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X. Topork. Westminster Theological Seminary in California.

It consists of many layers of thin-walled parenchyma cells with lot of intercellular spaces cheap 500 mg panmycin mastercard. It is composed of single layer of barrel shaped 83 Root hair Rhizodermis Cortex Endodermis Pith Ground plan Root hair Rhizodermis Cortex Passage cell Casparian strip Endodermis Pericycle Passage cell Phloem Protoxylem Metaxylem Pith A sector enlarged Fig panmycin 250mg without a prescription. There is a band like structure made of suberin present in the radial and transverse walls of the endodermal cells discount panmycin 500 mg free shipping. Their function is to transport water and dissolved salts from the cortex to the xylem. The main function of casparian strips in the endodermal cells is to prevent the re-entry of water into the cortex once water entered the xylem tissue. Pericycle Pericycle is the outermost layer of the stele and lies inner to the endodermis. The tissue, which is present between the xylem and the phloem, is called conjunctive tissue. Primary structure of dicotyledonous root - Bean root The transverse section of the dicot root (Bean) shows the following plan of arrangement of tissues from the periphery to the centre. It is made up of a single layer of parenchyma cells which are arranged compactly without intercellular spaces. These cells are loosely arranged with intercellular spaces to make gaseous exchange easier. Though chloroplasts are absent in the cortical cells, starch grains are stored in them. The radial and the inner tangential walls of endodermal cells are thickened with suberin. But these casparian strips are absent in the endodermal cells which are located opposite to the protoxylem elements. These thin- walled cells without casparian strips are called passage cells through which water and mineral salts are conducted from the cortex to the xylem elements. Water cannot pass through other endodermal cells due to the presence of casparian thickenings. Pericycle Pericycle is generally a single layer of parenchymatous cells found inner to the endodermis. Anatomy of monocot and dicot stems Primary structure of monocot stem - Maize stem The outline of the maize stem in transverse section is more or less circular. Internal structure of monocotyledonous stem reveals epidermis, hypodermis, ground tissue and vascular bundles. The continuity of this layer may be broken here and there by the presence of a few stomata. Hypodermis A few layer of sclerenchymatous cells lying below the epidermis constitute the hypodermis.. Ground tissue There is no distinction into cortex, endodermis, pericycle and pith. The entire mass of parenchymatous cells lying inner to the hypodermis forms the ground tissue. The cells of the ground tissue next to the hypodermis are smaller in size, polygonal in shape and compactly arranged. Towards the centre, the cells are loosely arranged, rounded in shape and bigger in size. Vascular bundles Vascular bundles are scattered in the parenchymatous ground tissue. Each vascular bundle is surrounded by a sheath of sclerenchymatous fibres called bundle sheath. Vascular bundles are numerous, small and closely arranged in the peripheral portion. Towards the centre, the bundles are comparatively large in size and loosely arranged. It can be distinguished into an outer crushed protophloem and an inner metaphloem. The two metaxylem vessels are located at the upper two arms and one or two protoxylem vessels at the base. In a mature bundle, the lowest protoxylem disintegrates and forms a cavity known as protoxylem lacuna. Primary structure of dicotyledonous stem - Sunflower stem Internal structure of dicotyledonous stem reveals epidermis, cortex and stele. Inner to the hypodermis, a few layers of chlorenchyma cells are present with conspicuous intercellular spaces. The cells of this layer are barrel shaped and arranged compactly without intercellular 92 Epidermal hair Epidermis Hypodermis Cortex Endodermis Pericycle Vascular bundle Pith Ground plan Epidermal hair Cuticle Epidermis Collenchyma Chlorenchyma Cortex Resin duct Parenchyma Starch sheath Bundle cap Primary phloem Cambium Metaxylem Protoxylem Pith Primary medullary ray A sector enlarged Fig. Since starch grains are abundant in these cells, this layer is also known as starch sheath. Pericycle Pericycle is the layers of cells that occur between the endodermis and vascular bundles. In the stem of sunflower (Helianthus), a few layers of sclerenchyma cells occur in patches outside the phloem in each vascular bundle. The bundle caps and the parenchyma cells between them constitute the pericycle in the stem of sunflower. Phloem conducts organic food materials from the leaves to other parts of the plant body. Xylem conducts water and minerals from the root to the other parts of the plant body. These extensions of the pith between the vascular bundles are called primary pith rays or primary medullary rays. Anatomical differences between dicot stem and monocot stem Dicot stem Monocot stem 1. Ground tissue is not differen- into cortex, endodermis, tiated, but it is a continuous mass pericycle and pith. When the xylem and the phloem lie in the same radius, the vascular bundle is called a.

