Friday, March 13, 2020
Craniotomy of Tumors Essay Example Craniotomy of Tumors Paper Craniotomy of Tumors Paper Surgeries pertaining to the brain for tumor removal are commonly done thru craniotomy. Craniotomy is also performed to examine the brain, remove a blood clot, manage hemorrhage, do biopsy, or to ease pressure inside the skull. The same with other surgeries, the patient will undergo diagnostic procedures prior to craniotomy like: computed tomography scans (CT) or magnetic resonance imaging (MRI) scans. This is done to determine the underlying problem that required the craniotomy as well as to get a better view at the brainÃ¢â¬â¢s structure. Angiography of the cerebrum may also be utilized to study the blood supply to the tumor, aneurysm, or other brain lesion. In the case of a tumor in the occipital lobe, the skull will be opened by making a curving incision at the nape of the neck around the occipital lobe. This paper discusses the procedure for a 40-year old, quadriplegic and HIV positive patient. Preparation of the Patient The patient is usually given drugs to ease anxiety. Other medications to reduce the risk of swelling, seizures and infection after the operation may be administered as well. Before and during the surgery, fluids will be restricted; a diuretic may be given if the patient is prone to retaining fluids. Intake of food or drink will not be permitted past midnight the night before surgery. The patient is admitted the morning of the procedure. Catheter will be inserted prior to patient going to the operating room. Since the patient is HIV positive, it is best that the patientÃ¢â¬â¢s schedule of operation/surgery will be the latest surgery for the day. Double gloving among the operating room staffs and surgeons should be imperative. Extra care in handling blood and body fluids should be maintained. Being quadriplegic, the patient will then be positioned in a modified fowlerÃ¢â¬â¢s position HOB elevated 15-20? , patient on his lateral side. During the Procedure General anesthesia is given while the patient lies on the operating table. The head is positioned in a 3-pin skull fixation device once the patient is asleep. The device, which is attached to the table, holds the patientÃ¢â¬â¢s head in position during the procedure. A lumbar drain is inserted in the patientÃ¢â¬â¢s lower back to help remove cerebrospinal fluid (CSF) that allows the brain to relax during surgery. Additional support may be placed due to the patientÃ¢â¬â¢s quadriplegic condition. A skin incision behind the hairline is made after the patientÃ¢â¬â¢s scalp has been prepped with an antiseptic. The surgeon makes the incision as far as the thin membrane covering the skull. Many small arteries have to be sealed by surgeon since the scalp is well supplied with blood. The skin flap is then folded back to expose the bone. A circle of holes is made in the skull with a hand drill or a craniotome. A fine wire saw is inserted through the holes by the surgeon to cut the outline of a bone flap to expose the brain. The cut bone flap is taken off exposing the brain protective covering called the dura (Mayfield clinic, 2009). The bone flap is saved until it is replaced at the end of the procedure. Surgery of the underlying cause then commences. The surgeon opens the dura using surgical scissors and exposes the brain. Retractors are used to gently expose a passage to the section needing surgery (restoration or removal). Various very small instruments and tools are used by the surgeon due to the difficulty of moving tissues aside to perform the repair or removal procedure. This is due to the compact structure of the brain. Evoked potential monitoring is oftentimes used to preserve the nerve functions and to ensure that it will not be additionally damaged in the surgery. This is accomplished by stimulating specific cranial nerves while monitoring brain responses. The retractors holding the brain are taken off after the surgery for the underlying cause has been completed and the dura is closed with stitches. The bone flap is put back in its original position and secured with titanium plates and screws. The plates and screws will remain permanently to support the area. In some instances, a drain is placed under the skin for a couple of days to take away blood or fluid from the repaired area. Finally, the surgeon stitches back the membrane, muscle and skin of the scalp together. A soft adhesive or turban-like dressing is placed over the incision. Post Surgery The patient is taken to the recovery room after surgery and vital signs are monitored as the patient regains consciousness (from anesthesia). Oxygen supply remains until the patient fully recovers. Since the patient is HIV positive, constant monitoring is required since the patient is immuno-compromised. Painkillers and drugs are given after the operation to manage any swelling and seizures that may arise are after the operation. Codeine may be given to relieve the headache and nausea that may occur as a result of stretching or irritation of the nerves of the scalp that happens during the craniotomy. An anticonvulsant medication to prevent seizure may