Pancreatitis : Symptoms and Management

Pancreatitis is inflammation of the pancreas gland.It is responsible for production of digestive enzymes like trypsin,amylase and lipase that aids in digestion of food.Pancreatitis occurs when these enzymes get auto-activated in pancreas  and start digesting pancreas itself.Pancreattis can be acute or chronic pancreatitis.While acute pancreatitis is mainly due to biliary stones,chronic pancreatitis is due to alcohol intake.But it also important to remember that there are many other conditions leading to Pancreatitis.Some other important causes are:

 

1.Abdominal Trauma 

2.Steroids

3.Mumps infection

4.Autoimmune condition

5.Hypercalcemia

6.Triglyceridemia

7.Scorpion sting

8.Pancreatic divisum

9.Medicines like  azathioprine, thiazides, sulfonamides, furosemide, estrogens, and tetracycline.

 

Acute pancreatitis is of short duration and does not leave any permanent damage.But in minority of cases it can be life threatening.Chronic pancreatitis is of longer duration and can have permanent tissue damage.As a result it cannot produce enough enzymes to digest the food and can lead to malabsorption of food and also sometimes insulin deficiency causing diabetes in later stages of disease.

 

What are symptoms of Pancreatitis?

1.Severe Abdominal pain that often radiates to back

2.Nausea and Vomiting that gets worse after food

3. Fever

4.Loss of weight

5.Oily,smelly stools

6.Diabetes in later stages (Polyuria,Polydipsia,Polyphagia)

 

 

Treatment of Pancreatitis in Nepal:

Doctors run necessary test to diagnose pancreatitis.Serum amylase and lipase are repeatedly done in hospital for diagnosis of the pancreatitis.Abdominal USG and CT scan are also helpful to diagnose the disease.Management includes treating the cause of pancreatits and symptomatic management of the attack.ICU stay may be needed in severe cases.Most of the cases need conservative management.In cases of Gall stones,Cholecystectomy is also done.

Management includes:

1.Pain management: You will be given IV analgesics to control abdominal pain

2.IV Fluids

3.Nutrition: It is good not to take anything by mouth when pancreatitis is severe to allow pancreas to rest and heal.However in mild cases,you can take low fat soft diet

4.Antibiotics: Antibiotics are used when infection is suspected.Not recommended in every case.

 

Complications of Pancreatitis

1.Pseudocyst of Pancreas

2.Pleural effusion

3.Malabsorption of food leading to weight loss

4.Diabetes Mellitus

Is pancreatitis completely curable ?

The answer lies in the cause of pancreatitis. If it is due to gall bladder stones causing blockage in outflow of enzymes ,removal of gall bladder and  the stone will cure the disease.if it is due to alcohol intake,stopping of alcohol consumption will cure your pancreatitis.To conclude, it can be said that if the cause can be treated,you pancreatitis can be cured.However in minority of cases,the cause is idiopathic that means even after running all the test,the cause of pancreatitis can not be found out.In such cases it is very difficult to cure the disease and there are high chances of repeated future attacks.

 

If you are looking for best gastroenterologist doctor to cure your pancreatitis ,Click here to view best doctor in Nepal.

Mcqs on Cardiology

Cardiology Quiz

Cardiology quiz

Question 1

1. Sudden and unexpected dyspneic episodes at rest can be associated with all except ?

Question 2

2. Which of the following is most characteristic of severe paroxysmal dyspnea of left ventricular failure?

Question 3

3.Orthopnea is seen in ?

The Rise of Omicron in Nepal after India


 

According to Ministry of Health and Population on 7 January,2022, additional 24 positive cases of omicron have been found in the last 24 hours.The officials confirmed that the cases were positive in 1,146 Covid-19 positive random samples collected throughout the nation during Poush.It included samples of peacekeepers who returned to Nepal from Sudan.

Dr Biraj Karmacharya, an epidemiologist stated "The rise in new cases is a clear indication that a third wave could hit Nepal anytime” .He added  “The new wave will start from schools, offices, unvaccinated areas and so on".The fact makes the vaccines more important for prevention of death and severe infection. 

The ministry of Health is predicting that a  third wave of Covid can start in Nepal anytime soon after there were 117,100 new COVID-19 cases on Friday in India with which Nepal shares an open border. Thousands of people cross the border each day.The covid-19 crisis management coordination committee,Nepal(CCMC)  are very concerned after 24 cases of Omicron were positive in Nepal on the same day.They have started taking precautions to stop the disease transmission,especially in the district that connects to India.Last week on saturday,The Palpa Hospital Administration stopped providing all health care services except emergency after the doctor and staffs were infected with Covid-19.On Thursday,three schools in Dang were closed after the students and teacher got infected with the virus.Health care workers who were vaccinated last year also got the virus which is a matter of concern for epidemiologists.However, the fact that Vaccination reduces severity of disease can not be neglected.

Government of Nepal has advised everyone to follow all the safety protocols against COVID-19 including usage of Masks and avoid gatherings.CCMC have instructed hospitals to be ready for a third wave and  keep extra stocks of medicines especially oxygen to the hospitals.

