47th Edition, OCTOBER 23rd 2013

“GASTRITIS”
Gastritis is an inflammation of the lining of the stomach, and has many possible causes. The main acute causes are excessive alcohol consumption or prolonged use of nonsteroidal anti-inflammatory drugs (also known as NSAIDs) such as aspirin or ibuprofen. Sometimes gastritis develops after major surgery, traumatic injury, burns, or severe infections. Gastritis may also occur in those who have had weight loss surgery resulting in the banding or reconstruction of the digestive tract. Chronic causes are infection with bacteria, primarily Helicobacter pylori, chronic bile reflux, and stress; certain autoimmune disorders can cause gastritis as well. The most common symptom is abdominal upset or pain. Treatment includes taking antacids or other medicines, such as proton pump inhibitors or antibiotics, and avoiding hot or spicy foods. For those with pernicious anemia, B12 injections are given, but more often oral B12 supplements are recommended.

Signs and Symptoms
• • • • • • •

Nausea Vomiting (if present, may be clear, green or yellow, blood-streaked, or completely bloody, depending on the severity of the stomach inflammation) Belching (if present, usually does not relieve the pain much) Bloating Early satiety Loss of appetite Unexplained weight loss

Causes

Acute: Erosive gastritis is a gastric mucosal erosion caused by damage to mucosal defenses. Alcohol
consumption does not cause chronic gastritis. It does, however, erode the mucosal lining of the stomach; low doses of alcohol stimulate hydrochloric acid secretion. Chronic: Chronic gastritis refers to a wide range of problems of the gastric tissues. The immune system makes proteins and antibodies that fight infections in the body to maintain a homeostatic condition. In some disorders the body targets the stomach as if it were a foreign protein or pathogen; it makes antibodies against, severely damages, and may even destroy the stomach or its lining.
Fitri Yuliyanti HSE Admin PT.National Utility Helicopters

47th Edition, OCTOBER 23rd 2013

• •

Metaplasia: Mucous gland metaplasia, the reversible replacement of differentiated cells, occurs in the setting of severe damage of the gastric glands, which then waste away (atrophic gastritis) and are progressively replaced by mucous glands. Coffee: Coffee can damage the lining of the gastrointestinal organs, causing gastritis and ulcers. The consumption of coffee is therefore not recommended for people with gastritis, colitis, and ulcers. Helicobacter pylori: Helicobacter pylori colonizes the stomach of more than half of the world's population, and the infection continues to play a key role in the pathogenesis of a number of gastroduodenal diseases.

Diagnosis
Often, a diagnosis can be made based on the patient's description of his or her symptoms, but other methods which may be used to verify gastritis include:

• • • • • •

Blood tests: o Blood cell count o Presence of Helicobacter pylori o Liver, kidney, gallbladder, or pancreas functions Urinalysis Stool sample, to look for blood in the stool X-rays ECGs Endoscopy, to check for stomach lining inflammation and mucous erosion Stomach biopsy, to test for gastritis and other conditions

Treatment
Over-the-counter antacids in liquid or tablet form are a common treatment for mild gastritis. Antacids neutralize stomach acid and can provide fast pain relief. When antacids do not provide enough relief, medications such as cimetidine, ranitidine, nizatidine or famotidine that help reduce the amount of acid the stomach produces are often prescribed. An even more effective way to limit stomach acid production is to shut down the acid "pumps" within acid-secreting stomach cells. Proton pump inhibitors reduce acid by blocking the action of these small pumps. This class of medications includes omeprazole, lansoprazole, rabeprazole, and esomeprazole. Proton pump inhibitors also appear to inhibit H. pylori activity. Cytoprotective agents are designed to help protect the tissues that line the stomach and small intestine. They include the medications sucralfate and misoprostol. Another cytoprotective agent is bismuth subsalicylate. Many people also drink milk to relieve symptoms, however the high calcium levels actually stimulate release of gastric acid from parietal cells, ultimately worsening symptoms. In addition to protecting the lining of stomach and intestines, bismuth preparations appear to inhibit H. pylori activity as well. Several regimens are used to treat H. pylori infection. Most use a combination of two antibiotics and a proton pump inhibitor. Sometimes bismuth is also added to the regimen. The antibiotic aids in destroying the bacteria, and the acid blocker or proton pump inhibitor relieves pain and nausea, heals inflammation, and may increase the antibiotic's effectiveness.
Source: www.wikipedia.com
Fitri Yuliyanti HSE Admin PT.National Utility Helicopters

47th Edition, OCTOBER 23rd 2013

SAFETY ALERT “RAPID DEPRESSURIZATION OF GAS CYLINDER”

Fitri Yuliyanti HSE Admin PT.National Utility Helicopters

47th Edition, OCTOBER 23rd 2013

Source : EMOI
Fitri Yuliyanti HSE Admin PT.National Utility Helicopters

47th Edition, OCTOBER 18th 2013

“AIRCRAFT NOISE MANAGEMENT” ”

Noise has historically been the principal environmental issue for aviation. It remains high on the agenda of public concern. In addition to aircraft in the air and on the ground, noise can arise from ground transport and other operational sources. All commercial aircraft must meet the International Civil Aviation Organization's (ICAO's) noise certification standards. These apply to aircraft designs and types when they are first approved for operational use. The 33rd ICAO Assembly adopted Resolution A33/7 introducing the concept of a ‘balanced approach’ to noise management, thereby establishing a policy approach to address aircraft noise, including international guidance for the introduction of operating restrictions on an airport-byairport basis. The ‘balanced approach’ concept of aircraft noise management comprises four principal elements and requires careful assessment of all different options to mitigate noise, including : • reduction of aircraft noise at source; • land-use planning and management measures; • noise abatement operational procedures; and, • operating restrictions. Other commonly applied noise management measures include: • establishing a technical partnership between airport air traffic control, aircraft operators and the airport operator to jointly progress aircraft noise management; • depicting preferred noise routes on a map that avoid residential areas as far as possible, monitoring track adherence accuracy and seeking to improve track-keeping; • avoiding over-flying sensitive sites such as hospitals and schools; • ensuring that the optimum runway(s) and routes are used as far as conditions allow; • using continuous descent approaches and departure noise abatement techniques; • avoiding unnecessary use of auxiliary power units by aircraft on-stand; • building barriers and engine test-pens to contain and deflect noise; • towing aircraft instead of using jet engines to taxi; • limiting night operations; • limiting the number of operations or the extent of a critical noise contour; • providing noise insulation for the most severely affected houses; • applying different operational charges based on the noisiness of the aircraft; • monitoring individual noise levels and penalizing any breach. Source : http://www.eurocontrol.int/environment/public/standard_page/noise.html
Fitri Yuliyanti HSE Admin PT.National Utility Helicopters

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