Asbaquez

Jasa dan Layanan Print Warna Online 24 Jam

noreply@blogger.com (Unknown) — Tue, 25 Apr 2017 20:50:00 +0000

Print Warna dan Hitam

Kami dari usaha Fotocopy dan Percetakan menyediakan jasa dan layanan print warna dan hitam secara 24 jam. Bagi anda yang membutuhkan print warna atau hitam dapat datang ke tempat kami, karena kami buka usaha jasa dan layanan selama 24 jam.

Bahan untuk print warna dan hitam :

1. HVS

2. Art Carton

3. Art Paper

4. Spanduk atau banner

5. Ex Banner dan Roll Banner

Sekian informasi dari kami tentang print warna atau hitam putih semoga Bagi anda yang sudah berpatisipasi dan melihat informasi yang diatas, kami ucapkan banyak terimakasih.

Kontak Person :

Delta Fotocopy dan Percetakan

Afrizon

Email : printingudazon@gmail.com

Telepon : 082313058735

Jl. Waru No. 12 A Rawamangun Jakarta Timur

Jasa dan Layanan Cetak Spanduk 24 Jam

noreply@blogger.com (Unknown) — Mon, 24 Apr 2017 13:19:00 +0000

SPANDUK ATAU BANNER

Kami dari Pencetakan menyediakan untuk kebutuhan untuk pembuatan Spanduk/printing spanduk/cetak spanduk. Adapun Jasa Cetak Spanduk/printing banner ini kami menyediakan Bahan Flexi Cina, Flexi Korea, dan tentunya dengan khawalitas yang bisa di jamin Keunggulannya, dan bagi anda yang lagi ingin mempromosikan usaha atau kegiatan-kegiatan yang tentunya sangat dibutuhkan spanduk karena peran spanduk sangat berguna sekali dalam mempromosikan suatu kegiatan atau usaha anda. Jika anda ingin untuk membuat spanduk atau mencetak spanduk dapat dilakukan ditempat kami, kami akan memberikan layanan 24 Jam.

Untuk pembuatan spanduk anda dapat desain spanduk dengan berbagai ukuran seperti ukuran 1 meter x 1 meter, 1 meter x 2 meter, 1 meter x 3 meter, dan begitulah selanjutnya. Untuk mengetahui lebih pastinya anda dapat desain spanduk sesuai dengan ukuran dan tempat yang akan anda pasang spanduk tersebut.

Cetak Spanduk di tempat kami lebih murah, berkualitas dan bisa ditunggu sangat cocok bagi anda yang tidak mempunyai waktu luang.

Finishing banner atau finishing spanduk

1. Lipat pinggir
2. Mata kancing.

Sekian informasi kami tenang layanan dan Jasa Cetak Spanduk Murah dan Cepat yang ada di jakarta, kami jelaskan untuk anda, Bagi anda yang sudah berpatisipasi dan melihat informasi yang diatas, kami ucapkan banyak terimakasih.

Kontak Person :

Delta Fotocopy dan Percetakan

Afrizon
Email : printingudazon@gmail.com
Telepon : 082313058735
Jl. Waru No. 12 A Rawamangun Jakarta Timur

Jasa dan Layanan Cetak ID Card Online

noreply@blogger.com (Unknown) — Mon, 24 Apr 2017 03:14:00 +0000

ID Card Online

ID Card merupakan sebuah kebutuhan utama bagi institusi di Indonesia maupun di dunia. Umumnya semua Sekolah, Universitas, Pabrik, Organisasi, Perkantoran pemerintahan maupun swasta sangat membutuhkan tanda pengenal bagi para siswa dan staffnya. Dengan demikian tingginya kebutuhan pasar akan ID Card, membuat berlomba-lombanya para pelaku usaha ID card untuk membuat produk yang terbaik.

Kami dari usaha Delta Fotocopy dan Percetakan menyediakan layananan Cetak Id Card untuk anda selama 24 Jam.

Bahan Cetak Id Card

1. Digital Photo Card atau PVC

2. Standard ID Card

Ukuran ID Card

Untuk ukuran Printing Id Card yaitu : 54mm x 86mm

Harga Printing Id Card

Untuk harga anda dapat menghubungi kami lewat via Telepon yang telah kami sediakan di bawah ini.

Demikian informasi tentang Printing ID Card yang kami berikan, semoga bermafaat bagi anda, dan apabila anda membutuhkan untuk printing ID Card dapat melakukan pemesanan kepada kami lewat alamat yang telah disediakan di bawah ini.

Delta Foto Copy

Jl. Waru No. 12A Rawamangun, Jakarta Timur 13220

Nama : Afrizon

Hp : 082313058735

Email : printingudazon@gmail.com

Eye pterygium | Understanding and defisini of pterygium Eye | Dust is one of the causes of Pterygium

noreply@blogger.com (Unknown) — Sun, 21 Aug 2016 13:35:00 +0000

EYE

Pterygium (Surfer's Eye) most often refers to a benign growth of the conjunctiva. A pterygium commonly grows from the nasal side of the sclera. It is usually present in the palpebral fissure. It is associated with, and thought to be caused by ultraviolet-light exposure (e.g., sunlight), low humidity, and dust. The predominance of pterygia on the nasal side is possibly a result of the sun's rays passing laterally through the cornea, where it undergoes refraction and becomes focused on the limbic area. Sunlight passes unobstructed from the lateral side of the eye, focusing on the medial limbus after passing through the cornea. On the contralateral (medial) side, however, the shadow of the nose medially reduces the intensity of sunlight focused on the lateral/temporal limbus.

Pterygium in the conjunctiva is characterized by elastotic degeneration of collagen (actinic elastosis) and fibrovascular proliferation. It has an advancing portion called the head of the pterygium, which is connected to the main body of the pterygium by the neck. Sometimes a line of iron deposition can be seen adjacent to the head of the pterygium called Stocker's line. The location of the line can give an indication of the pattern of growth.

The exact cause is unknown, but it is associated with excessive exposure to wind, sunlight, or sand. Therefore, it is more likely to occur in populations that inhabit the areas near the equator, as well as windy locations. In addition, pterygia are twice as likely to occur in men than women.

Some research also suggests a genetic predisposition due to an expression of vimentin, which indicates cellular migration by the keratoblasts embryological development, which are the cells that give rise to the layers of the cornea. These cells also exhibit an increased P53 expression likely due to a deficit in the tumor suppressor gene. These indications give the impression of a migrating limbus because the cellular origin of the pterygium is actually initiated by the limbal epithelium.

The pterygium is composed of several segments:

Fuchs' Patches (minute gray blemishes that disperse near the pterygium head)
Stocker's Line (a brownish line composed of iron deposits)
Hood (fibrous nonvascular portion of the pterygium)
Head (apex of the pterygium, typically raised and highly vascular)
Body (fleshy elevated portion congested with tortuous vessels)
Superior Edge (upper edge of the triangular or wing-shaped portion of the pterygium)
Inferior Edge (lower edge of the triangular or wing-shaped portion of the ptyerygium).

As it is associated with excessive sun or wind exposure, wearing protective sunglasses with side shields and/or wide brimmed hats and using artificial tears throughout the day may help prevent their formation or stop further growth. Surfers and other water-sport athletes should wear eye protection that blocks 100% of the UV rays from the water, as is often used by snow-sport athletes.

Symptoms of pterygium include persistent redness, inflammation, foreign body sensation, tearing, which can cause bleeding, dry and itchy eyes. In advanced cases the pterygium can affect vision as it invades the cornea with the potential of obscuring the optical center of the cornea and inducing' astigmatismand corneal scarring.

Some of the irritating symptoms can be addressed with artificial tears. However, no reliable medical treatment exists to reduce or even prevent pterygium progression. Definitive treatment is achieved only by surgical removal. Long-term follow up is required as pterygium may recur even after complete surgical correction.

If there is recurrence after surgery or if recurrence of pterygium is thought to be vision threatening, it is possible to use strontium (90Sr) plaque therapy. 90Sr is a radioactive substance that produces beta particles, which penetrate a very short distance into the cornea at the site of the operation. It suppresses the regrowth of blood vessels that occur with return of the pterygium. The treatment requires some local anaesthetic in the eye and is best done at the time of, or on the same day as the pterygium excision.

The 90Sr plaque is a concave metal disc about 1-1.5 cm in diameter that is hollow and filled with an insoluble strontium salt. The side placed on the eye is a very thin and delicate silver film that will contain the strontium but allow the beta particles to escape. The dose of radiation to the conjunctiva is controlled by the time that the plaque is left in contact with the surface. The integrity of the plaque surfaces is paramount to prevent exposure to patients and so is wipe tested to see if radioactive matter is escaping. Obviously this test must be done very very gently.

Conjunctival auto-grafting is a surgical technique that is effective and safe procedure for pterygium removal. When the pterygium is removed, the tissue that covers the sclera known as the conjunctiva is also extracted. Auto-grafting replaces the bare sclera with tissue that is surgically removed from the inside of the patients’ upper eyelid. That “self-tissue” is then transplanted to the bare sclera and is fixated using sutures, tissue adhesive, or glue adhesive.

Pterygium removal

Amniotic membrane transplantation is an effective and safe procedure for pterygium removal. Amniotic membrane transplantation offers practical alternative to conjunctival auto graft transplantation for extensive pterygium removal. Amniotic membrane transplantation is tissue that is acquired from the innermost layer of the human placenta and has been used to replace and heal damaged mucosal surfaces including successful reconstruction of the ocular surface. It has been used as a surgical material since the 1940s, and has been shown to have a strong anti-adhesive effect. Using an amniotic graft facilitates epithelialization, and has anti-inflammatory as well as surface rejuvenation properties. Amniotic membrane transplantation can also be fixated to the sclera using sutures, or glue adhesive. Amniotic membrane transplantation with Tisseel glue application and Mitomycin-C has shown excellent cosmetic outcomes with a surface free of redness, stitching, or patches, which makes the ocular surface suitable for vision correction surgery sooner.

Pharmacy | Understanding and Science Pharmacy | History of Pharmacy | Online pharmacy

noreply@blogger.com (Unknown) — Sun, 21 Aug 2016 13:33:00 +0000

PHARMACY

Pharmacy is the health profession that links the health sciences with the chemical sciences and it is charged with ensuring the safe and effective use of pharmaceutical drugs. The word derives from the Greek: φάρμακον (pharmakon), meaning "drug" or "medicine" (the earliest form of the word is the Mycenaean Greek pa-ma-ko, attested in Linear B syllabic script).

The scope of pharmacy practice includes more traditional roles such as compounding and dispensing medications, and it also includes more modern services related to health care, including clinical services, reviewing medications for safety and efficacy, and providing drug information. Pharmacists, therefore, are the experts on drug therapy and are the primary health professionals who optimize medication use to provide patients with positive health outcomes.

An establishment in which pharmacy (in the first sense) is practiced is called a pharmacy, chemist's or (in the United States) drug store. US drug stores commonly sell not only medicines, but also miscellaneous items such as candy (sweets), cosmetics, and magazines, as well as light refreshments or groceries.

The word pharmacy is derived from its root word pharma which was a term used since the 15th–17th centuries. In addition to pharma responsibilities, the pharma offered general medical advice and a range of services that are now performed solely by other specialist practitioners, such as surgery and midwifery. The pharma (as it was referred to) often operated through a retail shop which, in addition to ingredients for medicines, sold tobacco and patent medicines. The pharmas also used many other herbs not listed.

In its investigation of herbal and chemical ingredients, the work of the pharma may be regarded as a precursor of the modern sciences of chemistry and pharmacology, prior to the formulation of the scientific method.

Pharmacists are highly qualified, highly trained and skilled healthcare professionals who perform various roles to ensure optimal health outcomes for their patients. Many pharmacists are also small-business proprietors, owning the pharmacy in which they practice. Since pharmacists know about the chemical synthesis mode of action of a particular drug, and its metabolism and physiological effects on human body in great detail, they play a very important role in optimisation of a drug threatment for an individual.

Pharmacists are represented internationally by the International Pharmaceutical Federation (FIP). They are represented at the national level by professional organisations such as the Royal Pharmaceutical Society (RPS), the Pharmacy Guild of Australia (PGA), the American Pharmacists Association (APhA) and the Pakistan Pharmacists Society (PPS). See also: List of pharmacy associations.

In some cases, the representative body is also the registering body, which is responsible for the ethics of the profession.

History of pharmacy

The history of pharmacy as an independent science is relatively young. The origins of historiography pharmaceutical back to the first third of the s. XIX which is when the first historiographies that while not touching all aspects of pharmaceutical history is the starting point for the final start of this science.

Until the birth of pharmacy as an independent science, there is a historical evolution from antiquity to the present day that marks the course of this science, always connected to the medicine.

The earliest known Chinese manual on materia medica is the Shennong Bencao Jing (The Divine Farmer's Herb-Root Classic), dating back to the 1st century AD. It was compiled during the Han dynasty and was attributed to the mythical Shennong. Earlier literature included lists of prescriptions for specific ailments, exemplified by a manuscript "Recipes for 52 Ailments", found in the Mawangdui tomb, sealed in 168 BC. Further details on Chinese pharmacy can be found in the Pharmacy in China article.

In Ancient Greece, according to Edward Kremers and Glenn Sonnedecker, "before, during and after the time of Hippocrates there was a group of experts in medicinal plants. Probably the most important representative of these rhizotomoi was Diocles of Carystus (4th century BC). He is considered to be the source for all Greek pharmacotherapeutic treatises between the time of Theophrastus and Dioscorides." The Greek physician Pedanius Dioscorides is famous for writing a five volume book in his native Greek Περί ύλης ιατρικής in the 1st century AD. The Latin translation De Materia Medica (Concerning medical substances) was used a basis for many medieval texts, and was built upon by many middle eastern scientists during the Islamic Golden Age. The title coined the term materia medica.

In Japan, at the end of the Asuka period (538-710) and the early Nara period (710-794), the men who fulfilled roles similar to those of modern pharmacists were highly respected. The place of pharmacists in society was expressly defined in the Taihō Code (701) and re-stated in the Yōrō Code (718). Ranked positions in the pre-Heian Imperial court were established; and this organizational structure remained largely intact until the Meiji Restoration (1868). In this highly stable hierarchy, the pharmacists—and even pharmacist assistants—were assigned status superior to all others in health-related fields such as physicians and acupuncturists. In the Imperial household, the pharmacist was even ranked above the two personal physicians of the Emperor.

There is a stone sign for a pharmacy with a tripod, a mortar, and a pestle opposite one for a doctor in the Arcadian Way in Ephesus near Kusadasi in Turkey. The current Ephesus dates back to 400BC and was the site of the Temple of Artemis one of the seven wonders of the world, the home of Mark Anthony and Cleopatra, Mary Magdalen and where St Paul read his letter to the Ephesians.

In Baghdad the first pharmacies, or drug stores, were established in 754, under the Abbasid Caliphate during the Islamic Golden Age. By the 9th century, these pharmacies were state-regulated.

The advances made in the Middle East in botany and chemistry led medicine in medieval Islam substantially to develop pharmacology. Muhammad ibn Zakarīya Rāzi (Rhazes) (865-915), for instance, acted to promote the medical uses of chemical compounds. Abu al-Qasim al-Zahrawi (Abulcasis) (936-1013) pioneered the preparation of medicines by sublimation and distillation. His Liber servitoris is of particular interest, as it provides the reader with recipes and explains how to prepare the `simples’ from which were compounded the complex drugs then generally used. Sabur Ibn Sahl (d 869), was, however, the first physician to initiate pharmacopoedia, describing a large variety of drugs and remedies for ailments. Al-Biruni (973-1050) wrote one of the most valuable Islamic works on pharmacology entitled Kitab al-Saydalah (The Book of Drugs), where he gave detailed knowledge of the properties of drugs and outlined the role of pharmacy and the functions and duties of the pharmacist. Ibn Sina (Avicenna), too, described no less than 700 preparations, their properties, mode of action and their indications. He devoted in fact a whole volume to simple drugs in The Canon of Medicine. Of great impact were also the works by al-Maridini of Baghdad and Cairo, and Ibn al-Wafid (1008–1074), both of which were printed in Latin more than fifty times, appearing as De Medicinis universalibus et particularibus by `Mesue' the younger, and the Medicamentis simplicibus by `Abenguefit'. Peter of Abano (1250–1316) translated and added a supplement to the work of al-Maridini under the title De Veneris. Al-Muwaffaq’s contributions in the field are also pioneering. Living in the 10th century, he wrote The foundations of the true properties of Remedies, amongst others describing arsenious oxide, and being acquainted with silicic acid. He made clear distinction between sodium carbonate and potassium carbonate, and drew attention to the poisonous nature of copper compounds, especially copper vitriol, and also lead compounds. He also describes the distillation of sea-water for drinking.

In Europe pharmacy-like shops began to appear during the 12th century. In 1240 emperor Frederic II issued a decree by which the physician's and the apothecary's professions were separated. The first pharmacy in Europe (still working) was opened in 1241 in Trier, Germany.

In Europe there are old pharmacies still operating in Dubrovnik, Croatia located inside the Franciscan monastery, opened in 1317 ; and one in the Town Hall Square of Tallinn, Estonia dating from at least 1422.

The oldest is claimed to be set up in 1221 in the Church of Santa Maria Novella in Florence, Italy, which now houses a perfume museum. The medieval Esteve Pharmacy, located in Llívia, a Catalan enclave close to Puigcerdà, is also now a museum dating back to the 15th century, keeping albarellos from the 16th and 17th centuries, old prescription books and antique drugs.