also be given. Patient hospital discharge varies from only 2 days to 2 weeks depending on the surgery and complications. In this case, a high probability of complication might develop due to the patient being HIV positive. The bandage on the skull is changed regularly. Stitches or staples are removed 7Ã¢â¬â10 days after surgery in the doctorÃ¢â¬â¢s office. The patient should avoid getting the scalp wet until all the sutures have been removed. A clean cap or scarf can be worn until the hair grows back Reference Mayfield clinic. (2009, January). Craniotomy. Retrieved March 6, 2009, from mayfieldclinic. com/PE-Craniotomy. htm The surgeon marks with a felt tip pen a large square flap on the scalp that covers the surgical area. Following this mark, the surgeon makes an incision into the skin as far as the thin membrane covering the skull bone. Because the scalp is well supplied with blood, the surgeon will have to seal many small arteries. The surgeon then folds back a skin flap to expose the bone. Using a high speed hand drill or an automatic craniotome, the surgeon makes a circle of holes in the skull, and pushes a soft metal guide under the bone from one hole to the next. A fine wire saw is then moved along the guide channel under the bone between adjacent holes. The surgeon saws through the bone until the bone flap can be removed to expose the brain. After the surgery for the underlying cause is completed, the piece of skull is replaced and
Wednesday, February 26, 2020
Chicago Bulls and DNA Testing - Essay Example As the discussion outlines, a DNA test would have detected any anomalies in their systems and would have given the clubÃ¢â¬â¢s medical team a head`s up and thus prevented these situations. It is crucial for professional athletes especially the ones whose families have a history of these diseases and complications to undergo a DNA test. Examples of such diseases include heart diseases, blood pressure complications, asthma and hypertension. If the symptoms are detected, the medical team can determine if the athlete should be allowed to play or not, it all depends on how the level of the threat posed by the discovered signs is handled. There are no clear laws that prohibit or disallow DNA testing although some players feel that the club asking for a DNA test is abusing its powers. The club and the affected individuals to decide on whether the test should be conducted. Clubs and professional sports associations conduct DNA tests for different reasons. Some clubs especially in Major Lea gue Baseball conduct these tests to insulate themselves from lawsuits and spending of millions of dollars on players` medical bills and lawsuits. In the recent past, sports prospects from the Dominican Republic often lie about their age to gain access in the United States where they are offered millions of dollars only to find out that the player lied about his age and name. Clubs also perform the tests to prevent any future situation that may arise from earlier detected complications and spare the fans from witnessing terrifying spectacles as players collapse while playing on the field. Some countries such as Australia have made strides that ensure predictive genetic information cannot be used to make decisions affecting employment and this law extends to professional sports.
Monday, February 10, 2020
The Business Cycle and Macroeconomic Objectives - Term Paper Example Recognition of the relationship of withdrawals and injections has also been made which allows better overview of the markets. The relationship of withdrawal and injections has shown an indirect link similar to the savings and investments, taxation and government expenditures. The last and most essentials element of this paper is the discussion of the circular flow of income and the four macroeconomic objectives i.e. a) Economic Growth, b) Reduced Unemployment, c) Rise of Inflation, and d) Deterioration of Balance of Payments. The figure below provides a view on the relationship of the four main objectives of macroeconomics. The figure shows how in a short term the four objectives, i.e. faster growth of output, lower unemployment, lower inflation and the avoidance of balance of payments deficits are related to each other (Sloman and Sutcliffe). The relationship depends on the aggregate demand which is influenced by each phase of the business. a) Expansionary Phase: In this phase (phase 2), the aggregate demand grows very rapidly and the gap between the potential output and actual output is relatively narrower. Here the growth in the output will be relatively rapid and the levels of unemployment will be faced with a drop as well. This provides a solution for two issues however it leads to the other two sectors to be faced with issues (Sloman and Sutcliffe). With the higher levels of shortages the inflation is also affected and this leads to the deteriorating balance of payments which in turn leads to the domestic goods being less competitive in the international markets. b) Peak: At phase three of the cycle i.e. the peak phase, the level of unemployment is at the lowest and the output of the company is at the highest level.
