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By: R. Koraz, M.S., Ph.D.

Associate Professor, New York Institute of Technology College of Osteopathic Medicine at Arkansas State University

Benign enlargement Hyperplasia of glandular structures and connective tissues causes benign (nonmalignant) enlargement of prostate gland fungus gnats molasses buy genuine diflucan. Enlarged prostate gland stretches the urethra and obstructs urine outflow from bladder antifungal treatment for grass generic 200 mg diflucan with mastercard. Common symptoms are increase in the frequency of urination fungus yard 150mg diflucan with visa, difficulty in urination fungus yellow order diflucan on line amex, dribbling of urine after urination and occasional renal failure. Malignant enlargement Malignant enlargement (cancer) of prostate gland also causes obstruction of urinary passage. In addition, the metastasis (spread of cancer from primary site to other places) affects the other tissues, particularly bones. It is the collection of fluids from testes, seminal vesicles, prostate gland and bulbourethral glands. Semen is discharged during sexual act and the process of discharge of semen is called ejaculation. Secretions from seminal vesicles and bulbourethral glands provide mucoid consistency to semen. Seminal plasma contains the products from seminal vesicle and prostate gland. It also has small amount of secretions from the mucus glands, particularly the bulbourethral glands. Immediately, it coagulates and after some time it becomes liquid once again (secondary liquefaction). Fibrinogen secreted from the seminal vesicle is converted into a weak coagulum by the clotting enzymes secreted from prostate gland. Coagulum is liquefied after about 30 minutes, as it is lysed by fibrinolysin produced in prostate gland. When semen is ejaculated, the sperms are nonmotile due to the viscosity of coagulum. Sperms reach the fallopian tube in about 30 to 60 minutes after sexual intercourse. Head Head of sperm is oval in shape (in front view), with a length of 3 to 5 µ and width of up to 3 µ. Head is covered by a thin cell membrane and it is formed by a condensed nucleus with a thin cytoplasm. It develops from Golgi apparatus and it is made up of mucopolysaccharide and acid phosphatase. Acrosome also contains hyaluronidase and proteolytic enzymes, which are essential for the sperm to fertilize the ovum. Its anterior end is formed by thick disk-shaped anterior end 472 Section 7 t Reproductive System knob, which is also called proximal centriole. The body of the sperm consists of a central core called axial filament, covered by thin cytoplasmic capsule. It passes through the body and a perforated disc called end disk or end ring centriole. In the body, the axial filament is surrounded by a closely wound spiral filament consisting of mitochondria. Chief or main piece: It is enclosed by cytoplasmic capsule and has an axial thread. Oligozoospermia Oligozoospermia is the low sperm count with less than 20 million of sperms/mL of semen. Teratozoospermia Teratozoospermia is the condition characterized by presence of sperms with abnormal morphology. Retrograde ejaculation is the entrance of semen into urinary bladder instead of entering urethra. It is due to dysfunction of sphincter of the bladder, which is caused by prostatic surgery or excess use of drugs. Oligospermia Oligospermia is a genetic disorder characterized by low volume of semen. Mammary glands are not the female genital organs but are the important glands of female reproductive system. On either side at its upper part, the fallopian Uterus is made up of three layers: 1.

