Showing posts with label of. Show all posts
Showing posts with label of. Show all posts
Wednesday, March 18, 2015
The colour of Hope
The first photography post from The Perspectives. I clicked this with this one thought in my mind : To me, THE COLOUR OF HOPE IS RED. I clicked it in the dark so that the only light (signified as hope here) is that of the candle. The entire background is red and there is a certain illusion created from the light and the colours. Hope you like it. Thank you.
Tuesday, March 17, 2015
Sunday, March 15, 2015
Different types of Breast Cancers
A.The density of a young womans breast is due to the predominance of fibrous interlobular stroma and the paucity of adipose tissue .
B. Prior to pregnancy, the terminal duct lobular units (TDLUs) are small and are invested by loose cellular intralobular stroma.
C. During pregnancy, branching of terminal ducts results in more numerous TDLUs, and the number of acini per TDLU increases. Luminal cells within TDLUs undergo lactational change in preparation for milk production.
D. With increasing age, the TDLUs decrease in size and number, and the interlobular stroma is replaced by adipose tissue.
E. Mammograms become more radiolucent (darker) with age
Mammary duct ectasia. Chronic inflammation and fibrosis surround an ectatic duct filled with inspissated debris. The fibrotic response can mimic the irregular shape of malignant carcinomas on palpation or mammogram.
Fibroadenoma. A rubbery, white, well-circumscribed mass is clearly demarcated from the surrounding yellow adipose tissue. The fibroadenoma does not contain adipose tissue and therefore appears
denser than the surrounding normal tissue on mammogram.
Fibroadenoma. The lesion consists of a proliferation of intralobular stroma surrounding and often pushing and distorting the associated epithelium. The border is sharply delimited from the surrounding tissue
Phyllodes tumor. Compared to a fibroadenoma, there is increased stromal cellularity, cytologic atypia, and stromal overgrowth, giving rise to the typical leaflike
architecture.
Several biopsy specimens showing fibrocystic change of the breast. The scattered, poorly demarcated white areas represent foci of fibrosis. The biopsy specimen at the lower right reveals a transected empty cyst; those on the left have unopened blue dome cysts
Microscopic detail of fibrocystic change of the breast revealing dilation of ducts producing microcysts and, at right, the wall of a large cyst with visible lining epithelial cells.
A, Normal. A normal duct or acinus has a myoepithelial cell layer and a single luminal cell layer
B, Epithelial hyperplasia. The lumen is filled with a heterogeneous population of cells of different Morphologies with Irregular slitlike fenestrations
Sclerosing adenosis. The involved terminal duct lobular unit is enlarged, and the acini are compressed and distorted by the surrounding dense stroma. Calcifications are often present within the lumens.
It is mistaken for an invasive carcinoma, since the mammographic appearance is also similar.
Intraductal papilloma. A central fibrovascular core extends from the wall of a duct. The papillae arborize within the lumen and are lined by myoepithelial and luminal cells
A, Atypical ductal hyperplasia with slit like spaces. It falls short of a diagnosis of DCIS.
B, Atypical lobular hyperplasia. A population of monomorphic small, rounded, loosely cohesive cells partially fill a lobule.
