Assessment of Therapeutic Effects of Subcutaneous...

Background and Objective: Neurologic literatrure about therapeutic effect of subcutaneous corticosteroids in patients with migrainous chronic daily headache is scare. Aim of this research is assessment of therapeutic effects of this management in the patients. Methods: Consecutive patients with migrainous chronic daily headache in our headache clinic enrolled a prospective before and after therapeutic study during 2010-2013. Fourty mg Metylprednisolone was divided in four subcutaneous injection doses. Two injections were done in right and left suboccipital area exactly at retromastoid cervicocranial junction and two injections were performed in lower medial frontal area exactly at medial right and left eye brow limit. A headache daily was filled out by the patient before and one month after intervention. The severity of pain was classified based on the Pain Intensity Instrument, using a 0-to-10 point numeric rating scale. Paired t test and Chi-square served for statistical analysis. Results: 504 patients (378 females, 126 males) with migrainous chronic daily headache underwent the study. Dramatic, significant, moderate and mild or no improvement constituted 28.6%, 33.3%, 23.8%, and 14.3% of the post treatment courses respectively. Therapeutic effect of intervention on mean pain scores was significant; t=7.38, df=20, p=.000. Two cases developed subcutaneous fat atrophy in frontal injection site and 3 cases experienced syncope during injection. Conclusion: Subcutaneous

Factors Which Stimulated Atlantic Maritime Exploration in...

Name: Omar Joseph Course Code: Hist 1601 Student Number: 407001944 Title: Assess the factors which stimulated Atlantic Maritime exploration in 15th century During the period of time 1400-1499 great gains were made by the Europeans in their quest for knowledge of the world they lived in. In this time period the Europeans circum-navigated Africa, located the territories of the West Indies and basically redrew the map of the world. All these things had one thing in common; they were the result of extensive Atlantic maritime exploration. The reasons that European engaged in such aggressive exploration in 15th century can be attributed to several factors. These factors can be grouped into three major headings, technological and†¦show more content†¦Thus each time a new tax was applied to the goods the Moslem merchants raised the price at which they would sell the goods at to recoup their expenses. Therefore as the Italian merchants had to cover their expenses that raised the prices of the goods also. This fact proved economically unacceptable to the other European merchants. The high cost of purchasing these goods made European merc hants willing to fund exploration to find an alternate route to the goods of India. The merchants believed that by finding the alternate route they could remove the middle men from the process of obtaining the goods and also as the route would not have to go through any other kingdom the goods would not be subjected to the taxation with increased the price it cost to obtain the goods. Therefore by obtaining the goods at a cheaper price the merchant realized they would gain vastly increased profits. Similarly it was not only merchants that saw the importance of finding and controlling a shorter route to the riches of Africa and India. Nations also saw the great benefits controlling such routes would bring to them. This was the principle reason that nations such as Portugal and Spain pursued maritime exploration. Portugal had to engage in this activity due to the fact that they did not have the natural resources in Portugal to engage in empire building. Prince Henry â€Å"theShow Mor eRelatedFactors Which Stimulated Atlantic Maritime Exploration in 15th Century2074 Words   |  9 Pages407001944 Title: Assess the factors which stimulated Atlantic Maritime exploration in 15th century During the period of time 1400-1499 great gains were made by the Europeans in their quest for knowledge of the world they lived in. In this time period the Europeans circum-navigated Africa, located the territories of the West Indies and basically redrew the map of the world. All these things had one thing in common; they were the result of extensive Atlantic maritime exploration. The reasons that European

