#gastroenterology courses
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apollosimulationcenter · 1 month ago
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Advanced Medical Simulation Training Courses: Master Clinical Skills
Medical simulation training courses provide a safe, supervised setting for experiential learning that simulates real-world clinical scenarios.
Through the improvement of clinical skills, decision-making ability, and teamwork, simulation-based training is essential for improving patient care and safety for a variety of healthcare providers, including nurses and aspiring doctors.
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clatterbane · 5 months ago
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Oh yeah, about that persistent anemia that the new endo pretty much flipped over...
Yeah, I developed some suspicions of my own there, and it took maybe 2 seconds of searching to turn up plenty of info about PPIs directly causing iron absorption issues too. 🙄 Besides the other minerals I already knew about. They're pretty well known for that, leading to bone density problems for some people. Most likely also the reason my sodium and potassium levels have kept coming back just under the acceptable range too. You fuck around with the balance of digestive secretions and pH, it may have some unintended effects!
I've been stuck on high-dose PPIs ever since that big DKA crash in 2020 damaged my digestive system. They've actually kept me on the maximum dosages approved for adult humans, but I've ended up cutting it back some myself to the point that it's just higher than usual. (Partly to hopefully also cut back somewhat on potential side effects like this, but also thanks to repeated pharmacy supply issues with formats I can reasonably swallow with my now fucked-up esophagus!)
Never had any notable reflux issues before, but with that damage there's nothing really keeping the stomach acid down where it belongs. With evidence of that from some truly unpleasant testing where they dangle sensors down your throat. And of course they're trying to keep more acid from doing more damage. Some of that effect if I don't have the meds is probably from rebound acid overproduction, but if I don't take them for whatever reason now it gets ugly within a few days!
So yeah, I do seem to be stuck on the PPIs for the forseeable future now, whether I like it or not. It's just good to know that I do need to make sure to take in extra of certain minerals on a regular basis to try and compensate for that.
Am I surprised that two endos now, and the GP I got referred to for more tests over it have just completely overlooked well-known effects of meds they knew I was taking regularly, and which are readily found immediately by plugging "PPIs iron" into your search engine of choice? Not remotely.
Nope, they'd prefer to mutter direly about rare liver diseases and all kinds of less likely possibilities--and order a zillion blood tests. At least they DO seem to like to order various testing here when something looks off instead of just ignoring it, I will give them that. Guessing they are not under the same kind of pennypenching pressure that kinda got me needing the freaking PPIs at all.
PPIs are more within primary care's wheelhouse than endocrinology's. But. the gastroenterology guy who has been prescribing the stuff for a good while now ALSO did not put together that the borderline low electrolytes he was concerned about in the context of anesthesia might have some connection there before I brought it up as a possibility. To his credit, he also did not act like I must be on crack mentioning it, or seem to take it as some weird challenge to His Authority. But, the guy--who does come across as smart and competent enough--had obviously never considered this as a possibility.
This shit may be anything but unexpected by now. But, it really does sort of bring home just how bad at least 95% of clinicians seem to be at diagnostic pattern matching, in general.
(I mean, working with patterns like this is just one of the things my own brain has Always Just Done. Getting it to fucking shut up sometimes when it's not being useful, and channeling it into actually productive avenues are the bigger challenge. Seems to be another on the less shitty side of those neuroweird superpowers. But, some of these otherwise intelligent people are just so damn terrible at it by just about any standards. At the risk of sounding like some kind of condescending prick.)
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tanetime · 2 months ago
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Wait what was that about Wyneer’s messed up mouth and eating what-
Also are you ok. I know it’s been like two months but I don’t check your blog often tbh and your tags mentioned hopital 🥺
Wyneer's face got reposessed by the Taking Your Wish Too Literally and Fulfilling it Ironically™ police (read: Maxwell, accidentally) but boy's gotta eat. It turns out when your face is made out of nightmare fuel that's a whole lot of real estate where a mouth can go!
Also, thank you for asking about my health! I really wish I had something positive to say about that - I was actually going to make a post about my absence but I was waiting for news first. I still don't have news, but I'm going to answer this ask now under a readmore so that I don't look dead.
While I'm going to omit a lot of information this post is kind of a downer.
I'm not going to get into specifics because it was pretty awful, but my health over the course of 2024 deteriorated pretty badly. I was busy with getting promoted at work and trying to manage my carpal tunnel getting much worse (both bc it got bad and bc I had an injection to treat it that somehow made the pain in my hand 10x worse), so I kind of just... didn't realise how sick I was getting?? Until about May/June where I kind of hit a wall where I was like "wow, this weird illness I am ignoring is becoming really hard to ignore!"
IRL was busy and stressful so... I put off going to the doctor for months. I have a history of developing intolerances to new things suddenly so I figured something was making me sick and kept experimenting with removing things from my diet and environment until my health improved. We thought we found it - we suspected I was celiac for a bit, but, uh...
Ironically days after finally going to the doctor to get my symptoms checked out, I got woken up at 4am by what felt like something in my gut exploding and I ended up in the hospital. They kept me there for a week then discharged me because 1. while I was in extreme pain I evidently wasn't dying 2. in the process of getting misdiagnosed I got triaged to a hospital that didn't have a gastroenterology department and they had no means to diagnose or treat me.
We still don't actually know what is wrong, we've only narrowed it down; I've been on a waiting list to see someone about it since December. I'm in a lot of pain 24/7, have a lot of nasty symptoms, and feel lethargic all of the time. It sucks. I don't really have the energy to draw or make posts.
I really wish I had a happier answer for you. I'm sorry. But uh, that's the gist of why my blog has been extremely quiet.
On the bright side, I stopped working on my DST stuff pretty much the entirety of 2024, but back in December I picked modding back up and it's been fun. I'm very excited about it. I've just been too tired to make posts - I do want to get back into that at some point though.
If I get a prognosis that indicates that my absence is going to be lengthier I will probably make a post about it.
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sparguscityangel · 1 year ago
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The Dark Eco Incident
I held a mini contest by accident and @segaphantom won and requested a fic about his Spicy Jelly AU where TPL!Jak accidentally eats dark eco and transforms into Dark Jak. It was so fun to write that I wanted to share it. Congrats Sega! Enjoy!
This was easily the stupidest thing Jak had ever done.
Well, maybe top five. And maybe not the stupidest thing, but definitely up there for the stupidest thing.
Let’s rewind a little bit.
The origins of Jak’s seemingly indestructible stomach are vastly unknown. An expert gastroenterologist could explain in great detail the functions of the stomach along with its genetic makeup. They could ramble on and on about gastric acid and stomach lining and ulcers and all kinds of things that would make someone else lose their stomach contents at the truth of how truly disgusting the human body can be. A professional’s opinion would still be very appreciated, but seeing how the very field of gastroenterology wouldn’t be invented for several hundred years, the query must be passed on to psychology which also wouldn’t be invented for another several hundred years. But if they did exist back when Jak was a young teenager running around barefoot on a beach that has never known the horrors of pollution or plastic, they would probably point his predilection to putting anything and everything in his mouth on a suspected food insecurity brought on by trauma usually seen in children who grew up with scarce resources — usually during a war.
Of course, if one tried to tell Jak this, it would absolutely sound insane. As insane as time travel, in fact.
So, what could the village elders say other than Jak just had the appetite of a very hungry goat? He’d grow out of it eventually. He was young, after all, and growing boys needed to eat enough to power a small army. Especially when that growing boy is their small army, but they digress. The point is that as long as the villagers remember to keep any and all precious valuables out of reach of the kid, they’ll be fine.
Unfortunately for everyone involved, the villagers were elderly and, well, remembering wasn’t exactly their strong suit. Because of all the villages that speckled the coast where Samos the Sage could’ve easily picked to train the heir of the most powerful Haus — both literally and figuratively — in known history, he just had to pick the one with the most old people. It was like he followed the scent of arthritic cream and prunes until he came upon Sandover and pitched their tent there and if that wasn’t bad enough, if that wasn’t bad enough, he also forgot that he himself wasn’t a spring chicken. Sure, he adopted a young girl and in his dementia riddled brain must’ve believed that having a teenage daughter also made him young in spirit, but he was old and forgetful and he should’ve been more careful. Just as he always drilled into the heads of Jak and his annoying orange friend who Samos had prayed would’ve been left out of this time loop — all actions have consequences.
This was the consequences of his actions.
Not that he was aware of it occurring at the time.
