Tuesday 16 October 2007

LITUK UNDER QNTUM SEIGE-AD HOC


//////////////////SIKHS IN UK=0.6%



////////////////////Glycaemic control in type 1 diabetes and infant birth weight
Commentary by Dr G. Hawthorne
Large–for–gestational–age infants (birth weight ≥ 90th centile) are the most common complication in the pregnancies of women with type 1 diabetes, and are associated with increased morbidity of both mother and child



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17 Reasons Why Having Sex Is Good for Your HealthOctober 4, 2007 – 3:41 pm
Sex seems to be more than a hormonal discharge and some short moments of pure pleasure. Scientists show that sex is extremely beneficial for our health, while the lack of an active sex life might have negative effects. But too much sex, can also be harmful: more than thrice a week it can weaken the immune system, making us vulnerable to infections…
1. Our mental and emotional health balance is clearly influenced by sex. Abstinence is known to cause from anxiety to paranoia and depression… In fact, in case of light depressions, after having sex the brain releases endorphins, that decrease stress, inducing a state of euphoria.
2. Sex can be a beauty treatment. While having sex, a woman’s body doubles the estrogen level, and this makes her hair shine and the skin becomes softer.
3. A 10-year research carried on 1,000 middle-aged men at Queens University in Belfast, Ireland, showed that sex on a regular basis increases the humans’ lifespan. For the same age and health, those who had orgasms more frequently had half the death rate of men who did not have such frequent orgasms. This could be due to the plummeting stress hormones, reaction that installs after we have sex.
3. Sweating while having sex cleanse the skin pores, making the skin brighter and decreasing the risk of developing dermatitis.
4. Sex can make us lose weight. You burn all that fat and carbohydrates from the romantic dinner. Quickies of 20 minutes weekly mean 7 500 calories annually, that’s as much as you consume on 120 km (745 mi) of jogging. A sex session can burn about 200 calories. This is like running 15 minutes on a treadmill!
5. Sex strengthen our muscles. You can imagine the effort made by your muscles through those pushes and flexions. It depends on your stunts in bed, of course. And it’s clearly a lot more fun than running for miles.
6. The more active your sex life is, the more attractive for the opposite sex you are. High sexual activity makes the body release more pheromones, chemicals that attract the opposite sex.
7. Sex sharpens our senses, at least the smell. Following the orgasm, a rise of the hormone prolactin makes the brain’s stem cells form new neurons in the olfactory bulb, boosting a person’s olfactory abilities.
8. Sex is also a pain reliever, ten times more effective than Valium: immediately before orgasm, levels of the hormone oxytocin rise by five times, determining a huge release of endorphins. These chemicals calm pain, from a minor headache to arthritis or migraines, and with no secondary effects. Migraines also disappear because the pressure in the brain’s blood vessels is lowered while we have sex. So now we see that actually, a woman’s headache is rather a good reason for having sex, not against it.
9. Kissing your partner daily means less visits to dentist. Kissing stimulates salivation, which cleanses food left between the teeth and lowers the acidity in the mouth, the main cause of the tooth decay.
10. A good sex session can be a good remedy against stiff nose, being a natural antihistaminic that helps combating asthma and high fever.
11. Having sex regularly drops the cholesterol level, balancing the ratio good cholesterol: bad cholesterol.
12. The hormones released while we have sex helps both men and women; estrogen protects a woman’s heart but on the long term, it can be efficient also against Alzheimer’s disease and osteoporosis while testosterone strengthens the bones and muscles.
13. Sex is not beneficial not only for the heart, but also for the blood circulation, especially in the brain, because of the increased heart rate and deep breathing.
14. The sexual activity lowers the risk of getting colds and the flu. 1-2 intercourses weekly means 30 % higher levels of the antibody immunoglobulin A, that spurs the immune system.
15. Sex leads to a better control of the bladder, by strengthening the pelvis muscles controlling the flow of urine.
16. After orgasm, especially in the evening, we become sleepy. This is the effect of some good sex: it increases sleep quality. Following an orgasm, the body of both males or females becomes completely relaxed, so they may have a good deep sleep.
17. Sex fights cancer! Various researches have shown that a high ejaculation frequency and sexual activity are linked to a lower risk of prostate cancer later in life. A study found out that men who ejaculated 13 to 20 times monthly presented a 14% lower risk of prostate cancer than men who ejaculated on average, between 4 and 7 times monthly for most of their adult life. Those ejaculating over 21 times a month presented a 33% decreased risk of developing prostate cancer than the baseline group.


