Dyspepsia is a disorder which affects a large portion of the population. However, it is very important to differentiate between commonly presenting symptoms like gastroesophageal reflux disease, functional dyspepsia, and irritable bowel syndrome. Also various classifications and treatment protocols have been developed and revised to provide a rational platform for the clinicians. The ROME III classification has to a large extent given a direction to the clinicians to base their practice on, however, is a classification based on clinical trials and is really helpful in daily practice. In this issue we have tried to focus on the need for classification and approach to the patient with dyspepsia.

Irritable bowel syndrome is a part of the family of gastrointestinal motility disorders and is characterized by abdominal pain and altered bowel habits. It is highly prevalent throughout the world with the reported prevalence rates lying between 9% and 25%. The incidence of IBS varies between different ethnic groups and the incidence has also been reported to be different in males and females. The incidence also varies between various clinical subgroups (diarrhea-predominant/constipation-predominant) of the disorder. This is a chronic condition and is the most frequent symptom complex in patients who visit gastroenterologists throughout the world. However, this is one of the least understood GI disorders as it is not a disease but a complex of symptoms. The symptoms are often severe and quite bothersome, and thus have a negative effect on the patient’s quality of life and activity level, often leading to psychiatric complications. Besides this, a substantial economic burden of the disease and its impact in terms of man hours lost per annum make it one of the most troublesome symptom complexes in medicine, which need to be solved. This book has been designed to update the readers on the extensive research done over these years and on the many new potential mechanisms of pathogenesis of this troublesome condition. The reader will also be updated on the changing epidemiology of the condition. Diagnostic approach and management of IBS have also been thoroughly reviewed with an emphasis on the recent updates in the field. Typical supportive case scenarios have been included to exemplify and highlight various points discussed. Thus, it provides an excellent opportunity to widen one’s perspective in this area.

Cell health depends on a steady supply of fuel from glucose and free fatty acids. Both these major fuels are regulated by insulin. Cells in the muscle, liver, and fat need insulin to receive glucose, and hence do not become exposed to high blood glucose levels when the blood sugars are high and insulin levels are low. The lack of insulin slows the movement of glucose into these cells, and probably spares them from damage when blood sugars are high. However, other cells such as those in the brain, nervous system, heart, blood vessels and kidneys pick up glucose directly from the blood without using insulin. These cells, except the brain, are more prone to damage from high blood sugars because they become exposed to high internal levels of glucose. This to quite an extent explains why damage tends to occur in specific organs such as in nerve and kidney cells, and in small blood vessels like those in the eyes. This project on the organ damage in diabetes is an attempt to elaborate on the various factors to be considered in managing these patients, the pointers for early diagnosis and prevention of the same.

The pathogenesis of microvascular complications is complex and multifactorial. Yet, hyperglycemia emerges as the most important single cause, which has been proved by the Diabetes Control and Complications Trial (DCCT). Thus, the importance of protecting the body from hyperglycemia cannot be overstated; the direct and indirect effects on the human vascular tree are the major source of morbidity and mortality in both type 1 and type 2 diabetes. Generally, the injurious effects of hyperglycemia are separated into macrovascular complications (coronary artery disease, peripheral arterial disease, and stroke) and microvascular complications (diabetic nephropathy, neuropathy, and retinopathy). It is important for physicians to understand the relationship between diabetes and vascular disease because the prevalence of diabetes continues to increase in our country, and the clinical requirements for primary and secondary prevention of these complications are also expanding.

ECAB Health Impact of Probiotics: Vision & Opportunities - E-Book

Interventional Cardiology came into being during early 1950s. Interventional cardiology has seen substantial advances in last couple of decades, be it World or India. Interventional Cardiology started as brachial artery coronary cine angiography. The initial decade after the advent of interventional cardiology was only dedicated to its diagnostic use; it was in late seventies when the horizon of interventional cardiology broadened. In 1977 Andreas Gruentzig introduced the cardiologist to therapy, with percutaneous transluminal coronary angioplasty (PTCA). This initially slender spectrum of balloon dilatation has broadened into the large spectrum of interventional cardiology, which now encompasses both diagnostic and therapeutic modalities for coronary artery disease. The main advantages of interventional cardiology are the avoidance of the pain, scars, and long postoperative recovery associated with surgery. The book is a comprehensive guide to understand the clinical application of Interventional Cardiology with special reference and experience in India. The authors have put together the most relevant facts about the disease for an easy comprehension and understanding of the same by practitioners and students across the specialty.