At the time, Jak had simply been hungry. Ravenously so. Training had been becoming more intense lately, and alongside his sore muscles, his insides felt like they were about to turn to liquid from channeling so much eco in rapid succession. Samos insisted that there was still so much to do, so much to learn, but Jak was growing restless. Every time his uncle came home and told him about his travels, about the things he’s seen and the people he’s met, it made his stomach twist in knots with anticipation. Their family, his uncle told him, weren’t the sitting around type. They were explorers. Adventures. Innovators and lustful for danger. They came from a long, long line of ancestors who defy the odds and do spectacular things with their sharp minds and skills. After a lifetime of listening to these promises, it was only natural that Jak would long to be a part of those stories. The first thing he’d conquer once he was allowed to leave the village would be Misty Island — that, he was sure of.
But to conquer Misty Island meant to first complete his training. Which was supposed to begin nearly an hour ago, but hadn’t, and now he was starving.
The diet Samos approved for him of roots and fish was starting to turn bitter on his tongue. He missed the sweetness of mangos and the honeyed taste of caramelized bananas. Sometimes, he’d even get a craving to eat the prickly plant that grew high up on the cliffs, instincts telling him to skin the plant and grill it to make a meal that he has never eaten before in his life but would accurately tell anyone the taste of.
He was so, so hungry.
Well, if Samos wasn’t going to show up any time soon, then Jak was going to take matters into his own hands and find something to eat in the hut.
The roots that Samos kept in jars lined the wall of his other doohickies that he sternly told him and Daxter to not touch under any circumstances. They were filled with dirt, wriggling worms, mushrooms, crawling lacewings, and more dirt that smelled suspiciously like the yakkow pen on the edge of the village. Jak turned away from them once he spotted the jars containing liquified eco, his insides already beginning to twinge at the idea of having to channel them later when his training called for it. So, he turned his attention to the last place that he’d expect to find eco: The pantry.
A part of him warned him against straying from the carefully laid out diet. It told him that he should wait, and if he couldn’t wait, then he should at least look for something that followed the guidelines. Something healthy, for example. Carrots, bell peppers, sprouts, things of that nature that will give him energy.
The other part of him instantly spotted the jar of dark marmalade and went, “Yeah, that’ll do.”
Grabbing it off the shelf, Jak inspected it with eagerness. It was a violet color with some streaks of magenta, possibly run-off of some other fruit. A two-fruit marmalade. Though he couldn’t fathom what the majority of it was, he knew in his gut that the magenta was no doubt strawberries. Keira had been telling him and Daxter that the strawberry plant she had been nursing for the better part of a year had finally begun to yield fruit and she was extremely excited about all the possible desserts, jams, and fruit salads they could make with them. She must’ve started making things with them, and though Jak was a little hurt she didn’t give him any to try, he was excited regardless.
He found the toast easy enough. It was in a bread box nestled somewhere on Samos’ desk, no doubt often a snack for the sage while he worked on his mastery of green eco. The knife was salvaged from the junk drawer. Saliva began to pool in Jak’s mouth as he twisted the jar open, sniffing the contents. It wasn’t … the best smelling marmalade. Hell, looking at it now, it wasn’t even marmalade. The consistency was gelatinous and thinner than marmalade, and Jak was confident it was more of a jelly than anything else. The smell of bitter almonds and sickly sweetness assaulted his senses almost immediately, making him gag momentarily. He even almost considered not eating it after all, but then he remembered that fish often aren't the best smelling when they are gutted, so maybe it was the same for the jelly.
Jak plunged the knife in, moving it around and watched it come apart easily. It was like scooping up honey and the young man perked up when he saw the dark jelly drip off the knife and back into the jar. Already he could picture the taste of it, the sweetness that will hit his tongue and pair amazingly with the crunch of the toast. He wasted no time spreading it, evening it out across the entire square and then scooping a bit more until he couldn’t see the toast underneath it. It looked perfect.
The first bite, however, wasn’t what he expected.
He had prepared for a sweet taste, but instead was met with pinching on his tongue. His whole mouth, in fact. It stung and fizzed across his taste buds, setting them on fire in a way that both felt and tasted good. Keira must’ve added in a bit of spice or peppers, really giving it a good kick that Jak was all too happy about. Even though he thought it could use a bit more of it, he was satisfied with it nonetheless and craved more of the jelly.
He grabbed the jar and looked inside, noticing that there wasn’t much left. Surely Samos wouldn’t mind if he just went ahead and finished the jar, right? It’s not like jelly ever really hurt anyone.
______________
“Hey! Old Greenie!”
Samos sighed, grumbling as he shuffled to turn around and face the grating young boy coming toward him. The lanky boy leaned over the railing of the house of his uncle, kicking his feet in annoyance as if he had been patiently waiting for someone for far too long and his patience had run dry. He and Jak must’ve been in the middle of hide and seek, and by the looks of it, either Jak had grown tired of seeking or was just incredibly bad at it. That wouldn’t do. Samos would have to add observation training to the long list of skills that he would need to know before the time came. With every passing week, he was growing to resemble the angry young man in Haven more and more, and the thought of it scared him more than he’d like to admit. They were running out of time, and Samos needed to prepare the boy the best he could before his fate would be ripped out of his controlled hands.
One problem at a time, Samos.
“What is it, Daxter?”
“Are you guys done yet?”
Samos raised an eyebrow at him. “What the blue blazes are you talking about, boy?”
Daxter huffed, pushing away from the railing and hopping down the porch. His knobby knees barely made the landing, and he stood up with a wobble that he tried to hide by leaning against a post, crossing his arms.
“Training or whatever it is that you and Jak get up to up there. Are you done? It’s been hours,”
Training.
Oh, for Precursors’ sake, he forgot about training! Jak must’ve been waiting for him up in his hut this whole time and here Samos was, holding a basket of mushrooms and sprouts from the beach. The appointment had completely slipped his mind.
Without replying, Samos turned his heel and hurried toward his hut and the undoubtedly bored teenager. Who knows what he had gotten up to? His hut was full of delicate and precious artifacts and plants. It took years for him to build up a collection as extensive as his, especially when it came to hunting down the exact Precursor remnants that he needed to educate Jak on the way it all worked when activated by eco — and him. His bloodline, the divinity hidden within him that Samos has yet figured out how to bring up the subject to him. Unfortunately, the issue was that Jak was still fifteen and unbearably so. The blissful ignorance of youth hasn’t skipped him, and heir or not, he was still his father’s son and insanely impulsive when it came to recklessness.
“Hey! I’m talking to you!”
Samos ignored Daxter, lumbering up the wooden bridge as the teen trailed after him. He had to get back into th—
Something that sounded like glass broke. Oh, for Mar’s sake!
Entering the hut was like entering the scene of a crime. Dark eco stained and scorched the wooden planks of the flooring, scattered everywhere like someone went around the room and plopped heaps of it wherever they pleased. The small spark of hope that the Sage had was that the rest of the artifacts and plant life was relatively untouched, everything back in its place just as he left it except for the thing hunched over the biggest stain of dark eco.
The floor creaked under him and it aroused the attention of the creature, its head whipping up to stare at him with eyes as black as voids, large and eerie against the sickly gray pallor that colored what used to be light russet skin. It fed on the dark eco, scooping handfuls of it and licking it off his fingers and elongated talons. This was a creature that Samos had only seen once before, more than a decade ago when he was still not yet a wise sage but rather an arrogant Freedom Fighter that had committed almost as many atrocities as the tyrannical government he swore he was nothing like. He had hoped and prayed to never see it again, not for the remainder of this lifetime at least, and the internal clock inside him that counted down the minutes until the time loop was kickstarted against immediately started to flash zeros. The creature used its foot to scratch behind his ear, flicking it like a yakkow before continuing to devour the remains of the dark eco jar that Samos had sworn he had hidden away.
Behind him, both Keira and Daxter gasped and screamed, clinging to one another as they urgently tried to get out questions faster than their brain could phrase it. It snapped him out of his shock, springing him to action.
“Sweet Precursors, Jak! What did you do?!” he hollered, moving toward the creature with enough faux confidence that he hoped would intimidate him enough to be apprehended. He didn’t need to look at Daxter and Keira to know they were both staring at him with wide eyes and pinched brows, mouths hanging open in shock.
“Why are you calling that thing Jak?” Daxter screeched, then louder exclaimed, “Keira, why is he calling it Jak!?”
Samos rolled his eyes. He really should’ve done a better job educating them all. Precursors know what they will do when they see the angry and bigger version in the near future. “Because it’s Jak! The idiot must’ve gotten into my stash of dark eco and turned himself into this!” he whacked his staff on the head of the creature, earning him a hiss of pain, “This is why I told you to not touch anything in here!” Then he turned back to the gobsmacked teens standing in the doorway, “Well, don’t just stand there! Hold him down so I can turn him back!”