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Propane has a characteristic natural gas odour and is basically insoluble in water fungus gnats vinegar generic diflucan 200 mg with mastercard. It is usually shipped in low-pressure cylinders as liquefied gas under its own vapour pressure of ca 109 psig at 21°C fungus gnats nematodes cannabis buy 150mg diflucan otc. In sufficiently high concentrations fungus mega brutal order diflucan 400 mg fast delivery, resulting in oxygen deficiency fungus killing rattlesnakes diflucan 100 mg with mastercard, it will result in physical asphyxiation. The following safety measures supplement the general precautions listed in Table 9. Methane Methane is obtained commercially from natural gas wells and from cracking of petroleum fractions. Flammable liquid and combustible, corrosive, oxidizing or toxic substances and compressed gases should be kept separately. Avoid cylinders impeding or endangering means of escape from premises or from adjoining premises. A load-bearing surface (concrete, paved or compacted) is required where cylinders are to be stacked. The area should be at the separation distance from the property boundary, any building or fixed source of ignition quoted in Table 9. To give additional protection from thermal radiation from any cylinder stack fire the minimum separation distance to any nearby building housing a vulnerable population should, for quantities >400 kg, be 8 m or as in Table 9. Prohibit all sources of ignition, including smoking, within a store or within the separation distance (exclude motor vehicles other than fork-lift trucks and those for delivery/collection from open-air stores). Avoid openings into buildings, cellars, or pits within 2 m or the separation distances, whichever is greater. Remove weeds and long grass within the separation distance and up to 3 m from cylinders. Cylinders should be stored upright with the valves closed with any protective cover, cap or plug in place. Cylinders on a vehicle or trailer parked overnight rate as a single stack so that the separation distance in Table 9. Cylinders received into store and taken out for delivery should be checked for damage or leakage. Stacks should be inspected daily for stability and that they contain no damaged/leaking cylinders. Coalminers have inhaled air containing up to 9% methane with no apparent untoward effect but higher concentrations of at least 10% in air result in a feeling of pressure on the eyes and forehead which will disappear after breathing fresh air. At low concentrations the odour of methane is undetectable; at exposures of >5000 ppm there is a sweet oil-type odour. It is considered to be chemically inert at room temperature and atmospheric pressure but it does react under more forcing conditions and vigorous reactions have occurred with halogens, interhalogen compounds, and oxidizing agents such as liquid oxygen and dioxygen difluoride. Prohibit the use of naked flames or smoking in the vicinity of, or inside, the compound. The entire space within the building or storage area and outside any doorway, low level ventilator or other opening into the store within the separation distance set out in Table 9. Storage within a specially designed building or in a specially designed storage area within a building · Store separately from oxygen and oxidants, using a fire-resistant partition where necessary. Nitrogen Nitrogen is an odourless, colourless gas which comprises ca 79% by volume of air and is an essential constituent of all living organisms. Nitrogen is distributed as a pressurized gas in grey cylinders with black shoulders. Large volumes of atmospheric nitrogen are converted into ammonium sulphate for fertilizer and into nitric acid. Nitrogen is non-toxic but will cause asphyxiation through oxygen depletion of air and is the most common cause of gassing accidents in industry. There are no warning signs before unconsciousness occurs, and at high concentrations almost instant unconsciousness may occur and prove fatal (page 77). Nitrous oxide is a colourless, non-flammable, non-corrosive gas with a sweetish odour and taste. Nitrous oxide may also be obtained by the controlled reduction of nitrates or nitrites, decomposition of hyponitrites, or thermal decomposition of hydroxylamine. One of its main applications is, in combination with air or oxygen, as a weak anaesthetic in medicine and dentistry. It does not react with oxygen, ozone, hydrogen, chlorine, potassium, phosphine or aqua regia.

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Heme also forms a part of the structure of myoglobin (oxygenbinding pigment in muscles) and neuroglobin (oxygenbinding pigment in brain) fungus guard safe diflucan 200mg. In some abnormal conditions ascomycete fungus definition 100 mg diflucan amex, the iron is converted into ferric (Fe3+) state antifungal dog spray generic diflucan 50 mg on line, which is a stable form fungus gnats ground cinnamon 150mg diflucan visa. Among the four polypeptide chains, two are chains and two are -chains (Refer Table 11. These variants are produced because of structural changes in the polypeptide chains caused by mutation in the genes of the globin chains. Hemoglobinopathies Hemoglobinopathy is a genetic disorder caused by abnormal polypeptide chains of hemoglobin. It is found in people with hemoglobin C disease, which is characterized by mild hemolytic anemia and splenomegaly. It is present in people with hemoglobin E disease which is also characterized by mild hemolytic anemia and splenomegaly. It occurs due to mutation of genes of both in and chains, resulting in abnormal replacement of amino acids. Fetal hemoglobin ­ HbF Replacement of fetal hemoglobin by adult hemoglobin starts immediately after birth. Hemoglobin in Thalassemia and Related Disorders In thalassemia, different types of abnormal hemoglobins are present. In -thalassemia, the -chains are decreased, absent or abnormal and in -thalassemia, the -chains are decreased, absent or abnormal (Chapter 14). Hemoglobin is the only carrier for transport of oxygen, without which tissue death occurs within few minutes. When hemoglobin is altered, its oxygen carrying capacity is decreased resulting in lack of oxygen. So, it is important to know about the causes and the effects of abnormal hemoglobin derivatives. Normal percentage of hemoglobin derivatives in total hemoglobin: Carboxyhemoglobin: 3% to 5 % Methemoglobin: less than 3% Sulfhemoglobin: trace (undetectable). These derivatives prevent the transport of oxygen resulting in oxygen lack in tissues, which may be fatal. Since hemoglobin has 200 times more affinity for carbon monoxide than oxygen, it hinders the transport of oxygen resulting in tissue hypoxia (Chapter 127). Under normal circumstances also, body faces the threat of continuous production of methemoglobin. Methemoglobinemia Methemoglobinemia is the disorder characterized by high level of methemoglobin in blood. Antibacterial drugs like sulfonamides Antimalarial drugs like chloroquine Antiseptics Inhalant in cyanide antidote kit Local anesthetics like benzocaine. Porphobilinogen is converted into uroporphobilinogen I by uroporphobilinogen I synthase. There are four types of polypeptide chains namely, alpha, beta, gamma and delta chains. Each globin molecule is formed by the combination of 2 pairs of chains and each chain is made of 141 to 146 amino acids. Hemoglobin M is common in babies affected by blue baby syndrome (a pathological condition in infants, characterized by bluish skin discoloration (cyanosis), caused by congenital heart defect). Blood Level of Sulfhemoglobin Normally, very negligible amount of sulfhemoglobin is present in blood which is nondetectable. Soon, the hemoglobin is degraded in the reticuloendothelial cells and split into globin and heme. Iron is stored in the body as ferritin and hemosiderin, which are reutilized for the synthesis of new hemoglobin. In human being, most of the biliverdin is converted into a yellow pigment called bilirubin.