DEGREES OF BURN AND MANAGEMENT
- BURNS & SCALDS
- ELECTRICAL BURNS
- CHEMICAL BURNS
- RADIATION
- LIGHTENING
PRE-HOSPITAL CARE
- Remove patient from source
- Extinguish burning clothes
- Careful with electric source
- CPR
- If hospital is 30- 45 min away try to start IV
- Cold soaks ↓ pain but ↓ heat, so avoid hypothermia
- Cover the areas with clean sheets
- 100% O2 if suspected CO poisoning
- Check for respiratory burns
IN EMERGENCY
- ABC
- Assess the percentage and degree of burn
- Start IV line and infuse Ringer’s Lactate and calculate the fluid requirement
- Take patient’s weight
- Catheterize
- Oxygen if required
- TT injection
- Morphine
- Wound care- clean with saline and apply 1%silver sulphadiazene
- No role of prophylactic antibiotic
ASSESSMENT OF BURNS
Wallace’s Rule of Nine-in adults each upper extremity, and the head and neck are 9% TBSA, lower extremities, anterior and posterior trunk each are 18% while genitalia and perineum forms 1% of TBSA
Infant head is 18 % and lower limb is 14%, for each year after one year 1% to be taken off the head and neck area and added to the lower limbcs
Patient’s palm as 1 %
FLUID RESUSCITATION
- Modified Parkland’s formula
- 4ml X Body weight X % Burns ( 50 % )
- Ringer’s lactate to be given. 50% in first eight hours from the time of burns
- 50% in next 16 hours
- Response- 1ml/Kg/hr urine output. 50-70ml in adults
DEGREES OF BURN
FIRST DEGREE
- Sunlight exposure or burn by hot tea cup
- Injury confined to epidermis
- Red and dry
- Very painful
- Heals in 3-6 days without scarring
- Not included while calculating fluid requirement for burns
SECOND DEGREE SUPERFICIAL
- Hot liquid or flash flame
- Pink or mottled red in appearance
- Blisters or bulla, soft and moist
- Painful
- 7-10 days to heal and may have hypo or hyper pigmented areas
SECOND DEGREE DEEP
- Chalky white
- Soft and moist
- Sensation is obtunded
- More than 21 days to heal
- Heals with lot of scarring and contractures
THIRD DEGREE BURN
- Prolonged exposure or electric burn
- Dry and parchment like
- Translucent, can see fat and thrombosed veins
- No sensation
- Needs debridement of eschar and skin grafting
MAJOR BURNS
Partial thickness greater than 25%
Partial or full thickness burns of face, hands, genitalia and feet
Third degree burn greater than 10% area
Burns complicated by
Respiratory tract injury
Major soft tissue injury
Fractures
Electrical burns
MODERATE
Second degree burns 15-25%
Third degree less than 10% except hands, face and feet
MINOR
Second degree less than 15 %
Third degree less than 2 %
PATHOPHYSIOLOGY
Jackson’s three zones
- Zone of coagulation
- Zone of stasis
- Zone of hyperaemia
CVS- shift of fluid, ↓cardiac output, greater than 25 % burn even non burned tissue also swell
LUNGS- hyperventilation, ↓ protein, poor lung function
GIT- ileus, mucosal ischaemia, curling’s ulcers, translocation of bacteria
RENAL- renin- angiotensin- aldosterone system activated, ↓ urine output, ATN
IMMUNE SYSTEM- destruction of barrier, depression of cellular immunity
BODY TEMP. – loss of protective mechanism, heat loss & hypothermia, ↑ spike after dressing due to pyrogens such as interleukin-1
WOUND CARE
Clean with surgical detergent or clean water shower or water tank and twice daily dressing with 1% SSD
BIOLOGICAL DRESSINGS
Allograft, skin substitutes- collagen amino acid films
Amnion, porcine skin, integra, homograft, Burn mesh
Local care
Dressings
Open- neck, hand,
occlusive,
Biological
Early surgical excision and grafting
Tangential excision
ANTIBACTERIALS
Sulfonamide
Thick application
Twice daily
Good penetration
Silver Nitrate
Bacteriostatic
Black discoloration
Thick pads required
Leaching of Na, K, Cl, Mg and Ca
Poor penetration
Silve sulphadizene
1968 Charles Fox
Silver nitrate and acid sulphadizene
Bacteriostatic
Good penetration
Gentamicin
2.2% Cerium nitrate and SSD
NUTRITION
Metabolic needs ↑ by two to three fold
CURARIE FORMULA
25KCal x Body weight + 40KCal x % Burns
Supplement Vit C, zinc and B complex
INFECTION ( Clinical)
Conversion of 2o - 3o
Focal dark brown or black discoloration
Degeneration of wound with neoeschar
Rapid separation of eschar
Hemorrhagic discoloration of subeschar fat
Erythematous wound margin
Metastatic septic lesion in unburned tissue
INFECTION ( Histological)
Organism in unburned tissue
Hemorrhage in unburned tissue
↑ inflammatory reaction in adjacent tissue
Small vessel thrombosis or ischaemic necrosis of unburned tissue
Perineural and intralymphatic migration of organism
Vasculitis and perivascular cuffing of organisms
Other septic complications
- Pneumonia
- Sup. Thrombophlebitis
- Endocarditis
- Sepsis
Verduria
FASCIOTOMY, ESCHAROTOMY, ESCHARECTOMY, SKIN GRAFTING
Eschar is the burnt dead skin
Fascia is the deeper tissue covering the muscles
Burn wound excision
↓ hospital stay
↓ sepsis ( greater than 30% increased chance of sepsis)
Better cover, early healing, ↓ scar
Rapid restoration of function
ESCHAROTOMY
- If vascular or respiratory compromise due to thick constricting eschar
- Escharotomy done at the neutral lines.