Daxter snapped his eyes away from Jak and stared down the old man, going from shock to disbelief in a matter of seconds. “You expect us to touch him?! Do you not see the fangs?!”
“Oh, come off it. He’s no more dangerous than a Lurkerpuppy!”
“Have you ever been around a Lurkerpuppy? Those things bite!”
“He won’t bite you! Just … keep your fingers away from his mouth,”
Daxter opened his mouth to complain again, but he was cut off by Keira scoffing, pushing away from him and moving toward the creature currently trying suck out the dark eco from the grain of the wood. She cleared her throat, trying to get his attention, but it fell on deaf ears as he continued to lick and suckle the eco. Bracing herself with taunt muscles, the young girl squeezed her eyes shut and shot out her hand, her fingertips finding their way to the underside of his chin. For all that was good and— there was no way she was actually trying to pet the creature. Samos had seen the many methods both the Krimzon Guards and Underground had tested out to tame the killing machines and he doubted that a litt—
Except, it worked. Like a charm, it fucking worked.
The second her palm made contact with his chin, Jak’s eyes went wide and he stilled. For a few tense moments, all three of them held their breaths as they waited for a reaction or bite to come out of the creature. Something inside his throat rumbled, and he carefully wrapped his fingers around her wrist, tugging her closer to lay his jaw in her palm. He purred again, rubbing his face against her hand before she got the picture of what he wanted her to do. “Oh,” she hummed, testing her theory out by digging her nails in and scratching the spot just behind his ear.
“Mrrp!” he chimed, both hands coming up to hold her wrist in place as she pet and scratched the ferocious beast that used to be her best friend. Or was it her best friend that used to be a beast? None of them were really sure, and they didn’t have the energy to understand it, frankly. Samos had to act quick. If this went untreated for too long, who knows what the ramifications of ingesting dark eco would be. For all he knew, it could burn through him completely and leave them with a puddle of goggles and hair gel.
Samos gave them a wide berth, inching slowly toward the cabinet in the corner of the room where he had a plethora of medical-grade green eco. Balms, creams, gels, and medications all lined the shelves in neat rows, a proverbial candy store of care that should be able to cure just about any physical ailment. In his studies, Samos found that green eco could cure just about any damage caused by the dark eco, but he’d need to be careful. The only reason Jak wasn’t dead yet was because he, like his father and grandfather and great-grandfather and great-great-grandfather, was a channeler. He’d need to deliver the green eco in a way that would make it harder for Jak’s body to channel it and use it for energy rather than for its healing properties. It’d have to be administered with the syringes.
Samos was going to hate this.
Behind him, Jak had completely melted into Keira’s hands as she smiled and pet the creature like an oversized puppy. She scratched behind his ears, under his chin, cupped his jaw — wherever she touched him, it seemed that Jak was elated. His eyes squinted and he grinned with sharp fangs, breathing past the adorable noises he was making the more she pet him. This was so going to be blackmail when he transformed back.
“Hey, Dax! Look at this face! Oh, aren’t you just the cutest thing?” she giggled, pinching Jak’s cheeks with her thumbs. The creature cooed, almost as if he was agreeing with her.
Daxter didn’t seem convinced. “Yeah, I’m not going near that. Best friend or not, I like having all ten fingers right where they belong,”
“Oh, you big baby!” she huffed, bringing Jak’s cheek to press against her own, “He’s harmless!”
“Yeah, well, let’s see if you think he’s harmless after he bites off your face and sucks all your blood,”
“For the last time, Dax, there are no such thing as vampires and that was just a dream,”
“I know what I saw and if it was a dream, why did it feel so real!?”
“So the little green men are real too?”
“You’re going to look so stupid when I catch one,”
Keira shook her head at him, turning her attention back on Jak. The hands wrapped around her wrist started to slacken, now only loosely holding her in place as she continued to ravish him with soothing scratches. How could anyone be terrified of him? It’s like being afraid of a cabbit or muse. She lifted his ears up, hitching it up higher so it resembled the elongated ears of a cabbit and let out a squeal.
“Aw, come on, Dax! He’s too cute!”
When the boy sighed, Keira knew she won. She held Jak’s head cupped between her hands, facing him toward the teen to pet. He supposed it wouldn’t hurt. It’s Jak after all. He’s known him since they were practically in diapers, and he was confident that even while looking like this, Jak would still remember and cherish their friendship, right? That’s the kind of stuff friends do? Their bond persisting after hardships and all that other yakkow crap? Besides, Keira was right. He did look an awful lot like a cute, fuzzy animal. One pet wouldn’t hurt …
Daxter reached out like Keira had, though this time he kept his eyes trained on the sweet scrunched up face of his best friend. Why was he so afraid of him to begin with? He was nothing but a huge—
“YOUCH!”
“Daxter, get your hand out of his mouth! I need to give him the oral medication too!”
The boy just screamed, trying to wretch his hand free of the fangs currently trying their hardest to pierce his skin. It would’ve been nice to have had a heads up before Samos plunged the syringe into Jak, catching the teen off guard and setting off his fight or flight instincts at the drop of a hat. Keira was trying to ease Jak’s jaw free, cooing and humming into his ear while caressing his cheek, using her other hand to push down on his jaw so he could release Daxter. If he hadn't known any better, Daxter would think that Keira was more concerned with Jak’s feelings than Daxter’s once beautiful, perfect hand.
“Get him off!” he cried out, wriggling on the floor to alleviate the pain shooting up his arm.
“That’s it, Jak. Spit it out. You don’t know where that hand has been,” Keira whispered, digging her fingertips into the divet of his cheeks until they propped open enough to let Daxter’s hand go free, “Good boy! You got it!”
Daxter scrambled backwards, kicking his feet on the ground to wedge himself firmly in the doorway in case Jak tried to go for seconds. He held his hand against his chest — unharmed other than a small scratch and tiny indents of his friend’s teeth — and pointed an accusatory finger at Jak. “He tried to eat me! No good boy! Bad! Bad mutated monster of my best friend … boy,”
“Are you … crying?”
“Of course, I’m crying! He bit my hand!”
Samos loudly shushed them, his voice low and rumbling as he silenced all three of them. His head was starting to hurt from the situation and all the noise and he still needed to give Jak the medicine that should hopefully dry up any remains of the dark eco in his mouth and stomach. It was easier said than done though. Jak’s trust in him has gone from a little to zero now that he knows it was him that pricked him with the syringe. He didn’t need a twin bite mark to know this, watching the teen curl up closer to Keira and trying to hide behind his daughter while she petted his hair flat. If he wasn’t going to take it willingly, he’d have to go with plan B.
He waited. Eyeing the two with all the concentration he had inside him, Samos waited until Jak had completely calmed down from his attempt on Daxter’s hand’s life. Any signs of him relaxing enough to where he wouldn’t suspect the older man trying to hurt him again. There was no reasoning with Jak in this state, and he wasn’t about to waste time trying. Keira’s arm just wrapped around his shoulders, pressing his head to her shoulder while making soothing noises, Jak’s eyes going small and watery. It seems that Daxter’s outburst might’ve … hurt his feelings? He didn’t know, nor did he really care. He had one shot at this, and now was the moment to take it.
Yanking Jak away from Keira by the horn, Samos shoved the medicine in his mouth when the creature opened his mouth to cry out. He might’ve used more force than necessary when he held his head down and his lower jaw upwards, making sure that the creature couldn’t spit it out while Keira hollered at him to let him go. The sage grit his teeth, applying as much pressure as possible and losing the battle with Jak. Though this version of the supposed Dark Warrior was smaller, unrefined, and weaker, it didn’t mean that he wasn’t as powerful as his older self was. Samos still remembered the carnage he happened upon during the last leg of the invasion, shock and horror all dawning on him as he watched the monster leap between metalheads to keep them far away from the group as they made their way through the sector.
Samos also still remembered his daughter, standing elbow to elbow with the blonde Underground spy who wouldn’t be born for millenia, both helping out by shooting any metalhead that the Dark Warrior missed. Daxter standing bravely on Jak’s shoulder, yanking him by the hair to avoid close calls to the head or shoving him to the side to avoid an oncoming assault.
He couldn’t think about that now. It brought up too much heartache to think about what pain laid ahead for all three of them.
Something wet touched his wrist, and when Samos looked down, he wanted to curse the young man with all the profanities and more he could think of. The creature was foaming at the mouth, froth covering his lips and chin as he growled and barked at the Sage in an effort to get him to let go. He threw his head from side to side, trying to dislodge him, and catching Samos in the face in the process.
