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Z. Sibur-Narad, M.B. B.A.O., M.B.B.Ch., Ph.D.

Professor, University of Iowa Roy J. and Lucille A. Carver College of Medicine

The details will be concentrate on the follow items: - Background - Research Methods - Basic Information - Identity/age/gender - the pathologic types of lymphoma patients - Diagnose and treatment - Personal economic situation of lymphomas - Psychological conditions - What they need? Akpan University of Calabar hypertension young purchase bisoprolol 10mg, Medical Laboratory Science fetal arrhythmia 38 weeks generic bisoprolol 10 mg without a prescription, Calabar pulse pressure 80 mmhg bisoprolol 5 mg on-line, Nigeria Background: There is an increasing but controversial evidence that smoking is associated with metabolic syndrome blood pressure testers buy bisoprolol 5mg with mastercard. Metabolic syndrome has recently attracted much attention due to increasing knowledge of its relationship with cardiovascular mortality and morbidity and other associated problems. Methods: One hundred and forty one (141) apparently healthy male cigarette smokers and sixty (60) apparently healthy nonsmokers aged 18 to 45 years were recruited for the study. The smokers were subdivided into light (, 8 pack years), moderate (8-30 pack years) and heavy (. Conclusion: the unfavorable changes in the lipid profile and blood pressure observed in this study may predispose smokers to a higher risk of cardiovascular disease and there is a higher frequency of metabolic syndrome among smokers in Calabar compared with the nonsmokers. Many high school children are not well aware about the health hazards of arecanut consumption. Arecanut was introduced for majority of the school goers by either their friends or family. Aim: the current study was conducted to identify the knowledge on health effects, and current practice toward arecanut use among secondary school children living in Male City, Maldives. A total of 1350 questionnaire was distributed to the secondary school students studying at selected schools in Male City and 804 questionnaires were returned. The schools were selected through cluster sampling, while the students were selected via simple random sampling. The calculated sample size consists of 674 students which are equally selected from both genders. Ethical approval was obtained from Villa College as well from national health research committee at ministry of health. Results: Secondary school children in Male City have inadequate knowledge on harmful effects of arecanut use. The knowledge on harmful effects of arecanut use is more among girls, students at grade 9, students studying at Rehendhi school, and more among those who lives in both Hulhumale and Vilimale than those who live in Male. It was introduced by either friends or family members among large number of school children. Majority of participants used supari as a main form of arecanut, and Rasily supari was the favorite brand of supari among secondary school children. Boys start its use earlier, frequency, duration, and daily consumption is higher among boys than girls. Conclusion: Secondary school children have inadequate knowledge on harmful effects of arecanut use. Supari is the main form of arecanut use and most of the students initiated the habit at a younger age, which is an alarming threat to the society, hence there is an urgent need to start school based preventive programs, community awareness programs, for school children, teachers, parents, and general public at large as stopping the starting of a habit is much easier than quitting of same habit. Although there have been previous population-level studies which have highlighted adolescent smokers in Malaysia, little has been done to specifically ascertain smoking prevalence within a school-going population using objective measurement tools. Methods: this study was a cross-sectional study that involved 2,679 high school-going adolescents aged between 13 to 18 years old in Kuala Lumpur, Malaysia. Participants were also administered with a survey conducted right after the Smokerlyzer test to determine i) whether they smoked or not; ii) type of tobacco products used if smoked; iii) vaping or shisha usage; and iv) exposure to secondhand smoke. Descriptive analysis was conducted to determine the demographics of the study population. Inferential analysis was 2 carried out utilizing x tests or Student t-tests to test associations between smoking status and other independent variables. Interestingly, vaping was the most commonly used method of tobacco use among the studied adolescents, regardless of gender, followed by cigarettes and shisha.