///////////////////////////It may be useful to know what the PaCO2 is from time to time in order toinform your discussions with the parents about overall progress, especiallyif the infant is drifting towards chronic lung disease. Paul CrawshawSt Peter's, Chertsey -----Original Message-----From: discussion rcpch [mailto:discussion@listserv.rcpch.ac.uk] On Behalf OfSanjeev DeshpandeSent: 15 October 2007 19:05To: discussion rcpchSubject: Re: Blood Gases and NCPAP In the absence of any evidence, the best practice would be to do an investigation (including blood gas) if it is likely to alter the management. For a stable baby on NCPAP in minimal (<30%)> Hi>> I would be interested to know what is considered best> practice with> regard to the monitoring of blood gases in babies who are> stable on> NCPAP with minimal oxygen requirements.>> Does your unit monitor blood gases if the patient is> stable?>> if you monitor blood gases regularly how frequently do you> measure blood> gases>> Do you have any evidence to support your practice?>> Regards>> Mary Ledwidge>> Consultant Paediatrician>> Altnagelvin Area Hospital>> Western Health and Social Care Trust>




/////////////////////FITS AND FUNNY TURNS=ADC


EPILEPSY TO FUNNY TURNS=1 TO 3


SyncopeThe commonest cause of a non-epileptic spell was syncope, accounting for approximately 42% of all diagnoses. Syncopes are events caused by "a sudden reduction in cerebral perfusion by oxygenated blood, either from a reduction in cerebral blood flow itself or from a drop in the oxygen content (or a combination of the two)".8 One hundred children had a final clinical diagnosis of syncope (median age 9 years, range 8 months to 16 years), with girls (n = 55) represented more than boys (n = 45). Twenty two were seen after a single event and 78 after recurring events.
Thirty five children had syncopal events in set situations; for example, getting out of bed or having hair care. Specific immediate triggers for syncope were common (77/100 children); 34 occurred after minor injury, including immunisation or blood tests; 26 with orthostatic stresses, for example, standing still or standing from sitting; 9 if wishes were thwarted; 9 with sudden surprises/shocks; 8 after seeing blood; 4 with exercise; and 2 with "semantic syncope"—that is, in response to a gory story or the word "testicles". Twenty seven children had more than one trigger. Auras included light-headedness, visual disturbance, feeling hot and sweaty, and nausea. Eighty seven children followed auras with loss of consciousness. Forty five of these had at least one anoxic seizure (tonic posturing and/or clonic or myoclonic jerking), 32 of which were triggered ("reflex"); the age distribution for this subgroup was similar to that for the syncopal group as a whole (median 9 years, range 1–15 years). Post-syncopal symptoms varied from immediate or rapid recovery (n = 27) to combinations of nausea, vomiting, headache, confusion, and drowsiness for minutes or hours.
Clinically the mechanisms of syncope were prolonged expiratory apnoea (n = 8), vagally mediated (n = 54), orthostatic (n = 22), or unclear (n = 16).6 Most patients had an electrocardiogram (ECG) (n = 82); only one showed an abnormality (borderline prolonged QT interval). One MRI brain scan was performed because of a coincidental history of complicated migraine. Two children with recurring events were referred to a paediatric cardiologist.
PsychologicalEpisodic spells due to psychological causes were common (n = 31). The median age of onset was 12 years (range 2–16 years), with more girls (n = 18) than boys (n = 13). Pseudoseizures (non-epileptic events or illness behaviour presenting as seizures) occurred in five cases and indicated significant psychopathology. Other psychological causes included panic attacks, temper tantrums, and uncharacteristic unusual behaviours, for example, amnesia after thumping best friend.
MiscellaneousThirty one children had events with various causes (see fig 4). These included non-kinesogenic paroxysmal choreoathetosis, kinesogenic paroxysmal choreoathetosis, benign tonic up gaze of infancy, jitteriness, delirium, and Sandifer syndrome. Three babies had the characteristic features of benign neonatal sleep myoclonus. Three children with poorly controlled asthma presenting as dizziness and breathlessness on exertion were included in this group. Unusual causes such as a baby groaning in sleep and a baby with recurrent distress/colic due to milk intolerance were also included.

