Diovan

A Cahid Civelek, M.D.


https://www.hopkinsmedicine.org/profiles/results/directory/profile/5917932/ali-civelek

When attempting to write blood pressure chart age 80 mg diovan with visa, patients may nd they are involuntarily gripping the pen harder blood pressure medication causing low blood pressure diovan 40 mg free shipping, and there may also be involuntary movement at the wrist or in the arm blood pressure chart cholesterol cheap diovan online master card. A tremor may also develop blood pressure dehydration buy 160mg diovan amex, not to be confused with primary writing tremor in which there is no dystonia prehypertension food purchase cheap diovan line. There is some neurophysiological evidence that the condition is due to abnor malities within the spinal cord segmental motor programmes and muscle spindle afferent input to them blood pressure chart pregnant order 80 mg diovan overnight delivery. Excessive or pathological yawning (chasm) is compulsive, repetitive yawning not triggered by physiological stimuli such as fatigue or boredom. Cross References Parkinsonism; Sighing Yips Yips is the name given to a task-speci c focal dystonia seen in golfers, especially associated with putting. Abnormal co contraction in yips-affected but not unaffected golfers: evidence for focal dystonia. Yo-yo-ing is difficult to treat: approaches include dose fractionation, improved drug absorption, or use of dopaminergic agonists with concurrent reduction in levodopa dosage. Cross References Akinesia; Dyskinesia; Hypokinesia 380 Z Zeitraffer Phenomenon the zeitraffer phenomenon has sometimes been described as part of the aura of migraine, in which the speed of moving objects appears to increase, even the vehicle in which the patient is driving. Zooagnosia the term zooagnosia has been used to describe a difficulty in recognizing ani mal faces. In one case, this de cit seemed to persist despite improvement in human face recognition, suggesting the possibility of separate systems for animal and human face recog nition; however, the evidence is not compelling. In a patient with developmental prosopagnosia seen by the author, there was no subjective awareness that animals such as dogs might have faces. Nonrecogntion of familiar animals by a farmer: zooagnosia or prosopagnosia for animals. Cross References Agnosia; Prosopagnosia Zoom Effect the zoom effect is a metamorphopsia occurring as a migraine aura in which images increase and decrease in size sequentially. Up to now in your studies, you have been learning the normal features of human beings. General pathology covers the basic mechanisms of diseases whereas systemic pathology covers diseases as they occur in each organ system. And it is divided into ten chapters on Introduction, Cell injury, Inflammation, Healing, Hemodynamic disorders, Genetic diseases, Immunopathology, Neoplasia, Metabolic diseases, & Selected infectious diseases. Most of these topics represent the major categories of diseases that can occur in different organ systems. For example, acute inflammation can occur in different organs but wherever it occurs its mechanism is the same. That is, an acute inflammation in the skin has the same mechanisms & features as an acute inflammation of the meninges. Therefore, if one knows general pathology well, one can apply this knowledge to diseases in the various organ systems. Hence, your general pathology knowledge will facilitate your understanding of systemic diseases (Systemic Pathology). Therefore, after reading this book, you are encouraged to read books on systemic pathology. The reason for not including systemic pathology in this book was because the book conceived when the previous curriculum was being implemented. At this juncture, we would like to call up on all professional colleagues to include systemic pathology in the pathology lecture for Health Officer students since this is very basic for understanding clinical medicine. We would also like to mention that the new curriculum for Health Officer students includes systemic pathology. We also call up on all those concerned to write a book on systemic pathology for health science students. General pathology is necessary but not sufficient for understanding clinical medicine. Health science students* here means health officer, pharmacy, dentistry, midwifery, anesthesiology, nursing (B. There was no uniformity in what was taught to these students in the various institutions in Ethiopia. This book is intended to be a textbook of general pathology for health science students. Having good standardized textbooks contributes a lot to the proper training of health care workers. The Carter Center in Addis Ababa initiated the idea of writing standardized textbooks for health science students in Ethiopia to tackle the current critical lack of such books. In addition to initiating the idea of writing the book, the Carter Center paid allowances to the authors, arranged appropriate & conducive environment for the writing & reviewing process, & covered all the publishing cost. By doing so, we think, the Carter Center has contributed a lot to the improvement of the health science education & thereby to the betterment of the public health status in Ethiopia. For all of these reasons, our gratitude to the Carter Center in Addis Ababa is immense & deep! We immeasurably thank Ato Aklilu (of the Carter Center in Addis Ababa) for his immense understanding, fatherly guidance, encouragement, & patience. Wondwossen Ergete (Associate Professor of Pathology at the Addis Ababa University) for evaluating our work & giving us invaluable suggestions. Ato Getu Degu (Associate Professor of Biostatistics at the Public Health Department of Gondar University) efficiently organized the writing process in Gondar. At the end, even though we tried our best to be as accurate as possible, we bear all the responsibilities for any inadvertent mistakes this book may have. The core aspects of diseases in pathology Pathology is