Concluded Case

Chronic Motion sickness with GERD

Age 45 years male has complaints severe chronic motion sickness along with GERD since from 20 years H/o DTM, HTN under controlled H. Pylori positive HBSAG +ve Thyroid profile normal RFT, LFT Normal Endoscopy- Normal Now patient is under medication Tab. Normaxin BID Tab. Amlong At Cap. Omeprazole D Tab . K Glim M1 Kindly suggest further evaluation Dx & Rx

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Concluded answer

DM , HT with chronic hepatitis B and acid peptic reflux disease Adv 1) Proton pump inhibitor with GI motility agent for treatment of reflux oesophagitis ESoz D 40 mg once daily Itopride 50 mg one tablet three times a day 2) Strict control of diabetes and hypertension 3) H. Pylori treatment - RUT kit shows negative result as the disc is yellow in colour, positive result will have pink colour in the disc Adv - urea breath test to confirm H. Pylori infection 4) Hepatitis B surface antigen positive status Treatment of hepatitis B is indicated if A) Sonography shows cirrhosis of liver B) HBeAg is positive C) APRI index is more than 2 D) HBV DNA is more than 2000IU/ml

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H pylori kit. Omez, clarinova, novamox BD anti htn & dm tablets. Adv... Urea breath test.

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GERD with T2DM with HTN with HBSAg +ve with H.Pylori +ve Cap Pyloflush one tab twice daily for H.Pylori Replace Amlong AT to Telista MT 25 OD, ARBs and Cardioselective beta blockers are comparatively better in T2DM patients, Change Omez D to Protera D OD 30 mins BBF, Also can add syp digeraft 10ml at bedtime Further workup for Hep B is needed

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H.pyloric- tab pylokit *10 days Tab pan 40 mg bd * 10 days Normal diet Hbsag- adv USG abdomen and pelvis

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NEED'S.. MANAGEMENT FOR.. H PYLORI.. WITH.. PPI .. AMOXICILLIN.. CLARITHROMYCIN.. WITH.. TREATMENT FOR.. HBSAG +VE ..

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Triple therapy using a proton pump inhibitor or ranitidine bismuth citrate, combined with clarithromycin and amoxicillin or metronidazole.

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DM , HT with chronic hepatitis B and acid peptic reflux disease Adv 1) Proton pump inhibitor with GI motility agent for treatment of reflux oesophagitis ESoz D 40 mg once daily Itopride 50 mg one tablet three times a day 2) Strict control of diabetes and hypertension 3) H. Pylori treatment - RUT kit shows negative result as the disc is yellow in colour, positive result will have pink colour in the disc Adv - urea breath test to confirm H. Pylori infection 4) Hepatitis B surface antigen positive status Treatment of hepatitis B is indicated if A) Sonography shows cirrhosis of liver B) HBeAg is positive C) APRI index is more than 2 D) HBV DNA is more than 2000IU/ml

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Peptic Ulcer-advise your patient a proper diet routine with following medicines. 1-ptolyadi Kawath 20ml after meal 2-Avipatikar churan+Lilavlas ras before meal 3-Bhoiamala churan at bed time. hepatitis B-with titres My experiance says its very hard to reverse HBV +ve to -ve. Still you can decrease quantitative viral load significantly. You should use.... 1. Phalatrikadi Kashay 2. Arogyavardhini Ras 3. Nitya Mrudu Virechana 4. PathyaPathaya of Paandu & Kaamala. FATTY LIVER he must avoid fatty and spicy food.continune bhoeamalki and rohitikarist

Treat for H pylori. See the detailed evaluation considering chronic active hepatitis.

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Rx Abhyadi qwath BD Galo ghan tab 1bd Panchsakar powder HS for 1 to 2 weeks,

Naturolax powder with curd 2 times in day time 2 tsf with milk at bed time

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