Achalasia Oesophagi by Prof M.D Jeff Akvama

September 10, 2012 § Leave a comment


Achalasia Oesophagi

Prof Dr Jeff Akvama

10.09.2012

The disease which today is known as achalasia Oesophagi attracted attention as early as in the seventeenth century. Various names have been applied to the disease, such as cardiospasm, phrenospasm, cardioparesis, phrenocardiospasm and maga-oesophagus.

The term achalasia oesophagi was first presented by Arthur F. Hurst in 1913.Translated from Greek, achalasia oesophagi means “lack of relaxation” or “failure to relax” and, refers to the failure of the lower oesophageal sphincter to relax.

Although, achalasia is the word most commonly applied today to describe the condition, the disorder is actually a combination of motor failure at the lower portion of the oesophagus and absence of relaxation of the sphincter. Thus, the name achalasia is not totally suitable for the disease. However, it is more appropriate than cardiospasm which is still sometimes applied as a synonym. Hurst distinguished achalasia oesophagi as a separate entity.

Accurate investigations were carried out in 1926 by Rake who described that the disease was due to progressive degeneration of the Auerbachs`s plexus in the region of the epicardia. He demonstrated histologically that the ganglion cells in the Auerbach`s plexus were either absent or strikingly reduced in number. Ellis F.H Jr. et al. 1969 discovered irregularities in the vagus nerve.

Chagas disease, widely prevalent in South America is capable in producing changes in the oesophagus identical to achalasia oesophagi. Patients suffering from the disease have similar clinical symptoms and roentgenologic and manometric findings are identical to achalasia oesophagi.

Symptoms of the disease

Dysphagia 78%

Rumination/regurgitation 74%

Food stops 53%

Chest Pains 53%

Vomiting/Weight loss 45%

Retrosternal oppression 29%

Complication of the disease

Esophagitis 1.5%

Ulcerative carcinoma at the 0.5%

Proximal end of oesophagus

Pulmonary aspirations, 0.3%

Pneumonitis

Treatment of the disease

Medical treatments

Cimetidine

Spasmolytic

Dilatation Methods seem to be more effective than botulinum toxin injections.

Starck, Plummer, Negus, Bougienage and others

Surgical

Thirty years passed by, however, until Heller`s surgical procedure was accepted and adapted in 1913. The operative mortality was formerly high because, as a rule the operation was performed on patients in a very poor state. However, within the past many years, the mortality due to Heller`s myotomy operation, has fallen. A 7cm cut through the outside muscle layers of the oesophagus, leaving the inner mucosal layer undamaged, not too short and not too long.

Today, it has been found to be useful in the routine surgical treatment of achalasia oesophagi.

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  ACHALASIA OESOPHAGI, ranging from mild, moderate, pronounced and sigmoid

Jenny`s School of Catering

June 23, 2012 § Leave a comment


JENNY`S SCHOOL OF CATERING – HAATSO

P.O.BOX AN 10178 ACCRA – NORTH

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AFRICA- JENNY`S CATERING SCHOOL- HAATSO, ACCRA THE NUMBER ONE CATERING SCHOOL IN AFRICA

April 12, 2012 § Leave a comment


International affairs now claim the attention of every individual to the culinary art in Africa. It is hygienic and healthy and must equally be balanced. The School teaches students about changes and knowledge of culinary skills to a new level.

Nutrition is important for vulnerable groups in African societies such as children, the pregnant women and others.

Jenny’s Catering School in Africa makes nutritional plans that focus on what is good or sensible thing to do for a balanced, healthy diet and to prevent excessive intake of unhealthy foods, leading to physical harm. Our overall goal is to facilitate a change in bad eating habits. In order to meet individual requirements, age, height, weight are, taken into consideration when planning a diet.

Faulty nutrition in Africa leads to a number of diseases and under nutrition affects many children, and people of all ages in Africa.

The main aim of the School is to promote and maintain standards of hygienic practices in food preparation. We teach students how to make their own delicious meals at home and how to select and store fresh foodstuffs. We believe that cleanliness is next to Godliness, thus students learn the culture of hygiene.

We believe that the purpose of eating is not only for enjoyment but also for the nourishment of the body and soul. For these reasons, our students learn about freshness of food, its lifeline and force. Throughout the curriculum, the importance of cooking foods that nourish and delight the senses are reinforced.

Jenny’s Catering School aims to avoid spoilage and the potential for diseases. To maintain adequate bodily nutritional state to meet daily energy requirements, Jenny’s School of Catering has the facilities, ingredients and practices to meet energy requirements.

We offer practical knowledge in all courses with more than 60% of the time spent on practical classes. Teaching groups are, kept reasonably small to give each individual student the attention they deserve. We therefore, aim to provide the highest standards of training for our students and equip them with the skill set and knowledge to be the chefs of the future.

With Jenny’s, we go in for the best and have affiliations worldwide. We look forward to serving your needs.

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Nigeria, Liberia ,Sierra Leone ,South Africa, Benin, Cameroon, Ivory Coast, Gambia, Cape Verde, Togo

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