- If no improvement do fasciotomy( mostly in electric burns)
ESCHARECTOMY
Surgical removal of eschar
Early- done in 7- 12 days
Late- separates after two weeks.
Prepares bed for early grafting
Tangential excision and grafting
In second degree deep burns
Done on 2nd to 5th day
After 7 days it softens
Not more than 20% in one sitting
SEQUENTIAL EXCISION
- Done in deep second degree and third degree burns
- Blood loss 5% area one unit blood required
- Eschar sequentially removed with a guarded knife and grafted
Pinch, mesh, stamp, sheet
Thin, Intermediate, Thick ( Split thickness graft)
Full thickness graft
Priority areas
face, hands, axilla, cubital and popliteal fossa
Autograft, homograft, heterograft
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- Low voltage ( greater than 1000 volts )
- High voltage ( less than 1000 volts )
- Conversion of electrical energy to heat is governed by Ohm’s law
- C= V/R current in amperes
- Joule’s Law- J= C2RT relation between current and heat production
- Bone offers the most resistance
- Current takes the shortest path
- Body acts as volume conductor
- Arc injury is very deep
- “no release” phenomenon
- Skeletal injury due to fall.
- Cardiac- arrest, VT, AF, SVT, RBBB
- Renal- ARF, Myoglobinuria
- CNS- convulsions, coma, paraplegia
- Abdomen- Splenic injury
MANAGEMENT
General
Deep burns- maintain urine output of 2ml/kg/hr
Mannitol 12.5 gm/hour
50ml 7.5% NaHCO3 ( 45 mEq)
Cardiac monitoring ( CPK-MB)
The Future of e books
This is the type of e-textbook I want in my class. An excellent showcase for the use of mobile devices in schools. This is also the type of e-textbook that will convince the most ardent of naysyers about the benefits of technology and interactive touch devices in the classroom. Talk about engaging your learners, this would get even your most recalcitrant students investing in their own learning.
Read more »
http://www.ted.com/
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Inklings iPad Textbooks
Power and Possibilities of Interactive Books
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Monday, March 9, 2015
Australian scientists find a vaccine to prevent new strains of flu virus
Scientists at the University of Melbourne, Australia, discovered a new breakthrough in the search for better vaccines to prevent new strains of flu virus. They say, cells known as T-cells could be the key to a universal flu vaccine.
They find out why the influenza virus usually avoid white cells that protect the body from infection. The use of T-cells to attack the new virus strain will produce a vaccine that is durable and broad coverage in preventing seasonal and pandemic flu outbreaks.
One of the scientists involved in the study, Professor Stephen Turner, said the study will complement the existing treatment of the flu.
"I want to emphasize that we are not trying to replace the existing vaccine that actually works well," said Professor Stephen as reported by the BBC correspondent in Sydney, Phil Mercer.
Other viral infections
"The problem with the existing vaccine is the virus could change, so we are looking for is value added to existing vaccines so that we can produce not only antibodies but also immune T-cell immunity wider if the virus changes without our knowledge," added Professor Stephen .
