PYLORIC STENOSIS (GASTRIC OUTLET OBSTRUCTION)

Pyloric stenosis is rarely due to stenosis at the pylorus. More commonly, the obstruction is on one side of the pylorus, either in the first part of the duodenum due to chronic scarring from a duodenal ulcer or in the antrum due to a carcinoma. True pyloric stenosis can arise from a pyloric channel ulcer or very rarely from a congenital web or adult hypertrophic pyloric stenosis. Some instances of gastric stenosis are caused by inflammatory oedema...

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PEPTIC ULCER DISEASE

Worldwide, duodenal ulcers are more common than gastric ulcers and there is a significantly higher incidence of duodenal ulceration in males of all age groups. Dietary factors, drug ingestion (NSAIDs) and smoking are important in the aetiology. The most common causes are environmental ulcerogens (chemical or infective) acting in consort with factors that impair gastric mucosal resistance to injury and healing of mucosal lesions thereby leading to chronicity....

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UPPER GASTROINTESTINAL BLEEDING

Bleeding from the gastrointestinal tract may be caused by lesions located in the foregut (oesophagus, stomach and duodenum), midgut (small bowel up to mid transverse colon) and hindgut (distal colon and rectum). The bleeding  may be acute when the patient presents with hypovolaemia, or chronic when the clinical picture is that of symptomatic anaemia. The common causes of acute upper gastrointestinal haemorrhage are: •         chronic peptic ulceration; •         NSAID-induced bleeding; •         oesophagogastric varices. Irrespective...

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DYSPEPSIA

Gastroduodenal disease produces varied symptoms described by the term 'dyspepsia'. Dyspeptic symptoms are extremely common in the general population. An agreed international definition is 'episodic or persistent abdominal symptoms, often related to the intake of food, which patients or physicians believe to be due to disorders of the proximal portion of the digestive tract'. The symptoms included in this generic definition of dyspepsia are: •         pain or discomfort in the upper abdomen; •         nausea...

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WEIGHT LOSS IN GERIATRIC

Weight loss improves many of the adverse health outcomes associated with obesity, including preventing or delaying the onset of diabetes, improving blood sugar control in those with diabetes, reducing low-density lipoprotein (bad cholesterol), raising high-density lipoprotein (good cholesterol), improving hypertension, improving symptoms of osteoarthritis, and providing an improved sense of well-being. Individuals must only lose a small percentage of their weight (B5–10%) to begin seeing these improved health outcomes. As many people know from...

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THE IMMUNE MECHANISM

The actual body's defence mechanism is a remarkable safeguard procedure. That creates quick, particular, and also safety responses from the range likely pathogenic microbes in which inhabit the entire world by which we reside. The tragic examples of acquired immunodeficiency syndrome (AIDS) and the inherited severe combined immunodeficiencies (SCID) graphically show the outcomes of a nonfunctional adaptive body's defence mechanism. HELPS individuals and also young children using SCID frequently tumble unwilling recipient to be able to attacks...

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CLASIFICATION ACUTE CORONARY SYNDROME: UNSTABLE ANGINA AND NON-ST SEGMENT ELEVATION MYOCARDIAL INFARCTION

Acute coronary symptoms (ACS) details your procession of myocardial ischemia of which runs coming from unpredictable angina on just one end with the range in order to non–ST segment height myocardial infarction (MI) in the other end. Unsound angina is actually known coming from stable angina ( Section 70 ) by the new beginning or maybe difficult of signs or symptoms in the previous sixty nights or maybe by the growth of post-MI angina a day and up following your beginning of MI. If the clinical photo of unpredictable angina is actually coupled...

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CORONARY HEART FAILURE

Cardiovascular failure is often a heterogeneous symptoms by which abnormalities associated with cardiac functionality have the effect of the inability of the heart in order to water pump blood vessels in a production sufficient to satisfy the needs associated with metabolizing tissue as well as a chance to accomplish that only in abnormally raised diastolic challenges as well as quantities. One's heart failure symptoms will be seen as a signs associated with intravascular along with interstitial amount clog (shortness associated with breath of...

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GERIATRI PARADIGM

Geriatrics is the practice of care for frail older people. The epitome of geriatrics is treating multiple interactive problems that cross domains. In essence, geriatrics represents the intersection of chronic disease care and gerontology. Clinicians caring for older persons need to understand that diseases present differently in older persons, and their management is complicated by the presence of other factors. Older people take more medications, and hence are at greater risk of drug interactions. Older people may face problems in other sectors...

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HEALTH AND CARE SERVICES

Health care for older people involves managing chronic illness. In essence, geriatrics represents the intersection of chronic disease care and gerontology. Diseases present differently in older persons, and their treatment is complicated by the presence of impairments in other domains, such as affect, cognition, and economics. In the United States, older persons are the only group covered by a universal health care insurance system. Nonetheless, there remains substantial geographic variation in access to care. In general, older people still suffer...

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CANCER AND AGE

Cancer is the second leading cause of mortality after heart disease and the leading cause of death among women ages 40 to 79 and men ages 60 to 79. Within the 65þ age group, the population 85 years and older is projected to double from 4.3 million in 2005 million by 2030. Life expectancy has increased. More people are treated successfully after a cancer diagnosis, resulting in a greater prevalence of the elderly living with or developing cancer. It is important for all professionals dealing with the elderly to understand what the disease is...

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TREATMENT OF HYPERTENSION

The ability to find vulnerable plaques will make it possible to test the hypothesis that vulnerable patients require lower blood pressure, e.g., 120/70 mm Hg. As noted earlier, ACE inhibitors not only reduce blood pressure, stroke risk, and mortality in congestive heart failure, but also reduce the risk of reinfarction and of progressive atherosclerosis. Several mechanisms may contribute, including the anti-inflammatory action of ACE inhibitors. Related and equally promising drugs are the angiotensin receptor blockers, which have the putative...

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HYPERTENSION

Casual Office Blood Pressure Blood pressure is normally distributed within the population, with no natural cutoff point allowing discrimination between normotensive and hypertensive individuals. Moreover, the tendency for blood pressure to rise with age makes it difficult to apply uniformly any criteria of normal blood pressure. In women the blood pressure rise is steeper after menopause.The definition of hypertension is in some way arbitrary. By choosing specific blood pressure levels as upper limits of normal it is meant that the cardiovascular...

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PREVENTION ABOUT CARDIOVASCULAR DISEASES

For many years, organizations have sought to prevent the development of coronary heart disease in the many countries of the world. The World Health Organization (WHO) in its constitution states that health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. In the declaration of Alma Ata in 1978, it is further stated that the existing gross inequality in the health status of the people, particularly between developed and developing countries, is politically, socially, and economically...

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FACT, ARTHEROSCLEROSIS IN CARDIOVASCULAR DISEASES

Consequences of atherosclerosis are grouped under the broad phrase “cardiovascular diseases,” which is made up of coronary heart disease, cerebrovascular disease, and other circulatory disorders. These afflictions include the many manifestations of coronary heart disease, such as myocardial infarction, acute coronary syndromes, and heart failure, and the consequences of peripheral disease, such as stroke, peripheral vascular disease, aortic disease, and renal failure. Myocardial infarction and stroke have...

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