Doctor Quackie

Malignant neoplasm of the large intestines or colorectal cancer has low indicence in Asia. It's occurrence is probably related to high fat and low fiber diet. Gross features of colorectal cancer in the proximal colon is large bulky mass that undergoes necrosis. Colorectal cancer located in the distal colon show annular constriction like a napkin ring. Histologically, most colorectal cancer is adenocarcinoma. The tumor growth has a doubling time of about 620 days. Rectal cancers have a tendency to invade local structures. Screening for colorectal cancer is 50 years old where occult blood test, colonoscopy are recommended screening tests. Tumor marker screening of CEA has low sensitivity and specificity. CEA has low predictive value diagnosis in asymptomatic patients. The treatment of choice for colorectal cancer is surgery. Adjuvant chemotherapy is most effective when tumor burden is minimal and cell kinetics are optimal. 5-FU plus levamisole significantly re...

Esophageal varices is a result of alcoholic liver disease. Esophageal varices are portosystemic collateral. It is extremely dilated sub-mucosal veins in the lower third of the esophagus. Varices rupture if the wall tension becomes too great. Treatment of bleeding include sclerotherapy which occludes venous channel with the use of 1-3 ml of sclerosant. Sclerotherapy control bleeding 80-95% of the time with re bleeding rates at 50%.  Another treatment option for bleeding esophageal varices is endoscopic banding which also occludes venous channels. It has lesser complications compared to sclerotherapy.

Congenital Heart Disease In Adult Complex Congenital Heart Lesions These includes Tetralogy of Fallot (TOF) Transposition of Great Arteries (TGA) Single ventricle Tricuspid Atresia Ebstein Anomaly Dextrocardia Situs Inversus Totalis

Heart failure is a condition when the heart's pumping power is reduced. It has many causes. Manifestations include easy fatigability, edema, chest pain or difficulty breathing. Drugs used for the treatment of heart failures includes Diuretics Digoxin ACEi (or ARB) and ß-blocker Aldosterone Antagonists/Mineralocorticoid Receptor Antagonists Nitrates

Hypertension or high blood pressure affects of millions of people. It can lead to stroke, heart attack, kidney disease and even death. The treatment of hypertension is collaborative. It requires lifestyle modification, diet and medications. The medications of hypertension are classified into Diuretics Calcium Channel Blockers ACE inhibitors Angiotensin II receptor antagonists (ARBs) Adrenergic receptor antagonists Alpha-2 adrenergic receptor agonists Vasodilators

Acyanotic congenital heart disease in the adult population primarily involves left-to-right shunts, such as atrial septal defect, patent ductus arteriosus, and obstructive lesions such as aortic coarctation of the aorta. The most common form of cyanotic congenital heart disease in adults is tetralogy of Fallot. Most patients with congenital heart disease will need to undergo surgery, catheterization, or catheterization intervention. Results are excellent in the adult population. Atrial septal defect is a common cardiac anomaly that may be first encountered in the adult Defects of the ventricular septum are common as isolated defects or as a component of a combination of anomalies. The ductus arteriosus is a vessel leading from the bifurcation of the pulmonary artery to the aorta just distal to the left subclavian artery. Normally, the vascular channel is open in the fetus but closes immediately after birth. Aneurysm of an aortic sinus of Valsalva consists of a separation or ...