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Incidence r Mixedcellularity disease which mainly affects older 20 per 100 order atorlip-5 5mg online,000 per year cheap atorlip-5 5mg. Tumours arise due therapy or a combination depending on the stage of to multiple genetic lesions affecting proto-oncogenes Table12. Clinical features r Indolent: Most patients present with painless slowly Prognosis progressive lymphadenopathy. Lymph nodes may re- Indolent lymphomas have a predicted median survival duce in size spontaneously making it difcult to dis- time of 5 10 years. B symp- sponsive to chemotherapy but have a predicted median toms (fever >38 C, drenching night sweats, weight survival 2 5 years. On Paraproteinaemias examination there is lymphadenopathy and hep- atosplenomegaly. The cells are trophic to the skin particularly the hands and feet, and result Age in plaques and lumps of associated with generalised Most commonly diagnosed 60 65 years. Gas- trointestinallymphomaisparticularlycommoninthe Pathophysiology MiddleEastandisalsoseeninassociationwithcoeliac There is expansion of a single clone of plasma cells that disease. Cleavage of these immunoglobulins tribution according to the Ann Arbor system, which result in the production of Fab and Fc fragments; the Fab is sufxed by B if B symptoms are present (see fragment is termed the Bence-Jones protein and is found Table 12. Investigations There is also production of osteoclast stimulation fac- Thediagnosisismadebylymphnodebiopsy,cytogenetic tor causing lytic bone lesions, bone pain and hypercal- studies of lymphoma cells may give prognostic informa- caemia. Spinal cord compression occurs in approx- imately 10 20% of patients at some time during Pathophysiology the course of disease. Hypercalcaemia causes thirst, The abnormal proliferation of lymphoplasmacytoid polyuria, constipation and abdominal pain. Investigations The diagnosis of myeloma is made if there are: Clinical features r Bone marrow aspirate has at least 10 15% plasma Hyperviscosity presents as weakness, tiredness, confu- cells. Patients also often have peripheral lymphadenopa- Other investigations include: thy. Chemotherapy with single alkylating agents improves r Protein electrophoresis shows an IgM parapro- prognosis. Recently, thalidomide has been demonstrated to produce a signicant response Management in 30% of patients whose disease progressed following Chemotherapy produces a variable response. Supportive care includes blood transfu- pheresis is used for symptomatic hyperviscosity. Investigations Sex Electropheresis of serum protein demonstrates a raised X linked; males only affected. Aetiology Mutations on the X chromosome including deletions, Management frame shifts and insertions. One third of cases are new Aproportionofpatients will go on to develop multi- mutations. Clinical features Type 1 and 2 causes mild disease with bleeding following Investigations injury, menorrhagia and epistaxis. Type 3 causes spon- r Activated partial thromboplastin time is raised, but taneous bleeding from early life.