Thursday, January 30, 2020
International Terrorism Essay A majority of the international terrorist operations and strikes trace their root to the Asian Middle East region, which has become the cauldron of global terrorism. Since over two decades, the Middle East has turned into that most volatile, unstable and surcharged place in world, having seen two major armed conflicts and being home to a number of radical, hardliner and terrorist outfits, including Hamas, Hezbollah, and Al Qaeda. These outfits are collectively responsible for carrying a series of devastating terrorist attacks around the world, including 9/11, Madrid and London bombings, rocket attack on Israel and Mumbai carnage. The problem goes further deeper to reveal a simmering regional and sectarian discontent that further adds to the instability of the region. The common unifying thread among all of these factors is presence of ideological motivation of Islamic Jihad, which has made the entire issue extremely sensitive from political and religious angles. Hamas, Hezbollah and Islamic Jihad Both Hamas and Hezbollah have their origin rooted in conflict between Israel and Palestine since creation of Israel in 1948 (Lutz and Lutz, 2004). A majority of Arab and Middle Eastern countries protested IsraelÃ¢â¬â¢s creation and tried to liquidate the nation through armed intervention To represent the Palestinian cause, Palestine Liberation Organization emerged 1964, striving for liberation and demand of nationhood from Israel. The organization was formed when all the military and armed strengths of Arab nations was convincingly defeated by Israel in 1948 and 1956 wars and it was felt among radical sections of Palestine that only a guerilla tactics could work against a militarily superior Israel Lutz and Lutz, 2004) . Since its formation PLO worked as an umbrella organization, drawing support from various militant Islamic groups working in the area, chiefly Hamas which aims to create a completely Islamic state in the area. Unlike PLO, which has, in principal, favored religious tolerance and secularity as policy, Hamas has a clearly stated Islamic agenda, which draws support from other organizations of similar ideological base. Hamas is considered by several Western countries, including USA and Israel as a terrorist organization, and it is responsible for carrying out a series of strikes against Israel since its creation in 1987. Since 2002, Hamas has restructured itself to form a political organization and presently it is controlling the Gaza strip of PalestineÃ¢â¬â¢s territory (Morgan, 2005). Hezbollah is a Lebanon based political-resistance group, formed in 1982 to protest and struggle IsraelÃ¢â¬â¢s formation and its conflict with Lebanon (Albritton, 2006). Although, the outwardly the organization is involved in a number of social activities, such as running schools, hospitals, farming counseling services, the core characteristics of the organization have remained military. The organization is considered wholly or partly a terrorist outfit by USA and European nations due to its repeated involvement in terrorist attacks in Israel. Both Hamas and Hezbollah share a strong ideological bond in the concept of Islamic Jihad and they consider themselves committed to this cause. While in the religious terms, Jihad is a personal effort for purity, for all the practical purpose, it has evolved in the concept of Islamic supremacy and dominance over other believer sects. Proponents of Islamic Jihad advocate a sustained campaign, involving ideological and violent means in all degrees of extremity to the cause of complete elimination of non-believers (Morgan, 2005). The commitment to Islamic Jihad has infused both these organizations with radical elements and extended their involvement to various terrorist outfits, from Middle East to India and Indonesia, all of which justify their violent actions by theory of Jihad (Albritton, 2006; Merrit, Gilbert and Reinhart, 2004). Kurdish Conflict Kurdish conflict is one of the major political causes of disturbance in the Middle East. Kurds are a major ethnic-linguistic group spread across various countries of Middle East, specifically Iraq and Turkey where they form respectively 17 and 20 percent of the total population. The total Kurdish population is approximately 30 million, making them the fourth largest ethnic group in the region (Merrit, Gilbert and Reinhart, 2004). However, Kurdish community has a deep sense of grievance and resentment against the political framework of the