the study of disease by scientific methods. Diseases may, in turn, be defined as an abnormal variation in structure or function of any part of the body. Pathology gives explanations of a disease by studying the following four aspects of the disease. Knowledge or discovery of the primary cause remains the backbone on which a diagnosis can be made, a disease understood, & a treatment developed. There are two major classes of etiologic factors: genetic and acquired (infectious, nutritional, chemical, physical, etc). Pathogenesis Pathogenesis means the mechanism through which the cause operates to produce the pathological and clinical manifestations. Morphologic changes the morphologic changes refer to the structural alterations in cells or tissues that occur following the pathogenetic mechanisms. The structural changes in the organ can be seen with the naked eye or they may only be seen under the microscope. Those changes that can be seen with the naked eye are called gross morphologic changes & those that are seen under the microscope are called microscopic changes. Both the gross & the microscopic morphologic changes may only be seen in that disease, i. Therefore, such morphologic changes can be used by the pathologist to identify. In addition, the morphologic changes will lead to functional alteration & to the clinical signs & symptoms of the disease. Functional derangements and clinical significance the morphologic changes in the organ influence the normal function of the organ. By doing so, they determine the clinical features (symptoms and signs), course, and prognosis of the disease. In summary, pathology studies: Etiology I Pathogenesis I Morphologic changes I Clinical features & Prognosis of all diseases. This understanding will, in turn, enable health care workers to handle & help their patients in a better & scientific way. In addition, the pathologist can use the morphologic changes seen in diseases to diagnose different diseases. Diagnostic techniques used in pathology the pathologist uses the following techniques to the diagnose diseases: a. Histopathological techniques Histopathological examination studies tissues under the microscope. Once the tissue is removed from the patient, it has to be immediately fixed by putting it into adequate amount of 10% Formaldehyde (10% formalin) before sending it to the pathologist. Once the tissue arrives at the pathology department, the pathologist will exam it macroscopically. It is then impregnated (embedded) in paraffin, sectioned (cut) into thin slices, & is finally stained. It gives the nucleus a blue color & the cytoplasm & the extracellular matrix a pinkish color. Cytopathologic techniques Cytopathology is the study of cells from various body sites to determine the cause or nature of disease. Applications of cytopathology: the main applications of cytology include the following: 1. Screening for the early detection of asymptomatic cancer For example, the examination of scrapings from cervix for early detection and prevention of cervical cancer. Diagnosis of symptomatic cancer Cytopathology may be used alone or in conjunction with other modalities to diagnose tumors revealed by physical or radiological examinations. It can be used in the diagnosis of cysts, inflammatory conditions and infections of various organs. Surveillance of patients treated for cancer For some types of cancers, cytology is the most feasible method of surveillance to detect recurrence. The best example is periodic urine cytology to monitor the recurrence of cancer of the urinary tract. Therefore, it is appropriate for developing countries with limited resources like Ethiopia. Exfoliative cytology Refers to the examination of cells that are shed spontaneously into body fluids or secretions. Examples include sputum, cerebrospinal fluid, urine, effusions in body cavities (pleura, pericardium, peritoneum), nipple discharge and vaginal discharge. Abrasive cytology Refers to methods by which cells are dislodged by various tools from body surfaces (skin, mucous membranes, and serous membranes). Such cervical smears, also called Pap smears, can significantly reduce the mortality from cervical cancer. Hematological examination this is a method by which abnormalities of the cells of the blood and their precursors in the bone marrow are investigated to diagnose the different kinds of anemia & leukemia. Immunohistochemistry this is a method is used to detect a specific antigen in the tissue in order to identify the type of disease. Microbiological examination this is a method by which body fluids, excised tissue, etc. Biochemical examination this is a method by which the metabolic disturbances of disease are investigated by assay of various normal and abnormal compounds in the blood, urine, etc. Clinical genetics (cytogenetics), this is a method in which inherited chromosomal abnormalities in the germ cells or acquired chromosomal abnormalities in somatic cells are investigated using the techniques of molecular biology. Molecular techniques Different molecular techniques such as fluorescent in situ hybridization, Southern blot, etc. For example, in diabetes mellitus, biochemical investigation provides the best means of diagnosis and is of greatest value in the control of the disease. However, for most diseases, diagnosis is based on a combination of pathological investigations. The causes of disease Diseases can be caused by either environmental factors, genetic factors or a combination of the two. Environmental factors Environmental causes of disease are many and are classified into: 1. Physical agents these include trauma, radiation, extremes of temperature, and electric power. Chemicals With the use of an ever-increasing number of chemical agents such as drugs, in industrial processes, and at home, chemically induced injury has become very common. Many toxic chemicals are metabolized in liver and excreted in kidney, as a result, these organs are susceptible to chemical injury.

