Durfamed Global Resources Pharmaceuticals

22/08/2026

Many *illnesses* are not illnesses, but *normal ageing*. A hospital director gave these tips to older people: You are not sick, you are ageing. Many conditions you consider :illnesses* are not. They are signs that your *body* is ageing.

1. *Poor memory* is not Alzheimer's; it is a self-protective mechanism of the ageing brain. It is brain ageing, not a disease. If you forget where you put your keys, but you can find them yourself, it is NOT dementia.

2. *Walking slowly* and having unsteady legs and feet is not paralysis, but muscle degeneration. The solution is NOT to take medication, but to *move constantly*.

3. *Insomnia* is not an illness; it is the brain adjusting its rhythm. It is a change in the sleep pattern. Do not take sleeping pills. Long-term dependence on sleeping pills increases the risk of falls and cognitive decline. The best medicine for older adults to get restful sleep is to get more sun during the day and maintain a regular sleep schedule.

4. Body aches and pains are not rheumatism but a normal reaction to the ageing of the nervous system. Bones do loosen and thin, but 99% of "body aches and pains" are not a disease but rather a slow nerve conduction that amplifies the pain. This is called central sensitization, a common physiological change in older adults. Exercise is the cure, not medication.

5. High cholesterol. Older adults have slightly higher cholesterol levels because they have lived longer. Cholesterol is the raw material for synthesizing hormones and cell membranes. Too low a cholesterol level can easily reduce immunity. The guidelines for lowering blood pressure in older adults are

21/08/2026

HORMONAL IMBALANCE

Hormonal imbalance occurs when one or more hormones in the body are produced in amounts that are too high or too low for normal body functions.
Hormones are chemical messengers produced by glands such as the thyroid, pituitary, adrenal glands, pancreas, ovaries and te**es.
Hormones regulate:
1)Metabolism,
2)Reproduction,
3)Growth,
4)Mood,
5)Sleep,
6)Blood sugar and many other processes.

TYPES OF HORMONAL IMBALANCE
A) Reproductive hormone imbalance
Involves oestrogen, progesterone, testosterone, LH and FSH.
Can occur in:
•• Polycystic o***y syndrome (PCOS)
•• Menopause/perimenopause
•• Pregnancy and postpartum period
•• Testicular or ovarian disorders

B) Thyroid hormone imbalance
Involves T3, T4 and TSH.
•• Hypothyroidism: thyroid hormones are too low.
•• Hyperthyroidism: thyroid hormones are too high.

C) Insulin imbalance
Insulin controls blood glucose.
Insulin x imbalance can lead to:
•• Insulin resistance
•• Prediabetes
•• Type 2 diabetes
•• Abnormal blood sugar levels

D) Prolactin imbalance
Prolactin is primarily involved in breast development and milk production.
Excess prolactin (hyperprolactinaemia) can cause:
•• Irregular or absent menstruation
•• Breast milk production when not breastfeeding
•• Infertility
•• Reduced libido

E) Adrenal hormone imbalance
Involves hormones such as cortisol and aldosterone.
Examples include:
•• Cushing syndrome: The body making too much cortisol
•• Addison disease: The body not producing enough cortisol and aldosterone.

SYMPTOMS OF HORMONAL IMBALANCE
Symptoms vary considerably depending on the hormone involved.

SYMPTOMS IN WOMEN
•• Irregular, heavy or absent periods
•• Difficulty becoming pregnant
•• Acne
•• Excess facial/body hair
•• Hair thinning or hair loss
•• Weight gain or unexplained weight loss
•• Hot flashes or night sweats
•• Vaginal dryness
•• Reduced sexual desire
•• Mood changes
•• Fatigue

SYMPTOMS IN MEN
•• Reduced libido
•• Erectile difficulties
•• Reduced muscle mass
•• Increased body fat
•• Infertility
•• Reduced facial/body hair
•• Fatigue
•• Mood changes

GENERAL SYMPTOMS
•• Unexplained weight changes
•• Excessive thirst or urination
•• Poor sleep
•• Anxiety or irritability
•• Headaches
•• Palpitations
•• Temperature intolerance
•• Changes in skin or hair
Important: These symptoms are not specific to hormonal imbalance. Conditions such as anaemia, stress, infections, nutritional deficiencies and other medical problems can cause similar symptoms.