For example wide pulse pressure in young adults order bisoprolol 5 mg, if Drug X is metabolized by a specific enzyme that is inhibited by Drug Y blood pressure medication when pregnant buy cheap bisoprolol 5 mg online, then the plasma concentration of Drug X will be nursece4less hypertensive disorder proven 5mg bisoprolol. If a specific enzyme that is induced by Drug Y metabolizes the same Drug X pulse pressure blood pressure buy discount bisoprolol 10 mg on line, the plasma concentration of Drug X will be decreased. Oxidation: Oxidation, which always occurs with an accompanying reduction, is the primary drug metabolizing reaction in which oxygen or a negatively charged radical is added or hydrogen or positively charged radical is removed from the compound. Barbiturates, acetaminophen, nicotine, paracetamol, and steroids are examples of drugs that are primarily oxidized. The Cytochrome P450 family of enzymes is primarily responsible for these Phase I reactions. Some substances are oxidized through non-microsomal enzymes (cytoplasmic and mitochondrial). For example, choline esters, procaine, oxytocin, aspirin, amides and many anesthetics are hydrolyzed. For example, the anti-malarial drug proguanil is cyclicized to the active metabolite, cycloguanil. Decyclization: Decyclization is the opening up of ring structure of the cyclic molecule, as occurs with phenytoin and barbiturates. Substances may be conjugated to glucuronic acid and/or specific groups including acetyl, carboxyl, amino, hydroxyl and sulfhydral groups. Glucoronide conjugation (Glucuronidation): Compounds with carboxylic or hydroxyl acid groups are conjugated with glucoronic acid, which is derived from glucose. Aspirin, nicotine, morphine, acetaminophen, lorazepam, and thyroxine are examples of drugs that represent glucoronide conjugation. Acetylation: Compounds having hydrazine residues or amino groups are conjugated (acetylated) with the cofactor Acetyl-CoA. Examples of acetylated drugs include sulfonamides such as dapsone, isoniazid, hydralazine and procainamide. Genetic variations in these enzymes can cause an individual to be a fast acetylator where the drug in question is reduced in efficacy by that individual and slow acetylators where the drug in question may cause toxicity and drug interactions because it is inefficiently excreted. In the transport process, the drug or its metabolite is excreted via the kidney, feces, respiratory system, or by the skin. The routes include: Kidney Bile Saliva and sweat Milk Exhalation via the pulmonary system Hepatic Excretion: Drugs can be excreted in the bile, and then by the feces, especially if they are conjugated with glucoronic acid. The process is as follows: the drug is absorbed and is glucuronidated or sulfated in the liver and secreted through the bile and into the feces. Glomerular Filtration: Glomerular capillaries contain non-diaphragm fenestrated pores that are among the largest in the body. Non-protein bound drugs (lipid soluble or insoluble) presented to the glomerulus are filtered and potentially excreted as well. This filtration is based on their plasma protein binding and characteristics of renal blood flow. Protein bound drugs are not filtered by the normal kidneys because the size of the protein-drug complex is too large. Tubular Re-absorption: Tubular re-absorption is the re-entry or back diffusion of (lipid soluble) drugs. Water soluble and ionized drugs are excreted intact, and examples include aminoglycoside and tobramycin. Changes in urinary pH can affect the excretion patterns of ionized drugs, which are explained below. Weak bases are ionized more in acidic urine and the renal excretion of these weak bases is increased. Tubular Secretion: this is the energy dependent active transport process that decreases the free drug concentration in the plasma. Increased drug dissociation from plasma binding proteins allows increased secretion by the tubules and therefore increased excretion. Plasma Half-life this is the time required for the plasma concentration to be reduced to half of its original value. A plateau can be achieved using other delivery systems as well, but the mathematics is more complicated.

The process was strengthened by working in partnership with the Uganda Bodaboda Association 2010 blood pressure medication for ptsd buy bisoprolol 10 mg with mastercard, an umbrella association that brings all the motorists together hypertension cdc discount bisoprolol 10mg with mastercard. It also included the Uganda Police Services pulse pressure wave velocity 10 mg bisoprolol overnight delivery, Ministry of Health and the private sector hypertension jnc 7 classification cheap bisoprolol 10mg mastercard. Aim: To use motorists to deliver cancer education, awareness and facilitate blood donation for cancer patients in Uganda. Strategy/ Tactics: the event was branded with the theme "Know your health, donate blood, save life". It involved mobilization of the motorcycle riders through the BodaBoda 2010 association, a cancer awareness motorcycle ride across Kampala City, led by the head of traffic Uganda police as the chief rider. This was conducted along Kampala road and finally convened on the Uganda railway grounds, where the event was crowned with cancer education, screening and blood donation for the cancer patients. Outcomes: There were large number of motorcycle riders 1000 who passionately turned up for the community event, high expectations to know about cancer and being able to go with cancer education materials for their families and communities. The event attracted over 1500 individuals both the motorcycle riders and the community. What was learned: Using popular service groups has a high success rate in delivering cancer awareness and screening services to the least households in the community. Wang Hope Foundation for Cancer Care, Taipei, Taiwan, Province of China Background and context: In 2012, Hope Foundation for Cancer Care initiated "Running for Hope" project (road running around Taiwan) to raise awareness of Pap test and female cancers, during which lack of awareness about cancer prevention among general public was observed. Aim: To implement campaigns about healthy life styles which include staying away from cancer-causing factors, healthy diet, regular exercise, weight management and effective cancer screening. The five tips are: proper diet, regular exercise, saying no to cigarettes, alcohol and beetle nuts, weight management and regular screening. Program/Policy process: In 2013 and 2014, cancer prevention short films were played in campuses. Eyeball was invited to create the mascot Bao-Di, launching the new cancerprevention slogan "Cancer prevention-five tips to keep you safe-proper diet, regular exercise, saying no to cigarettes, alcohol and beetle nuts, weight management and regular screening". The mascot Bao-Di took on the role of educating the public about how to prevent cancer. In 2017, more social media strategies were applied, including the Bao-Di journal, celebrity-featured short-films, Line stickers and taxi advertisements. Lack of awareness about cancer-prevention through direct contact with general public during the road running project was observed. Development of localized risk-reducing signs and mascots taken inspiration from campaigns of international cancer-prevention organizations. Multimedia teaching was used to enhance learning and retention; social media was used to engage groups and individuals. Content development involved iterative consultation among project leaders, medical experts and target audience, often on social media. High-quality teaching videos were recorded in English and Nigerian Pidgin languages. Facebook was used to promote the campaign, engage local audience, and for Facebook Live presentation. Local health professionals projected the video in appropriate language to audiences in religious and community groups. The Facebook Live presentation had 1500 views, reached 9302 people and was shared 107 times. A total of 25 Facebook posts were made, resulting in 628 like, 1908 video views, 160 shares, and reached 14,222 people. Most questions focused on the causes and prevention of prostate cancer, especially on the use of nutritional supplements. What was learned: Cloud computing enabled us to have one presenter; this eliminated the need to find a presenter for each organization. Audience appreciated simplified videos used in explaining the disease process and need for personalized early detection. Facebook live presentation attracted the most reactions on social media, with most comments showing that people liked the intervention. Audience feedback showed that adding advocacy cellphone video by a survivor helped demystify prostate cancer. Having the main presentation video in different file formats and sizes enhanced sharing on social media, as most Nigerians access the Internet on cell phones. Aim: this paper aims at evaluation of brochures for cancer patients which were created during the project and its primary goal is to define new topics for future educational material.

