Constipation is a prevalent yet often overlooked gastrointestinal complication in patients with Type 2 Diabetes Mellitus (T2DM). Affecting up to 60% of diabetic patients, this condition significantly impacts quality of life and may lead to severe complications if left untreated. Despite its prevalence, the connection between diabetes and constipation remains understudied and frequently undertreated in clinical practice. This session will explore the multifaceted relationship between T2DM and constipation, including the role of medications, and lifestyle factors. Join us as Gastroenterologist Dr. Manish Bhatnagar discuss the pathophysiology, diagnosis, and management strategies for this important complication. 

Diabetes and Constipation: An Overlooked, Understudied and Undertreated GI Complication in T2DM Patients 

Ascites is the pathologic accumulation of fluid within the peritoneal cavity. It is the most common complication of cirrhosis and occurs in about 50% of patients with decompensated cirrhosis in 10 years. Other causes of Ascites include malignant neoplasia, tuberculous infection, cardiac insufficiency, renal diseases, etc. Effective management of ascites is crucial for improving patient outcomes and quality of life. Join us as Gastroenterologist Dr. Manish Bhatnagar discusses these key aspects of ascites management, bringing their expertise in diagnosing and treating this challenging condition. Enhance your clinical skills and stay updated on the latest best practices to improve patient care and outcomes.

Management of Ascites

Nonalcoholic fatty liver disease (NAFLD) is a condition in which fat builds up in your liver. Nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH) are types of NAFLD. NAFLD is a spectrum of diseases including simple fatty liver, NASH, fibrosis, and cirrhosis, with a complex ‘multi-hit’ pathophysiology. Non-alcoholic fatty liver disease (NAFLD) has a global prevalence of about 25%. Incidence is increasing with rising levels of obesity, type 2 diabetes, and metabolic syndrome, and NAFLD is predicted to become the leading cause of cirrhosis requiring liver transplantation in the next decade. Diagnosis involves the identification of hepatic steatosis, followed by risk stratification for significant fibrosis. Renowned gastroenterologist Dr. Manish Bhatnagar will share his insights on this pressing health issue.

Non-alcoholic Fatty Liver Disease

The Hepatitis A virus is a common infectious etiology of acute hepatitis worldwide and is most commonly transmitted through the oral-fecal route via exposure to contaminated food, water, or close physical contact with an infectious person. Hepatitis E virus causes about 20 million new infections and over 55,000 deaths annually. It commonly causes an acute illness that is typically indistinguishable from other forms of acute hepatitis. A vast majority of patients are asymptomatic or have a mild clinical disease. Drug-induced liver injury (DILI) is an acute or chronic response to a natural or manufactured compound, where treatment begins with the removal of the offending agent, and the prognosis for recovery is usually favourable after discontinuation of the drug. Join renowned Gastroenterologist, Dr. Manish Bhatnagar as he shares his expertise on Hepatitis A, E and DILI.

Physician's Guide to Hepatitis : Decoding Hepatitis A, E and Drug - Induced Liver Injury

Hepatitis B virus and Hepatitis C virus infections are major causes of acute and chronic liver disease (e.g. cirrhosis and hepatocellular carcinoma) globally and cause an estimated 1.4 million deaths annually. While HCV is the most prevalent cause of parenteral hepatitis worldwide, around one-third of the global population has had an infection with the Hepatitis B virus. Testing and diagnosis of hepatitis B and C infection is the gateway for access to both prevention and treatment services and is a crucial component of an effective response to the hepatitis epidemic. In this session, Medflix Superstar, Dr. Manish Bhatnagar will take us through the Basic Guide to Hepatitis B and Hepatitis C.

Physician's Guide to Hepatitis : Hepatitis B & C

In clinical practice, it is normal to face challenging clinical cases, whose diagnosis does not seem obvious. While classical presentations of uncomplicated disease are diagnosed by pattern recognition, complex problems require analytical thought in addition. In this setting, the physician will need to make use of the complementary laboratory and imaging tools. Nevertheless, the clinical history is the most fundamental tool that triggers the diagnostic process followed by a detailed, careful, and precise physical examination. In this session, Medflix superstar, Dr. Manish Bhatnagar will address the Diagnoses that may be missed and share tips to approach medical conditions like Lactose Intolerance, Eosinophilic esophagitis, and Celiac disease.

