It’s that how to become a teacher season again, the start of another college year, bringing by using it the guarantee of teachers providing essay as well as term document assignments. When the research is performed, the query becomes: How can you take which pile associated with notes and transform it into bit of great composing? The solution? By developing a great operating outline very first. The operating outline's primary purpose orbits around showing regions of the research that require more investigation. The operating outline also creates a common essay composing roadmap that may be re-arranged or even tweaked from any point throughout the writing process if your problem along with flow evolves. Think from it more like a brainstorming action before transitioning to the level of composing the tough draft.
Understand the Paper's Objective or Subject
First points first. Know the actual teacher's reason behind assigning the actual essay, or even, in the situation of phrase papers, understand the teacher's subject. Also observe the teacher's parameters for that finished document and maintain them in your mind during the study, outlining as well as writing procedure. The teacher's parameters can sometimes include the following: duration, typed or even handwritten, font as well as font dimension, margins, in-text info, proper quote format, bibliography, endnotes or even footnotes. Make notations about the working outline therefore it is obvious exactly where these a few of these things (quotations, info, footnotes, endnotes) ought to be contained in the final document. If required, write the actual "purpose" or even "topic" towards the top of the operating outline like a reminder in order to keep the actual outline as well as paper concentrated.
Research, Information, and Organizing the info.
Second points second. Do the study for the actual essay or even term document. Take massive notes. Individual notes through topic factors. Make notations or even draw icons that show points that appear to be more or even less essential than other people. As a person take information, keep all of the bibliography information using the notes for your source. Write the actual bibliography info in proper bibliography structure (the teacher will give you this information using the parameters for that paper; otherwise ask).
Take information either in writing, on catalog cards, or utilizing a computer term processing plan. Index cards could be stacked as well as organized within the general arrangement how the working outline is going to be in. Paper notes could be cut aside and organized very much the same as the actual index credit cards. With the actual index greeting card and document note-taking techniques, care must be taken to consider which information and quotes originated from which source for quotation, endnote or even footnote reasons.
Probably the simplest way to arrange notes into a plan is by using the term processing plan. Type within the notes underneath the bibliography source entries as well as save that as you file tagged "notes". Then arrange the operating outline through cutting as well as pasting in the notes file towards the working describe, and preserving the operating outline inside a separate document. Either method, as the actual working outline has been created, maintain asking: Does this bit of information fulfill the paper's objective or subject? If the info doesn't quite appear to fit, set this aside for some time. If this obviously does not fit, dispose of it.
Operating Outline how to become a teacher The Setup
Set in the working describe like every other outline. Use Roman numerals for that Introduction, the primary points and also the conclusion. Indent as well as use capitol British letters for that main helping evidence for every main stage. Switch in order to Arabic amounts and indent again to incorporate details and information connected towards the supporting proof. Indent once again and make use of lowercase British letters with regard to finer factors (these might or might not be included within the final paper based on whether the increase or detract in the topic and also the flow from the paper). With regard to longer documents, like phrase papers, the details listed alongside the Roman numerals may be used to create sub-headings, which split the document into scaled-down sections and allow it to be easier to see.
Highlight, make use of symbols, or create notes within the margin when groing through the operating outline, prior to starting the composing process. Make be aware of places where much more research is required, where a few tweaking or even re-organization might be needed, or even where estimates, endnotes, footnotes, or even in-text info belong. Use various color highlighters or even ink giving special importance to every notation. Red of vital, yellow with regard to "caution", purple with regard to citations … what ever symbols or even colors are utilized they ought to hold significance towards the student making the describe and composing the document.
The how to become a teacher information accustomed to write the actual introduction could be the same because that accustomed to write the final outcome. From the actual notes put aside for the actual introduction or conclusion, create a tough, rough draft from the introduction that provides an sign of exactly what information is going to be presented within the paper, without having stating this outright.
Incorrect Way: "I 'm writing this particular paper to inform you how to produce a working describe. I may back this up along with supporting proof or info. Then I'll conclude through reminding you concerning the ways We showed you to setup a operating outline. inch
Right Method: "It's the season when instructors start providing essay as well as term document assignments. To assist organize the info obtained within the research materials before composing those documents, begin with this particular easy operating outline procedure. "
The important thing Points
There might be only 3 how to become a teacher tips regarding essays or even more than 3 for phrase papers. The amount of key factors doesn't issue. The just thing which counts is that every key stage gets its Roman numeral within the working describe, with its supporting evidence and extra details. The important thing points will end up either just one essay paragraph or perhaps a separate portion of the phrase paper, which may be listed below a sub-heading which reflects the important thing point's intention.
