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This study is just a preliminary step toward a deeper understanding of the relationship and implications of internet addiction on personality traits among adolesce nts hypertension stage 1 buy coumadin 2mg otc. Discussion A number of studies have been conducted across the world blood pressure medicine cheap coumadin 2 mg online, especially among adolescents with respect to internet addiction blood pressure just before heart attack order coumadin discount. They tend to increase the net serving time and eliminate the set schedule indicating emotional instability and poor planning blood pressure levels high purchase coumadin 1 mg without a prescription. Significant behavioural and socio occupational functional differences were revealed between the two groups. Dependents were found to have delays in the work at hand in order to spend time online. Individuals were able to meet a set of diagnostic criteria that show signs of impulse-control difficulty. The findings of the study suggested nearly 40% subjects on a severe level of internet addiction while 35% and 26% came under the ambit of moderate and mild severity level respectively. The subjects who were found to be severely addicted to the internet scored poorly on Conclusion There is no way to stop science and technology development. The ever increasing need for high speed internet and its affordability has penetrated deep into our lives which has led to the emergence of internet addiction. From the findings of previously conducted studies Indian Journal of Public Health Research & Development, March 2020, Vol. The sample size of 100 subjects is very small therefore, generalizability of the sample must be addressed with caution. Also present are some bias in terms of methodology by utilizing convenient purposive sampling technique. Albeit, on a smaller platform this study would definitely help to further strengthen the need for stringent discretion on the use of internet. Not only it would help to focus on this potential pathological condition but also on the need for preventive and interventional strategies to tackle this condition. Conflict of Interest: Nil Source of Funding: Self Ethical Clearance: Consent to administer the questionnaire taken from the Principle of the participating school. Clinical psychology of Internet addiction: a review of its conceptualization, prevalence, neuronal processes, and implications for treatment. Internet addiction: Prevalence and risk factors: A cross-sectional study among college students in Bengaluru, the Silicon Valley of India. An overview of internet use among professionals of Moradabad: a critical appraisal. A Cross-Sectional Study on the Prevalence, Risk Factors, and Ill Effects of Internet Addiction Among Medical Students in Northeastern India. The Role of Internet User Characteristics and Motives in Explaining Three Dimensions of Internet Addiction. Cyberpsychology & behavior; the impact of the Internet, multimedia and virtual reality on behavior and society. The measurement of Internet addiction: A critical review of existing scales and their psychometric properties. A study on the prevalence of internet addiction and its association with psychopathology in Indian adolescents. Negative and positive impact of internet addiction on young adults: Empericial study in Malaysia. Validation and psychometric analysis of the Internet Addiction Test in Spanish among college students. Padmasani2, Sailakshmi Ganesan3 Associate Professor, Faculty of Physiotherapy, 2Professor, Department of Paediatrics, Sri Ramachandra Institute of Higher Education & Research, Porur, 3Head of Department, Department of Physiotherapy, the Spastics Society of Tamil Nadu, Taramani, Chennai, Tamil Nadu, India 1 Abstract Background: Preterm birth is defined as babies born alive at less than 37 weeks of gestation. The awareness of environmental factors on development gave rise to the idea formation of various early intervention programs. The guidelines for early intervention progression should be tailored respecting the growing needs of preterm infants. Hence, the current literature states a need for a protocol with proper dosage in improving the motor outcomes. Objective: the current study aimed to validate the content of early intervention protocol in Indian population. Materials and Method: the process of content validation of early intervention protocol involved development stage and expert judgment stage.

