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Hepatic encephalopathy

Hepatic encephalopathy is due to rise in ammonia levels in blood Signs and symptoms : 1.Drowsiness, sleepiness, 2.personality changes, 3.flapping tremor in hands (asterixis) 4.musty odour in breath (fetor hepaticus) 5.slurred speech 6.irritability Diagnosis: 1.blood ammonia levels 2.electroencephalogram join test Treatment: 1.Lactulose 2.adequate protein intake 3.oxygen therapy 4.iv fluids 5.Antibiotics –Mrunali Gondane

Management of Fibroids

Management of fibroids includes investigations and treatment Investigations •Hb, blood group •Ultrasound: location, size, number,for follow up of fibroids after menopause and during GnRH therapy •Hysterosalpingography and salpingography: to identify submucous fibroid and to check patency of fallopian tubes in infertility. •Hysteroscopy: to identify a submucous polyp and excising it under direct visualisation. •D and …

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