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.

Read More: http://drbcshah.com/ulcerative-colitis/

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.

- See more at: http://drbcshah.com/hernia-repair-incisional/

मूळव्याध
डॉ.साधनादेव,जनरलसर्जन,शुभमक्लिनिक,टायटनशॊरुमवर,सिन्हगडरोड,वेळ-सन्ध्या.७ते९ [९८९०७५८०२६] with appointment कन्सल्टन्ट- SANJEEVAN HOSPITAL,KARVE ROAD
SAHYADRI MAIN, KARVE ROAD
GALAXY CARE HOSPITAL
DEENDAYAL HOSPITAL
स्त्री व पुरुषांच्या सर्व प्रकारच्या शस्त्रक्रिया कमी खर्चात करण्य़ासाठी दिवसा व सन्ध्या.सम्पर्क ९८९०७५८०२६
टॉयलेट मधील अवान्छीत रक्तदान थांबवा !!!!!!
मूळव्याध म्हणजे शौचमार्गाकडील रक्तवाहिन्या फ़ुगून बाहेर येणॆ व रक्तस्त्राव होणॆ
कारणॆ-मलावरोध,बध्द्कोष्ठता,सन्डासला जोर करणॆ,कुन्थणॆ,तन्तुमय जेवण न घेणॆ,व्यायामाचा अभाव, पाणी कमी पिणॆ, धुम्रपान,जाडीवाढणे ,मद्यपान,मांसाहार,जड वजन उचलणॆ इत्यादी.तसेच गर्भवती स्त्रिया व प्रसुती नंतर हा त्रास वाढतो.
लक्षणॆ- कोम्ब बाहेर येणॆ,शौचास कडक होणॆ,शौचासदूखणॆ,पोटदूखणॆ,रक्तस्त्रावहोणॆ,खाजणॆ,जडपणा वाटणे,एनिमिया,अशक्तपणा येणे
ह्यामधील कोणत्याही लक्षणास दुर्लक्षू नये व माझा सल्ला घ्यावा.कारण मूळव्याध व कर्करोग एकाचवेळी असु शकतात.
निदान-सर्जनकडील योग्य तपासणी,प्रोक्टॊस्कोपी व सोनोग्राफी करणॆ,तपासताना भूलेची गरज नसते.
उपाय- शस्त्रक्रिया हाच एकमेव उपाय "एक टाका पुढचे नऊ टाकॆ वाचवतो".
वेळेत शस्त्रक्रिया हेच एकमेव उत्तर आहे.
होमिओपॅथि अथवा आयुर्वेदाने पुर्ण बरा न होणारा आजार आहे.
आहारातबदल,सॅलड,कोन्डा,तन्तुमयजेवणघेणॆ,पाणी
भरपूर पिणॆ,मेडीकल/औषधे,क्रिम्स,लॅक्जेटीव्ज घेणॆ
बॅन्डीन्ग,कोयाग्युलेशन,हेहि ओप्शन आहेत.
मूळव्याधिचे कोम्ब हा फ़िशरचा प्रकार असुन त्याचि शस्त्रक्रिया करावि कारण ते दुखतात,पु होतो ,फ़िस्तुला होतो.कोम्ब व पाइल्स बरे करनारि औषधे अस्तित्वत नाहीत.
पारम्पारीक मूळव्याध शस्त्रक्रिया हि गोल्ड स्टॅन्डर्ड शस्त्रक्रिया मानली जाते,कमी खर्चात होते, व आत्यधुनिक औषधे असल्यामुळॆ वेदनारहित होते,टॊईलेटवरिल ताबा कधीच जात नाही,पण बरे हॊण्य़ास २ दिवस लागतात. आता हार्मोनिक /कॉटरी वापरून लवकर बरी होते.हा आजार शस्त्रक्रिया करुन घेतल्यास पूर्ण बरा होतो कारण औषधे फ़क्त तात्पुरता आराम देतात.
स्टॆपलर वापरुन केलेली- २१व्या शतकातील नवी शस्त्रक्रिया,२ दिवसात घरी जाता येते, कमी दुखते,पुन्हा होत नाही,रक्तस्त्राव होत नाही, पण महाग आहे.
मेडिकल/औषधे घेउन आजार वाढवण्य़ापेक्षा सर्जन कडून तपासणॆ व पूर्ण बरे होणॆ महत्वाचे.
स्वउपचार व मेडीकल मधून स्वतःची स्वतः औषधे घेणे टाळा.
स्त्रीपेशंटची स्त्रीसर्जन कडून तपासणी केली जाते त्यामुळे त्यांना न संकोचता दाखवता येते.
तसेच स्त्री व पुरुषांच्या कमी खर्चात शस्त्रक्रिया होतात त्यामुळे पेशंटचा फायदा होतो.
मूळव्याध न होण्यासाठी काय कराल?
वजन कमी करणे,पाणी भरपूर पिणॆ, तन्तुमय जेवण घेणॆ,मलावरोध व बध्द्कोष्ठता टाळणॆ,ब्येथे काम तालने
व्यायाम करणे, न कुन्थणॆ, सर्जनचा सल्ला घेणे सर्वात महत्वाचे.
मोफत तपासणी शिबिर- ६ ते ९ औगस्त २०१३ वेळ- ७ ते ८.३० with appointment

