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    P. Kalan. Arizona State University.

    After staining quality 100 mg kamagra oral jelly, the slides are differentiated to remove the hematoxylin from most cytoplasmic components other than mitochondria discount 100mg kamagra oral jelly with mastercard. The fresh tissue is treated with silver nitrate and exposed to strong light, which reduces the silver. Silver Method for Golgi complex: Many methods have been used for staining the Golgi complex of the cell. One of the best methods consists of direct fixation of fresh tissue in a solution of silver nitrate in formalin, development in hydroquinone-formalin, followed by the usual procedure for paraffin embedding and sectioning. In the slides prepared for the class sets, the nuclei of the cells have been stained lightly by azocarmine. See the first laboratory exercise, Introduction: Microscopy – Cytology for a description of the properties of neutral red and Janus green vis a vis particular subcellular organelles. It is a specially prepared combination of basic fuchsin, resorcin, ferric chloride, water and alcohol. When this solution is placed on a dried blood smear, the methyl alcohol acts as the fixative, and the dissolved dye begins the staining process. The major parts of the instrument will be named and a method for the effective use of the microscope will be outlined. The comments apply to the Nikon student microscope but will apply directly, or with slight modification, to student instruments of other manufacturers. The microscope consists of a compound optical system (the objective lens and the ocular lens); a movable specimen support (the mechanical stage); an illumination system (the lamp and the condenser lens with its iris diaphragm). The microscopes used in the course have a binocular head, which may be rotated after loosening its clamping screw. One of the eyepieces may have a pointer, and note that one (or both) eyepiece(s) may be focused separately to compensate for dioptric differences between your eyes. The revolving nosepiece is the inclined, circular metal plate to which the objective lenses, usually four, are attached. A lever projects from the condenser and it is used to vary the opening of the condenser (or iris) diaphragm. For work with the scanning (4x) and low-power (10x) objectives, the condenser diaphragm should be wide open. For work with the high-dry (40x) and oil-immersion objectives (100x), however, the diaphragm should be closed slowly while looking at a sharply focused section until the level of illumination is just slightly reduced. In examining a slide with the light microscope, the following sequence of steps should be used: 1) Place the slide on the stage and examine it with the scanning objective (4x). When turning the nosepiece, grasp the nosepiece itself or the part of the objective adjacent to the nosepiece to avoid excess stress on the objective. The following procedure must 105 be used when working with the oil immersion lens: a) focus carefully on a selected area with the high-dry objective, b) swing the high-dry objective out of the light path and allow the nosepiece to remain in an intermediate position between the high-dry and the oil-immersion objectives, c) place a drop of immersion oil (available in the bookstore) on the slide in the appropriate region to be studied, d) swing the oil-immersion objective into position. When finished using the oil-immersion objective, both the objective and the slide must be wiped with lens paper (available in the bookstore). If oil is allowed to dry on the high-dry or oil- immersion objective, the optical performance of the instrument will be severely reduced. If this is done by mistake, the high-dry objective must be cleaned by wiping the front element with lens paper. Thus, their timely recognition orders arise from tumor secretion of hormones, peptides, or cyto- kines or from immune cross-reactivity between malignant and nor- may lead to detection of an otherwise clinically occult tu- mal tissues. Such a scenario systems, most notably the endocrine, neurologic, dermatologic, occurs most commonly with neurologic paraneoplastic dis- rheumatologic, and hematologic systems. Although considerable clinical overlap with non- cer, gynecologic tumors, and hematologic malignancies. In some paraneoplastic disorders has long confounded the diagnosis instances, the timely diagnosis of these conditions may lead to of these conditions, numerous serologic and radiographic detection of an otherwise clinically occult tumor at an early and highly treatable stage. Treatments include addressing the underlying malignancy, immunosuppression (for neurologic, dermatologic, longer, and as diagnostic methods improve, this preva- and rheumatologic paraneoplastic syndromes), and correction lence will likely increase. Yet, given the rarity of individual of electrolyte and hormonal derangements (for endocrine para- paraneoplastic syndromes, there are few prospective clini- neoplastic syndromes). This review focuses on the diagnosis and treatment of paraneoplastic syndromes, with emphasis on those cal trials to guide management. Initial literature searches syndromes frequently represent subtypes of conditions that for this review were conducted using PubMed and the keyword also occur outside of a cancer association. During the past several years, medical advances have not A Glossary providing expansions of additional abbreviations appears at the only improved the understanding of paraneoplastic syn- end of this article.