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The feedback fungus around genital area buy cheapest diflucan and diflucan, along with analyses of the project outcomes anti fungal meds for dogs order diflucan cheap, will be included in a final report fungus gnats garlic buy diflucan from india, presented at appropriate conferences and published in relevant professional publications fungus gnats tomato seedlings generic diflucan 100mg amex. Involving patients with cancer in medical decision-making requires them to have an adequate understanding their disease and treatment options. Limited health literacy poses a barrier to patient engagement in their own care, contributing to health disparities and poorer cancer outcomes. Aim: Our primary objective was to determine levels of health literacy among patients with cancer and the extent of its association with patient preference for care. We also sought to identify sociodemographic and clinical characteristics associated with limited cancer health literacy. Methods: As part of a larger prospective cohort study, N 5 345 adult cancer patients attending a large, universityaffiliated outpatient oncology clinic were recruited using consecutive sampling. The relationship between cancer health literacy and patient preference for shared care was examined using bivariate analysis, with logistic regression used to identify predictors. One out of every two patients with cancer in this study were found to possess limited health literacy, making this a significant issue particularly given its association with lesser patient preference for shared care. This study marks an important first step toward increasing health literacy among patients with cancer and empowering patients to participate in their care, which may help mitigate the impact of disparities such as lower educational and socioeconomic levels traditionally associated with poorer cancer outcomes. Empowering Patients and Care Givers Empowering patients and cancer caregivers with information and training Learning Experience Contribution to Effective Cancer Education? A registered cancer society in Malaysia, KanWork supports those affected by cancer by providing such information through regular structured education program. The programs were designed based on the learners needs addressing issues related to medical, clinical, psychological, spiritual, motivational, and healthy lifestyle. The programs were carried out in collaboration with cancer hospitals at their venues. For accountability and further improvement, there is a need to evaluate the effectiveness of the program. To determine the relationship between program management (learning experience provided to participants, and facilities), and the cancer education program effectiveness. Methods: A customized instrument to measure the education program effectiveness related constructs was developed guided by literature. The questionnaire was administered to 868 participants of 8 cancer education programs carried out between 2015 and 2017. Results: Majority (91%) who attended the education program were women and cancer patient/survivor (50%). An appropriate learning experience to learner is critical to ensure the education program effectiveness. Adult learners joined the program to solve their problematic situation in their cancer journey. An appropriate learning experience is one that contributes to meeting their needs, they can follow. The experienced facilitators, expert in their respective fields were able to provide meaningful learning experience to participants. Conclusion: Appropriate learning experiences and program facilities contributes toward effective cancer education program in a Malaysian context. Prevalence was estimated as cumulative incidence over 20 years from diagnosis, with deductions for all-cause mortality. Regional totals were projected upwards to account for the countries for whom direct estimates were not made. Empowering Patients and Care Givers Epidemiology Cancer Treatment Among the Elderly in the United States: Complexities of Aging and Comorbidities 1 Empowering patients and cancer caregivers with information and training Identifying Gaps in Metastatic Breast Cancer Patient Knowledge and Their Communication Experiences With Health Care Professionals and Developing Visually Based Solutions to Overcome Those Gaps C. One-third of patients felt they did not have enough knowledge to participate in decision-making for treatment and 58% of patients felt rushed to start; 71% did not recall discussing goals/hobbies; and just 62% discussed pain and symptom management. International Agency for Research on Cancer: Breast cancer: estimated incidence, mortality and prevalence worldwide in 2012. Management of these patients can become increasingly complicated as physicians administer multiple combinations of drugs and therapies.

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