40 yr old male,h/o suprapubic catheterisation 5 months back for urethral stricture;came with chief complaints of pain abdomen with o stipati on fir 3 days, on x ray multiple air fluid level with pneumoperitoneum. On exploratory laparotomy, one perforation 100cm from dj flexure ,another 150cm from dj flexure,in between two circumferential stricture was there. Resection(50cm)and anastomoses done in two layer.specimen sent for HPE. What can be the cause circumferential multiple stricture with multiple perforation??guess plz

An otherwise healthy 50-year-old male presents to his new family physician with a rash he’s had for several years. He mentions that the skin eruption becomes erythematous and pruritic after exercising, and when he scratches it. On examination, reddish-brown freckle-like macules are seen on his upper extremities, back, and abdomen. A skin biopsy reveals an increased number of dermal mast cells. Which of the following is most commonly associated with this patient’s likely diagnosis? A) Interstitial lung disease B) Peptic ulcer disease C) Chronic pancreatitis D) Crohn disease

Ayurvedic Treatment... pt. hv stomach pain since 1 year... but not get relief from allopathic medicines so sue needs Ayurvedic treatment for this...

a 37 told alcoholic continuously drinking alcohol since 2days presented with sudden onset of abdominal pain since today morning,o/e vital are stable with no urine output since morning x-ray abdomen erect attached how will. u manage the. case

34/M Patient who was apparently well 10 days back with no problems, has come with: Abdominal distension, nausea, burping, hiccups off & on, difficulty breathing, occasional mild coughing x 10 days Chronic tobacco chewer, occassional alchol consumption H/o passing frequent scanty stools. H/o dark / blackish stool x 1 day H/o yellowish to dark yellow urine x 10 days with occasional reddish urine No h/o fever, burning micturition, bleeding from any site Patient had been prescribed AKT-4 yesterday and has taken 1 dose today morning. H/o severe headache 10 days back. Similar episode 5 years back. No details about investigations available at present. ---- GCS = 15. Vitals stable. Pallor present. No apparent icterus, edema, cyanosis, lymphadenopathy. However, GC seems poor. Chest: A/E reduced bilaterally (rt > lt). B/L crepts. Abd: Distended, mild generalized tenderness more pronounced in RUQ and epigastrium No significant findings on genital or per-rectal exam. CVS and neurological exam - no significant findings. ---- Patient has some reports from his consultation elsewhere. (Attached). Somehow I feel that the provided reports do not match the patient's condition. ---- Diagnosis, work-up and management?