We wish to thank the Work Group Co-Chairs prehypertension warsaw 2014 generic 10mg bisoprolol with amex, Drs John Kellum and Norbert Lameire arteria digitalis palmaris communis cheap 5mg bisoprolol fast delivery, along with all of the Work Group members who volunteered countless hours of their time developing this guideline blood pressure medication questions discount bisoprolol 5mg on line. Mounting evidence suggests that acute arrhythmia genetic purchase 10mg bisoprolol overnight delivery, relatively mild injury to the kidney or impairment of kidney function, manifest by changes in urine output and blood chemistries, portend serious clinical consequences. It has only been in the past few years that moderate decreases of kidney function have been recognized as potentially important, in the critically ill,2 and in studies on contrast-induced nephropathy. Possible explanations include the untoward effects of decreased kidney function such as volume overload, retention of uremic compounds, acidosis, electrolyte disorders, increased risk for infection, and anemia. Furthermore, more severe reductions in kidney function tend to be associated with even worse outcome as compared to milder reductions. Oliguria and anuria Volume depletion and hypotension are profound stimuli for vasopressin secretion. As a consequence the distal tubules and collecting ducts become fully permeable to water. Concentrating mechanisms in the inner medulla are also aided by low flow through the loops of Henle and thus, urine volume is minimized and urine concentration maximized (4500 m Osmol/kg). Conversely, when the tubules are injured, maximal concentrating ability is impaired and urine volume may even be normal. Analysis of the urine to determine tubular function has a long history in clinical medicine. Indeed, a high urine osmolality coupled with a low urine sodium in the face of oliguria and azotemia is strong evidence of intact tubular function. Intact tubular function, particularly early on, may be seen with various forms of renal disease. Classification as ``benign azotemia' or ``acute renal success' is not consistent with available evidence. Finally, although severe oliguria and even anuria may result from renal tubular damage, it can also be caused by urinary tract obstruction and by total arterial or venous occlusion. These conditions will result in rapid and irreversible damage to the kidney and require prompt recognition and management. More recently, investigators have emphasized the role of endothelial dysfunction, coagulation abnormalities, systemic inflammation, endothelial dysfunction, and oxidative stress in causing renal injury, particularly in the setting of sepsis. For example, patients with arterial catastrophes (ruptured aneurysms, acute dissection) can suffer prolonged periods of warm ischemia just like animal models. During the First World War the syndrome was named ``war nephritis',17 and was reported in several publications. The syndrome was forgotten until the Second World War, when Bywaters and Beall published their classical paper on crush syndrome. Smith who is credited for the introduction of the term ``acute renal failure', in a chapter on ``Acute renal failure related to traumatic injuries' in his textbook the kidney-structure and function in health and disease (1951). Indeed, as a syndrome, it includes patients without actual damage to the kidney but with functional impairment relative to physiologic demand. Unfortunately, these are not widely known and are variably practiced 15 chapter 1. Importantly, there is no unifying approach to the diagnosis and care of these patients. This agency was created to provide objective, science-based information to improve decision making in health-care delivery. A major contribution of this agency was the establishment of a systematic process for developing evidence-based guidelines. It is now well accepted that rigorously developed, evidencebased guidelines, when implemented, have improved quality, cost, variability, and outcomes. K Clinical practice guidelines in the field have the potential to reduce variations, improve outcomes, and reduce costs. K Summary Small changes in kidney function in hospitalized patients are important and associated with significant changes in shortand long-term outcomes.