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Anatomical methods - for study of gross and microscopic gut structure for academic purposes were those routinely available in college anatomy departments discount 5 mg atorlip-5 with amex. Pathological methods ranged from routine histological methods to hitherto unused approaches like dissecting microscopy of intestinal villi obtained by Crosby intestinal capsule; and special histological stains to detect and measure intestinal mucosal cell contents like lactase enzyme discount atorlip-5 5 mg without a prescription. Aung Than Batu 3 Bibliography of Research Findings on Gastrointestinal Diseases in Myanmar 4 Bibliography of Research Findings on Gastrointestinal Diseases in Myanmar Introduction This bibliography was compiled with the aim to accumulate all available data on diseases and disorders of gastrointestinal tract research studies carried out in Myanmar. An extensive literature review was carried out to collect all published data on diseases and disorders of gastrointestinal tract research in country. In collection, literature written in English with research findings on human gastrointestinal diseases, and conducted by a research team which included at least one Myanmar investigator was compiled. Abstracts published in international and local conference/ seminars/ symposium/ were also compiled. All publications on diseases and disorders of the gastrointestinal tract recorded by biographies as mentioned in Who s Who in Medicine in Burma (1972) and Who s Who in Health and Medicine in Myanmar (2003) were included. The search was further extended to all medical subjects and to related science theses such as Zoology. Contact with libraries at Medical Universities, Arts and Sciences Universities, Myanmar Medical Association were made through visits, postal and email services. The information obtained were recorded and analyzed by place of research work, category of research, and type of information provided. The compiled abstracts are arranged according to the year of publication and are arranged according to the name of the first authors. The abstracts are numbered consecutively and continuously from 001 to 537 throughout all decades. Also, there is an Overview and Summing up at the end of each decade describing the nature of studies and the progress of scientific methods during that decade. An Expert Technical Committee for the Study of Intestinal Helminthic Infection in Burma was appointed by the Burma Medical Research Council in 1968. Although there have been several previous prevalence studies of intestinal helminths in Myanmar this Technical Committee conducted the first systemic attempt to review the situation and assess the health impact of intestinal helminthiasis in Myanmar. Its Report provided the framework and guidance for further research on the subject for many years to come. Descriptive epidemiological studies of intestinal helminthiasis were carried out in different urban and rural communities especially among school children. These studies and many more in the following decades provided base-line data on the extent of intestinal helminthiasis in the country. Cholera in epidemic form had been the main concern of the health administration and the people since colonial times. Now, the importance of acute (non-cholera) diarrhoea as a cause of high mortality and morbidity, especially in children, became better recognized and the subject of epidemiological and bacteriological studies. Bacteriological investigations of the responsible etiological agents for diarrhoea in children and cholera were done, using simple routine laboratory methods including serology.

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The prokinetic agent limits the reflux of gastric contents into the esophagus and works together with the acid suppressing medication buy 5mg atorlip-5 with mastercard. A procedure called a laporoscopic Nissen fundoplication surgically tightens the junction between the stomach and esophagus to prevent reflux cheap 5 mg atorlip-5 otc. Unfortunately, the procedure has not proven to be completely effective since some patients achieve only a partial or temporary response. Anecdotal experience suggests that cough due to smoking will resolve or significantly improve within four weeks of quitting. If cough does not resolve after four weeks of abstinence from tobacco, other causes need to be evaluated. Interestingly, research studies have shown that smokers have a diminished cough reflex sensitivity compared to nonsmokers. This is probably due to chronic cigarette smoke-induced desensitization of cough receptors lining the respiratory tract. Furthermore, after as little as two weeks of smoking cessation, the cough reflex becomes measurably more sensitive, even in subjects who had been smoking for many years. Indeed, cigarette smoke-induced suppression of the cough reflex might explain why smokers are more inclined to suffer respiratory tract infections compared to nonsmokers. This has been shown in studies of healthy subjects21,22 and in patients with chronic cough. This is the only class of drugs known to cause cough, and does so in 5 - 20% of patients taking these medications. In most patients, cough will resolve within one week, although in a subgroup of individuals, the cough may linger for several months. Within several months of the attack, it was observed that many of those exposed developed a persistent cough, eventually termed World Trade Center cough. Ambulatory care visits to physician offices, hospital outpatient departments, and emergency departments: United States, 1999-2000. Effect of the second-generation antihistamine, fexofenadine, on cough reflex sensitivity and pulmonary function. Application and validation of a computerized cough acquisition system for objective monitoring of acute cough: a meta-analysis. Chronic persistent cough: experience in diagnosis and outcome using an anatomic diagnostic protocol. Interpretation of positive results of a methacholine inhalation challenge and 1 week of inhaled bronchodilator use in diagnosing and treating cough-variant asthma. Antitussive effect of the leukotriene receptor antagonist zafirlukast in subjects with cough-variant asthma. Eosinophilic airway inflammation as an underlying mechanism of undiagnosed prolonged cough in primary healthcare patients. Chronic cough due to gastroesophageal reflux disease: efficacy of antireflux surgery.

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