scholarly journals Epigastric discomfort in a 91-year-old woman

2020 ◽  
pp. flgastro-2020-101578
Author(s):  
Shigetsugu Takano ◽  
Akihiro Suzuki ◽  
Yoshio Masuya ◽  
Hiroshi Suzuki ◽  
Masayuki Ohtsuka
1968 ◽  
Vol 114 (512) ◽  
pp. 859-861 ◽  
Author(s):  
Julius Merry ◽  
Arnold Whitehead

Metronidazole (Flagyl) is an established and effective treatment of urogenital trichomoniasis. J. A. T. Taylor (1964) was using metronidazole to treat a husband and wife for this condition, when she observed the following. The husband, who was a chronic alcoholic, seemed to lose his craving for alcoholic drinks. Sometimes he experienced flushing of the face and shoulders and epigastric discomfort when he took metronidazole soon after alcohol, i.e. he experienced a disulfiram type reaction. The wife reported that alcohol drinks tasted unpleasant to her during therapy. Taylor then studied 53 alcoholic patients and concluded that metronidazole (i) decreased tolerance for alcohol, (ii) diminished craving for alcohol and (iii) produced an uncomfortable reaction to alcohol.


2011 ◽  
Vol 18 (01) ◽  
pp. 83-88
Author(s):  
GHAZANFAR ALI SANDHU ◽  
MOHAMMAD MOHSIN RANA ◽  
M. BADAR BASHIR ◽  
Saeed Akthar ◽  
Abedur Rehman

Hypoglycemic symptoms are a very common experience for diabetics ranging from an innocent increased appetite to dreadful unconsciousness. This study was designed to assess the patient’s awareness about the symptoms, experience of individual symptoms and their ability to recognize and to respond accordingly. Materials and Methods: All diabetic patients were assessed for the awareness of different symptoms of hypoglycemia, their experience of individual symptoms in last six months and ability of the patient and family members to recognize and to respond accordingly to these symptoms on a prescribed proforma with the help of trained staff. Results: We had 1260 new cases of DM during the study period with valid diagnosis and taking either sulphonylurea or Insulin who were enrolled in the study. 280 patients had no idea of the symptoms. 564 patients knew no more than three symptoms. Palpitation and sweating were the most commonly known 80% and experienced 65% symptoms. Hunger and epigastric discomfort were the next best known 73% and experienced 58% symptoms. Loss of consciousness was the next in the list in terms of knowledge 52% and experience 23%. Coldness of body 28%, severe weakness 24%, blurred vision 12%, abnormal behavior 12% and altered consciousness 6% were the next in the list of experience. Early morning headache, night terror and frequent awakening were the least known 3% and recognized1% symptoms. Abnormal behavior and altered consciousness were not known to any patient as a symptom. Of those who knew or experienced the symptoms, eating anything available was the most common response, only 35% responded by eating rapidly available food items like sugar, honey, candies, beverages, fruit juice or jams. 3% of patients even resorted to taking diet colas initially and only later took other food after waiting for some time. In the event of patient getting unconscious, 80% of the times attendants did not consider hypoglycemia initially at home at first such experience. Discussion: Patient must be properly educated about these symptoms before prescribing these agents and shall be repeatedly evaluated at each visit. Failing to recognize early and mild symptoms may lead to a terrifying experience.


Author(s):  
Fatima Aslam ◽  
Karimah Hanim Abd Aziz ◽  
Nurjasmine Aida Jamani ◽  
Razman Mohd Rus