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The presence in the list of reference of indicators like i/ Frequency of daily intake of food and drink of people buy panmycin 500mg with visa, ii/ Proportion of dentists providing advice on tobacco use cessation to their patients order panmycin from india, iii/ Incidence annual of oral cancer in adults contribute of laying common foundations for an integrated approach of health surveillance buy panmycin 250mg with visa.. A critical analysis of the methodological criteria used in international scientific literature has underlined that new and complementary trends should be recommended to improve the production of higher quality information in oral health epidemiology. Standardized procedures including health interview and health clinical surveys in relation with core indicators should be developed and used. Similarly, thought should be given to the design and implementation of an Oral Health Surveillance System, based on oral health primary care providers which would support national health surveillance systems such as Health National Interview Survey and Health National Clinical Survey. The analysis of the scientific literature showed weaknesses in the evaluation of oral health trends in terms of methodology, quality control, and presentation of results. The ability to interpret and make conclusions in public oral health are therefore limited. New or complementary measures should be put in place in order to improve the quality of medical information in oral health epidemiology. The range of potential quality methods is vast, making a full review impracticable. Existing data sources might not permit the construction of the desired indicators, because the required variables are missing or recorded differently. Dedicated data collection that would yield comparable information on a national level might be prohibively expensive. Thus, to tackle the problem in a way that respects time and resource constraints, an opportunistic rather than idealistic approach seems warranted. The main disadvantage of relying on existing data sources is that the data systems have usually been designed for purposes other than quality measurement and may therefore not always provide exactly the desired information. The following limitations are commonly observed: Limited geographic coverage in several countries, data are only available for selected regions. However, the distribution of caries is very skewed and although risk groups are increasingly targeted for prevention, appropriate and prudent surveillance and care should be provided for all patients since caries can occur and can progress in all risk groups. The population presenting oral disorders need care adopting a longitudinal perspective, with an emphasis on prevention and health promotion.. In dental caries management, the focus has been around preventive caries management for children, but caries is a disease process that needs to be managed over a persons lifetime. The evidence is leading to an international trend in clinical practice, to move away from operative intervention towards prevention of caries. The dentist in the particular scope of their exercises, indeed have to make pay their attention focus on two types of approaches. They have to attempt in the first place to prevent the occurrence of chronic oral health diseases - caregivers of children could play a major part in keeping children free of obvious dental caries. This by setting up an optimal treatment and by providing best practices for managing oral diseases once they have been diagnosed. Oral health information systems--towards measuring progress in oral health promotion and disease prevention. Are we ready to move from operative to non-operative/preventive treatment of dental caries in clinical practice? Although useful and even essential, comparisons between countries have many caveats (Kosonen 1994, Kautto & Moisio 2004, Gissler et al. An important condition is comparable units of measurements, and therefore creation and development of indicators is essential (Kosonen 1994). Without reliable indicators a picture of a situation or developments may remain ambiguous. The lack of standardisation both in indicator definitions and methods of measurement has hindered international comparisons (Koponen & Aromaa 2006). It also includes sexual health, the purpose of which is the enhancement of life and personal relationships, and not merely counseling and care related to reproductive and sexually transmitted diseases. For each indicator there is an operational