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Magnetic Loop Basket – A two-in-one Instrument: (Endoscopy –2006;38(7):723-25).

Aluminium Phosphide Induced Esophageal Stricture: Unusual Complication: (Endoscopy –2006;38(2) E23).

Achalasia Cardia: A study of 113 Patients Managed with Indigenous Dilators : (Tropical Gastroenterology – 2006;27(1) 31-33).

Endoscopy Assisted Removal of Ferromagnetic Coins with Novel Magnetic Instrument - (Digestive Endoscopy – 2007).

Indigenized Short Striped Nitinol Wire for Esophageal Stricture Dilatation – (Indian Journal of Gastroenterology – 2006;(25(3):170-1).

Endoscopic Management of Sharp Metallic Foreign Bodies - (Endoscopy 2007; 39(1)E331.

Endoscopic Management of Pancreatic ductal disruption after bullet injury-Case Report (Journal of Pancreas-2009;10(3):318-20).

Non Variceal Upper Gastrointestinal Bleed-A Review -(Apollo Journal of Medicine-2008).

Eosinophilic Esophagitis-(IJCP-2008).

Post transplant biliary complications in a LDLT program-(Tropical Gastroenterology -2009).

Asymptomatic Hepatic Artery Thrombosis (HAT) - Post Liver transplantation can exist- (Tropical Gastroenterology -2009).

Endoscopic management of post transplant biliary complications- (Tropical Gastroenterology -2009).

Peritransplant management of chronic hepatitis C- (Tropical Gastroenterology 2010;31(2):75-81.

Book chapter: Spontaneous Bacterial Peritonitis: a Review - (Rajasthan Medical Journal – 2006).

Book chapter: Chronic Pancreatitis – Epidemiological and Clinical Spectrum in Jaipur - (a Chapter in Text-Book titled Chronic Pancreatitis and Pancreatic Diabetes in India, 2006)

Book chapter: Predicting outcome of Idiopathic Ulcerative colitis - Why and How.

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CLOSTRIDIUM DIFFICILE-Antibiotic Diarrhoea,Restrict Use Of ANTIBIOTICS Unnecssarily
CLOSTRIDIUM DIFFICILE often called C-difficile, or C- diff, is a type of bacteria that causes symptoms that can range from diarrhea to life threatening inflammation of the colon.Since the commonest cause of this diarrhea is long term use of antibiotics , it is also called antibiotic diarrhea. In recent years C-diff has become more frequent, more severe and difficult to treat. Your risk is greatest if you are taking or have recently taken antibiotics. The risk is higher if you take multiple antibiotics for a prolonged period. Seen more in older age group, recently hospitalized for an extended period. C-diff infections are seen more in nursing home or longterm care facilities. It is found more among patients with weakened immunity and those who have some underlying medical illnesses. Patients who have had some abdominal surgeries or have colon disease such as inflammatory bowel disease , colorectal cancer or previous C-diff infection are also at risk. The antibiotic that most often leads to C-diff infection include fluroquinolones, cephalosporins, clindamycin and penicillins. These drugs can destroy some of the normal, helpful bacterias in your colon. Once established it produces toxins that attacks the lining of the intestine. The toxin destroys cells and produces plaques of inflammatory cells and decaying cell debris inside the colon. Some new strains of C-diff has emerged that are resistant to certain medications and are deadly. Stool tests like enzyme immune assay and tissue cultures are used to detect this infection.Flexible sigmoidoscopy is sometimes used to confirm the diagnosis. CT scan may be ordered if there is a concern about possible complications like pseudomembranous colitis. Bowel perforation and toxic megacolon are also some of the complication of C-diff.Severe diarrhea may cause dehydration and in some cases kidney function may deteriorate. If not treated promptly this can be fatal.Most common symptoms are, watery diarrhea 10-15 times a day, abdominal cramping, fever, pus or blood in the stool, nausea, dehydration, loss of appetite and weight loss. The first step in treating C-diff is to stop taking the antibiotic that triggered the infection. In an ironic twist, the standard treatment for C-diff is another antibiotic. Usually metronidazole , for mild to moderate and vancomycin, for severe symptoms are the drug of choice. Probiotics are given in conjunction with the antibiotics to restore intestinal flora.For people with severe pain, organ failure or inflammation of the colon , surgery to remove the diseased portion of the colon may be the only option. Would you like to share this with your colleagues? Email Be the first one to share this post