Diagnoses Flying Under the Physician's Radar: From Lactose Intolerance to Celiac Disease

Chronic diarrhoea, defined as a decrease in stool consistency for more than four weeks, is a common but challenging clinical scenario. It can be divided into three basic categories: watery, fatty (malabsorption), and inflammatory. However, some of these categories tend to overlap. Nevertheless, it is absolutely important to take an effective history and to perform a careful physical examination. In this session, Dr. Manish Bhatnagar, a renowned Gastroenterologist and a Medflix Superstar will take us through the list of diagnostic possibilities in these patients using a case-based approach.

Chronic Diarrhoea : Think Beyond the Gut

Chronic pancreatitis is a progressive inflammatory disorder that results in irreversible destruction of exocrine and endocrine pancreatic parenchyma caused by atrophy and/ or replacement with fibrotic tissue. Functional consequences include severe abdominal pain, diabetes mellitus, and malabsorption. When pancreatic enzyme activity in the intestinal lumen is reduced below the threshold needed for digestive functions, primarily pancreatic lipase, it is referred to as pancreatic exocrine insufficiency (PEI). Top Gastroenterologist, Dr. Manish Bhatnagar will take us through the etiology, pathophysiology, evaluation, and management of chronic pancreatitis and PEI.

Clinical Overview of Chronic Pancreatitis & PEI

The disorder known as gastroesophageal reflux disease (GERD) is brought on by the retrograde reflux of stomach contents into the oesophagus. Numerous people's lives are impacted by the clinical management of GERD, which also significantly uses up social and medical resources. Our esteemed expert, Dr. Manish Bhatnagar will discuss the diagnosis, management, and role of the interprofessional team in providing better care for patients with GERD in this session.

A Review of Gastroesophageal Reflux Disease

Gastrointestinal (GI) tuberculosis (TB) accounts for 1% to 3 % of all TB cases worldwide. It can occur in the context of active pulmonary disease or as a primary infection without pulmonary involvement.  This session aims to provide doctors with a comprehensive understanding of gastrointestinal tuberculosis, a significant health concern worldwide. Dr. Bhatnagar will delve into the epidemiology, pathogenesis, clinical manifestations, and diagnostic approaches related to this condition. He will share evidence-based strategies and practical tips to aid doctors in effectively diagnosing and treating patients with this condition.

GI Tuberculosis: An Overview

Discover a new world of medical research with our outstanding speakers at the upcoming Changing Practice : November Roundup, which is being hosted by the renowned expert Dr. Mahadev Desai. We'll be talking about some excellent studies in the field of rheumatology and recent articles from BMJ, a distinguished expert panel will be there to offer advice. Get a seat at this #MustAttendSession, broadcast live only on Medflix, to advance your medical expertise!

Changing Practice - November Round Up

Fatty liver disease, once considered a benign condition, has emerged as a significant health concern with far-reaching consequences. There is an intricate relationship between fatty liver disease, metabolic syndrome, insulin resistance, obesity, and other metabolic disorders. Let's Explore and Understand the risks and implementing appropriate monitoring and management strategies with Dr. Manish Bhatnagar in preventing disease progression and improving patient outcomes.

Fatty Liver: No more a Benign Disease

Proton pump inhibitors (PPIs) are a mainstay in the management of acid peptic disorders; they are highly effective at relieving symptoms and are generally well tolerated. However, there is growing concern about their increasing use owing to being linked to a number of adverse events (PPI-associated adverse events [PAAEs]). Therefore, de-prescribing of PPIs is considered an important strategy to lower pill burden. Join in LIVE with renowned senior gastroenterologist, Dr Manish Bhatnagar, to understand the latest recommendations in prescribing & de-prescribing proton pump inhibitors. 

PPI's: Too much of a good thing?

Probiotics have been widely studied in a variety of gastrointestinal diseases. Clinicians remain confused by the lack of precise instructions on when to use probiotics and which probiotic is best for treating certain gastrointestinal problems. There has been great interest in the role of probiotics and the treatment of childhood diarrhoea, antibiotic associated diarrhoea, Clostridium difficile infection, Irritable bowel syndrome and inflammatory disease. In this discussion with Dr. Manish Bhatnagar, we will first illustrate the concept of prebiotics & probiotics, covering the most recently well-established scientific findings regarding the direct and indirect mechanisms by which these dietary approaches can influence gut immunity.

