#esophageal tumors

[lupine-publishers-ctgh]

Lupine Publishers | Validity of Serum Markers for Fibrosis Staging in Chronic Hepatitis B and C Patients

Introduction

According to latest report globally about 350 million people are affected by Hepatitis B virus and about 686,000 die every year from Hepatitis B related diseases[1,2]. Similarly, more than 185 million people around the world are infected with Hepatitis C virus, of whom 350,000 die each year[3,4]. Hepatic fibrosis, regardless of the underlying a etiology, is a consequence of accumulation of extracellular matrix components in the liver. This process is caused by persistent liver damage and consequent wound healing reaction, leading to cirrhosis, portal hypertension, and hepatocellular carcinoma (HCC), all these cumulatively leading to increased morbidity and mortality [5,6]. Thus accurate assessment of liver fibrosis is essential for successful individualized disease management for people with chronic hepatitis B and C7. Although liver biopsy, till date, remains the gold standard for diagnosis of liver fibrosis but it is far from optimal because of many associated complications [8,9,10]. To overcome these limitations multiple noninvasive modalities have been introduced. Various non-invasive parameters which could replace the biopsy of the infected liver include: - FIB-4[11], APRI[12], AST/ALT ratio[13], Kings Score[14], Frons index[15], Elastography[16] and Fibro scan[17]. Our study included the following three parameters as alternative to liver biopsy: FIB-4, APRI (Aspartate Aminotransferase to Platelet Ratio Index) and AST/ALT Ratio (Aspartate transaminase)/ (Alanine transaminase).

Materials and Methods

The current study was a hospital based prospective study which was conducted in the Department of Internal Medicine and Department of Gastroenterology, Government Medical College, Srinagar, J&K (INDIA). The study was approved by the respective ethical committees of the college. The study was conducted over a period of 36 months starting from August 2014 to July 2017. The study was approved by the respective ethical committees of the college. A total of 262 patients were included and out of them 172 were infected with hepatitis B and 90 patients were infected with hepatitis C. All Chronic Hepatitis B (CHB) and Chronic Hepatitis C (CHC) patients seen in the OPD or admitted in IPD were enrolled and investigated as per the study design. Patients were explained about the liver biopsy procedure, its advantages and possible adverse effects. Patient’s history was taken, and physical examination was carried out. Written informed consent was obtained from each participant. Patients were ≥ 18 years of age of either sex. All patients’ laboratory data (alanine aminotransferase [ALT], aspartate aminotransferase [AST], platelet count) were collected. FIB-4[12], APRI[13]were calculated by sterlings[11]and wai’s[12] formulas respectively:

Fibrosis stage was calculated by abstraction from liver biopsy reports. Fibrosis scores from different scoring systems (IASL[18], Metavir[19], Ishak[20], Knodell[21]) were mapped to a F0–F4 equivalency scale: F0, no fibrosis; F1, portal fibrosis without septa; F2, portal fibrosis with few septa; F3, numerous septa without cirrhosis; and F4, cirrhosis (Table 1). If the patient had more than one biopsy, the earliest biopsy with the highest fibrosis stage and available laboratory results was used for this analysis[18].

Statistical Analysis

We first validated predefined serum markers then developed and validated cut-offs of the serum markers for classification of cirrhosis (F4) or advanced fibrosis (F3–F4). The serum markers of interest were as follows: APRI, FIB-4 and ALT/AST ratio, as defined in the previous section. The endpoints of interest were the presence of advanced fibrosis (F3–4 vs F0–2) and the presence of cirrhosis (F4 vs F0–3) in case of Chronic Hepatitis C. However, in our study, in patients with chronic hepatitis B infection who underwent liver biopsy, no patient had a histological grade of F3 or F4. In such scenario, comparison was made between those with few bridges or septa (F2) and no fibrosis (F0). The data was entered in Microsoft Excel Spreadsheet. Continuous variables were summarized as mean and standard deviation (SD). Categorical variables were summarized as percentages. Radius of Curvature (ROC) curves were constructed for APRI and FIB-4 scores and AST/ ALT ratio. Liver biopsy results was taken as standard. Area under ROC curve was reported along with its 95% confidence interval for APRI, FIB-4 and AST/ALT ratio. A p-value of <0.05 was considered as statistically significant.

Results

Out of 90 CHC patients, 18 belonged to 18-30-year age group, 36 patients belonged to 31-45 age group. Twenty-three patients were between 46-60 years of age whereas thirteen patients belonged to 61-75-year age group. Similarly, out of 172 CHB, 34 belonged to 18-30-year age group, 68 patients belonged to 31-45 age group. Fifty-five patients were between 46-60 years of age whereas fifteen patients belonged to 61-75-year age group. In our study out of 172 patients of CHB, 107 were male and 65 were females with male to female ratio of 1.6:1. Similarly out of 90 patients of hepatitis CHC, 56 were males and 34 were females and the male to female ratio was 1.6:1. On combining the two groups, out of 262 patients there was slight male preponderance with total male to female ratio of 1.6:1.

A. Chronic Hepatitis C

We compared AUROCs of the FIB-4 index with those of the other indices for the classification of advanced fibrosis and cirrhosis, respectively (Figure-1&2, Table 2&3).

The AUROC for FIB-4 in differentiating F3–F4 from F0–F2 was 0.940 (95% CI: 0.788–0.994) when compared with AST/ALT Ratio with p value of 0.019 and AUROC for APRI was 0.856(95% CI: 0.680–0.957) when compared with FIB-4 with p value of 0.321 for CHC. The AUROC for FIB-4 in differentiating F4 from F0–F3 was 0.926 (95% CI: 0.769–0.989) when compared with AST/ALT Ratio with p value of 0.007 and AUROC for APRI was 0.070(95% CI: 0.721–0.974)) when compared with FIB-4 with p value of 0.374 for CHC.

B. Chronic Hepatitis B

In case of CHB, comparison was done between AUROCs of the FIB-4 index with those of the other indices for the classification of those with few bridges or septa (F2) and no fibrosis (F0); and fibrous portal expansion (F2 vs F0-F1)(Figure-3,Table 4). The AUROC for FIB-4 in differentiating F2 from F0–F1 was 0.839 (95% CI: 0.667–0.944) when compared with AST/ALT Ratio with p value of 0.038 and AUROC for APRI was 0.801(95% CI: 0.614– 0.915) when compared with FIB-4 with p value of 0.732 for CHB.