    Occupied bed bed holding a client that is unable to get up as a result of his or her condition or generalized weakness discount 100mg kamagra oral jelly with mastercard. Oral of or pertaining to the mouth Orthopenia difficult breathing relieved by seating or standing erect Output All fluid lost from the body purchase 100mg kamagra oral jelly with mastercard. Parenteral administered in to the body in a way other than through the alimentary canal (subcutaneous, intravenous, intramuscular), as parenteral medication Pedal pulse pulse on the foot felt over the dorsal pedis artery or posterior tibial artery Perineal care bathing the genital and surrounding area. Perioperative the period surrounding surgery; includes preoperative, intraoperative, and postoperative periods. Pharmachokinetics actions of drug Pharmachology the study of chemicals (drugs, medications) and their effect. Potentiation enhancement of one agent by another, so that the combined action is greater than the sum of the two. Postural drainage Position adapted to facilitate expectoration of material in patients with lung disease. Pressure ulcer ulcerated sore often cause by prolonged pressure on a bony prominence or other area, especially if the client is allowed to lie in one position for an extended period. Protective device piece of equipment, most often a vest or a belt, used to ensure the safety of the client ()ie, helping client to remain in a chair without falling); also called a client reminder device. Protective isolation attempts to prevent harmful microorganisms from coming into contact with the client; also called reverse or neutropenic isolation Pulse The beat of the heart felt in the arteries. Recumbent lying down Rotation process of turining about an axis, as rotation of the hand of the fetus in preparation of delivery. Rectal of the rectum Retention enema An injection of fluid that is retained in the rectum for absorption into the blood stream. Splint A device for immobilizing part of the body Spore The seeds of microorganisms, which are resistant to drying, heat, and disinfectants Standard precaution precautions designed for the care of all clients regardless of diagnosis or infection status. Sterile Specially treated so that all microorganisms are destroyed 361 Stethoscope Instrument for magnifying sound Specimen A small amount of body excretion or body fluid that is sent to a laboratory for examination. Suppository Rectally administered cones containing a medication in the base that is soluble at body temperature. Systole Blood pressure period during the beating phase of the heartbeat during which blood is expelled from heat. Synergism joint action of agents in which the combined effects is greater than the sum of the individual parts. Tachypenea conditions in which breaths are abnormally rapid, more than 20 per minute Thermometer An instrument used to measure temperature. Traction exertion of a pulling force ; an apparatus attached to the client to maintain stability of 362 a joint or aligned fracture or to exert a pulling force elsewhere, as in the lower back, to relieve pressure. Transimission-based- precaution: precaution designed for clients with specific infection or diagnoses Tympanic membrane eardrum. Elizabeth College of Nursing Government Higher Secondary School Chengalpet Medical College Ottanchantram. Special recognition and due acknowledgement is hereby made to the Director of School Education and the Joint Director of School Education Chennai. Nursing is a major component of the health care develivery system and nurses make up the largest employment group within the system. Nursing services are necessary for every patient seeking care of various types including primary, secondary, tertiary and restorative. As nursing is an important part of health care delivery system, the nurses need to have a sound knowledge about nursing as a profession and common professional activi­ ties. With the present introduction of Vocational courses such as nursing in the academic stream as one of the options, it is believed that it will contribute towards the basic nursing care of individuals, families and community for health and happiness. In this edition a new chapter on “Bio Medical Waste Management” have been added in view of the fact that these knowledge will be essential for the students to learn before entering into the profes­ sional course. The subject contents has been developed, refined and reconstructed at several points as per the current perspectives. Anatomy and Physiology: 50 Definition of anatomy & physiology 19 Anatomical positions 19 Cells & Tissues 20 Musculo – skeletal system 22 Nervous system 33 Cardio – Vascular system 37 Blood 38 Digestive system 40 Respiratory system 46 Excretory system 49 Endocrine system 51 Sense organ 55 Reproductive system 61 3. Definition of Learning 74 Characteristics of learning by insight 76 Observation, Attention, &Perception 77 Emotion 80 Personality 83 Defence mechanism 87 4. Principles and practice of nursing 60 Definition of Nursing process 91 Steps in Nursing process 91 Admission of a patient 92 Orientation