order cheap diovan on-line

In other words hypertension treatment guidelines 2014 buy 40 mg diovan otc, the overt act of interpreting is skipped in an attenuated process of perceptual knowing arrhythmia from excitement 160 mg diovan mastercard. He goes on to contrast this account with a more positivist approach: Intellectualism cannot conceive any passage from the perspective to the thing itself heart attack get me going radio edit buy generic diovan 160mg online, or from sign to signi cance otherwise than as an interpretation blood pressure chart emt purchase 160 mg diovan mastercard, an apperception prehypertension causes diovan 80mg low price, a cognitive intention pulse pressure 50-60 buy diovan online now. The analysis of motor habit as an extension of exis tence leads on, then, to an analysis of perceptual habit as the coming into possession of a world. Our experience of habitual perceptions is so attenuated as to skip the stage of conscious interpretation and intent. It is just such a modernist account that would explain why it is commonly believed that for one to be a racist one must be able to access in consciousness some racist belief, and that if intro spection fails to produce such a belief then one is simply not racist. A fear of African Americans or a condescension toward Latinos is seen as simple perception of the real, justi ed by the nature of things in themselves without need of an interpretive intermediary of historico-cultural schemas of meaning. The Phenomenology of Racial Embodiment 189 If interpretation by this account operates as simple perception, at least in certain cases, are we not led to pessimism about the possibility of altering the perceptual habits of racializations Here I would think that the multiple schemas operating in many if not most social spaces today would mitigate against an absolute deter minism and thus pessimism. Perceptual practices are dynamic even when con gealed into habit, and that dynamism can be activated by the existence of multiple forms of the gaze in various cultural productions and by the challenge of contra dictory perceptions. White Ambitions Phenomenological descriptions of racial identity can reveal a differentiation or distribution of felt connectedness to others. The felt connectedness to visibly similar others may produce either ight or empathic identi cation or other possible dispositions. In an earlier memoir, he recounts how as an adolescent he tried to shave the darkness off his skin in a t of agonized frustration (1983, 5). Like Kerouac again, Rodriguez wants to escape, and he experiences racial identity as a cage constraining his future, his aspirations; also like Kerouac he experiences it as somehow at odds with his felt subjectivity. His postural body image is internally incoherent, and Rodriguez struggles persistently against the racial parameters that Fanon says characterizes colonized consciousness. Where Kerouac forgoes white ambition and yet resigns himself to whiteness, Rodriguez pursues white ambitions and in this way seeks to escape his visible identity and to repudiate his felt connection with visibly similar others. Rodriguez recounts a conversation he had with an American Indian student when he was teaching at Berkeley. The mixed person, unless she or he declares in her self-representation as well as her everyday practices to be identi ed with one group or another, feels rejection from every group, and is ready to be slighted on an everyday basis for presuming an unjusti ed association. She is constantly on trial, and unable to claim epistemic authority to speak as or to represent. Rodriguez experiences a double hybridity: the hybridity of a Mexican American educated and enculturated in an Anglo environment, and the hybridity of Latinidad itself, be tween indigenismo and conquistador. Rodriguez de ects this denigration by demarcating his hybrid world into neatly mapped spaces and urging their segregation. He argues that Spanish, the mother tongue, the female tongue, is proper to the private sphere, and should be spoken only at home for bilingual Latinos in the United States. He characterizes English as the public language, the language of social intercourse, the language for intervening in politics, and thus a language clearly coded masculine. English is justi ably normative because its universality is simply