Do People Have The Right To Choose free essay sample

When Essay, Research Paper Hickey 1 What precisely is euthanasia? There are many signifiers of this pattern, including physician assisted sucide, active mercy killing, and inactive mercy killing. In one commendation, mercy killing is the pattern of stoping a individuals life. Euthanasia is practiced worldwide be it legitimate or extremely illegal. Along with our apprehension and acception of mercy killing in todays # 8217 ; society, comes the unreciprocated inquiry, do people have the right to take when to decease? Euthanasia, besides known as clemency violent death, is the pattern of stoping life in order to give release from incurable agony or disease. The word comes form the Hellenic for an easy decease. Euthanasia, technically, refers to assisting patients end their ain lives and does non use to halting life prolonging interventions such as inhalators, or a bash non revive order. ( Glossary # 8230 ; ) Euthanasia can be active or inactive. Active mercy killing agencies that a doctor or other individuals involved with the attention of a patient, takes a calculated action to kill. We will write a custom essay sample on Do People Have The Right To Choose or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Administering an overdose of any prescribed drug is considered active mercy killing. Passive mercy killing agencies allowing a patient dice by manner of the deficiency of intervention, or suspending intervention that has begun. Examples of passive mercy killing include taking patients off a inhalator or taking other life-support systems. Stoping the nutrient Hickey 2 supply, normally occurs in the aged with intavenous devices. ( International # 8230 ; ) A great trade of the contention environing mercy killing comes from the determination procedure. Who decides if a patient is to decease? This issue has non been established lawfully in the United States. The affair is left to province jurisprudence, which normally allows the doctor in charge to propose the option of decease to a patients relatives, particularly if the patient is encephalon dead. ( Euthanasia # 8230 ; ) In an effort to do determinations about when their ain lives should stop, several terminally sick patients in the early 1990 # 8217 ; s used a controversial self-destruction device, developed by Dr. Jack Kevorkian, to stop their lives. This device was created from bit aluminium, a plaything auto, and other garbages scavenged from garage gross revenues and flea markets. The device consisted of a needle which was inserted into the arm of the patient get downing the endovenous flow of a toxicant solution. Kevorkian subsequently switched to a more luxuriant machine which consisted of a tightly fitted mask placed over the face, conncected to a C monoxide case shot. Kevorkian has been involved in 27 deceases to day of the month and has neer been convicted of any incorrect making. ( The Real # 8230 ; ) In parts of Europe, the determination devising procedure has go really flexible. Even in instances where the patients are Hickey 3 non encephalon dead, patients have been put to decease without their consent, at the petition of relations, or at the insisting of doctors. Many instances of nonvoluntary mercy killing affect older people or newborn babies. This is believed to be caused by the # 8220 ; non worthy of life # 8221 ; construct practiced in Nazi Germany ( 1933-45 ) . ( Nazism ) In states where nonvoluntary mercy killing is non legal, the tribunal systems have proven to be really indulgent in covering with medical personel who pattern it. In the Neatherlands and Japan, for illustration, if doctors follow certain guidlines they may transport out mercy violent deaths on terminally sick people. Courts have besides proven to be slightly indulgent with friends or relations who have assisted terminally ill patients to decease. ( Flynn 1-2 ) Euthanasia may look like a dignified manner of death, and in one commendation is described as painlessly seting to decease people who have incurable, painful, or straitening dieseases or disablements. This definition has proven false nevertheless. When a individual is killed with drugs ( deadly injection ) there organic structure frequently has violent paroxysms and musculus cramps. This is by no means a peaceable or dignified manner of deceasing. Besides, if a patient is non killed by the drugs administered to them, so they are frequently times suffocated with a plastic bag by the go toing doctor. ( International Anti # 8230 ; ) Hickey 4 Many physicians are opposed to the legilization of mercy killing. They believe that it is contrary to the full Hippocratic Oath which states, # 8220 ; # 8230 ; I will follow that system of regimen which, harmonizing to my ability and judgement, I see for the benefit of my patients # 8230 ; I will give no lifelessly medical specialty to any one if asked, nor suggest any such advocate # 8230 ; # 8221 ; One doctor provinces, # 8220 ; It ( mercy killing ) would gnaw trust between terminally sick patients and their physicians. # 8221 ; He farther goes on to province that, # 8220 ; Alternatively of therapists, physicians would go traders in decease # 8230 ; As a physician, I would non desire the province stating me to make away with somebody. # 8221 ; ( Risley 1-2 ) Mercy violent death is lawfully considered slaying in the United States, whether it involves shooting person with a drug to # 8220 ; hasten decease # 8221 ; or striping the individual of foods necessary to maintain him or her alive. But most provinces including Iowa, now have Torahs allowing # 8220 ; drawing the stopper # 8221 ; on person who has signed a papers stating he or she does non desire life prolonged by unreal agencies. This papers is called a bash non revive order. The papers provinces if a patients # 8217 ; bosom stops whipping, cardiorespiratory resuscitation will non be performed to protract life. ( Can We # 8230 ; ) Oregon has a # 8220 ; Death With Dignity Act # 8221 ; which states, # 8220 ; An Hickey 5 grownup who is capable and a occupant of Oregon may originate a written petition for medicine. The individual must be declared terminally ill by an go toing doctor. The individual must besides me declared terminally ill by a consultin doctor. The individual must recieve guidance to be certain of mental compitence. The go toing physician must inquire the patient to notify next of family. The individuals # 8217 ; medical records must be exhaustively reviewed. # 8221 ; This helps to do certain that all participants of this plan are sound of head and terminally ill. ( The Oregon # 8230 ; ) Euthanasia is explicitly criminalized in 35 provinces. Nine provinces criminalize assisted sucicide through common jurisprudence. ( Alabama, Idaho, Maryland, Massachusetts, Michigan, Nevada, South Carolina, Vermont, West Virginia ) Three provinces have abolished the common jurisprudence of offenses and do non hold legislative acts criminalizing aided self-destruction. ( North Carolina, Utah, Wyoming ) In Ohio, that province # 8217 ; s supreme tribunal ruled that aided self-destruction is non a offense. Merely the province of Oregon licenses doctor assisted suicide. If a doctor is convicted of any incorrect making in relation to the decease of a patient which is lawfully, ethically, or morally incorrect they may hold there liscense to pattern medical specialty revoked. ( Assisted suicide # 8230 ; )