CAUSES OF HORMONAL IMBALANCE
Common causes include:
•• Polycystic o***y syndrome (PCOS)
•• Thyroid disease
•• Diabetes and insulin resistance
•• Pregnancy
•• Breastfeeding
•• Menopause
•• Chronic stress
•• Obesity or being significantly underweight
•• Poor nutrition
•• Excessive exercise
•• Certain medications
•• Pituitary disorders
•• Adrenal disorders
•• Ovarian or testicular disorders
•• Certain tumours affecting hormone-producing glands
•• Sleep problems

PREVENTION OF HORMONAL IMBALANCE
Not every hormonal disorder can be prevented, especially those caused by genetics or autoimmune disease. However, the risk of some hormone-related problems can be reduced by:
•• Maintaining a healthy weight
•• Eating a balanced diet
•• Exercising regularly
•• Getting adequate sleep
•• Managing chronic stress
•• Avoiding smoking
•• Limiting excessive alcohol intake
•• Avoiding unnecessary hormone or steroid use
•• Managing diabetes and other chronic diseases
•• Having appropriate medical check-ups

TREATMENT OF HORMONAL IMBALANCE
Treatment depends on the specific hormone abnormality and its cause. There is no single medicine that treats all hormonal imbalances.
Possible treatments include:
1)Lifestyle treatment for some conditions
•• Weight management,
•• Exercise,
•• Improved nutrition
•• Better sleep may significantly improve hormone function.

2) Hormone replacement
Examples include:
•• Thyroid hormone replacement for hypothyroidism
•• Testosterone replacement in carefully selected men with confirmed deficiency
•• Oestrogen/progesterone therapy in selected menopausal patients.

3) Medicines that suppress excessive hormones
For example:
•• Medicines for hyperthyroidism such as Carbimazole 5mg (Carbiroid)
•• Medicines that reduce prolactin, such as Cabergoline (Gostinex)
•• Medicines that improve insulin sensitivity in some patients with PCOS or diabetes.

4) Treatment of the underlying disease
For example, treating PCOS, thyroid disease, pituitary disease or adrenal disease may restore more normal hormone function.

5) Surgery: Occasionally required for certain hormone-producing tumours or structural problems.

LIFESTYLE CHANGES THAT SUPPORT HORMONAL HEALTH.
1)Eat a balanced diet, Such as:
•• Vegetables and fruits
•• Whole grains
•• Beans and legumes
•• Eggs, fish and lean meats
•• Nuts and seeds
•• Healthy fats such as avocado and olive oil

2) Reduce excessive:
•• Sugary drinks
•• Refined carbohydrates
•• Highly processed foods
•• Trans fats
•• Excessive alcohol

3) Exercise
•• Aim for approximately 150 minutes of moderate physical activity per week, if medically appropriate, plus strength exercises.
•• Exercise can improve insulin sensitivity, body composition, sleep and overall metabolic health.

4) Sleep
Most adults should aim for about 7–9 hours of quality sleep per night.

5) Manage stress
Chronic stress can affect cortisol and other hormonal systems. Helpful activities include:
•• Walking
•• Relaxation exercises
•• Meditation/prayer
•• Social activities
•• Adequate rest

6) Maintain a healthy weight
Both significant excess weight and being severely underweight can interfere with reproductive and metabolic hormones.