Conclusion: The actual Rough Write
Much from the information accustomed to create the actual introduction is going to be used to create the summary. As using the introduction, don't emphasize the readers (teacher) that which you told all of them. When composing this tough, rough draft from the conclusion, think about how the subject or reason for the document developed with the writing procedure, until it reached this summary.
Working Describe: Read Via
Once the actual how to become a teacher working describe is finished, set this aside as well as let rest to have an hour, a day time or a couple of days - anything you have period for. Then return to it and go through it. Will it flow nicely? Does this need tweaking or even re-arranging? Will it need estimates? Does this need info? Does this need a little more research someplace? Does some bit of information not really belong?
When the teacher really wants to see a plan before composing begins, then you definitely have one prepared to show. The instructor may explain what's good concerning the working describe and where it requires work prior to writing. Take this particular as goal criticism (a critique targeted at making the ultimate written composition or phrase paper a much better finished product). When the teacher does not demand the copy from the working describe, then simply utilize it to start the composing process.
Keep in mind that the operating outline setup is not really written within stone, it doesn't need to be followed precisely. Working outlines are merely tools to assist organize the study materials, to indicate potential difficulties, and to keep a stability between an excessive amount of and insufficient information. First and foremost, they link the gap between your research process and also the writing procedure.
Medical Terminology Online Course
Monday, February 27, 2012
Monday, January 30, 2012
Heart Palpitations After Eating
The signs and symptoms of heart palpitations after eating illness include symptoms from the head as well as neck region, mental signs and symptoms, symptoms which affect the actual eyes and also the ears, signs and symptoms that impact the anxious system, muscle and skeletal signs and symptoms, and symptoms in the other systems in your body.
Lyme illness symptoms within its sophisticated stage are very difficult to recognize, because they're common signs and symptoms, and not really ones which are specific towards the disease. Thus whenever a patient doesn't have history of getting gone towards the woods or to be bitten with a deer mark, he must undergo a number of laboratory examinations. This is really he can have the right span of antibiotic remedy. Read this short article to learn about the various symptoms associated with advanced Lyme illness.
Symptoms within the Head as well as Neck Region
Advanced Lyme illness would affect the top and neck of the guitar area through producing signs and symptoms of hair thinning with absolutely no apparent cause, stiffness or even pain within the jaw, head aches, hoarseness, aching throat, mouth spasms, lack of taste feelings, and ingesting difficulty.
Psychological Symptoms
Symptoms which concern your brain upon getting the advanced stage from the Lyme illness are probably the following: short-term lack of memory, changes within the mood, trouble in resting, depression, considering difficulties as well as confusion.
Symptoms which Affect the actual Eyes and also the Ears
When one is experiencing fuzzy or dual vision, attention floaters, discomfort, sensitivity in order to light, optic neuritis as well as dryness, it is probably that he's the sophisticated symptoms from the Lyme illness. In addition to that particular, the affected individual may also have the following feelings in their ears: clicking on or humming noises, ringing in the ears, pain, stress, sensitivity in order to loud seem and reduction in hearing capability.
Symptoms which Affect the actual Nervous Program
The heart palpitations after eating symptoms which occur whenever Lyme illness reaches it's advanced phase would consist of feelings associated with burning, tremors, numbness, weak point, dizziness, strolling difficulties, lightheadedness, pain within the spinal line, and jerking actions that occur suddenly. Other symptoms that could also happen within the disease’ persistent stage tend to be paralysis from the face, also called Bell’s palsy, motion sickness that could increase within degree, as well as restless lower-leg syndrome.
Muscle and Skeletal Signs and symptoms
heart palpitations after eating symptoms within the advanced phase that impacts the muscle tissue and bones from the patient might include sensations for example pain as well as swelling within the joints, as well as stiffness, signs and symptoms indicative associated with arthritis. Like the chronic stage from the disease, the individual would additionally feel muscle mass cramps, pain within the bone, stiffness from the neck or even back, and feelings to be heavy. Patients might report feelings of arthritis attacks in spite of having absolutely no prior comparable attacks previously, with knees since the bodily areas most often affected. Likewise, these sufferers, if not really treated having a complete span of antibiotics, might have 60 percent of these with repeated arthritis problems. That is based on a report through the University associated with Maryland Clinic.