Cut-off Values for Predicting Fibrosis and Cirrhosis Using FIB-4 in CHC

Based on the AUROC analysis in the previous section, FIB- 4 had the best overall utility for prediction of advanced fibrosis and cirrhosis in a chronic hepatitis C population compared with the other two markers, as FIB-4 score outperformed the other serum markers and was superior to AST/ALT ratio and almost similar to APRI. We next derived optimal cut-off values of FIB-4 for distinguishing the lower end of liver stage (F0–F2) and upper end of liver stage (F3, cirrhosis) for CHC. The optimal cut-off of FIB-4 in distinguishing F3,F4 vs F0-F2 was >2.30 with sensitivity and specificity of 91.7% and 88.9% respectively. For APRI, optimal cut-off was >1.66 with sensitivity and specificity of 75% and 91.4% respectively and for AST/ALT ratio optimal cut-off was >1.35 with sensitivity and specificity of 50% and 83.9% respectively. Similarly, the optimal cut-off of FIB-4 in distinguishing F4 vs F0- F3 was >2.50 with sensitivity and specificity of 100% and 81.8% respectively. For APRI, optimal cut-off was >1.74 with sensitivity and specificity of 87.5% and 82.4% respectively and for AST/ALT ratio optimal cut-off was >1.43 with sensitivity and specificity of 57.5% and 80.9% respectively.

Cut-off Values for Predicting few bridges or septa (F2) and no fibrosis (F0); and fibrous portal expansion (F2 vs F0-F1) in CHB

Similarly, the optimal cut-off of FIB-4 in distinguishing few bridges or septa (F2) and no fibrosis (F0); and fibrous portal expansion (F2 vs F0-F1) was >1.33 with sensitivity and specificity of 86.3% and 78.5% respectively. For APRI, optimal cut-off was >0.68 with sensitivity and specificity of 80.1% and 82.9% respectively and for AST/ALT ratio optimal cut-off was >0.54 with sensitivity and specificity of 71.2% and 73.6% respectively[Table 5].

Discussion

While analysing our results for these markers, FIB-4 was found out to be a better marker for detecting the degree of fibrosis in CHC. In early stages of fibrosis (F0-F2), keeping a cut-off value >2.3, the sensitivity and specificity of FIB-4 was 91.7% and 88.9% respectively. At further advanced degree of fibrosis i.e., cirrhosis, the sensitivity of cut-off value of >2.5 for FIB-4 reaches 100%. The cut-off valve obtained of APRI score 1.66 was similar to study conducted by [22]where the cut-off valve of APRI has been 1.5, the sensitivity and specificity of APRI has been more than 75% and 91.4% for F0-F2 and F3, F4 (significant fibrosis) score. The APRI score in similarity with FIB-4 score is quite valuable in advanced stage of fibrosis (cirrhosis), but in early stages of fibrosis the APRI score has not been of much significance, though the effect can be attributed to very less number of patients in this group. The higher sensitivity and specificity pattern obtained from FIB-4 and APRI score was not reflected by AST/ALT ratio in our study, with the sensitivity and specificity falling to 50% and 37% to stages F3 and F4 respectively.

The superiority of FIB-4 and APRI with AST/ALT ratio in predicting the fibrosis is validated by the study conducted by [23]. However in case of CHB,FIB-4 has definitely being shown to be almost close to liver biopsy in predicting the histopathology of liver. The other two scoring systems like APRI and AST/ALT ratio have not proved to be better than FIB-4. The results of the study conducted by Yilmaz et al. [24] reported that APRI had acceptable accuracy for assessment of fibrosis with CHC but same was not applicable for CHB, though we had no patients of advanced fibrosis, but even on comparing the patients of mild with moderate fibrosis, APRI was not as significant marker with AUC of 0.644 and 95% CI of 0.455 to 0.804. FIB-4 again served as a significant marker to distinguish patients of mild fibrosis (F0, F1) from patients with moderate fibrosis with AUC of 0.839 and 95% CI (0.667 to 0.944) and p-valve of 0.038. The studies conducted by Zhang et al. [25] in the past revealed FIB-4 as a diagnostic marker to discriminate between patients of early fibrosis and advanced fibrosis. The advantage of our study was its prospective design and adoption of strict inclusion and exclusion criteria. The disadvantage of our study was the small sample size.

Conclusion

Thus, our study suggests that FIB-4 and APRI are excellent surrogate markers for liver fibrosis while ASL/ALT is not a very sensitive marker. Among all these scores FIB-4 is the best. On the basis of our results, we recommend use of FIB-4 as a surrogate marker for liver fibrosis across all age groups. We further recommend that larger number of patients to be undertaken in future studies.

For More Lupine Publishers Open Access Journals Please visit our Website:  

https://lupinepublishers.com/index.php

For more  Current Trends in Gastroenterology and Hepatology articles please click here: https://lupinepublishers.com/gastroenterology-hepatology-journal/index.php

[drajaysharma]

Dr. Ajay Sharma is a best chemotherapy doctor in delhi, providing chemotherapy treatment for cancer in delhi; find more about chemotherapy treatment for breast cancer in delhi, cervical cancer, stomach cancer, lung cancer, colon cancer etc.

[ed-recoverry]

Cancer Symptoms and Ways to Check Masterlist!!!

I’m not a doctor, just a quick guide to check in on how you are actually doing! Sometimes have a check list is what you need as a reminder to go to the doctor! Stay safe and healthy!

Breast Cancer Signs and Symptoms

How to perform a breast examination for breast cancer

How to perform breast examination for breast cancer as a biological male

Signs and symptoms of lung cancer

Lung cancer screening information

Signs and Symptoms of Colon (Colorectal) Cancer

Colon (Colorectal) cancer screening and tests

Prostate cancer symptoms

Information about prostate exams

Types of skin cancer and what it looks like

Everything about skin cancer

Stomach cancer signs and symptoms

Liver cancer symptoms and causes

Esophageal cancer symptoms and causes

Cervical cancer symptoms and causes

Reduce risk of cervical cancer (aka get your HPV vaccine!!!!!)