inevitable, Rodriguez argues. Thus he has been an important public critic of bilingual education programs and any policy that might have the effect of incorrectly merging what should be carefully sequestered realms of discourse. Assimilation to an Anglo world is life; the resistance to assimilation is an embrace of death. Unlike Kerouac on this point, Rodriguez does not romanticize the nonwhite racial Other, which is a form 9 of love Lewis Gordon aptly likens to pet loving. For Rodriguez, ambition can only be white; there is no conception of an ambition beyond or apart from intercourse in a dominant Anglo world. Racial difference is often experienced as a distancing without regard to spatial proximity. Anglo identity is again associated with the public, the realm of ambition, the sphere of action in a social world, while Indian identity remains on the Phenomenology of Racial Embodiment 191 the body, pulling against ambition, social intercourse, even, Rodriguez says, life itself. Thus, he sees the man as a near somnambulist, a man poised between the life embodied in the New York Review of Books and the death of a historical dreamworld. I would argue that this mediation through the visible, working on both the inside and the outside, both on the way we read ourselves and the way others read us, is what is unique to racialized identities as opposed to ethnic and cultural identities. The criteria thought to determine racial identity have ranged from ancestry, experience, self-understanding, to habits and practices, yet these sources are coded through visible inscriptions on the body. The processes by which racial identities are produced work through the shapes and shades of human morphology, the size and shape of the nose, the design of the eye, the breadth of the cheekbones, the texture of hair, and the intensity of pigment, and these subordinate other markers such as dress, customs, and practices. And the visual registry thus produced has been correlated with rational capacity, epistemic reliability, moral condition, and, of course, aesthetic value. Rodriguez has learned this visual registry in its dominant white form, and thus he moves back and forth 10 between exploring its racism and adopting it as his own perspective, letting it dominate his body image almost as a perceptual habit-body, or habit of perception. What could be more permanently visible than that which is inscribed on the body itselffi As I have already argued, racial identities that are not readily visible create fear, consternation, and the sometimes hysterical determination to nd their visible trace. The case of Alice Rhinelander that I discussed in the introduction, forced to bare her breasts in a court of law, exhibits this determination, as does the Nazi effort to nd physical signs of Jewish identity that could be measured with calipers. Similar to the Jews, the Irish were a racialized group internal to Europe until the twentieth century. The observer in this passage experienced a disequilibrium in his cor poreal self-image prompted by nding his own features in the degraded Other. Clearly, one source of the importance of visibility for racialized identities is the need to manage and segregate populations and to catch individuals who trespass beyond their rightful bounds. But there is another reason for the importance of visibility, a reason I would argue is as signi cant as the rst: visible difference naturalizes racial meanings. In other words, the visible is not merely an epiphenomenon of culture, and thus precisely lies its value for racialization. We may need to be trained to pick out some features over others as the most salient to identity, but those features nonetheless have a material reality. Locating race in the visible thus produces the experience that racial identity is immutable. This is why race must work through the visible markers on the body, even if those markers are made more visible through learned processes. In some cases, the perceptual habits are so strong and so unnoticed that visible difference is deployed in every encounter. In other situations, the deployment of visible difference can be dependent on the presence of other elements to become salient or all-determining. For an example of such a situation, I will relate a case I discussed with a philosophy graduate student with whom I regularly converse about