to the ward 93 Care of belongings 94 Discharge of a patient 94 Bed & Bed making 94 Therapeutic environment 96 Psycho social environment 96 Body Mechanics and Positioning 96 Hygienic Needs –Personal hygiene 98 Safety & Comfort Needs 99 Activity & Exercises 100 Moving, shifting & lifting patients 101 Oxygen Need 102 Elimination Needs 104 5. Medical & surgical Asepsis: 20 Definition of asepsis 126 Principles of asepsis 126 Types of asepsis 126 Basic principles of surgical asepsis 127 - Use of gloves 127 - Use of Aprons 127 - Use of Masks 128 Sterilization and disinfection 128 - Definition 128 - Methods of sterilization 128 Handling of sterile articles 133 Biomedical Waste Management 134 - Classification of waste 134 - Segregation, Packing and Transporting 135 - Categories of biomedical waste 135 7.

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    In contrast purchase kamagra oral jelly 100 mg on line, movements at the hip joint are restricted by strong ligaments purchase kamagra oral jelly 100 mg without prescription, which reduce its range of motion but confer stability during standing and weight bearing. Anatomical names for most joints are derived from the names of the bones that articulate at that joint, although some joints, such as the elbow, hip, and knee joints are exceptions to this general naming scheme. Articulations of the Vertebral Column In addition to being held together by the intervertebral discs, adjacent vertebrae also articulate with each other at synovial joints formed between the superior and inferior articular processes called zygapophysial joints (facet joints) (see Figure 9. The orientation of the articular processes at these joints varies in different regions of the vertebral column and serves to determine the types of motions available in each vertebral region. In the neck, the articular processes of cervical vertebrae are flattened and generally face upward or downward. This orientation provides the cervical vertebral column with extensive ranges of motion for flexion, extension, lateral flexion, and rotation. In the thoracic region, the downward projecting and overlapping spinous processes, along with the attached thoracic cage, greatly limit flexion, extension, and lateral flexion. However, the flattened and vertically positioned thoracic articular processes allow for the greatest range of rotation within the vertebral column. The articulations formed between the skull, the atlas (C1 vertebra), and the axis (C2 vertebra) differ from the articulations in other vertebral areas and play important roles in movement of the head. The atlanto-occipital joint is formed by the articulations between the superior articular processes of the atlas and the occipital condyles on the base of the skull. The paired superior articular processes of the axis articulate with the inferior articular processes of the atlas. The third articulation is the pivot joint formed between the dens, which projects upward from the body of the axis, and the inner aspect of the anterior arch of the atlas (Figure 9. These articulations allow the atlas to rotate on top of the axis, moving the head toward the right or left, as when shaking your head “no. This joint involves the articulation between the mandibular fossa and articular tubercle of the temporal bone, with the condyle (head) of the mandible. Located between these bony structures, filling the gap between the skull and mandible, is a flexible articular disc (Figure 9. With the mouth closed, the mandibular condyle and articular disc are located within the mandibular fossa of the temporal bone. During opening of the mouth, the mandible hinges downward and at the same time is pulled anteriorly, causing both the condyle and the articular disc to glide forward from the mandibular fossa onto the downward projecting articular tubercle. The temporomandibular joint is supported by an extrinsic ligament that anchors the mandible to the skull. This ligament spans the distance between the base of the skull and the lingula on the medial side of the mandibular ramus. Temporomandibular joint disorder is a painful condition that may arise due to arthritis, wearing of the articular cartilage covering the bony surfaces of the joint, muscle fatigue from overuse or grinding of the teeth, damage to the articular disc within the joint, or jaw injury. Temporomandibular joint disorders can also cause headache, difficulty chewing, or even the inability to move the jaw (lock jaw). During depression of the mandible (opening of the mouth), the mandibular condyle moves both forward and hinges downward as it travels from the mandibular fossa onto the articular tubercle. Opening of the mouth requires the combination of two motions at the temporomandibular joint, an anterior gliding motion of the articular disc and mandible and the downward hinging of the mandible. What is the initial movement of the mandible during opening and how much mouth opening does this produce? This is a ball-and-socket joint formed by the articulation between the head of the humerus and the glenoid cavity of the scapula (Figure 9. However, this