Other Impacted Body Techniques
The digestive tract of someone who’s reached the sophisticated stage from the Lyme disease may also be affected. Symptoms in this region would consist of constipation, diarrhea, nausea or vomiting, as nicely as pain within the stomach. Affected respiratory system and circulatory systems might have the subsequent: shortness associated with breath, pain within the chest region, cough, evening sweats, center palpitations, center blockage, as well as heart murmurs, in addition to heart assault.
Overall, when an individual has reached the actual advanced phases of heart palpitations after eating he might feel very tired, might have changes within his bodyweight without any kind of apparent factors, and emotions of discomfort in their body which transfer in order to different areas. In addition to that particular, the signs and symptoms might vanish, but and then reappear before long. Infections are also known to come back, as nicely as increase within the sensitivity in order to particles which cause allergy towards the patient.
Lyme illness symptoms within its sophisticated stage are very difficult to recognize, because they're common signs and symptoms, and not really ones which are specific towards the disease. Thus whenever a patient doesn't have history of getting gone towards the woods or to be bitten with a deer mark, he must undergo a number of laboratory examinations. This is really he can have the right span of antibiotic remedy. Read this short article to learn about the various symptoms associated with advanced Lyme illness.
Symptoms within the Head as well as Neck Region
Advanced Lyme illness would affect the top and neck of the guitar area through producing signs and symptoms of hair thinning with absolutely no apparent cause, stiffness or even pain within the jaw, head aches, hoarseness, aching throat, mouth spasms, lack of taste feelings, and ingesting difficulty.
Psychological Symptoms
Symptoms which concern your brain upon getting the advanced stage from the Lyme illness are probably the following: short-term lack of memory, changes within the mood, trouble in resting, depression, considering difficulties as well as confusion.
Symptoms which Affect the actual Eyes and also the Ears
When one is experiencing fuzzy or dual vision, attention floaters, discomfort, sensitivity in order to light, optic neuritis as well as dryness, it is probably that he's the sophisticated symptoms from the Lyme illness. In addition to that particular, the affected individual may also have the following feelings in their ears: clicking on or humming noises, ringing in the ears, pain, stress, sensitivity in order to loud seem and reduction in hearing capability.
Symptoms which Affect the actual Nervous Program
The heart palpitations after eating symptoms which occur whenever Lyme illness reaches it's advanced phase would consist of feelings associated with burning, tremors, numbness, weak point, dizziness, strolling difficulties, lightheadedness, pain within the spinal line, and jerking actions that occur suddenly. Other symptoms that could also happen within the disease’ persistent stage tend to be paralysis from the face, also called Bell’s palsy, motion sickness that could increase within degree, as well as restless lower-leg syndrome.
Muscle and Skeletal Signs and symptoms
heart palpitations after eating symptoms within the advanced phase that impacts the muscle tissue and bones from the patient might include sensations for example pain as well as swelling within the joints, as well as stiffness, signs and symptoms indicative associated with arthritis. Like the chronic stage from the disease, the individual would additionally feel muscle mass cramps, pain within the bone, stiffness from the neck or even back, and feelings to be heavy. Patients might report feelings of arthritis attacks in spite of having absolutely no prior comparable attacks previously, with knees since the bodily areas most often affected. Likewise, these sufferers, if not really treated having a complete span of antibiotics, might have 60 percent of these with repeated arthritis problems. That is based on a report through the University associated with Maryland Clinic.
Other Impacted Body Techniques
The digestive tract of someone who’s reached the sophisticated stage from the Lyme disease may also be affected. Symptoms in this region would consist of constipation, diarrhea, nausea or vomiting, as nicely as pain within the stomach. Affected respiratory system and circulatory systems might have the subsequent: shortness associated with breath, pain within the chest region, cough, evening sweats, center palpitations, center blockage, as well as heart murmurs, in addition to heart assault.
Overall, when an individual has reached the actual advanced phases of heart palpitations after eating he might feel very tired, might have changes within his bodyweight without any kind of apparent factors, and emotions of discomfort in their body which transfer in order to different areas. In addition to that particular, the signs and symptoms might vanish, but and then reappear before long. Infections are also known to come back, as nicely as increase within the sensitivity in order to particles which cause allergy towards the patient.
Monday, January 23, 2012
Medical Training To Become a Pharmacist
School starts for most of us at age 4 or even 5. We graduateat 17/18 years old from supplementary school. About this basis, we possess alreadyspent a lot of our conformative years learning. But for individuals who wish to review medicine andto be a doctor; they will need to continue learning for a) an additional 4 many years asan undergrad, b) four years from medical college, and c) an additional 3 in order to 7 yearsas a good intern as well as resident; but d) if they would like to specialise inside a specificfield then a few more many years of study are needed. This implies that a lotof function, study as well as patience is needed before you're finally set up as adoctor – maybe once you have reached age 30!
