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Dr. Siddique Akbar satti has been explaining various causes of gastric outlet obstruction, this case is the continuation of his current subject.   This is the case of 76 year old male with past medical history of hypertension and Acid peptic disease presented to the outpatient department of Capital Hospital Islamabad complaining of dyspepsia, early satiety, weight loss since last 3 months and vomiting if he tries to eat more. Lab studies and abdominal ultrasound were unremarkable. All these symptoms in view of his age and previous history of APD suggest that there could be some stricture or growth around gastric outlet, so in order to confirm that Dr. Siddique Akbar Satti went for upper GI endoscopy which was done on 6/4/15. He got the following picture of this old gentle man.     Dr. S A Satti writes in his report, “There is a Polypoidal growth in the duodenum bulb causing obstruction in the passage of D2. There is patchy ulcer...

This is a case of a 75-year-old male, who presented to the medical outpatient department of Capital Hospital Islamabad with history of dyspepsia for the last 6 months and vomiting since last fourteen days. He also had a significant history of weight loss. There wasn’t any history of black stools, constipation, diarrhoea, dizziness, headache. But he was feeling fatigued, dizziness and generalized weakness. He vomits right after eating or drinking fluids. The vomitus consists of the contents of recently eaten food. He was given medication for symptomatic relief but medication wasn’t of great help for him. Considering his age and the signs/symptoms, Dr. Siddique Akbar Satti who was on the case, went for an upper GI endoscopy. He did the endoscopy and got the following picture of the stomach. Dr. Satti says in his report that the gastric cavity is dilated with large amount of residual food and fluid, even after 12 hours of fasting. There is a large sized ulcer ...

  Q: sir, my wife is presently 50 years old. she has chronic dry eyes and she is losing her eyesight rapidly.on the advice of doctors, she is using eyedrops regularly with a negative result. what do you suggest? Regards, mukul sarma A: I am sorry about this problem. The problem of dry eyes occurs when tear product decreases or due to bad quality of tears. The problem of dry eyes is more common in women of post-menopausal age and tear production starts to decrease after the age of 50. Moreover if you have a medical condition such as diabetes , Sjogren's syndrome , rheumatoid arthritis, scleroderma thyroid disorder or vitamin A deficiency that is affecting tear production or you are taking some medications such as anti-allergic, antihypertensive agents, hormone replacement drugs or some antidepressants, which decrease the production of tears, then your problem may aggravate. Your wife has the two risk factors that she is 50 and is probably post-menopausal. Now, if she...

A 53 year old male with medical history of   An episode of Hematemesis a day ago. Vomiting soon after taking meal since last one month Dyspepsia or indigestion sine last 3 years. Early satiety Abdominal fullness Epigastric discomfort   Presented to the Emergency Department of CDA hospital on 6th June 2015. Dr. Siddique Akbar Satti was on the case. Patient with such a long history of dyspepsia and an episode of hematemesis, without any history of any explainable risk factor such as, Portal hypertension, chronic hepatitis, esophageal varices , alcoholism, malena, Diabetes, was very unusual, and raise the suspicion that there is something wrong.   Dr. Siddique Akbar Satti, went for Upper GI endoscopy as he was of the view that the vomiting that follows soon after having meal, suggests that there is something wrong with the gastric outlet. So he did his endoscopy.   Following are the endoscopic views of the patient stomach.     ...