Middle East, as they have been largely side tracked by almost all the political establishments; to aggravate the issue, some countries even tried to break down their sense of identity and forcibly merge them with rest of the population (Morgan, 2005). KurdÃ¢â¬â¢s persistent demands for identity, recognition and greater zone of influence in politics have brought them regularly in conflict with Middle Eastern political establishment which has tried to suppress repeatedly. Kurds are guided by a strong sense of nationality they view themselves as a distinct nation. In fact, there is a complete sentiment among Kurds, identifying themselves as separate clans with their distinct sense of nationality. This has led to several major Kurdish revolts in both Iraq and Turkey. Former IraqÃ¢â¬â¢s president, Saddam Hussein crushed a series of such revolts ruthlessly in 1980s, resulting in systematic murder of over 5000 Kurds (Lutz and Lutz, 2004). After the end of Saddam HusseinÃ¢â¬â¢s rule in second Gulf War of 2003-04, the Kurdish demand for independent homeland has intensified. This demand is supported by the entire Kurdish Diaspora who view a separate homeland as the only lasting and legitimate solution to the centuries of neglect, overlook and ignorance of Kurdish identity and culture by Iraq, Iran, and Turkey. Alarmed at this demand, the radical elements in these countries have collaborated with Islamic terrorist groups and carried out a number of terrorist attacks, that are aimed to wipe out the Kurdish leadership and cause fear in the community. However, the effect of these attacks has been largely opposite as it has led to the feeling among the Kurds that their own nation can be the only guarantee of their safety and security (Teson, 2005). Al Qaeda. Any mention of religious terrorism is incomplete without discussion on Islamic terrorism and jihad ideology which is widely held as the single most potent challenge to the democratic and free world. The most prominent actor in Islamic terrorism is Al Qaeda led by Osama Bin Laden, which has acquired the form of an international organization, recruiting members from all the Islamic nations and using them as against the Western and Asian democracies (Lutz and Lutz, 2004). Al Qaeda acts as veritable global terrorist organizations, with massive fund raising capabilities, central leadership style, and a network of dedicated sub units which are ready to strike at the behest of the central command. In studying the reach and influence of Al Qaeda, analysts found that the prime motivational force used by Bin Laden and other key terrorists in the organization is religious. The origin of Al Qaeda is traced back to early 1980s when then USSR invaded Afghanistan and Muslims fighters from around the Islamic world poured in Afghanistan to fight a war that was given an instant religious color. The religious cause did not lose its appeal for the fighters even after the war ended, and they looked for further challenges which, in their opinion, had contaminated the purified and hence medieval perception of Islam they held (Lutz and Lutz, 2004). This search brought them in immediate conflict with the secular world, which is epitomized by USA. In consequence, Al Qaeda network started targeting US military bases in Saudi Arabia, US embassies in Nairobi, Kenya and Dar-es-Salaam and US warships; the campaign reached its zenith in 9/11 airlines attacks, which was a watershed event in terrorism history (Lutz and Lutz, 2004). Despite US and British campaign against the Al Qaeda network, the organization continues recruit members from religious sympathizers and attack soft targets, as evidenced against recent terrorist attacks in Mumbai. USA has actively engaged itself to eliminate the threat of Al Qaeda, which is logically justifiable, as itÃ¢â¬â¢s partially responsible for creation of the terrorist network. Although there has been both international and domestic criticism against USAÃ¢â¬â¢s efforts to combat Al Qaeda in Afghanistan and its bordering areas, this strategy has paid dividends and it has severely undermined the organization (Teson, 2005). To completely eliminate the threat of Al Qaeda, a combination of military and political strategies is required where the terrorist network is attacked at its functional, operational and organizational level. USA should ensure the neutralization of Al Qaeda leadership and cadres and simultaneously hold meaningful dialogue with Islamic countries to desist their youths from joining the terror outfit.