Kidney cancer signs and causes

Symptoms and causes of thyroid cancer

Bladder cancer symptoms, causes, and treatment

Cardiac tumors: types, symptoms, and treatment

Brain Tumors and Brain Cancer

Risks and causes of eye cancer

Oral cancer: causes, symptoms, and treatment

Throat Cancer symptoms and causes

Uterine Cancer (Endometrial Cancer): symptoms and treatment

Bone Cancer: Symptoms, Signs, Treatment, Causes & Stages

Retroperitoneal cancer 

Testicular cancer: symptoms and causes

Tonsil Cancer: Symptoms, Signs & Causes

Vaginal cancer - Symptoms and causes

Soft Palate Cancer: Symptoms, Causes & Treatment

Pancreatic Cancer: Symptoms, Causes & Treatment

Signs and symptoms of penile cancer

Parathyroid cancer - symptoms, diagnosis, treatment

Signs and Symptoms of Adrenal Cancers

Diaphragm Tumors

Gallbladder Cancer: Symptoms, Treatment & Prognosis

Small Intestine Cancer: Symptoms, Causes, Prognosis & Treatment

Blood Cancer Signs, Symptoms & Diagnosis

Head and Neck Cancers: Symptoms & Treatment

[allthegeopolitics]

Uruguay's former guerilla-turned-president, Jose Mujica, widely known as a leftist icon who transformed his small country into one of the most socially liberal in all of Latin America, said Monday that he has esophageal cancer. Mujica, 88, said he was diagnosed during a routine medical checkup last Friday. He said the tumor discovered in his esophagus is particularly dangerous because he also suffers from an autoimmune disease.

Continue Reading

[halseysora]

day 1 of weightloss

60 lbs gained in a year. I hate looking in the mirror. I don't recognize myself. tpn has ruined my body. I can't eat or drink but my doctor has taken me off the tpn now. I have a feeding tube but can't tolerate tube feeds. I'm terrified and I know what's to come. I've been here before. 205.0 lbs today. last time I was here I wasn't starting malnourished. I dropped to 107. I don't mind having a small body but I don't feel good when I do. I'm more comfortable in my skin when I'm smaller. this is where I'll be weighing in and documenting my journey.

I have a paralyzed stomach (extremely severe gastroparesis), Ehlers danlos syndrome, hereditary alpha tryptase syndrome, eosinophilic esophagitis, chronic diarrhea, intestinal dysmotility, esophageal dysmotility, vocal cord disfunction, POTS, inappropriate tachycardia, migraine, brain tumor (left cingulate gyrus glioma), intractable nausea and vomiting, and the list continues.

When I first got sick with everything the weight melted off with me doing nothing. Now the pounds packed on and wont stop. I'm assuming bc the tpn. I want them to fall off again but I can't exercise. I literally lay in bed all day otherwise I pass out or dislocate or puke... I just don't want to hate myself when I look in the mirror, but I'm also not in the position to actively try to lose weight. I'm pretty much leaving it up to nature.

So, here we go...

[wafflenati0n]

Incase you didn't know. This is what the different ribbon colors mean!

❤ - The red ribbon represents AIDS/HIV, alcohol and substance abuse, Vasculitis, love, heart, and disease.

🧡 - The orange ribbon represents hunger, leukemia, animal protection awareness, self harm awareness, multiple sclerosis, ADHD (attention defficent hyperactive disorder) and kidney cancer.

💛 - The yellow ribbon represents supporting our troops, suicide prevention, genocide awareness, sarcoma and bone cancer awareness.

💚 - The green ribbon represents tissue and organ donations or transplants, mental health, mental illness, leukemia, environment, kidney neural tube defects, save the earth movement, go green movement, and the recycling movement.

💙 - The blue ribbon represents child abuse prevention, arthritis, sex trafficking and slavery, and prostate cancer.

💜 - the purple ribbon represents Sarcoidosis lupus, fibromyalgia, religious tolerance, violence against women, domestic violence, cycstic fibrosis, Alzheimer's disease, pancreatic cancer, and epilepsy.

Violet - Hodgkin's lymphoma.

🤍 - The white ribbon represents victims of Terrorism, peace, blindness, and Holocaust Remembrance.

🖤 - The black ribbon represents mourning and melanoma.

Lime green - The lime green ribbon represents lymphoma, Non-hodgkin's lymphoma, muscular dystrophy, and mental health.

Teal - The team ribbon represents gynelogicial cancer, and sexual assault.

Periwinkle - The periwinkle ribbon represents eating disorders, pulmonary hypertension esophageal cancer and stomach cancer.

💗 - The pink ribbon represents breast cancer.

Cream - The cream ribbon represents Paralysis, spinal cord injuries, spinal diseases and disorders.

Light Blue - The light blue ribbon represents prostate cancer and men's health.

Lavender - The lavender ribbon represents all cancers (general cancer awareness), and Eplisey.

Pearl - The pearl ribbon represents lung cancer and lung disease, and multiple sclerosis.

Gray - The gray ribbon represents diabetes, brain cancer, and asthma.

Silver - The silver ribbon represents Brain disorders.

Gold - The gold ribbon represents childhood cancer.

Zebra Patterned - The zebra patterned ribbon represents rare diseases and cancers, such as nueroendocrine, tumors, carcinoid cancer, Ehlers-Danlos Syndromes and Whipple's disease. These are just examples, this is not excluding any other rare dieseases or cancers. (Credit to @

Hope this helps someone! If I'm missing one or got one wrong, let me know in my asks box.

[kingdrawcse]

The chemistry behind Green Tea!

Research reveals that catechins in tea, particularly Catechin, exhibit anti-cancer properties by inhibiting tumor cell growth and reducing DNA damage, preventing colorectal, stomach, and esophageal cancers. Drinking green tea over 3 times a week lowers the risk of digestive system cancers by 17% and antioxidants help combat aging and improve obesity symptoms.

[gastro-delhi]

Gastrointestinal Cancer surgery in Delhi

Gastrointestinal Cancer

What is gastrointestinal cancer?

Gastrointestinal cancer is characterized by the development of cancerous cells in the gastrointestinal system. The organs that may be affected during gastrointestinal cancer include the stomach, pancreas, small intestine, large intestine, colon, liver, rectum, and anus. In 2018, the new cases of gastrointestinal cancers were 4.8 million. The number of total deaths occurring throughout the world due to gastrointestinal cancer was 3.4 million. Gastrointestinal cancer accounts for almost 26% of the total cancer incidence globally. These cancers also have a share of around 35% in all cancer-related deaths. Early diagnosis helps in the effective management of the disease.