Maybe a person don’t desire to be in the actual student industry for this kind of along period what exactly are your choices whereby you can still function in themedical field to create a career? Aside through studying to become a doctor, thereplenty associated with work choices still inside the medical area. To provide you with an concept, here are a number of them.
Nurses tend to be always sought after whether in america or somewhere else. This happens because numerous nurses tend to be of “baby boomer” age and therefore are nearing retirement within an age exactly where today’s youngsters are no more excited regarding training and for this reason many nurses are now being hired through other nations; in Australia there's seems to be a higher percentage associated with nurses originating from Africa.
In Sydney nurses go to university exactly where they discover such subjects for example anatomy, the field of biology, chemistry, an infection control, healthcare terminology, physiology and many others prior to undergoing on to hospital wards to savor hands upon training. There tend to be exams in order to pass that test their own knowledge to ensure that hopefully presently there won’t end up being any problems when it's time to complete the genuine article. However while this is actually the way healthcare professionals achieve certification now I've heard the actual older more knowledgeable nurses say how the old way is better and which learning at work is better over-all. I guess within the interests associated with efficiency and also the dollar the actual “newer “method is recognized as what you want..
Obviously various jobs need different instruction and instruction periods. With regard to pharmacists, laboratory technicians as well as nurses, the research period is under the 8 years or even more required through Doctors. For the nurse the actual qualifying period is generally around 3 to 4 years.
Pharmacists distribute drugs in the store. They possess theknowledge in order to recommend the drug much like that recommended if for whatever reason itis unobtainable or even indeed out of your reach. Sometimes they offer advice in order to doctorsin order to look for the proper individual dosage because they know about patient sideeffects.
Lab specialist positions are for those who dependingon their own training would be the people whotest examples or guy the X-ray or even mammogram devices when needed.
With just a little medical training you may be successfulworking beyond a medical center environment. You can train in order to qualify because medicaltranscribers where your work is in order to transcribe what a doctor has said utilizing a taperecorder. You execute the work from home and after that return the actual document/s towards the doctor.
Resources:
how to become a pharmacist
how to become a pharmacist
how to become a pharmacist
how to become a pharmacist
Pharmaceutical businesses need sales people to market theirdrugs in order to doctors as well as hospitals. Obviously training to the specific utilizes and effectsof the person drug ingredients must be studied carefully to be able to bean efficient representative from the company.
In short it may be seen which anyone could make a profession oncehe or she's made the decision about that path they would like to study and also have undergonethe needed medical instruction. If you cannot study full-time there isalways the possibility of buying school that provides part period or onlinetuition.
Just keep in mind that after you have earned your own degree yourcareer offers started and also you are in your to an extended and satisfying lifetime ofwork inside a field of the choosing.
Maybe a person don’t desire to be in the actual student industry for this kind of along period what exactly are your choices whereby you can still function in themedical field to create a career? Aside through studying to become a doctor, thereplenty associated with work choices still inside the medical area. To provide you with an concept, here are a number of them.
Nurses tend to be always sought after whether in america or somewhere else. This happens because numerous nurses tend to be of “baby boomer” age and therefore are nearing retirement within an age exactly where today’s youngsters are no more excited regarding training and for this reason many nurses are now being hired through other nations; in Australia there's seems to be a higher percentage associated with nurses originating from Africa.
In Sydney nurses go to university exactly where they discover such subjects for example anatomy, the field of biology, chemistry, an infection control, healthcare terminology, physiology and many others prior to undergoing on to hospital wards to savor hands upon training. There tend to be exams in order to pass that test their own knowledge to ensure that hopefully presently there won’t end up being any problems when it's time to complete the genuine article. However while this is actually the way healthcare professionals achieve certification now I've heard the actual older more knowledgeable nurses say how the old way is better and which learning at work is better over-all. I guess within the interests associated with efficiency and also the dollar the actual “newer “method is recognized as what you want..
Obviously various jobs need different instruction and instruction periods. With regard to pharmacists, laboratory technicians as well as nurses, the research period is under the 8 years or even more required through Doctors. For the nurse the actual qualifying period is generally around 3 to 4 years.
Pharmacists distribute drugs in the store. They possess theknowledge in order to recommend the drug much like that recommended if for whatever reason itis unobtainable or even indeed out of your reach. Sometimes they offer advice in order to doctorsin order to look for the proper individual dosage because they know about patient sideeffects.
