative Care Pharmacist
Speed Dating with a Palliative Care Pharmacist Mary Lynn McPherson, PharmD, MA, MDE, BCPS Professor and Executive Program Director Online Master of Science, Graduate Certificates, and PhD* in Palliative Care Graduate.umaryland.edu/palliative | [email protected] *pending MHEC approval Objectives 1. Discuss 3 pearls related to pharmacology of palliative medications. 2. Discuss 3 pearls related to appropriateness of maintenance medications in EOL care. 3. Discuss 3 pearls related to using palliative medications in a safe and effective manner. Equianalgesic Opioid Dosing 2010 Equianalgesic Doses (mg) 2018 Equianalgesic Doses (mg) Drug Parenteral Oral Drug Parenteral Oral Morphine 10 30 Morphine 10 25 Fentanyl 0.1 NA Fentanyl 0.15 NA Hydrocodone NA 30 Hydrocodone NA 25 Hydromorphone 1.5 7.5 Hydromorphone 2 5 Oxycodone 10* 20 Oxycodone 10* 20 *Not available in the US Reprinted with permission from McPherson ML. Demystifying opioid conversion calculations: a guide for effective dosing, 2nd ed. Bethesda: ASHP; ©2018. NOTE: Learner is STRONGLY encouraged to access original work to review all caveats and explanations pertaining to this chart. Equianalgesic Opioid Dosing 2010 Equianalgesic Doses (mg) 2018 Equianalgesic Doses (mg) Drug Parenteral Oral Drug Parenteral Oral Morphine 10 30 Morphine 10 25 Fentanyl 0.1 NA Fentanyl 0.15 NA Hydrocodone NA 30 Hydrocodone NA 25 Hydromorphone 1.5 7.5 Hydromorphone 2 5 Oxycodone 10* 20 Oxycodone 10* 20 *Not available in the US Reprinted with permission from McPherson ML. Demystifying opioid conversion calculations: a guide for effective dosing, 2nd ed. Bethesda: ASHP; ©2018. NOTE: Learner is STRONGLY encouraged to access original work to review all caveats and explanations pertaining to this chart. -
ESCHERICHIOSIS Simple Choice
ESCHERICHIOSIS Simple choice 1. Choose the clinical sign of escherichiosis in infants: A. Repeated, persistent vomit B. Seizures C. Positive meningeal signs D. Excavated abdomen E. Stool with mucus and blood 2. Specify the character of stools in escherichiosis with enteropathogenic E. coli: A. Liquid, watery, whitish B. Watery, undigested, light yellow C. Liquid, with mucus and blood D. Semi-liquid with mucus E. Liquid, voluminous, greenish, with mucus 3. Indicate the clinical sign of hypokalemia in infants: A. Fever B. Pronounced flatulence C. Bulging of anterior fontanelle D. Seizures E. Thirst 4. Choose the basic indication for the treatment of acute intestinal infection in young children: A. Anti-diarrheal drugs (Imodium, Lopedium) B. Activated charcoal C. Antiemetics D. Oral rehydration E. Antivirals 5. Choose which of the E. coli more frequently causes acute diarrheal disease in infants: A. Enteropathogenic E. coli B. Enteroinvasive E. coli C. Enterotoxigenic E. coli D. Enterohaemorrhagic E. coli E. Enteroadherent E. coli 6. Specify the character of stools in echerichiosis with enterotoxigenic E. coli: A. Liquid, watery, appearance of "rice-porridge", odorless B. Poor, frequent, with plenty of mucus and blood streaks C. Abundant, watery, frothy, yellow D. Liquid, abundant, greenish, foul-smelling E. well formed with mucous and blood 7. Mark the predominant intestinal microflora in infants: A. Escherichia B. Lactobacteria C. Candida D. Bacteria E. Doderlein bacillus 8. Specify the section of the digestive tract affected by in enteroinvasive E. coli: A. Stomach B. Duodenum C. Ileum D. Cecum E. Colon 9. Select the incorrect statement regarding oral rehydration in children: A. -
PENTASA Rectal Suspension 1G Package Insert.Pdf