WHEN TO VISIT THE HOSPITAL
You should seek medical evaluation if you have:
•• Periods that repeatedly become irregular or disappear
•• Difficulty conceiving
•• Unexplained major weight changes
•• Persistent excessive tiredness
•• Persistent acne or excessive facial/body hair
•• Unexplained breast milk production
•• Erectile dysfunction or markedly reduced libido
•• Persistent palpitations or tremors
•• Excessive thirst and urination
•• Symptoms suggestive of thyroid disease

A doctor may order tests such as;
•• TSH/T4
•• Prolactin
•• LH
•• FSH
•• Oestradiol
•• Progesterone
•• Testosterone
•• HbA1c (Test to measure average blood sugar levels over the past two to three months)

12/08/2026

CHOLESTEROL

Cholesterol is a fatty substance found in every cell of the body. It is essential for making hormones, vitamin D, bile acids (which help digest fats), and maintaining healthy cell membranes.
Your body makes most of the cholesterol it needs in the liver, while the rest comes from food.

TYPES OF CHOLESTEROL
1)LDL (Low-Density Lipoprotein): Also known as Bad cholesterol, Carries cholesterol to the arteries.
High levels can lead to plaque buildup, increasing the risk of heart attack and stroke.
LDL cholesterol range : 2.0mmol/L - 3.6mmol/L

2) HDL (High-Density Lipoprotein): Also known as Good cholesterol, removes excess cholesterol from the bloodstream and carries it back to the liver.Higher HDL levels help protect the heart.
HDL cholesterol range: 0.9mmol/L - 2.9mmol/L.

3) Triglycerides: A type of fat stored in the body for energy. High levels increase the risk of heart disease, especially when combined with high LDL or low HDL.
Triglycerides: 0.1mmol/L - 1.7 mmol/L

4) Total Cholesterol: The combined amount of LDL, HDL, and part of the triglycerides.
Total cholesterol: 3.3mmol/L - 5.3mmol/L

CAUSES OF HIGH CHOLESTEROL
1.Eating foods high in saturated and trans fats
2. Obesity or being overweight
3. Physical inactivity
4. Smoking
5. Excessive alcohol intake
6. Diabetes
7. High blood pressure
8. Kidney disease
9. Hypothyroidism (underactive thyroid)
10. Family history (genetic high cholesterol)
11. Increasing age

SYMPTOMS OF HIGH CHOLESTEROL
1.Chest pain (angina)
2. Heart attack
3. Stroke
4. Pain in the legs when walking
5. Shortness of breath
6. Sudden weakness or numbness on one side of the body
7. Difficulty speaking or understanding speech
8. Sudden loss of vision
9. Severe pain in leg
10. Leg Coldness
11. Leg Discoloration

LABORATORY DETECTION OF HIGH CHOLESTEROL
The best way to detect cholesterol is through a “blood lipid profile test" preferably done on an empty stomach.

DISEASES CAUSED BY HIGH LDL CHOLESTEROL
1)Coronary artery disease (CAD): Narrowing of the arteries that supply blood to the heart.

2) Heart attack: Occurs when a coronary artery becomes completely blocked, cutting off blood supply to part of the heart muscle.

3) Stroke: Happens when blood flow to part of the brain is blocked by a clot or narrowed artery, or when a blood vessel in the brain is damaged.

4) Peripheral artery disease (PAD): Narrowing of arteries in the legs. Causing leg pain, cold feet and slow-healing wounds.

5) Carotid artery disease: Narrowing of the arteries in the neck that supply blood to the brain.

6) Chronic kidney disease: Reduced blood flow to the kidneys, contributing to kidney damage over time.

7) High blood pressure (hypertension): Hardened, narrowed arteries make it more difficult for blood to flow, which can contribute to elevated blood pressure.

8) Aortic aneurysm: Weakening and bulging of the body's largest artery, which can rupture if left untreated.

PREVENTION
1.Eat a heart-healthy diet.
2. Exercise for at least 150 minutes per week.
3. Maintain a healthy weight.
4. Stop smoking.
5. Limit alcohol intake.
6. Control diabetes and high blood pressure.
7. Have your cholesterol checked regularly.