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Figure 4 Miscellaneous diagnoses (n = 31).
DaydreamsChildren who daydream are sometimes referred because of concern that they may have childhood absence epilepsy. In this series 20 children with daydreams were seen (median age 8 years, range 6 months to 13 years). In 16 of these children EEGs were performed, all of which were normal. Elements in the history suggesting daydreams rather than childhood absence epilepsy included male sex, situational events, lack of eyelid movements during events, and prolonged "absences" (more than a few seconds). Children who daydream were also more likely to have attentional problems, learning difficulties, or hearing impairment.
Night terrorsSeventeen children had a history of waking with a combination of fear, distress, confusion, and often somnambulism within two hours or so of going to sleep. Characteristically there was a single event only per night. Boys (n = 11) were affected more than girls (n = 6), the median age of onset was 7 years (range 1–11 years), and there was often a long history before presentation (average duration of symptoms 22.8 months). Four children had routine EEG and one had a sleep EEG. Chlorpheniramine was prescribed for one child and trimeprazine for another.
MigraineTwelve children (median age 13 years, range 6–15 years) were seen with migraine, often involving symptoms including dizziness, nausea, paresthesiae, and visual disturbance. EEGs (n = 7) and CT brain scans (n = 7) were requested in children with suspected focal seizures or basilar migraine. Alice in Wonderland syndrome, a migraine variant involving intermittent micropsia or macropsia or other distortions of visual perception, was diagnosed in a further four children.
Benign paroxysmal vertigoNine children (median age 3 years, range 1–11 years) presented with abrupt episodes of vertigo without loss of consciousness, which settled with time. The possibility of focal seizures warranted an EEG and ECG in two children. One child was referred to an audiologist with hyperacusis, and another to an ENT specialist with possible vestibular dysfunction associated with recurrent ear infection.
Ritualistic movementsEight children (median age 2 years, range 1–6 years) presented with repetitive manneristic behaviours, often with a glazed, contented expression. Average duration of symptoms at presentation was 22 months. Included in this group were three girls with episodes involving rocking pelvic movements and a glazed expression thought to be gratification phenomena. Most children could be easily distracted out of these spells.
Exaggerated parental anxiety/fabricated illnessSix children were seen with factitious seizures. Parents either gave good descriptions of seizures, which could not be independently verified, or remained convinced of the diagnosis of epilepsy despite reassurance that this was not the case after full evaluation. In four cases parents eventually demurred and gave up the diagnosis, but two required social services intervention.
Unclassified eventsAn "unclassified event" was defined by the following criteria:
No clear epileptic or non-epileptic diagnosis made
No active treatment given
Child well between events
Normal physical examinations on repeated occasions
Follow up in clinic until events cease or become very infrequent
Family and doctor reassured about absence of significant pathology.