In addition to potentially generate a universal vaccine, these findings may also reveal a better understanding of immune white blood cells against viral infections, including HIV and hepatitis C.
Every year recorded between three and five million cases of severe flu. The virus is killing 500,000 people per year worldwide.
Read more »
They find out why the influenza virus usually avoid white cells that protect the body from infection. The use of T-cells to attack the new virus strain will produce a vaccine that is durable and broad coverage in preventing seasonal and pandemic flu outbreaks.
One of the scientists involved in the study, Professor Stephen Turner, said the study will complement the existing treatment of the flu.
"I want to emphasize that we are not trying to replace the existing vaccine that actually works well," said Professor Stephen as reported by the BBC correspondent in Sydney, Phil Mercer.
Other viral infections
"The problem with the existing vaccine is the virus could change, so we are looking for is value added to existing vaccines so that we can produce not only antibodies but also immune T-cell immunity wider if the virus changes without our knowledge," added Professor Stephen .
In addition to potentially generate a universal vaccine, these findings may also reveal a better understanding of immune white blood cells against viral infections, including HIV and hepatitis C.
Every year recorded between three and five million cases of severe flu. The virus is killing 500,000 people per year worldwide.
Impact of Health Risk Of Oral Sex
At present a lot of changing sexual behavior as well as oral sex is often done today. Oral sex itself has a bad impact and risks to health. From the research of oral sex can lead to cancer of tonsils and base of tongue.
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The increasing cases of cancer caused by oral sex is triggered by the infection of human papillomavirus (HPV), which can be transmitted through various types of sexual activity.
"The more you perform oral sex has been associated with increased HPV infection," said Dr. Greg Hartig, head of ENT surgery at the University of Wisconsin School of Medicine and Public Health in Madison, as quoted by FoxNews, Thursday (27/01/2011).
Research conducted by Dr. William Lydiatt, professor and chief of surgical oncology at the University of Nebraska Medical Center, Omaha found that approximately 60-70 percent of cancer cases are related to HPV-positive tonsil.
Meanwhile, a study published New England Journal of Medicine in 2007 found that young people affected tonsil and base of tongue cancer with a positive HPV test result is mostly due to perform oral sex on her partner.
People doing 6 times or more oral sex partners have a risk 3.4 times higher risk of oropharyngeal cancer (cancer of the tongue, back of the throat or tonsils). This risk will increase if he often bergonta sexual partners.
Researchers also reported that since 1973, people with tonsil and base of tongue cancer is increasing every year. The widespread practice of oral sex among adolescents a factor that contributed to the increasing number of cancer patients.
People who are exposed to HPV virus has a specific location depends on which body part first enters the body. If you enter through the vagina commonly cause cervical cancer in the mouth but if it will cause cancer in the mouth and throat.
"Sexual Practices of people have changed from time to time. I do not know why they prefer to perform oral sex compared to other sexual activity," said Hartig. It favors experimenting with sexual activity, but need to see the effects and risks of these behaviors on health.
Big Blue Book of Beginner Books
Big Blue Book of Beginner Books
Summery:
Big Blue Book of Beginner Books is a great big book made up of smaller books. Each if the books are well known childrens classics and can be bought separately but of course more fun to get in a huge book of everything.
This book is about an animal who wants to go to the zoo. After getting thrown out, he meets a boy and a girl who want to know why he is so sad. He then proceeds to show them all the tricks he can do that would be great for the zoo. They are amazed and find him the perfect home.
A boy sitting relaxing sees a fly that goes by. The fly is running from the frog who is running from the cat. The list goes on until they all find out the big scare.A hunter with a gun was running from big noise that goes bump and thump. The book keeps building up with all the animals until the boy finds the source. It is funny and will make kids laugh.
Are You My Mother
This is a classic that does not need much explaining. This book is about a little chick who hatches and goes out into the big world to find his mother. He meets all sorts of fun things from an old car to a machine that goes snort. He is sadden until he finds his mother.
