DR MANISH-2.pdf laser proctology piles and fistula
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Get the best piles and fistula treatment in Jaipur with advanced laser proctology techniques. Dr. Manish Rajput, a renowned specialist, provides painless, quick, and highly effective treatments for piles, fissures, and fistula. Using cutting-edge laser technology, the procedures ensure minimal discomfort, no stitches, and faster recovery, helping patients return to their daily lives with ease. Dr. Rajput is committed to offering personalized care and long-term solutions, ensuring lasting relief and improved quality of life. With his expertise and modern facilities, you can expect safe and reliable treatment for all proctological conditions.
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✅ Color-coded cues and visually intuitive slides
✅ Bonus learning tips for quick recall and exam preparation
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PEPTIC ULCER DISEASE (PUD) , H PYLORI AND GERD TREATMENT BY DR .ANKUSH GOYAL ...
PEPTIC ULCER DISEASE (PUD) , H PYLORI AND GERD TREATMENT BY DR .ANKUSH GOYAL ...Dr Ankush goyal Comprehensive Management of Peptic Ulcer Disease and GERD
I. Introduction
Peptic Ulcer Disease (PUD) and Gastroesophageal Reflux Disease (GERD) are distinct yet overlapping disorders of the gastrointestinal system, marked by significant morbidity worldwide. These conditions illustrate the consequence of a disturbed harmony between offensive gastric secretions and the protective barriers of the mucosa. From ancient remedies to modern-day proton pump inhibitors and eradication therapies, the treatment approaches to these disorders represent a triumph of translational medicine.
While PUD typically involves mucosal erosion in the stomach or proximal duodenum due to Helicobacter pylori infection or NSAID use, GERD arises from the reflux of gastric contents into the esophagus due to incompetent lower esophageal sphincter tone. Both conditions necessitate a thorough understanding of their etiopathogenesis for rational therapy and long-term management. This document explores the latest, evidence-based treatment paradigms, structured with clarity and clinical relevance.
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II. Peptic Ulcer Disease (PUD)
Definition and Epidemiology
Peptic ulcers are breaks in the mucosal lining of the stomach or duodenum that penetrate the muscularis mucosa. Gastric ulcers typically occur on the lesser curvature of the stomach, while duodenal ulcers are found in the first part of the duodenum.
Globally, the prevalence of PUD has declined, largely due to H. pylori eradication, yet NSAID-related ulcers persist, especially among the elderly.
Etiology and Risk Factors
Helicobacter pylori infection – Present in ~90% of duodenal and 70% of gastric ulcers.
NSAIDs – Inhibit prostaglandin synthesis, compromising mucosal defense.
Smoking – Impairs mucosal healing.
Stress (critical illness) – Leads to stress ulcers.
Zollinger-Ellison Syndrome – Gastrinoma with excess acid secretion.
Corticosteroids, alcohol, and genetic predisposition are other contributors.
Pathophysiology
The balance between aggressive factors (acid, pepsin, H. pylori, NSAIDs) and defensive mechanisms (mucus, bicarbonate, blood flow, prostaglandins) determines mucosal integrity.
H. pylori causes chronic inflammation and epithelial damage. NSAIDs decrease prostaglandins, reducing mucosal blood flow and bicarbonate production.
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III. Clinical Features of Peptic Ulcer
Epigastric pain: Most common symptom; burning or gnawing in nature.
Duodenal ulcers: Pain relieved by food, occurs 2–3 hours after meals.
Gastric ulcers: Pain worsens with food intake.
Nausea, bloating, early satiety
Complications:
Bleeding: Hematemesis, melena.
Perforation: Sudden severe abdominal pain.
Gastric outlet obstruction
Penetration into adjacent organs (e.g., pancreas)
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IV. Diagnosis of Peptic Ulcer
Endoscopy: Gold standard for diagnosis and biopsy to rule out malignancy.
Rapid urease test, histology, urea breath test, stool antigen – for H. pylori.
Serologic testing (less preferred).
Barium study
Post-exercise thermoregulation and associated factors
Post-exercise thermoregulation and associated factorsProf. Walid Kamal Post-exercise, especially in the heat, the body needs to restore its temperature balance. This process is complex, influenced by both thermal factors (like skin temperature) and nonthermal factors (like age, fitness, and blood pressure). These factors affect how quickly the body can lose heat and recover its core temperature. Understanding these influences is key to preventing heat strain and optimizing performance for athletes, workers, and military personnel.
Dental Avulsion & its Management
Dental Avulsion & its ManagementDr. Mukesh Kumar Dey This presentation is based on the series and flowcharts decisions to be made and of methods when dealing with a case of tooth avulsion in children (more specifically) and adults.
All references have been enumerated in the last slides.
