Download or read book Inflammatory Bowel Diseases ECAB written by Philip Augustine and published by Elsevier Health Sciences. This book was released on 2012-07-05 with total page 141 pages. Available in PDF, EPUB and Kindle. Book excerpt: Inflammatory bowel disease (IBD) encompasses a spectrum of autoimmmune diseases which include ulcerative colitis, Crohn’s disease, and indeterminate colitis. Ulcerative colitis is a relapsing nontransmural inflammatory disease restricted to colon, which may be classified as proctitis, left-sided colitis, or pancolitis depending on the extent of involvement. Some patients also develop ileal inflammation (backwash ileitis), which occasionally complicates its differentiation from Crohn’s ileocolitis. Crohn’s disease is defined as a relapsing transmural inflammatory disease of gastrointestinal mucosa that may affect the entire gastrointestinal tract (GIT) from the mouth to the anus. There is discontinuous involvement of various portions of the GIT and may get complicated by formation of strictures, abscesses, or fistulas. It closely resembles intestinal tuberculosis both clinically and on investigations. GI tuberculosis is often suspected on the basis of its clinical, radiological, and endoscopic features, but histological or microbiologic proof of the disease is often difficult to achieve. Therefore, the majority of patients are treated with antitubercular drugs on presumptive diagnosis only. Similar clinical, endoscopic, radiological, and histological features of GI tuberculosis and Crohn’s disease pose a serious challenge to the treating physician. The rate of misdiagnosis of these conditions using conventional diagnostic measures has been reported to be around 50–70%. Thus differentiation and diagnosis of these conditions is difficult but very important for correct treatment of the patients. Recently some serological tests have come up for diagnosing Crohn’s disease and ulcerative colitis, which may help to distinguish these disorders from each other and from GI tuberculosis. Besides diagnosis, treatment for IBD is also an emerging field in which active research is going on. The traditional drugs used in treatment of IBD include steroids and aminosalicylates. Recent studies have evaluated the role of azathioprine, methotrexate, and cyclosporine. Apart from improving efficacy of therapy in short term, these agents have raised debate on complications of therapy, long-term efficacy, and cost. Management of IBD during pregnancy and fistulising Crohn’s disease are other areas of concern.
Download or read book ECAB Inflammatory Bowel Disease E Book written by B S Ramakrishna and published by Elsevier Health Sciences. This book was released on 2014-12-11 with total page 160 pages. Available in PDF, EPUB and Kindle. Book excerpt: ECAB Inflammatory Bowel Disease - E-Book
Download or read book Alcoholic Liver Disease ECAB written by Philip Abraham and published by Elsevier Health Sciences. This book was released on 2009-09-15 with total page 168 pages. Available in PDF, EPUB and Kindle. Book excerpt: Alcoholic liver disease involves an acute or chronic inflammation of liver occurring as a consequence of alcohol abuse. The pathological changes occur in 3 stages namely, fatty liver, alcoholic liver disease and cirrhosis, with the final stage traditionally considered to be irreversible. Alcoholic liver disease is responsible for a significant number of premature deaths per annum all around the globe. There is an urgent need to educate the masses about the hazards of alcohol abuse. An efficient system to encourage and prolong the period of alcohol abstinence is the need of the hour. The importance of lifestyle modifications like weight reduction and cessation of smoking in the progression of liver disease needs to be communicated to the patients and the medical community as well. Moreover, realization of the role of nutrition in the management and recovery of ALD would enhance the treatment strategies for this condition. This book has been designed to update the readers on the important aspects of ALD and is a step forward to enable the society in combating the social and economic losses that occur as a result of alcohol abuse. The book has stressed upon various aspects of ALD like the role of nutrition, epidemiology and pathogenesis, and the possible therapeutic strategies involved. Supportive case scenarios have also been incorporated with relevance to the topics covered under the book. Overall, the book presents to the readers an excellent compilation of clinically applicable literature sourced from the most acclaimed physicians in the country.