freedom of movement is due to the lack of structural support and thus the enhanced mobility is offset by a loss of stability. The large range of motions at the shoulder joint is provided by the articulation of the large, rounded humeral head with the small and shallow glenoid cavity, which is only about one third of the size of the humeral head. The socket formed by the glenoid cavity is deepened slightly by a small lip of fibrocartilage called the glenoid labrum, which extends around the outer margin of the cavity. The articular capsule that surrounds the glenohumeral joint is relatively thin and loose to allow for large motions of the upper limb. Some structural support for the joint is provided by thickenings of the articular capsule wall that form weak intrinsic ligaments. These include the coracohumeral ligament, running from the coracoid process of the scapula to the anterior humerus, and three ligaments, each called a glenohumeral ligament, located on the anterior side of the articular capsule. However, the primary support for the shoulder joint is provided by muscles crossing the joint, particularly the four rotator cuff muscles.

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    Census data are necessary for accurate description of population’s health status and are principal source of denominator for rates of disease & death cheap kamagra oral jelly 100 mg free shipping. It provides information on: Size and composition of a population The trends anticipated in the future buy discount kamagra oral jelly 100mg online. Data was collected on: Age, sex and size of the population Mortality, fertility Language, ethnicity Housing From these data different health indices could be calculated. Crude birth rate, crude death rate, age specific mortality rate and sex specific mortality rate are some of the examples of the indicators that could be calculated. Vital statistics: This is a system by which all births and deaths occurring nationnwide are registered, reported and compiled centrally. There is no nationwide birth and death registration system in Ethiopia but the system should be established in the future. The main characteristics of vital statistics are: Comprehensive – all births and deaths should be registered. Health Service Records All health institutions report their activities to the Ministry of Health through the regional health bureaus. Advantages: Easily obtainable Available at low cost Continuous system of reporting Causes of illness and death available. The major problems related to this source (health service records) are low compliance and delays in reporting. Health Surveys Health surveys are studies conducted on a representative sample population to obtain more comprehensive data for monitoring the health status of a population. Advantages of surveys based on interview: They are more representative of the health condition of the community. Documentary sources - Clinical records and other personal records, death certificates, publications etc. If you want to know the number of people in your kebele who are properly using latrines, which method of data collection would be appropriate? When the disease occur as epidemic, outbreak, and pandemic it is considered as excess of what is expected. Epidemic: The occurrence of disease or other health related condition in excess of the usual frequency in a given area or among a specific group of people over a particular period of time. There is no general rule about the number of cases that must exist for a disease to be considered an epidemic. If the number of cases exceeds the expected level on the basis of the past experience of the particular population, then it is an epidemic. An epidemic may cover a small area within a city, or an entire nation or may have a worldwide distribution. Common Source Epidemics:- Disease occurs as a result of exposure of a group of susceptible persons to a common source of a pathogen, often at the same time or within a brief time period. When the exposure is simultaneous, the resulting cases develop within one incubation period of the disease and this is called a point source epidemic. Food borne epidemic following an event where the food was served to many people is a good example of point source epidemic. If the exposure to a common source continues over time it will result in a continuous common source epidemic. A waterborne outbreak that spreads through a contaminated community water supply is an example of a common source epidemic with continuous exposure. The epidemic curve may 55 have a wide peak because of the range of exposures and the range of incubation periods. It can occur through direct person to person transmission or it can involve more complex cycles in which the agent must pass through a vector as in malaria. Propagated spread usually results in an epidemic curve with a relatively gentle upslope and somewhat steeper tail. When it is difficult to differentiate the two types of epidemics by the epidemic curve, spot map (studying the geographic distribution) can help.

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