für 44.10€ kaufen ···· Rheinberg-Buch.de - Bücher, eBooks, DVD & Blu-ray This book aims to determine the age and sex distribution of patients with end stage renal disease in Benin City Nigeria. 2. Study renal changes in chronic renal failure (CRF)and determine where possible the causal agents in relation to chronic renal failure. 3. Compare results with those of similar studies.Twenty nine of the patients (58%) are males, 21 (42%) are females, with a male to female ratio of 1.38:1. The largest concentration of CRF related deaths occurred in the 30-39 years 18 (36%), with the age range varying from 8 years in a male child who died of Good Pastures syndrome, to a 65 year old woman dying ofchronic hypertensive renal disease. The average age of patients dying from CRF is 43.9 years SD 6.6. Adult polycystic kidney disease is responsible for 2 (4%), Systemic lupus erythematosus 1(2%). Chronic glomerulonephritis is responsible for 21 (42%), the most significant cause of both end stage kidney disease and CRF. Diabetic nephropathy is responsible 7(14%) Hypertension is responsible for 15 cases (30%). Chronic renal failure related deaths in Benin city Nigeria has a slight male preponderance of 1.38:1, and occurred in the average age group of 43.9 years SD 6.6. ····· 10361101086
für 44.10€ kaufen ···· Rheinberg-Buch.de - Bücher, eBooks, DVD & Blu-ray Chronic wounds are a common cause of morbidity world wide. The frequent lack of any clinical assessment of patients in the community has led to long periods of ineffective and often in appropriate treatment.When considering any health care problem it is useful to have a clear impression of scale of the problem and the burden of care it represents.The prevalence of leg ulceration has been the subject of study for more than 20 years.A leg ulcer is not a discrete disease with clear diagnostic criteria rather it is the consequence of various kinds of underlying disease process.The range of diseases and conditions with the potential for leg ulceration is broad.Although diagnostic and therapeutic decisions in patients with vascular diseases are guided primarily by the history and physical examination, the use of non invasive investigations has increased significantly in recent years mainly as a result of technological advances in ultrasonography ····· 10361101078
für 44.10€ kaufen ···· Rheinberg-Buch.de - Bücher, eBooks, DVD & Blu-ray Diagnosis of cause of syncope is very difficult and often unrewarding even though it is fairly common problem. Universally accepted guidelines are not well established till now and only expert consensuses are available for managing syncope patients. In this study we choose a subset of young adults presentating with syncope and did extensive clinical evaluation followed by routine 12 lead ECG and then subjected them to either Tilt Table Testing or Holter monitoring, and we could arrive to diagnosis of syncope in majority of our patients without doing extensive investigations. This book focuses on various theories/mechanisms of syncope and detailed explanation for them have been elucidated clearly. To improve the diagnostic yield of HUTT (Head Up Tilt Table) we analysed clinical predictors or likelihood ratios of positive tilt table test based upon routine clinical examination and also did Time Domain and Frequency Domain analysis of Heart Rate Variability during HUTT testing. ····· 10361101048
für 53.10€ kaufen ···· Rheinberg-Buch.de - Bücher, eBooks, DVD & Blu-ray In vestibular neuritis, most of researchers had focused on studying its effects on gaze problems &illusion of change in head orientation or movement. In this essence, therapy was mostly directed to alleviate vertigo symptoms and gaze disorders through vestibular rehabilitation therapy addressing vestibule-ocular reflex VOR. This study focused mainly on examination of balance & posture control (vestibule-spinal reflex VSR) in patients suffering from vestibular neuritis under variable complex situations. It also addressed the effectiveness of Vestibular Rehabilitation Therapy VRT promoting balance control on the patient`s status& overall performance. Results elaborated that the majority of patients with vestibular neuritis really suffered gaze stabilization deficits however they also suffered balance disorders especially for complex actions and situations. Vestibular rehabilitation therapy using exercises promoting both VOR& VSR i .e. enhancing gaze stabilization & balance were superior to alleviate patients` symptoms and improve residual disabilities as shown by subjective& objective measures. In this way, VRT could have better image among patients as well as physicians. ····· 10361100944