“Precursors!” he hissed, hands coming up to cup his nose with a groan. The simple act cost them their advantage, releasing Jak enough for him to crawl out of the window and scale upward toward the observator on the roof. Keira ran after him, stopping short of leaning out the window to call his name as the sounds of scuttling echoed from the ceiling. Straw rained down on her head, entering the hut as she snapped her head to face the two injured men.
“We have to do something! What if he slips and falls down?!”
“You’re worried about him?!” Daxter whined, holding out his uninjured hand, “He practically mauled me!”
“Grow a pair!”
“Keira,” Samos snapped, standing up with great effort by leaning heavily on his staff. He felt his nose, wincing at how tender it was, but ultimately concluding that it wasn’t broken. He’s going to have one hell of a bruise, but it wasn’t broken. “He’ll be fine. He’ll turn back to normal in an hour or so when he burns through the eco,”
“But Daddy—”
He waved her off. “Believe me, sweetie. I’ve seen men channel more eco than he did and turn back to normal within minutes. Just let him get it out of his system,” he sighed, looking over the mess. It was all cosmetic, and shouldn’t take more than an hour to clean up if some elbow grease was put into it. He was just grateful that Jak hadn’t disturbed Chomper, otherwise they would’ve been in real trouble. “Daxter! Get this place cleaned up! I want this floor to be spotless!”
The red-head groaned, grumbling as he stood up and automatically grabbed a broom, which was interesting. Usually Daxter had to get through exactly eleven minutes of complaining before he even considered grabbing a mop, but today there was nothing coming from the peanut gallery. Good. He wasn’t in the mood to listen to Daxter. He needed to make more syringes to replenish the ones he used on Jak. Samos pulled out his mortar and pestle, the aloe leaf, and a jar of raw green eco and got to work mixing the ingredients together. Keira still lingered by the window, torn between giving Daxter a hand or climbing out to get Jak down from the roof. Bless her heart. Her capacity for love and affection went far beyond what was ever necessary and he loved her for that, though he could sometimes do without the stubbornness that accompanied it. He wasn’t foolish enough to believe that raising a teenage girl would be easy, but Precursors, someone could’ve at least made a manual or something to help other clueless fathers navigate it.
It’s why he didn’t stop her from busying herself with making him a snackbox, mentioning under her breath that the dark eco and toast didn’t count as lunch and he still needed to eat — creature or not.
Jak will tire himself out eventually. In the morning, this will all be a funny story they will reminisce on for years and years to come. It’s not like the eco will last forever, right? The dark eco will deplete and burn out like wax, Jak will revert back, get cold, and come back down to the hut where Samos will attempt to make the occurrence seem completely normal. He’ll spin some yarn about some great dark sage long ago who had made the same mistake and how it left him permanently altered after he gorged himself on too much of it. If he’s successful, it’ll steer Jak in the opposite direction of dark eco, keep him as far from it as he can be before the inevitable time comes where he won’t be able to escape it for two years. Come spring, and Jak’s world will be flipped completely upside down. The least Samos could do was offer him that bit of mercy before them.
It’s what he tells himself later that night, when the moon is full and big hanging in the night sky, and Jak’s howling can be heard from far and near. He’ll tire himself out eventually, even if he’s been at it for six hours now with no signs of stopping.
Fuck the Haus of Mar
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Lord Gastroenterology would you rather have a flock of turkeys or geese
Can any one of you fools read? My name is GHIRAHIM. LORD GHIRAHIM.
Regarding your bizarre question, I would choose geese, of course. They are far more aggressive and would make fine additions to my army, despite not being of demonic descent.
Should their incessant squawking prove too vexing, I know a few moblins who could come up some recipes good enough for my hordes.
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fursasaida · 2 years ago
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fucking hell. turns out ozempic/wegovy/etc is giving people gastroparesis. they are saying "extreme cases" are rare so far. who knows what the definition of "extreme" is. and at this point in my life I am automatically skeptical of declarations that medical conditions are rare. to wit:
In clinical trials, nearly half of people, 44%, who took Wegovy reported nausea, and almost 1 in 4 reported vomiting; both are common symptoms of gastroparesis. In the clinical trials for Ozempic, which is the same medication as Wegovy but given at a lower dose, 1 in 5 people reported nausea and 1 in 10 reported vomiting.
there would be a kind of folkloric poetic justice about this, it's very just-so story, especially regarding those who clear out stocks buying from shady "pharmacies" purely for weight loss. but in the end what we have here is mostly people who did what society and their doctors told them and are now suffering tremendously for it. people losing their jobs because they throw up too much every day to work. fucking horrific.
even better, diabetes is a risk factor for gastroparesis. diabetes. the thing other than weight loss for which these drugs are usually prescribed.
moreover. slowing the stomach is a known side effect for this medication class, but these particular, new drugs seem to have an exciting twist:
What seems to be unusual about cases like Wright’s and Knight’s, Nguyen said, is that they didn’t improve after they stopped taking the medication.
“In my experience, when you stop the GLP-1 agonist, the gastric emptying improves, and it gets better,” said Nguyen, who is also a spokesperson for the American Gastroenterological Association.
so, in at least some cases, the damage seems to be longer lasting if not permanent. who knows!!! this is medically induced dysautonomia, so of course nobody has a fucking clue.
speaking of which, here's the grimly familiar part:
Gastroparesis can have many causes, including diabetes, which is a reason many people are on these drugs in the first place. Women are known to be at higher risk for the condition, too. In more than half of cases of gastroparesis, doctors are unable to find a cause.
“They may just be really unlucky,” said Dr. Michael Camilleri, a gastroenterologist at the Mayo Clinic, said of the people who shared their cases with CNN.
On the other hand, this is how the drugs work, although not many doctors or patients understand this or the problems that may follow, he said.
same bat time, same bat channel.
there's a whole section on surgery risk, too. the reason you're supposed to fast before a surgery involving anaesthesia is to empty the stomach and minimize digestive acids, which can otherwise affect your lungs during surgery in really dangerous ways. if you're on these meds, you can follow your prep instructions perfectly and still have a full stomach when you show up. and patients often don't think to mention this med to the surgical team, because they're not aware of the connection - or even actively hide it, because being on a weight loss drug is embarrassing. anaesthesiologists are Worried.
anyway, since this sadly has to be said in the context of suffering for thinness qua beauty and patients being way too willing to accept awful side effects due to warped relationships with the medical system:
Nguyen, the Stanford doctor, said patients need to pay attention to the side effects. If you vomit once or twice, that might be normal, but persistent vomiting is not.
“They should be evaluated. Consider reducing the dose or stopping the medication,” she said.
“If your vomiting is affecting your hydration or you are having to take other medications to treat the side effects of this medication, then I think it’s time to reconsider.”
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drdevendra112 · 4 days ago
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Trusted Hands, Proven Expertise: Your Guide to the Best Surgical Care in Jaipur
When it comes to surgical treatment, the importance of choosing the right surgeon cannot be overstated. A skilled general surgeon does more than perform procedures—they diagnose conditions accurately, recommend the right course of action, and ensure safe and effective surgical outcomes. In a medical hub like Jaipur, patients from across Rajasthan and neighboring states turn to Sawai Mansingh Hospital (SMS) for advanced and reliable care. It’s no surprise that many consider it the home of the Best general surgeon in SMS Hospital Jaipur.
General surgery covers a wide range of procedures, from appendectomies and hernia repairs to gallbladder surgeries and complex abdominal interventions. In a high-pressure environment like SMS Hospital, precision, experience, and the ability to make swift decisions are critical. That’s where experienced surgeons step in—those who not only have strong academic backgrounds but also real-time clinical expertise in high-volume settings.
Sawai Mansingh Hospital is renowned for its excellent infrastructure, updated medical technology, and most importantly, its dedicated and highly skilled doctors. Among them, Dr Devendra Saini SMS surgeon doctor in Jaipur, one of best associate professor in Sawai Mansingh Hospital S.M.S, has earned a reputation for surgical excellence, patient care, and academic leadership.
With years of surgical experience and a firm commitment to ethical and evidence-based medical practice, Dr. Saini has become a trusted name among both peers and patients. His ability to handle both routine and complicated surgeries with precision, along with his calm demeanor, has made him a preferred choice for those seeking dependable surgical care. Whether it's a planned elective procedure or an emergency surgery, patients know they are in safe hands.
As an associate professor, Dr. Saini also plays a key role in training future surgeons at SMS Hospital. His students appreciate his hands-on approach, clarity in teaching, and his deep knowledge of surgical anatomy and operative techniques. This academic involvement ensures that he stays updated with the latest advancements in surgical science, which directly benefits his patients.