Lab specialist positions are for those who dependingon their own training would be the people whotest examples or guy the X-ray or even mammogram devices when needed.
With just a little medical training you may be successfulworking beyond a medical center environment. You can train in order to qualify because medicaltranscribers where your work is in order to transcribe what a doctor has said utilizing a taperecorder. You execute the work from home and after that return the actual document/s towards the doctor.
Resources:
how to become a pharmacist
how to become a pharmacist
how to become a pharmacist
how to become a pharmacist
Pharmaceutical businesses need sales people to market theirdrugs in order to doctors as well as hospitals. Obviously training to the specific utilizes and effectsof the person drug ingredients must be studied carefully to be able to bean efficient representative from the company.
In short it may be seen which anyone could make a profession oncehe or she's made the decision about that path they would like to study and also have undergonethe needed medical instruction. If you cannot study full-time there isalways the possibility of buying school that provides part period or onlinetuition.
Just keep in mind that after you have earned your own degree yourcareer offers started and also you are in your to an extended and satisfying lifetime ofwork inside a field of the choosing.
Monday, October 10, 2011
Hypernatremia
Hypernatremia is a greater than normal concentration of sodium in the blood. Sodium is an electrolyte that helps with nerve and muscle function, and also helps to maintain blood pressure.
Hypernatremia occurs when the body loses too much water in relation to the amount of sodium in the blood. Excessive water loss can occur if the kidneys excrete too much urine.
Hypernatremia can cause neurological damage due to shrinkage of brain cells. Hypernatremia is the condition of drinking a tremendously large amount of h2o in a short period. It is important to learn about this condition so that you don't overload you're system with water. Hypernatremia is defined as a plasma sodium concentration greater than 150 meq/L and is less common than hyponatremia. Hypernatremia – Seen in infants with dehydration, renal disease or diabetes insipidus. Severe hypernatremia can lead to confusion, muscle twitching, seizures, coma, and death.
Patients with hypernatremia may also have evidence of ECF volume expansion. Hypernatremic dehydration can occur when a child with diarrhoea receives fluids that contain high quantities of sodium. The tendency to hypernatremia is aggravated when PD is initiated with frequent exchanges of small volumes of hypertonic solution. Most patients with hypernatremia secondary to water loss appear euvolemic with normal total body sodium, because loss of water without sodium does not lead to overt volume contraction. So someone with severe hypernatremia, you still give them normal saline.
Similarly, a patient with hypernatremia must have lost more water than he was able to drink.
We present three neonates with severe hypernatremia secondary to inadequate exclusive breast-feed, two of whom developed intracranial hemorrhage during hospital stay with review of literature.
Although hyponatremia may be present, hypernatremia is not unusual because of the relatively high sodium administration in the various solutions because of the greater perspiration (higher respiration rate, relatively higher body surface area, thinner skin, artificial heating lamp) and especially because of the correction of acidosis with sodium bicarbonate. This listing is a sample listing of patents related to Hypernatremia for is only meant as a recent sample of applications filed, not a comprehensive history. If the body does not maintain salt balance then it may lead to hypernatremia with heart attack and even death.
Hyperchloremia, excess sodium OR deficit of bicarb. Can be expected with hypernatremia or metabolic acidosis. Hypernatremia reflects a deficiency of water relative to total body sodium content and is actually a disorder of water balance rather than a disorder of sodium balance.
Hypernatremia occurs when the body loses too much water in relation to the amount of sodium in the blood. Excessive water loss can occur if the kidneys excrete too much urine.
Hypernatremia can cause neurological damage due to shrinkage of brain cells. Hypernatremia is the condition of drinking a tremendously large amount of h2o in a short period. It is important to learn about this condition so that you don't overload you're system with water. Hypernatremia is defined as a plasma sodium concentration greater than 150 meq/L and is less common than hyponatremia. Hypernatremia – Seen in infants with dehydration, renal disease or diabetes insipidus. Severe hypernatremia can lead to confusion, muscle twitching, seizures, coma, and death.
Patients with hypernatremia may also have evidence of ECF volume expansion. Hypernatremic dehydration can occur when a child with diarrhoea receives fluids that contain high quantities of sodium. The tendency to hypernatremia is aggravated when PD is initiated with frequent exchanges of small volumes of hypertonic solution. Most patients with hypernatremia secondary to water loss appear euvolemic with normal total body sodium, because loss of water without sodium does not lead to overt volume contraction. So someone with severe hypernatremia, you still give them normal saline.