Until the birth of pharmacy as an independent science, there is a historical evolution from antiquity to the present day that marks the course of this science, always connected to the medicine.

Pharmacies within hospitals differ considerably from community pharmacies. Some pharmacists in hospital pharmacies may have more complex clinical medication management issues whereas pharmacists in community pharmacies often have more complex business and customer relations issues.

Because of the complexity of medications including specific indications, effectiveness of treatment regimens, safety of medications (i.e., drug interactions) and patient compliance issues (in the hospital and at home) many pharmacists practicing in hospitals gain more education and training after pharmacy school through a pharmacy practice residency and sometimes followed by another residency in a specific area. Those pharmacists are often referred to as clinical pharmacists and they often specialize in various disciplines of pharmacy. For example, there are pharmacists who specialize in hematology/oncology, HIV/AIDS, infectious disease, critical care, emergency medicine, toxicology, nuclear pharmacy, pain management, psychiatry, anti-coagulation clinics, herbal medicine, neurology/epilepsy management, pediatrics, neonatal pharmacists and more.

Hospital pharmacies can often be found within the premises of the hospital. Hospital pharmacies usually stock a larger range of medications, including more specialized medications, than would be feasible in the community setting. Most hospital medications are unit-dose, or a single dose of medicine. Hospital pharmacists and trained pharmacy technicians compound sterile products for patients including total parenteral nutrition (TPN), and other medications given intravenously. This is a complex process that requires adequate training of personnel, quality assurance of products, and adequate facilities. Several hospital pharmacies have decided to outsource high risk preparations and some other compounding functions to companies who specialize in compounding. The high cost of medications and drug-related technology, combined with the potential impact of medications and pharmacy services on patient-care outcomes and patient safety, make it imperative that hospital pharmacies perform at the highest level possible.

Hospital pharmacy

A hospital pharmacy is concerned with pharmacy service to all types of hospital and differs considerably from a community pharmacy.

Some pharmacists in hospital pharmacies may have more complex clinical medication management issues whereas pharmacists in community pharmacies often have more complex business and customer relations issues. Because of the complexity of the medication use system, many pharmacists practicing in hospitals gain more education and training after pharmacy school through a pharmacy practice residency and sometimes followed by another residency in a specific area.

Hospital pharmacies can usually be found within the premises of the hospital. Hospital pharmacies usually stock a larger range of medications, including more specialized and investigational medications (medicines that are being studied, but have not yet been approved), than would be feasible in the community setting. Hospital pharmacies typically provide medications for the hospitalized patients only, and are not retail establishments. They typically do not provide prescription service to the public. Some hospitals do have retail pharmacies within them (see illustration), which sell over-the-counter as well as prescription medications to the public, but these are not the actual hospital pharmacy.

Clinical pharmacists provide direct patient care services that optimizes the use of medication and promotes health, wellness, and disease prevention. Clinical pharmacists care for patients in all health care settings but the clinical pharmacy movement initially began inside hospitals and clinics. Clinical pharmacists often collaborate with physicians and other healthcare professionals to improve pharmaceutical care. Clinical pharmacists are now an integral part of the interdisciplinary approach to patient care. They work collaboratively with physicians, nurses and other healthcare personnel in various medical and surgical areas. They often participate in patient care rounds and drug product selection. In most hospitals in the United States, potentially dangerous drugs that require close monitoring are dosed and managed by clinical pharmacists.

Clinical pharmacy

Clinical pharmacy is the branch of Pharmacy where pharmacists and pharmaconomists provide patient care that optimizes the use of medication and promotes health, wellness, and disease prevention. Clinical pharmacists and clinical pharmaconomists care for patients in all health care settings but the clinical pharmacy movement initially began inside hospitals and clinics. Clinical pharmacists/pharmaconomists often collaborate with physicians and other healthcare professionals.

Clinical pharmacists and clinical pharmaconomists have extensive education in the biomedical, pharmaceutical, sociobehavioral and clinical sciences. Most clinical pharmacists have a Doctor of Pharmacy (Pharm.D.) degree and many have completed one or more years of post-graduate training (e.g. a general and/or specialty pharmacy residency). Many clinical pharmacists also choose to become Board Certified through the Board of Pharmaceutical Specialties (BPS) which was organized in 1976 as an independent certification agency of APhA (American Pharmacists Association). A pharmacist may become a Board Certified Pharmacotherapy Specialist (BCPS), a Board Certified Oncology Pharmacist (BCOP), Board Certified Nuclear Pharmacist (BCNP), Board Certified Nutrition Support Pharmacist (BCNSP), or a Board Certified Psychiatric Pharmacist (BCPP) through the Board of Pharmaceutical Specialities (BPS). There are also subspecialties within the Pharmacotherapy specialty: Cardiology and Infectious Disease. It is denoted as an "Added Qualification" or AQ. In order to obtain one of these specialties you must first be a Board Certified Pharmacotherapy Specialist and then submit a portfolio to the Board of Pharmaceutical Specialties for review to determine if they will grant you the added qualifications. An up-to-date explanation of pharmacy education leading to the Doctor of Pharmacy degree and Specialty Board Certification can be viewed at: http://www.youtube.com/watch?v=MvPb5peBnAY.

Within the system of health care, clinical pharmacists are experts in the therapeutic use of medications. They routinely provide medication therapy evaluations and recommendations to patients and other health care professionals. Clinical pharmacists are a primary source of scientifically valid information and advice regarding the safe, appropriate, and cost-effective use of medications. Clinical pharmacists are also making themselves more readily available to the public. In the past, access to a clinical pharmacist was limited to hospitals, clinics, or educational institutions. However, clinical pharmacists are making themselves available through a medication information hotline, and reviewing medication lists, all in an effort to prevent medication errors in the foreseeable future.

In some states, clinical pharmacists are given prescriptive authority under protocol with a medical provider (i.e., MD or DO), and their scope of practice is constantly evolving.

Since about the year 2000, a growing number of internet pharmacies have been established worldwide. Many of these pharmacies are similar to community pharmacies, and in fact, many of them are actually operated by brick-and-mortar community pharmacies that serve consumers online and those that walk in their door. The primary difference is the method by which the medications are requested and received. Some customers consider this to be more convenient and private method rather than traveling to a community drugstore where another customer might overhear about the drugs that they take. Internet pharmacies (also known as Online Pharmacies) are also recommended to some patients by their physicians if they are homebound.

While most internet pharmacies sell prescription drugs and require a valid prescription, some internet pharmacies sell prescription drugs without requiring a prescription. Many customers order drugs from such pharmacies to avoid the "inconvenience" of visiting a doctor or to obtain medications which their doctors were unwilling to prescribe. However, this practice has been criticized as potentially dangerous, especially by those who feel that only doctors can reliably assess contraindications, risk/benefit ratios, and an individual's overall suitability for use of a medication. There also have been reports of such pharmacies dispensing substandard products.

Of particular concern with internet pharmacies is the ease with which people, youth in particular, can obtain controlled substances (e.g., Vicodin, generically known as hydrocodone) via the internet without a prescription issued by a doctor/practitioner who has an established doctor-patient relationship. There are many instances where a practitioner issues a prescription, brokered by an internet server, for a controlled substance to a "patient" s/he has never met. In the United States, in order for a prescription for a controlled substance to be valid, it must be issued for a legitimate medical purpose by a licensed practitioner acting in the course of legitimate doctor-patient relationship. The filling pharmacy has a corresponding responsibility to ensure that the prescription is valid. Often, individual state laws outline what defines a valid patient-doctor relationship.

Canada is home to dozens of licensed internet pharmacies, many of which sell their lower-cost prescription drugs to U.S. consumers, who pay one of the world's highest drug prices. In recent years, many consumers in the US and in other countries with high drug costs, have turned to licensed internet pharmacies in India, Israel and the UK, which often have even lower prices than in Canada.

In the United States, there has been a push to legalize importation of medications from Canada and other countries, in order to reduce consumer costs. While in most cases importation of prescription medications violates Food and Drug Administration (FDA) regulations and federal laws, enforcement is generally targeted at international drug suppliers, rather than consumers. There is no known case of any U.S. citizens buying Canadian drugs for personal use with a prescription, who has ever been charged by authorities.

Recently developed online services like Australia's Medicine Name Finder and the Walgreens' Drug Info Search provide information about pharmaceutical products but do not offer prescriptions or drug dispensations. These services often promote generic drug alternatives by offering comparative information on price and effectiveness.

Online pharmacy

Online pharmacies, or Internet pharmacies, are pharmacies that operate over the Internet. Many such pharmacies are, in some ways, similar to community pharmacies; the primary difference is the method by which the medications are requested and received. Some customers consider this to be more convenient than traveling to a community drugstore, in the same way as ordering goods online rather than going to a shop.

While many internet pharmacies sell prescription drugs only with a prescription, some do not require a pre-written prescription. In some countries, this is because prescriptions are not required. Some customers order drugs from such pharmacies to avoid the inconvenience of visiting a doctor or to obtain medications their doctors were unwilling to prescribe. People living in the United States and other countries where prescription medications are very expensive may turn to online pharmacies to save money. Many of these websites employ their own in-house physicians to review the medication request and write a prescription accordingly. Some websites offer medications without a prescription or a doctor review. This practice has been criticized as potentially dangerous, especially by those who feel that only doctors can reliably assess contraindications, risk/benefit ratios, and the suitability of a medication for a specific individual. Pharmacies offering medication without requiring a prescription and doctor review or supervision are sometimes fraudulent and may supply counterfeit—and ineffective and possibly dangerous—medicines.

In the United States, there has been a push to legalize importation of medications from Canada and several European countries to reduce consumer costs. Although importation of prescription medication usually violates Food and Drug Administration (FDA) regulations and federal laws, enforcement is generally targeted at international drug suppliers, rather than consumers. Often Americans purchase lower-cost foreign drugs by driving to Canadian or Mexican pharmacies, buying their medications when traveling abroad on vacation, or, buying by mail from foreign pharmacies.

Cancer | Understanding and definition of Cancer

noreply@blogger.com (Unknown) — Sun, 21 Aug 2016 13:30:00 +0000

CANCER

Cancer is a class of diseases in which a group of cells display uncontrolled growth, invasion that intrudes upon and destroys adjacent tissues, and sometimes metastasis, or spreading to other locations in the body via lymph or blood. These three malignant properties of cancers differentiate them from benign tumors, which do not invade or metastasize.

Causes of Cancer

Researchers divide the causes of cancer into two groups: those with an environmental cause and those with a hereditary genetic cause. Cancer is primarily an environmental disease, though genetics influence the risk of some cancers. Common environmental factors leading to cancer include: tobacco, diet and obesity, infections, radiation, lack of physical activity, and environmental pollutants. These environmental factors cause or enhance abnormalities in the genetic material of cells. Cell reproduction is an extremely complex process that is normally tightly regulated by several classes of genes, including oncogenes and tumor suppressor genes. Hereditary or acquired abnormalities in these regulatory genes can lead to the development of cancer. A small percentage of cancers, approximately five to ten percent, are entirely hereditary.

The presence of cancer can be suspected on the basis of symptoms, or findings on radiology. Definitive diagnosis of cancer, however, requires the microscopic examination of a biopsy specimen. Most cancers can be treated. Possible treatments include chemotherapy, radiotherapy and surgery. The prognosis is influenced by the type of cancer and the extent of disease. While cancer can affect people of all ages, and a few types of cancer are more common in children, the overall risk of developing cancer increases with age. In 2007 cancer caused about 13% of all human deaths worldwide (7.9 million). Rates are rising as more people live to an old age and lifestyles change in the developing world.

Cancers are classified by the type of cell that the tumor resembles and is therefore presumed to be the origin of the tumor. These types include:

Carcinoma: Cancer derived from epithelial cells. This group includes many of the most common cancers, including those of the breast, prostate, lung and colon.
Sarcoma: Cancer derived from connective tissue, or mesenchymal cells.
Lymphoma and leukemia: Cancer derived from hematopoietic (blood-forming) cells
Germ cell tumor: Cancer derived from pluripotent cells. In adults these are most often found in the testicle and ovary, but are more common in babies and young children.
Blastoma: Cancer derived from immature "precursor" or embryonic tissue. These are also commonest in children.

Cancers are usually named using -carcinoma, -sarcoma or -blastoma as a suffix, with the Latin or Greek word for the organ or tissue of origin as the root. For example, a cancer of the liver is called hepatocarcinoma; a cancer of fat cells is called a liposarcoma. For some common cancers, the English organ name is used. For example, the most common type of breast cancer is called ductal carcinoma of the breast. Here, the adjective ductal refers to the appearance of the cancer under the microscope, which suggests that it has originated in the milk ducts.

Benign tumors (which are not cancers) are named using -oma as a suffix with the organ name as the root. For example, a benign tumor of smooth muscle cells is called a leiomyoma (the common name of this frequently occurring benign tumor in the uterus is fibroid). Confusingly, some types of cancer also use the -oma suffix, examples including melanoma and seminoma.

Cancer pathogenesis is traceable back to DNA mutations that impact cell growth and metastasis. Substances that cause DNA mutations are known as mutagens, and mutagens that cause cancers are known as carcinogens. Particular substances have been linked to specific types of cancer. Tobacco smoking is associated with many forms of cancer, and causes 90% of lung cancer.

Many mutagens are also carcinogens, but some carcinogens are not mutagens. Alcohol is an example of a chemical carcinogen that is not a mutagen. In Western Europe 10% of cancers in males and 3% of cancers in females are attributed to alcohol.

Decades of research has demonstrated the link between tobacco use and cancer in the lung, larynx, head, neck, stomach, bladder, kidney, esophagus and pancreas. Tobacco smoke contains over fifty known carcinogens, including nitrosamines and polycyclic aromatic hydrocarbons. Tobacco is responsible for about one in three of all cancer deaths in the developed world, and about one in five worldwide. Lung cancer death rates in the United States have mirrored smoking patterns, with increases in smoking followed by dramatic increases in lung cancer death rates and, more recently, decreases in smoking followed by decreases in lung cancer death rates in men. However, the numbers of smokers worldwide is still rising, leading to what some organizations have described as the tobacco epidemic.

Cancer related to one's occupation is believed to represent between 2–20% of all cases. Every year, at least 200,000 people die worldwide from cancer related to their workplace. Currently, most cancer deaths caused by occupational risk factors occur in the developed world. It is estimated that approximately 20,000 cancer deaths and 40,000 new cases of cancer each year in the U.S. are attributable to occupation. Millions of workers run the risk of developing cancers such as lung cancer and mesothelioma from inhaling asbestos fibers and tobacco smoke, or leukemia from exposure to benzene at their workplaces.

Diet, physical inactivity, and obesity are related to approximately 30–35% of cancer cases. In the United States excess body weight is associated with the development of many types of cancer and is a factor in 14–20% of all cancer death. Physical inactivity is believed to contribute to cancer risk not only through its effect on body weight but also through negative effects on immune system and endocrine system.

Diets that are low in vegetables, fruits and whole grains, and high in processed or red meats are linked with a number of cancers. A high salt diet is linked to gastric cancer, aflatoxin B1, a frequent food contaminate, with liver cancer, and Betel nut chewing with oral cancer. This may partly explain differences in cancer incidence in different countries for example gastric cancer is more common in Japan with its high salt diet and colon cancer is more common in the United States. Immigrants develop the risk of their new country, often within one generation, suggesting a substantial link between diet and cancer.

Worldwide approximately 18% of cancers are related to infectious diseases. This proportion varies in different regions of the world from a high of 25% in Africa to less than 10% in the developed world. Viruses are usual infectious agents that cause cancer but bacteria and parasites may also have an effect.

A virus that can cause cancer is called an oncovirus. These include human papillomavirus (cervical carcinoma), Epstein-Barr virus (B-cell lymphoproliferative disease and nasopharyngeal carcinoma), Kaposi's sarcoma herpesvirus (Kaposi's Sarcoma and primary effusion lymphomas), hepatitis B and hepatitis C viruses (hepatocellular carcinoma), and Human T-cell leukemia virus-1 (T-cell leukemias). Bacterial infection may also increase the risk of cancer, as seen in Helicobacter pylori-induced gastric carcinoma. Parasitic infections strongly associated with cancer include Schistosoma haematobium (squamous cell carcinoma of the bladder) and the liver flukes, Opisthorchis viverrini and Clonorchis sinensis (cholangiocarcinoma).

Up to 10% of invasive cancers are related to radiation exposure, including both ionizing radiation and non-ionizing radiation. Additionally, the vast majority of non-invasive cancers are non-melanoma skin cancers caused by non-ionizing radiation from ultraviolet radiation.

Sources of ionizing radiation include medical imaging, and radon gas. Radiation can cause cancer in most parts of the body, in all animals, and at any age, although radiation-induced solid tumors usually take 10–15 years, and up to 40 years, to become clinically manifest, and radiation-induced leukemias typically require 2–10 years to appear. Some people, such as those with nevoid basal cell carcinoma syndrome or retinoblastoma, are more susceptible than average to developing cancer from radiation exposure. Children and adolescents are twice as likely to develop radiation-induced leukemia as adults; radiation exposure before birth has ten times the effect. Ionizing radiation is not a particularly strong mutagen. Residential exposure to radon gas, for example, has similar cancer risks as passive smoking. Low-dose exposures, such as living near a nuclear power plant, are generally believed to have no or very little effect on cancer development. Radiation is a more potent source of cancer when it is combined with other cancer-causing agents, such as radon gas exposure plus smoking tobacco.