Beyond technical skill, what sets a great surgeon apart is the ability to communicate well with patients and their families. Dr. Saini is known for explaining procedures clearly, discussing risks honestly, and offering guidance at every step of the patient’s journey—from diagnosis to recovery. This transparency builds trust and greatly reduces patient anxiety, which is a major part of healing.
Patients also benefit from SMS Hospital’s multidisciplinary approach, where general surgeons often work with specialists in gastroenterology, oncology, radiology, and intensive care to ensure comprehensive treatment. Dr. Saini’s collaborative nature ensures smooth coordination across departments, which leads to better outcomes and shorter hospital stays.
Moreover, accessibility and affordability are major reasons why SMS Hospital is preferred by thousands. Under the expert guidance of surgeons like Dr. Saini, patients get world-class treatment at minimal cost—especially critical for those coming from rural or economically challenged backgrounds.In conclusion, when you're looking for trusted, compassionate, and skilled surgical care, finding the Best general surgeon in SMS Hospital Jaipur is a step toward a safer and faster recovery. Dr. Devendra Saini, with his blend of experience, academic contribution, and patient-first approach, continues to be a beacon of excellence in the field of general surgery in Rajasthan.
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herniadoctors · 6 days ago
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Best Laparoscopic Surgeon in Indore | Dr Achal Agrawal
Are you looking for the best laparoscopic surgeon in Indore? Our expert doctors offer minimally invasive surgery with faster recovery.
Dr. Achal Agrawal specialises in, laparoscopic, and gastroenterological surgery. He is the director of Indore Laparoscopy Center. He chose to specialise in minimal access surgery after earning a Gold Medal and distinction for his post-graduate work in general surgery and after observing several pioneers in the field.
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nursingwriter · 9 days ago
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Nursing Intro / Job Description for Endoscopy Nurse An endoscopy nurse is a position available to Licensed Practical Nurses (LPNs), as well as Registered Nurses. Therefore, the minimum requirements of the position are the LPN or RN degree. The service and care provided will vary from institution to institution, or employer to employers. However, the basic functions of the endoscopy nurse include providing support services for surgeons and physicians during any process involving endoscopy. Keefe (n.d.) describes the position as providing care to patients "with actual or potential problems involving the gastrointestinal (GI) tract during specialized procedures performed with lighted, flexible instruments known as endoscopes," (p. 1). Patient populations are diverse, because endoscopy procedures are performed in pediatric as well geriatric applications and everything in between. Therefore, the endoscopy nurse works in a diverse health care environment and with a diverse patient population. The endoscopy nurse is intimately familiar with infection control methods, equipment, standard operating procedures, and best practices rooted in evidence. II. Education and Certification "According to the Society of Gastroenterology Nurses and Associates (SGNA), many endoscopy nurses begin their practice in a hospital setting, caring for a defined patient population on a medical-surgical, pediatric, or critical care unit," (cited by Keefe, n.d.). However, there are clear-cut educational and certification requirements for becoming an endoscopy nurse. Educational requirements for the profession/occupation include a minimum of an associate degree in nursing (AND), but a baccalaureate degree in nursing (BSN) may be preferred. NCLEX certification will help the nurse achieve Registered Nurse (RN) status for added responsibility, leadership opportunities, and salary increases. A variety of educational institutions will offer endoscopy as an area of specialization within their core nursing department. The length of time it takes to complete the endoscopy nursing specialty program will vary, depending on whether the nurse already possesses a degree such as an AND, a NSN, or an RN degree. The minimum amount of education required will be two years for the associate degree program, plus an additional amount of time spent training for the area of specialization. The Society of Gastroenterology Nurses and Associates (SGNA) offers a comprehensive training course specializing in all areas of gastroenterology, which covers endoscopy. This accredited institution offers nurses the option of distance learning for the area of specialization. SGNA also offers a nurse fellows program and a scholars program, as well as annual courses for continuing education and professional development. III. Employment Jobs are readily available in the field of endoscopy nursing. The Website CareerBuilder.com, for example, lists 322 jobs in the field of endoscopy nursing specifically ("Endoscopy Jobs," 2012). These positions are located all over the country, in different types of health care institutions. In the state of Florida, there are five endoscopy nursing positions currently open, and four of those are located in South Florida ("Endoscopy Jobs," 2012). The CareerBuilder.com website is one of many offering information for job seekers. On SimplyHired.com, a search for endoscopy nursing positions in the Miami-Dade and Broward County areas yielded 78 hits. There are positions available at Baptist and the Coral Gables Hospital, among other places. These positions vary in terms of the qualifications they expect. Some are positions for Registered Nurses alone, whereas others are for endoscopy technicians. The technician positions tend to be per diem roles with little room for advancement, but the RN positions are more lucrative and offer greater opportunities for advancement within the organization in terms of becoming a manager or leader. According to Kaufman (2011), the job outlook for endoscopy nurses is bright because historically, endoscopy nurse vacancies reflect total nurse vacancies. "Endoscopy registered nurses are among the specialty caregivers to benefit from historic demand," (Kaufman, 2011). There are, therefore, "expect excellent career prospects" for endoscopy nurses (Kaufman, 2011). Nursing in general has a positive job outlook with rapid growth, but specializations like endoscopy are even in greater demand. Job environments include all health care settings, but the largest rate of growth for endoscopy and other nurses are private practices (Kaufman, 2011). IV. Professional Activities The Society of Gastroenterology Nurses and Associates (SGNA) is the primary national professional organization for this field. Registered Nurses and Licensed Vocational/Practical Nurses can pay $125 annually or $235 bi-annually for membership. An alternative option is $205 for an 18-month membership. There is no express option for a student membership. However, the Society of Gastroenterology Nurses and Associates (SGNA) offers opportunities for Assistive Personnel (e.g., technicians, technologists, assistants) involved in or associated with gastroenterology and/or endoscopy nursing practice to pay $95 per year or $180 for two years of membership. Similar packages are available for non-voting affiliate members including physicians, and non-voting, non-practicing memberships for $60 per year, and $120 for two years. Students who are not yet certified practitioners can become a non-voting, non-practicing member to start networking for their career. The SGNA does offer a range of options for continuing education, which is expected because of the changing nature of endoscopy technology and technique. Continuing education units are not, however, specified by CEU code on the SGNA website. An annual convention from SGNA offers the best option for networking and professional development. The state of Florida also has its own gastroenterology society, covering needs of endoscopy nurse professionals. Additionally, the Mayo Clinic offers an advanced endoscopy fellowship in Florida, which is a one-year continuing education fellowship program (Advanced Endoscopy Fellowship, Florida, 2012). It does not offer its own accreditation and is geared mainly for physicians but it shows how important the field of endoscopy is to health care in general. V. Conclusion / Reflection As a student at Miami-Dade Community College, I have my eyes set on an advanced nursing degree. I see a lot of promise in the profession of nursing in general. When investigating my options for how to apply the nursing degree to the professional world, it became clear that an area of specialization that is in high demand such as endoscopy would be ideal for my needs. I have the ability to focus, and would appreciate the steady workplace environment that endoscopy nursing has to offer. Moreover, endoscopy nursing offers ample opportunity for personal and professional development via networking with other nurses in the field, becoming a nurse manager or leader who can educate and train others, and working alongside other qualified professionals to ensure delivery of quality of care. I see myself fitting in well with my colleagues who are in the general gastroenterology sector. While exploring the field of endoscopy nursing, I realized that it takes a series of steps in order to fulfill the ultimate objective of working as a full-time, full-fledged, gastroenterology Registered Nurse. The first step is to obtain my associates or bachelors degree. The initial step will provide for me the foundation of knowledge required to succeed as a more advanced and specialized professional. During this time, I can acquire work in a healthcare institution in South Florida, where I can gain general understanding of heath care procedure, practice, and policy. The initial work experience will also expose me to different areas of nursing that coincide with endoscopy, and this will in turn show me what types of situations I will deal with once I am an endoscopy nurse. For example, there are certain diseases associated more often with gastroenterology problems and I will need to familiarize myself with these conditions. Professional experience will also help me hone my practice as a nurse, working from a caring perspective. Moreover, much of the training for endoscopy areas of specialization occurs on the job rather than in formal educational settings (Kaufman, 2011; Keefe, n.d.). For this reason, it is especially important to be patient while I develop my skills in the health care institution as a registered nurse. When I become certified, and am a member of professional organizations like the Society of Gastroenterology Nurses and Associates (SGNA), I will be able to participate in research and practice that will help advance the profession. In addition to providing patient care for individuals, I will be able to work towards improving public health and safety for all. I am thrilled to learn that the job outlook for endoscopy nursing is promising, within South Florida especially. References Advanced Endoscopy Fellowship, Florida (2012). Mao Clinic. Retrieved online: http://www.mayo.edu/msgme/residencies-fellowships/internal-medicine-and-subspecialties/advanced-endoscopy-fellowship-florida "Endoscopy Jobs," (2012). CareerBuilder.com. Retrieved online: http://www.careerbuilder.com/JobSeeker/Jobs/JobResults.aspx?tally=Category+Navigator+Selected&APath=2.21.0.0.0&nvjtl=JN050&sc_cmp1=js_navg_nvjtl&IPath=JRKV&excrit=QIDA3855799626362stauseALLrawWordsEndoscopyCIDUSSIDTID0ENRNODTPDRNSYDIYESINDALLPDQAllPDQAllPAYL0PAYHgt120POYNOETDALLREALLMGTDCSUPDCFRE30CHLALQSsid_unknownSSNOTITL0OB-relvRAD30JQTRADJDVFalseHostUSMaxLowExp-1RecsPerPage25 Florida Gastroenterology Society (2012). Retrieved online: http://www.fl-gastrosociety.org/ Kaufman, C. (2011). Endoscopy registered nurse salary & career outlook. Schools.com. Retrieved online http://www.schools.com/news/endoscopy-registered-nurse-salary-career-outlook.html Keefe, S. (n.d.). Training for endoscopy nursing. Retrieved online: http://www.ehow.com/way_5535234_training-endoscopy-nursing.html Society of Gastroenterology Nurses and Associates (SGNA). Website retrieved at: http://www.sgna.org/ Read the full article
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lovelysingh09 · 12 days ago
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The Best Gastroenterology Hospital in Bangalore
Everyday life can be challenging with digestive issues. I’d been living with stomach pain, nausea and digestion gone wrong for months. Antacids, home remedies, diet changes, medicines  nothing I tried worked, and the discomfort never faded. Eventually, it was impacting my work, my sleep and my health. So frustrated, I looked for a real solution.