NAME OF THE MEDICINAL PRODUCT PENTASA® Rectal Suspension 1 g QUALITATIVE AND QUANTITATIVE COMPOSITION Each bottle of rectal suspension contains 1 g (1g/100mL) mesalazine. Excipients: Disodium edetate, sodium metabisulphite, sodium acetate, purified water and hydrochloric acid for pH adjustment. PHARMACEUTICAL FORM Rectal suspension 1 g. Appearance of PENTASA® rectal suspension 1 g: White to slightly yellow suspension with a pH value between 4.4 and 5.0. THERAPEUTIC INDICATIONS Treatment of ulcerative proctosigmoiditis. POSOLOGY AND METHOD OF ADMINISTRATION Posology: Adults: 1 rectal suspension at bedtime. Paediatric population: There is little experience and only limited documentation for an effect in children. Method of administration: 1. A visit to the toilet is recommended before administration of the rectal suspension. 2. Immediately before use take the rectal suspension bottle out of the aluminium foil pack and shake it well (Figure 1). 3. To break the seal twist the nozzle clockwise one full turn (the nozzle should then be in the same direction as before turning) (Figure 2). 4. Put your hand in one of the plastic disposal bags provided in the pack (Figure 3). 5. Hold the container as shown in the picture (Figure 4). Lubricate top part of rectal applicator. 6. To administer the rectal suspension, lie on your left side with the left leg straight and the right leg bent forward for balance. Carefully insert the applicator tip into the rectum. Maintain sufficient steady hand pressure while dispersing the bottle content. The bottle content should be applied within max. 30-40 seconds (Figure 5). 7. Once the bottle is empty, withdraw the tip with the bottle still compressed. -
Role of Microrna in Inflammatory Bowel Disease
cells Review Role of MicroRNA in Inflammatory Bowel Disease: Clinical Evidence and the Development of Preclinical Animal Models Kanika Suri 1, Jason A. Bubier 2 , Michael V. Wiles 2, Leonard D. Shultz 2, Mansoor M. Amiji 3 and Vishnu Hosur 2,* 1 Department of Bioengineering, Northeastern University, Boston, MA 02115, USA; [email protected] 2 The Jackson Laboratory, Bar Harbor, ME 04609, USA; [email protected] (J.A.B.); [email protected] (M.V.W.); [email protected] (L.D.S.) 3 Department of Pharmaceutical Sciences, Northeastern University, Boston, MA 02115, USA; [email protected] * Correspondence: [email protected] Abstract: The dysregulation of microRNA (miRNA) is implicated in cancer, inflammation, cardio- vascular disorders, drug resistance, and aging. While most researchers study miRNA’s role as a biomarker, for example, to distinguish between various sub-forms or stages of a given disease of interest, research is also ongoing to utilize these small nucleic acids as therapeutics. An example of a common pleiotropic disease that could benefit from miRNA-based therapeutics is inflammatory bowel disease (IBD), which is characterized by chronic inflammation of the small and large intestines. Due to complex interactions between multiple factors in the etiology of IBD, development of ther- Citation: Suri, K.; Bubier, J.A.; apies that effectively maintain remission for this disease is a significant challenge. In this review, Wiles, M.V.; Shultz, L.D.; Amiji, M.M.; we discuss the role of dysregulated miRNA expression in the context of clinical ulcerative colitis Hosur, V. Role of MicroRNA in (UC) and Crohn’s disease (CD)—the two main forms of IBD—and the various preclinical mouse Inflammatory Bowel Disease: Clinical Evidence and the Development of models of IBD utilized to validate the therapeutic potential of targeting these miRNA. -
Dysphagia from Wikipedia, the Free Encyclopedia Jump To: Navigation
Dysphagia From Wikipedia, the free encyclopedia Jump to: navigation, search Not to be confused with Dysphasia. Dysphagia ICD-10 R13 ICD-9 438.82, 787.2 DiseasesDB 17942 MedlinePlus 003115 eMedicine pmr/194 MeSH D003680 Dysphagia is the medical term for the symptom of difficulty in swallowing.[1][2][3] Although classified under "symptoms and signs" in ICD-10,[4] the term is sometimes used as a condition in its own right.[5][6][7] Sufferers are sometimes unaware of their dysphagia.[8][9] It is derived from the Greek dys meaning bad or disordered, and phago meaning "eat". It may be a sensation that suggests difficulty in the passage of solids or liquids from the mouth to the stomach,[10] a lack of pharyngeal sensation, or various other inadequacies of the swallowing mechanism. Dysphagia is distinguished from other symptoms including odynophagia, which is defined as painful swallowing,[11] and globus, which is the sensation of a lump in the throat. A psychogenic dysphagia is known as phagophobia. It is also worthwhile to refer to the physiology of swallowing in understanding dysphagia. Contents 1 Signs and symptoms 2 Differential diagnosis 3 Diagnostic approach 4 Epidemiology 5 References 6 See also 7 External links Signs and symptoms Some patients have limited awareness of their dysphagia, so lack of the symptom does not exclude an underlying disease.