issues in the classroom. John himself then began to relax in the classroom, interacting without self consciousness with a largely white class. Despite the hierarchy between students and teacher, there seemed to be little or no racial distancing in their interactions. However, at a certain point in the semester, John introduced the subject of race into the course through an assigned reading on the cognitive dimensions of racism. Previously open-faced students lowered their eyes and declined to participate in discussion. John felt a dif ferent texture of perception, as if he were being watched or observed from a dis tance. It was not that before he had thought of himself as white, but that he had imagined and experienced himself as normative, accepted, recognized as an instructor capable of leading students toward greater understanding. Now he was reminded, forcibly, that his body image self was unstable and contingent, and that his racialized identity was uppermost in the minds of white students who suddenly developed a skeptical attitude toward his analysis and imparted it in a manner they had not been con dent enough to develop before. I have experienced this scenario many times myself, if I raise the issue of race, cultural imperialism, the U. Epistemic authority is shifted away from a professor of color when he or she addresses issues of race, away from women addressing issues of gender. Sud denly, white students lose their analytical docility and become vigilant critics of biased methodology. The visible identity of the teacher counteracts all claims of objectivity or earned authority as knower. Such an experience, as Eduardo Men dieta has suggested, is as if one nds oneself in the world ahead of oneself, the space one occupies as already occupied. Before a nonwhite professor assigns an article on race, white studentspostural body image can remain intact, un challenged. The teachersotherness at this stage can be subsumed under a number of nonthreatening categories, from the compliant servant to the assimilated other who demonstrably accepts a white worldview as the truth, and so on. The students do not perceive the teachersrecognition of them as challenging in any way. When race enters the classroom as a theme, and especially as a theme introduced by a nonwhite, their con dence and ease about how the teacher is perceiving them begins to erode, creating a break between rst and third-person perspectives. Disequilibrium for whites is not an in evitable result of the mere presence of racial others, then, even in a historico-racial schema of white supremacy, though it may be experienced as a potential disrup tion that the body appreciates and which puts it in the mode of watchfulness. A hyperactive self-awareness must inter rogate the likely meanings that will be attributed to every utterance, gesture, or action one takes. The available options of interaction across the visible difference seem closed down to two: combative resistance without hope of persuasion, or an attempt to return to the category of nonthreatening other, perhaps through attaining the place of the not-really-other. Neither can yield a true relationship or dialogue; both are options already given within the white dominant racial structure. When I was much younger, I remember nding out with a shock that a white lover, my rst serious relationship, had pursued me because I was Latina, which no doubt stimulated his vision of exoticism. We had grown up in the same neighbor hood, attended the same schools, listened to the same music, and shared similar ambitions toward college and escape from our shared class. Yet our rst encounters, our rst dates, which I had naively believed were dominated by a powerful emo tional and intellectual connection, were experienced by him as a fascinating 11 crossing over to the forbidden, to the Other in that rei ed, racializing sense. I felt incredulity, and then humiliation, trying to imagine myself as he saw me, replaying 194 Racialized Identities and Racist Subjects my gestures and actions, re ecting back even on the clothes I wore, all in an attempt to discern the signs he may have picked up, to see myself as he must have seen me.

Order generic diovan from india. MCQ on Blood Transfusion | B. Pharm | Nursing | Pharmacist | GPAT | Bhushan Science.

purchase diovan 160 mg with visa

Syndromes

References