Dr: Mohamed Khadar

ESOPHAGEAL CANCER Esophageal Cancer is a serious form of cancer that develops in the esophagus, the long tube that connects the back of your mouth with your stomach. The most common types of esophageal cancer are adenocarcinoma, which starts in the glandular cells producing fluids such as mucus, and squamous cell carcinoma, which starts in flat cells of the esophageal lining. Although the causes of esophageal cancer aren’t known, chronic irritation from gastroesophageal reflux disease (GERD), Barrett’s esophagus, smoking, obesity, and heavy alcohol use are leading risk factors for the disease. SYMPTOMS: • Difficulty in Swallowing • Unintentional Weight Loss • Chest Pain • Heart Burn • Indigestion • Coughing • Hoarse Voice DIAGNOSIS: • Endoscopy – During endoscopy, your doctor passes a flexible tube equipped with a video lens (videoendoscope) down your throat and into your esophagus. Using the endoscope, your doctor examines your esophagus, looking for cancer or areas of irritation. Sam

Nephrolithiasis • Calcium oxalate (and to some degree calcium phosphate) stones account for 80% of all kidney stones • Remaining stones are uric acid (10%), struvite (10-15%) and cystine (1%) stones • It is possible for patient to have multiple stones and for them to be more than one type of stone Risk Factors • Crystallization occurs when otherwise soluble solutes precipitate due to supersaturation or changes in urinary pH, protein content, or due to reaction with other solutes • Crystals cause epithelial injury, deposition of stone formation, bleeding, obstruction, and pain • Frequently identified risk factors include hypercalciuria, hyperoxaluria, hypocitraturia, decreased calcium intake, increased oxalate intake, increased animal protein intake, and decreased hydration • There is more than 2-fold increase in risk of kidney stones with positive family hx of kidney stones • Patients with history of kidney stones have a 10-30% 3-5 year recurrence rate • 25% of people with gout will ge