Introduction: Co-morbidities such as obesity, gestational diabetes and pregnancy induced hypertension during pregnancy can be dangerous to the mother and foetus. Regular physical activity during pregnancy not only maintains maternal and foetal wellbeing, but it also maintains physical fitness and brings various health benefits. However, many women reduce their physical activity levels during pregnancy.Objectives: Thus, this study aimed to identify the barriers that could prevent pregnant mothers from doing physical activities.Methods: This is a cross-sectional study involving 168 pregnant women aged 18 to 35 years between gestational age 12 to 35 weeks in a primary health clinic in Kuantan, Pahang. Their socio-demographic characteristics were recorded, and barriers for physical activity assessed through a set of pre-tested questionnaire.Descriptive statisticswere used to describe the sociodemographiccharacteristics and the barriers.Results: The mean (SD) age was 28.0 (3.6) and majority of them were of Malay ethnicity from B40 group. Two thirds (74.4%) had tertiary education and 66.7% were working mothers. More than half (53.0%) of the participants wereoverweight and obese.Moreover, 58% of the participants had leg cramp and 63.1% felt fatigue. Almost 80.4% had backache and 46.4% had epigastric discomfort.Conclusion: Barriers such as leg cramp, backache, fatigue and epigastric discomfort could prevent pregnant women from conducting physical activities. Opportunistic recommendation by physician and concerns on the physical activity should be addressed.International Journal of Human and Health Sciences Supplementary Issue: 2021 Page: S23


2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Kazuhiko Omori ◽  
Youichi Yanagawa

The patient was a 64-year-old woman with systemic lupus erythematosus, thrombophlebitis of the lower legs, cerebral infarction with left hemiparesis, and colostomy after perforation of the sigmoid colon. On the morning of her presentation, the patient felt epigastric abnormality. Thereafter, hematemesis occurred twice, leading her to call an ambulance in the afternoon. Upon arrival, electrocardiography before securing a venous route and obtaining blood samples revealed ST segment elevation in leads II, III, and aVF. As her vital signs were stable and her hemoglobin level had decreased by just 1.1 g/dl in comparison to the previous day, emergency coronary angiography (CAG) was performed. CAG revealed complete occlusion at section #4. She underwent right coronary angioplasty with stent placement. The patient’s course after angioplasty was uneventful. On the 15th hospital day, esophagogastroduodenoscopy revealed esophageal erosion and superficial gastritis. She was discharged on foot the following day. When physicians treat patients with hematemesis, electrocardiography and the measurement of troponin are essential before esophagogastroduodenoscopy.


2020 ◽  
Vol 06 (02) ◽  
pp. e125-e127
Author(s):  
Shadi Nassar ◽  
Alaa El-Kheir ◽  
Charif Khaled ◽  
Anis Nassar ◽  
Joseph Boujaoude ◽  
...  

AbstractDespite its first identification in 1885, intraluminal duodenal diverticulum remains a rare entity and only a few case reports are found in the literature. Its diagnosis is almost always delayed due to the lack of specific symptoms and to the very vague presentation consisting of mild epigastric discomfort. However, with the aid of new diagnostic modalities and imaging, it has become easier to diagnose this entity when its symptoms persist. Finally, it can remain undiagnosed in asymptomatic patients.


2020 ◽  
Vol 76 ◽  
pp. 49-51
Author(s):  
Jad J. Terro ◽  
Etienne El-Helou ◽  
Alaa Kansoun ◽  
Alaa Taha ◽  
Jocelyne Karaki ◽  
...  

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Y. Tjendra ◽  
K. Lyapichev ◽  
J. Henderson ◽  
C. P. Rojas

Duplication cyst of the stomach is a rare congenital malformation, typically diagnosed in the first year of life. In most adult cases the cyst remains asymptomatic, but patients may present with abdominal symptoms including epigastric discomfort or pain. We present a case of a 65-year-old male with an asymptomatic gastric tumor diagnosed incidentally during initial workup of his esophageal adenocarcinoma. Computed tomography revealed a low density soft tissue tumor near the gastroesophageal junction. Endoscopic ultrasonography demonstrated a cystic lesion as a hypoechoic round mass with well-defined borders. Following complete laparoscopic resection, microscopic review revealed a cyst lined with respiratory pseudostratified ciliated columnar epithelium and layers of smooth muscle with an outermost thin fibrous capsule consistent with a foregut duplication cyst.


Blood ◽  
2000 ◽  
Vol 96 (10) ◽  
pp. 3357-3363 ◽  
Author(s):  
Susanne Reich ◽  
Christoph Bührer ◽  
Günter Henze ◽  
Dieter Ohlendorf ◽  
Michael Mesche ◽  
...  