LIFESTYLE CHANGES
1.Healthy eating
2. Regular exercise
3. Weight loss if overweight
4. Smoking cessation
5. Limiting alcohol

TREATMENT
1.Statins (e.g., Atorvastatin, Rosuvastatin and Simvastatin)
2. Fibrates (mainly for high triglycerides)
3. Omega-3 fatty acid preparations.

FOODS TO AVOID
1.Fried foods
2. Fatty red meat
3. Processed meats (sausages, bacon)
4. Chicken skin
5. Butter
6. Full-fat milk and cheese
7. Cream
8, Ice cream
9. Palm oil in large amounts
10. Coconut oil in large amounts
11. Cakes, pastries, and doughnuts
12. Biscuits and cookies
13. Fast foods
14. Instant noodles (frequent intake)
15. Sugary drinks
16. Excess sugar and sweets

NIGERIAN FOODS TO LIMIT
1.Deep-fried puff-puff
2. Akara fried in excessive oil
3. Fried yam
4. Fried plantain
5. Suya with excessive visible fat
6. Fatty beef
7. Goat skin (ponmo) in large quantities
8. Organ meats (liver, kidney, intestine) in large amounts

BEST FOODS TO EAT
1.High-fibre foods Such as Oats, Whole wheat, Brown rice, Millet, Guinea corn, Beans, Lentils.

2. Fruits such as Apples, Oranges, Avocados, Pears, Berries, Berries, Watermelon, Pawpaw (papaya).

3. Vegetables such as Spinach, Ugu (fluted pumpkin), Okro, Garden eggs, Cabbage, Carrots, Tomatoes, Broccoli.

4. Healthy proteins such as Fish (especially salmon, sardines, mackerel), Skinless chicken, Turkey, Beans, Soybeans, Tofu.

5. Healthy fats such as Olive oil, Groundnuts (in moderation), Almonds, Walnuts, Cashews (moderation), Avocado.

6. Low-fat dairy such as Skimmed milk, Low-fat yogurt

EXAMPLE OF A HEART-HEALTHY NIGERIAN MEAL PLAN.
1.Breakfast: Oatmeal with low-fat milk and a banana.

2. Lunch: Brown rice with beans and grilled fish, served with vegetables.

3. Dinner: Boiled yam with vegetable soup made with minimal oil and skinless chicken or fish.

4. Snacks: Fruit, unsalted groundnuts (small handful), or low-fat yogurt.

23/07/2026

The worst poison that is silently destroying your kidneys:
1. Not walking enough (Inactivity)
2. Abuse of painkillers such as Ibuprofen, Diclofenac etc
3. Excessive salt from refined products such as bread and fast foods
4. Refined sugar in drinks and foods

20/07/2026

DOCTOR'S WRITING AND PRESCRIPTION
The unique way Doctors write is about professionalism and time constraint.
A good Nurse is advised to master this writing to be able to understand Doctors prescriptions. With the understanding of this prescription, a good Nurse is able to dispense the correct medication to her patient.

Doctors' writing and prescriptions are expected to be clear, accurate, and legally compliant. A standard prescription usually includes:

1. Patient information:
~ Full name
~ Age and/or date of birth
~ S*x (if relevant)
~ Date.

2. Diagnosis: This is done in the medical laboratory to discover illnesses, using samples gotten from the patient's body. This is optional but often recommended.

3. Medication details:
~ Generic drug name (preferred)
~ Strength (e.g., 500 mg)
~ Dosage form (tablet, capsule, syrup, injection, cream, etc.)
~ Dose (how much to take)
~ Route of administration (oral, IV, IM, topical, etc.)
~ Frequency (e.g., twice daily)
~ Duration (e.g., for 7 days)

4. Special instructions:
~ Before or after meals
~ Shake well before use
~ Complete the full course
~ Avoid alcohol, driving, or certain foods if applicable

5. Prescriber's details:
~ Doctor's name
~ Qualifications
~ Registration/licence number
~ Signature and stamp
~ Contact information

EXAMPLE OF PRESCRIPTION
Date: 20/07/2026
Rx
1) Tab. Paracetamol 500 mg
Take 1 tablet by mouth every 6 hours as needed for pain or fever for 3 days.