für 61.20€ kaufen ···· Rheinberg-Buch.de - Bücher, eBooks, DVD & Blu-ray The best way to manage small and medium sized vestibular schwannomas is currently a matter of heated debate. As these tumors are not immediately life-threatening, patients are invariably concerned about how management would affect their quality of life. In comparison with microsurgical resection of vestibular schwannomas, radiosurgery has a lower morbidity rate, a similar risk of requiring further surgery, and higher patient satisfaction. As this information becomes more widely available, radiosurgery may replace surgical resection as the preferred management strategy for patients with small to medium sized vestibular schwannomas This work evaluates the applicability and effectiveness of gamma knife stereotactic radiosurgery as a treatment modality for vestibular schwannoma. It also reviews the use of gamma knife radiosurgery as a safe and efficient alternative therapy. ····· 10361100855
für 44.10€ kaufen ···· Rheinberg-Buch.de - Bücher, eBooks, DVD & Blu-ray Two-dimensional strain ( ) and strain rate imaging (SRI), are new ultrasound (US) indices for quantifying regional wall deformation. Tissue Doppler imaging (TDI) has already been shown to complement established parameters in evaluating early systolic and diastolic performance. However, the widespread use of this methodology remains limited due to the fact that Doppler-derived velocity and deformation data are one-dimensional, resulting in an angle dependency of the measurements. Speckle tracking is a novel method of assessing regional as well as global `contractility`. This method overcomes many limitations inherent in assessing myocardial functioning with current methodology. ····· 10361100814
für 44.10€ kaufen ···· Rheinberg-Buch.de - Bücher, eBooks, DVD & Blu-ray Sonography is an imaging tool with many advantages while assessing the immature skeleton. In the last decade the Ponseti method of correcting clubfoot deformity by serial castings has gained terrain. By well-defined ultrasound (US) imaging projections the severity of the foot deformity can be assessed and its treatment monitored dynamically. Sonography can also be used in teaching how to perform the correcting manoeuvres properly. A reproducible US protocol for evaluating congenital clubfoot pathoanatomy, especially the talo-navicular and the calcaneo- cuboid joints, was developed. Normal configurations of the relationships at these joints were obtained by investigating healthy babies. Variations in clubfoot pathoanatomy are described. Morphological changes taking place during early clubfoot treatment, using the Ponseti method, were assessed and compared with a group treated by intensive physiotherapy and plexidur splint. The detailed descriptions of the sonographic protocol and its clinical implications should be useful to paediatric orthopaedic surgeons, physiotherapists, radiologist and other medical professionals treating and assessing clubfeet. ····· 10361100792
für 44.10€ kaufen ···· Rheinberg-Buch.de - Bücher, eBooks, DVD & Blu-ray Arterial stiffness has established as cardiovascular risk factor, it has also emerged as a potential target for intervention. Its serve as reliable surrogates marker in clinical endpoints like myocardial and cerebrovascular incidents. Drugs may improves the stiffness of arterial wall through either functional or structural mechanism. This book therefore review the effect of oral hypoglycaemic agent (OHA) metformin or sulfonylurea or combination on arterial stiffness in Malay diabetic patient. Diabetic patients have increased arterial stiffness compared with age and sex-matched non diabetic subjects, which may partly explain why diabetes mellitus are associated with increased CV risk. This study also showed that two different groups of OHA have no effect in relation to arterial stiffness. The information and finding should be useful to professionals who involved in care of diabetic patient and anyone who interest in chronic diseases management. ····· 10361100747
für 44.10€ kaufen ···· Rheinberg-Buch.de - Bücher, eBooks, DVD & Blu-ray The HIV epidemic is a new, complex challenge in the world today. AIDS is not simply a health issue but a general development concern above all else. It is a social and economic threat in countries where it is rampant. Its health impact is revealed in its association with morbidity and mortality. The increasing number of people, mostly healthy productive young men and women dying daily is causing concern. This book addresses the challenges of HIV and AIDS epidemic. ····· 10361100736
für 71.10€ kaufen ···· Rheinberg-Buch.de - Bücher, eBooks, DVD & Blu-ray Cerebral aneurysms and arteriovenous malformations (AVMs) are two major causes of hemorrhagic cerebrovascular diseases, Intra-arterial cerebral angiography is always the definitive diagnostic test in cerebral aneurysm however high resolution CT & CTA can discover small cerebral aneurysms that conventional angiography fails to reveal, also MRI & MRA are very useful in diagnosis of intracranial aneurysms. On the other hand, Cerebral angiography is the method of choice for the diagnosis of cerebral AVMs while advanced post processing techniques of 3D CTA and MRA studies can be used to highlight the feeding artery, the nidus and the draining veins. Cerebral aneurysms can be treated by surgical clipping or endovascular coiling with detachable coils, while treatment options of cerebral AVMs include endovascular embolization, radiosurgery and microscopic surgery. This book provides the basic and advanced information about intracranial aneurysms & arteriovenous malformations, how to diagnose and how to treat by endovascular technique, for the radiologists and interventionists. ····· 10361100727