What are the various types of gastrointestinal cancer treated in Delhi?

Treatment of all types of gastrointestinal cancers is available in Delhi. Some of them are:

Stomach Cancer: Stomach cancer is the development of malignant cells in the stomach. It is also known as gastric cancer. There are several types of stomach cancer. The most common type of stomach cancer is adenocarcinoma.

Pancreatic Cancer: Pancreatic cancer initiates in the pancreatic tissues. The pancreas assists in the digestion of food and secretes necessary hormones. The most common type of pancreatic cancer is pancreatic duct adenocarcinoma. This cancer occurs in the duct that carries the digestive juice from the pancreas.

Liver Cancer: Liver is present in the abdominal cavity and performs several functions. Liver cancer is of several types. The most common type is hepatocellular carcinoma which occurs in hepatocytes.

Colorectal cancer: Cancer of the colon is known as colon cancer. Cancer of the rectum is known as rectal cancer. Both cancers are sometimes clubbed together and called colorectal cancer.

Anal cancer: Cancer of the anal tissue is known as anal cancer. The most common type of anal cancer is squamous cell carcinoma.

Esophageal cancer: Esophagus is a long hollow structure that extends from the oral cavity to the stomach. Esophageal cancer is the cancer of any tissue of the esophagus.

What are the symptoms of gastrointestinal cancer?

Symptoms of gastrointestinal cancer depend upon the site of cancerous tissues in the gastrointestinal tract.The symptoms of these cancers depend upon the location of the tumor.Some of the common symptoms of gastrointestinal cancer include abdominal swelling and pain, weight loss or loss of appetite, digestion problems, change in bowel frequency or narrowing of stool, diarrhea or constipation, tiredness or weakness, and black o tar-colored stool. Jaundice and difficulty in swallowing are other symptoms.

What are the causes of gastrointestinal cancer?

The exact cause of gastrointestinal cancer is not known. The information about the division of cells is stored in the DNA. However, due to certain factors, this information gets disturbed. It results in uncontrolled cell division resulting in the development of tumors. The tumor then moves to the nearby or distant lymph nodes and other organs.

What are the risk factors for gastrointestinal cancer?

Several factors increase the risk of gastrointestinal cancer. Some of them are:

Gender: Men are at increased risk for developing gastrointestinal cancer than women.

Underlying medical conditions: Several underlying diseases increase the risk of gastrointestinal cancer. Hepatitis A or B infection increases the risk of liver cancer. H. Pylori infection increases the risk of gastric cancer. Prolonged ulcers and gastritis also increase the risk of stomach cancer.

Unhealthy lifestyle: People consuming alcohol, smoking, and unhealthy diets are at higher risk of developing gastrointestinal cancer.

Age: The risk of gastrointestinal cancer increases with age.

How can I prevent the development of gastrointestinal cancer?

Various methods may reduce the risk of gastrointestinal cancer. Some of them are:

Routine checkups, such as colonoscopy or abdominal imaging, in high-risk patients.

Managing diseases such as gastritis, H. Pylori infection, and hepatitis.

Leading a healthy lifestyle, i.e., limiting the consumption of alcohol, exercise quit smoking, and take a healthy diet.

You should consult with the best GI surgeon in Delhi to know more about the measures to reduce the risk of gastrointestinal cancer.

How does the doctor diagnose gastrointestinal cancer?

There are several ways to diagnose gastrointestinal cancer. These are:

Physical examination: The doctor may evaluate the symptoms of the patients such as abdominal pain, weight loss, and loss of appetite.

Laboratory tests: The doctor may advise the patients to undergo blood tests, urine tests, and stool tests to rule out the presence of other diseases.

Other techniques: Techniques such as colonoscopy, endoscopy, MRI, CT scan, and ultrasound helps in determining the anatomical changes in the gastrointestinal tract.

Biopsy: The doctor may obtain a small tissue sample from the suspected site and analyze it in the laboratory for malignancy.

Which doctors should I consult for the treatment of gastrointestinal cancer in Delhi?

Visit a specialized gastroenterologist for an initial evaluation of your condition. If the specialist suspects that you might have cancer, he may refer you to the gastrointestinal oncologist. The oncologist will perform a comprehensive analysis. If you have gastrointestinal cancer that requires surgery, the doctor may advise you to consult the best GI surgeon in Delhi.

What are the treatments for gastrointestinal cancer in Delhi?

Various options are available for gastrointestinal cancer treatment in Delhi. Some of the options are:

Surgery: If the surgeon can easily reach the cancerous tissue, it is the preferred treatment option. The surgeon may remove the affected part. Radiotherapy or chemotherapy may accompany the surgery in killing those malignant cells that are difficult to reach.

Chemotherapy: The doctor prescribes you chemotherapeutic medicines that kill the cancerous cells. The doctor may use this therapy along with radiation therapy or surgery.

Radiation therapy: The doctor may also advise you to undergo radiation therapy. During the therapy the radiologists target the high-energy radiation on the cancerous cells, thereby killing them.

What is the prognosis of gastrointestinal cancer?

Prognosis depends upon several factors. These are the stage of diagnosis, age of the patient, organ involved, and response to treatment. People with cancer diagnosed at an early stage have a better outcome than those with cancer who progressed in the advanced stage.

How many days do I need to stay for treatment of gastrointestinal cancer in Delhi?

It depends upon the type of treatment and the stage of your disease. If you are undergoing chemotherapy or radiation therapy are outpatient.

You can also search:

HIPEC Surgeon in Delhi Gastrointestinal Cancer surgery in Delhi Colorectal Surgery in Delhi Laparoscopic Esophageal Surgery in Delhi Laparoscopic Pancreatic Surgery in Delhi Laparoscopic Colorectal Surgery in Delhi Laparoscopic Hepatobiliary Surgery in Delhi GI Surgeon in Delhi Stomach cancer treatment in Delhi Gallbladder stone Surgery in Delhi Robotic surgery in Delhi Esophagus Surgery in Delhi Laparoscopic Gastrointestinal Surgery in Delhi Colorectal surgeon in Delhi Pancreatic treatment in Delhi Cancer surgeon in Delhi

[gastrohubhospital24]

Importance of Sonography, Esophageal Manometry, and Anorectal Manometry

Medical advancements have introduced a variety of diagnostic tests to understand complex health issues better. Among these, sonography, esophageal manometry, and anorectal manometry play significant roles in diagnosing and managing various conditions. In this blog, we’ll explore their importance, uses, and benefits.