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पाचन रहेगा ठीक, यदि माने आयुर्वेद की सीख l
पाचन रहेगा ठीक,
यदि माने आयुर्वेद की सीख l
आज की भागदौड भरी जिन्दगी,अनियमित दिनचर्या एवं खान पान की गलत आदतों के कारण अधिकतर व्यक्ति पेट के रोगों से ग्रस्त हैं, पाचन संस्थान का हमारे पूरे शरीर की सेहत पर प्रभाव पड़ता है खानपान की आदतों में यदि निम्न सुधार कर लिया जाये तो पेट के रोगों के होने की सम्भावना काफी कम हो जाती है-
* रेशे युक्त आहार लें- रेशा युक्त आहार कब्ज,अपचन ,बवासीर,कोलेस्ट्रोल,मोटापा आदि रोगों से बचाता है ,रेशा चोकर युक्त आटा ,सलाद,हरी सब्जियां,फल,चावल,दाल आदि में पाया जाता है l
* संतुलित भोजन करें -भोजन में ,दही ,छाछ ,अंकुरित अन्न ,दूध,दलिया ,खिचड़ी आदि का नियमित सेवन करना चाहिए, छाछ को अमृत तुल्य कहा गया है,मांसाहार ,पूडी ,परांठे ,मिठाई,मिर्च मसाले ,जंक फ़ूड,मैदा आदि का ज्यादा सेवन नहीं करना चाहिए l
* प्रात:काल पानी पीयें - सुबह उठने के बाद चाय के बजाय 2-3 गिलास पानी पीना चाहिए,बैड टी से पेट में एसिड बनता है l
* खाना अच्छी तरह चबा चबा कर खाएं-अच्छी तरह चबा चबा कर खाने से भोजन में लार रस अच्छी तरह मिल जाता है ,जिससे भोजन का पाचन अच्छी तरह से होता है ,जल्दी जल्दी भोजन निगलने से अपचन,गैस,कब्ज,एसिडिटी आदि रोगों की उत्पत्ति होती है l
* शाम को भोजन के बाद घूमें -शाम को खाना सोने से 2-3 घंटे पहले एवं हल्का होना चाहिए ,भोजन के बाद 15-20 मिनट अवश्य घूमें ,इससे बहुत से रोगों से बचाव तो होता ही है साथ ही नींद भी अच्छी आती है,भोजन हमेशा निश्चित समय पर खाने की कोशिश करनी चाहिए l
* नशा न करें -धूम्रपान , तम्बाकू एवं अत्यधिक शराब का सेवन पेट के रोगों के साथ साथ शरीर के अन्य रोगों का भी कारण होता है l
* व्यायाम एवं योगा करें-नियमित रूप से व्यायाम,योगा करने एवं पैदल घूमने से बहुत से रोगों से बचाव होता है ,पाचन शक्ति अच्छी रहती है तथा मानसिक तनाव काफी कम हो जाता है l

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Waited too long
I got a call from emergency that a 32 year old female had come with severe pain in abdomen & vomiting. She had pain since five days and no she was also running fever. I went to examine her. She looked familiar. She had my old case papers. She meet me couple of years back. She had Gallstones but refused to get operated because she said it was hardly causing any symptoms.
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Emergency Laproscopic Hernia Surgery
Fifty five years old female patient came to me with swelling in Umbilical region since two Years. She had no pain initially hence she Ignored it. As swelling increase, she started getting mild pain and one day she landed up in emergency with severe pain & vomiting. She described that her pain was like delivery pain – wave pattern of severe pain due to intestines trapped in the hernia.
Two option of emergency surgery – open or Laproscopic (key hole) surgery were given to patient. She choose to undergo Laproscopic Surgery as that is relatively painless during post operative period and also the scar is cosmetic.


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Passing blood in stools
Mr. B______, a 50 year old patient from Saudi Arabia came to me with bleeding while passing stools (also read this interesting case ) since childhood. He was often treated for piles in his country but there was no relief. Ultimately being frustrated with his disease, he came to India. He was skinny and pale. I examined his anal canal but did not see any plies. There appeared some mass in rectum. I posted him for colonoscopy. Almost whole of his colon from rectum to cecum was involved with multiple small grape like growths called polyps. I biopsied few of them and they came benign. The diagnosis of Multiple colonic polyposis was established.
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Inflammatory bowel disease
Inflammatory bowel disease (IBD) is not a single disease. The term IBD is used mainly to describe two diseases:

Crohn’s disease
ulcerative colitis

Both Crohn’s disease and ulcerative colitis are chronic (long-term) diseases that involve inflammation of the gastrointestinal tract (gut). However, there are important differences between the two.

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Ulcerative colitis
Ulcerative colitis is a long-term (chronic) condition affecting the colon.

Symptoms include:
Bloody diarrhoea
Abdominal pain
A frequent need to go to the toilet
Weight loss

These can range from mild to severe, with the condition being unpredictable. Symptoms can flare up and then disappear (known as remission) for months or even years.

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Belly button pain
Often female patients come with belly button pain or pain around belly button. There are many causes. Commonest cause is muscle stretching. In India its generally common in females because of multiple pregnancies, obesity, poor muscle tone & lifting heavy weight. The navel gets so stretched that it starts to tear and the contents which are suppose to be inside start protruding out. The belly button everts & protrudes out This is called herniation. Often due to obesity this protrusion is not recognized and the patients continues to experience pain and not realize the swelling in the belly button.
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Hernia Repair, Incisional
An incisional hernia happens when a weakness in the muscle of the abdomen allows the tissues of the abdomen to protrude through the muscle. The hernia appears as a bulge under the skin, and can be painful or tender to the touch. In the case of an incisional hernia, the weakness in the muscle is caused by the incision made in a prior abdominal surgery. An incisional hernia is typically small enough that only the peritoneum, or the lining of the abdominal cavity, pushes through. In severe cases, portions of organs may move through the hole in the muscle.

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