Unlike chemical or physical triggers for cancer, ionizing radiation hits molecules within cells randomly. If it happens to strike a chromosome, it can break the chromosome, result in an abnormal number of chromosomes, inactivate one or more genes in the part of the chromosome that it hit, delete parts of the DNA sequence, cause chromosome translocations, or cause other types of chromosome abnormalities. Major damage normally results in the cell dying, but smaller damage may leave a stable, partly functional cell that may be capable of proliferating and developing into cancer, especially if tumor suppressor genes were damaged by the radiation. Three independent stages appear to be involved in the creation of cancer with ionizing radiation: morphological changes to the cell, acquiring cellular immortality (losing normal, life-limiting cell regulatory processes), and adaptations that favor formation of a tumor. Even if the radiation particle does not strike the DNA directly, it triggers responses from cells that indirectly increase the likelihood of mutations.

Most cancers are initially recognized either because signs or symptoms appear or through screening. Neither of these lead to a definitive diagnosis, which usually requires the opinion of a pathologist, a type of physician (medical doctor) who specializes in the diagnosis of cancer and other diseases. People with suspected cancer are investigated with medical tests. These commonly include blood tests, X-rays, CT scans and endoscopy.

Palliative care is a multidisciplinary approach to symptom management to include physical, emotional, spiritual, and psycho-social distress. Palliative care is often confused with hospice, and therefore only involved when patients approach end of life despite the fact national guidelines recommend early palliative care involvement in certain individuals with cancer to assist with complex symptoms (pain, shortness of breath, fatigue, nausea) and coping with their illness. In people who have metastatic disease when first diagnosed, oncologists should consider a palliative care consult immediately. Additionally, an oncologist should consider a palliative care consult in any patient they feel has a prognosis of less than 12 months even if continuing aggressive treatment.

Cancer has a reputation as a deadly disease. Taken as a whole, about half of patients receiving treatment for invasive cancer (excluding carcinoma in situ and non-melanoma skin cancers) die from cancer or its treatment. However, the survival rates vary dramatically by type of cancer, with the range running from basically all patients surviving to almost no patients surviving.

Patients who receive a long-term remission or permanent cure may have physical and emotional complications from the disease and its treatment. Surgery may have amputated body parts or removed internal organs, or the cancer may have damaged delicate structures, like the part of the ear that is responsible for the sense of balance; in some cases, this requires extensive physical rehabilitation or occupational therapy so that the patient can walk or engage in other activities of daily living. Chemo brain is a usually short-term cognitive impairment associated with some treatments. Cancer-related fatigue usually resolves shortly after the end of treatment, but may be lifelong. Cancer-related pain may require ongoing treatment. Younger patients may be unable to have children. Some patients may be anxious or psychologically traumatized as a result of their experience of the diagnosis or treatment.

Survivors generally need to have regular medical screenings to ensure that the cancer has not returned, to manage any ongoing cancer-related conditions, and to screen for new cancers. Cancer survivors, even when permanently cured of the first cancer, have approximately double the normal risk of developing another primary cancer. Some advocates have promoted "survivor care plans"—written documents detailing the diagnosis, all previous treatment, and all recommended cancer screening and other care requirements for the future—as a way of organizing the extensive medical information that survivors and their future healthcare providers need.

Progressive and disseminated malignant disease harms the cancer patient's quality of life, and some cancer treatments, including common forms of chemotherapy, have severe side effects. In the advanced stages of cancer, many patients need extensive care, affecting family members and friends. Palliative care aims to improve the patient's immediate quality of life, regardless of whether further treatment is undertaken. Hospice programs assist patients similarly, especially when a terminally ill patient has rejected further treatment aimed at curing the cancer. Both styles of service offer home health nursing and respite care.

Predicting either short-term or long-term survival is difficult and depends on many factors. The most important factors are the particular kind of cancer and the patient's age and overall health. Medically frail patients with many comorbidities have lower survival rates than otherwise healthy patients. A centenarian is unlikely to survive for five years even if the treatment is successful. Patients who report a higher quality of life tend to survive longer.[94] People with lower quality of life may be affected by major depressive disorder and other complications from cancer treatment and/or disease progression that both impairs their quality of life and reduces their quantity of life. Additionally, patients with worse prognoses may be depressed or report a lower quality of life directly because they correctly perceive that their condition is likely to be fatal.

In the developed world, one in three people will be diagnosed with invasive cancer during their lifetimes. If all people with cancer survived and cancer occurred randomly, the lifetime odds of developing a second primary cancer would be one in nine. However, cancer survivors have an increased risk of developing a second primary cancer, and the odds are about two in nine. About half of these second primaries can be attributed to the normal one-in-nine risk associated with random chance. The increased risk is believed to be primarily due to the same risk factors that produced the first cancer (such as the person's genetic profile, alcohol and tobacco use, obesity, and environmental exposures), and partly due to the treatment for the first cancer, which typically includes mutagenic chemotherapeutic drugs or radiation. Cancer survivors may also be more likely to comply with recommended screening, and thus may be more likely than average to detect cancers.

While many diseases (such as heart failure) may have a worse prognosis than most cases of cancer, it is the subject of widespread fear and taboos. Euphemisms, once "a long illness", and now informally as "the big C", provide distance and soothe superstitions. This deep belief that cancer is necessarily a difficult and usually deadly disease is reflected in the systems chosen by society to compile cancer statistics: the most common form of cancer—non-melanoma skin cancers, accounting for about one-third of all cancer cases worldwide, but very few deaths—are excluded from cancer statistics specifically because they are easily treated and almost always cured, often in a single, short, outpatient procedure.

Cancer is regarded as a disease that must be "fought" to end the "civil insurrection"; a War on Cancer has been declared. Military metaphors are particularly common in descriptions of cancer's human effects, and they emphasize both the parlous state of the affected individual's health and the need for the individual to take immediate, decisive actions himself, rather than to delay, to ignore, or to rely entirely on others caring for him. The military metaphors also help rationalize radical, destructive treatments.

In the 1970s, a relatively popular alternative cancer treatment was a specialized form of talk therapy, based on the idea that cancer was caused by a bad attitude. People with a "cancer personality"—depressed, repressed, self-loathing, and afraid to express their emotions—were believed to have manifested cancer through subconscious desire. Some psychotherapists said that treatment to change the patient's outlook on life would cure the cancer. Among other effects, this belief allows society to blame the victim for having caused the cancer (by "wanting" it) or having prevented its cure (by not becoming a sufficiently happy, fearless, and loving person). It also increases patients' anxiety, as they incorrectly believe that natural emotions of sadness, anger or fear shorten their lives. The idea was excoriated by the notoriously outspoken Susan Sontag, who published Illness as Metaphor while recovering from treatment for breast cancer in 1978.

Although the original idea is now generally regarded as nonsense, the idea partly persists in a reduced form with a widespread, but incorrect, belief that deliberately cultivating a habit of positive thinking will increase survival. This notion is particularly strong in breast cancer culture.

Chicken Cemani | Black Chicken | Cemani Raising Chickens

noreply@blogger.com (Unknown) — Sun, 21 Aug 2016 13:23:00 +0000

CEMANI CHICKEN

Cemani chicken is a local race of chickens that developed in the region Kedu, precisely in the Village Kedu, District Kedu, Waterford, and the Village Kalikuto, Grabag District, Magelang. This local race is known for its black, but there is also the type who is white. Kedu chicken chicken being developed as a superior race.

Raising chickens

Raising chickens cemani relatively easy, it just takes patience. Chicken little cemani highly susceptible to death, especially at low temperatures. To anticipate the maintenance of DOC until the age of one month is placed in a given cage Box incandescent lamps. Incandescent lamp will help keep the room temperature remains warm. On the morning of chicks Chicken Cemani box placed at the site of the sunlight and placed on a relatively quiet place if the sun was blazing.

Food cemani chicken at a young age is concentrated starter with each feeding hungry chickens, the more chicks cemani the faster growing foods just do not get too fat. After one month of age have started to feed mixed with other foods such as bran, rice and mix the food is all around us. Giving this mixture to save feed concentrates, because according to experience growth cemani chicken chicken feed concentrate cemani with pure and mixed no significant differences, in terms of economically less profitable.

Body Cemani Chicken

With Increasing age cemani Also chicken Increased body size and number of feathers, the chicken Should begin to move in a wider cage. Adjusted heating with incandescent lamps with the requirement, if the temperature is too cold cans be nullified. That Cages are too narrow will of interfere with growth and create a humid cage. The cage That moisture will of Potentially bring in germs. Placement of the cage Should Be separate from the settlement and adequate sun exposure, especially in the morning. Therefore, the pattern of cultivation Power cemani cultivated chicken cage facing eastwards.

In cemani chicken adult maintenance feeding is set twice a day, with food in the form of concentrated chicken, grits, rice bran and other food mixtures. Cage also was no longer a box but a limited form of cages, cage bateray, or allowed to roam free. Providing laying concentrate is intended to improve the quality and number of eggs produced. The eggs produced by chickens can cemani dieramkan natural way through cemani breeders, chicken breeders or breeding kamoung wild duck. With a more modern way of chicken eggs can cemani dieramkan using hatching machine, with the hatch 21 days same as ordinary chicken.

Symptoms and prevention of the virus zika

noreply@blogger.com (Unknown) — Sun, 14 Aug 2016 12:05:00 +0000

VIRUS ZIKA

Zika occurs through intermediary Aedes, particularly Aedes aegypti species. Disease it causes named as Zika, Zika disease (Zika disease) or fever Zika (Zika fever).

Zika virus that has infected humans can cause several symptoms, such as fever, joint pain, conjunctivitis (red eyes), and rash. Zika disease symptoms can resemble the symptoms of dengue and chikungunya disease, and can last a few days to a week.

Zika virus first found in rhesus monkey in the jungle Zika, Uganda, in 1947. Zika virus then rediscovered in the mosquito species Aedes Africanus in the same forest in 1948 and in humans in Nigeria in 1954. Zika virus becoming endemic diseases and began to spread beyond Africa and Asia in 2007 in the South Pacific region. In May 2015, this virus is widespread in Brazil. The spread of this virus continues to occur in January 2016 in North America, South America, the Caribbean, Africa, and Samoa (Oceania). In Indonesia alone, Zika virus have been found in Jambi in 2015.

Zika Virus Causes

The cause of the disease Zika (Zika disease) or fever Zika (Zika fever) is the Zika virus. Zika virus included in the line flavivirus virus that still comes from the same family as the virus that causes the disease dengue / dengue.

Zika virus is spread to humans by infected Aedes mosquitoes. Mosquitoes become infected after biting patients who already have the virus. These mosquitoes are very active during the day and live and breed in the indoor or outdoor are close to humans, especially in the area that there is a puddle of water.

Although rare, Zika virus can be transmitted from a mother to her baby. Zika virus is likely transmitted from a pregnant mother to the fetus in the womb. Can also persalinan.Hingga infants were infected at this time, cases of Zika virus transmission through breastfeeding have not been found so medical experts still encourage infected mothers to breastfeed their babies.

In addition, there are some reports that Zika virus transmission occurs through blood transfusions and sexual contact.

Zika Virus Symptoms

In addition to general symptoms that have been mentioned, other symptoms Zika virus found are headache, pain behind the eyes, and tired. These symptoms are generally mild and lasted until about one week.

Regarding the Zika virus incubation period is unknown, but possibly lasting up to 2-7 days since patients exposed to this virus (bitten by mosquito vectors). Of the five people infected with the virus Zika, a person becomes ill from the virus. Although rare, severe cases can occur that require further treatment in the hospital, or even death.

Zika virus transmission that occurs in the womb was associated with the occurrence of microcephaly and brain damage in the fetus. Microcephaly is a condition in which the circumference of the head is smaller than normal size.

Virus Diagnosis Zika

Viewed from symptoms that mimic many other diseases, the examination of these trips ever undertaken by the patient, particularly to areas which have cases of Zika virus infection can help narrow the differential diagnosis. The doctor may ask area, time, and activity during a visit to the area.

The doctor may do blood tests to detect viral nucleic acid, isolating the virus, or serologic testing. In addition through blood sampling is usually done in 1-3 days after symptoms appear, urine and saliva may also be a test material in the third to fifth day.

Zika Virus Treatment

Zika virus treatment focuses on reducing symptoms felt by the patient as vaccines and medications aimed at this disease has not been found. Treatment of the symptoms experienced may include infusion of fluids to prevent dehydration, pain medication to relieve fever and headache, as well as adequate rest. Use of aspirin and other nonsteroidal anti-inflammatory drugs are not recommended before the possibility of dengue affected patients can be eliminated.

For patients who have been infected with the virus Zika expected to avoid mosquito bites during this virus because Zika virus that can survive long in the patient's blood can be spread to others through mosquito bites.

Zika Virus Prevention

Preventing mosquito bites is one of the preventive measures early can help you avoid infection Zika virus. Some preventive measures that can be done when you are in an area affected Zika virus, among others:

Ensuring the place you live has air conditioning or at least have curtains doors and windows to prevent mosquitoes from entering the room.

Use mosquito nets on the beds if the area you are visiting does not have the above.
Use long-sleeved shirts and pants
Use insect repellent material which is listed on the environmental protection agency or environmental protection agency (EPA), in accordance with the instructions on the packaging. Instructions attached will provide information on the application, the application area is allowed, the time and duration of application.
Infants under the age of two months are not allowed to use insect repellent material so you must ensure that the baby clothes can protect from mosquito bites.
Also, use of mosquito nets in a crib, stroller, and a sling or other baby carrier tools.
Pay attention to body area children older adults when applying insect repellent material. Avoid areas of the body that is injured or experiencing irritation, eye area, mouth and hands.
Choose care, washing, or use clothing and equipment that use materials containing permethrin. Learn about product information and instructions regarding the use of protection provided. Avoid using these products on the skin.
Learn well as information about the area you will visit, such as health facilities and the outdoor area is open before the departure time arrives, especially areas Zika virus.
Perform tests Zika virus after returning you, especially pregnant women, from the spread of the virus Zika.

Understanding and definition of Alzheimer's | Causes and prevention of Alzheimer's

noreply@blogger.com (Unknown) — Wed, 03 Aug 2016 17:44:00 +0000

Alzheimer's disease (AD), also called Alzheimer disease, senile dementia of the Alzheimer type, primary degenerative dementia of the Alzheimer's type, or simply Alzheimer's, is the most common form of dementia. This incurable, degenerative, and terminal disease was first described by German psychiatrist and neuropathologist Alois Alzheimer in 1906 and was named after him. Most often, it is diagnosed in people over 65 years of age, although the less-prevalent early-onset Alzheimer's can occur much earlier. In 2006, there were 26.6 million sufferers worldwide. Alzheimer's is predicted to affect 1 in 85 people globally by 2050.

Although the course of Alzheimer's disease is unique for every individual, there are many common symptoms. The earliest observable symptoms are often mistakenly thought to be 'age-related' concerns, or manifestations of stress. In the early stages, the most common symptom is inability to acquire new memories, observed as difficulty in recalling recently observed events. When AD is suspected, the diagnosis is usually confirmed with behavioural assessments and cognitive tests, often followed by a brain scan if available.

As the disease advances, symptoms include confusion, irritability and aggression, mood swings, language breakdown, long-term memory loss, and the general withdrawal of the sufferer as their senses decline. Gradually, bodily functions are lost, ultimately leading to death. Individual prognosis is difficult to assess, as the duration of the disease varies. AD develops for an indeterminate period of time before becoming fully apparent, and it can progress undiagnosed for years. The mean life expectancy following diagnosis is approximately seven years. Fewer than three percent of individuals live more than fourteen years after diagnosis.

The cause and progression of Alzheimer's disease are not well understood. Research indicates that the disease is associated with plaques and tangles in the brain. Currently used treatments offer a small symptomatic benefit; no treatments to delay or halt the progression of the disease are, as of yet, available. As of 2008[update], more than 500 clinical trials have been conducted for identification of a possible treatment for AD, but it is unknown if any of the tested intervention strategies will show promising results. A number of non-invasive, life-style habits have been suggested for the prevention of Alzheimer's disease, but there is a lack of adequate evidence for a link between these recommendations and reduced degeneration. Mental stimulation, exercise, and a balanced diet are suggested, as both a possible prevention and a sensible way of managing the disease.

Because AD cannot be cured and is degenerative, management of patients is essential. The role of the main caregiver is often taken by the spouse or a close relative. Alzheimer's disease is known for placing a great burden on caregivers; the pressures can be wide-ranging, involving social, psychological, physical, and economic elements of the caregiver's life. In developed countries, AD is one of the most costly diseases to society.

The first symptoms are often mistakenly attributed to aging or stress. Detailed neuropsychological testing can reveal mild cognitive difficulties up to eight years before a person fulfills the clinical criteria for diagnosis of AD. These early symptoms can affect the most complex daily living activities. The most noticeable deficit is memory loss, which shows up as difficulty in remembering recently learned facts and inability to acquire new information.

Subtle problems with the executive functions of attentiveness, planning, flexibility, and abstract thinking, or impairments in semantic memory (memory of meanings, and concept relationships) can also be symptomatic of the early stages of AD. Apathy can be observed at this stage, and remains the most persistent neuropsychiatric symptom throughout the course of the disease. The preclinical stage of the disease has also been termed mild cognitive impairment, but whether this term corresponds to a different diagnostic stage or identifies the first step of AD is a matter of dispute.

Early

In people with AD the increasing impairment of learning and memory eventually leads to a definitive diagnosis. In a small portion of them, difficulties with language, executive functions, perception (agnosia), or execution of movements (apraxia) are more prominent than memory problems. AD does not affect all memory capacities equally. Older memories of the person's life (episodic memory), facts learned (semantic memory), and implicit memory (the memory of the body on how to do things, such as using a fork to eat) are affected to a lesser degree than new facts or memories.

