35 yrs male pain epigastium,,with h/o gastritis,,diagnosis?treatment?

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ECG is Normal. If clinically also non-cardiac presentation and gastritis is confirmed, You can proceed with evaluation of Gastritis. Obtain Food,addiction history. Any hematemesis? See if Any offending medications currently recieving? like,NSAIDs/Steroids/Antiplatelets? Relation of the pain with food intake, Constitutionally Type-A personality? Clinically, Examine for any epigastric tenderness,mass palpable. Measures: For Gastritis, 1) Proton pump inhibitors Tab Pantoprazole.,(Pantodac) C. Esomoprazole( Nexpro) Cap. Omeprazole(Omez) with Domperidone if vomittings/nausea. 2. Alternatively,H2 receptor like Ranitidine. 3. Antacid preparation like Mucaine Gel, 4. Ulcer coating Gel.like Liquid Sucralfate (Sparacid/Sucrafil). 5) If any reflux disease symptoms associated, Levosulpiride with PPI combinations can be selected. Lifestyle Changes: Is Very important, Dietary modifications should be advised. 1.Soft diet,Bland diet till acute episode is treated. 2. Regular meals timings. 3. Avoid long gap between meals. 4. Avoid spicy/ oily food. 5. Avoid Alcohol/Smoking/Tobbacco. 6. Avoid tea/coffee. 7. Reduce stress, Ensure regular sleep. 8. Avoid NSAIDs painkillers. If Gastritis is severe or recurrent,can plan dignostic investigations like Upper Gastroduodenal scopy(UGD scopy). If diffuse antral gastritis:PPIs/Antacids. If ulcer: Can obtain biopsy from ulcer site,in suspicious looking ulcers and in relevant age group cases to rule out malignancy. Medications:PPIs, ulcer coating agents like sucralfate. - Biopsy for H.Pylori. Course of H.Pylori kit (HP Kit/Sompraz HP kit )in ,Positive cases .Also,empirically in Refractory and chronic Gastritis cases.

thank you for the detailed explanation sir. it is so informative
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ECG IS NORMAL. MOST LIKELY DIAGNOSIS IS ACIDOPEPTIC DISORDER. VARIOUS OTHER DIFFERENTIAL DIAGNOSES ARE UTI AND CHOLI LITHESIS AND CHOLICYSTITIS AND LOWER LOBE PNEUMONIA. INVESTIGATION REQUIRED ARE CBC URINE EXAMINATION AND X RAY CHEST PA VIEW AND ENDOSCOPY. TREAT ACCORDINGLY.

ECG normal life style modification . drastic changes food habits. Rx Hurry ,worry, curry Avoid Tea ,stress, chilly ,oil ,spices .bidi ,wine ,tobacco etc. Cap Pantaprazole + Domperidone OD. empty stomach. Tab Anafortan tid SOS Tab Normaxin TID Tab Oxytetracycline TID. Tab Uniezyme MPS BD . Mucaine MPS after meal 6 week. Life style modification is biggest drug. otherwise chances of relapse is very common.

Essentially WNL. Treat for symptoms of gastritis/acid reflux

ECG is normal,patient is having non cardiac chest pain.has h/o gastritis so symptomatic treatment for gastritis can be given. also rule out costochondritis,GERD,Gallbladder disease

Normal sinus rhythm

Normal ECG.

Gastric ulcer. gastroscopy Divol gel tab . Drotin-Ds Rekool-D

but repeat ECG after one hour some timed later er can see we sjoud ruleout IWMi

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