Wednesday, January 22, 2020
Choir Changed My Life Freshmen year of High School changed my life for the better, although at first I was very reluctant to think so. My mom and her boyfriend had been commuting for two years after he was offered a much better job in Las Vegas. We decided it would be best for me to finish up middle school and freshman year of high school, head out for the gamblerÃ¢â¬â¢s city. This change was extreme for me and had I not gone, I would have never joined the choir, which is where this story begins. I walked into McKinney North High School (where all freshmen had to attend that year) and signed up for my first year of high school classes. My mom thought itÃ¢â¬â¢d be a good idea to join a club or an interactive, fun, and exciting class. I had my doubts at first, but I decided to join the school Choir. I wouldnÃ¢â¬â¢t have had much of a problem walking in on my first day, but Las Vegas schoolÃ¢â¬â¢s start a few weeks later than McKinneyÃ¢â¬ ¦so they were on their second nine weeks and had all gotten a chance to get to know each other. I on the other hand, walked in and silenced the room. Mr. Nelms, the Choir teacher, introduced me to the Choir and had me singÃ¢â¬ ¦in front of everyone. I was beyond nervous. Turns out I did OK and I was from then on, an alto. I realized I would be moving to McKinney High School from North after the re-zoning of schoolÃ¢â¬â¢s which I was actually very excited about. I had to face another new choir, and a new teacher Mr. Garms. Mr. NelmÃ¢â¬â¢s referred a handful of us to be in Concert Choir. It turns out I was one of the few. I was too nervous to accept, for I didnÃ¢â¬â¢t think I was Concert Choir material quite yet. Turns out I made a lot of friends in Chamber Singers (the choir I ended up in) and couldnÃ¢â¬â¢t of been happier with my decision to stay. I was put in Concert Choir again my Junior year but still didnÃ¢â¬â¢t think I was quite ready, so again I got out of it and stayed in Chamber. I became the leader of my Choir and was the best sight reader.
Tuesday, January 14, 2020
Many Filipinos, to this day, believe that what you eat and crave for during pregnancy has a direct influence on the physical attributes of the baby. However, scientific studies prove that there is no link between paglilihi and the unborn babyÃ¢â¬â¢s physical attributes. As Genetics tell us, our physical attributes are inherited from our parentsÃ¢â¬â¢ and grandparentsÃ¢â¬â¢ set of genes and not from food cravings. Reference: Lui B., Ã¢â¬Å"Five Health Myths Many Filipinos BelieveÃ¢â¬ , Filipinonurses.org (http://filipinonurses.org/index.php/2012/03/five-shocking-health-myths-that-most-filipinos-believe/); Ã¢â¬Å"Pregnant WomenÃ¢â¬ , Health Aspect (http://healthaspect.wordpress.com/tag/craving-paglilihi/). Myth #2: Post-labor Stomach Binding It is a common practice for Filipina women to bind their abdomen tightly after pregnancy, believing that this practice helps the uterus to retract and gets the stomach back into shape. However, scientific evidence suggests otherwise. Tying a cloth around oneÃ¢â¬â¢s tummy can put pressure on the uterus, causing it to bleed. It can also lead to further complications, especially if youÃ¢â¬â¢ve experienced a C-section. Evidence also suggests that a combination of diet and mild exercise is the best way to get back into shape after pregnancy. Reference: Ã¢â¬Å"Cultural dimensions of pregnancy, birth and post-natal careÃ¢â¬ , Queensland Government (http://www.health.qld.gov.au/multicultural/health_workers/filipino-preg-prof.pdf); Ã¢â¬Å"Will using a corset or tying a cloth around my stomach help it regain its pre-pregnancy shape?