Download or read book Pancreatic Exocrine Insufficiency ECAB written by Pramod Kumar Garg and published by Elsevier Health Sciences. This book was released on 2010-09-29 with total page 142 pages. Available in PDF, EPUB and Kindle. Book excerpt: The exocrine pancreatic function can be impaired by many different pancreatic disease as well as diseases that do not appear to be directly linked to the exocrine pancreas. Hormones stimulating exocrine function (e.g. CCK) might be reduced in diseases affecting the intestinal mucosa (IBD, celiac disease, AIDS) resulting in decreased exocrine secretion. The function of digestive enzymes might be affected by post-cibal asynchrony or by a decreased intraduodenal pH as in Zollinger-Ellison syndrome (ZE). An atrophy of pancreatic tissue might be caused by a lack of trophic factors, as may occur in IDDM, and pancreatic damage might occur due to drugs used for the treatment of other diseases. While some of these conditions appear to be rather rare and of minor clinical relevance, exocrine pancreatic involvement is very frequent in patients with diabetes mellitus. The diagnosis of the condition can be made by the exploration of the exocrine pancreatic secretion, which has been mainly used for the diagnosis of chronic pancreatitis and detection of pancreatic exocrine insufficiency of any etiology. Thus, diagnosis of the disease is classically based on the demonstration of either the morphological and/or the functional changes that typically develop over time in the course of the disease. Exocrine pancreatic function impairs progressively as chronic pancreatitis develops. Thus, exocrine pancreatic dysfunction refers to a mild, moderate or severe reduction of the exocrine pancreatic secretion. Finally, pancreatic function becomes insufficient to maintain a normal digestive process. Pancreatic exocrine insufficiency refers to the stage of maldigestion and malabsorption of nutrients as a consequence of a primarily and/or secondarily impaired exocrine pancreatic function. Pancreatic enzymes remain as the cornerstone for the effective treatment of various disease pathologies resulting in pancreatic exocrine insufficiency. The rigid criteria set forth by the FDA in the USA will ensure that effective pancreatic enzyme preparations will be available and allow the clinician to successfully treat maldigestion, malabsorption, vitamin deficiencies, protein-calorie malnutrition, and in selected patients, the abdominal pain associated with chronic pancreatitis and PEI. Pancreatic enzymes are particularly underused in chronic pancreatitis patients with PEI, post-gastric and intestinal surgery patients who develop an asynchrony of enzyme delivery to the intestine, and pancreatic cancer patients. Earlier use of potent pancreatic enzymes will enhance the quality of life for these patients. This clinical update has been designed to update the readers on the important aspects of the pancreatic exocrine insufficiency, resulting from different conditions and its impact on the patient. The book has stressed upon the various aspects of the condition like its etiology, diagnosis, evaluation, and management approach to the patient. Overall, the book presents to the readers an excellent compilation of clinically applicable literature sourced from the most acclaimed physicians across globe.
Download or read book Irritable Bowel Syndrome ECAB written by Uday C Ghoshal and published by Elsevier Health Sciences. This book was released on 2012-07-05 with total page 121 pages. Available in PDF, EPUB and Kindle. Book excerpt: Irritable bowel syndrome is a part of the family of gastrointestinal motility disorders and is characterized by abdominal pain and altered bowel habits. It is highly prevalent throughout the world with the reported prevalence rates lying between 9% and 25%. The incidence of IBS varies between different ethnic groups and the incidence has also been reported to be different in males and females. The incidence also varies between various clinical subgroups (diarrhea-predominant/constipation-predominant) of the disorder. This is a chronic condition and is the most frequent symptom complex in patients who visit gastroenterologists throughout the world. However, this is one of the least understood GI disorders as it is not a disease but a complex of symptoms. The symptoms are often severe and quite bothersome, and thus have a negative effect on the patient’s quality of life and activity level, often leading to psychiatric complications. Besides this, a substantial economic burden of the disease and its impact in terms of man hours lost per annum make it one of the most troublesome symptom complexes in medicine, which need to be solved. This book has been designed to update the readers on the extensive research done over these years and on the many new potential mechanisms of pathogenesis of this troublesome condition. The reader will also be updated on the changing epidemiology of the condition. Diagnostic approach and management of IBS have also been thoroughly reviewed with an emphasis on the recent updates in the field. Typical supportive case scenarios have been included to exemplify and highlight various points discussed. Thus, it provides an excellent opportunity to widen one’s perspective in this area.