Similarly, a patient with hypernatremia must have lost more water than he was able to drink.
We present three neonates with severe hypernatremia secondary to inadequate exclusive breast-feed, two of whom developed intracranial hemorrhage during hospital stay with review of literature.
Although hyponatremia may be present, hypernatremia is not unusual because of the relatively high sodium administration in the various solutions because of the greater perspiration (higher respiration rate, relatively higher body surface area, thinner skin, artificial heating lamp) and especially because of the correction of acidosis with sodium bicarbonate. This listing is a sample listing of patents related to Hypernatremia for is only meant as a recent sample of applications filed, not a comprehensive history. If the body does not maintain salt balance then it may lead to hypernatremia with heart attack and even death.
Hyperchloremia, excess sodium OR deficit of bicarb. Can be expected with hypernatremia or metabolic acidosis. Hypernatremia reflects a deficiency of water relative to total body sodium content and is actually a disorder of water balance rather than a disorder of sodium balance.
Primary angle closure glaucoma
Primary angle closure glaucoma medical terminology is a type of primary glaucoma (wherein there is no obvious systemic or ocular cause) in which rise in intraocular pressure occurs due to blockage of the aqueous humour outflow by closure of a narrower angle of the anterior chamber.
ETIOLOGY
(A) Predisposing risk factors. These can be divided into anatomical and general factors:
I. Anatomical factors. Eyes anatomically predisposed to develop primary angle-closure glaucoma (PACG) include:
Hypermetropic eyes with shallow anterior chamber.
Eyes in which iris-lens diaphragm is placed anteriorly.
Eyes with narrow angle of anterior chamber, which may be due to: small eyeball, relatively large size of the lens and smaller diameter of the cornea or bigger size of the ciliary body.
Plateau iris configuration.
II. General factors include:
Age. PACG is comparatively more common in 5th decade of life.
Sex. Females are more prone to get PACG than males (male to female ratio is 1:4)
Type of personality. It is more common in nervous individuals with unstable vasomotor system.
Season. Peak incidence is reported in rainy season.
Family history. The potential for PACG is generally believed to be inherited.
Race. In caucasians, PACG accounts for about 6% of all glaucomas and presents in sixth to seventh decade. It is more common in South-East Asians, Chinese and Eskimos but uncommon in Blacks. In Asians it presents in the 5th to 6th decade and accounts for 50% of primary adult glaucomas in this ethnic group.
(B) Precipitating factors. In an eye that is predisposed to develop angle closure glaucoma, any of the following factors may precipitate an attack:
Dim illumination, Emotional stress, Use of mydriatic drugs like atropine, cyclopentolate, tropicamide and phenylephrine.
(C) Mechanism of rise in IOP. The probable sequence of events resulting in rise of IOP in an anatomically predisposed eye is as follows:
First of all due to the effect of precipitating factors there occurs mid dilatation of the pupil which increases the amount of apposition between iris and anteriorly placed lens with a considerable pressure resulting in relative pupil block. Consequently the aqueous collects in the posterior chamber and pushes the peripheral flaccid iris anteriorly (Iris bombe), resulting in appositional angle closure due to iridocorneal contact.
Eventually there occurs rise in IOP which is transient to begin with. But slowly the appositional angle closure is converted into synechial angle closure (due to formation of peripheral anterior synechiae) and an attack of rise in IOP may last long.
In some cases a mechanical occlusion of the angle by the iris is sufficient to block the drainage of aqueous. For this reason the instillation of atropine in an eye with a narrow angle is dangerous, since it may precipitate an attack of raised IOP.
ETIOLOGY
(A) Predisposing risk factors. These can be divided into anatomical and general factors:
I. Anatomical factors. Eyes anatomically predisposed to develop primary angle-closure glaucoma (PACG) include:
Hypermetropic eyes with shallow anterior chamber.
Eyes in which iris-lens diaphragm is placed anteriorly.
Eyes with narrow angle of anterior chamber, which may be due to: small eyeball, relatively large size of the lens and smaller diameter of the cornea or bigger size of the ciliary body.
Plateau iris configuration.
II. General factors include:
Age. PACG is comparatively more common in 5th decade of life.
Sex. Females are more prone to get PACG than males (male to female ratio is 1:4)
Type of personality. It is more common in nervous individuals with unstable vasomotor system.
Season. Peak incidence is reported in rainy season.
Family history. The potential for PACG is generally believed to be inherited.