///////////////////NYSTAGMUS

EMED

Medical/Legal Pitfalls:
The principal medical/legal pitfall in the management of acquired nystagmus is related to misdiagnosis of a serious or life-threatening etiology. Life-threatening causes of nystagmus should first be ruled out with a pertinent history and physical examination. Appropriate consultation and/or imaging should be obtained without delay if a serious underlying cause is suspected.
Special Concerns:
Bruns nystagmus
The first manifestation of slow-growing cerebello-pontine angle tumors (eg, acoustic neurinoma, exophytic brain stem glioma, cerebellar tumors, metastases) may be a vestibular nystagmus associated with peripheral vestibular symptoms. Peripheral vestibular nystagmus has a horizontal jerk component with the fast phase directed away from the side of the lesion. In addition, an ipsilateral, slow, gaze-evoked nystagmus with gaze to the side of the lesion may be seen as the tumor expands to compress the brain stem. A small amplitude rapid jerk nystagmus in primary position with the fast phase directed away from the side of the lesion in combination with a slow, gaze-evoked nystagmus directed toward the side of the lesion suggests a mass compressing the brain stem with peripheral vestibular nerve involvement. This is known as Bruns nystagmus.
Acquired nystagmus most often is a result of vestibular dysfunction. A resting tone is present in the vestibular system, even when the head is at rest. Therefore, any loss of neural activity on either side from a pathologic process (eg, mass lesion, ischemia) results in a relative overexcitation of the contralateral side, causing the eyes to drift toward the side of the lesion (ie, nystagmus with the fast phase away from the lesion).