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Anti malarial agents of pharmacology by Darade K.K
Anti malarial agents of pharmacology by Darade K.Kkrushna darade The PDF titled “Anti Malarial Agents” provides a detailed overview of malaria, its causative Plasmodium species, life cycle, symptoms, and the classification of antimalarial drugs. It explains drug mechanisms, pharmacokinetics, adverse effects, and therapeutic uses, aiding in understanding malaria treatment and prevention.
BIOMECHANICS & KINESIOLOGY OF THE WRIST COMPLEX.pptx
BIOMECHANICS & KINESIOLOGY OF THE WRIST COMPLEX.pptxdrnidhimnd The wrist is composed of radiocarpal and intercarpal articulations
The wrist consists of 10 small carpal bones but can be functionally divided into the radiocarpal and the midcarpal joints.
The radiocarpal joint involves the broad distal end of the radius and two carpals, the scaphoid and the lunate.
There is also minimal contact and involvement with the triquetrum
This ellipsoid joint allows movement in two planes: flexion– extension and radial–ulnar flexion.
It should be noted that wrist extension and radial and ulnar flexion primarily occur at the radiocarpal joint but a good portion of the wrist flexion is developed at the midcarpal joints.
History collection of a patient with renal disorder.pptx
History collection of a patient with renal disorder.pptxRishika Rawat Patients with moderate or severe chronic kidney disease sometimes appear pale, wasted, or ill. Deep (Patients with moderate or severe chronic kidney disease sometimes appear pale, wasted, or ill. Deep respiration suggests hyperventilation in response to metabolic acidosis with acidemia. Patients with nephrotic syndrome and fluid overload can present with periorbital swelling and edema of extremities.) respiration suggests hyperventilation in response to metabolic acidosis with acidemia. Patients with nephrotic syndrome and fluid overload can present with periorbital swelling and edema of extremities.
EMERGING AND REEMERGING INFECTIOUS DISEASES.pptx
EMERGING AND REEMERGING INFECTIOUS DISEASES.pptxAnuragVerma491530 This comprehensive seminar presentation on Emerging and Re-emerging Diseases explores one of the most critical challenges in global public health today. The content delves into the definitions, differences, and classifications of emerging and re-emerging infectious diseases, shedding light on the dynamic nature of disease epidemiology in the 21st century.
The presentation highlights factors contributing to the emergence and resurgence of diseases, including globalization, increased human-animal interaction, urbanization, climate change, deforestation, antimicrobial resistance (AMR), and gaps in immunization. Through relevant case studies and recent outbreaks such as COVID-19, Nipah virus, Zika, Ebola, Monkeypox, Dengue, Tuberculosis, and others, the seminar underscores the importance of disease surveillance, rapid response systems, and the “One Health” approach.
It also discusses the role of national and international health agencies like WHO, CDC, and India’s IDSP in disease monitoring and control. The presentation is enriched with visuals, stats, and key strategies for prevention and control, making it a valuable educational tool for medical students, community medicine postgraduates, public health professionals, and policy makers.
By the end of this seminar, viewers will gain a deeper understanding of how emerging and re-emerging diseases pose evolving threats and how a proactive, multidisciplinary public health response is essential to safeguard communities globally.
newer Drug Delivery system by Dr Shraddha pharmacology.pptx
newer Drug Delivery system by Dr Shraddha pharmacology.pptxDr Shraddha Mishra novel drug delivery system , newer drug delivery system by dr shraddha mishra mbbs md pharmacology
PREMATURE RUPTURE OF MEMBRANES.pptx FOR NURSING STUDENTS CREATED BY KIRAN KAR...
PREMATURE RUPTURE OF MEMBRANES.pptx FOR NURSING STUDENTS CREATED BY KIRAN KAR...KIRAN KARETHA Premature rupture of membranes (PROM), also known as pre-labor rupture of membranes, refers to the rupture of the amniotic sac (or "water breaking") before the onset of true labor.
TYPES
Preterm premature rupture of membrane: when rupture of membranes occurs before the 37th week of gestational age.
Term premature rupture of membrane: when rupture of membranes occurs at or after the 37th week of pregnancy but before the onset of true labor.
3) Prolonged premature rupture of membrane: when rupture of membranes occurs for more than 24 hours before delivery.
4) Pre-viable pre-term premature rupture of membrane: when rupture of membranes occurs before 24 weeks of gestation. It is also known as Mid-trimester premature rupture of membrane
CLINICAL MANIFESTATION
painless leakage of fluid from vagina
fetal can easily feel through belly due to loss of fluid
decrease uterine size
abdominal pain and back pain
fetal heart sound altered
gush of fluid
oligohydramnios
DIAGNOSTIC EVALUATION
History collection (steady loss of small amount of fluid from vagina)
Sterile speculum examination: A sterile speculum examination involves using a sterile speculum, a medical instrument, to gently open the vagina for a visual examination of the cervix and vaginal walls, ensuring the speculum is sterilized before use, to prevent infection.