A 75 year old female came to me in emergency with complaints of constipation, inability to pass faltus (obstipation), severe pain abdomen, persistent vomiting, extreme weakness & stomach fullness since 5 days.

Prior to this, she had chronic constipation often alternating with loose stools since six months. She was taking laxatives from various doctors but it was helping her some times.

She had low haemoglobin (anemia) & was taking treatment from General practitioner.

On examination she was looking toxic and her abdomen was distended. She per rectal examination showed that there was no stools.

X-ray of abdomen showed that the large intestine was totally blocked. CT Scan revealed a possiblity of a tumour in har large intestine.

Her haemoglobin was 6 grams ( half of normal).
She required urgent surgery to relieve blockage in her intestine.
She was a high risk for surgery in view of old age , low haemoglobin, weak heart & major surgery.

She was taken for surgery & part of her large intestine was removed. After surgery, she was in ICU. In few days she was discharged. - http://drbcshah.com/a-case-of-anemia-with-cancer-colon/

HEPATITIS C TREATMENT ALONE AND WITH HEPATITIS B OR WITH HIV INFECTION;

DR.D.R.NAKIPURIA ,SENIOR GASTRO INTEST SPECIALIST & HIV/AIDS CONSULTANT
drnakipuria@gmail.com, 09434143550,09832025033
FOLLOW ON FACE BOOK:www.facebook.com/drnakipuria
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Treatment for hepatitis C virus (HCV) infection is indicated even in acute stage as result is ver good and resonse comes early and SVR IS ACHIEVED,ALTHOUGH 15-20 % of ACUTE HCV themselves clear witout treatment but 80% become chronic mostly spead by blood contamination or needle stick injury (1-10%) very less by sexual exposure,mother to child only 4%,huggung kissing ,eating together almost never transmit it,direct with blood in veins,or breached skin or even contact mith mucosa spreads it but chance by sweat,saliva,tear is less but blood,peritoeneal, ascitic,csf, vaginal,semen,urine,stool is infective.treatment for HCV has advanced dramatically in the past few years as direct-acting antiviral agents, or DAAs or drugs kike SOBOSFUVIR,SIMEPREVIR,SOVAPREVIR,DAROPREVIR,GS5885,DACLATASVIR, have improved cure rates and shortened treatment duration WITH ADDED TELAPREVIR AND BOCEPREVIR with standarad Peglyated Interferon and Ribavarin.

Mostly patient know about infection in late stage or chrnic stage when patient notice fatigue,weakness,malaise,nausea,vomiting,fever,or jaundice where we get either by ELSA ENNZYME BASED ANTIBODIES AAGINST HCV IS FOUND which is 95% correct but comes after 6 months some time so acute case is diagnosed late and reconfirmed by Blot Testing of HCV ANTIBODIES ALSO CALLED RIBA,once HCV RNA BY PCR IS DETECTED THEN CONFIRM DIAGNOSIS MADE .The main measure of hepatitis C treatment success is virologic response, or reduction of HCV RNA. Viral load is typically measured after four weeks on treatment (rapid virologic response, or RVR), after 12 weeks (early virologic response, or EVR), at the end of treatment, and after finishing treatment.Beside raised Liver enzymes,altered level of Blodd clottings due to liver disease or features of cirrhosis and ascites with oesophageal varices usually comes late and even jaundice some times comes very late till then cirrhotic changes in LIVER confirmed by Biopsy or mostly by FIBOSCAN or ELSATOGRAPHY is done now a days,biopsy also excludes malignancy and associted advancing inflammation as seen diminished after good therapy responding to treatment .

Sustained virologic response (SVR), or continued undetectable HCV viral load 24 weeks after completing treatment, is traditionally considered a cure. The FDA recently said SVR at 12 weeks post-treatment can also be considered a cure. Sustained response can halt liver disease progression and lowers the risk of developing cirrhosis and liver cancer.Usually 6 genotypes of HCV is known where no 1 is further divided in a,b,c,etc,Type 1 and 4 are late responder and 2,3 good responder,again genetic analysis of "cc is better responding than""tt" or "ct" type.