Download or read book ECAB Probiotics in Prevention of Lifestyle Disorders E Book written by B S Ramakrishna and published by Elsevier Health Sciences. This book was released on 2014-12-11 with total page 133 pages. Available in PDF, EPUB and Kindle. Book excerpt: ECAB Probiotics in Prevention of Lifestyle Disorders - E-Book
Download or read book Carcinoma Gallbladder ECAB written by Gourdas Choudhuri and published by Elsevier Health Sciences. This book was released on 2012-07-05 with total page 118 pages. Available in PDF, EPUB and Kindle. Book excerpt: Carcinoma gallbladder is the third most common GI malignancy and the most common biliary tract malignancy in North India. Of all the known risk factors, gallstones are most commonly associated with GBC. Bile stasis and chronic inflammation along with occupational exposure to heavy metals, dietary carcinogens, and radiation exposure have been found to be responsible for the increased incidence of GB neoplasms. Infections with S. typhii and S. paratyphii along with Helicobacter sp. have also been associated with GBC. p 53 and ras gene mutations are strongly associated with GBC. Early diagnosis of GBC still remains a challenge and is often diagnosed as a part of investigations of any other disease. Most GBCs are at advanced stage at presentation. USG and CT scan are the common modes for the preliminary diagnosis of GBC. Surgery remains the key treatment modality and the only hope for long-term survival. A large number of patients present at the unresectable stage of the tumor, and palliation remains the only alternative to ensure better quality of life.
Download or read book ECAB Cholestatic Liver Disease E Book written by Prabha Sawant and published by Elsevier Health Sciences. This book was released on 2014-12-11 with total page 154 pages. Available in PDF, EPUB and Kindle. Book excerpt: ECAB Cholestatic Liver Disease - E-Book
Download or read book Acute Pancreatitis ECAB written by Pramod Kumar Garg and published by Elsevier Health Sciences. This book was released on 2013-05-24 with total page 282 pages. Available in PDF, EPUB and Kindle. Book excerpt: Acute pancreatitis is defined as an acute inflammatory process of the pancreas that may also involve peripancreatic tissues and/or remote organ systems. It typically presents with sudden deep, boring pain that starts in the epigastrium and radiates to the back, which usually worsens on intake of food. It may be of varying severity ranging from mild to severe. Mild disease, if managed promptly and adequately resolves with minimal or no sequelae and seldom leads to extended morbidity or mortality. However Severe Acute Pancreatitis has a longer course of resolution, usually requires hospitalization and has a greater propensity to lead to adverse outcomes. As a thumb rule, it has greater morbidity and mortality rates as compared to Mild Acute Pancreatitis. Understandably, the management protocol for the severe acute pancreatitis is more invasive and emergent, and may require intensive care management. Hence understanding and assessment of the condition in the first 48 hours is a critical step in deciding the outcome. The various assessment criteria that are used to prognosticate and plan the management for this disease have been discussed in this clinical update. Previously, the condition was thought to be caused by infection, but now it is an established fact that it is an acute inflammation of the pancreatic gland with activation of the pancreatic enzymes within the gland leading to its autodigestion. Previously, acute pancreatitis was considered to be mostly associated with chronic alcohol abuse or acute bouts of binge drinking. With the availability of data from recent studies in India and the Asian subcontinent, Biliary disease is emerging as the commonest etiological agent. Extensive genetic analysis and mapping have helped put a cause to the erstwhile "idiopathic" cases. Newer diagnostic modalities and minimal invasive procedures have made the conventional surgeries nearly obsolete now. The rationale and use of antimicrobial treatment in the medical management of the condition has also undergone a change. This clinical update has been designed to update the readers on the important aspects of Acute Pancreatitis. The book has stressed upon various aspects of the condition like the etiology, pathogenesis, diagnosis and evaluation along with an insight into the management approach of the patient including the supportive and nutritional management. Overall, the book presents to the readers an excellent compilation of clinically applicable literature sourced from the most acclaimed physicians in the country.