Sonography

Sonography, also known as ultrasound imaging, uses sound waves to create images of internal organs. It is a painless, non-invasive method that helps doctors diagnose issues related to the abdomen, heart, and other soft tissues. It is commonly used for monitoring pregnancies and detecting conditions like gallstones, liver diseases, or tumors.

Esophageal Manometry

Esophageal manometry is a specialized test used to evaluate the function of the esophagus. It measures the muscle contractions that move food from the throat to the stomach. This test is particularly helpful in diagnosing swallowing disorders, acid reflux, or conditions like achalasia.

Anorectal Manometry

Anorectal manometry is another vital test that examines the muscles and nerves in the rectum and anus. It is mainly used to diagnose chronic constipation, fecal incontinence, or problems related to bowel movements. This procedure provides critical data to help doctors plan effective treatments.

Conclusion

Sonography, esophageal manometry, and anorectal manometry are essential diagnostic tools that help in identifying and treating various health issues. Whether it's detecting structural problems or assessing muscle functionality, these tests play a crucial role in modern medicine. If you have symptoms related to the digestive or pelvic systems, consult your doctor to learn if these tests are right for you.

This blog simplifies the technical aspects of these important medical procedures, making it easy for readers to understand their relevance.

[coolgalaxytyphoon]

When it comes to advanced and specialized upper gastrointestinal (GI) surgeries in Jagamara, DrPremGastro is a trusted name. Offering cutting-edge treatments, Dr. Premananda Patnaik and his team provide comprehensive care for various GI conditions, ensuring patients receive the highest quality medical attention.

Understanding Upper GI Surgery

Upper GI surgery involves procedures that target the upper digestive tract, including the esophagus, stomach, and small intestine. These surgeries address a wide range of conditions, such as:

. Gastroesophageal reflux disease (GERD)

. Hiatal hernia

. Esophageal cancer

. Stomach ulcers

. Obstructions in the upper digestive tract

At DrPremGastro, the emphasis is on minimally invasive techniques wherever possible, which means faster recovery times, reduced pain, and minimal scarring for patients.

Why Choose DrPremGastro?

1. Expertise in GI Surgeries:

Dr. Premananda Patnaik is a renowned gastroenterologist and surgeon with extensive experience in handling complex upper GI cases.

2. State-of-the-Art Facilities:

The clinic in Jagamara is equipped with the latest medical technologies to ensure accurate diagnoses and effective treatments.

3. Patient-Centric Care:

Every patient receives personalized care, from the initial consultation to post-operative follow-ups, ensuring their comfort and confidence throughout the treatment journey.

4. Minimally Invasive Techniques:

Using laparoscopic and endoscopic approaches, the team ensures quicker recovery times and a better overall experience for patients.

Common Procedures at DrPremGastro

. Laparoscopic Fundoplication: For GERD and hiatal hernia.

. Gastrectomy: Partial or total removal of the stomach for cancer or severe ulcers.

. Esophagectomy: Surgical removal of the esophagus in cancer cases.

. Endoscopic Treatments: Non-surgical solutions for diagnosing and treating upper GI issues.

Your Trusted GI Surgeon in Jagamara

DrPremGastro is committed to helping patients regain their health and improve their quality of life. Whether it’s managing chronic reflux, removing tumors, or treating severe ulcers, you can trust the expertise and compassionate care offered by the team.

Contact DrPremGastro

If you’re looking for expert upper GI surgery in Jagamara, schedule your consultation today. Experience world-class care right here in your neighborhood!

Liver Surgery in bhubaneswar

Colorectal Surgery in Bhubaneswar

Upper gi surgery in Bhubaneswar

Gall Bladder Surgery in Bhubaneswar

Pancreas Surgery in bhubaneswar

[drajaysharma]

Dr. Ajay Sharma is a best chemotherapy doctor in delhi, providing chemotherapy treatment for cancer in delhi; find more about chemotherapy treatment for breast cancer in delhi, cervical cancer, stomach cancer, lung cancer, colon cancer etc.

[drmanishkumargupta]

Upper Gastrointestinal (GI) Bleeding: Symptoms, Causes, Diagnosis, Prevention, and Treatment

Upper gastrointestinal (GI) bleeding is a serious condition that can lead to significant health complications if not treated promptly. It refers to any form of bleeding that originates from the upper part of the gastrointestinal tract, which includes the esophagus, stomach, and duodenum (the first part of the small intestine). If you are experiencing any symptoms of upper GI bleeding, it's crucial to seek medical attention immediately.

At Gastro, Liver & Endoscopy Center, under the expert care of Dr. Manish Gupta, one of the Best Gastro Specialists in Ghaziabad, we offer comprehensive diagnostic and treatment services for GI-related conditions, including upper GI bleeding. This blog will help you understand the symptoms, causes, diagnosis, prevention, and treatment of upper GI bleeding, so you can make informed decisions about your health.

Symptoms of Upper GI Bleeding:

The symptoms of upper GI bleeding can vary depending on the severity of the bleeding, but common signs include:

Hematemesis (Vomiting Blood): Vomiting blood, which may appear red or look like coffee grounds, is one of the most noticeable signs of upper GI bleeding. The darker appearance occurs when blood is partially digested.

Melena (Black, Tarry Stools): Black, sticky stools that have a foul odor are a sign of digested blood. This occurs when blood from the upper GI tract mixes with digestive enzymes and acids before being excreted.

Hematochesia (Bright Red Blood in Stool): In some cases, blood may pass through the stool in a bright red form, indicating that the bleeding is more recent.

Abdominal Pain: Patients may experience discomfort or pain in the upper abdomen, particularly after eating.

Weakness and Fatigue: Chronic or severe bleeding can lead to anemia, causing symptoms like fatigue, dizziness, and weakness.

Paleness: A pale appearance, especially when associated with other symptoms, can signal a drop in red blood cells due to blood loss.