Language problems are mainly characterised by a shrinking vocabulary and decreased word fluency, which lead to a general impoverishment of oral and written language. In this stage, the person with Alzheimer's is usually capable of adequately communicating basic ideas. While performing fine motor tasks such as writing, drawing or dressing, certain movement coordination and planning difficulties (apraxia) may be present but they are commonly unnoticed. As the disease progresses, people with AD can often continue to perform many tasks independently, but may need assistance or supervision with the most cognitively demanding activities.

Moderate

Progressive deterioration eventually hinders independence; with subjects being unable to perform most common activities of daily living. Speech difficulties become evident due to an inability to recall vocabulary, which leads to frequent incorrect word substitutions (paraphasias). Reading and writing skills are also progressively lost. Complex motor sequences become less coordinated as time passes and AD progresses, so the risk of falling increases. During this phase, memory problems worsen, and the person may fail to recognise close relatives. Long-term memory, which was previously intact, becomes impaired.

Behavioural and neuropsychiatric changes become more prevalent. Common manifestations are wandering, irritability and labile affect, leading to crying, outbursts of unpremeditated aggression, or resistance to caregiving. Sundowning can also appear. Approximately 30% of patients develop illusionary misidentifications and other delusional symptoms. Subjects also lose insight of their disease process and limitations (anosognosia). Urinary incontinence can develop. These symptoms create stress for relatives and caretakers, which can be reduced by moving the person from home care to other long-term care facilities.

Advanced

During this last stage of AD, the patient is completely dependent upon caregivers. Language is reduced to simple phrases or even single words, eventually leading to complete loss of speech. Despite the loss of verbal language abilities, patients can often understand and return emotional signals. Although aggressiveness can still be present, extreme apathy and exhaustion are much more common results. Patients will ultimately not be able to perform even the simplest tasks without assistance. Muscle mass and mobility deteriorate to the point where they are bedridden, and they lose the ability to feed themselves. AD is a terminal illness, with the cause of death typically being an external factor, such as infection of pressure ulcers or pneumonia, not the disease itself.

Several competing hypotheses exist trying to explain the cause of the disease. The oldest, on which most currently available drug therapies are based, is the cholinergic hypothesis, which proposes that AD is caused by reduced synthesis of the neurotransmitter acetylcholine. The cholinergic hypothesis has not maintained widespread support, largely because medications intended to treat acetylcholine deficiency have not been very effective. Other cholinergic effects have also been proposed, for example, initiation of large-scale aggregation of amyloid, leading to generalised neuroinflammation.

In 1991, the amyloid hypothesis postulated that amyloid beta (Aβ) deposits are the fundamental cause of the disease. Support for this postulate comes from the location of the gene for the amyloid beta precursor protein (APP) on chromosome 21, together with the fact that people with trisomy 21 (Down Syndrome) who have an extra gene copy almost universally exhibit AD by 40 years of age. Also APOE4, the major genetic risk factor for AD, leads to excess amyloid buildup in the brain before AD symptoms arise. Thus, Aβ deposition precedes clinical AD. Further evidence comes from the finding that transgenic mice that express a mutant form of the human APP gene develop fibrillar amyloid plaques and Alzheimer's-like brain pathology with spatial learning deficits.

An experimental vaccine was found to clear the amyloid plaques in early human trials, but it did not have any significant effect on dementia. Researchers have been led to suspect non-plaque Aβ oligomers (aggregates of many monomers) as the primary pathogenic form of Aβ. These toxic oligomers, also referred to as amyloid-derived diffusible ligands (ADDLs), bind to a surface receptor on neurons and change the structure of the synapse, thereby disrupting neuronal communication. One receptor for Aβ oligomers may be the prion protein, the same protein that has been linked to mad cow disease and the related human condition, Creutzfeldt-Jakob disease, thus potentially linking the underlying mechanism of these neurodegenerative disorders with that of Alzheimer's disease.

In 2009, this theory was updated, suggesting that a close relative of the beta-amyloid protein, and not necessarily the beta-amyloid itself, may be a major culprit in the disease. The theory holds that an amyloid-related mechanism that prunes neuronal connections in the brain in the fast-growth phase of early life may be triggered by aging-related processes in later life to cause the neuronal withering of Alzheimer's disease. N-APP, a fragment of APP from the peptide's N-terminus, is adjacent to beta-amyloid and is cleaved from APP by one of the same enzymes. N-APP triggers the self-destruct pathway by binding to a neuronal receptor called death receptor 6 (DR6, also known as TNFRSF21). DR6 is highly expressed in the human brain regions most affected by Alzheimer's, so it is possible that the N-APP/DR6 pathway might be hijacked in the aging brain to cause damage. In this model, beta-amyloid plays a complementary role, by depressing synaptic function.

A 2004 study found that deposition of amyloid plaques does not correlate well with neuron loss. This observation supports the tau hypothesis, the idea that tau protein abnormalities initiate the disease cascade. In this model, hyperphosphorylated tau begins to pair with other threads of tau. Eventually, they form neurofibrillary tangles inside nerve cell bodies. When this occurs, the microtubules disintegrate, collapsing the neuron's transport system. This may result first in malfunctions in biochemical communication between neurons and later in the death of the cells. Herpes simplex virus type 1 has also been proposed to play a causative role in people carrying the susceptible versions of the apoE gene.

Another hypothesis asserts that the disease may be caused by age-related myelin breakdown in the brain. Demyelination leads to axonal transport disruptions, leading to loss of neurons that become stale. Iron released during myelin breakdown is hypothesized to cause further damage. Homeostatic myelin repair processes contribute to the development of proteinaceous deposits such as amyloid-beta and tau.

Oxidative stress and dys-homeostasis of biometal (biology) metabolism may be significant in the formation of the pathology.

AD individuals show 70% loss of locus coeruleus cells that provide norepinephrine (in addition to its neurotransmitter role) that locally diffuses from "varicosities" as an endogenous antiinflammatory agent in the microenvironment around the neurons, glial cells, and blood vessels in the neocortex and hippocampus. It has been shown that norepinephrine stimulates mouse microglia to suppress Aβ-induced production of cytokines and their phagocytosis of Aβ. This suggests that degeneration of the locus ceruleus might be responsible for increased Aβ deposition in AD brains.

Alzheimer's disease is characterised by loss of neurons and synapses in the cerebral cortex and certain subcortical regions. This loss results in gross atrophy of the affected regions, including degeneration in the temporal lobe and parietal lobe, and parts of the frontal cortex and cingulate gyrus. Studies using MRI and PET have documented reductions in the size of specific brain regions in patients as they progressed from mild cognitive impairment to Alzheimer's disease, and in comparison with similar images from healthy older adults.

Both amyloid plaques and neurofibrillary tangles are clearly visible by microscopy in brains of those afflicted by AD. Plaques are dense, mostly insoluble deposits of amyloid-beta peptide and cellular material outside and around neurons. Tangles (neurofibrillary tangles) are aggregates of the microtubule-associated protein tau which has become hyperphosphorylated and accumulate inside the cells themselves. Although many older individuals develop some plaques and tangles as a consequence of aging, the brains of AD patients have a greater number of them in specific brain regions such as the temporal lobe. Lewy bodies are not rare in AD patient's brains.

Alzheimer's disease has been identified as a protein misfolding disease (proteopathy), caused by accumulation of abnormally folded A-beta and tau proteins in the brain. Plaques are made up of small peptides, 39–43 amino acids in length, called beta-amyloid (also written as A-beta or Aβ). Beta-amyloid is a fragment from a larger protein called amyloid precursor protein (APP), a transmembrane protein that penetrates through the neuron's membrane. APP is critical to neuron growth, survival and post-injury repair. In Alzheimer's disease, an unknown process causes APP to be divided into smaller fragments by enzymes through proteolysis. One of these fragments gives rise to fibrils of beta-amyloid, which form clumps that deposit outside neurons in dense formations known as senile plaques.

AD is also considered a tauopathy due to abnormal aggregation of the tau protein. Every neuron has a cytoskeleton, an internal support structure partly made up of structures called microtubules. These microtubules act like tracks, guiding nutrients and molecules from the body of the cell to the ends of the axon and back. A protein called tau stabilizes the microtubules when phosphorylated, and is therefore called a microtubule-associated protein. In AD, tau undergoes chemical changes, becoming hyperphosphorylated; it then begins to pair with other threads, creating neurofibrillary tangles and disintegrating the neuron's transport system.

Exactly how disturbances of production and aggregation of the beta amyloid peptide gives rise to the pathology of AD is not known. The amyloid hypothesis traditionally points to the accumulation of beta amyloid peptides as the central event triggering neuron degeneration. Accumulation of aggregated amyloid fibrils, which are believed to be the toxic form of the protein responsible for disrupting the cell's calcium ion homeostasis, induces programmed cell death (apoptosis). It is also known that Aβ selectively builds up in the mitochondria in the cells of Alzheimer's-affected brains, and it also inhibits certain enzyme functions and the utilisation of glucose by neurons.

Various inflammatory processes and cytokines may also have a role in the pathology of Alzheimer's disease. Inflammation is a general marker of tissue damage in any disease, and may be either secondary to tissue damage in AD or a marker of an immunological response.

Alterations in the distribution of different neurotrophic factors and in the expression of their receptors such as the brain derived neurotrophic factor (BDNF) have been described in AD.

The vast majority of cases of Alzheimer's disease are sporadic, meaning that they are not genetically inherited although some genes may act as risk factors. On the other hand, around 0.1% of the cases are familial forms of autosomal-dominant inheritance, which usually have an onset before age 65.

Most of autosomal dominant familial AD can be attributed to mutations in one of three genes: amyloid precursor protein (APP) and presenilins 1 and 2. Most mutations in the APP and presenilin genes increase the production of a small protein called Aβ42, which is the main component of senile plaques. Some of the mutations merely alter the ratio between Aβ42 and the other major forms—e.g., Aβ40—without increasing Aβ42 levels. This suggests that presenilin mutations can cause disease even if they lower the total amount of Aβ produced and may point to other roles of presenilin or a role for alterations in the function of APP and/or its fragments other than Aβ.

Most cases of Alzheimer's disease do not exhibit autosomal-dominant inheritance and are termed sporadic AD. Nevertheless genetic differences may act as risk factors. The best known genetic risk factor is the inheritance of the ε4 allele of the apolipoprotein E (APOE). Between 40 and 80% of patients with AD possess at least one apoE4 allele. The APOE4 allele increases the risk of the disease by three times in heterozygotes and by 15 times in homozygotes. Geneticists agree that numerous other genes also act as risk factors or have protective effects that influence the development of late onset Alzheimer's disease. Over 400 genes have been tested for association with late-onset sporadic AD, most with null results.

Alzheimer's disease is usually diagnosed clinically from the patient history, collateral history from relatives, and clinical observations, based on the presence of characteristic neurological and neuropsychological features and the absence of alternative conditions. Advanced medical imaging with computed tomography (CT) or magnetic resonance imaging (MRI), and with single photon emission computed tomography (SPECT) or positron emission tomography (PET) can be used to help exclude other cerebral pathology or subtypes of dementia. Moreover, it may predict conversion from prodromal stages (mild cognitive impairment) to Alzheimer's disease.

Assessment of intellectual functioning including memory testing can further characterise the state of the disease. Medical organisations have created diagnostic criteria to ease and standardise the diagnostic process for practicing physicians. The diagnosis can be confirmed with very high accuracy post-mortem when brain material is available and can be examined histologically.

The National Institute of Neurological and Communicative Disorders and Stroke (NINCDS) and the Alzheimer's Disease and Related Disorders Association (ADRDA, now known as the Alzheimer's Association) established the most commonly used NINCDS-ADRDA Alzheimer's Criteria for diagnosis in 1984, extensively updated in 2007. These criteria require that the presence of cognitive impairment, and a suspected dementia syndrome, be confirmed by neuropsychological testing for a clinical diagnosis of possible or probable AD. A histopathologic confirmation including a microscopic examination of brain tissue is required for a definitive diagnosis. Good statistical reliability and validity have been shown between the diagnostic criteria and definitive histopathological confirmation. Eight cognitive domains are most commonly impaired in AD—memory, language, perceptual skills, attention, constructive abilities, orientation, problem solving and functional abilities. These domains are equivalent to the NINCDS-ADRDA Alzheimer's Criteria as listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) published by the American Psychiatric Association.

Although cardiovascular risk factors, such as hypercholesterolemia, hypertension, diabetes, and smoking, are associated with a higher risk of onset and course of AD, statins, which are cholesterol lowering drugs, have not been effective in preventing or improving the course of the disease. The components of a Mediterranean diet, which include fruit and vegetables, bread, wheat and other cereals, olive oil, fish, and red wine, may all individually or together reduce the risk and course of Alzheimer's disease. Its beneficial cardiovascular effect has been proposed as the mechanism of action. There is limited evidence that light to moderate use of alcohol, particularly red wine, is associated with lower risk of AD.

Reviews on the use of vitamins have not found enough evidence of efficacy to recommend vitamin C, or folic acid with or without vitamin B12, as preventive or treatment agents in AD. Additionally vitamin E is associated with important health risks. Trials examining folic acid (B9) and other B vitamins failed to show any significant association with cognitive decline. Docosahexaenoic acid, an Omega 3 fatty acid, has not been found to slow decline.

Long-term usage of non-steroidal anti-inflammatory drug (NSAIDs) is associated with a reduced likelihood of developing AD. Human postmortem studies, in animal models, or in vitro investigations also support the notion that NSAIDs can reduce inflammation related to amyloid plaques. However trials investigating their use as palliative treatment have failed to show positive results while no prevention trial has been completed. Curcumin from the curry spice turmeric has shown some effectiveness in preventing brain damage in mouse models due to its anti-inflammatory properties. Hormone replacement therapy, although previously used, is no longer thought to prevent dementia and in some cases may even be related to it. There is inconsistent and unconvincing evidence that ginkgo has any positive effect on cognitive impairment and dementia, and a recent study concludes that it has no effect in reducing the rate of AD incidence. A 21-year study found that coffee drinkers of 3–5 cups per day at midlife had a 65% reduction in risk of dementia in late-life.

People who engage in intellectual activities such as reading, playing board games, completing crossword puzzles, playing musical instruments, or regular social interaction show a reduced risk for Alzheimer's disease. This is compatible with the cognitive reserve theory, which states that some life experiences result in more efficient neural functioning providing the individual a cognitive reserve that delays the onset of dementia manifestations. Education delays the onset of AD syndrome, but is not related to earlier death after diagnosis. Learning a second language even later in life seems to delay getting Alzheimer disease. Physical activity is also associated with a reduced risk of AD.

Medical marijuana appears to be effective in delaying Alzheimer's Disease. The active ingredient in marijuana, THC, prevents the formation of deposits in the brain associated with Alzheimer's disease. THC was found to inhibit acetylcholinesterase more effectively than commercially marketed drugs. THC was also found to delay amylogenesis.

Some studies have shown an increased risk of developing AD with environmental factors such the intake of metals, particularly aluminium, or exposure to solvents. The quality of some of these studies has been criticised, and other studies have concluded that there is no relationship between these environmental factors and the development of AD.

While some studies suggest that extremely low frequency electromagnetic fields may increase the risk for Alzheimer's disease, reviewers found that further epidemiological and laboratory investigations of this hypothesis are needed. Smoking is a significant AD risk factor. Systemic markers of the innate immune system are risk factors for late-onset AD.

Hepatitis | Understanding and definition of Hepatitis

noreply@blogger.com (Unknown) — Wed, 03 Aug 2016 17:39:00 +0000

Hepatitis (plural hepatitides) is a medical condition defined by the inflammation of the liver and characterized by the presence of inflammatory cells in the tissue of the organ. The name is from the Greek hepar , the root being hepat-, meaning liver, and suffix -itis, meaning "inflammation" (c. 1727). The condition can be self-limiting (healing on its own) or can progress to fibrosis (scarring) and cirrhosis.

Hepatitis may occur with limited or no symptoms, but often leads to jaundice, anorexia (poor appetite) and malaise. Hepatitis is acute when it lasts less than six months and chronic when it persists longer. A group of viruses known as the hepatitis viruses cause most cases of hepatitis worldwide, but it can also be due to toxins (notably alcohol, certain medications, some industrial organic solvents and plants), other infections and autoimmune diseases.

Initial features are of nonspecific flu-like symptoms, common to almost all acute viral infections and may include malaise, muscle and joint aches, fever, nausea or vomiting, diarrhea, and headache. More specific symptoms, which can be present in acute hepatitis from any cause, are: profound loss of appetite, aversion to smoking among smokers, dark urine, yellowing of the eyes and skin (i.e., jaundice) and abdominal discomfort. Physical findings are usually minimal, apart from jaundice in a third and tender hepatomegaly (swelling of the liver) in about 10%. Some exhibit lymphadenopathy (enlarged lymph nodes, in 5%) or splenomegaly (enlargement of the spleen, in 5%).

Acute viral hepatitis is more likely to be asymptomatic in younger people. Symptomatic individuals may present after convalescent stage of 7 to 10 days, with the total illness lasting 2 to 6 weeks.

A small proportion of people with acute hepatitis progress to acute liver failure, in which the liver is unable to clear harmful substances from the circulation (leading to confusion and coma due to hepatic encephalopathy) and produce blood proteins (leading to peripheral edema and bleeding). This may become life-threatening and occasionally requires a liver transplant.