 

Matrika Eye Center

Located at Dhunge Dhara Marg,Ward no 9,Old Baneswor, Kathmandu ,Matrika Eye Centre is one of the finest centre for Eye health care in Nepal.Matrika is a center with highly qualified doctors, new age modern equipment for Diagnostic, Preventive and therapeutic purpose.It was established with the vision of providing quality eye health care.
It provides services as comprehensive eye problem investigations, treatment, therapies, glasses/contact lenses and surgeries. Laser eye surgery(LASIK and SMILE) is done at Matrika eye centre for permanent removal of  glasses/contact lenses by the experts minimizing side effects and complications.Oculoplastic surgeries      (reshaping your eyelids, removing saggy eye bags, removing tired lines around the eyes, etc), cataract surgeries, squint eye surgeries along with all other minor surgeries are performed here.
Matrika eye centre is established in 2019.Since then it is getting popularity because of Glasses removal surgery by Dr. Kishore Raj Pradhan.
The question might come to your mind "Who is  Dr. Kishore Raj Pradhan"?
Dr Pradhan is medical director of Matrika Eye Centre.Dr. Kishore Pradhan,the first Refractive Surgeon of Nepal is a very dedicated doctor and works with the motto of "Everybody has the right to sight".He has done laser eye surgery of many people till now.Recently Cricketer Dipendra Rawat and Sanjeeb Malla also had their glasses removal surgery at Matrika Eye centre.Sanjeeb Malla is so happy after the operation that he wrote "You are my third eye " to Dr Kishore Pradhan.It is very clear that if you want to remove your power glasses completely and have a normal eyesight again,Matrika is the best place for you

With the same vision ,he along with his team of Matrika eye centre keep doing free eye health camps in remote districts of Nepal where people do not have access to basic health facilities.The team of Matrika Eye centre include Dr. Kishore Raj Pradhan , Dr. Namrata Gupta, Dr. Kiran Shakya, Dr. Simanta Khadka.






Dr Dinesh Upreti - General Physician At Rajbiraj,Nepal

Dr Dinesh Upreti
Dr. Dinesh Upreti
Dr. Dinesh Upreti is a General physician.
General physician is a doctor who has done Masters in Internal Medicine and can treat all the non-surgical cases.He has the ability to diagnose what is wrong in your body.
Through a rigorous and comprehensive training program, general physicians acquire knowledge,training and skills.
Dr Upreti is capable to deal with the entire range of the patient's medical problems.He is scientific  and rationale in approach to providing expert diagnosis.Dr Upreti is able to assess and choose drugs and other medical therapies ,and he is highly skilled in clinical decision making and also thinks of economic status of patient before prescribing them any drugs.
He completed his MBBS from Universal college of medical sciences Bhairahawa  in 2013. Since he studied in scholarship,he had to work at district hospital Bajhang for two years from 2013 to 2015.He then joined BPKIHS for Internal Medicine residency.
Dr Upreti completed MD Internal Medicine from BPKIHS Dharan in 2019.He then Worked for one year at Rapti Academy of Health Sciences DANG.
He also worked for one year at Gajendra Narayan Singh Sagarmatha Zonal Hospital Rajbiraj.He provided service at Chhinnamasta hospital,Rajbiraj for 2 years.

Dr. Manu Basnet-One of the leading Gastroenterologist in Nepal

Dr.Manu Basnet is one of the leading Gastroenterologist in Nepal.Gastroenterologist is a doctor who is trained to find and treat disease of the gastro-intestinal tract.It includes disease of from mouth to colon including liver,gall bladder and pancreas.You may need to visit a gastroenterologist when you have problem with swallowing,chest burn,chronic diarrhoea,abdominal pain.

Dr.Manu Basnet Completed MBBS from BPKIHS, Dharan in 2000.He worked as house officer in ICU/CCU of TUTH, Maharajganj, Kathmandu for one year.He served in PHC Lete,Mustang and PHC Syringa,Gulmi under government of Nepal for one and half year.After 3 year of his service,he joined Internal Medicine Residency at TUTH,IOM,Maharajganj and got his post-graduate degree of Internal medicine in 2006.He then worked for improving the health quality of the country.He started working in Butwal Hospital Private Limited,Butwal.He then got a  chance to be lecturer at Lumbini Medical College,Tansen and ignite the flame of knowledge in young minds.Without further ado,he joined Lumbini Medical College.

Dr Manu went to Hyderabad,India in 2011 and got training on endoscopy and Colonoscopy.He then started doing endoscopy and colonoscopy in Nepal.After returning from AIG,Institute Hyderabad,He worked as gastroenterologist in  Norvic International Hospital from 2014 to 2021.

Dr Manu Basnet is the first doctor in Nepal to do enteroscopy in 2017.He is the one of the best doctor for Endoscopic ultrasound,ERCP and other endoscopic diagnostic and therapeutic procedure in Nepal.He is currently practicing at Star hospital,Sanepa with the best endoscopic equipment and suite.With years of trainning,he has expertise in treating :

1.Hepatitis

2.Pancreatitis

3.Peptic ulcer

4.Crohn's disease

5.Ulcerative Colitis

He says “People do not need to go India or other country for treatment. At the star hospital,we provide the best digestive disease service.” He has treated and cured thousands of patients with digestive disease.People are glad that they visited him for treatment.