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Acarophobia
Fear of itching or of the insects that cause itching.
Aerophobia
Fear of drafts, air swallowing, or airbourne noxious substances.
Aeroacrophobia
Fear of open high places.
Aeronausiphobia
Fear of vomiting secondary to airsickness.
Agoraphobia
Fear of open spaces or of being in crowded, public places like markets. Fear of leaving a safe place.
Agyrophobia
Fear of streets or crossing the street.
Aichmophobia
Fear of needles or pointed objects.
Ailurophobia
Fear of cats.
Alektorophobia
Fear of chickens.
Alliumphobia
Fear of garlic.
Amaxophobia
Fear of riding in a car.
Amychophobia
Fear of scratches or being scratched.
Anginophobia
Fear of angina, choking or narrowness.
Anglophobia
Fear of England, English culture, etc.
Angrophobia
Fear of anger or of becoming angry.
Anthropophobia
Fear of people or society.
Aphenphosmphobia
Fear of being touched. (Haphephobia)
Arachibutyrophobia
Fear of peanut butter sticking to the roof of the mouth.
Astrophobia
Fear of stars and celestial space.
Asymmetriphobia
Fear of asymmetrical things.
Ataxiophobia
Fear of ataxia (muscular incoordination)
Atelophobia
Fear of imperfection.
Atomosophobia
Fear of atomic explosions.
Automatonophobia
Fear of ventriloquist's dummies, animatronic creatures, wax statues
Bacillophobia
Fear of microbes.
Bacteriophobia
Fear of bacteria.
Batophobia
Fear of heights or being close to high buildings.
Batrachophobia
Fear of amphibians, such as frogs, newts, salamanders, etc.
Belonephobia
Fear of pins and needles. (Aichmophobia)
Cancerophobia
Fear of cancer.
Carcinophobia
Fear of cancer.
Catagelophobia
Fear of being ridiculed.
Catapedaphobia
Fear of jumping from high and low places.
Cheimaphobia or Cheimatophobia
Fear of cold.
Chemophobia
Fear of chemicals or working with chemicals.
Chiraptophobia
Fear of being touched.
Cholerophobia
Fear of anger or the fear of cholera.
Chorophobia
Fear of dancing.
Chromophobia or Chromatophobia
Fear of colors.
Chronophobia
Fear of time.
Chronomentrophobia
Fear of clocks.
Claustrophobia
Fear of confined spaces.
Cleithrophobia or Cleisiophobia
Fear of being locked in an enclosed place.
Climacophobia
Fear of stairs, climbing or of falling downstairs.
Clithrophobia or Cleithrophobia
Fear of being enclosed.
Cometophobia
Fear of comets.
Coimetrophobia
Fear of cemeteries.
Coitophobia
Fear of coitus.
Coprastasophobia
Fear of constipation.
Coprophobia
Fear of feces.
Coulrophobia
Fear of clowns.
Counterphobia
The preference by a phobic for fearful situations.
Cremnophobia
Fear of precipices.
Cryophobia
Fear of extreme cold, ice or frost.
Crystallophobia
Fear of crystals or glass.
Cyberphobia
Fear of computers or working on a computer.
Cyclophobia
Fear of bicycles.
Decidophobia
Fear of making decisions.
Deipnophobia
Fear of dining or dinner conversations.
Demophobia
Fear of crowds. (Agoraphobia)
Dextrophobia
Fear of objects at the right side of the body.
Didaskaleinophobia
Fear of going to school.
Dikephobia
Fear of justice.
Doxophobia
Fear of expressing opinions or of receiving praise.
Dromophobia
Fear of crossing streets.
Dutchphobia
Fear of the Dutch.
Dysmorphophobia
Fear of deformity.
Dystychiphobia
Fear of accidents.
Ecclesiophobia
Fear of church.
Electrophobia
Fear of electricity.
Elurophobia
Fear of cats. (Ailurophobia)
Enochlophobia
Fear of crowds.
Enosiophobia or Enissophobia
Fear of having committed an unpardonable sin or of criticism.
Entomophobia
Fear of insects.
Ergasiophobia
1) Fear of work or functioning. 2) Surgeon's fear of operating.
Erythrophobia, Erytophobia or Ereuthophobia
1) Fear of redlights. 2) Blushing. 3) Red.
Felinophobia
Fear of cats. (Ailurophobia, Elurophobia, Galeophobia, Gatophobia)
Francophobia
Fear of France, French culture. (Gallophobia, Galiophobia)
Frigophobia
Fear of cold, cold things.
Galeophobia or Gatophobia
Fear of cats.
Gallophobia or Galiophobia
Fear France, French culture. (Francophobia)
Geniophobia
Fear of chins.
Gephyrophobia, Gephydrophobia, or Gephysrophobia
Fear of crossing bridges.
Germanophobia
Fear of Germany, German culture, etc.
Glossophobia
Fear of speaking in public or of trying to speak.
Haphephobia or Haptephobia
Fear of being touched.
Hellenologophobia
Fear of Greek terms or complex scientific terminology.
Heresyphobia or Hereiophobia
Fear of challenges to official doctrine or of radical deviation.
Herpetophobia
Fear of reptiles or creepy, crawly things.
Hierophobia
Fear of priests or sacred things.
Hormephobia
Fear of shock.
Homophobia
Fear of sameness, monotony or of homosexuality or of becoming homosexual.
Hydrargyophobia
Fear of mercurial medicines.