If you notice any of these signs, it is essential to consult a Top Gastroenterologist in Noida, such as Dr. Manish Gupta, as soon as possible for an accurate diagnosis and timely treatment.

Causes of Upper GI Bleeding:

Several factors can lead to upper GI bleeding. Some of the most common causes include:

Peptic Ulcers: Peptic ulcers are sores that develop in the lining of the stomach or duodenum. These ulcers can erode blood vessels, leading to bleeding. Helicobacter pylori infection and prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs) are common causes of peptic ulcers.

Gastritis: Inflammation of the stomach lining, often caused by infection, alcohol consumption, or prolonged use of painkillers, can lead to bleeding.

Esophageal Varices: Swollen veins in the lower part of the esophagus can rupture and cause significant bleeding. Esophageal varices are commonly associated with liver disease, particularly cirrhosis.

Mallory-Weiss Tear: A tear in the lining of the esophagus, often caused by severe vomiting or retching, can result in upper GI bleeding.

Gastrointestinal Cancer: Tumors in the stomach or esophagus can cause bleeding, often in the later stages.

Angiodysplasia: Abnormal blood vessels in the gastrointestinal tract can rupture and cause bleeding.

A comprehensive evaluation by an experienced gastroenterologist, such as Dr. Manish Gupta, can help identify the exact cause of the bleeding and tailor the treatment accordingly.

Diagnosis of Upper GI Bleeding:

To diagnose upper GI bleeding, your gastroenterologist will perform a thorough physical examination and review your medical history. The following diagnostic tests may be used:

Endoscopy (EGD): The most common procedure for diagnosing upper GI bleeding is an upper endoscopy (also called esophagogastroduodenoscopy or EGD). During this procedure, a flexible tube with a camera is inserted through the mouth to examine the esophagus, stomach, and duodenum.

Blood Tests: Blood tests, including complete blood count (CBC), liver function tests, and coagulation tests, help assess the severity of the bleeding, anemia, and liver function.

Stool Test: A stool sample may be collected to check for the presence of blood, especially when melena is suspected.

CT Scan or Angiography: In certain cases, imaging studies like a CT scan or angiography may be used to locate the source of bleeding, particularly in cases of active or recurrent bleeding.

At Gastro, Liver & Endoscopy Center, we offer state-of-the-art diagnostic tools to ensure accurate and timely diagnosis. As one of the Best Gastroenterologists in Ghaziabad, Dr. Manish Gupta provides expert care and uses the latest technology to identify the root cause of your symptoms.

Prevention of Upper GI Bleeding:

While some causes of upper GI bleeding cannot be prevented, there are several lifestyle changes and precautions that can reduce the risk:

Avoid Excessive Alcohol Consumption: Excessive alcohol use is a major risk factor for both gastritis and esophageal varices. Limiting alcohol intake can significantly lower your risk.

Use NSAIDs Wisely: Nonsteroidal anti-inflammatory drugs, like ibuprofen and aspirin, can irritate the stomach lining and increase the risk of ulcers and bleeding. If you must take them, do so under the guidance of a doctor.

Treat Helicobacter pylori Infection: If you have been diagnosed with an H. pylori infection, it is essential to undergo appropriate treatment to eradicate the bacteria and reduce the risk of developing ulcers.

Manage Chronic Conditions: Conditions such as cirrhosis, liver disease, and clotting disorders can increase the risk of bleeding. Regular monitoring and treatment can help manage these conditions.

Eat a Balanced Diet: A healthy diet, rich in fiber and low in processed foods, helps maintain the health of your gastrointestinal system and can aid in preventing ulcers and other gastrointestinal issues.

Consulting with a Top Gastroenterologist in Noida, such as Dr. Manish Gupta, can provide valuable guidance on lifestyle changes and preventive measures based on your specific health profile.

Treatment of Upper GI Bleeding:

The treatment for upper GI bleeding depends on the cause and the severity of the bleeding. The primary treatment options include:

Endoscopic Therapy: If the bleeding is from a source that can be directly visualized, such as an ulcer or varices, endoscopic treatments like cauterization, injection therapy, or banding can be used to stop the bleeding.

Medications: Proton pump inhibitors (PPIs) may be prescribed to reduce stomach acid and promote healing of ulcers. If bleeding is due to an H. pylori infection, antibiotics will be used to treat the infection.

Blood Transfusion: In cases of severe blood loss, blood transfusions may be necessary to stabilize the patient and replenish lost red blood cells.

Surgery: In rare cases, when other treatments fail or if the bleeding is from a large tumor, surgery may be required to remove the affected area of the gastrointestinal tract.

At Gastro, Liver & Endoscopy Center, Dr. Manish Gupta, as one of the Best Gastroenterologists in Ghaziabad, offers personalized treatment plans for upper GI bleeding to ensure the best possible outcomes.

[snehalblog]

Exploring the Cancer Immunotherapy Market: Emerging Trends, Key Innovations, and Growth Opportunities - UnivDatos

Cancer immunotherapy has been considered the most revolutionary method in the field of oncology and has changed the cancer treatment paradigm. Companies have developed a promising type of treatment that recognizes the human body's immune system to identify and subsequently eliminate cancerous cells in patients with different types of cancer. As the understanding of cancer immunotherapy grows quickly, some of the recent trends and new developments in this area are following.

Access sample report (including graphs, charts, and figures): https://univdatos.com/get-a-free-sample-form-php/?product_id=5089&utm_source=LinkSJ&utm_medium=Snehal&utm_campaign=Snehal&utm_id=snehal

Advancements in Checkpoint Inhibitors

· August 2024 – Merck announced that PD-L1 expression thresholds for certain advanced gastric, gastroesophageal junction (GEJ) and esophageal cancer indications for immune checkpoint inhibitors, including KEYTRUDA (pembrolizumab), Merck’s anti-PD-1 therapy, will be discussed during an upcoming meeting of the U.S. Food and Drug Administration’s (FDA) Oncologic Drugs Advisory Committee (ODAC).

· August 2022 - Bristol Myers Squibb announced that OpdualagTM (nivolumab and relatlimab-rmbw), a new,  first-in-class, fixed-dose combination of nivolumab and relatlimab, administered as a single intravenous infusion, was approved by the U.S. Food and Drug Administration (FDA) for the treatment of adult and pediatric patients 12 years of age or older with unresectable or metastatic melanoma.1 The approval is based on the Phase 2/3 RELATIVITY-047 trial, which compared Opdualag (n=355) to nivolumab alone (n=359).