Chronic hepatitis often leads to nonspecific symptoms such as malaise, tiredness and weakness, and often leads to no symptoms at all. It is commonly identified on blood tests performed either for screening or to evaluate nonspecific symptoms. The occurrence of jaundice indicates advanced liver damage. On physical examination there may be enlargement of the liver.

Extensive damage and scarring of liver (i.e. cirrhosis) leads to weight loss, easy bruising and bleeding tendencies, peripheral edema (swelling of the legs) and accumulation of ascites (fluid in the abdominal cavity). Eventually, cirrhosis may lead to various complications: esophageal varices (enlarged veins in the wall of the esophagus that can cause life-threatening bleeding) hepatic encephalopathy (confusion and coma) and hepatorenal syndrome (kidney dysfunction).

Acne, abnormal menstruation, lung scarring, inflammation of the thyroid gland and kidneys may be present in women with autoimmune hepatitis.

Ethanol, mostly in alcoholic beverages, is a significant cause of hepatitis. Usually alcoholic hepatitis comes after a period of increased alcohol consumption. Alcoholic hepatitis is characterized by a variable constellation of symptoms, which may include feeling unwell, enlargement of the liver, development of fluid in the abdomen ascites, and modest elevation of liver blood tests. Alcoholic hepatitis can vary from mild with only liver test elevation to severe liver inflammation with development of jaundice, prolonged prothrombin time, and liver failure. Severe cases are characterized by either obtundation (dulled consciousness) or the combination of elevated bilirubin levels and prolonged prothrombin time; the mortality rate in both categories is 50% within 30 days of onset.

Alcoholic hepatitis is distinct from cirrhosis caused by long term alcohol consumption. Alcoholic hepatitis can occur in patients with chronic alcoholic liver disease and alcoholic cirrhosis. Alcoholic hepatitis by itself does not lead to cirrhosis, but cirrhosis is more common in patients with long term alcohol consumption. Patients who drink alcohol to excess are also more often than others found to have hepatitis C. The combination of hepatitis C and alcohol consumption accelerates the development of cirrhosis.

Non-alcoholic fatty liver disease (NAFLD) is the occurrence of fatty liver in people who have no history of alcohol use. It is most commonly associated with obesity (80% of all obese people have fatty liver). It is more common in women. Severe NAFLD leads to inflammation, a state referred to as non-alcoholic steatohepatitis (NASH), which on biopsy of the liver resembles alcoholic hepatitis (with fat droplets and inflammatory cells, but usually no Mallory bodies).

The diagnosis depends on medical history, physical exam, blood tests, radiological imaging and sometimes a liver biopsy. The initial evaluation to identify the presence of fatty infiltration of the liver is medical imaging, including such ultrasound, computed tomography (CT), or magnetic resonance (MRI). However, imaging cannot readily identify inflammation in the liver. Therefore, the differentiation between steatosis and NASH often requires a liver biopsy. It can also be difficult to distinguish NASH from alcoholic hepatitis when the patient has a history of alcohol consumption. Sometimes in such cases a trial of abstinence from alcohol along with follow-up blood tests and a repeated liver biopsy are required.

NASH is becoming recognized as the most important cause of liver disease second only to hepatitis C in numbers of patients going on to cirrhosis.

Ischemic hepatitis is caused by decreased circulation to the liver cells. Usually this is due to decreased blood pressure (or shock), leading to the equivalent term "shock liver". Patients with ischemic hepatitis are usually very ill due to the underlying cause of shock. Rarely, ischemic hepatitis can be caused by local problems with the blood vessels that supply oxygen to the liver (such as thrombosis, or clotting of the hepatic artery which partially supplies blood to liver cells). Blood testing of a person with ischemic hepatitis will show very high levels of transaminase enzymes (AST and ALT), which may exceed 1000 U/L. The elevation in these blood tests is usually transient (lasting 7 to 10 days). It is rare that liver function will be affected by ischemic hepatitis.

Cholesterol | Understanding and definition of cholesterol | The cause of cholesterol

noreply@blogger.com (Unknown) — Sat, 30 Apr 2016 19:37:00 +0000

Cholesterol is a waxy steroid of fat that is manufactured in the liver or intestines. It is used to produce hormones and cell membranes and is transported in the blood plasma of all mammals. It is an essential structural component of mammalian cell membranes. It is required to establish proper membrane permeability and fluidity. In addition cholesterol is an important component for the manufacture of bile acids, steroid hormones, and Vitamin D. Cholesterol is the principal sterol synthesized by animals; however, small quantities can be synthesized in eukaryotes such as plants and fungi. It is almost completely absent among prokaryotes including bacteria. Although cholesterol is important and necessary for mammals, high levels of cholesterol in the blood can damage arteries and are potentially linked to diseases such as those associated with the cardiovascular system (heart disease).

The name cholesterol originates from the Greek chole- (bile) and stereos (solid), and the chemical suffix -ol for an alcohol. François Poulletier de la Salle first identified cholesterol in solid form in gallstones, in 1769. However, it was only in 1815 that chemist Eugène Chevreul named the compound "cholesterine".

Since cholesterol is essential for all animal life, it is primarily synthesized from simpler substances within the body. However, high levels in blood circulation, depending on how it is transported within lipoproteins, are strongly associated with progression of atherosclerosis. For a person of about 68 kg (150 pounds), typical total body cholesterol synthesis is about 1 g (1,000 mg) per day, and total body content is about 35 g. Typical daily additional dietary intake in the United States is 200–300 mg. The body compensates for cholesterol intake by reducing the amount synthesized.

Cholesterol is recycled. It is excreted by the liver via the bile into the digestive tract. Typically about 50% of the excreted cholesterol is reabsorbed by the small bowel back into the bloodstream. Phytosterols can compete with cholesterol reabsorption in the intestinal tract, thus reducing cholesterol reabsorption.

Cholesterol is required to build and maintain membranes; it modulates membrane fluidity over the range of physiological temperatures. The hydroxyl group on cholesterol interacts with the polar head groups of the membrane phospholipids and sphingolipids, while the bulky steroid and the hydrocarbon chain are embedded in the membrane, alongside the nonpolar fatty acid chain of the other lipids. In this structural role, cholesterol reduces the permeability of the plasma membrane to protons (positive hydrogen ions) and sodium ions.

Within the cell membrane, cholesterol also functions in intracellular transport, cell signaling and nerve conduction. Cholesterol is essential for the structure and function of invaginated caveolae and clathrin-coated pits, including caveola-dependent and clathrin-dependent endocytosis. The role of cholesterol in such endocytosis can be investigated by using methyl beta cyclodextrin (MβCD) to remove cholesterol from the plasma membrane. Recently, cholesterol has also been implicated in cell signaling processes, assisting in the formation of lipid rafts in the plasma membrane. In many neurons, a myelin sheath, rich in cholesterol, since it is derived from compacted layers of Schwann cell membrane, provides insulation for more efficient conduction of impulses.

Within cells, cholesterol is the precursor molecule in several biochemical pathways. In the liver, cholesterol is converted to bile, which is then stored in the gallbladder. Bile contains bile salts, which solubilize fats in the digestive tract and aid in the intestinal absorption of fat molecules as well as the fat-soluble vitamins, Vitamin A, Vitamin D, Vitamin E, and Vitamin K. Cholesterol is an important precursor molecule for the synthesis of Vitamin D and the steroid hormones, including the adrenal gland hormones cortisol and aldosterone as well as the sex hormones progesterone, estrogens, and testosterone, and their derivatives.

Animal fats are complex mixtures of triglycerides, with lesser amounts of phospholipids and cholesterol. As a consequence, all foods containing animal fat contain cholesterol to varying extents. Major dietary sources of cholesterol include cheese, egg yolks, beef, pork, poultry, and shrimp.

Human breast milk also contains significant quantities of cholesterol.

The amount of cholesterol present in plant-based food sources is generally much lower than animal based sources. In addition, plant products such as flax seeds and peanuts contain cholesterol-like compounds called phytosterols, which are suggested to help lower serum cholesterol levels.

Total fat intake, especially saturated fat and trans fat, plays a larger role in blood cholesterol than intake of cholesterol itself. Saturated fat is present in full fat dairy products, animal fats, several types of oil and chocolate. Trans fats are typically derived from the partial hydrogenation of unsaturated fats, and do not occur in significant amounts in nature. Trans fat is most often encountered in margarine and hydrogenated vegetable fat, and consequently in many fast foods, snack foods, and fried or baked goods.

A change in diet in addition to other lifestyle modifications may help reduce blood cholesterol. Avoiding animal products may decrease the cholesterol levels in the body not only by reducing the quantity of cholesterol consumed but also by reducing the quantity of cholesterol synthesized. Those wishing to reduce their cholesterol through a change in diet should aim to consume less than 7% of their daily energy needs {metric units Joules (J) or (kJ), pre-SI calories (Cal) or (kcal)} from animal fat and fewer than 200 mg of cholesterol per day.

It is debatable that a diet, changed to reduce dietary fat and cholesterol, can lower blood cholesterol levels, (and thus reduce the likelihood of development of, among others, coronary artery disease leading to coronary heart disease), because any reduction to dietary cholesterol intake could be counteracted by the organs compensating to try to keep blood cholesterol levels constant. Also pointed out is the experimental discovery that in the diet, ingested animal protein can raise blood cholesterol more than the ingested saturated fat or any cholesterol. Moreover, the benefits of a diet supplemented with plant sterol esters has been questioned.

All animal cells manufacture cholesterol with relative production rates varying by cell type and organ function. About 20–25% of total daily cholesterol production occurs in the liver; other sites of higher synthesis rates include the intestines, adrenal glands, and reproductive organs. Synthesis within the body starts with one molecule of acetyl CoA and one molecule of acetoacetyl-CoA, which are dehydrated to form 3-hydroxy-3-methylglutaryl CoA (HMG-CoA). This molecule is then reduced to mevalonate by the enzyme HMG-CoA reductase. This step is the regulated, rate-limiting and irreversible step in cholesterol synthesis and is the site of action for the statin drugs (HMG-CoA reductase competitive inhibitors).

Mevalonate is then converted to 3-isopentenyl pyrophosphate in three reactions that require ATP. This molecule is decarboxylated to isopentenyl pyrophosphate, which is a key metabolite for various biological reactions. Three molecules of isopentenyl pyrophosphate condense to form farnesyl pyrophosphate through the action of geranyl transferase. Two molecules of farnesyl pyrophosphate then condense to form squalene by the action of squalene synthase in the endoplasmic reticulum. Oxidosqualene cyclase then cyclizes squalene to form lanosterol. Finally, lanosterol is then converted to cholesterol.

Cholesterol is only slightly soluble in water; it can dissolve and travel in the water-based bloodstream at exceedingly small concentrations. Since cholesterol is insoluble in blood, it is transported in the circulatory system within lipoproteins, complex discoidal particles which have an exterior composed of amphiphilic proteins and lipids whose outward-facing surfaces are water-soluble and inward-facing surfaces are lipid-soluble; triglycerides and cholesterol esters are carried internally. Phospholipids and cholesterol, being amphipathic, are transported in the surface monolayer of the lipoprotein particle.

In addition to providing a soluble means for transporting cholesterol through the blood, lipoproteins have cell-targeting signals that direct the lipids they carry to certain tissues. For this reason, there are several types of lipoproteins within blood called, in order of increasing density, chylomicrons, very-low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL), low-density lipoprotein (LDL), and high-density lipoprotein (HDL). The more cholesterol and less protein a lipoprotein has the less dense it is. The cholesterol within all the various lipoproteins is identical, although some cholesterol is carried as the "free" alcohol and some is carried as fatty acyl esters referred to as cholesterol esters. However, the different lipoproteins contain apolipoproteins, which serve as ligands for specific receptors on cell membranes. In this way, the lipoprotein particles are molecular addresses that determine the start- and endpoints for cholesterol transport.

Chylomicrons, the least dense type of cholesterol transport molecules, contain apolipoprotein B-48, apolipoprotein C, and apolipoprotein E in their shells. Chylomicrons are the transporters that carry fats from the intestine to muscle and other tissues that need fatty acids for energy or fat production. Cholesterol which is not used by muscles remains in more cholesterol-rich chylomicron remnants, which are taken up from the bloodstream by the liver.

VLDL molecules are produced by the liver and contain excess triacylglycerol and cholesterol that is not required by the liver for synthesis of bile acids. These molecules contain apolipoprotein B100 and apolipoprotein E in their shell. During transport in the bloodstream, the blood vessel cleave and absorb more triacylglycerol from IDL molecules, which contain an even higher percentage of cholesterol. The IDL molecules have two possible fates: Half are into metabolism by HTGL, taken up by the LDL receptor on the liver cell surfaces and the other half continue to lose triacylglycerols in the bloodstream until they form LDL molecules, which have the highest percentage of cholesterol within them.

LDL molecules, therefore, are the major carriers of cholesterol in the blood, and each one contains approximately 1,500 molecules of cholesterol ester. The shell of the LDL molecule contains just one molecule of apolipoprotein B100, which is recognized by the LDL receptor in peripheral tissues. Upon binding of apolipoprotein B100, many LDL receptors become localized in clathrin-coated pits. Both the LDL and its receptor are internalized by endocytosis to form a vesicle within the cell. The vesicle then fuses with a lysosome, which has an enzyme called lysosomal acid lipase that hydrolyzes the cholesterol esters. Now within the cell, the cholesterol can be used for membrane biosynthesis or esterified and stored within the cell, so as to not interfere with cell membranes.

Synthesis of the LDL receptor is regulated by SREBP, the same regulatory protein as was used to control synthesis of cholesterol de novo in response to cholesterol presence in the cell. When the cell has abundant cholesterol, LDL receptor synthesis is blocked so that new cholesterol in the form of LDL molecules cannot be taken up. On the converse, more LDL receptors are made when the cell is deficient in cholesterol. When this system is deregulated, many LDL molecules appear in the blood without receptors on the peripheral tissues. These LDL molecules are oxidized and taken up by macrophages, which become engorged and form foam cells. These cells often become trapped in the walls of blood vessels and contribute to artherosclerotic plaque formation. Differences in cholesterol homeostasis affect the development of early atherosclerosis (carotid intima-media thickness). These plaques are the main causes of heart attacks, strokes, and other serious medical problems, leading to the association of so-called LDL cholesterol (actually a lipoprotein) with "bad" cholesterol.

Also, HDL particles are thought to transport cholesterol back to the liver for excretion or to other tissues that use cholesterol to synthesize hormones in a process known as reverse cholesterol transport (RCT). Having large numbers of large HDL particles correlates with better health outcomes. In contrast, having small numbers of large HDL particles is independently associated with atheromatous disease progression within the arteries.

Cholesterol is susceptible to oxidation and easily forms oxygenated derivatives known as oxysterols. Three different mechanisms can form these; autoxidation, secondary oxidation to lipid peroxidation, and cholesterol metabolizing enzyme oxidation. A great interest in oxysterols arose when it was shown they exert inhibitory actions on cholesterol biosynthesis. This finding became known as the “oxysterol hypothesis”. Additional roles for oxysterols in human physiology include; their participation in bile acid biosynthesis, function as transport forms of cholesterol, and regulation of gene transcription.

According to the lipid hypothesis, abnormal cholesterol levels (hypercholesterolemia)—that is, higher concentrations of LDL and lower concentrations of functional HDL—are strongly associated with cardiovascular disease because these promote atheroma development in arteries (atherosclerosis). This disease process leads to myocardial infarction (heart attack), stroke, and peripheral vascular disease. Since higher blood LDL, especially higher LDL particle concentrations and smaller LDL particle size, contribute to this process more than the cholesterol content of the LDL particles, LDL particles are often termed "bad cholesterol" because they have been linked to atheroma formation. On the other hand, high concentrations of functional HDL, which can remove cholesterol from cells and atheroma, offer protection and are sometimes referred to as "good cholesterol". These balances are mostly genetically determined but can be changed by body build, medications, food choices, and other factors.

Conditions with elevated concentrations of oxidized LDL particles, especially "small dense LDL" (sdLDL) particles, are associated with atheroma formation in the walls of arteries, a condition known as atherosclerosis, which is the principal cause of coronary heart disease and other forms of cardiovascular disease. In contrast, HDL particles (especially large HDL) have been identified as a mechanism by which cholesterol and inflammatory mediators can be removed from atheroma. Increased concentrations of HDL correlate with lower rates of atheroma progressions and even regression. A 2007 study pooling data on almost 900,000 subjects in 61 cohorts demonstrated that blood total cholesterol levels have an exponential effect on cardiovascular and total mortality, with the association more pronounced in younger subjects. Still, because cardiovascular disease is relatively rare in the younger population, the impact of high cholesterol on health is still larger in older people.

Elevated levels of the lipoprotein fractions, LDL, IDL and VLDL are regarded as atherogenic (prone to cause atherosclerosis). Levels of these fractions, rather than the total cholesterol level, correlate with the extent and progress of atherosclerosis. On the converse, the total cholesterol can be within normal limits, yet be made up primarily of small LDL and small HDL particles, under which conditions atheroma growth rates would still be high. In contrast, however, if LDL particle number is low (mostly large particles) and a large percentage of the HDL particles are large, then atheroma growth rates are usually low, even negative, for any given total cholesterol concentration. Recently, a post-hoc analysis of the IDEAL and the EPIC prospective studies found an association between high levels of HDL cholesterol (adjusted for apolipoprotein A-I and apolipoprotein B) and increased risk of cardiovascular disease, casting doubt on the cardioprotective role of "good cholesterol".

pulmonary hypertension

noreply@blogger.com (Unknown) — Sat, 30 Apr 2016 19:34:00 +0000

Hypertension (HTN) or high blood pressure is a cardiac chronic medical condition in which the systemic arterial blood pressure is elevated. It is the opposite of hypotension. Hypertension is classified as either primary (essential) hypertension or secondary hypertension; About 90–95% of cases are categorized as "primary hypertension," which means high blood pressure with no obvious medical cause. The remaining 5–10% of cases (Secondary hypertension) are caused by other conditions that affect the kidneys, arteries, heart or endocrine system.