This is a great book all about opposites from big to little an up and down. This book takes kids on a great adventure starting with easy opposites ending with more complex ones like work and play.
The Best Nest
Mr Bird loves his nest. He sings about it all the time but not Mrs. Bird. So the two of them go out to find the best nest. Every time the birds settle down, Mr. Bird starts to sing but Mrs. Bird fines something wrong. One nest is full of mail while the other nest has loud bells. After going from place to place, they finally settled on one home that they got to share with their new baby chick who loved it as much as they did.
P.J. Funnybunny did not want to be a bunny. He decided to try living with bears but was sick after some hibernation. He was sad after he could not fly with the birds and the beavers worked to hard. In the end his family was just right for him.
Pros:
- 6 books in one
- Great for beginners
- Nice colorful pictures
- Great classics
Cons:
- Your child might want to read all of the in one sitting :)
Suggestions:
- A few of the stories like the Fly Went By, is sequential. After you read it to your child a few times ask them what comes next.
- For Go, Dog, Go, you will have a great opportunity to work on opposites. For a young child try pointing to the pictures and have them tell you the different opposites.
Bottom Line:
I found the Big Blue Book of Beginner Books great to read before nap. I would show my child the cover and have them choose one. I read it to them and they went off to nap. It was great. We had so much fun enjoying all the stories. My girls also like to keep books in their bed. Rather then cluttering up the space, they have one book that has it all. It is such a great book. I would recommend getting it for your kids or giving it as a present. It is well worth it.
* If you would like to get Big Blue Book of Beginner Books feel free to click on any of the links or book above.
Dont forget about the amazing GIVEAWAY. Only a few days left to enter.
Monster List of iBook Tutorials
There are numerous sites that are now offering Tutorials and how-to guides for creating ebooks in iBook Author. As teachers are now comfortable with the idea of creating their own e-textbooks more and more people are looking for resources to learn how to build touch enabled books that take full advantage of the iPad capabilities. Inserting video and high resolution photographs is one thing but how about inserting 3D manipulatives and models that are touch sensitive. Here is a list of some of the resources online. If you know of other good ones please add them in the comments section and we will update the list.
Web Tutorials:
Publishing with iBooks Author:
This book is intended to get you up and writing in iBooks Author. You’ll learn what to expect from this new tool and what its strengths and limitations are. You’ll see how you can create beautifully designed pages and how you can bring those designs to life with interactive content in ways that, before now, were only possible in a web browser on the Internet.
http://shop.oreilly.com/product/0636920025597.do
iBook Author: The Complete GuideWant to create your own interactive eBook for the iPad? It’s actually really simple using the iBooks Author program that Apple provides for free! Many classrooms are reading their text books on an iPad. To make this easy Shawn Ozbun has put together the complete guide to help walk you through the entire creation and publishing process.
Emerson College - Department of Journalism:
This is a great little site with close to 40 small tutorials for learning to use iBooks Author. These tutorial start at the basic like Starting iBooks, Using Templates and An Overview of the Toolbar right through to Inserting and Modifying html and Inserting and Modifying 3D Widgets. This is a good site to start your iBook Author journey
http://ecjourno.com/diyjourno/?page_id=38
This book is intended to get you up and writing in iBooks Author. You’ll learn what to expect from this new tool and what its strengths and limitations are. You’ll see how you can create beautifully designed pages and how you can bring those designs to life with interactive content in ways that, before now, were only possible in a web browser on the Internet.
http://shop.oreilly.com/product/0636920025597.do
http://shawnozbun.com/ipad/ibook-author-the-complete-guide/
This is a great little site with close to 40 small tutorials for learning to use iBooks Author. These tutorial start at the basic like Starting iBooks, Using Templates and An Overview of the Toolbar right through to Inserting and Modifying html and Inserting and Modifying 3D Widgets. This is a good site to start your iBook Author journey
http://ecjourno.com/diyjourno/?page_id=38
Jermy Dorm posted a great article over at iPads in Education Ning. In it Jeremy discusses the different insertable widgets that can be added to iBooks. He has written a simply and easy to read article for the teacher with little technical know-how. It makes for a good read to open up your eyes to the very real possibilities that are on offer even to the most techno phobic amongst us.