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The aim of head injury management is to minimise damage arising from secondary complications heart attack with pacemaker order generic coumadin on line. Alternatively brain damage can be classified as primary occurring at impact arrhythmia questions and answers order 2mg coumadin overnight delivery, or secondary from ongoing neuronal damage blood pressure chart in pdf order discount coumadin on-line, haematoma heart attack pulse order coumadin, brain swelling, ischaemia or infection. Multiple contusions do not in themselves contribute to depression of conscious level, but this may arise when bleeding into the contusions produces a space-occupying haematoma. Dura Dura Extradural A skull fracture tearing the middle meningeal vessels bleeds into the extradural space. Occasionally extradural haematomas result from damage to the sagittal or transverse sinus. A progressive increase in intracranial pressure due to a supratentorial haematoma initially produces midline shift. Herniation of the medial temporal lobe through the tentorial hiatus follows (lateral tentorial herniation), causing midbrain compression and damage. Uncontrolled lateral tentorial herniation or diffuse bilateral hemispheric swelling will result in central tentorial herniation. Herniation of the cerebellar tonsils through the foramen magnum (tonsillar herniation) and consequent lower brain stem compression may follow central tentorial herniation or may result from the infrequently occurring traumatic posterior fossa haematoma. Infection Compound depressed fracture Basal fracture Subfalcine herniation Mid-line shift Lateral tentorial herniation Tonsillar herniation Central tentorial herniation Meningitis Dural tear Cerebral abscess the presence of a dural tear provides a potential route for infection. Over the subsequent 48 hours, further damage results from release of excitotoxic neurotransmitters which cause Ca2+ influx into cells and triggers the phospholipid cascade (page 246). Depending on the severity of the injury, effects may range from mild coma to death. Superior cerebellar peduncle Pons the macrosopic appearance may appear entirely normal but in some patients pathological sections reveal small haemorrhagic tears, particularly in the corpus callosum or in the superior cerebellar peduncle. Microscopic evidence of neuronal damage depends on the duration of survival and on the severity of the injury. After a few days, retraction balls and microglial clusters are seen in the white matter. Even a minor injury causing a transient loss of consciousness produces some neuronal damage. Since neuronal regeneration is limited, the effects of repeated minor injury are cumulative. Cerebral swelling Vasodilatation Oedema Cerebral swelling this may occur with or without focal damage. It results from either vascular engorgement or an increase in extra- or intracellular fluid. The exact causative mechanism remains unknown Intracranial pressure 220 Cerebral ischaemia Cerebral ischaemia commonly occurs after severe head injury and is caused by either hypoxia or impaired cerebral perfusion. After head injury, however, autoregulation is often defective and hypotension may have more drastic effects. Glutamate excess and free radical accumulation may also contribute to neuronal damage (see page 246). Administer oxygen and check respiratory movements are adequate; if not, ventilate. Examine chest for possible flail segment or haemo/ pneumothorax X-ray chest Check pulse and blood pressure. However, if difficulty occurs in maintaining blood pressure, then urgent laparotomy or thoracotomy would take precedence over investigation of a possible intracranial haematoma. Points to determine: Period of loss of consciousness: relates to severity of diffuse brain damage and may range from a few seconds to several weeks.

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Therefore arrhythmia chest pain purchase coumadin 5 mg with amex, workers exposed to glyphosate though the inhalation route excreted glyphosate in the urine blood pressure medication cause weight gain buy genuine coumadin on-line. Reported cases of the toxic effects of pesticides from 2007-2013 were found predominantly in the northeastern region of Thailand9 cheap 2mg coumadin with mastercard. Health risk behaviors regarding agrochemical use have been a lack of attention to safety precautions and the use of inappropriate protective equipment11 arterial blood gas values coumadin 1mg with mastercard. Currently, there are no glyphosate regulations or standards in occupational health and safety, which is concerning with regard to the health effects on farmers exposed to glyphosate. Health Risk Assessment Tool: In the present study, the likelihood of glyphosate exposure (amount of pure glyphosate multiplied by spraying frequency per year) was divided into four levels of scoring according to the quantity of glyphosate applied per year: score of 1: below 100 milliliters; score of 2: 100-499 liters; score of 3: 500-1000 milliliters; and a score of 4: above 1000 milliliters. Severity of glyphosate toxicity experienced six months after application was assessed by using a symptom questionnaire which looked at the adverse health effects according to four criteria: level 1 is no symptoms expressed, level 2 is mild symptoms (headache, dizziness, rash, cough, numbness, stuffy nose, sore throat, hand irration, itchy skin, drowsiness, fatigue and xerostomia), level 3 is moderate symptoms (nausea, vomiting, chest pain, oliguria, skin burning, burning-stinging-itchy eyes, eczema, blurred vision, exfoliation and diarrhea) and level 4 is severe symptoms (wheezing, hematemesis, kidney failure, pneumonia, shock and syncope). Finally, the likelihood and severity of glyphosate exposure scores were applied in the health risk assessment matrix14, in which four resulting risk levels were calculated: level 1 is acceptable risk (score: 1-2), level 2 is low risk (score: 3-4), level 3 is medium risk (score: 6-9) and level 4 is high risk (score:12-16). Material and Method Data Collection: the study was designed as a cross-sectional study and carried out from November to December 2019; the sample was chosen from 487 farmers who performed pesticide application and whose information was in the Nampong district office of Public Health record. From these farmers, 243 farmers were eventually chosen to be included in the study; this number was calculated under the known number of population in a small size12, and by using a previous finding of proportion of glyphosate detection in urine of 0. Data was collected by using a questionnaire on personal data, health effects, application information and personal protection