2) Cap. Amoxicillin 500 mg
Take 1 capsule by mouth every 8 hours for 7 days.

Advice: Drink plenty of fluids and complete the antibiotic course.

Dr. Joy Chiamaka, MBBS
Medical Registration No.: ###XX
(Signature)

COMMON PRESCRIPTION ABBREVIATIONS AND MEANING.

1/7 ~ One day

5/7 ~ Five days

1/52 ~ One Week

3/52 ~ Three Weeks

1/12 ~ One Month

4/12 ~ Four Months

# ~ Broken Bone (fracture)

A&E ~ Accident and Emergency

AC ~ Before meals

AM ~ Morning

AMHP ~ Approved Mental Health Professional

b.d.s/bds/BDS ~ 2 times a day

b.i.d/bid/bd ~ Twice a day/Twice Daily/2 times daily

BMI ~ Body mass index

BNO ~ bowels not open

BO ~ bowels open

BP ~ blood pressure

Cap ~ Capsule/Caplet

c/c ~ chief complaint

CMHN ~ Community mental health nurse

CPN ~ community psychiatric nurse

CT-Scan ~ Computerised Tomography Scan

CXR ~ chest X-ray

DNR ~ do not resuscitate

Dr ~ doctor

Dx ~ diagnosis

ECG ~ electrocardiogram

ED ~ emergency department

EMU ~ early morning urine sample

EUA ~ examination under anaesthetic

FBC ~ full blood count

GA ~ general anaesthetic

gtt ~ drop

h ~ hour

h/o ~ history of

Hb ~ haemoglobin (a substance in red blood cells that moves oxygen around the body)

HCA ~ health Care Assistant

CNA ~ Certified Nursing Assistant

HCSW ~ healthcare support worker

HDL ~ high-density lipoprotein (a type of cholesterol)

HRT ~ hormone replacement therapy

HS – At bedtime

Ht ~ height

Hx ~ history

i ~ 1 tablet

ii ~ 2 tablets

iii ~ 3 tablets

INJ ~ Injection

INF ~ Infusion

i.m/IM ~ injection into a muscle

i.v/IV ~ injection directly to a vein

INR ~ international normalised ratio (a measure of how long blood takes to clot)

IVI ~ intravenous infusion

Ix ~ investigations

LA ~ local anaesthetic

LDL ~ low-density lipoprotein (a type of cholesterol)

LFT ~ liver function test (a type of blood test measuring enzymes and proteins in your liver)

LMP ~ last menstrual period

Mg ~ Milligram

Ml ~ Millilitre

M/R ~ modified release

MRI ~ magnetic resonance imaging

MRSA ~ methicillin-resistant Staphylococcus aureus

MSU ~ mid-stream urine sample

n.p.o/npo/NPO ~ nothing by mouth/not by oral administration

NAD ~ nothing abnormal discovered

NAI ~ non-accidental injury

NBM ~ nil by mouth

NG ~ nasogastric(running between your nose and stomach)