Iatrophobia
Fear of going to the doctor or of doctors.
Insectophobia
Fear of insects.
Isopterophobia
Fear of termites, insects that eat wood.
Ithyphallophobia
Fear of seeing, thinking about or having an erect penis.
Japanophobia
Fear of Japanese.
Katagelophobia
Fear of ridicule.
Kenophobia
Fear of voids or empty spaces.
Kolpophobia
Fear of genitals, particularly female.
Kosmikophobia
Fear of cosmic phenomenon.
Leukophobia
Fear of the color white.
Lilapsophobia
Fear of tornadoes and hurricanes.
Lockiophobia
Fear of childbirth.
Logizomechanophobia
Fear of computers.
Lygophobia
Fear of darkness.
Lyssophobia
Fear of rabies or of becoming mad.
Mageirocophobia
Fear of cooking.
Maieusiophobia
Fear of childbirth.
Mechanophobia
Fear of machines.
Medomalacuphobia
Fear of losing an erection.
Medorthophobia
Fear of an erect penis.
Melanophobia
Fear of the color black.
Melophobia
Fear or hatred of music.
Metathesiophobia
Fear of changes.
Methyphobia
Fear of alcohol.
Microbiophobia
Fear of microbes. (Bacillophobia)
Misophobia
Fear of being contaminated with dirt of germs.
Molysmophobia or Molysomophobia
Fear of dirt or contamination.
Musophobia or Murophobia
Fear of mice.
Mysophobia
Fear of germs or contamination or dirt.
Nebulaphobia
Fear of fog. (Homichlophobia)
Nephophobia
Fear of clouds.
Nosophobia or Nosemaphobia
Fear of becoming ill.
Nucleomituphobia
Fear of nuclear weapons.
Obesophobia
Fear of gaining weight.(Pocrescophobia)
Ochlophobia
Fear of crowds or mobs.
Ochophobia
Fear of vehicles.
Onomatophobia
Fear of hearing a certain word or of names.
Opiophobia
Fear medical doctors experience of prescribing needed pain medications for patients.
Pagophobia
Fear of ice or frost.
Paralipophobia
Fear of neglecting duty or responsibility.
Parturiphobia
Fear of childbirth.
Peccatophobia
Fear of sinning. (imaginary crime)
Pediculophobia
Fear of lice.
Pedophobia
Fear of children.
Phalacrophobia
Fear of becoming bald.
Phallophobia
Fear of a penis, esp erect.
Pharmacophobia
Fear of taking medicine.
Phonophobia
Fear of noises or voices or one's own voice; of telephones.
Phthiriophobia
Fear of lice. (Pediculophobia)
Phthisiophobia
Fear of tuberculosis.
Pnigophobia or Pnigerophobia
Fear of choking of being smothered.
Poliosophobia
Fear of contracting poliomyelitis.
Politicophobia
Fear or abnormal dislike of politicians.
Porphyrophobia
Fear of the color purple.
Potophobia
Fear of alcohol.
Pharmacophobia
Fear of drugs.
Proctophobia
Fear of rectum.
Psychrophobia
Fear of cold.
Pteronophobia
Fear of being tickled by feathers.
Rectophobia
Fear of rectum or rectal diseases.
Rhabdophobia
Fear of being severely punished or beaten by a rod, or of being severely criticized. Also fear of magic.(wand)
Rhypophobia
Fear of defecation.
Scabiophobia
Fear of scabies.
Scatophobia
Fear of fecal matter.
Scolionophobia
Fear of school.
Scotophobia
Fear of darkness. (Achluophobia)
Scriptophobia
Fear of writing in public.
Seplophobia
Fear of decaying matter.
Sinophobia
Fear of Chinese, Chinese culture.
Sitophobia or Sitiophobia
Fear of food or eating. (Cibophobia)
Social Phobia
Fear of being evaluated negatively in social situations.
Sociophobia
Fear of society or people in general.
Soteriophobia
Fear of dependence on others.
Spacephobia
Fear of outer space.
Spectrophobia
Fear of specters or ghosts.
Staurophobia
Fear of crosses or the crucifix.
Stenophobia
Fear of narrow things or places.
Suriphobia
Fear of mice.
Taphephobia Taphophobia
Fear of being buried alive or of cemeteries.
Tapinophobia
Fear of being contagious.
Technophobia
Fear of technology.
Teleophobia
1) Fear of definite plans. 2) Religious ceremony.
Teratophobia
Fear of bearing a deformed child or fear of monsters or deformed people.
Tetanophobia
Fear of lockjaw, tetanus.
Textophobia
Fear of certain fabrics.
Thalassophobia
Fear of the sea.
Tocophobia
Fear of pregnancy or childbirth.
Tomophobia
Fear of surgical operations.
Topophobia
Fear of certain places or situations, such as stage fright.
Toxiphobia or Toxophobia or Toxicophobia
Fear of poison or of being accidently poisoned.
Trichinophobia
Fear of trichinosis.
Trichopathophobia or Trichophobia or Hypertrichophobia
Fear of hair. (Chaetophobia)
Tropophobia
Fear of moving or making changes.
Trypanophobia
Fear of injections.
Tuberculophobia
Fear of tuberculosis.
Vaccinophobia
Fear of vaccination.
Vestiphobia
Fear of clothing.
Wiccaphobia
Fear of witches and witchcraft.
Xanthophobia
Fear of the color yellow or the word yellow.
Xylophobia
1) Fear of wooden objects. 2) Forests.
/////////////////////sickle cell an in INDIA=TRIBAL AREA OF MAHARASHTRA
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