Prebiotics, Probiotics & the Gut Microbiome

Jaundice, a clinical manifestation of elevated serum bilirubin, is a common clinical finding in clinical practice. Jaundice is most often caused by decompensation of preexisting chronic liver disease, alcoholic hepatitis, and gallstone disease. Careful history, physical examination, and routine laboratory tests lead to accurate diagnosis in most patients with jaundice. Renowned gastroenterologist Dr Manish Bhatnagar provides a comprehensive description of the day-to-day clinical picture of jaundice, which will undoubtedly streamline our approach to treating it in routine practise.

Approach to Jaundice: Day-to-day Hepatology

Upper GI bleeding includes hemorrhage originating from the esophagus to the ligament of Treitz, at the duodenojejunal flexure. It can be categorized based upon anatomic and pathophysiologic factors: ulcerative, vascular, traumatic, iatrogenic, tumors, portal hypertension & usually presents with hematemesis, “coffee-ground” emesis, and/or melena. Peptic ulcer disease: the most common cause, accounts for about half of major upper GI bleeds. Dr. Manish Bhatnagar, renowned Senior Consultant in Gastroenterology, is here to provide us all with a practical diagnostic algorithm to the case of suspected upper gastrointestinal bleeding(UGIB). The discussion is aimed to address the dilemmas in diagnosis of an upper GI Bleed, which in turn will guide us towards definitive investigations and interventions.

Diagnostic Dilemmas: Upper GI Bleeding

The defining features of IBS are the presence of recurrent abdominal pain in association with altered bowel habits & the spectrum, duration and severity of symptoms can range from inconvenient to incapacitating. IBS presents an interesting conundrum given its diagnostic ambiguity and overlap with other functional gastrointestinal disorders. The Rome criteria currently divide IBS into 4 subtypes based on the most prominent bowel habit: IBS with constipation (IBS-C), IBS with diarrhea (IBS-D), IBS with mixed bowel habit (IBS-M; with alternating between constipation and diarrhea) and IBS unclassified (IBS-U). To simplify the diagnosis and treatment modalities of IBS, we have Dr. Manish Bhatnagar join us on Medflix for an in-depth guide on the approach to IBS. 

Gut Check: Approach to IBS Diagnosis and Treatment

Inflammatory bowel disease (IBD) is a chronic inflammatory disease of the gastrointestinal tract and includes both Crohn's disease and ulcerative colitis. Given that the presentation of IBD is not specific, the differential diagnosis is broad and encompasses a wide spectrum of diseases, many of which can mimic and/or even coexist with IBD. Mycobacterium tuberculosis ('the great mimic') may coexist with IBD or mimic CD entirely. Accurate diagnosis of IBD and exclusion of these mimics are crucial for patient management. Renowned senior gastroenterologist Dr. Manish Bhatnagar helps us address these dilemmas in diagnosis with a few interesting cases and clinical scenarios! 

Diagnostic Dilemmas : IBD

Association of Physicians of India - APICON 2023 & Medflix jointly present India's largest LIVE medical quiz series! Prepare for the most thrilling quizzes of the year! 7 days, 7 specialties & unlimited learning. Our faculty Quizmaster for this editon is Dr. Manish Bhatnagar, a renowned Gastroenterologist with over 2 decades of experience. Join in, play along, and obtain insightful clinical knowledge while winning fun cash prizes and taking home your API certificate of attendance. Experience the joy of learning medicine, tune in on 10th Jan at 9PM!

APIQUIZ : Gastroenterology Edition

Consultant Gastroenterologist, Hepatologist & Therapeutic Endoscopist | Chairman - ICON Hospital, Ahmedabad

Despite the availability of effective screening and treatment options, the management of patients with incidentally detected HBsAg positivity is often complex, requiring careful consideration of liver function, viral load, and potential risk factors for progression to chronic disease or liver-related complications. This session will delve into the appropriate clinical approach for managing patients with incidentally detected HBsAg positive status. Dr. Manish Bhatnagar, will discuss the latest diagnostic strategies, risk assessment tools, and treatment options, as well as the importance of patient education and follow-up care. Attendees will gain practical insights into how to navigate the often-overlooked aspects of managing this condition in routine clinical practice.

Dr. Manish Bhatnagar

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