U.S. national interests

By the time the World War II came to an end, the United States of America had begun involvement in world affairs. It was the richest and perhaps the most powerful nation at that time. Before world war two, the U.S preferred the isolationist policy to partnering with other nations on international matters.Advertising We will write a custom essay sample on U.S. national interests specifically for you for only $16.05 $11/page Learn More This saw the U.S economy suffer greatly after the World War I since America had gone into the war alone. To avoid further hurting their economy, the U.S changed from their isolationist policy to an interventionist policy which was more involving as it included other nations in form of allies. It was also partly caused by the U.S. realizing that instability and lack of peace in other parts of the world would eventually affect them in one way or the other. This triggered America’s support in the formation and hosting of the United Nations (UN). It also actively participated in the North Atlantic Treaty Organization (NATO). These were effort to ensure stability and peace as it became essential to minimize conflicts and solve them peacefully. With relative peace and stability, the U.S. could pursue its political and economic interests abroad. The main focus of this paper is to support the U.S. national interests and goals articulated after World War II. After world war two, America equated its national interests with pursuance of world superpower status. It had invested heavily in industrialization and therefore had mass production of various goods and services. To successfully pursue its political, social and economic interests, the U.S. had to make sure that there was enduring peace and democracy across the world. The U.S. made treaties and agreements with far-flung nations. These were countries of great interest to the U.S. in terms of trade and security; for the world order to be in place as it desired, the U.S. had to ensure it leads the way. The interventionist approach was of great benefit in helping the U.S. to enforce the new world order. For instance, the Spanish-American war in which the U.S. won within a short period of time helped in making it known as a powerful nation. The triumph in the war was followed by the U.S. taking control of an empire in the Caribbean and the Pacific. America had laid strong foundations for prosperity long before the two world wars. American education, innovation, military and science levels were highly advanced compared to other countries. This acted as an advantage to them to accomplish their mission. In as much as the U.S. chose to pursue the interventionist’s approach internationally, diplomacy largely came before militarism. This is evidenced by the fact that U.S. had the highest number of treaties and agreements with different nations. Theses treaties helped the U.S. in so many ways in its quest to be a superpower; it incre ased the market for America’s goods and services.Advertising Looking for essay on government? Let's see if we can help you! Get your first paper with 15% OFF Learn More Given its strong economic status, the U.S. gave out loans to nations like Germany and Japan which were reeling from devastation effects of the World War II. Since the U.S. promised to defend its allies, it won admiration leading to a strong relationship between them. The far reaching and stretched American empire had to be protected at all costs. This explains why America had so many military bases across the world. Arguably, change of America’s policy from isolationist prevented the outbreak of third world war. This was through active participation in the North Atlantic Treaty Organization (NATO) and the United Nations (UN). While the North Atlantic Treaty Organization suppressed war outbreaks through militarism, the United Nations largely used diplomacy among member states. For the Unite d Nations, diplomacy was the preferred conflict resolution tool but militarism was a measure of last resort. In spite of this, America’s steady growth to becoming a superpower, competition emerged from the communist Union of Soviet Socialist Republics (USSR). Ideological differences saw the two superpowers take contrasting paths on most issues. The 1950’s saw the beginning of decolonization in Africa. The two got embroiled in a fight to spread their ideologies among the newly-independent African countries. This shows how much interested the U.S. was in African countries given the fact it is a continent with minerals and resources. International politics and issues are dynamic. America’s foreign policy has to an extent also evolved to adapt to changes. America’s interventionist approach has won America Co-operation with other nations. For instance, Myanmar has benefitted from America’s interventionist policy. Today, it is on the path to democracy as compared to when it was under dictatorship before the U.S. intervened. The U.S. national interests and goals have also been under great scrutiny even by the U.S. citizens themselves. They fear their country’s over reliance on external oil. What happens if our relationship with these nations becomes strained? Such are the worries the U.S. has to an extent it does not want re-establishment and re-allocation of international responsibilities. In conclusion, the U.S. national interests and goals articulated after the World War II. First, they ensured that they obtained peace with majority of nations to act as a gateway through which they could pursue their interests and articulate their goals.Advertising We will write a custom essay sample on U.S. national interests specifically for you for only $16.05 $11/page Learn More Evidence to show that the U.S. had national interests after the World War II include: they had the highest number of treaties and agreements with different nations, they fought to obtain their interests and formed international policy which won them co-operation with many nations across the world. This essay on U.S. national interests was written and submitted by user Hezekiah Burt to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