Best Psychiatrist in Kathmandu-Nepal

We know it is frustrating when you can not focus in study or work, When your mind is overthinking each and every event.We understand that you are in search of good psychiatrist in Nepal and you will find them with Medicosguide.

Mental health is an important aspect of our health.There are  so many mental health problems that can be treated with medicine and therapy but only under psychiatrist supervision.Mental health is as important as physical health.There are so many misconception regarding mental health problems.It is not true that you will need medicine for your entire life.Before going into any conclusion of mental diseases you should discuss your problem with a good psychiatrist which we have listed here under "Best Psychiatrist in Kathmandu,Nepal".What can be some of the symptoms of mental health problems?

Best Gastroenterologist in Nepal

1. Dr. Kamal Raj Subedi

Dr. Kamal Raj is a consultant gastroenterologist and interventional Gastrointestinal endoscopist at HAMS hospital and Grande International Hospital.He has worked in Dhulikhel Hospital, Kathmandu from 2018 to 2019.He was then actively involved in ERCP(Endoscopic Retrograde Cholangiopancreatography).He is also working at Kist Medical College and Teaching Hospital,Nepal as a consultant gastroenterologist.He has done Fellowship in Gastroenterology and Digestive Endoscopy from University of the East Ramon Magsaysay Memorial Medical Center,Philippines.

Contact: Dr. Kamal Raj Subedi – Welcome to HAMS Hospital

2. Dr. Nandu Silwal Poudyal

SHAPU (Seasonal Hyperacute Pan-uveitis) EYE DISEASE in Nepal

Around 34 patients of SHAPU(Seasonal hyper-acute panuveitis) has been reported in pokhara since one month.SHAPU has not been reported outside Nepal until now.The prevalence of disease is highest in Pokhara , from where the disease has originated in 1975.Most of the cases are reported in end of monsoon season (August-September).Only timely treatment can prevent blindless.

SHAPU is a rare entity occurring in odd years since 1975 in Nepal.It is increasing at an alarming rate in Gandaki province since beginning of this september.It mostly affects child of 5 to 15 years of age.It can rapidly cause destructive intra-ocular inflammation.It can progress to blindness if not treated.The etiology of SHAPU is not clear yet but it has strong associations with Gazalina moth.The dust on scale of the moth when comes in contact with eyes can cause damage to retina and pupil.Studies are being done to find out if SHAPU is due to auto-immune response to the moth antigens or by pathogens delivered by moth. Characteristics features of SHAPU are red eye,leukocoria,fibrinous exudates in anterior chamber and inability to dilate pupil with little or no pain.No standard treatment protocol has been developed against SHAPU till now.So to cover both infectious and immunological aspects,broad spectrum antibiotics and steroids are used for its treatment.Vitrectomy has been considered a useful procedure for treatment of SHAPU.

The fact that it commonly affects children is not well understood.The blame can be given to their low immunity than adult but no proof of state of immunocompromised has been found till date.



Nipah Virus-Recent death in Kerala,India.

A 12 year old boy of kerala,India died of Nipah virus on September 5,2021.It is after 3 years that kerala reported  a case of Nipah virus after the outbreak was contained in 2018.

Nipah virus is a zoonotic virus that means the transmission occurs between animals and human.Bats are the natural reservoir of Nipah virus.The virus is known to infect pigs and human.It can cause  from mild illness to encephalitis and ultimately death.In 1999,an outbreak of the disease in malaysia and singapore caused 300 human cases and more than 100 deaths.About one million pigs were killed to control the virus.It is now a disease of concern because man to man transmission are seen in caregivers of infected people in Bangladesh and India.

Nipah virus can be transmitted via

1.Direct contact with infected animals(pigs,bats)

2.Eating food products that are contaminated with body fluids of infected bats

3.Body fluids of an infected person(respiratory droplet,urine or blood)

Sign and symptoms of Nipah virus are very similar to Covid 19.It ranges from subclinical cases to acute respiratory infection to fatal encephalitis.Infected people usually develop symptoms after 4 to 14 days of exposure to the virus that means the incubation period of Nipah virus is 4-14 days.It initially presents with fever,headache,malaise,myalgia,sore throat and vomiting which progresses rapidly to dizziness,drowsiness,altered consciousness (neurological manifestations of encephalitis).Encephalitis and seizures occur in severe casses.The patient may progress to coma.The case fatality rate is 40-80 % that means death may occur in 40 - 80 % of cases. Persistent convulsions have been reported in survivors of Nipah virus.

The diagnosis of this virus is difficult due to its non-specific symptoms.The tests used to diagnose are real time polymerase chain reaction (RT-PCR) and ELISA.Early diagnosis helps in limiting the transmission of the Nipah virus.

There is no specific treatment or vaccine against Nipah virus.Management is supportive care with hydration,rest and symptomatic treatment as they occur.


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