Not everyone with hepatitis C needs treatment, but it is recommended for people with at least moderate liver damage, usually determined by a liver biopsy. Treatment during acute infection (the first six months after infection) has a very high success rate, but most people do not realize they are infected this soon. Overall, about 25% of people clear HCV spontaneously without treatment, but the proportion is lower among people with HIV.

The previous standard of care for chronic hepatitis C was pegylated interferon alfa-2a (Pegasys) or alfa-2B (PegIntron) injected once weekly plus a weight-adjusted oral dose of ribavirin. Treatment duration is 48 weeks for people with difficult-to-treat HCV genotypes 1 or 4 and 24 weeks for those with genotypes 2 or 3. The overall SVR rate for HCV mono-infected people is about 75% for genotypes 2 or 3, but less than 50% for genotype 1. For the most difficult-to-treat groups of patients, response rates can be as low as 5%.

Several factors influence how well interferon-based therapy works. In addition to HCV genotype, high pre-treatment HCV viral load, advanced liver fibrosis or cirrhosis, insulin resistance, and HIV co-infection are associated with poorer response. People trying treatment again after previous non-response do not do as well as those being treated for the first time. People of African descent generally do not respond as well as white patients.

In 2009, researchers discovered that the latter two factors are largely attributable to variations in the IL28B gene. People with the favorable "CC" gene pattern respond best to interferon, people with the "TT" pattern have the lowest response rates, and people with the "CT" pattern are in between.

Pegylated interferon causes notorious side effects, including flu-like symptoms (fever, chills, fatigue, muscle aches), depression, and low white blood cell count. Ribavirin can cause anemia due to red blood cell destruction. These side effects may be severe enough that people avoid going on treatment, stop treatment prematurely, or lower their drug doses.

"Overall, about 25% of people clear HCV spontaneously without treatment, but the proportion is lower among people with HIV."
In 2011, the FDA approved the first two DAAs for genotype 1 chronic hepatitis C, the protease inhibitors Incivek (telaprevir, developed by Vertex) and Victrelis (boceprevir, developed by Merck). In pivotal clinical trials, adding one of these drugs to pegylated interferon/ribavirin raised overall treatment response rates significantly, both for HIV-negative and HIV-positive patients.

Both drugs are taken three times daily with pegylated interferon/ribavirin (Incivek for 12 weeks, Victrelis for 28 or 36 weeks), followed by continued treatment with pegylated interferon/ribavirin alone. Treatment-naïve people with good early viral suppression can stop treatment sooner (at 24 or 28 weeks), while others continue treatment through week 48.

In Phase 3 clinical trials of HIV-negative people, Incivek SVR rates were 79% for previously untreated people, 86% for prior relapsers, and 32% for prior null responders (those who previously had little or no decrease in HCV viral load). Victrelis SVR rates were 90% for previously untreated people and 66% for prior relapsers and partial non-responders (null responders were excluded).

So-called difficult-to-treat patient groups do not respond as well to hepatitis C therapy but may have a more urgent need for treatment. People with liver cirrhosis can be successfully treated with triple therapy including Incivek or Victrelis, but they have a higher frequency of side effects; studies of liver transplant recipients are underway. HIV/HCV co-infected people using Incivek or Victrelis can achieve response rates close to those of HCV mono-infected people with similar side effects. However, due to drug-drug interactions, these DAAs should not be combined with certain antiretrovirals.

Not surprisingly, adding another drug to the mix can increase adverse events. The most notable side effect of Incivek is skin rash, while Victrelis can cause anemia.
Most cirrhotic liver goes for LIVER TRANSPLANT but usually relapse of HCV occurs after 03-05 yrs but chances of tumor is less so it is practised very much.
Ptient with HBV ARE TREATED WITH HEPATITIS B DRUGS USUSALLY RIBAVARIN IS ADDED AS IT HELPS BOTH OR TENOFOVIR ,EMTRICITABINE AND LAMUVIDINE IS ALSO TRIED,PEGLYATED INTERFERON 21 OR 2B IS ALSO USEFUL,both are treated at a time.
With HIV if cd4 count less than 200 then first HIV is treated and after improvemnet treatment for HCV taken but in presence of HBV or HCV HIV TREATMENT is started soon irrespective of CD4 count ,same way along with HIV,HCV TREATMENT STARTED DASS DRUGS ARE ADDED WITH INTERFERON AND RIBAVARIN WITH HIV MEDICINES SOME DRUGS LIKE PROTESE INHIBITORS AND NUCLOSIDE OR NUCLEOTIDE ANALOGUE INTERACT WE AVOID IT,NEVIRAPINE,DDS IS AVOIDED .