Subhas Ganguli – Dr. Ganguli

Colonoscopy

“What is a colonoscopy ?” “Why has my doctor ordered this test for me ?” “What should I expect ?” – please see below for more information.

General Information about Colonoscopy:

What is it and what to expect – Mayo Clinic, Cleveland Clinic, CDN Cancer Society, WebMD, Johns Hopkins.
Videos: Introduction, what happens during the procedure, 6 reasons to get one.
P reparation instructions for those on a plant-based diet.

Patient Information – Lifestyle

Slides

GI Diseases & Lifestyle

Orodispersible Budesonide (Jorveza)

Jorveza is a medicine used to treat adults with eosinophilic oesophagitis. Eosinophilic oesophagitis is inflammation of the oesophagus (the passage that leads from the mouth to the stomach), which causes symptoms such as dysphagia (difficulty swallowing) and blockage of the oesophagus. It is caused by a large build-up of white blood cells called eosinophils in the lining of the oesophagus.

It is essential to follow the instructions below in order to use this drug correctly:

To take this medication, place a tablet on the tip of your tongue and gently press it against the roof of your mouth until it dissolves. The tablet should dissolve in approximately 2 minutes but may take up to 20 minutes. While the tablet is dissolving, you can swallow the dissolved material in your saliva a little bit at a time but do not chew or swallow the undissolved tablet.
Tablets MUST NOT be chewed or swallowed whole
This medication should be taken at least 30 minutes after a meal and NOT with liquid or food.
Avoid brushing your teeth, eating or drinking, or rinsing your mouth for at least 30 minutes after taking the tablet. Do not use any oral solutions, sprays, or chewable tablets for 30 minutes before or after taking this medication.

References

European Medicines Agency – Jorveza 4/26/22
Medbroadcast – J o rveza 4/26/22

Administration

Current Protocols

Original Google Docs

Patient Information on other Diseases

Viral Hepatitis

City of Hamilton Information here
Hepatitis C (HCV)
1. NIH Information
2. CDC Information for the public

GI Teaching

Masks 2

There’s a great site here with instructions on how to make your own masks – note that their recommended patter is ‘Clover‘ – just click on the word ‘Clover’ at the top of the page to be taken to the instructions.

If you live in the Hamilton area, here is information on where you can get supplies (leave them a message – they check their messages daily):

Discount Fabric Mart
317 Ottawa St North, Hamilton, ON
Work 905-549-2293
Cell 905-531-1344
Email: discountfabricmart@gmail.com

If you’d like to see information on how effective home made masks are, see here.

Masks 1

If you’re looking for info on how to make masks & where to get supplies (in Hamilton) see here.

Study 1: Transmission Reduction Potential of FFP2 (N-95 equivalent), homemade and surgical masks.

Reference: R Sabel Plos One 2008:3(7):e2618

Aim

To assess the transmission reduction potential of FFP2 masks vs surgical masks vs home-made masks.

Methods

Assessed transmission reduction potential provided by personal respirators surgical masks and home-made masks when worn during a variety of activities by healthy volunteers and a simulated patient.

Long-term protection was assessed during 3 hours of regular activity by a volunteer.

Protection factor was assessed measuring particle concentration inside and outside the mask with PF = 1 meaning complete absence of protection (ie the higher the number the better)

The table below shows the average of the median protection factors after 3 hours of a combination of various activities:

Median Protection Factors of Different Types of Masks

Study 2: Efficacy of Homemade Masks & Protection form an Influenza Pandemic

Aim

To compare homemade masks to surgical masks.

Reference: A Davies Disaster Med Public Health Preparedness 2013:0:1-6

Methods

In the first part of the experiment, different materials were compared in terms of filtration efficiency (for bacteria and an RNA bacteriophage as well as pressure Drop across fabric.

In the second part of the study, a homemade mask (made out of 100% cotton T-shirt material) was compared to a surgical mask.

Results

The table below lists the Mean % Filtration efficiency to an RNA bacteriophage of different materials:

The fit factor of homemade and surgical masks was then compared as well as a comparison to no mask. A ‘Fit Factor’ (FF) was calculated (high number = better fit):

When compared, homemade masks had a FF of 2.0 vs 5.0 for surgical masks

They then had volunteers cough & looked at the median number of colony forming units (CFUs) isolated from volunteers coughing when wearing a surgical mask, a homemade mask, and no mask:

Comparing No mask vs Homemade mask median CFUs was 2.0 vs 1.0 (P=0.04)

When comparing No mask vs Surgical mask, median CFUs was 2.0 vs 0.9 (P<0.001)

When comparing the total number of CFUs of different sizes isolated from 21 volunteers coughing when wearing No mask vs Homemade mask vs Surgical mask they saw 200 vs 43 vs 30 CFU.

Thus in all the measures, a homemade mask was better than no mask, but worse than a surgical mask.