http://ipadeducators.ning.com/profiles/blogs/ibooks-author-and-interactive-content
Class Widgets:
iBooks Author comes with 6 inbuilt widgets to add great interactive elements to your iBooks. Sliding Puzzles, Live Twitter Feeds, Interactive Timelines, Embedded YouTubes or Vimeo, Embedded Google Maps or Live Polling. With Class Widgets, you can easily add more. No need to program or install Dashcode, just click on the Wizard and download your auto-generated widget.
http://classwidgets.com/
iBook Creatives:
This is the home of iBookCreatives.com - a community for and of iBook authors. Here you’ll find tips, tools, news, reviews, and tutorials related to publishing e-books with Apple’s free publishing tool – iBook Author. There are a number of tutorials on adding PowerPoint, Keynotes or just useful keyboard shortcuts.
http://ibookcreatives.com/2012/02/02/keyboard-shortcuts-for-ibooks-author/
http://www.tes.co.uk/mypublicprofile.aspx?uc=2261160
This is a clear and concise tutorial for adding images into your iBook. It is written by cartoonist and illustrator Mark Anderson. He recognises the potential that iBook Author has for education but wants people to see beyond that and see the potential of the tool as a self publishing platform.
http://www.andertoons.com/cartoon-blog/2012/01/adding-a-cartoon-to-ibooks-author.html
This is a single tutorial for creating fullscreen ibook pages. The possibility to make an image to pop up fullscreen, so that any small illustration may be appreciated as big as the iPad display allows – and even more, zooming in. There are at least three ways to do this in iBooks Author, each one with its own drawbacks: because fullscreen and borderless aren’t synonyms.
http://www.davidebarranca.com/2012/04/ibooks-author-fullscreen-images/
Videos:
1. Apple iBooks Author Tour
http://www.youtube.com/watch?v=pr076C_ty_M
2. Adding HTML to iBooks Author with Tumult Hype
http://www.youtube.com/watch?v=9_3-OWNb6Dg&feature=related
3. iBook Author Tutorial - Sharing Your iBook Author File With a Friend
http://www.youtube.com/watch?v=HYVogclRy1U
Paid Resources:
Templates for iBooks: $4.49
Templates for iBooks Author provide you with 20 Templates. The variety of styles includes astrology, science, urban and wild life, leisure and many more. To use Templates for iBooks Author you just need a Mac with iBooks Author 1.0 or later. All the Templates are flexible -pictures can be replaced with a drag-and-drop ease, as most of the elements are easy to move, resize or delete.
http://itunes.apple.com/au/app/templates-for-ibooks-author/id507420043?mt=12
Meet iBooks Author: $4.99
This hands-on guide steers you through how to lay out your Multi-Touch ebook. Starting with picking a template, you learn how to add and use text, import from Pages and Word, and create a table of contents. This practical, approachable guide will quickly help you start creating Multi-Touch ebooks!
http://www.peachpit.com/store/product.aspx?isbn=0133069877
Book Palette: $9.99 AUJumsoft Book Palette offers you 20 beautiful templates for iBooks Author. Each template included in the app features an assortment of stylish and modern page layouts. You can use them as a starting point and go from there by typing or pasting your own text, adding or removing text boxes, and dropping images or other media.
http://itunes.apple.com/au/app/book-palette/id497704085?mt=12
iBooks Author Templates: $19.99 AU
Have a great idea but cant get it onto the page. Choose from dozens of professionally designed templates by name-brand designers. Say good bye to boring designs and hello to an eBook that stands out from the crowd. All of the template designs are 100% customizable. Import your own photos, change a color, or drag and drop any element to your hearts content. These templates start from $19.99
http://www.ibooksauthortemplates.com/
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