Ã¢â¬ , Baby Center (http://www.babycenter.in/x1049750/will-using-a-corset-or-tying-a-cloth-around-my-stomach-help-it-regain-its-pre-pregnancy-shape). Myth #3: Eating twin bananas may lead to twins This myth has many variations, with some claiming that bananas lead to regular twins while others insist on Siamese twins, which is a serious condition wherein twins are born with part of their bodies joined together. However, this myth has no scientific basis, as twin development happens purely by chance or because of your genes (for non-identical twins). Reference: Ã¢â¬Å"Pregnancy Myths and FactsÃ¢â¬ , Huggies PH (http://www.huggies.com.ph/pregnancy-myths-facts.aspx). Myth #4: Ã¢â¬Å"UsogÃ¢â¬ or the StrangerÃ¢â¬â¢s Evil Eye Usog is an age-old Filipino superstition. The belief states that discomfort (fever, bloating, nausea/vomiting) is brought to the baby by a stranger or visitor who is said to have an evil eye. A simple greeting from the visitor is said to be enough to cause this curse. To counter the curse, the stranger would need to say Ã¢â¬Å"pwera usogÃ¢â¬ while licking his thumb and applying saliva while tracing a cross on the infantÃ¢â¬â¢s forehead. Despite having no scientific basis or proof regarding the occurrences of usog, many superstitious Filipinos believe in the practice to this date. However, this superstition lacks scientific proof. Reference: Ina Atutubo, MD, Ã¢â¬Å"Is Ã¢â¬Å"UsogÃ¢â¬ for Real?Ã¢â¬ , Smart Parenting (http://www.smartparenting.com.ph/kids/baby/is-usog-for-real/page/2); Ã¢â¬Å"UsogÃ¢â¬ , Wikipedia (http://en.wikipedia.org/wiki/Usog) Despite the fact that many Filipino superstitions and myths lack scientific explanation, many mothers-to-be still follow them by the letter for two reasons: the Ã¢â¬Å"better to be safe than sorryÃ¢â¬ mentality, and out of respect for the elders or tradition. Some of these superstitions are harmless, but do take extra care and always consult with your OB-gyne before subjecting yourself or your baby to any healing or cleansing rituals. Keeping a healthy balance between modern medicine and Filipino culture will ensure a safe and healthy pregnancy.
Monday, January 6, 2020
Analyze the evidence that American politics is becoming more polarized. If so, is this a reaction to the polarization of political elites? Approx 1500 words 13/12/10 The election of 2008... marked the end of an epoch. No longer could Republicans count on the basic conservatism of the American people, the reflexive hostility to candidates who favour big government (Darman, 2010, 34) In the 1970s and 1980s there was a consensus that the importance of political parties was in decline, that the shared conservative ideology of the American electorate was reflected in the similar ideology and policy of the Democratic and Republican party. Now, however, the parties are seemingly taking on renewed importance as the population ofÃ¢â¬ ¦show more contentÃ¢â¬ ¦The red/ blue map shown in Figure one shows how modern Polarisation has manifested itself over the last four elections. The dark red and blue show that those states have voted Republican or democratic respectively all four times. Lighter shades show that party has won all but once, while purple shows states which have gone to the Republicans and Democrats twice each. On first glance this seems to back up the polarization theory, as Fiorina and Adams put it; when the 2004 election almost reproduced the 2000 map, belief in the polarization narrative peaked as social conservatives gloated about the purported importance of Ã¢â¬Å"values votersÃ¢â¬ for the re-election of President Bush, and liberal commentators bitterly accepted that interpretation.(2008, 564, 565) However when one examines the map in figure 2 which breaks down the 2008 election by county, rather than state. This map seems to throw an interesting side note onto the red state/ blue state theory. While there is seldom a completely red or blue dominated state, in terms of area covered on the map, there is far more covered by republican red. The fact that the democrats won the election with so much less area covered shows that the blue areas are high in population denstity- cities and large towns. Rather than Republican south versus Democratic coasts, Figure 2 indicatesShow MoreRelatedIs Political Polarization Good or Bad for American Politics and Government?963 Words Ã |Ã 4 PagesThomas Mann of Brookings Institutions writes that, Ã¢â¬Å"in addition to the decline in competition, American politics today is characterized by a growing ideological polarization between the two major partiesÃ¢â¬ . In addition to his opinion, political data has shown that political polarization is increasing and is more readily seen in the way the American government functions in the political sphere. 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