Gastroenterology International

Viral hepatitis, caused by hepatitis viruses A through E, still remains a major public health problem in India. AVH being most commonly encountered seasonal disease found in the epidemic area of northern India in Bhiwani Haryana. As it is most common water borne infection found in the children’s at the age group between the 4-14 years of age. The HAV is most common than the HEV infection found in the children’s, the cases has been reported and found in the study which has been found here and cases reported and achieved and found more of HAV Cases. The cases here reported have been between the Months of June especially during the summer vacation of the school. The inference drawn here is conclusive of the water borne disease such as the diarrhea, and the Hepatitis A.1 The observation made during the summer season, the more exposure to the water due to thirst, excessive travelling, and swimming pool and water parks.

Viral hepatitis, caused by hepatitis viruses A through E, still remains a major public health problem in India. AVH being most commonly encountered disease and the times it get takes for the recovery is quite questionable. The patient or parents of the child usually changes the doctors as and when there is change in the laboratory parameters. The phase of the hepatitis is divided in to the three phase where the early phase, mid phase and recovery phase. The early phase where the symptomatically patient has the high raise in the LFT parameter such as the SGOT and SGPT. The second phase where the transaminase starts settling down and the bilirubin starts increasing and transaminase starts settling down and later phase where he Bilirubin stay high and starts falling down and transaminase touches he baseline, overall procedure takes the 30-45 days for recovery in the patients. This study has been made to understand the pathophysiology of the acute viral hepatitis and its recovery takes the quite prolonged. The concept and the different phases of the acute viral hepatitis has been mentioned base on the textual and the clinical experience of the gastroenterologist.

Introduction: Liver abscess is an infectious space occupying lesion in liver parenchyma. It could be pyogenic or amoebic in origin. The most common source is biliary followed by abdominal infection and hematogenous spread. We describe a patient with liver abscess caused by a fish bone which penetrated into liver capsule through the gastric wall.

Methods: A 65 year old male presented with history of fever and mild abdominal discomfort. He was evaluated and was found to have a liver lesion on ultrasonography. Triphasic CECT scan abdomen revealed a liver abscess in segment 4 with hyper dense linear material within. Ultrasound had missed out foreign body within the abscess. On probing, there was history of fish bone ingestion a month earlier. Endoscopy did not reveal any gastric lesion or breach in mucosa. He was given antibiotics and taken up for surgery. Laparoscopic liver abscess drainage was done and foreign body- fish bone was noted within the abscess. Patient improved clinically and was doing well on follow up.

Conclusion: Liver abscess due to fish bone penetrating liver capsule through stomach is very rare. The transgastric penetration of foreign body should be kept in mind whenever there is unusual cause of liver abscess with foreign body within. CECT abdomen may be more helpful than an ultrasound abdomen.

Medical education relies upon the through clinical examination and history taking in exact and proper diagnosis of the patient.1 The patient who has the symptoms which has the presentation of the multiple system sharing the same presentation need2 judicious examination and through evaluation. Similarly the article case study selected here is the syncope2 vs Siezure where both have the common feature such as the LOC– Loss of consciousness need the through evaluation for the same.3 Differentiating between syncope and seizures, a relatively easy task, is not quite so simple in the ED.4 Transient loss of consciousness can occur from seizure or syncope, and the emergency clinician must distinguish between the two general5 conditions, especially if it's the patient's first episode, and direct the appropriate initial evaluation and follow-up.6 Ten percent of patients diagnosed as having a seizure do not have a seizure disorder but rather a cardiovascular event that caused transient loss of consciousness.7 Basic ED labs and an ECG, even an out patient EEG, are not always sensitive enough to differentiate seizures8 from syncope. Long-term ECG monitoring, as well as tilt table testing, are some tools that can further reveal the origin of the transient loss of consciousness.9

Cancer and its treatments often pose significant nutritional challenges for patients, leading to malnutrition, which impacts physical, emotional, and psychological well being. Loss of appetite, taste changes, difficulty swallowing, and malabsorption are common issues faced by cancer patients, contributing to malnutrition. As key members of the healthcare team, nurses and dietitians are instrumental in addressing these challenges and ensuring that patients receive proper nutrition. They collaborate to develop personalized nutrition plans tailored to individual needs, treatment protocols, and side effect management. Various feeding techniques are employed to meet the nutritional requirements of cancer patients. The interdisciplinary collaboration between nurses and dietitians is crucial for providing comprehensive care to cancer patients. Nutritional assessments, modified diets, appetite stimulation, pain management, and oral care are some of the strategies employed by these healthcare professionals to support oral feeding. A cancer survivor continues their journey post-treatment, nutrition remains a significant aspect of survivorship care. Nurse and dietitian led survivorship programs focus on promoting healthy lifestyles, and physical activity, and addressing long term dietary challenges faced by cancer survivors. In conclusion, the collaboration between nurses and dietitians plays a pivotal role in addressing the nutritional challenges faced by cancer patients. By providing personalized nutrition plans and interventions, these healthcare professionals enhance patient care, treatment tolerability, and overall well-being. Through their combined efforts, cancer patients are better equipped to face the challenges of treatment, improve their nutritional status, and ultimately lead better lives during and after their battle with cancer.