[12] When dysphagia goes undiagnosed or untreated, patients are at a high risk of pulmonary aspiration and subsequent aspiration pneumonia secondary to food or liquids going the wrong way into the lungs. Some people present with "silent aspiration" and do not cough or show outward signs of aspiration. -
Emerging Options for the Management of Travelers' Diarrhea
December 2018 Volume 14, Issue 12, Supplement 8 Emerging Options for the Management of Travelers’ Diarrhea Robert Steffen, MD Emeritus Professor, Epidemiology, Biostatistics and Prevention Institute WHO Collaborating Centre for Travellers’ Health University of Zurich Zurich, Switzerland Adjunct Professor, Epidemiology, Human Genetics and Environmental Sciences Division University of Texas School of Public Health Houston, Texas A CME Activity Approved for 1.00 AMA PRA Category 1 Credit(s)TM Jointly provided by Postgraduate Institute for Medicine and Gastro-Hep Communications, Inc. Release Date: December 1, 2018 Expiration Date: December 31, 2019 Estimated time to complete activity: 1.00 hour Project ID: 13602 ON THE WEB: gastroenterologyandhepatology.net Supported through an educational Indexed through the National Library of Medicine grant from Aries Pharmaceuticals, Inc. (PubMed/Medline), PubMed Central (PMC), and EMBASE Target Audience managers, and other individuals who are in a position to control the This activity has been designed to meet the educational needs of gastro- content of this activity to disclose any real or apparent conflict of inter- enterologists and nurses involved in the management of patients with est (COI) they may have as related to the content of this activity. All travelers’ diarrhea. identified COIs are thoroughly vetted and resolved according to PIM policy. PIM is committed to providing its learners with high-quality Educational Objectives activities and related materials that promote improvements or quality -
The Diagnosis and Medical Treatment of Acute Intestinal Obstruction
Med- MONOGRAPHS. No. \ical I. The Diagnosis and Medical Treatment of ACUTE INTESTINAL OBSTRUCTION. 2&P ill. I?, fU3,>w:& Cuppleg €J)f Algonquin i^urti, $uMi$bet£, S&ogton. Jnfeeftnaf OBefrucfton. R. H. FITZ, M.D. Reprinted from The Boston Medical and Surgical Journal. THE DIAGNOSIS AND MEDICAL TREATMENT OF ACUTE INTESTINAL OBSTRUCTION. BY REGINALD H. FITZ, M.D. Professor ofPathological Atiatomy in llTTrvard University, and Physician to the Massachusetts Getteral Hospital. BOSTON CUPPLES AND HURD, Publishers Algonquin 1889 THE DIAGNOSIS AND MEDICAL TREAT- MENT OF ACUTE INTESTINAL OB- STRUCTION. 1 BY REGINALD H. FITZ, M. D., OF BOSTON. In the consideration of intestinal obstruction from a medical point of view, the subjects of chiefest importance undoubtedly relate to diagnosis and treatment. The present communication is intended to call attention to those features which may possibly serve to characterize the former, and to mark the limits of the latter up to the point of surgical interference. It will be admitted without much question that the difficulties of exact diagnosis, and the possibilities of permanent relief, are greatest in acute, internal forms of obstruction. It is, there- fore, to this part of the subject, in particular, that the present enquiry is directed. The term intestinal obstruction would seem to be equivalent to stoppage of the bowels, and refers to the absence of an important function of this appa- ratus. The conspicuous causes of such a stoppage are essentially mechanical, and the anatomist finds the bands and cords, the slits and pouches, the 1 Read before the Congress of *merican Physicians and Surgeons in Washington, D.