nocte ~ every night

NSAID ~ non-steroidal anti-inflammatory drug

o.d/od/OD ~ Once a day

o/e ~ On Examination

OT ~ Occupational Therapist

p.c ~ after food/after meal

p.m/pm/PM ~ afternoon/evening

p.o/po/PO ~ Orally/By mouth/Oral administration

p.r/pr/PR ~ rectally

p.r.n/prn/PRN ~ as needed/when needed

p/c ~ presenting complaint

physio ~ physiotherapist

POP ~ plaster of paris

PU ~ passed urine

q. ~ Every

q.1.d/q1d ~ every day

q.1.h/q1h ~ every hour

q.2.h/q2h ~ every 2 hours

q.4.h/q4h ~ every 4 hours

q.6.h/q6h~ every 6 hours

q.8.h/q8h ~ every 8 hours

q.d/qd ~ every day / daily

q.d.s/qds/QDS ~ 4 times a day

q.h/qh ~ every hour, hourly

q.i.d/qid ~ 4 times a day

q.o.d/qod ~ every other day/alternate days

q.s/qs ~ a sufficient quantity/enough

RN ~ registered nurse

RNLD ~ learning disability nurse

RTA ~ road traffic accident

Rx ~ Prescription/Treatment

Supp ~ Suppository

S.C/SC ~ Subcutaneous injection/injection under the skin

S/R ~ Sustained release

SLT ~ speech and language therapist

SpR ~ specialist registrar

stat ~ immediately/with no delay/now

Syr ~ Syrup

Tab ~ Tablet

t.d.s/tds/TDS ~ 3 times a day

t.i.d/tid ~ 3 times a day

TCI ~ to come in

TFT ~ thyroid function test

TPR ~ temperature, pulse and respiration

TTA ~ to take away

TTO ~ to take out

U&E ~ urea and electrolytes

u.d/ud ~ as directed

UCC ~ urgent care centre

UTI ~ Urinary tract infection

Vag ~ Vaginally

Wt ~ Weight



Durfamed Global Resources Pharmaceuticals 2026

21/06/2026

21/06/2026

Important supplements for Men
1. Magnesium
2. Omega 3
3. Vit D3
4. Zinc
5. Creatine

21/06/2026

Sleep the right way to avoid back pains, Rheumatic pains and Arthritis later in life.


Cc

29/04/2026

ARTHRITIS.
Arthritis is a damage to joints (where bones meet), often through cartilage loss or inflammation that causes pain, swelling, and stiffness in the joints.
It can affect people of any age, but is common in older people..

TYPES OF ARTHRITIS
1. Osteo-arthritis:
Caused by wear and tear of joint cartilage in the knees, hips, spine, and hands

2. Rheumatoid Arthritis (Rheumatism):
An autoimmune disease that attacks both wrists joints.

3. Gout Arthritis:
Caused by buildup of uric acid crystals in joints
which affects the big toe.
Uric acid is found in Foods such as liver, red meat, seafoods, sugary drinks and alcohol.

SYMPTOMS OF ARTHRITIS
1.Joint pain
2. Swelling
3. Stiffness (especially in the morning)
4. Reduced movement
5. Warmth or redness over the joint
6. Sudden severe pain
7. Redness
8. Fatigue
9. Pain during movement
10. Reduced flexibility

HOME REMEDIES
1.Warm compress for stiffness
2. Cold compress for swelling
3. Gentle massage

HELPFUL DIETS FOR ARTHRITIS PATIENTS
1.Eat foods rich in omega-3 (fish, walnuts)
2. Increase fruits and vegetables
3. Reduce sugary and processed foods

LIFESTYLE CHANGES FOR ARTHRITIS PATIENTS
1.Regular light exercise
2. Walking
3. Stretching
4. Maintaining a healthy weight
5. Avoiding joint overuse
6. Always take NSAIDs after meals
7. Avoid combining multiple NSAIDs

TREATMENT OF ARTHRITIS
1. Pain Relievers for Mild/Moderate Pain
Paracetamol 500 mg take 1g every 6–8 hours
Max: 4 g per day
Safe and first-line for osteoarthritis

2. NSAIDs for severe pain & Inflammation
a). Ibuprofen 400 – 800mg every 8 hours
Max: 2400 mg/day
Take after food
b). Diclofenac 50mg 2–3 times daily
Max: 150 mg/day
c). Naproxen 250 – 500mg twice daily
Good for chronic arthritis

Avoid long-term use of NSAIDs in:
a). Peptic ulcer
b). Kidney disease
c). Pregnancy (especially 3rd trimester)

3. For Rheumatoid Arthritis:
a). Methotrexate 7.5 – 15mg once a week. With folic acid 5 mg weekly
b). Prednisolone 5 – 10mg daily (short-term use).

