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Management of Acute Upper GI Bleed
With a mortality rate of 2-10%, upper gastrointestinal bleeding (UIB) is a frequent medical emergency. Patients who have been determined to have a very low risk of dying or needing an intervention can be treated as outpatients. Red cell transfusion at a hemoglobin level of 70–80 g/L and intravenous fluids as needed for resuscitation are advised for all other patients. Proton pump inhibitors (PPIs) and the prokinetic drug erythromycin may be delivered when resuscitation is started, with antibiotics and vasoactive medications advised in patients with cirrhosis. Endoscopy should be performed within 24 hours, with early endoscopy being explored in high-risk patients, such as those with hemodynamic instability, following resuscitation.
About the Speaker
Dr. PRITHVI PRIYADARSHINI SHIVALINGAIAH
MBBS,MD,DNB DM, Gastroenterology in CMC Hospital Dubai
Upcoming Case Discussions
Alpha Lipoic Acid in Oxidative Stress
Alpha-lipoic acid (ALA) is a potent antioxidant that helps combat oxidative stress by neutralizing free radicals. It regenerates other antioxidants like vitamin C and E, enhancing overall antioxidant defense. ALA plays a crucial role in reducing cellular damage caused by conditions like diabetes, neuropathy, and aging. Its ability to function in both water- and fat-soluble environments makes it versatile in protecting various tissues. Regular supplementation of ALA may improve mitochondrial function and reduce inflammation associated with oxidative stress.
Alternative Route to Chronic Pain Management
Same, Same but Different" patterns in pain refer to situations where patients report similar symptoms or sensations but have distinct underlying causes or mechanisms. This concept emphasizes the importance of thorough clinical evaluation, as seemingly identical pain experiences may require different diagnostic approaches and treatments.
Advances in Diagnosing and Treating Neural Tube Defects
Significant advances in diagnosing and treating neural tube defects (NTDs) have improved outcomes for affected individuals. Early diagnosis is enhanced by advanced prenatal imaging, such as high-resolution ultrasound and fetal MRI, and biomarkers like elevated maternal serum alpha-fetoprotein (MSAFP). Innovations in fetal surgery, such as in-utero repair of spina bifida, have demonstrated improved neurological outcomes by minimizing damage before birth. Postnatal care has also improved with better surgical techniques, physical therapy, and assistive technologies. Preventive strategies, including mandatory folic acid supplementation, have significantly reduced NTD incidence globally, highlighting the importance of early intervention and multidisciplinary care in managing NTDs.
Digital Interventions in Prevention and Control of Diabetes
Digital tools like mobile apps, wearable devices, and telemedicine are transforming diabetes management by enabling real-time monitoring of blood glucose levels and personalized feedback. AI-powered platforms offer predictive analytics to assess risks and optimize treatment plans. Online education programs promote lifestyle modifications, including healthy eating and exercise. Virtual coaching and remote consultations improve accessibility to healthcare for underserved populations. These interventions empower patients to take proactive control of their condition, reducing complications and enhancing quality of life.
Case Based Discussion on Bronchiolitis
Bronchiolitis is a common respiratory infection in infants and young children, primarily caused by the respiratory syncytial virus (RSV). It presents with nasal congestion, cough, wheezing, and difficulty breathing, often following an upper respiratory infection. Management is largely supportive, focusing on hydration, oxygen therapy, and suctioning nasal secretions. Routine use of bronchodilators, steroids, or antibiotics is not recommended. Severe cases may require hospitalization for respiratory support, such as high-flow nasal cannula or mechanical ventilation. Preventive measures include proper hand hygiene and, in high-risk infants, palivizumab prophylaxis. Prompt recognition and appropriate care are key to reducing complications and improving outcomes.