Choosing the Right Hospital
After several unsuccessful treatment attempts, a friend recommended Sapthagiri Hospital as an option for the best gastroenterology treatment in Bangalore. Initially, I was ambivalent, but I chose to attend. As soon as I got there, I sensed a change. It was a well done hospital and everybody took care of me with professionalism.
Fast and Accurate Diagnosis
The doctors took a careful history of my symptoms and recommended endoscopy, ultrasound and lab work. To the contrary of my experiences, I didn’t have to wait weeks for results. The hospital’s advanced technology gave quick, accurate answers. My doctor told me I had IBS (Irritable Bowl Syndrome) and chronic gastritis. Having pinpointed the exact problem was a relief.
Personalized Treatment Plan
The staff at Sapthagiri Hospital also believed that temporary relief was not their Type and they start tåhro treatment. They provided me with a treatment plan that satisfied my needs, that included:
Anti-inflammatory medication and digestive medication.
What you eat impacts gut health.
Probiotics to maintain a proper balance of good bacteria in my stomach.
Alterations in lifestyle or lifestyle adjustments to alleviate stress and aid in digestion.
Follow-Up Care to track my recovery and change treatment as necessary.
A Supportive Environment
The care I received wasn’t merely medical — it was emotional, too. The doctors patiently addressed my concerns, and the hospital staff ensured my comfort during the course of my treatment. “I was apprehensive about the whole process, but as usual, Willow gave me a wonderful experience. They patiently answered all my questions in detail to prevent me from feeling anxious. It left me confident in my recovery.
Noticeable Improvement
I was feeling better within weeks. My digestive was more efficient, the pain lessened, I felt invigorated. The best gastroenterology hospital in Bangalore restored my health and routine. The follow-up visits helped me stay on track and avoid further problems.
Prioritizing Digestive Health
I learned through this experience that stomach problems should not be overlooked. If you get the right treatment at the right time, it can help you avoid long-term problems. Sapthagiri Hospital: Give Experts Good care to Acquired the Efficient Solutions.
Today, I am a lot healthier and more conscious about the things I consume and how I live my life. Getting help from specialists changed my life, and I urge anyone with digestive issues to take that step toward health.
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pace-hospitals · 26 days ago
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Comprehensive Management of Recurrent Ascites Following Right Hemicolectomy for Abdominal TB
PACE Hospitals’ Surgical Gastroenterology team successfully performed a Exploratory Laparotomy with Adhesiolysis and Drain Placement for a 20-year-old female patient suffering from recurrent loculated ascites following a right hemicolectomy for abdominal tuberculosis (TB).
Chief Complaints
A 20-year-old female patient presented to the Gastroenterology Department at PACE Hospitals, Hitech City, Hyderabad, with complaints of intermittent abdominal pain over the last month. Ten days ago, she developed generalized, non-radiating abdominal pain, along with recurring abdominal distension and discomfort after meals. She also had intermittent bilious vomiting about three days ago. 
For the past three years, she has experienced similar symptoms, including reflux, which have been managed with oral antacids for the last year.
Medical History
Delving further, it was understood that the patient underwent a laparotomy for intestinal obstruction in 2014, followed by adhesiolysis with bowel resection. Post-surgery, she received antitubercular treatment (ATT) for four months but later defaulted on the treatment. A CECT scan evaluation revealed peritoneal thickening with loculated ascites and a suspected ovarian mass, possibly a germ cell tumor, along with moderate loculated ascites. Ascitic fluid analysis was negative for AFB, and serum CEA levels were within normal limits. The patient had no other comorbidities.
The previous findings, including peritoneal thickening and a suspected ovarian mass, raised concerns about potential recurrence or related pathology, necessitating further evaluation and management.
Diagnosis
Upon admission to PACE Hospitals, the patient’s vital signs were stable. Following a detailed physical examination, it was noted that she had been suffering from intermittent abdominal pain for the last month.
The diagnostic tests revealed recurrent loculated ascites, indicating a buildup of fluid in the abdomen, which appeared to be a complication following her previous right hemicolectomy for abdominal tuberculosis (TB).
Surgical procedure
Following discussions with Dr. CH Madhusudan, the Consultant Surgical Gastroenterologist, it was concluded that an exploratory laparotomy, including adhesiolysis and drain placement, would be the best course of action for the patient’s treatment.
After being admitted with the aforementioned symptoms, the patient underwent further evaluation and was taken for surgery. An exploratory laparotomy with adhesiolysis and drain placement was successfully performed. This procedure was crucial for addressing bowel obstruction and preventing further adhesion-related complications.
Best Gastroenterology hospital in Hyderabad, Telangana, India
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ilshospitalskolkata · 28 days ago
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When should I see a gastroenterologist?
Digestive health plays a vital role in overall well-being, and any persistent issues with your stomach, intestines, or liver should not be ignored. A Gastroenterologist in Dumdum specializes in diagnosing and treating disorders of the digestive system, including acid reflux, irritable bowel syndrome (IBS), liver diseases, and more. But how do you know when it’s time to see a specialist? Here are some key signs and symptoms that indicate you should consult a gastroenterologist.
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Signs You Should See a Gastroenterologist
1. Persistent Heartburn or Acid Reflux
Occasional heartburn is common, but if you experience frequent acid reflux or gastroesophageal reflux disease (GERD), a gastroenterologist can help with effective treatment options. Long-term reflux can damage the esophagus, leading to complications like Barrett’s esophagus.
2. Chronic Abdominal Pain
If you have persistent or severe stomach pain, bloating, or cramping that lasts for weeks, it could be a sign of ulcers, gallstones, Crohn’s disease, or irritable bowel syndrome (IBS). Consulting a Gastroenterologist in Dumdum can help identify the cause and provide the right treatment.
3. Difficulty Swallowing (Dysphagia)
Trouble swallowing food or liquids could indicate an esophageal disorder, narrowing of the esophagus, or even an underlying neurological condition. A gastroenterologist can perform tests such as an endoscopy to diagnose and treat the issue.
4. Unexplained Weight Loss
If you are losing weight rapidly without any changes in diet or lifestyle, it could be due to digestive disorders, celiac disease, or even gastrointestinal cancers. A gastroenterologist can help determine the underlying cause.
5. Blood in Stool or Changes in Bowel Habits
Bloody stools, black stools, constipation, diarrhea, or changes in bowel habits lasting more than a few weeks should not be ignored. These symptoms may indicate colorectal cancer, hemorrhoids, or infections, requiring immediate medical attention.