Fibromyalgia Irritable Bowel Syndrome and Tender Points free essay sample

Fibromyalgia: Irritable Bowel Syndrome and Tender Points BY Jkush374 Fibromyalgia Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and multiple tender points. Tender points refers to tenderness that occurs in precise, localized areas, particularly in the neck, spine, shoulders, and hips. People with this syndrome may also experience sleep disturbances, morning stiffness, irritable bowel syndrome, anxiety, and other symptoms. Fibromyalgia affects 3 to 6 million Americans. It primarily occurs in women of childbearing age, but hildren, the elderly, and men can also be affected. Although the cause of fibromyalgia is unknown, researchers have several theories about what causes or triggers the disorder. Some scientists believe that the syndrome may be caused by an injury or trauma. This injury may affect the central nervous system. Fibromyalgia may be associated with changes in muscle metabolism, such as decreased blood flow, causing fatigue and decreased strength. Others believe the syndrome may be triggered by an infectious agent such as a virus in susceptible people but no such agent has been identified. We will write a custom essay sample on Fibromyalgia: Irritable Bowel Syndrome and Tender Points or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Fibromyalgia is difficult to diagnose because many of the symptoms mimic those of other disorders. The physician reviews the patients medical history and makes a diagnosis of fibromyalgia based on a history of chronic widespread pain that persists for more than 3 months. The American College of Rheumatology (ACR) has developed criteria for fibromyalgia that physicians can use in diagnosing the disorder. According to ACR criteria, a person is considered to have fibromyalgia if he or she has widespread pain in combination with tenderness in at least 11 of 18 specific tender point sites. The 18 Tender points are at the base of the skull beside the spinal column; at the base of the neck in the back; on the top of the shoulder toward the back; on the breastbone; on the outer edge of the forearm about 2 cm below the elbow; over the shoulder blade; at the top of the hip; on the outside of the hip; and on the fat pad over the knee. Some other symptoms include pain, fatigue, memory and concentration impairment, sleep disorders, exercise difficulties, irritable bowel syndrome, chronic headaches, Jaw pain, and others to many to list here. Treatment of fibromyalgia requires a wide-ranging approach. The physician, physical therapist, and patient may all play an active role in the management of fibromyalgia. Studies have shown that aerobic exercise, such as swimming and walking, improve muscle fitness and reduce muscle pain and tenderness. Heat and massage may also give short-term relief. Anti-depressant medications may help elevate mood, improve quality of sleep, and relax muscles. Patients with fibromyalgia may benefit from a combination of exercise, medication, physical therapy, and relaxation. Common sleep-aid medications include Ambien, Lunesta, clonazepam, orepinephrine are commonly prescribed in low doses for the treatment of fibromyalgia, Examples include amitriptyline, cyclobenzaprine, Cymbalta, and Savella. The pain medication Ultram may help with the treatment of fibromyalgia pain also. In addition to medications some other treatments that can be preformed to help alleviate the symptoms of fibromyalgia, these include trigger point injections with lidocaine, physical therapy, occupational therapy, acupuncture/acupressure, relaxation/biofeedback techniques, osteopathic manipulation, chiropractic care, therapeutic massage, and a gentle exercise program. As you can see fibromyalgia is very difficult to diagnose and to treat. Also from everything to I have read on it there is no specific reason on how the disease started or what caused it or any glaring factor that can be concentrated on how to treat fibromyalgia. This is exactly why many suffers from the disease feel helpless and scared cause they dont know what course of action to take to help alleviate their pain. Because of the on going pain and seemingly no answers as to why it is happing or what is causing it, many suffers start to feel as if they Just have to live with the pain and that it is normal. Which in turn is not good for the suffers mental state of mind. My aunt was diagnosed with fibromyalgia and few years ago and I can see how the on going pain and lack of a specific reason for the pain has affected her both physically and mentally, not to mention the many number of medications that she has been prescribed that have not helped. Although this is not a deadly disease it can affect people very profoundly. With on going research I hope that one day soon they will find a cause and a cure, and at the least away to help alleviate the symptoms of this disease to bring some relief to its suffers.