Checkpoint inhibitors have been among the prominent immunotherapeutic agents since they allow treatment to block proteins that suppress the immune system’s attack on cancerous cells. More recent discoveries in this regard are increasing the applicability of these drugs in treatment. For example, new checkpoint inhibitors are emerging to target further proteins apart from the most common PD-1 and CTLA-4 pathways. To this end, drugs that target TIM-3, LAG-3, and other novel checkpoints are in initial clinical trials and may have better positive results on patients who do not benefit from current therapies.

The Building Blocks For Extension of CAR-T Cell Treatment

CAR-T therapy or Chimeric Antigen Receptor T-cell treatment has brought about a new era of cures for some blood malignancies. This form of treatment entails modifying a patient’s T-cells in a way that the cellular receptors will detect the cancer cells. New directions are therefore aimed at applying CAR-T in solid tumors which were previously difficult to manage through this process. The strategies including dual-target CAR-T cells and combined therapies make efforts to improve the therapeutic outcomes and minimize the side effects of CAR-T treatments for solid tumors.

Emergence of Bispecific Antibodies

Bispecific antibodies are a recently developed category of therapeutics with the capability to bind two different antigens at the same time. This approach targets two sites, and this can help in increasing the specificity of treatment. The results of the newest clinical trials have confirmed the opportunities offered by bispecific antibodies for the treatment of numerous cancers, including hematologic malignancies as well as solid cancers. For instance, bispecific T-cell engagers are getting effective in the process of stimulating T-cells to assassinate cancerous cells more proficiently.

Artificial intelligence in the advancement of drug development

The AI technology is steadily being utilized in the enhancement of the cancer immunotherapies. Self-learning algorithms are being utilized to mine big data sets from clinical studies, genetics, and pharmacology. The objective of this technology is to find out the possible therapeutic agents, evaluate patients’ outcomes, and select the most effective treatment regimen. AI-converted methods enable responsible findings for immunotherapies and the selection of possible therapies according to patients’ characteristics.

Advances in Combination Therapies

The use of immunotherapy in conjunction with other approaches forms a subtopic that is currently receiving much attention. The use of checkpoint inhibitors in conjunction with targeted therapy, chemotherapy, or radiation seems to possess profitability in boosting treatment outcomes. Recent has shown that such combination approaches can bypass resistance mechanisms and add value to patients’ enhanced survival. For instance, the administration of PD-1 inhibitors with other reagents has generated various success in diverse cancer varieties, such as melanoma and non-small cell lung cancer.

Focus on Overcoming Resistance

This is one of the main problems and pitfalls regarding immunotherapy at the moment. Scientists are studying the causes of resistance, and the ways to counteract it at present. Several of these strategies are based on the concept of avoiding immune suppression that can be occasioned by tumor microenvironments. Immunotherapy can be combined with agents changing the activity of immune cells within a tumor; the tumor microenvironment can be modified or the immunotherapy can be tried after which other agents can be used to change immune cell activity in tumors.

Improved Utilisation and Equality in Treatment

Thus, as the range of applications of cancer immunotherapies expands, there is a rising interest in the ways to increase its availability and inclusiveness. There are ongoing attempts to make these from-out wonderful promising treatments reachable to a larger number of patients including those living in remote areas or from low-income households. Efforts need to be made to keep costs down, prevent treatment from becoming more complex than it needs to be, and raise awareness to make immunotherapy available to all who might benefit from it.

Biomarkers and Personalized Medicine: Novel Findings.

One of the main objectives is the identification of biomarkers that could help to identify patients with responses to immunotherapy. These biomarkers allow physicians to know which patients are likely to benefit from the therapies, therefore improving patients’ treatment plans. New developments in biomarker identification and verification are opening new possibilities for better immunotherapy approaches to work by patient and tumor properties.

Regulatory and Policy Developments

That is why the regulatory bodies have responded to the dynamics of Immunotherapy by making changes in the guidelines and approval of the different techniques. Various strategies are being adopted including simplification of the regulatory process relating to the approval of new immunotherapy drugs and combinations. Besides, the policies used to enhance the clinical trial models and obtain experimental treatments are beneficial in delivering new treatments to patients faster.

Future Directions and Outlook

There are enormous prospects for cancer immunotherapy to grow in the future because of constant progression and advancements. New technologies, new classes of drugs, and more utilization of combination therapies are likely to provide better solutions to the current issues and improve the outcomes. As this progress goes on, the ideal has been to develop new more efficient, targeted, and available options to treat cancer thus translating to increased survival and improved patient quality of life.

Click here to view the Report Description & TOC: https://univdatos.com/get-a-free-sample-form-php/?product_id=5089&utm_source=LinkSJ&utm_medium=Snehal&utm_campaign=Snehal&utm_id=snehal

Conclusion

In conclusion, immunotherapy is at the forefront of new cancer treatments, many breakthroughs are going to be driving the future of cancer immunotherapy. From checkpoint inhibitors to CAR-T cells and from integration of Artificial Intelligence and combinations this area of cancer therapy is moving fast. With time and more developments in research and new inventions in medical fields the chances to transform the way cancer is treated and provide patients a fresh lease of life increases. According to the UnivDatos Market Insights analysis, the rising number of cancer cases globally, advancements in research and development, high efficacy of immunotherapy, increasing investment and funding, advancements in biomarker identification, and rising regulatory approvals and accelerated pathways drive the Cancer Immunotherapy market. As per their “Cancer Immunotherapy Market” report, the global market was valued at USD 120 Billion in 2023, growing at a CAGR of about 10% during the forecast period from 2024 - 2032.

[gastrohv]

Reasons To Visit The Best Gastroenterologist In Westchester County, White Plains, New Rochelle, Bronxville, and Yonkers, NY

Normal life can be affected by minor yet niggling issues such as bloating and occasional abdominal pain. Flatulence and other associated problems are embarrassing as well. Sure, most digestive issues may be treated with OTC drugs. Still, continuous or persistent abdominal problems require intervention by the best gastroenterologist in Westchester County, White Plains, New Rochelle, Bronxville, and Yonkers, NY.