Persistent hypertension is one of the risk factors for stroke, myocardial infarction, heart failure and arterial aneurysm, and is a leading cause of chronic kidney failure. Moderate elevation of arterial blood pressure leads to shortened life expectancy. Dietary and lifestyle changes can improve blood pressure control and decrease the risk of associated health complications, although drug treatment may prove necessary in patients for whom lifestyle changes prove ineffective or insufficient.

Blood pressure is usually classified based on the systolic and diastolic blood pressures. Systolic blood pressure is the blood pressure in vessels during a heart beat. Diastolic blood pressure is the pressure between heartbeats. A systolic or the diastolic blood pressure measurement higher than the accepted normal values for the age of the individual is classified as prehypertension or hypertension.

Hypertension has several sub-classifications including, hypertension stage I, hypertension stage II, and isolated systolic hypertension. Isolated systolic hypertension refers to elevated systolic pressure with normal diastolic pressure and is common in the elderly. These classifications are made after averaging a patient's resting blood pressure readings taken on two or more office visits. Individuals older than 50 years are classified as having hypertension if their blood pressure is consistently at least 140 mmHg systolic or 90 mmHg diastolic. Patients with blood pressures higher than 130/80 mmHg with concomitant presence of diabetes mellitus or kidney disease require further treatment.

Hypertension is also classified as resistant if medications do not reduce blood pressure to normal levels.

Exercise hypertension is an excessively high elevation in blood pressure during exercise. The range considered normal for systolic values during exercise is between 200 and 230 mm Hg. Exercise hypertension may indicate that an individual is at risk for developing hypertension at rest.

Secondary hypertension

Some additional signs and symptoms suggest that the hypertension is caused by disorders in hormone regulation. Hypertension combined with obesity distributed on the trunk of the body, accumulated fat on the back of the neck ('buffalo hump'), wide purple marks on the abdomen (abdominal striae), or the recent onset of diabetes suggests that an individual has a hormone disorder known as Cushing's syndrome. Hypertension caused by other hormone disorders such as hyperthyroidism, hypothyroidism, or growth hormone excess will be accompanied by additional symptoms specific to these disorders. For example, hyperthyrodism can cause weight loss, tremors, heart rate abnormalities, reddening of the palms, and increased sweating. Signs and symptoms associated with growth hormone excess include coarsening of facial features, protrusion of the lower jaw, enlargement of the tongue, excessive hair growth, darkening of the skin color, and excessive sweating.:499. Other hormone disorders like hyperaldosteronism may cause less specific symptoms such as numbness, excessive urination, excessive sweating, electrolyte imbalances and dehydration, and elevated blood alkalinity. and also cause of mental pressure.

In pregnancy

Hypertension in pregnant women is one symptom of pre-eclampsia. Pre-eclampsia can progress to a life-threatening condition called eclampsia, which is the development of protein in the urine, generalized swelling, and severe seizures. Other symptoms indicating that brain function is becoming impaired may precede these seizures such as nausea, vomiting, headaches, and vision loss.

In addition, the systemic vascular resistance and blood pressure decrease during pregnancy. The body must compensate by increasing cardiac output and blood volume to provide sufficient circulation in the utero-placental arterial bed.

In children

Some signs and symptoms are especially important in newborns and infants such as failure to thrive, seizures, irritability, lack of energy, and difficulty breathing. In children, hypertension can cause headache, fatigue, blurred vision, nosebleeds, and facial paralysis.

Even with the above clinical symptoms, the true incidence of pediatric hypertension is not known. In adults, hypertension has been defined due to the adverse effects caused by hypertension. However, in children, similar studies have not been performed thoroughly to link any adverse effects with the increase in blood pressure. Therefore, the prevalence of pediatric hypertension remains unknown due to the lack of scientific knowledge.

Couses

Essential hypertension is the most prevalent hypertension type, affecting 90–95% of hypertensive patients. Although no direct cause has been identified, there are many factors such as sedentary lifestyle, smoking, stress, visceral obesity, potassium deficiency (hypokalemia), obesity (more than 85% of cases occur in those with a body mass index greater than 25), salt (sodium) sensitivity, alcohol intake, and vitamin D deficiency that increase the risk of developing hypertension. Risk also increases with aging, some inherited genetic mutations, and having a family history of hypertension. An elevated level of renin, a hormone secreted by the kidney, is another risk factor, as is sympathetic nervous system overactivity. Insulin resistance, which is a component of syndrome X (or the metabolic syndrome), is also thought to contribute to hypertension. Recent studies have implicated low birth weight as a risk factor for adult essential hypertension.

Secondary hypertension by definition results from an identifiable cause. This type is important to recognize since it's treated differently to essential hypertension, by treating the underlying cause of the elevated blood pressure. Hypertension results in the compromise or imbalance of the pathophysiological mechanisms, such as the hormone-regulating endocrine system, that regulate blood plasma volume and heart function. Many conditions cause hypertension. Some are common, well-recognized secondary causes such as Cushing's syndrome, which is a condition where the adrenal glands overproduce the hormone cortisol. Hypertension is also caused by other conditions that cause hormone changes, such as hyperthyroidism, hypothyroidism (citation needed), and certain tumors of the adrenal medulla (e.g., pheochromocytoma). Other common causes of secondary hypertension include kidney disease, obesity/metabolic disorder, pre-eclampsia during pregnancy, the congenital defect known as coarctation of the aorta, and certain prescription and illegal drugs.

Hypertension is generally diagnosed on the basis of a persistently high blood pressure. Usually this requires three separate sphygmomanometer (see figure) measurements at least one week apart. Often, this entails three separate visits to the physician's office. Initial assessment of the hypertensive patient should include a complete history and physical examination. Exceptionally, if the elevation is extreme, or if symptoms of organ damage are present then the diagnosis may be given and treatment started immediately.

Creatinine (renal function) testing is done to determine if kidney disease is present, which can be either the cause or result of hypertension. In addition, it provides a baseline measurement of kidney function that can be used to monitor for side-effects of certain antihypertensive drugs on kidney function. Additionally, testing of urine samples for protein is used as a secondary indicator of kidney disease. Glucose testing is done to determine if diabetes mellitus is present. Electrocardiogram (EKG/ECG) testing is done to check for evidence of the heart being under strain from high blood pressure. It may also show if there is thickening of the heart muscle (left ventricular hypertrophy) or has experienced a prior minor heart disturbance such as a silent heart attack. A chest X-ray may be performed to look for signs of heart enlargement or damage to heart tissue.

Prevention

The degree to which hypertension can be prevented depends on a number of features including current blood pressure level, sodium/potassium balance, detection and omission of environmental toxins, changes in end/target organs (retina, kidney, heart, among others), risk factors for cardiovascular diseases and the age at diagnosis of prehypertension or at risk for hypertension. A prolonged assessment that involves repeated blood pressure measurements provides the most accurate blood pressure level assessment. Following this, lifestyle changes are recommended to lower blood pressure, before the initiation of prescription drug therapy. The process of managing prehypertension according the guidelines of the British Hypertension Society suggest the following lifestyle changes:

* Weight reduction and regular aerobic exercise (e.g., walking): Regular exercise improves blood flow and helps to reduce the resting heart rate and blood pressure.

* Reduce dietary sugar

* Reduce sodium (salt) in the body by disuse of condiment sodium and the adoption of a high potassium diet which rids the renal system of excess sodium. Many people use potassium chloridesalt substitute to reduce their salt intake.

* Additional dietary changes beneficial to reducing blood pressure include the DASH diet (dietary approaches to stop hypertension) which is rich in fruits and vegetables and low-fat or fat-free dairy products. Research sponsored by the National Heart, Lung, and Blood Institute. showed this diet to be effective. In addition, an increase in dietary potassium, which offsets the effect of sodium has been shown highly effective in reducing blood pressure.

Discontinuing tobacco use and alcohol consumption has been shown to lower blood pressure. The exact mechanisms are not fully understood, but blood pressure (especially systolic) always transiently increases following alcohol or nicotine consumption. Abstaining from cigarette smoking reduces the risks of stroke and heart attack associated with hypertension.
Vasodialators such as niacin.
Limiting alcohol intake to less than 2 standard drinks per day can reduce systolic blood pressure by between 2-4mmHg.
Reducing stress, for example with relaxation therapy, such as meditation and other mindbody relaxation techniques, by reducing environmental stress such as high sound levels and over-illumination can also lower blood pressure. Jacobson's Progressive Muscle Relaxation and biofeedback are also beneficial, such as device-guided paced breathing, although meta-analysis suggests it is not effective unless combined with other relaxation techniques.
Increasing omega 3 fatty acids can help lower hypertension. Fish oil is shown to lower blood pressure in hypertensive individuals. The fish oil may increase sodium and water excretion.

These have all been shown to significantly reduce blood pressure in people with hypertension. If hypertension is high enough to justify immediate use of medications, lifestyle changes are still recommended in conjunction with medication. Drug prescription should take into account the patient's absolute cardiovascular risk (including risk of myocardial infarction and stroke) as well as blood pressure readings, in order to gain a more accurate picture of the patient's cardiovascular profile. Different programs aimed to reduce psychological stress such as biofeedback, relaxation or meditation are advertised to reduce hypertension. However, in general claims of efficacy are not supported by scientific studies, which have been in general of low quality.

Regarding dietary changes, a low sodium diet is beneficial; A Cochrane review published in 2008 concluded that a long term (more than 4 weeks) low sodium diet in Caucasians has a useful effect to reduce blood pressure, both in people with hypertension and in people with normal blood pressure. Also, the DASH diet (Dietary Approaches to Stop Hypertension) is a diet promoted by the National Heart, Lung, and Blood Institute (part of the NIH, a United States government organization) to control hypertension. A major feature of the plan is limiting intake of sodium, and it also generally encourages the consumption of nuts, whole grains, fish, poultry, fruits and vegetables while lowering the consumption of red meats, sweets, and sugar. It is also "rich in potassium, magnesium, and calcium, as well as protein".

Several classes of medications, collectively referred to as antihypertensive drugs, are currently available for treating hypertension. Reduction of the blood pressure by 5 mmHg can decrease the risk of stroke by 34%, of ischaemic heart disease by 21%, and reduce the likelihood of dementia, heart failure, and mortality from cardiovascular disease. The aim of treatment should be reduce blood pressure to <140/90 mmHg for most individuals, and lower for individuals with diabetes or kidney disease (some medical professionals recommend keeping levels below 120/80 mmHg). If the blood pressure goal is not met, a change in treatment should be made as therapeutic inertia is a clear impediment to blood pressure control. Comorbidity also plays a role in determining target blood pressure, with lower BP targets applying to patients with end-organ damage or proteinuria.

The first line antihypertensive supported by the best evidence is a low dose thiazide-based diuretic.

Some cite the writings of Sushruta in the 6th century BC as being the first mention of symptoms like those of hypertension. Others propose even earlier descriptions dating as far as 2600 BCE. Main treatment for what was called the "hard pulse disease" consisted in reducing the quantity of blood in a subject by the sectioning of veins or the application of leeches. Well known individuals such as The Yellow Emperor of China, Cornelius Celsus, Galen, and Hipocrates advocated such treatments.

Our modern understanding of hypertension began with the work of physician William Harvey (1578–1657), who was the first to describe correctly the systemic circulation of blood being pumped around the body by the heart in his book "De motu cordis". The basis for measuring blood pressure were established by Stephen Hales in 1733. Initial descriptions of hypertension as a disease came among others from Thomas Young in 1808 and specially Richard Bright in 1836. The first ever elevated blood pressure in a patient without kidney disease was reported by Frederick Mahomed (1849–1884). It was not until 1904 that sodium restriction was advocated while a rice diet was popularized around 1940.

Studies in the 1920s demonstrated the public health impact of untreated high blood pressure; treatment options were limited at the time, and deaths from malignant hypertension and its complications were common. A prominent victim of severe hypertension leading to cerebral hemorrhage was Franklin D. Roosevelt (1882–1945). The Framingham Heart Study added to the epidemiological understanding of hypertension and its relationship with coronary artery disease. The National Institutes of Health also sponsored other population studies, which additionally showed that African Americans had a higher burden of hypertension and its complications. Before pharmacological treatment for hypertension became possible, three treatment modalities were used, all with numerous side-effects: strict sodium restriction, sympathectomy (surgical ablation of parts of the sympathetic nervous system), and pyrogen therapy (injection of substances that caused a fever, indirectly reducing blood pressure).

The first chemical for hypertension, sodium thiocyanate, was used in 1900 but had many side effects and was unpopular. Several other agents were developed after the Second World War, the most popular and reasonably effective of which were tetramethylammonium chloride and its derivative hexamethonium, hydralazine and reserpine (derived from the medicinal plant Rauwolfia serpentina). A randomized controlled trial sponsored by the Veterans Administration using these drugs had to be stopped early because those not receiving treatment were developing more complications and it was deemed unethical to withhold treatment from them. These studies prompted public health campaigns to increase public awareness of hypertension and the advice to get blood pressure measured and treated. These measures appear to have contributed at least in part of the observed 50% fall in stroke and ischemic heart disease between 1972 and 1994.

A major breakthrough was achieved with the discovery of the first well-tolerated orally available agents. The first was chlorothiazide, the first thiazide and developed from the antibiotic sulfanilamide, which became available in 1958; it increased salt excretion while preventing fluid accumulation. In 1975, the Lasker Special Public Health Award was awarded to the team that developed chlorothiazide. The British physician James W. Black developed beta blockers in the early 1960s; these were initially used for angina, but turned out to lower blood pressure. Black received the 1976 Lasker Award and in 1988 the Nobel Prize in Physiology or Medicine for his discovery. The next class of antihypertensives to be discovered was that of the calcium channel blockers. The first member was verapamil, a derivative of papaverine that was initially thought to be a beta blocker and used for angina, but then turned out to have a different mode of action and was shown to lower blood pressure. ACE inhibitors were developed through rational drug design; the renin-angiotensin system was known to play an important role in blood pressure regulation, and snake venom from Bothrops jararaca could lower blood pressure through inhibition of ACE. In 1977 captopril, an orally active agent, was described; this led to the development of a number of other ACE inhibitors.

How to Make Rendang

noreply@blogger.com (Unknown) — Fri, 29 Apr 2016 17:23:00 +0000

Rendang Padang, this cuisine is the hallmark of the cuisine berasala Minang from West Sumatra parts of Indonesia. The main foods made from beef diungkep, then added with a selection of spices that makes this food very tasty and delicious. Coupled with the length of these foods can hold up to many months to make this meal even more special. Very tempting not the food on this one, especially for those of you who often eat in restaurants andalas, Minang and others, would have increased his hunger when he heard, just take prescription rendang presented herein baseball lost tasty and tender to the original, because the recipe and carnya obtained directly from the field which had a very tasty pizza restaurant. Please direct them to try it yourself, as follows.

This meal includes foods renowned throughout the world.

As for the ingredients to make rendang we present as follows:

Ingredients :

1 kg of beef selection, cut the size according to taste

3 Old coconuts, made coconut milk

15 grains of red onion

8 cloves garlic

1 ounce red chili (curly)

2 cm Ginger

2 cm galangal crushed

1 teaspoon ground pepper

2 stalks Lemongrass first geprek

2 seeds sour kandis

2 pieces Flowers deaf

3 pieces lime leaves

4 sheets of bay leaves

1 sheet turmeric leaf

Salt

Sugar

Supplementary material :

Coconut serundeng that have been roasted beforehand

1 oz Beef liver cut into small cubes and boiled

How to make rendang Indonesian cuisine

Puree the first onion and garlic, chilli, ginger and galangal
Start ungkep beef that had been cut with the seasoning paste, wait until the steam and air-dried meat ungkepan.
Put coconut milk, pepper, lemongrass, tamarind kandis, dullness flowers, lime leaves, bay leaf, salt and sugar, then mix well, do not forget turmeric leaf tatters but also advance
Wait until the coconut milk to a boil, and slightly remove the oil, then reduce the heat
Combine the supplementary material into rendang and stir again until evenly
Pursue in order to stir rendang not stick to the griddle, wait until it changes color and dries rendang
Lift rendang, and ready to be served.

Additions make rendang Indonesian cuisine:

To add to the tenderness of meat rendang we try to create meat that has been cut should be beaten or digeprek first and then in ungkep

In the process pengungkepan rendang meat is soft and tasty usually require a longer period of time less than a full night or a day, to allow the flavors used permeated

In cooking try coconut milk is not broken and how to use a circular motion upwards like when the draw.

Thus we divide the recipe and how to make rendang may be useful and can be practiced to make everyday cooking for you. May be useful

Dragon Fruit Cultivation

noreply@blogger.com (Unknown) — Thu, 28 Apr 2016 22:48:00 +0000

Dragon fruit is the fruit of several cactus species. The fruit is native to Mexico, Central America and South America, but is now also cultivated in Asian countries such as Taiwan, Vietnam, the Philippines, Indonesia and Malaysia. The fruit can also be found in Okinawa, Israel, Australia northern and southern China. This fruit only blooms at night.