The butyrate derivative isobutyramide (IBT) increases fetal hemoglobin (HbF) in patients with β-hemoglobinopathies, but little is known about its usefulness for prolonged therapeutic use. We treated 8 patients with transfusion-dependent β-thalassemia with 350 mg/kg of body weight per day of oral IBT for 126 to 384 days. During the trial period, the hemoglobin level was maintained between 85 g/L (range 82-87 g/L) (pretransfusion) and 115 g/L (range 110-119 g/L) (post-transfusion) (median, interquartile range), corresponding to 4-week transfusion intervals in all patients during the pretreatment phase. Adverse effects (bitter taste, epigastric discomfort) did not cause discontinuation of IBT. HbF increased in all patients from 3.1% (range 1.9%-4.8%) to 6.0% (range 3.3%-8.7) (P = .0017), while free Hb dropped from 0.48 g/L (range 0.39-0.81 g/L) to 0.19 g/L (range 0.16-0.24 g/L) (P < .0001). Transfusion intervals were consistently extended to 8 or 9 weeks in 1 patient, resulting in a decrease of daily iron load from 455 μg/kg per day (range 451-459 μg/kg per day) before therapy to 211μg/kg per day (range 203-286 μg/kg per day) during the 12-month treatment period. Prolongation of transfusion intervals achieved by IBT was less consistent in another patient, whose parenteral iron load nevertheless decreased from 683 μg/kg per day (range 618-748 μg/kg per day) to 542 μg/kg per day (340-596 μg/kg per day). In the other 6 patients, no prolongation of transfusion intervals was achieved. Response to treatment was associated with high pretreatment HbF (> 4.5%), high parental HbF, and increased erythropoietin levels (> 150 IU/L). We conclude that IBT prolongs transfusion intervals and reduces parenteral iron burden in some patients with transfusion-dependent β-thalassemia.


2015 ◽  
Vol 100 (9-10) ◽  
pp. 1326-1331
Author(s):  
Shingo Kanaji ◽  
Satoshi Suzuki ◽  
Tetsu Nakamura ◽  
Ayako Tomono ◽  
Naoki Urakawa ◽  
...  

Laparoscopic partial resection of gastric gastrointestinal stromal tumors (GISTs) ≤5 cm in size is widely performed, whereas that of large GISTs (size &gt;5 cm) is controversial because of oncologic and technical safety. Furthermore, laparoscopic resection of GISTs located at the esophagogastric junction (EGJ) is difficult because of the high risk of narrowing or/and deformity of the EGJ. In the current study we report a case of laparoscopic partial resection of a large GIST located at the EGJ. A 74-year-old female patient visited our institution complaining of epigastric discomfort. An esophagogastroduodenoscopy and an abdominal computed tomography scan revealed a 7.5 × 4.0 cm GIST at the EGJ and upper stomach. The patient underwent laparoscopic partial resection with intracorporeal suturing, without any breakage of the pseudocapsule. The defect of the esophagogastric wall after resection was closed by intracorporeal running suture. The patient's postoperative course was uneventful. To the best of our knowledge, this is the first report of laparoscopic resection of a large GIST located at the EGJ. Our technique of intracorporeal manual suturing following laparoscopic gastric resection can be a valid option for minimally invasive surgery for a large GIST located at the EGJ.


Gastrointestinal Stromal Tumors account for 1% - 2% of all gastrointestinal (GI) tract tumors. Among GISTs, duodenal localization occurs in less than 5% and usually presents with upper GI bleeding. A 45-year-old man presented in the outpatient department with complaints of epigastric discomfort, intermittent melena and undocumented weight loss for the preceding 3 months. Initial upper GI endoscopy showed mild duodenitis and no other upper GI pathology. For unexplained symptoms, a CT Scan was performed which demonstrated a well-defined solid lesion along the second part of the duodenum. An endoscopic ultrasound (EUS)-guided biopsy of a subepithelial lesion at D2 was performed. Immunohistochemistry findings were suggestive of GIST. Wedge resection of the duodenal mass was done. Duodenal GIST should be considered as a differential in cases of GI bleeding when other differentials have been ruled out. Limited resection of duodenal GIST should be considered over pancreaticoduodenectomy, in case of small size tumors.


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