Kirjahaku
Etsi kirjoja tekijän nimen, kirjan nimen tai ISBN:n perusteella.
70 tulosta hakusanalla Parakrama Chandrasoma
Gastroesophageal Reflux Disease (GERD) is one of the most common maladies of mankind. Approximately 40% of the adult population of the USA suffers from significant heartburn and the numerous antacids advertised incessantly on national television represents a $8 billion per year drug market. The ability to control acid secretion with the increasingly effective acid-suppressive agents such as the H2 blockers (pepcid, zantac) and proton pump inhibitors (nexium, prevacid) has given physicians an excellent method of treating the symptoms of acid reflux. Unfortunately, this has not eradicated reflux disease. It has just changed its nature. While heartburn, ulceration and strictures have become rare, reflux-induced adenocarcinoma of the esophagus is becoming increasingly common. Adenocarcinoma of the esophagus and gastric cardia is now the most rapidly increasing cancer type in the Western world. The increasing incidence of esophageal adenocarcinoma has created an enormous interest and stimulus for research in this area. GERD brings together a vast amount of disparate literature and presents the entire pathogenesis of reflux disease in one place. In addition to providing a new concept of how gastroesophageal reflux causes cellular changes in the esophagus, GERD also offers a complete solution to a problem that has confused physicians for over a century. Both clinical and pathological information about reflux disease and its treatment are presented. GERD is meant to be used as a comprehensive reference for gastroenterologists, esophageal surgeons, and pathologists alike.
Diagnostic Atlas of Gastroesophageal Reflux Disease
Parakrama T. Chandrasoma
Academic Press Inc
2007
sidottu
Gastroesophageal reflux is one of the most common maladies of mankind. Approximately 40% of the adult population of the USA suffers from significant heartburn and the numerous antacids advertised incessantly on national television represents a $8 billion per year drug market. The ability to control acid secretion with the increasingly effective acid-suppressive agents such as the H2 blockers (pepcid, zantac) and proton pump inhibitors (nexium, prevacid) has given physicians an excellent method of treating the symptoms of acid reflux.Unfortunately, this has not eradicated reflux disease. It has just changed its nature. While heartburn, ulceration and strictures have become rare, reflux-induced adenocarcinoma of the esophagus is becoming increasingly common. Adenocarcinoma of the esophagus and gastric cardia is now the most rapidly increasing cancer type in the Western world.At present, there is no histologic test that has any practical value in the diagnosis of reflux disease. The only histologic diagnostic criteria are related to changes in the squamous epithelium which are too insensitive and nonspecific for effective patient management. It is widely recognized that columnar metaplasia of the esophagus (manifest histologically as cardiac, oxyntocardiac and intestinal epithelia) is caused by reflux. However, except for intestinal metaplasia, which is diagnostic for Barrett esophagus, these columnar epithelia are not used to diagnose reflux disease in biopsies. The reason for this is that these epithelial types are indistinguishable from "normal" "gastric" cardiac mucosa. In standard histology texts, this "normal gastric cardia" is 2-3 cm long.In the mid-1990s, Dr. Chandrasoma and his team at USC produced autopsy data suggesting that cardiac and oxyntocardiac mucosa is normally absent from this region and that their presence in biopsies was histologic evidence of reflux disease. From this data, they determined that the presence of cardiac mucosa was a pathologic entity caused by reflux and could therefore be used as a highly specific and sensitive diagnostic criterion for the histologic diagnosis of reflux disease. They call this entity "reflux carditis". In addition, the length of these metaplastic columnar epithelia in the esophagus was an accurate measure of the severity of reflux disease in a given patient.At present, there is some controversy over whether cardiac mucosa is totally absent or present normally to the extent of 0-4 mm. While this should not be a deterrent to changing criteria which are dependent on there normally being 20-30 cm of cardiac mucosa, there has been little mainstream attempt to change existing endoscopic and pathologic diagnostic criteria in the mainstream of either gastroenterology or pathology. The ATLAS will be the source of easily digestible practical information for pathologists faced with biopsies from this region. It will also guide gastroenterologists as they biopsy these patients.
GERD: A New Understanding of Pathology, Pathophysiology, and Treatment transforms the assessment of gastroesophageal reflux disease (GERD) from its present state, which is largely dependent on clinical definition and management, to a more objective scientific basis that depends on pathologic assessment. Sequential chapters in this single-author book describe the fetal development of the esophagus, the normal adult state, and the way exposure to gastric juice causes epithelial and lower esophageal sphincter damage at a cellular level. It allows recognition of the pathologic manifestations of lower esophageal sphincter damage and develops new histopathologic criteria for quantitating such damage. This understanding provides new pathologic criteria for definition and diagnosis of GERD from its earliest cellular stage. Algorithms based on measurement of sphincter damage can identify, even before the onset of clinical GERD, persons who will never develop GERD during life, those who develop GERD but remain with mild and easily controlled disease, and those who will progress to severe GERD with failure to control symptoms, Barrett esophagus and adenocarcinoma. Aggressive early intervention in the last group with the objective of preventing disease progression to its end points of uncontrolled symptoms and adenocarcinoma becomes feasible.
This study first establishes the discriminatroy and elitist nature of standard languages and standardisation itself, considering as counter-example the case of Sri Lankan English as symptomatic of the 'other' or postcolonial Englishes. On the basis of this understanding of the standard, while at the same time, accepting the necessity of standards, however attenuated, the writer argues for the active broadening of the standard to include the greatest variety possible - privileging 'meaning' over other rules - and holds that this would in fact work towards extending the bounds of linguistic tolerance.