6. Jaundice or Liver Issues
Yellowing of the skin or eyes (jaundice), excessive fatigue, and swelling in the abdomen could indicate liver disease, hepatitis, or cirrhosis. A gastroenterologist specializes in liver health and can recommend the best course of treatment.
7. Frequent Bloating and Gas
Occasional bloating is normal, but persistent bloating, excessive gas, and stomach discomfort can be a sign of food intolerances, small intestinal bacterial overgrowth (SIBO), or gastrointestinal disorders.
8. Family History of Digestive Disorders
If you have a family history of colon cancer, Crohn’s disease, or ulcerative colitis, regular screenings and check-ups with a gastroenterologist are essential to detect issues early and prevent complications.
Top Hospitals for Gastroenterology in Dumdum
1. ILS Hospitals, Dumdum
A leading multi-specialty hospital, ILS Hospitals in Dumdum offers advanced endoscopic procedures, liver disease treatments, and comprehensive digestive care. Their expert team of gastroenterologists provides personalized treatment plans for patients.
2. Columbia Asia Hospital, Salt Lake
Columbia Asia Hospital is known for its specialized gastroenterology department, offering treatments for GERD, liver diseases, pancreatic disorders, and GI cancers.
3. AMRI Hospital, Salt Lake
AMRI Hospital provides cutting-edge diagnostic and treatment services for digestive disorders, including colonoscopy, endoscopy, and liver disease management.
Conclusion
If you're experiencing persistent digestive issues, abdominal pain, acid reflux, or unexplained weight loss, consulting a Gastroenterologist in Dumdum is essential. ILS Hospitals, Columbia Asia Hospital, and AMRI Hospital offer top-notch gastroenterology services, ensuring expert diagnosis and treatment. Early consultation can prevent complications and help maintain optimal digestive health.
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rmceducation · 2 months ago
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What programs and courses does Jalal-Abad State University offer?
Jalal-Abad State University offers a wide range of programs and courses in the field of medicine, tailored to meet the needs of aspiring medical professionals. Here are some of the programs and courses offered by the university:
Medical Programs
1.General Medicine (MBBS)
2. Pediatrics
3. Dentistry
4. Pharmacy
5. Nursing
Postgraduate Programs
1.Master's in General Medicine 2. Master's in Pediatrics 3. Master's in Dentistry 4. Master's in Pharmacy 5. Residency programs in various specialties
Specialized Courses
1.Internal Medicine
2. Surgery
3. Obstetrics and Gynecology
4. Pediatrics and Child Health
5. Infectious Diseases
6. Public Health
7. Healthcare Management
Clinical Residency Programs
General Surgery
2. Orthopedics
3. Urology
4. Neurology
5. Cardiology
6. Gastroenterology
7. Nephrology
Distance Learning Programs
1.Online courses in medical specialties 2. Continuing medical education (CME) programs
International Programs
1.Joint programs with European and American universities
2. Exchange programs for students and faculty
Certification Courses
1.Emergency Medicine
2. Critical Care Medicine
3. Pain Management
4. Medical Ultrasound
5. Medical Research Methodology
Jalal-Abad State University's programs and courses are designed to provide students with a comprehensive education, combining theoretical knowledge with practical skills. The university's faculty and staff are committed to ensuring that graduates are well-equipped to succeed in their chosen careers.
In addition to these programs, Jalal-Abad State University also offers research opportunities, electives, and extracurricular activities to enhance students' learning experience.
In conclusion, Jalal-Abad State University offers a diverse range of programs and courses, catering to the needs of students seeking a career in medicine. With its strong focus on practical skills and research, the university prepares graduates for success in the medical field.
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ghapps · 2 months ago
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Digital Platforms for APP Education in GI
Medical education has changed dramatically. Gone are the days when staying updated meant flipping through bulky textbooks or sitting in long, in-person seminars. Now, everything you need to advance in gastroenterology is just a click away.
Why GHAPP’s Digital Platform Stands Out
Not all online learning is created equal. Some platforms feel too rigid, others lack engagement, and some just throw too much information at you without real-world application. GHAPP takes a different approach—one that’s tailored to how APPs actually learn and practice.
Virtual Learning Modules—Structured, Yet Flexible – Study on your own terms with bite-sized, interactive modules that don’t feel like a lecture.
AI-Powered Personalized Learning – The system adapts to your specialty and interests, offering tailored recommendations so you’re always learning what’s most relevant to your practice.
Expert-Led Courses & Webinars – It’s not just theory—you’ll learn from leading gastroenterologists, hepatologists, and experienced APPs who bring real-world insights into every session.
Instead of passive learning, GHAPP provides an interactive experience—one that makes sure you’re engaged, informed, and always a step ahead.
Stay Ahead with GHAPP’s Digital Learning for Gastroenterology APPs
Your expertise is your most valuable asset—and staying up to date doesn’t have to feel like a chore. With GHAPP’s digital platforms, you can continue growing, learning, and improving patient care—all on your own terms.
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priteshwemarketresearch · 3 months ago
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Optical Imaging Systems Market Insights: Growth, Size, and Future Trends
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The Optical Imaging Systems market growth is predicted to develop at a compound annual growth rate (CAGR) of 11.2% from 2025 to 2035, when global Optical Imaging Systems market forecast revenue is projected to reach USD 6.12 Billion in 2035, based on an average growth pattern. The global Optical Imaging Systems Market Size is estimated to reach a value of USD 2.95 Billion in 2025.
𝐂𝐥𝐚𝐢𝐦 𝐲𝐨𝐮𝐫 𝐬𝐚𝐦𝐩𝐥𝐞 𝐜𝐨𝐩𝐲 𝐨𝐟 𝐭𝐡𝐢𝐬 𝐫𝐞𝐩𝐨𝐫𝐭 𝐢𝐧𝐬𝐭𝐚𝐧𝐭𝐥𝐲:
https://wemarketresearch.com/reports/request-free-sample-pdf/optical-imaging-systems-market/1632
Market Growth Outlook Summary
The Optical Imaging Systems market growth is predicted to develop at a compound annual growth rate (CAGR) of 11.2% from 2025 to 2035,Factors influencing the market growth and adoption of optical imaging systems include greater need and adoption of non-invasive tools for rapid scanning and identification of disorders, increased prevalence of age-related macular degeneration, decreased patient exposure to eradicating radiations, increased GDP expenditure on healthcare among rapidly growing economies, and increased research to adopt these tools in the fields of dentistry, gastroenterology, and gynecology.
Optical imaging Market Dynamics
DRIVERS: Increasing prevalence of eye disorders due to the rising geriatric population
The global market is expanding due in large part to the increasing frequency of eye problems brought on by the growing elderly population worldwide. In the elderly, the tear layer becomes less stable and deteriorates more quickly, increasing the risk of eye problems. Hence, the likelihood of developing severe eye conditions rises sharply with age, especially after the age of sixty.
The pandemic had an adverse effect on the market for optical imaging devices as well. Reduced hospitalizations and shifts in healthcare priorities caused a decline in optical imaging system sales. Additionally, the market suffered from the full lockdowns that caused a delay in R&D efforts. But as the world gradually returns to normal and governments from various nations concentrate on research and development in the healthcare industry after the pandemic, the market is anticipated to rise significantly over the course of the forecast period.
Optical Imaging Market News
The new Azurion neuro biplane system, which Royal Philips revealed in February 2024, is a considerable improvement to the company's Image-Guided Therapy System Azurion. With improved 2D and 3D imaging and X-ray detector positioning flexibility, the new interventional system is intended to expedite neurovascular operations and assist care teams in making the best decisions more quickly, treating more patients, and improving outcomes.
Optical Imaging Market Segment Analysis
Market Segments
By Technology
Photoacoustic Tomography
Optical Coherence Tomography
Hyperspectral Imaging
Near-Infrared Spectroscopy
Diffuse Optical Tomography
Others
By Product
Imaging Systems
Optical
Spectral
Optical Imaging Software
Illumination Systems
Other
By Application
Pathological
Intraoperative
Others
By Therapeutic Area
Ophthalmology
Cardiology
Oncology
Dermatology
Neurology
By End-user
Hospitals
Diagnostic Centers
Others
Optical Imaging - Competitive Landscape
 Carl Zeiss Meditec AG
Leica Microsystems
Canon Inc.
PerkinElmer Inc.
Koninklijke Philips N.V.
Optovue, Inc.
St. Jude Medical
Topcon Corporation
Olympus Corporation
Prior Scientific
Thorlabs Inc.
Abbott Laboratories
Headwall Photonics Inc.