equipment. The second tool was an applied risk matrix for health risk assessment, which consisted of two parts: likelihood of glyphosate exposure and severity of subsequent symptoms from exposure to glyphosate. Table 1: Glyphosate amount exposed to from application (quantity per year) Score 1 2 3 4 Glyphosate exposure (milliliters) < 100 100-499 500-1000 >1000 Number (%) 19(7. The severity of health adverse effects with regard to symptoms associated with glyphosate usage was assessed by using a questionnaire, and it was found that 186 (76. Table 4: Severity of adverse symptoms among sprayers Mild symptom Headache Dizziness Rash Cough Number(%) 19(7. More than half of the farmers in the present study had a spraying frequency of less than five times per year, probably resulting in a low level of annual exposure among the participants. While spraying, workers either did not have access to a filter mask or did not want to wear it in hot weather conditions, indicating use was unbearable21. In northern Thailand, another study found that the highest percentage of farmers with health effects were those who exhibited mild symptoms of headache, dizziness and rash or roseola symptoms after pesticide application22. This study found that farmers expressed burning-stinging-itchy eyes and skin burning as per previous reports23. In this study, the fact that severe symptoms were not found may be since pure glyphosate has very low toxicity to humans in short-term exposure. However, acute effects caused by glyphosate have been reported, such as drowsiness, vomiting, sore throat and an alert mental state which may result in suicide attempts and accidents24. The sprayers had a low to medium level of health risk according to actual amounts of glyphosate dispensed, Indian Journal of Public Health Research & Development, March 2020, Vol. Therefore, primary health care centers should be able to assess the health risks of herbicide application among farmers through health surveillance programs. Pesticide Use, Poisoning, and Knowledge and Unsafe Occupational Practices in Thailand. Occupational Health and Safety for Agricultural Workers in Thailand: Gaps and Recommendations, with a Focus on Pesticide Use. Glyphosate Biomonitoring for Farmers and Their Families: Results from the Farm Family Exposure Study. Evaluation and comparison of self-protection behaviors of farmers on pesticides usage in eastern provinces of Thailand. Herbicide Exposure to Maize Farmers in Northern Thailand:Knowledge, Attitude, and Practices. Model development to reduce pesticide risk behaviors among rubber farmers in Khogyang Community, Trang, Thailand.

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Counsel patients regarding the toxicities associated with the pharmacologic agents used in prostate cancer treatment arteriovenous oxygen difference discount coumadin 1mg with visa. Develop patient-specific education materials regarding management of cutaneous toxicities of agents used in colon cancer treatment arteria femoral cheap coumadin master card. The optimal combination blood pressure yogurt order coumadin, sequence arteria hepatica propia buy coumadin with paypal, and treatment duration are unknown, but the ability of an individual to receive all active agents during the course of the disease is associated with the greatest likelihood of increasing overall survival. Family history of cancer: father, lung: diagnosed age 71, died age 73; mother, breast: died at age 93. He has a paternal aunt and paternal grandmother who both were diagnosed with unspecified malignancies. Neck/Lymph Nodes No cervical or supraclavicular adenopathy Lungs/Thorax Lungs are clear in all fields. Multiple small, external iliac lymph nodes are present, predominantly on the left. Patient has metastatic androgen-dependent hormone-sensitive disease and is here for consideration of initial treatment options. What signs, symptoms, and other information are consistent with metastatic prostate cancer in this case? Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. Docetaxel and estramustine compared with mitoxantrone and prednisone for refractory prostate cancer. Chemotherapy with mitoxantrone plus prednisone or prednisone alone for symptomatic hormone-resistant prostate cancer: a Canadian randomized trial with palliative end points. How should the therapy you recommended be monitored for efficacy and adverse effects? He is complaining of increased pain in his pelvis and more bone pain in his ribs and back over the last 2 months, although he is still able to participate in church social activities and play golf on the weekends. His bone scan shows numerous intense foci in the skull, scapulae, spine, and femurs. What pharmacotherapeutic options are available to the patient for his progressive androgen-independent metastatic prostate cancer? Locate information resources that are available to prostate cancer patients and their families. Physical examination findings were significant for decreased breath sounds (worse on the left side than the right) and enlarged, painless supraclavicular lymph nodes on the left side. Chest x-ray revealed a large heterogeneous mass at the apex of the left lung also involving the mediastinum. Pathology revealed cells consistent with lymphoma, but definitive diagnosis could not be made. The oncologist on call was consulted, and it was recommended for him to follow up as an outpatient for further evaluation and treatment recommendations. He states that he does not eat many vegetables, as he must save room for "the good stuff" on the buffet. In addition, he describes an unexplained weight loss of approximately 25 pounds over the last 3 months. He states that he occasionally has some dyspnea on exertion, but he is able to carry out activities of daily living without limitations. Genit/Rect Normal male genitalia Ext Without edema, warm to the touch; pulses palpable bilaterally Neuro Symmetric cranial nerve function. Balance and coordination of the upper extremities are intact, with no evidence of tremor. Lymph Node Survey the lymph node survey is negative for any palpable peripheral nodes in the preauricular, postauricular, cervical, supraclavicular, infraclavicular, or axillary areas. What pharmacologic measures should be instituted to treat or prevent the acute toxicities associated with the chemotherapy regimen? What are potential late complications of the chemotherapy regimen, and how can they be detected and prevented? He was initiated on darbepoetin, 500 mcg every 3 weeks, and ferrous sulfate, 325 mg 3 times daily. The darbepoetin dose was subsequently reduced to 300 mcg every 3 weeks due to hemoglobin increase above 11 g/dL.

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