In this stylish, taut and meditative collection of eleven stories, Radhika Vyas Sharma explores through the prism of short fiction the challenges posed to individuals and families by the processes of migration of homelands while simultaneously dealing with the never ending human quest for love and closure. From rural Rajasthan to the San Francisco Bay Area, each of these stories is homage to human resilience. In the title story Parikrama, a young man embarks upon a journey, a personal spiritual circumambulation, to connect the dots of his deceased parents' lives stumbling upon some unexpected secrets of his own. In another story, Agony Aunt a young immigrant Indian mother makes a difficult choice between a sustaining a rare friendship and preserving her self-respect. While Beneath Her Veil the Stars Faded Away set in the late 1980's in small town Rajasthan tells the tale of an uncommon friendship between a childless middle-aged school principal and a young bride. Parikrama is eleven stories like sashes, sari pins, flowers, waves - a range of style, motifs and voices strung together in a garland of storytelling.CONTINUED....
तोलोलिंग की चोटी पर बीस दिन से भारतीय जवान शहीद हो रहे थे। आखिरी हमले की रात वे दुश्मन के बंकर के बेहद करीब पहुँच गए, लेकिन तभी गोलियों की बौछार हो गई। वे घायल थे, लेकिन वापसी उन्हें मंजूर नहीं थी। शरीर से बहते खून की परवाह किए बिना उन्होंने एक ग्रेनेड दागा और कारगिल में भारत को पहली जीत मिल गई। उसके सामने 100 चीनी सिपाही खड़े थे; गिनती की गोलियाँ बची थीं, लेकिन मातृभूमि का कर्ज चुकाते वक्त उसके हाथ नहीं काँपे और उसने युद्ध के मैदान को दुश्मन सिपाहियों का कब्रिस्तान बना दिया। ये भारतीय सेना की वे युद्ध गाथाएँ हैं, जो आप शायद आज तक नहीं जान पाए होंगे। रणभूमि में कान के पास से निकलती गोलियाँ जो सरसराहट पैदा करती हैं, वही कहानी इस किताब में है। बडगाम में मेजर सोमनाथ शर्मा की कंपनी ने कैसे श्रीनगर को बचाया और सियाचिन में पाकिस्तान के किले को किसने ढहाया, इस पराक्रम के हर पल का ब्योरा यह किताब देती है। सन् 1947 से लेकर करगिल तक भारतीय सैनिकों की वीरता की ये वे सच्ची कहानियाँ हैं, जो बताती हैं कि विपरीत हालात के बावजूद कैसे अपने प्राणों की परवाह किए बिना हमारे सैनिकों ने अदम्य साहस और शौर्य दिखाया। यह उस पराक्रम की झलक है, जो युद्धभूमि में दिखा और आज इस पुस्तक के जरिए आप तक पहुँच रहा है। भारतीय जाँबाजों के शौर्य, साहस, निडरता और राष्ट्रप्रेम का जीवंत प्रमाण है यह कृति 'पराक्रम', जो पाठकों को न केवल प्रेरित करेगी, वरन् भारतीय सैनिकों के समर्पण के प्रति श्रद्धा से नतमस्तक कर देगी।
Siddhpur Parikrama: Matru Tirth Siddhpur Manas Parikrama
Geeta Sureshkumar Bhatt
Createspace Independent Publishing Platform
2014
nidottu
शरद जोशी के व्यंग्य का क्षेत्र बहुत व्यापक और विविधवर्णी रहा है। लेखन उनकी आजीविका का भी साधन था। एक सम्पूर्ण लेखक का जीवन जीते हुए उन्होंने अपने दैनंदिन की लगभग हर घटना, हर खबर को अपने व्यंग्यकार की निगाह से ही देखा। उनके विषयों में प्रमुख यद्यपि समकालीन राजनीति और नौकरशाही में व्याप्त भ्रष्टाचार ही रहा लेकिन क्षरणशील समाज की भी ज्यादातर नैतिक दुविधाओं को उन्होंने अपना विषय बनाया।मुक्तिबोध ने कहीं कहा था कि सच्चा लेखक सबसे पहले अपना दुश्मन होता है, अपने कटघरे में जो लेखक खुद को खड़ा नहीं कर सकता, वह दूसरों को भी नहीं कर सकता। शरद जोशी भी जब मौका आता है, खुद भी अपने व्यंग्य के सामने खड़े हो उसकी धार का सामना करते हैं। अपने अनेक निबन्धों में उन्होंने अपनी मध्यवर्गीय सीमाओं, चिन्ताओं और हास्यास्पदताओं का मजाक बनाया है।सच्चे व्यंग्यकार की तरह उन्होंने अपने लेखन में न सिर्फ जीवन की समीक्षा की, बल्कि व्यंग्य की जमीन पर जमे रहते हुए कहानी और लघु-कथाओं आदि विधाओं में भी प्रयोग किए। कवि-मंचों पर उनकी गद्यात्मक उपस्थिति तो अपने ढंग का प्रयोग थी ही।'परिक्रमा' उनका पहला व्यंग्य-संग्रह है जिसका प्रकाशन 1958 में हुआ था। इस नजरिये से इसका अध्ययन विशेष महत्व रखता है।
Din Abhi Dhala Nahi is a novella which tells a story about Aditya and Shruti who lived a sweet simple life in their 1BHK flat, everything was going smooth but one day decides to part ways, what went behind this is what the story is about.