Race. In caucasians, PACG accounts for about 6% of all glaucomas and presents in sixth to seventh decade. It is more common in South-East Asians, Chinese and Eskimos but uncommon in Blacks. In Asians it presents in the 5th to 6th decade and accounts for 50% of primary adult glaucomas in this ethnic group.
(B) Precipitating factors. In an eye that is predisposed to develop angle closure glaucoma, any of the following factors may precipitate an attack:
Dim illumination, Emotional stress, Use of mydriatic drugs like atropine, cyclopentolate, tropicamide and phenylephrine.
(C) Mechanism of rise in IOP. The probable sequence of events resulting in rise of IOP in an anatomically predisposed eye is as follows:
First of all due to the effect of precipitating factors there occurs mid dilatation of the pupil which increases the amount of apposition between iris and anteriorly placed lens with a considerable pressure resulting in relative pupil block. Consequently the aqueous collects in the posterior chamber and pushes the peripheral flaccid iris anteriorly (Iris bombe), resulting in appositional angle closure due to iridocorneal contact.
Eventually there occurs rise in IOP which is transient to begin with. But slowly the appositional angle closure is converted into synechial angle closure (due to formation of peripheral anterior synechiae) and an attack of rise in IOP may last long.
In some cases a mechanical occlusion of the angle by the iris is sufficient to block the drainage of aqueous. For this reason the instillation of atropine in an eye with a narrow angle is dangerous, since it may precipitate an attack of raised IOP.
Wednesday, August 31, 2011
Herpes Zoster Ophthalmicus Medical Terminology
Medical terminology course explain about Herpes zoster ophthalmicus is an acute infection of Gasserian ganglion of the fifth cranial nerve by the varicella-zoster virus (VZV).
It constitutes approximately 10 percent of all cases of herpes zoster.
It is thought that, usually in elderly people (can occur at any age) with depressed cellular immunity, the virus reactivates, replicates and travels down along one or more of the branches of the ophthalmic division of the fifth nerve.
About 50 percent cases of herpes zoster ophthalmicus get ocular complications.
The Hutchinson's rule, which implies that ocular involvement is frequent if the side or tip of nose presents vesicles (cutaneous involvement of nasociliary nerve), is useful but not infallible.
Lesions of herpes zoster are strictly limited to one side of the midline of head.
Clinical phases of H. zoster ophthalmicus are :
1. Acute, which may totally resolve.
2. Chronic, which may persist for years.
3. Relapsing, where the acute or chronic lesions reappear sometimes years later.
It constitutes approximately 10 percent of all cases of herpes zoster.
Etiology
Varicella zoster virus. It is a DNA virus and produces acidophilic intranuclear inclusion bodies. It is neurotropic in nature.Comprehensive OPHTHALMOLOGY
Mode of infection. The infection is contracted in childhood, which manifests as chickenpox and the child develops immunity. The virus then remains dormant in the sensory ganglion of trigeminal nerve.It is thought that, usually in elderly people (can occur at any age) with depressed cellular immunity, the virus reactivates, replicates and travels down along one or more of the branches of the ophthalmic division of the fifth nerve.
Clinical features
In herpes zoster ophthalmicus, frontal nerve is more frequently affected than the lacrimal and nasociliary nerves.About 50 percent cases of herpes zoster ophthalmicus get ocular complications.
The Hutchinson's rule, which implies that ocular involvement is frequent if the side or tip of nose presents vesicles (cutaneous involvement of nasociliary nerve), is useful but not infallible.
Lesions of herpes zoster are strictly limited to one side of the midline of head.
Clinical phases of H. zoster ophthalmicus are :
1. Acute, which may totally resolve.
2. Chronic, which may persist for years.
3. Relapsing, where the acute or chronic lesions reappear sometimes years later.
Inflammations Of The Cornea Medical Terminology
Medical terminology online course explain about Inflammation of the cornea (keratitis) is characterised by corneal oedema, cellular infiltration and ciliary congestion.
It is difficult to classify and assign a group to each and every case of keratitis; as overlapping or concurrent findings tend to obscure the picture.
However, the following simplified topographical and etiological classifications provide a workable knowledge.
Topographical (morphological) classification:
(A) Ulcerative keratitis (corneal ulcer) Corneal ulcer can be further classified variously.
1. Depending on location:
(a) Central corneal ulcer
(b) Peripheral corneal ulcer
2. Depending on purulence:
(a) Purulent corneal ulcer or suppurative corneal
ulcer (most bacterial and fungal corneal ulcers
are suppurative).