Pooling test: During a speculum examination, healthcare providers look for amniotic fluid accumulating in the posterior vaginal fornix (the area at the back of the vagina).
This pooling of fluid suggests that the amniotic sac has ruptured, allowing fluid to leak into the vagina.
Nitrazine test: The nitrazine test, using nitrazine paper (phenaphthazine), is a method to determine vaginal pH and detect potential amniotic fluid leakage, which can indicate a ruptured amniotic membrane, by observing a color change from yellow to blue.
Fern test: The fern test involves collecting a vaginal fluid sample, allowing it to dry on a glass slide, and then examining the dried sample under a microscope.
When amniotic fluid is present, the sodium chloride in it crystallizes, forming a characteristic fern-like pattern.
MANAGEMENT
If the patient is term > 37 weeks : Approximately 90% of patient will go into spontaneous labor within 24 hours. labor should be induced either at the time of presentation or the patient can be expected managed.
Induction of labor reduces the time of delivery and the rates of chorioamnionitis and endometritis and admission to the neonatal intensive care unit.
If the patient does not go into spontaneous labor on her own then labor induction should be performed with oxytocin. So, use oxytocin or prostaglandins as indicated Otherwise, perform cesarean delivery.
COMPLICATIONS
IF FETUS REMAIN IN UTERO
Neonatal conditions
Infection and sepsis
Deformations
Umbilical cord compression
Pulmonary hypoplasia
#BRAINWAVE LEARNING pdf by #SM - #Sujitha #mohitha (doctor of pharmacy 💊) #ph...
#BRAINWAVE LEARNING pdf by #SM - #Sujitha #mohitha (doctor of pharmacy 💊) #ph...Mohithakumaran In this Depression we described about
Definition
Types
Etiology
Epidemiology
Signs and symptoms
Complications
Diagnosis
Treatment
Overview of Parkinson’s disease :- Etiology, types, pathogenesis,signs,treate...
Overview of Parkinson’s disease :- Etiology, types, pathogenesis,signs,treate...Arghadeep Sarkar This ppt consisting about Parkinsonism and parkinson's disease and all related points like etiology,types of PD, pathogenesis,epidemology,signs -syptoms, diagnosis, treatment, drug classification
Ranitidine Recall:- Regulatory Response to NDMA Contamination
Ranitidine Recall:- Regulatory Response to NDMA ContaminationSuyash Jain Ranitidine Recall:- Regulatory Response to NDMA Contamination
introduction about ranitidine
rise and fall of ranitidine:- drug discovery pipeline
NDMA Contamination: A Ticking Time Bomb
VALISURA laboratory
Claims by VALISURA
Testing Methods for NDMA
Regulatory Procedure Timeline
European Medical Agency
CHMP(Committee for Medicinal Products for Human Use)
usfda
Recall
what are recalls
21CFR
Recall Process: A Step-by-Step Guide
Regulatory actions
(FDA recall, EMA recommendations)
Guidelines to consumers
Alternatives to ranitidine
What Ranitidine Taught Us About Drug Safety?
Adulterants screening in Herbal products using Modern Analytical Techniques
Adulterants screening in Herbal products using Modern Analytical Techniques28SamruddhiKadam Basic introduction to adulteration in Herbal products, M Pharm Pharmaceutical Analysis Semester 2
Basic types of Adulterations in herbal products.
Modern hyphenated techniques used in determination of adulteration of herbal drugs which includes TLC, HPTLC, HPLC, LC-MS, LC-NMR, SFC, LC-IR,etc.
Various modern analytical techniques used in Quantification of Adulterants present in herbal product.
Examples of various drugs causing adulteration in Herbal products.
DR MANISH-2.pdf laser proctology piles and fistula
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- 3. Medical school (MBBS):2005-2011: -People’s Medical College, Bhopal(MP) DNB (Radio diagnosis): - Apollo hospital, Hyderabad(Telangana) FVIR (PDCC):- Tata Memorial Centre, Mumbai(Maharashtra) Senior Resident: Hinduja Hospital Mumbai, SMS Hospital Jaipur Past Visiting Doctor:Leelavati Hospital Mumbai, Breach Candy Hospital Mumbai, Wockhardt Hospital Mumbai, Hinduja Hospital Mumbai Ex Assitant Professor:JNU Medical College, Jaipur Currently Working as Senior Consultant Interventional Radiologist in various corporate hospitals of Rajasthan based in Jaipur HIS EDUCATION
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