expression essays

expression essays Ideology is an ever-present factor in our everyday lives. A good amount of the information we receive is tainted by ideological values. These values, unique to the source of the information are windows or reinforcements on their standings regarding any number of topics. When we receive the information at hand it is then subject our own individual ideological beliefs and values that we hold true. Ideology in film is such a powerful factor that in my opinion it is the biggest factor that should be consider when analyzing the information of the film. When it comes down to it film is a direct result of what someone is showing you. What that person is showing you is what they want you to see and what they dont want you to see, tainted by their own ideological standings. Oliver Stones explicit left-wing film Natural Born Killers uses ideologies as an underlying theme being examined by the bi-polar categories of Relative versus Absolute, Secular versus Religious, and Outsiders versus Insiders. In this paper I hope to dissect and explain the bi-polar categories regarding ideology. In the film Natural Born Killers Woody Harrelson and Juliette Lewis are Mickey Knox and Mallory Wilson, two young, attractive mass murderers in love in Stone's wild-eyed satire on the American fascination with criminals. After killing Mallory's loathsome parents, the pair perform a ritual "marriage" and take off on a "honeymoon" killing spree that wipes out 52 people pursued by a bad cop just as criminal. Bloodthirsty t.v. reporter Wayne Gale (Robert Downey Jr.) reports their every move to an adoring public. While warden Dwight McClusky (Tommy Lee Jones) is only too eager to welcome such celebrities to his prison for his own gain. The underlying ideological expression of Stone in this film is what I thought made it so powerful. Comparing the bi-polar category of Relative versus absolute and th ...

Seagram building Essay Example | Topics and Well Written Essays - 2500 words

Seagram building - Essay Example The design of the building was given by Ludwig Mies van der Rohe who came to America from Germany (Whiffen and Koeper, 1984). The mythic ideals of German efficiency and clean cut German design are certainly evident from the way the building is structured yet the overall mix of the faà §ade of the building does not make it stick out like a sore thumb amongst the other buildings which surround it. The design also takes its cues from the American architect Philip Johnson who worked on the building from the time it was started in 1954 to the time it was completed in 1958. The building contains 38 floors and the exterior represents a fine example of post modern architecture that focuses on corporate seriousness and hints of gothic styling (Muschamp, 1999). The initial purpose of the building was to serve as corporate headquarters and the primary offices for Seagram’s & Sons but with time other offices and companies have established their bases in the building as well. While it would be interesting to study how the tenants of the building have changed with time, for our purposes, it is perhaps more important to study the architecture and the art of the building. The building faces Park Avenue over a broad plaza of Vermont granite which is lined by water pools on both sides that have ledges of marble that has been given an antique look (Whiffen and Koeper, 1984). The architecture of the tower itself is based on the steel structure that holds the building together with walls of pink-gray glass that give the building a distinctive look. The second element, which helps in creating the now classic look for the building, come from the bronze that has been used to make the various spandrels and I-beams which are visible on the exterior of the building (Muschamp, 1999). Discussing the building in the context of its surroundings Speyer (1968) says that: â€Å"The inescapable drama of