Download or read book ECAB Health Impact of Probiotics Vision Opportunities E Book written by G Balakrish Nair and published by Elsevier Health Sciences. This book was released on 2014-12-11 with total page 177 pages. Available in PDF, EPUB and Kindle. Book excerpt: ECAB Health Impact of Probiotics: Vision & Opportunities - E-Book
Download or read book Hepatic Encephalopathy ECAB written by Prabha Sawant and published by Elsevier Health Sciences. This book was released on 2013-06-17 with total page 104 pages. Available in PDF, EPUB and Kindle. Book excerpt: Hepatic encephalopathy is the clinical syndrome resulting from increased ammonia levels in blood. The most common cause of HE is chronic liver disease. However, acute liver failure, Reye’s syndrome, or metabolic defects are other causes. The true prevalence of overt HE is difficult to establish because of the considerable heterogeneity in etiology and disease severity. However, HE has been reported to be present in around 50% of patients with cirrhosis or with porto-caval shunts at some time during their illness. It is less common in patients with portosystemic shunts without liver disease. Thirty percent of patients dying of end-stage liver disease experience significant encephalopathy, approaching coma. After TIPS placement, approximately 1/3 of patients will experience overt HE. Minimal HE (MHE) is difficult to diagnose due to lack of standard diagnostic tests. Its clinical significance with regards to progression to overt encephalopathy has however, not been established. Conventional treatment of hepatic encephalopathy relies primarily on reducing the production and absorption of ammonia. Identification and correction of the precipitating factors and general supportive measures are important management steps. There are very few randomized controlled trials (RCT) of therapies and even these are bugged by lack of a control group and small sample sizes.
Download or read book ECAB clinical Update Gastroenterology Hep Mar April issue 2 written by Abraham and published by Elsevier India. This book was released on with total page 120 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book ECAB Gastrointestinal Hemorrhage E Book written by Peush Sahni and published by Elsevier Health Sciences. This book was released on 2014-12-11 with total page 151 pages. Available in PDF, EPUB and Kindle. Book excerpt: ECAB Gastrointestinal Hemorrhage - E-Book
Download or read book Portal Hypertension ECAB written by Abraham Koshy and published by Elsevier Health Sciences. This book was released on 2012-06-07 with total page 119 pages. Available in PDF, EPUB and Kindle. Book excerpt: Defined as a portal pressure of 12 mmHg or more, portal hypertension results from a combination of increased intrahepatic vascular resistance and increased blood flow through the portal venous system. Esophagogastric varices is the most important complication of severe portal hypertension because of the high risk of bleeding and mortality associated with them. Ascites is another important complication which may at times be refractory to treatment and may also get complicated by spontaneous bacterial peritonitis and hepatorenal syndrome. Portal hypertension is a predictable and preventable condition but has no definite cure. An aggressive approach to prevention and treatment of portal hypertension is therefore warranted. Treatment of portal hypertension is evolving rapidly and many changes in the therapeutic protocols have been incorporated in recent times. Endoscopic treatment of the bleeding varices and prophylactic role of beta-blockers to prevent rebleeding are well-established therapeutic options. The measurement of the hepatic venous pressure gradient may identify a suboptimal response to beta-blockers in patients at risk of bleeding from varices. However, the costeffectiveness of routine hepatic venous pressure gradient measurements to guide primary prophylaxis has not been examined. Besides these, there is a definite role of somatostatin analogs and shunt surgeries in the treatment of portal hypertension and its complications. This book is designed to update the reader on all such issues related to diagnosis, treatment and complications of portal hypertension along with supportive typical case scenarios. Thus it provides an excellent opportunity to widen one’s perspective in this area.
Download or read book Hepatitis ECAB written by Abhijit Chowdhury and published by Elsevier Health Sciences. This book was released on 2009-07-15 with total page 138 pages. Available in PDF, EPUB and Kindle. Book excerpt: Hepatitis means inflammation of the liver, which can be classified as acute or chronic depending upon the duration of the condition. Various etiological agents have been correlated with the occurrence of various forms of the disease. The developed countries have a majority of drug-induced and toxic liver injury, while the developing countries like India present with a majority of feco-oral and blood borne transmissions of the disease. Viral hepatitis virtually constitutes a separate etiological group. It causes a set of typical clinical, biochemical, and histological changes with or without icterus resulting from hepatic cell damage. It may be acute or chronic. The acute form causes considerable morbidity and mortality, and the chronic sequelae may prove to be fatal by resulting in liver cirrhosis and hepatocellular carcinoma (HCC). Hepatitis A and E are transmitted feco-orally, while B and C are transmitted only through blood/secretions. Hepatitis D occurs only in association with hepatitis B. Morphological pattern of liver injury in acute hepatitis varies with etiology and severity of insult. The typical lesion in all forms of acute viral hepatitis is panlobular infiltration with mononuclear cells, predominantly lymphocytes, hepatic cell necrosis, and variable degree of cholestasis, Kupffer cell hyperplasia. In fulminant hepatic failure, massive hepatic necrosis results in a soft shrunken liver. All forms of acute viral hepatitis run similar clinical course, which include incubation period after infection during which they are asymptomatic, followed by prodromal, icteric, and convalescent phases. Extrahepatic manifestations of viral hepatitis include renal, neurological, and hematological disorders. Most patients with acute viral hepatitis recover with supportive management. Hospitalization is required only in severe cases as evidenced by prolonged PT, altered sensorium, deep jaundice with ascites. Identification of etiology of acute hepatitis is of prime importance for the treatment of hepatitis. Definitive therapy is needed in drug-induced hepatitis. Most mild forms of viral hepatitis resolve with supportive treatment. Progressive liver failure mandates urgent liver transplantation. Prognostic models (Kings’ College criteria, Clichy’s criteria) have been developed for early identification of patients who would require liver transplant.