4. For Gout Arthritis:
a). Colchicine 600mcg (0.6mg) tablet
Acute attack: 1.2 mg, then 0.6 mg after 1 hour
Then 0.6 mg 1–2 times daily.

b). Allopurinol 100mg tablet
Dosage: 100 mg daily, then increase gradually up to 300 mg/day.
Used for prevention, not during acute attack.

5. Diclofenac/Ibuprofen gel
Apply to affected joint 2–3 times daily

PRESCRIPTION FORMAT FOR AN ADULT WITH ARTHRITIS.
Patient: Adult
Condition: Arthritis (joint pain + inflammation)
Medications
1.Diclofenac 50 mg tablets
Take 1 tablet twice daily after meals
Duration: 5–7 days

2. Paracetamol 1 g tablets
Take 1 tablet every 8 hours as needed for pain
Max: 4 g/day

3. Omeprazole 20 mg capsules
Take 1 capsule once daily before breakfast
Duration: While using NSAIDs (protects stomach)

4. Prednisolone 5 mg tablets (if severe pain/swelling)
Take 1–2 tablets daily for 3–5 days only, then stop

Durfamed Global Resources Pharmaceuticals

08/04/2026

*PEPTIC ULCER DISEASE (PUD)*

Peptic ulcer disease is an open sore that develops in the lining of the stomach or duodenum (first part of small intestine).

TYPES
Gastric ulcer – in the stomach
Duodenal ulcer – in the duodenum

CAUSES.
1. Helicobacter pylori infection (most common worldwide)
2. Long-term use of NSAIDs (e.g., ibuprofen, diclofenac)
3. Excess acid production
4. Severe stress (ICU patients)
5. Smoking & alcohol

RISK FACTORS
1. Irregular eating
2. Excess pepper/spicy meals
3. Frequent painkiller use
4. Smoking
5. Previous ulcer history

SYMPTOMS
1. Burning stomach pain (upper abdomen)
2. Pain 2–3 hrs after food (duodenal ulcer)
3. Pain immediately after eating (gastric ulcer)
4. Bloating
5. Nausea
6. Vomiting
7. Weight loss

DIAGNOSIS
1. Endoscopy (gold standard)
2. H. pylori stool or breath test
3. Full blood count (check anemia)

DANGER SIGNS
1. Black stool
2. Vomiting blood
3. Sudden severe abdominal pain (perforation)

COMPLICATIONS
1. Bleeding
2. Perforation
3. Gastric outlet obstruction
4. Chronic anemia

TREATMENT
1. Triple therapy combination (Proton Pump Inhibitors + 2 antibiotics) for H. pylori. Such:
Amoxicillin 1g, Clarythromycin 500mg and Rabeprazole 20mg.
Lansoprazole 30mg, Clarythromycin 250mg and Tinidazole 500mg.
Omeprazole 20mg, Tinidazole 500mg and Clarythromycin 250mg

2. Use Chamomile tea, an herbal infusion with honey. It is widely used to improve sleep quality, aid digestion, reduce anxiety, and provide anti-inflammatory benefits. It's rich in antioxidants and acts as a gentle, natural sedative.

3. Use supplements such as Mastic & Licorice Capsule and Zinc Carnosine capsule to coat the intestinal lining.

4. Stop NSAIDs(Non Steroidal Anti-inflammatory Drugs e.g Diclofenac, Piroxicam, Sudrex, Boska, Real Xtra etc)

5. For acid reflux, Use antacid suspension such as Gestid, Gascol, Ulgicid,

DIET FOR AN ULCER PATIENT
✔ Pap
✔ Oatmeal
✔ Boiled rice
✔ Vegetables
✔ Banana etc

AVOIDABLE TRIGGERS
❌ Peppery and spicy foods/soups
❌ Fried foods
❌ Carbonated drinks
❌ Alcohol and Smoke
❌ Late Night meals
❌ Large meals
❌ Hot and cold meal
❌ Beverages
❌ Energy Drinks