definition, justification for selection, criteria for selection, data sources and (when appropriated) references. A systematic review of factors associated with teenage pregnancy in European Union (Imamura, 2007). Results came from 4444 studies identified and screened, 20 met the inclusion criteria. The well-recognized factors of socioeconomic disadvantage disrupted family structure and low educational level and aspiration appear consistently associated with teenage pregnancy. However, surprisingly for some of us, evidence that access to services in itself is a protective factor remains inconsistent. Although further association with diverse risk-taking behaviours and lifestyle, sexual health knowledge, attitudes and behaviour are reported, the independent effects of these factors too remain unclear. Another conclusion resulting from the systematic review was that included studies varied widely in terms of methods and definitions used. First, we cannot synthesize or generalize key findings as to how all these factors interact with one another and which factors are the most significant. Future research ensuring comparability and generalizability of results related to teenage sexual health outcomes will help gain insight into the international variation in observed pregnancy rates and better inform interventions (Imamura, 2007). Friends, books and magazines were the most important source of information on puberty for every country. School teachers appeared as one of he most important sources of information of sexual and reproductive systems of men and women. In every country the large majority of respondents had already had a boy or girl friend: 76. More than 47% (between 47% in Estonia and 58% in Belgium) respondents had already had heterosexual intercourse. However, some outcomes of this apparently similar sexual and reproductive behaviour of young people is obviously different when considering the same four Member States. Teenage pregnancy is a good example, with rates, 1n 2005, varying between 6% in Portugal and 2 % in Belgium (Estonia with 4 % and Czech Republic 1 %). This seems to be due to either one of the following reason: contraceptive failure (Portugal, for instance, having a huge use of emergency contraception, with sales increasing enormously from 80.

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The physi- and fiber 500mg panmycin with visa, along with high intake of calcium appear to cian or health care provider should explain the benefits decrease the risk for colorectal cancer best buy for panmycin. There is a and potential risks associated with each option before suggestion that postmenopausal hormone replacement deciding on the screening process panmycin 500mg low price. There may be false-positive results where the test can indicate the presence of blood when there is nothing wrong with the colon. Of Americans over clinicians screen men and women at the age of 50 years the age of 50, 3050% will develop these polyps. The cancer risk is related There are different options and different benefits of to specifics of the adenomas including their size, number, each option. It is based on this fair evidence that sigmoidoscopy alone or in combi- understanding that screening for colorectal cancer nation reduces mortality. It is a flexible tube, especially the first few inches and specific test for finding cancer in polyps (mean- where the light is located. Within the scope there are ing that most of the cases it detects are really cancer channels for air to be put into the patient to open up the and most of the ones it says are not cancer are really colon. There is a suction channel to pull out extra fluid not cancer), but does come with higher risk than the and small bits of stool. The risks are small, but include biopsy from the lining of the colon (a small piece of tis- a risk of bleeding and perforation, usually related to sue usually is removed). The colonoscopies when empty of stool after laxatives and enemas, col- require an overnight bowel cleansing preparation, lapses and is very flat. In order to visualize the lining of mild sedation, highly trained personnel to do the test, the colon, the person doing the examination usually has and a longer recovery time. At this point, the task to put in some air to open this area up so he/she can force feels that it is not certain whether the potential see the mucosa. At the beginning of the examination, added benefits of colonoscopy, relative to the other the scope is inserted into the patient. The main exami- screening alternatives, are large