Download or read book Chronic Pancreatitis ECAB written by Pramod Kumar Garg and published by Elsevier Health Sciences. This book was released on 2013-06-17 with total page 222 pages. Available in PDF, EPUB and Kindle. Book excerpt: Chronic pancreatitis (CP) is defined as a continuous or recurrent inflammatory disease of the pancreas characterized by progressive and irreversible morphological changes. It typically causes pain and permanent impairment of pancreatic function. In chronic pancreatitis, areas of focal necrosis are typically associated with perilobular and intralobular fibrosis of the parenchyma, by stone formation in the pancreatic duct, and by the development of pseudocysts. Late in the course of the disease a progressive loss of endocrine and exocrine function occurs. In the past, chronic pancreatitis was considered to be mostly associated with chronic alcohol abuse. During the past 2 decades idiopathic chronic pancreatitis and, moreover, hereditary pancreatitis have been recognized as distinct disease entities. Usually the diagnosis is made by a combination of imaging procedures such as ultrasound and endoscopic retrograde cholangiopancreatography, and exocrine and endocrine function tests. Therapy is presently restricted to symptom control for the lack of a causal treatment strategy. Thirty to sixty percent of all patients develop disease-associated complications such as persistent pain, strictures of the common bile duct, or pancreatic duct stones that may require either endoscopic or surgical treatment. Chronic pancreatitis is a difficult condition to live with as well as to treat. Optimal care needs to be carried out in a multidisciplinary environment that can address both the physical and psychological aspects of the disease. It is commonly seen in alcohol-dependent individuals, but many other groups of individuals suffer with irreversible inflammatory destruction of the pancreas. Abdominal pain is the predominant feature and pain specialists are an important part of any pancreatic team. Exocrine and endocrine failure are addressed by appropriate nutrition with supplements and insulin, whilst the complications that are seen over time, may require a combination of endoscopic and surgical treatment. This clinical update has been designed to update the readers on the important aspects of CP. The book has stressed upon various aspects of the condition like the etiology, pathogenesis, diagnosis and evaluation along with an insight into the management approach of the patient. Supportive case scenarios have also been incorporated with relevance to the topics covered under the book. Overall, the book presents to the readers an excellent compilation of clinically applicable literature sourced from the most acclaimed physicians in the country.
Download or read book Deep Vein Thrombosis ECAB written by O P Yadava and published by Elsevier Health Sciences. This book was released on 2013-04-26 with total page 318 pages. Available in PDF, EPUB and Kindle. Book excerpt: Venous thromboembolism is a common and potentially lethal disease. Patients who have pulmonary embolism are at especially high risk for death. Sudden death is often the first clinical manifestation. Only a reduction in the incidence of venous thromboembolism can reduce sudden death owing to pulmonary embolism and venous stasis syndrome owing to deep vein thrombosis. Improvement in the incidence of venous thromboembolism will require (i) better recognition of persons at risk, (ii) improved estimates of the magnitude of risk, (iii)avoidance of risk exposure when possible, (iv)more widespread use of safe and effective prophylaxis when risk is unavoidable, and (v) targeting of prophylaxis to those persons who will benefit most. Early and timely diagnosis and management of deep vein thrombosis and pulmonary embolism considerably reduces the subsequent morbidity and mortality.
