Treatment
It aims at relieving the pain, curing the ulcer, and eradicating the infection, via:-
- A change in lifestyle and habits
- Decreasing gastric acid production
- Buffering the acidity of the stomach
- Increasing mucus secretion
- Antibiotics to get rid of the bacteria to prevent recurrence and complications like malignancy.
It aims at relieving the pain, curing the ulcer, and eradicating the infection, via:-
- A change in lifestyle and habits
- Decreasing gastric acid production
- Buffering the acidity of the stomach
- Increasing mucus secretion
- Antibiotics to get rid of the bacteria to prevent recurrence and complications like malignancy.
Decreasing gastric acid production:-
• Anti-muscarinics, like pirenzepine (they target M1 receptors in the stomach). nobody really uses them because of their low efficacy and atropine-like effects at higher doses.
• anti-histamines, like cimetidine (they target H2 receptors). They do a great job. Cimetidine, being the prototype, has more side effects than the newer drugs like famotidine; it has anti-androgenic effects (like gynecomastia), causes some CNS problems especially in the elderly, and is a potent inhibitor of CYP450. It also has weaker effect on acid secretion than famotidine.
Some guidelines suggest using them for 6 weeks as initial treatment, and then lowering the dose by half for 6 months (in addition to antibiotics, obviously).
• Protein-Pump Inhibitors (PPIs), like Omeprazole and pentoprazole. They are great, we love them, and they work fine.
Their side effects are usually diarrhea (due to decreased HCl level), deficiency in intrinsic factor (and therefore B12 deficiency), and osteoporosis (because osteoclasts also use K/H ATPase pump, which the PPIs inhibit). Also, omeprazole, but not the others, is an inhibitor of CYP450. Anyway, all PPIs change the bioavailability of drugs because the alter the acidity of the stomach.
The guideline is to take them initially for 4 weeks, then lower the dose by half for 4 months because they are more effective than cimetidine and his cousins.
It should be noted that all the drugs that decrease gastric acid secretion must not be discontinued suddenly, because this may increase HCl levels to terrible levels and causes a rebound ulcer.
• Anti-muscarinics, like pirenzepine (they target M1 receptors in the stomach). nobody really uses them because of their low efficacy and atropine-like effects at higher doses.
• anti-histamines, like cimetidine (they target H2 receptors). They do a great job. Cimetidine, being the prototype, has more side effects than the newer drugs like famotidine; it has anti-androgenic effects (like gynecomastia), causes some CNS problems especially in the elderly, and is a potent inhibitor of CYP450. It also has weaker effect on acid secretion than famotidine.
Some guidelines suggest using them for 6 weeks as initial treatment, and then lowering the dose by half for 6 months (in addition to antibiotics, obviously).
• Protein-Pump Inhibitors (PPIs), like Omeprazole and pentoprazole. They are great, we love them, and they work fine.
Their side effects are usually diarrhea (due to decreased HCl level), deficiency in intrinsic factor (and therefore B12 deficiency), and osteoporosis (because osteoclasts also use K/H ATPase pump, which the PPIs inhibit). Also, omeprazole, but not the others, is an inhibitor of CYP450. Anyway, all PPIs change the bioavailability of drugs because the alter the acidity of the stomach.
The guideline is to take them initially for 4 weeks, then lower the dose by half for 4 months because they are more effective than cimetidine and his cousins.
It should be noted that all the drugs that decrease gastric acid secretion must not be discontinued suddenly, because this may increase HCl levels to terrible levels and causes a rebound ulcer.
La bohème
عنترة بن شدّاد، بغلظته وشدّته وفروسيته عبّر لعبله برقة متناهية عن نمو حبّها داخله رويدًا رويدًا بصورة مدهشة : "وَظلّ هواكَ ينمو كل يومٍ كَمَا ينمُو مشيبي في شبابي"
خُلِقتُ مِنَ الحَديدِ أَشَدَّ قَلبًا
وَقَد بَلِيَ الحَديدُ وَما بَليتُ
وَإِنّي قَد شَرِبتُ دَمَ الأَعادي
بِأَقحافِ الرُؤوسِ وَما رَويتُ
وَفي الحَربِ العَوانِ وُلِدتُ طِفلًا
وَمِن لَبَنِ المَعامِعِ قَد سُقيتُ
فَما لِلرُمحِ في جِسمي نَصيبٌ
وَلا لِلسَيفِ في أَعضايَ قوتُ
- عنترة بن شداد
وَقَد بَلِيَ الحَديدُ وَما بَليتُ
وَإِنّي قَد شَرِبتُ دَمَ الأَعادي
بِأَقحافِ الرُؤوسِ وَما رَويتُ
وَفي الحَربِ العَوانِ وُلِدتُ طِفلًا
وَمِن لَبَنِ المَعامِعِ قَد سُقيتُ
فَما لِلرُمحِ في جِسمي نَصيبٌ
وَلا لِلسَيفِ في أَعضايَ قوتُ
- عنترة بن شداد
0/0
https://youtu.be/REhlyvtiIhQ
باختصار: المسلسل حواراته كلها بلا معنى، ولهذا هو مسلسل عظيم. لأنه مثال على الـ doublespeak
Forwarded from 0/0 (Haidar A. Fahad)
الإزدواج بالكلام (Doublespeak) هو أسلوب يدّعي أنه يُستخدم للتواصل، لكنه ليس كذلك. هو أسلوب يجعل السيء يبدو جيدًا، والسالب يظهر موجبًا، والغير مرغوب يبدو جذّابًا أو على الأقل قابلًا للإحتمال. الإزدواج بالكلام هو اللغة التي تتفادى وترمي بالمسؤولية بعيدًا عن المتكلِّم.
- كتاب Doublespeak
- كتاب Doublespeak
0/0
الإزدواج بالكلام (Doublespeak) هو أسلوب يدّعي أنه يُستخدم للتواصل، لكنه ليس كذلك. هو أسلوب يجعل السيء يبدو جيدًا، والسالب يظهر موجبًا، والغير مرغوب يبدو جذّابًا أو على الأقل قابلًا للإحتمال. الإزدواج بالكلام هو اللغة التي تتفادى وترمي بالمسؤولية بعيدًا عن…
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إذا ترحَّلتَ عن قومٍ وقد قَدروا
ألّا تُفارِقهُمْ فالرَّاحلونَ هُمُ
شرُّ البلادِ مكانٌ لا صديقَ بهِ
وشرُّ ما يَكسِبُ الإنسانُ ما يَصِمُ
- أبو الطيّب المتنبي
ألّا تُفارِقهُمْ فالرَّاحلونَ هُمُ
شرُّ البلادِ مكانٌ لا صديقَ بهِ
وشرُّ ما يَكسِبُ الإنسانُ ما يَصِمُ
- أبو الطيّب المتنبي
0/0
https://thebaffler.com/salvos/enter-the-supersensorium-hoel
He offers an interesting explanation to: why we love fiction & stories?