enough to justify the nation of the colon occurs as the scope is withdrawn added risks, cost, and inconvenience for all patients. The test takes about 15 minutes and patients toler- colonoscopy for screening purposes need only be ate the test very well. There is The age at which colorectal cancer screening a small risk of bleeding if a biopsy is taken and there is should be stopped is not known. In general, screening a very miniscule risk of perforation if a biopsy is has been done in patients younger than 80 years of age. The test overall is very well tolerated, espe- In theory, the yield should be higher in older persons, cially in the hands of experienced endoscopists. The main the specimens before testing them, does increase the differences between the sigmoidoscopy and the sensitivity of finding blood. It is important to remember colonoscopy are that the latter examines the entire that three different stool cards from spontaneously colon and requires a sedative and a more extensive voided stools are the standard and that neither a rectal bowel-cleansing regimen. The sig- abnormal is found, the physician can remove a piece of moidoscopy should not be performed in the presence it (biopsy), which is sent to the lab for further evaluation. Possible complications of colonoscopy are bleeding and 179 Comfort Women puncture of the colon; however, these complications are the different types of cervical wall cells (squamous and very uncommon. This procedure takes between 30 and columnar epithelium) of the cervix interface, called the 60 minutes. The sedatives and pain medications protect transition zone (T zone) and all margins of any visible the patient from feeling any discomfort during the exam- lesions. The patient generally needs to wait for 12 hours may be necessary depending on the original abnormality for the sedative to wear off. It is most safe for the patient noted upon cellular (cytological) examination of the if he/she brings someone to drive him/her home. This tissue is then examined for the characteristics Suggested Reading of abnormal growth/cancer and for involvement of the Barker, L. New York: Lippincott, Williams & conization (special type of tissue removal technique) Wilkins. Usually biopsies are painless; however, a local anesthetic may be used during a diagnostic excisional Suggested Resources procedure. Once performed, colposcopic evaluation is usually followed closely for at least 12 years. The cervix is more vascular (increased blood supply) in pregnancy and there is an increased risk of bleeding. It is usually done to evaluate any lesions suspected of representing abnormal tissue growth or cancer. This may be an abnormal Pap smear or any lesion which does not resolve spontaneously in a reasonable amount of time as decided by the clini- cian. The colposcope is an instrument which permits Comfort Women Sexual exploitation has magnification of lesions of the genital tract. However, the Japanese tion of acetic acid is applied to areas of the genital tract military not only exploited women sexually, but also and abnormal areas turn white enhancing the quality of actually enslaved them. After gross microscopic called Jungun Wianbu in Korean or Jugan Inafu in examination of the affected tissue for acetowhite Japanese, meaning military comfort women. Some Dutch and Australian perhaps due to shame and fear that society would judge women, mostly nurses, also became comfort women. A few The few Japanese women to become comfort women made attempts to reveal the plight of former comfort were Japanese prostitutes. There was tension In the beginning, Japan tricked the majority of the between Japan and Korea after the war and during the young girls into becoming comfort women by promising postcolonial period; it was feared that any mention of factory-type jobs. The opportunity for work was appeal- the comfort women issue would destroy the delicate ing to many young women and their families, because economic relations between the two countries. Kim Korea allowed Japan to lure these young women away Hak Soon filed a lawsuit against the Japanese easily. Some women received draft notices, women also joined the lawsuit, but remained anony- whereas others were simply promised work. Japan has established a private some as young as 13; even married women were not fund for payment to former comfort women, but has safe. Many were abducted right off the street and were not provided any official acknowledgment. Many Counsel for the Women Drafted for Military Sexual had no heat and only thin straw mats on the floor.