(b) Non-purulent corneal ulcers (most of viral, chlamydial and allergic corneal ulcers are non-suppurative).
3. Depending upon association of hypopyon:
(a) Simple corneal ulcer (without hypopyon).
(b) Hypopyon corneal ulcer.
4. Depending upon depth of ulcer:
(a) Superficial corneal ulcer
(b) Deep corneal ulcer
(c) Corneal ulcer with impending perforation
(d) Perforated corneal ulcer.
5. Depending upon slough formation:
(a) Non-sloughing corneal ulcer
(b) Sloughing corneal ulcer
(B) Non-ulcerative keratitis.
1. Superficial keratitis:
(a) Diffuse superficial keratitis
(b) Superficial punctate keratitis (SPK)
2. Deep keratitis:
(a) Non-suppurative
(i) Interstitial keratitis
(ii) Disciform keratitis
(iii) Keratitis profunda
(iv) Sclerosing keratitis
(b) Suppurative deep keratitis
(i) Central corneal abscess
(ii) Posterior corneal abscess.
Etiological classification:
1. Infective keratitis:
(a) Bacterial
(b) Viral
(c) Fungal
(d) Chlamydial
(e) Protozoal
(f) Spirochaetal
2. Allergic keratitis
(a) Phlyctenular keratitis
(b) Vernal keratitis
(c) Atopic keratitis
3. Trophic keratitis
(a) Exposure keratitis
(b) Neuroparalytic keratitis
(c) Keratomalacia
(d) Atheromatous ulcer
4. Keratitis associated with diseases of skin and mucous membrane.
5. Keratitis associated with systemic collagen vascular disorders.
6. Traumatic keratitis, which may be due to mechanical trauma, chemical trauma, thermal burns, radiations.
7. Idiopathic keratitis e.g:
(a) Mooren's corneal ulcer
(b) Superior limbic keratoconjunctivitis
(c) Superficial punctate keratitis of Thygeson.
Classification
It is difficult to classify and assign a group to each and every case of keratitis; as overlapping or concurrent findings tend to obscure the picture.
However, the following simplified topographical and etiological classifications provide a workable knowledge.
Topographical (morphological) classification:
(A) Ulcerative keratitis (corneal ulcer) Corneal ulcer can be further classified variously.
1. Depending on location:
(a) Central corneal ulcer
(b) Peripheral corneal ulcer
2. Depending on purulence:
(a) Purulent corneal ulcer or suppurative corneal
ulcer (most bacterial and fungal corneal ulcers
are suppurative).
(b) Non-purulent corneal ulcers (most of viral, chlamydial and allergic corneal ulcers are non-suppurative).
3. Depending upon association of hypopyon:
(a) Simple corneal ulcer (without hypopyon).
(b) Hypopyon corneal ulcer.
4. Depending upon depth of ulcer:
(a) Superficial corneal ulcer
(b) Deep corneal ulcer
(c) Corneal ulcer with impending perforation
(d) Perforated corneal ulcer.
5. Depending upon slough formation:
(a) Non-sloughing corneal ulcer
(b) Sloughing corneal ulcer
(B) Non-ulcerative keratitis.
1. Superficial keratitis:
(a) Diffuse superficial keratitis
(b) Superficial punctate keratitis (SPK)
2. Deep keratitis:
(a) Non-suppurative
(i) Interstitial keratitis
(ii) Disciform keratitis
(iii) Keratitis profunda
(iv) Sclerosing keratitis
(b) Suppurative deep keratitis
(i) Central corneal abscess
(ii) Posterior corneal abscess.
Etiological classification:
1. Infective keratitis:
(a) Bacterial
(b) Viral
(c) Fungal
(d) Chlamydial
(e) Protozoal
(f) Spirochaetal
2. Allergic keratitis
(a) Phlyctenular keratitis
(b) Vernal keratitis
(c) Atopic keratitis
3. Trophic keratitis
(a) Exposure keratitis
(b) Neuroparalytic keratitis
(c) Keratomalacia
(d) Atheromatous ulcer
4. Keratitis associated with diseases of skin and mucous membrane.
5. Keratitis associated with systemic collagen vascular disorders.
6. Traumatic keratitis, which may be due to mechanical trauma, chemical trauma, thermal burns, radiations.
7. Idiopathic keratitis e.g:
(a) Mooren's corneal ulcer
(b) Superior limbic keratoconjunctivitis
(c) Superficial punctate keratitis of Thygeson.
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