Others
Optical Imaging Systems Industry: Regional Analysis
North America Market Forecast: North America holds the largest share of the global Optical Imaging Systems market, accounting for approximately 45% of the market. This region dominates the optical imaging systems market, driven by advanced healthcare infrastructure, significant investment in medical technology, and a high prevalence of chronic diseases requiring diagnostic imaging
Europe Market Statistics: Europe holds a substantial share, driven by the increasing prevalence of chronic diseases and aging populations in countries like Germany, France, and the UK. Additionally, supportive government policies and funding for research in healthcare technology enhance the region's contribution to the market.
Key Benefits For Stakeholders
The study provides an in-depth analysis of the global optical imaging market along with the current trends and future estimations to explain the imminent investment pockets.
A comprehensive analysis of the factors that drive and restrict the market growth is provided in the report.
Comprehensive quantitative analysis of the industry from 2025 to 2035 is provided to enable the stakeholders to capitalize on the prevailing market opportunities.
Extensive analysis of the key segments of the industry helps to understand the application and services of optical imaging used across the globe.
Key market players and their strategies have been analyzed to understand the competitive outlook of the market.
Conclusion, 
The optical imaging systems market is on a Strong Growth trajectory, driven by technological advancements, increasing demand for high-quality imaging solutions, and expanding applications in healthcare, industrial sectors, research, and defense. The adoption of non-invasive diagnostic tools, coupled with innovations like hyperspectral and 3D imaging, is transforming various industries by improving accuracy and operational efficiency. 
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cerificatecoursegma · 3 months ago
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Fellowship in Internal Medicine after MBBS Online: A Comprehensive Guide
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Pursuing a fellowship in internal medicine after completing an MBBS (Bachelor of Medicine and Bachelor of Surgery) degree has become a popular pathway for medical graduates seeking specialization and advanced training. With advancements in technology and the rise of online education, the availability of online fellowship programs in internal medicine has made it more accessible for physicians worldwide. This article aims to provide a detailed overview of online fellowship programs in internal medicine, highlighting their significance, benefits, course structure, and how they serve as a stepping stone for a successful career in medicine.
1. Understanding Internal Medicine
Internal medicine is a medical specialty that focuses on the diagnosis, treatment, and prevention of diseases in adults. Internal medicine physicians, also known as internists, are experts in managing complex and chronic conditions such as diabetes, hypertension, cardiovascular diseases, respiratory disorders, and infectious diseases. They often serve as primary care physicians, coordinating comprehensive care and guiding patients through various healthcare settings.
Given the broad scope of internal medicine, it plays a pivotal role in modern healthcare. Internists are expected to have a deep understanding of various organ systems and their interplay, as well as the ability to provide holistic care to patients. Therefore, fellowship programs in internal medicine are essential for gaining the necessary expertise to thrive in this field.
2. Why Pursue a Fellowship in Internal Medicine After MBBS?
After completing an MBBS, physicians typically have a solid foundation in medical knowledge and clinical skills. However, internal medicine fellowships allow doctors to gain in-depth expertise and specialized knowledge. The main reasons why an MBBS graduate might consider pursuing an online fellowship in internal medicine include:
Specialization: Fellowships offer advanced training in internal medicine, providing a focus on various subspecialties such as cardiology, endocrinology, gastroenterology, or critical care. This enables physicians to treat complex cases with confidence and precision.
Career Advancement: A fellowship in internal medicine opens doors to better job opportunities, higher salaries, and leadership positions in healthcare organizations. Many hospitals and clinics prefer internists who have completed a fellowship for specialized roles.
Patient Care Excellence: Advanced training equips internists with the knowledge and skills to handle intricate medical cases and provide comprehensive care to patients with multiple co-existing conditions.
Global Opportunities: Online fellowships in internal medicine allow physicians to access training from prestigious institutions across the globe. This international exposure enhances their understanding of diverse healthcare systems and broadens their professional horizons.
3. Advantages of Online Fellowships in Internal Medicine
In recent years, online education has gained significant traction, particularly in the medical field. Online fellowships in internal medicine are designed to meet the needs of busy professionals who seek flexibility in their learning schedules. The advantages of pursuing an online fellowship include:
Flexibility and Convenience: Physicians can access coursework, attend virtual lectures, and complete assignments at their own pace, allowing them to balance their clinical practice with academic pursuits.
Cost-Effectiveness: Online fellowships often have lower tuition fees compared to traditional on-campus programs. Additionally, physicians save on travel, accommodation, and relocation expenses.
Access to Expert Faculty: Many online fellowship programs collaborate with renowned medical institutions and healthcare professionals, giving participants the opportunity to learn from experts in the field of internal medicine.
Global Networking: Online platforms facilitate interaction with fellow physicians, professors, and mentors from around the world. This helps in building a professional network that extends beyond geographical boundaries.
Continuing Medical Education (CME) Credits: Many online fellowship programs offer CME credits, which are essential for medical professionals to maintain their licenses and stay updated with the latest developments in medicine.
4. Structure of Online Fellowship Programs in Internal Medicine
The structure of online fellowship programs in internal medicine typically involves a combination of theoretical coursework, clinical case discussions, and hands-on virtual training. Though the specifics may vary depending on the institution offering the program, the general structure includes the following components:
Core Curriculum: The fellowship begins with a comprehensive core curriculum that covers advanced topics in internal medicine. This may include the pathophysiology, diagnosis, and treatment of common medical conditions, as well as an introduction to subspecialties like nephrology, rheumatology, and infectious diseases.
Case-Based Learning: Physicians engage in case-based learning, where they analyze and solve clinical cases in real-time or simulated environments. This helps sharpen their diagnostic skills and decision-making abilities.
Clinical Rotations (Virtual or In-Person): Some online fellowships may require participants to complete clinical rotations, either virtually or at affiliated hospitals. These rotations allow fellows to gain practical experience and apply their knowledge to real-world patient care.
Research and Publications: Many programs emphasize the importance of medical research and publication. Fellows are encouraged to undertake research projects and contribute to scientific journals or conferences.
Mentorship and Guidance: A strong mentorship component is often integrated into online fellowships, where experienced physicians guide fellows through their academic and clinical journey, providing personalized feedback and support.
5. Eligibility Criteria for Online Fellowships in Internal Medicine
The eligibility criteria for online fellowship programs in internal medicine may vary depending on the institution, but some common requirements include:
MBBS Degree: Candidates must hold a recognized MBBS degree or an equivalent qualification from an accredited medical institution.
Medical License: Many programs require candidates to have an active medical license in their country of practice.
Work Experience: Some fellowships may require prior clinical experience, typically ranging from one to three years of practice in internal medicine or a related field.
Language Proficiency: As many online programs are conducted in English, proficiency in the language is often a prerequisite. Some institutions may require applicants to provide language test scores such as IELTS or TOEFL.
6. Top Institutions Offering Online Fellowships in Internal Medicine
Several prestigious institutions and organizations offer online fellowships in internal medicine. Some well-regarded programs include:
GlobalMed Academy: GlobalMed Academy offers an online fellowship in internal medicine designed for physicians seeking advanced training in adult primary care and internal medicine subspecialties. Through its continuing medical education (CME) platform, Harvard provides online fellowships in various medical specialties, including internal medicine. These programs focus on evidence-based practice, clinical decision-making, and research.
MediCOLL Learning: MediCOLL Learning offers online fellowship programs that provide training in internal medicine, along with opportunities to gain CME credits. These programs are designed for physicians who wish to enhance their expertise in a particular area of internal medicine.
7. Challenges of Pursuing an Online Fellowship
Despite the numerous benefits, pursuing an online fellowship in internal medicine can come with challenges. Some of the common issues include:
Limited Hands-On Training: While virtual clinical rotations and case-based learning are valuable, they may not fully replace hands-on patient care experiences.
Time Management: Balancing clinical practice, personal commitments, and fellowship coursework can be challenging for physicians, particularly those working in demanding healthcare settings.
Technology Dependency: Online fellowships rely heavily on technology, and technical issues such as poor internet connectivity or platform malfunctions may disrupt the learning experience.
8. Conclusion
Pursuing an online fellowship in internal medicine after MBBS is a promising option for physicians who want to advance their careers, gain specialized knowledge, and provide the highest level of patient care. The flexibility, accessibility, and global reach of online programs make them an attractive choice for busy medical professionals seeking continuous education and training. However, careful consideration of the program’s curriculum, mentorship, and clinical training opportunities is essential to ensure that the fellowship meets individual career goals and professional aspirations.
In an ever-evolving healthcare landscape, obtaining a fellowship in internal medicine helps physicians stay at the forefront of medical knowledge, preparing them for leadership roles and enabling them to deliver superior patient care in their chosen fields.
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