In 1870 this plant was brought French people of Guyana to Vietnam as an ornamental plant. By Vietnamese and Chinese fruit are considered a blessing. Therefore, the fruit is always placed between two tail green dragon statues on the altar table. The red color of the fruit looks striking between the colors green dragons. The fruit of this habit among the Vietnamese were deeply influenced Chinese culture known as thang Loy (dragon fruit). The term Thang Loy then translated in Europe and other countries who speak English as dragon fruit (dragon fruit).

Dragon fruit plants consist of roots, stems, thorns, flowers, and fruit. The roots of dragon fruit just hairy roots growing in the soil at the top chord as hanging roots. The roots grow along the stem to the spine of the fin in the corner of the trunk. At the thorn, will grow flowers shaped like flowers Wijayakusuma. Flowers that do not fall develop into fruit. Dragon fruit is rounded oval shape about the size of an avocado. Bright red fruit leather for the kind of white and red dragon fruit, dark red to black dragon fruit, and yellow for the yellow dragon fruit. All over his skin filled with tassels are analogous with dragon scales. Therefore, this fruit called dragon fruit.

The stem is triangular in shape, prickly very short and inconspicuous, so it is often considered a "spineless cactus". The flowers bloom in the early evening when the flower buds are already measuring about 30 cm. Outer petals beige, blossom around nine o'clock at night, then followed crown pure white inside, includes a number of yellow stamens. Flowers like the funnel was finally fully open at midnight, because the dragon fruit is known as night blooming cereus. When in full bloom, dragon fruit spreads fragrance. This scent to lure the bats, in order to pollinate the flowers of dragon fruit.

In general, dragon fruit cultivated by cuttings or seed seeding. Plants will thrive if planted porous media (not muddy), nutrient rich, sandy, enough sunlight and the temperature between 38-40 ° C. If the treatment is good enough, the plant will begin to bear fruit at the age of 11-17 months. Dragon fruit is very adaptive cultivated in various daearah with altitude 0-1200 m asl. The most important thing is to get enough sunlight is a condition of a red dragon fruit growth.

Dragon fruit can grow to soil conditions and altitude of any location, but the plant is quite greedy for nutrients, so if the soil contains a great fertilizer, then the growth will be good. Within 1 year, dragon fruit tree can reach a height of 3 meters. According to some sources, the dragon fruit is not widely cultivated in Indonesia. In the meantime, the area Mojokerto, Jember, Malang, Pasuruan, Banyuwangi, Ponorogo, Kalibawang, Kulon Progo, Batam and Bandung is an area that has been cultivating this plant.

The dragon fruit flesh should be split up to look when it will be consumed. The texture of the fruit is often equated with kiwi fruit because its seeds are black and crispy. The flesh tasted a bit sweet when eaten and have a low calorie content. Dragon fruit seeds have a peppery taste and rich in lipids and eaten along with the flesh, but the seeds must be chewed as it is difficult to digest by the body. Besides eaten directly, dragon fruit can also be processed into various forms of foods and beverages such as soup, salad, chips, jelly, fruit juice, porridge pearls, and so on.

Red dragon fruit as a fruit that has many benefits to help cope and help cure various diseases. Starting from the trunk of dragon fruit, dragon fruit flesh, until the skin dragon fruit also has lots of vitamins and substances that are very useful. Doctors also highly recommend the red dragon fruit, as fruit consumption that can be used for therapy in the treatment of a disease.

Here are some of the benefits of dragon fruit:

Red dragon fruit to help cure cancer, vitamin complexes, has been recommended by doctors as a fruit of cancer treatment therapies.
Beautify the appearance, with its vitamin C content is high, the red dragon fruit helps maintain healthy skin, even the fruit and the skin can also be used as a scrub.
Because the sweetness of red dragon fruit is not derived from glucose, the red dragon fruit can also help cure diabetes.
Maintaining the health and stamina, with the content of antioxidants and vitamins.
Preventing osteoporosis or bone calcification, as the red dragon fruit contains a lot of organic calcium.
6. contains vitamin B3 which serves to lower cholesterol levels and to cure cough and asthma to be able to cope with high blood pressure.
Caring for the health of the eye, because the beta-carotene contained in dragon fruit is useful for maintaining eye health.
Maintaining heart health, because the content of vitamin C, B1, B2, and B3 contained in the dragon fruit can maintain heart health.

Pests found in dragon fruit mealy bugs (Hemiptera: Pseudococcidae) jackbeardsleyi Pseudococcus species, Ferrisia virgata, and Planococcus sp, aphids (Hemiptera: Aphididae) .. Species Aphis gossypii, Branchycaudus helichrysi, and Toxoptera odinae, ants (Hymenoptera: Formicidae) sp Oecophylla species, Camponotus sp, Euprenolepis sp and sp Polycharis, grasshoppers (Orthoptera: Acrididae) species Valanga sp, Oxya sp and sp Atractomorpha, mites (Acarina: Tetranycidae); Snail (Acathina fulica), and birds. Chickens are not considered pests, but they can cause severe damage to the fruit if they are allowed to be present in the garden. Diseases found in dragon fruit is red algae rust (Cephaleuros sp.), Wine place orange (Fusarium sp.), White wine (Botryosphaeria sp. And Phomopsis sp.), Stem Blight (Helminthosporium sp.) And anthracnose (Colletotrichum sp. ), Dothiorella spot, brown stem rot, yellow stem, fruit rot (Colletotrichum sp. and Helminthosporium sp.) citrus fruit spot (Alternaria sp.). A black spot disease on the stems have not been identified. Pests and diseases have not been controlled in a particular system, perhaps because their occurrence does not result in significant losses.

Pediatrics | History and definition of Pediatrics

noreply@blogger.com (Unknown) — Sat, 31 Oct 2015 20:44:00 +0000

Pediatrics (also spelled paediatrics or pædiatrics) is the branch of medicine that deals with the medical care of infants and children. Most pediatricians are members of a national body, such as the Canadian Paediatric Society, the British Association of Paediatric Surgeons or the American Academy of Pediatrics.

One of the major challenges facing pediatricians is that the range of body sizes (and weights) that they face in pediatrics is much greater than in adult medicine. For example, a preterm neonate can be less than 2kg in weight while an obese adolescent may be larger than the typical adult.

Childhood is the period of greatest growth, development and maturation of the various organ systems in the body. Years of training and experience (above and beyond basic medical training) goes into recognizing the difference between normal variants and what is actually pathological.

Another major difference between pediatrics and adult medicine is that children are minors and, in most jurisdictions, cannot make decisions for themselves. The issue of guardianship, legal responsibility and informed consent must always be considered in every pediatric procedure. In a sense, pediatricians often have to treat the parents (and sometimes, the family), not just the child.

Abraham Jacobi is considered the father of pediatrics.

Paediatrics is a relatively new medical specialty, developing only in the mid19th century. Arthur Jacobi (1830–1919) is known as the father of paediatrics because of his many contributions to the field., he was a Prussian-American.

According to A.B. Desai, "Soraneus in Greece in the 2nd century AD wrote the first known manuscript devoted to paediatrics...The first printed book on paediatrics was in Italian (1472) – Bagallarder's Little Book on Disease in Children." Rhazes (865–925) in Persia wrote The Diseases of Children, the first book to deal with paediatrics as an independent field of medicine.

In the Western world, the first generally accepted paediatric hospital is the Hôpital des Enfants Malades (French: Hospital for Sick Children), which opened in Paris in June 1802 on the site of a previous orphanage. From its beginning, this famous hospital accepted patients up to the age of fifteen years, and it continues to this day as the paediatric division of the Necker-Enfants Malades Hospital, created in 1920 by merger with the physically contiguous Necker Hospital, founded in 1778 for adults.

This example was only gradually followed in other European countries. The Charité (a hospital founded in 1710) in Berlin established a separate Paediatric Pavilion in 1830, followed by similar institutions at Saint Petersburg in 1834, and at Vienna and Breslau (now Wrocław), both in 1837. The English-speaking world waited until 1852 for its first paediatric hospital, the Hospital for Sick Children, Great Ormond Street, some fifty years after the founding of its namesake in Paris. In the USA, the first similar institutions were the Children's Hospital of Philadelphia, which opened in 1855, and then Boston Children's Hospital (1869).

Paediatrics differs from adult medicine in many respects. The obvious body size differences are paralleled by maturational changes. The smaller body of an infant or neonate is substantially different physiologically from that of an adult. Congenital defects, genetic variance, and developmental issues are of greater concern to paediatricians than they often are to adult physicians.

Treating a child is not like treating a miniature adult. A major difference between paediatrics and adult medicine is that children are minors and, in most jurisdictions, cannot make decisions for themselves. The issues of guardianship, privacy, legal responsibility and informed consent must always be considered in every paediatric procedure. In a sense, paediatricians often have to treat the parents and sometimes, the family, rather than just the child. Adolescents are in their own legal class, having rights to their own health care decisions in certain circumstances.

The training of paediatricians varies considerably across the world.

Depending on jurisdiction and university, a medical degree course may be either undergraduate-entry or graduate-entry. The former commonly takes five or six years, and has been usual in the Commonwealth. Entrants to graduate-entry courses (as in the USA), usually lasting four or five years, have previously completed a three- or four-year university degree, commonly but by no means always in sciences. Medical graduates hold a degree specific to the country and university in and from which they graduated. This degree qualifies that medical practitioner to become licensed or registered under the laws of that particular country, and sometimes of several countries, subject to requirements for "internship" or "conditional registration".

Pediatricians must undertake further training in their chosen field. This may take from four to eight or more years, (depending on jurisdiction and the degree of specialization). The post-graduate training for a primary care physician, including primary care paediatricians, is generally not as lengthy as for a hospital-based medical specialist.

In most jurisdictions, entry-level degrees are common to all branches of the medical profession, but in some jurisdictions, specialization in paediatrics may begin before completion of this degree. In some jurisdictions, paediatric training is begun immediately following completion of entry-level training. In other jurisdictions, junior medical doctors must undertake generalist (unstreamed) training for a number of years before commencing paediatric (or any other) specialization. Specialist training is often largely under the control of paediatric organizations (see below) rather than universities, with varying degrees of government input, depending on jurisdiction.

Like other medical practitioners, paediatricians are traditionally considered to be members of a learned profession, because of the extensive training requirements, and also because of the occupation's special ethical and legal duties.

A common misconception is that Paediatricians enjoy high social status, often combined with expectations of a high and stable income and job security. However, paediatric medical practitioners in general often work long and inflexible hours, with shifts at unsociable times, and may earn less than other professionals whose education is of comparable length. Neonatologists or general paediatricians in hospital practice are often on call at unsociable times for perinatal problems in particular—such as for Cesarean section or other high risk births, and for the care of ill newborn infants.

Obesity Causes and prevention | Factors affecting Obesity

noreply@blogger.com (Unknown) — Sat, 31 Oct 2015 20:40:00 +0000

Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems. Body mass index (BMI), a measurement which compares weight and height, defines people as overweight (pre-obese) if their BMI is between 25 and 30 kg/m2, and obese when it is greater than 30 kg/m2.

Obesity increases the likelihood of various diseases, particularly heart disease, type 2 diabetes, breathing difficulties during sleep, certain types of cancer, and osteoarthritis. Obesity is most commonly caused by a combination of excessive food energy intake, lack of physical activity, and genetic susceptibility, although a few cases are caused primarily by genes, endocrine disorders, medications or psychiatric illness. Evidence to support the view that some obese people eat little yet gain weight due to a slow metabolism is limited; on average obese people have a greater energy expenditure than their thin counterparts due to the energy required to maintain an increased body mass.

Dieting and physical exercise are the mainstays of treatment for obesity. Moreover, it is important to improve diet quality by reducing the consumption of energy-dense foods such as those high in fat and sugars, and by increasing the intake of dietary fiber. To supplement this, or in case of failure, anti-obesity drugs may be taken to reduce appetite or inhibit fat absorption. In severe cases, surgery is performed or an intragastric balloon is placed to reduce stomach volume and/or bowel length, leading to earlier satiation and reduced ability to absorb nutrients from food.

Obesity is a leading preventable cause of death worldwide, with increasing prevalence in adults and children, and authorities view it as one of the most serious public health problems of the 21st century. Obesity is stigmatized in much of the modern world (particularly in the Western world), though it was widely perceived as a symbol of wealth and fertility at other times in history, and still is in some parts of the world.

Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health. It is defined by body mass index (BMI) and further evaluated in terms of fat distribution via the waist–hip ratio and total cardiovascular risk factors. BMI is closely related to both percentage body fat and total body fat.

In children, a healthy weight varies with age and sex. Obesity in children and adolescents is defined not as an absolute number, but in relation to a historical normal group, such that obesity is a BMI greater than the 95th percentile. The reference data on which these percentiles are based are from 1963 to 1994, and thus have not been affected by the recent increases in weight.

Excessive body weight is associated with various diseases, particularly cardiovascular diseases, diabetes mellitus type 2, obstructive sleep apnea, certain types of cancer, and osteoarthritis. As a result, obesity has been found to reduce life expectancy.

Obesity is one of the leading preventable causes of death worldwide. Large-scale American and European studies have found that mortality risk is lowest at a BMI of 20–25 kg/m2 in non-smokers and at 24–27 kg/m2 in current smokers, with risk increasing along with changes in either direction. A BMI above 32 has been associated with a doubled mortality rate among women over a 16-year period. In the United States obesity is estimated to cause an excess 111,909 to 365,000 deaths per year, while 1 million (7.7%) of deaths in the European Union are attributed to excess weight. On average, obesity reduces life expectancy by six to seven years: a BMI of 30–35 reduces life expectancy by two to four years, while severe obesity (BMI > 40) reduces life expectancy by 10 years.

Obesity increases the risk of many physical and mental conditions. These comorbidities are most commonly shown in metabolic syndrome, a combination of medical disorders which includes: diabetes mellitus type 2, high blood pressure, high blood cholesterol, and high triglyceride levels.

Complications are either directly caused by obesity or indirectly related through mechanisms sharing a common cause such as a poor diet or a sedentary lifestyle. The strength of the link between obesity and specific conditions varies. One of the strongest is the link with type 2 diabetes. Excess body fat underlies 64% of cases of diabetes in men and 77% of cases in women.

Health consequences fall into two broad categories: those attributable to the effects of increased fat mass (such as osteoarthritis, obstructive sleep apnea, social stigmatization) and those due to the increased number of fat cells (diabetes, cancer, cardiovascular disease, non-alcoholic fatty liver disease). Increases in body fat alter the body's response to insulin, potentially leading to insulin resistance. Increased fat also creates a proinflammatory state, and a prothrombotic state.

Although the negative health consequences of obesity in the general population are well supported by the available evidence, health outcomes in certain subgroups seem to be improved at an increased BMI, a phenomenon known as the obesity survival paradox. The paradox was first described in 1999 in overweight and obese people undergoing hemodialysis, and has subsequently been found in those with heart failure and peripheral artery disease (PAD).

In people with heart failure, those with a BMI between 30.0–34.9 had lower mortality than those with a normal weight. This has been attributed to the fact that people often lose weight as they become progressively more ill. Similar findings have been made in other types of heart disease. People with class I obesity and heart disease do not have greater rates of further heart problems than people of normal weight who also have heart disease. In people with greater degrees of obesity, however, risk of further events is increased. Even after cardiac bypass surgery, no increase in mortality is seen in the overweight and obese. One study found that the improved survival could be explained by the more aggressive treatment obese people receive after a cardiac event. Another found that if one takes into account chronic obstructive pulmonary disease (COPD) in those with PAD the benefit of obesity no longer exists.

At an individual level, a combination of excessive food energy intake and a lack of physical activity is thought to explain most cases of obesity. A limited number of cases are due primarily to genetics, medical reasons, or psychiatric illness. In contrast, increasing rates of obesity at a societal level are felt to be due to an easily accessible and palatable diet, increased reliance on cars, and mechanized manufacturing.

A 2006 review identified ten other possible contributors to the recent increase of obesity: (1) insufficient sleep, (2) endocrine disruptors (environmental pollutants that interfere with lipid metabolism), (3) decreased variability in ambient temperature, (4) decreased rates of smoking, because smoking suppresses appetite, (5) increased use of medications that can cause weight gain (e.g., atypical antipsychotics), (6) proportional increases in ethnic and age groups that tend to be heavier, (7) pregnancy at a later age (which may cause susceptibility to obesity in children), (8) epigenetic risk factors passed on generationally, (9) natural selection for higher BMI, and (10) assortative mating leading to increased concentration of obesity risk factors (this would not necessarily increase the number of obese people, but would increase the average population weight). While there is substantial evidence supporting the influence of these mechanisms on the increased prevalence of obesity, the evidence is still inconclusive, and the authors state that these are probably less influential than the ones discussed in the previous paragraph.

The per capita dietary energy supply varies markedly between different regions and countries. It has also changed significantly over time. From the early 1970s to the late 1990s the average calories available per person per day (the amount of food bought) has increased in all parts of the world except Eastern Europe. The United States had the highest availability with 3,654 calories per person in 1996. This increased further in 2003 to 3,754. During the late 1990s Europeans had 3,394 calories per person, in the developing areas of Asia there were 2,648 calories per person, and in sub-Saharan Africa people had 2,176 calories per person. Total calorie consumption has been found to be related to obesity.

