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DMC Huron Valley-Sinai Hospital offers hope for severe sinus sufferers through new image-guided surgery that opens up passages, allowing freer breathing and higher quality of life. See two patients who have undergone the procedure and hear about their new lease on life. ~ Detroit Medical Center
esophago-gastro- duodinoscopy
Gastroduodinoscopy requires special training and considerable experience but affords valuable information.
By its implement the whole of the interior of the stomach as well as esophagus, the first part and the proximal section of the second part of the duodenum and both efferent and afferent loops of the gastrojujenostomy if present can be scrutinized.
Gastroscopy is valuable in the diagnosis of gastric ulcers, in checking the results of medical treatment of chronic gastric ulcer. Gastroduodinoscopy is valuable in differential diagnosis between chronic peptic ulcer and gastric carcinoma, in diagnosis of small gastric neoplasm, in the detection of certain forms of gastritis, in examination of a stoma, in cases of gastrojujenostomy, in cases of duodinitis and duodenal ulcer.
Now its' the Era of
VIDEOGASROSCOPE
Direct means of diagnosis of upper G.I. diseases
Continuous Video recording of the entire procedure is there by which
we can review the whole procedure by playing the Video.
We are doing final diagnosis of upper G.I. lesions with biopsy.
Treatment becomes easy and to the point.
Early detection of pre malignant and malignant lesions is appreciable.
Current treatment is a combination of pegylated interferon-alpha-2a or pegylated interferon-alpha-2b (brand names Pegasys or PEG-Intron) and the antiviral drug ribavirin for a period of 24 or 48 weeks, depending on hepatitis C virus genotype. In a large multicenter randomized control study among genotype 2 or 3 infected patients (NORDymanIC),[35] patients achieving HCV RNA below 1000 IU/mL by day 7 who were treated for 12 weeks demonstrated similar cure rates as those treated for 24 weeks.[36][37]
Pegylated interferon-alpha-2a plus ribavirin may increase sustained virological response among patients with chronic hepatitis C as compared to pegylated interferon-alpha-2b plus ribavirin according to a systematic review of randomized controlled trials .[38] The relative benefit increase was 14.6%. For patients at similar risk to those in this study (41.0% had sustained virological response when not treated with pegylated interferon alpha 2a plus ribavirin), this leads to an absolute benefit increase of 6%. About 16.7 patients must be treated for one to benefit (number needed to treat = 16.7; click here [39] to adjust these results for patients at higher or lower risk of sustained virological response). However, this study's results may be biased due to uncertain temporality of association, selective dose response.
Treatment is generally recommended for patients with proven hepatitis C virus infection and persistently abnormal liver function tests.
Treatment during the acute infection phase has much higher success rates (greater than 90%) with a shorter duration of treatment; however, this must be balanced against the 15-40% chance of spontaneous clearance without treatment (see Acute Hepatitis C section above).
Those with low initial viral loads respond much better to treatment than those with higher viral loads (greater than 400,000 IU/mL). Current combination therapy is usually supervised by physicians in the fields of gastroenterology, hepatology or infectious disease.
The treatment may be physically demanding, particularly for those with a prior history of drug or alcohol abuse. It can qualify for temporary disability in some cases. A substantial proportion of patients will experience a panoply of side effects ranging from a 'flu-like' syndrome (the most common, experienced for a few days after the weekly injection of interferon) to severe adverse events including anemia, cardiovascular events and psychiatric problems such as suicide or suicidal ideation. The latter are exacerbated by the general physiological stress experienced by the patient.
Male 19 y. age victim of penetrating brain injury. All the criteria for the encephalic death diagnosis were present. The presence of this complex spinal reflex doesn't exclude the brain death diagnosis and must be known and understood by the professionals involved in this very important diagnosis