Morphine is bitter order panmycin paypal, and you may prefer to mask the taste by taking it with some other drink generic 250mg panmycin free shipping. Most palliative care patients need 75mg/day for the last 3months of their life for adequate pain relief order panmycin 500mg fast delivery. Most patients receiving regular morphine need an antiemetic such as chlorpromazine (which the patient may be using already), or prochlorperazine 5-10mg tid increasing to 4hrly, or metoclopramide 10mg tid Fig. B, plasma concentration-time curves for an oral, and an intravenous Efficacy decreases with repeated use (tolerance), so that dose. Notice that after an oral dose the concentration rises to a lower increasing doses are needed (37-3). C, doses are too widely spaced to maintain may occur if treatment is stopped abruptly (physical analgesia. The thresholds between no effect and a useful effect and between a useful effect and toxicity are rising. Antacids and metoclopramide will help with gastric Morphine 10mg = Codeine 100mg = distension, and hiccough. Tramadol 40mg = Buprenorphine 150g Cyclizine 50mg tid, or domperidone 10-20mg tid are Opioids cause respiratory depression: treat an acute useful adjuncts for nausea. It helps also as a night sedative, or phenytoin 150-300mg nocte are useful for shooting or although other benzodiazepines may give less hang-over stabbing pains. It is important, though, to remember that the quality by renal failure or cerebral oedema. If there is a specific point giving rise to pain or a specific nerve involved, inject the site with methylprednisolone 40mg (or hydrocortisone 200mg) in 2ml lidocaine. It may improve appetite and hepatoma and hepatitis B, bladder carcinoma and promote a sense of well-being. In some areas, certain cancers are very common In a child, adjust doses appropriately. Although a few tumours can be If there is a smelly ulcer or fungating tumour, managed optimally with very limited facilities, many use metronidazole 400mg tid and apply yoghurt or honey cannot. This will relieve nausea: intractable vomiting is a expensive; however the relief of suffering is often not very horrible way to die. Avoid metoclopramide and domperidone if vomiting is due to malignant bowel obstruction, because they Your hospital may be a long way from any referral centre, increase bowel motility, and may make things worse. You may be unable to get prompt and reliable histological reports, If there are excessive respiratory secretions, or even any reports at all, and there will almost certainly try hyoscine 04mg qid sc. If there is dyspnoea from a pleural effusion, Remember the possibility of complications and drain it (9. Make the diagnosis of malignant disease clinically, and examine the patient carefully to assess its extent. If you are sending away a node for histology, always cut it across: with experience you will be able to recognize the caseation of tuberculosis, and to distinguish hyperplasia from a tumour. However, after taking a biopsy for malignancy, wait for the histological report before starting toxic chemotherapy. When you take tissue from an ulcer or a large mass, take some from the edge of the lesion, so that you include normal and abnormal tissue. Most malignant tumours have 4 stages, or sometimes 5, some of which may be subdivided. The first 2 stages are usually curable, whereas the last 2 can usually only be palliated. Both the stage of a tumour, and often its histological grade, influence the prognosis, both with and without treatment. Occasionally, you will see some large resectable tumours, malignant or benign (24-7). Alternatively A chest drain may relieve a massive pleural effusion, you can use the tied-off finger end of used gloves for very whose recurrence you may forestall by installation of talc small specimens. If you want to send a very large specimen for histology, such as treat or palliate yourself. Fix the whole specimen in a help him, persuade him not to waste his money on them. When it is fixed, seal it in a polythene bag, pack it in a cardboard box; you may then have to send it by messenger! Remember to label & orient your specimen places where medicine has to be bought by individual carefully, with a hospital number in case the name is patients, the poor are likely to get nothing. Even so, make unreadable, and give accurate clinical information to the every effort to have some drugs available to treat such pathologist on your request form. You will also have to decide where the treatment of tumours comes in your own priorities, when more cost-effective calls on your resources are so great. You must also petrol for the hospital ambulance, so his parents took him there by bus. While he was waiting total and differential white count (from which you will be to be sent to the oncologist again, he died, after a total history of less than able to work out the absolute granulocyte count), a month. Before you use any cytotoxic agent, you must decide if the (3) Treatment is easily possible in a district hospital. Category 2/3: Chemotherapy may reduce tumour size, but overall benefit is equivocal: Most remaining malignancies. Your laboratory facilities may be minimal, your drugs limited, your nurses inexperienced with chronic cancer patients, and your rehabilitation facilities rudimentary. You do however have two advantages; you can follow up a patient more easily than a referral centre, and his relatives are likely to live much nearer. B, note the protrusion of the eye: without immediate treatment, vision 90% Normal activity but signs or symptoms of disease present. Tropics, Livingstone, with kind permission 70% Totally independent, but unable to work or do normal activity. Unfortunately, there are no other tumours which are quite 50% Requiring considerable help, and needing frequent nursing care. You need to know where chemotherapy alone or adjuvant 20% Disability complicated by severe sickness. Carefully follow peripheral vein, and bury it under a tunnel in the skin to the rules about reducing the dose and stopping treatment prevent it becoming infected.