The widespread availability of nutritional guidelines has done little to address the problems of overeating and poor dietary choice. From 1971 to 2000, obesity rates in the United States increased from 14.5% to 30.9%. During the same period, an increase occurred in the average amount of food energy consumed. For women, the average increase was 335 calories per day (1,542 calories in 1971 and 1,877 calories in 2004), while for men the average increase was 168 calories per day (2,450 calories in 1971 and 2,618 calories in 2004). Most of this extra food energy came from an increase in carbohydrate consumption rather than fat consumption. The primary sources of these extra carbohydrates are sweetened beverages, which now account for almost 25 percent of daily food energy in young adults in America. Consumption of sweetened drinks is believed to be contributing to the rising rates of obesity.

As societies become increasingly reliant on energy-dense, big-portion, fast-food meals, the association between fast-food consumption and obesity becomes more concerning. In the United States consumption of fast-food meals tripled and food energy intake from these meals quadrupled between 1977 and 1995.

Agricultural policy and techniques in the United States and Europe have led to lower food prices. In the United States, subsidization of corn, soy, wheat, and rice through the U.S. farm bill has made the main sources of processed food cheap compared to fruits and vegetables.

Obese people consistently under-report their food consumption as compared to people of normal weight. This is supported both by tests of people carried out in a calorimeter room and by direct observation.

The main treatment for obesity consists of dieting and physical exercise. Diet programs may produce weight loss over the short term, but maintaining this weight loss is frequently difficult and often requires making exercise and a lower food energy diet a permanent part of a person's lifestyle. Success rates of long-term weight loss maintenance with lifestyle changes are low ranging from 2–20%.

One medication, orlistat (Xenical), is current widely available and approved for long term use. Weight loss however is modest with an average of 2.9 kg (6.4 lb) at 1 to 4 years and there is little information on how these drugs affect longer-term complications of obesity. It use is associated with high rates of gastrointestinal side effects and concerns have been raised about negative effects on the kidneys.

The most effective treatment for obesity is bariatric surgery. Surgery for severe obesity is associated with long-term weight loss and decreased overall mortality. One study found a weight loss of between 14% and 25% (depending on the type of procedure performed) at 10 years, and a 29% reduction in all cause mortality when compared to standard weight loss measures. However, due to its cost and the risk of complications, researchers are searching for other effective yet less invasive treatments.

History and presence of the University of Al - Azhar

noreply@blogger.com (Unknown) — Sat, 31 Oct 2015 20:30:00 +0000

History and presence of the University of Al - Azhar - University of Al-Azhar is one of the main centers of education Arabic literature and Sunni Islamic studies in the world and is the second oldest university degree providers in the world. The university is associated with Al-Azhar mosque in Old Cairo region.

The university originally built by Bani Fatimid Ismaili Shiite sect that embraces, and the designation of Al-Azhar take on the name of Lady Fatimah, the daughter of the Prophet Muhammad. The mosque was built around the year 970 ~ 972. Lessons begin at Al-Azhar in Ramadan in October 975, when the chairman of the Supreme Court of Abul Hasan Ali ibn al-Nu'man start teaching from the book "Al-Overview" on the topic of Shiite jurisprudence. Madrasah, where religious education, which is connected with the mosque was built in 988. Later, it was a school for Sunnis ahead of the mid-century, well-maintained and kept up to date.

Currently, the mission of the university among others, is the spread of Islamic religion and culture. For this purpose, Islamic scholars (ulama) issued edicts (fatwa) to address various problems that asked of them from around the world of Sunni Islam, the behavior of individuals or the Muslim community the right (for example, recently was fatwa regarding clarification and and prohibition against female genital mutilation). Al-Azhar also trains pedakwah appointed by the Egyptian government.

Library of Al-Azhar is considered the number two paramount importance in Egypt after the Egyptian National Library and Archives. Al-Azhar in partnership with ITEP, an information technology company Dubai, in May 2005 launched a project HE Sheikh Mohammed bin Rashid Al Maktoum to Preserve and Publish Manuscript of Al-Azhar Online ("Al-Azhar Online Project"); with a mission to provide online access to the public over the entire collection of rare manuscripts (consisting of about seven million pages) owned Al-Azhar library.

Faculty Son in the province of Cairo:

Faculty Arabic
Faculty Dirasat Islamiyah
Faculty of Engineering
Faculty of Agriculture
Faculty of Engineering Faculty of Agriculture
Medical School
Faculty of Dentistry
Faculty of Pharmacy
Faculty of Science and Mathematics
Faculty of Commerce
Faculty of Adab and Humanities
faculty of Law
Faculty Ushuluddin
Courses Faculty of Al Azhar
Faculty of Media Information
Faculty of Education
Faculty of Physical Education and Health
Faculty of Da'wa

Faculty Son provinces outside Cairo:

Faculty of Medicine (Dumyat)
Faculty of Engineering (Qina)
Faculty of Shariah wal Qonun (Asyut)
Faculty of Da'wa wal Ushuluddin (Manshourah)
Faculty of Da'wa wal Ushuluddin (Minoufiyah)
Faculty of Arabic (Minoufiyah)
Faculty of Arabic (Girja)
Faculty of Shariah wal Qonun (Tanta)
Faculty Dirasat Islamiyah (Qina)
Faculty of Arabic (Zaqaziq)
Faculty of Science (Asyut)
Faculty Dirasat Islamiyah (Aswan)
Faculty of MT (Tafahna Al-Ashraf)
Faculty of Arabic (Asyut)
Faculty of Sharia (Damanhur)
Faculty of Dentistry (Asyut)
Faculty of Al-Quran and qiraat wa Ulumiha (TANTA)

Faculty Princess in the province of Cairo:

Faculty of Economics
Faculty of Psychology
Faculty of Pharmacy
Medical School
Faculty Dirasat Islamiyah
Faculty of Dentistry
Faculty of Science and Mathematics
Faculty of Engineering

Faculty Princess outside the province of Cairo:

Faculty Dirasat Islamiyah (Alexandria)
Faculty Dirasat Islamiyah (Asyut)
Faculty Dirasat Islamiyah (Sohaj)
Faculty of Religion For Women (Asir Ramadan)
Faculty of Religion For Women (Thaybah)
Faculty of Economics of the Interior (Tanta)
Faculty Dirasat Islamiyah (Manshourah)

Food removers Bloating Naturally

noreply@blogger.com (Unknown) — Sat, 31 Oct 2015 20:13:00 +0000

Food removers Bloating Naturally - Abdominal bloating or excess gas is a problem caused by the process of digestion is not proper. High-fiber foods such as cabbage and beans are often regarded as the cause of this condition.

But do not worry there are a variety of foods that can prevent and relieve flatulence effectively.

Here are foods that can reduce the production of excess gas in the stomach.

1. Peppermint

"Peppermint can help relieve spasms and cramps in the stomach," said Guido Mase clinical herbalist, as reported by Yahoo Health website on Thursday (29/10).

2. Ginger

This root is known as one of the best natural remedies for nausea. Ginger is also good as an anti-inflammatory and helps digestive problems.

3. Fennel seeds and bulbs

Small pinch of seeds is rapidly reduce gas and bloating.

4. Apple cider vinegar

Strength apple cider vinegar are many and one of them is help with digestive problems like acid reflux. Plus apple cider vinegar is fermented foods full of healthy bacteria that are essential for maintaining healthy bowel and digestion.

5. Radicchio

One type of chicory has a bitter taste, but the bitter taste of this function improves digestion and increases the production of digestive enzymes.

6. The roots of burdock

This root is popular in herbal medicine worldwide and truly beneficial for gut health. This root is rich in starch prebiotics that feed the beneficial intestinal organisms.

Tips and How To Pregnancy Feels More Comfortable

noreply@blogger.com (Unknown) — Sat, 31 Oct 2015 19:58:00 +0000

Tips and How To Pregnancy Feels More Comfortable - Pregnant women have extra challenges ranging from morning sickness, leg cramps, back pain, and weight increased drastically. Some even have trouble breathing. Well, the question is, is there any way to reduce complaints during pregnancy?

1. Familiarize warm bath before you sleep

Cold water bath will help soothe muscles and joints are aching and help you get better sleep.

2. Use a pillow maternity

Maternity pillow or cushion prenatal C-shaped pillow is available online, and in some stores selling maternity. This cushion will make it easier for you to sleep at night and prevent back and hip was sore when you wake up in the morning.

3. Use a chair that has a footrest

Find a comfortable chair in your living room, there should be one chair that allows you to menselonjorkan legs because the more time you spend on your feet during pregnancy then you will feel more tired and inconveniences. Menselonjorkan your feet will relieve discomfort and prevent swelling and other circulatory problems.

4. Avoid tight clothes

Your blood circulation during pregnancy be interrupted so the last thing you should do is make it worse by wearing tight clothing. Choose clothing that is loose and comfortable.

5. Choose comfortable shoes that have plenty of room

Look for shoes or sandals that make you really feel comfortable, because your feet will bear the burden of your discomfort. You may have to buy shoes that are one size bigger because your feet will swell.

6. Swim

Swimming is a form of cardio exercises that will strengthen your muscles, improve blood circulation and most importantly ease your weight. Swimming is also a therapy that will calm the muscles and joints.

7. Drinking water ice cold

Drinking ice water will refresh you and also cleanse your system and promote cell division process in which a baby grows.

The company carries nissan 1 Million Sales in China

noreply@blogger.com (Unknown) — Thu, 29 Oct 2015 20:58:00 +0000

The company carries nissan 1 Million Sales in China - Nissan Motor Co., the biggest Japanese carmaker by sales in China, said it will sell one million passenger vehicles a year for the first time in the country as demand rebounds in the world’s largest auto market.

A recovery in demand and marketing efforts are contributing to the rise in sales, and the automaker will report “very good” October sales, Jun Seki, Nissan’s China head, said in a brief interview at the Tokyo Motor Show on Wednesday. The company sold 952,400 passenger vehicles in China last year.

China’s auto sales are rebounding after the central government cut a purchase tax on small passenger vehicles from Oct. 1. Industry retail deliveries rose 11 percent in the first three weeks of the month from a year earlier, according to the China Passenger Car Association. Demand had expanded at the slowest pace in three years in the first nine months, weighed down by moderating economic growth and a summer stock-market rout that dented consumer confidence.

The tax cut, effective through the end of next year, is for purchases of vehicles with 1.6-liter engines or smaller, a category that covers about 70 percent of autos sold in China.

Separately, Honda Motor Co.’s China chief, Seiji Kuraishi, said he expects the carmaker to meet its sales target this year for 900,000 units in the country, driven by demand for sport utility vehicles. Competition remains intense and companies that face declines in sales may cut prices, he said.

The automaker will monitor the market carefully before taking the next step, Kuraishi said. Industrywide sales in China will expand at a slower pace next year, Honda’s Chairman Fumihiko Ike said.

World University Illusion

noreply@blogger.com (Unknown) — Thu, 29 Oct 2015 15:33:00 +0000

World University Illusion - Germany again made a new breakthrough with the launch of an online university for refugees. With the university, Germany offers higher education free of charge wherever the refugees are located.

University Kiron said, all students need a computer and an internet connection. For those who do not have internet access can be offline by downloading when no internet access.

To register for this online university, the student must submit documents including the recognition of refugee status from the UNHCR. To fund its activities, non-profit university has collected 216 636 dollars before launching this October. The funds collected voluntarily.

Kiron University spokesman, Tim Brandt told Aljazirah, this idea was born in the summer of 2014. At that time the founder Vincent Zimmer and Mark Kressler discuss their vision at a conference.

Vincent, said he wanted to start a revolution in higher education by developing a new type of university. "The University offered to refugees who do not have access to higher education," he said.

Germany has been the main destination countries of migrants.

Often the reason Exit Body Odor

noreply@blogger.com (Unknown) — Thu, 29 Oct 2015 00:14:00 +0000

Often the reason Exit Body Odor - In carrying out daily activities, often sweating out to be disturbing when it raises the unpleasant aroma. Despite trying to wear fragrances such as perfumes, but sometimes unpleasant scent of sweat still appear.

"Sweat was actually happening because of the metabolic processes in the body, when metabolism occurs it will emit body heat. And in order to lower the temperature, the body sweat," said Grace Tumbelaka, medical specialists Sports Medicine when met at fX Sudirman, South Jakarta, Wednesday (28 / 10).Sweat usually come out after doing physical activity with moderate to high intensity. But not impossible, at rest or when feeding will be sweating, all returned as a living human body, do not stop metabolized.But often the problem is the sweat released by sweat glands in certain parts such as the armpits. In glands contained in body folds such as the armpits, sweat produced by sweat glands that section contains fat and protein intake for the bacteria in the skin."Sweat it contains mostly water and minerals, but the sweat produced by certain glands that contain fat and protein," says Grace.Fats and proteins with small amounts that will be overhauled by the bacteria so that the process will produce a gas perombakannya unpleasant inhaled. However, Grace also confirmed that sweat and body odor is associated with a variety of factors, one of which is the environment in which humans are a factor."Different sweat in Saudi Arabia to Jakarta. In Arabic with environmental conditions such as the sweat will quickly evaporate, while in Jakarta with high humidity, perspiration," said Grace.Although the environmental conditions of Jakarta's hot with high humidity of about 80 to 90 percent is a very ideal conditions for bacteria to live, but Grace said that there are ways to avoid body odor after sweating.First, the body and clothing hygiene must be maintained. With the condition of the body and clothing hygiene, then there will be a lot of bacteria that grow. Second, using a deodorant that can help reduce the less than ideal conditions for the bacteria grow. Some even promise deodorant can reduce excessive sweating."With the situation that there is no chance of the bacteria to grow, so the smell was by itself would be reduced," said Grace. (source: techcrunch.com)

This is the Key to Success Apple Records Sales

noreply@blogger.com (Unknown) — Wed, 28 Oct 2015 23:50:00 +0000

This is the Key to Success Apple Records Sales - Chief Executive Officer (CEO) of Apple, Tim Cook said Apple has scored sales growth of 40 percent and reach $ 25 billion, equivalent to Rp340,812 trillion (refer to Rp13.632 per USD exchange rate) in the third quarter 2015 report. The acquisition has increased when compared to the same period last year.
Quoted from page Business Insider on Thursday (29/10/2015), according to Cook, the revenue growth was obtained due to the aggressiveness of the company pushes the sales of products to a wider market. As for how the approach in partnership with the company's senior technology, such as Cisco and IBM.
This approach is done in order to make Apple products, such as iPhone, iPad, and Mac is increasingly recognized to some other technology companies and gain a greater market share. As a result, efforts are apparently fruitless approaches.
Since the iPhone launched in 2007, people around the world are eager to use it at work, but there is always a bottleneck. As is known, Apple products are made only focused on the consumer and does not have the expertise to make your Apple device super friendly to all the technology department, with the security and control of compliance or a specific business line applications.
Apple products is superior in terms of usability and design, which makes people want to use their iPhone more than, say, companies such as the BlackBerry and the clunky old Windows laptop / stiff.
Now, with the growth of earned income, Apple can focus on pushing its products to each office. The reason is, Apple really know exactly that all the people on earth are eager to use Apple products.

Risks can Processed Meat Causes Cancer

noreply@blogger.com (Unknown) — Wed, 28 Oct 2015 19:16:00 +0000

Risks can Processed Meat Causes Cancer, - Processed meats such as ham, bacon, sausages, including red meat, can cause cancer. Thus the sound of the latest report from the International Agency for Research on Cancer (IARC), a research body under the World Health Organization (WHO). The comments came after a panel of experts looked at more than 800 scientific research results about cancer.

Actually, many experts have long believed that processed meats, including red meat, have contributed to the increased risk of cancer, especially those associated with gastrointestinal cancers such as colon and stomach cancer. So, IARC announcement is not surprising but it is more stressed.

"They have the definitive authority on this subject," said David Katz, MD, director of Yale University's Prevention Research Center, in New Haven, CT.

"For a long time we do not recommend the consumption of processed meat ahead of time before the WHO announcement is issued," said Katz again.

Experts still do not know how much the consumption of processed meat can increase the risk of cancer called. But they believe, the more you eat, the higher the risk you have.

The producers of processed meat had not yet approved the IARC statement. They consider this announcement to be weak. They point to the 22-member panel that does not agree the statement that processed meat increases the risk of cancer.

"Cancer is a complex disease, even highly intelligent brain could not fully understand the disease," said Shalene McNeill, PhD, RD, executive director for the research field of human nutrition at the National Cattlemen's Beef Association.

"Billions of dollars have been dhabiskan to research worldwide. And none of the food that has been shown to cause cancer, "said Shalene in the National Cattlemen's Beef Association.

Since 1970, health experts classify food and objects around us into five groups of cancer-related, ranging from children's toys, chemicals, up to the daily diet. The five groups are:

Group 1: carcinogenic, causing cancer.
Group 2A: probable cause of cancer.
Group 2B: possibly cause cancer.
Group 3: Not sure, not enough evidence.
Group 4: do not cause cancer.

Processed meat itself, according to the IARC, in the first group, while red meat entering two groups, namely the probable cause of cancer.

Scavengers child beauty queen

noreply@blogger.com (Unknown) — Wed, 28 Oct 2015 19:07:00 +0000

Scavengers child beauty queen - A mother will always be a figure that is proud of his children, no matter what kind of work he does. This is done by a woman who was elected Queen of Beauty in Thailand who kiss the feet of her mother, who worked as scavengers.

Woman named Mint was successfully won a beauty contest Miss Uncensored News Thailand in 2015 despite her status as a child scavengers. He did not forget the land even though its name has been bounced into a beauty queen.

In fact, Mint kiss and prostrate on his mother's feet as a form of gratitude. His own life story is quite sad. She always helps her mother collect used goods for sale.

Mint does not even ashamed of it because that way he could support his family. The 17-year-old girl to prove that with a hard and difficult life, he actually could carve achievements and keep the memory of his mother during this