The patient may visit a general physician or request the opinion of the family doctor first.Complex complaints may not be treated perfectly unless examined by an expert. Thus, it makes sense to look for the top gastroenterologist in the vicinity before following a self-treatment plan.

It suffices to know that a gastroenterologist is a medical professional specializing in all kinds of problems related to the digestive system. Their training equips them with special skills required for the identification, diagnosis, and treatment of all digestive system problems. Furthermore, the certificate that they earn at the end of their studies makes them capable of performing multiple diagnostic tests and procedures that general physicians cannot do.

While the general practitioner advises the simple solutions, consistent symptoms such as the following need to be checked by a gastroenterologist once the general doctor cannot treat the underlying condition and refers the patient to such an expert:

· Abdominal pain · Bloating · Indigestion · Gas and pain · Nausea and vomiting · Diarrhea · Constipation · Bleeding from the rectum · Unexplained weight loss or weight gain · Heartburn · Jaundice

Conditions Treated by The gastroenterologist

The gastroenterologist confirms the diagnosis by checking the symptoms followed by diagnostic tests. The specialist devises a treatment plan with the following conditions usually treated by this specialist doctor:

· Pancreatic, biliary, and gallbladder diseases like Gallstones, Pancreatitis, or Cholecystitis · Irritable bowel syndrome (IBS) · Inflammatory bowel disease (IBD) · Food allergies and intolerances such as the Celiac disease · Small intestinal bacterial overgrowth (SIBO) · Stomach ulcers · Diverticulitis · Appendicitis (This is usually treated by surgery when the condition is acute) · Colorectal polyps · Hemorrhoids · Esophageal disorders that make Swallowing difficult · Gastroesophageal reflux disease (GERD) · Esophagitis · Hiatal hernias · Liver diseases that include Viral hepatitis, Toxic hepatitis, Fatty liver disease, and Cirrhosis

Tests Advised by a gastroenterologist

Physical examination is the first method of being convinced of a health problem. The expert may order several blood and stool tests to corroborate their diagnosis. However, many gastroenterologists also examine the insides of the intestines with an endoscope to discover the root cause. The endoscopic procedures vary according to the problem. The following methods can provide significant results in diagnosis and treatment:

· Upper endoscopy or EGD · Endoscopic ultrasound · Enteroscopy · endoscopic retrograde cholangiopancreatography (ERCP) · Polypectomy for removal of polyps

The gastroenterologist is the first professional to suspect cancer when diagnosing and treating the patient. The following cancers occurring in the under-mentioned areas may be diagnosed and staged by the specialist as well:

· Stomach · Colorectal · Gastrointestinal stromal tumors · Duodenum · Small intestine · Esophageal · Liver · Pancreas · Gallbladder · Bile duct

A patient may consult a well-known weight loss doctor in Westchester County, White Plains, New Rochelle, Yonkers, and Bronxville, NY, to ensure weight loss to remain healthy and fit.

[doctorsandclinicians]

Exploring the Specialized World of Thoracic Surgery: From Lung Cancer to Chest Trauma

Thoracic Surgery is a specialized field in medicine that focuses on the surgical treatment of diseases affecting organs inside the thorax, but typically excluding the heart. The thoracic cavity comprises the chest and its contents, including the lungs, esophagus, trachea, bronchi, chest wall, and diaphragm. Though once considered a subspecialty of general surgery, it has grown over the decades into its own comprehensive discipline due to advancements in surgical techniques, medical technology, and understanding of related diseases.

Thoracic surgeons deal with a wide variety of conditions ranging from lung cancer and esophageal cancer to gastroesophageal reflux disease (GERD), tumors in the chest, pneumothorax (collapsed lung), lung transplants, achalasia (esophageal disorder), hiatal hernias, and chest trauma among others. They may also treat conditions that involve the chest wall, such as chest wall tumors and deformities.

[gicancercaredr]

Food Pipe Cancer Specialist in Max Hospital

Dr. Sanjeev Kumar – Food Pipe Cancer Specialist in Max Hospital

If you are searching for a Food Pipe Cancer Specialist in Max Hospital, look no further than Dr. Sanjeev Kumar. With 12 years of extensive experience in the field of oncology, Dr. Kumar has become a trusted name for advanced cancer care and precision treatments. His expertise in diagnosing and treating esophageal (food pipe) cancer makes him one of the leading cancer specialists in Delhi NCR.

Why Choose Dr. Sanjeev Kumar for Food Pipe Cancer?

Extensive Experience Dr. Sanjeev Kumar has 12 years of experience treating various gastrointestinal cancers, including food pipe cancer. His patient-first approach ensures personalized care with the latest medical advancements.

Specialization in Esophageal Cancer Dr. Kumar has in-depth expertise in handling complex esophageal cancer cases. His work at Max Hospital, one of the top healthcare institutions, ensures access to cutting-edge facilities and world-class treatment protocols.

Advanced Treatment Techniques From endoscopic procedures to robotic-assisted surgeries, Dr. Kumar is proficient in offering modern solutions that improve recovery time and patient outcomes. He focuses on minimally invasive procedures, ensuring faster recovery and fewer complications.

Holistic Cancer Care Dr. Kumar’s treatment approach involves not only managing cancer but also addressing nutrition, rehabilitation, and emotional well-being. He collaborates with a multi-disciplinary team at Max Hospital to provide comprehensive care, including post-surgery support and follow-ups.

Conditions Treated by Dr. Sanjeev Kumar

Esophageal (Food Pipe) Cancer

Stomach Cancer

Pancreatic Cancer

Colorectal Cancer

Liver Tumors

Max Hospital – The Best Choice for Cancer Care

Max Hospital is recognized for its state-of-the-art infrastructure and top-notch medical services. Patients under Dr. Sanjeev Kumar’s care benefit from access to:

24/7 Critical Care Support

Modern Surgical Suites

Comprehensive Cancer Support Services

Book an Appointment Today

For those seeking the best treatment from a Food Pipe Cancer Specialist in Max Hospital, Dr. Sanjeev Kumar offers compassionate care backed by 12 years of expertise. Don’t delay your health—schedule a consultation and explore the latest treatment options.

Contact us today to book your appointment with Dr. Sanjeev Kumar. Get the right care at the right time, only at Max Hospital!