für 61.20€ kaufen ···· Rheinberg-Buch.de - Bücher, eBooks, DVD & Blu-ray an electrophsiological study in children.The aim of my work was to point out the risk stratification for morbidity, mortality and occurrence of SVT in children and adolescents with accessory pathways using their clinical data, 24 hour holter monitoring, exercise ECG and electrophysiological study.we conclude the following statments The 12 lead surface ECG during and after the SVT attacks and holter monitoring can be used non invasively to detect preexcitation in children with SVT. The localization of the accessory pathway can be done using fine and crude algorithm in the 12 lead surface ECG to localize accessory pathway. Not all accessory pathways are manifest thus EPS is done to exclude concealed pathways. During EPS the electrophysiologist should be aware that patients can have more than one AP. This study suggests that the left lateral position is a common site for accessory pathways to be looked for. Caution should be taken while ablating septally located pathways since they have a high rate of recurrence. Recommendation ····· 10361100710
für 44.10€ kaufen ···· Rheinberg-Buch.de - Bücher, eBooks, DVD & Blu-ray Almost all asthma patient demonstrate bronchial hyper responsiveness. Bronchial hyper responsiveness is an abnormality of the airway, which makes the airways to narrow too much & too easily in response to various stimuli either direct or indirect . Bronchoprovocation test is performed to evaluate the bronchial hyper responsiveness. In this study we proved that hypertonic saline is an equally effective bronchoprovocative agents as methacholine which was commonly used for challenge test or bronchoprovocation test for the diagnosis of Bronchial Asthma. More over hypertonic saline has very little effect or no effect in contrast to methacholine on normal subject,which is responsible for false positive result. So we can conclude that , hypertonic saline is more specific bronchoprovocative agent in the diagnosis of bronchial asthma .Since hypertonic saline is very cheap & easily available , we propose that it should be considered as reliable bronchoprovocative agent for the diagnosis of Bronchial asthma in underdevloped countries . ····· 10361100677
für 53.10€ kaufen ···· Rheinberg-Buch.de - Bücher, eBooks, DVD & Blu-ray There is currently no effective tool available to quickly and economically measure a change in landmass in the setting of biomedical professionals and environmental specialists. The purpose of this study is to structure and demonstrate a statistical change- detection method using remotely sensed data that can detect the presence of an infectious land borne disease. Data sources included the Texas Department of Health database, which provided the types of infectious land borne diseases and indicated the geographical area to study. A method was developed to identify statistically the severity of changes of the landmass over a three-year period. Data analysis included using a unique statistical detection procedure to measure the severity of change in landmass when a disease was not present and when the disease was present. The statistical detection method was applied to two different remotely sensed platform types and again to two like remotely sensed platform types. The results indicated that when the statistical change detection method was used for two different types of remote sensing mediums (i.e.- digital orthophoto quadrangle and aerial videography) ····· 10361100650
für 44.10€ kaufen ···· Rheinberg-Buch.de - Bücher, eBooks, DVD & Blu-ray Current study was designed to study variation of blood pressure with different seasons in Delhi, which has extremes of temperatures e.g.maximum temperature in summer crosses 40°C and minimum temperature in winter falls close to 0°C. Relationship of variation in blood pressure with meteorological factors has been analyzed.During summer,patients, particularly women often complain of symptoms such as weakness, giddiness and blackouts.These are often attributed by patients and even physicians to lowered blood pressure.Current study seeks to establish magnitude of this problem and analyse if there is an association of these symptoms with variation in blood pressure.The study shows significant increase in mean systolic and diastolic blood pressure during winter compared to summer.Results also show that the problem of summer associated symptoms is common but not associated with variation in blood pressure.The symptoms were not related to hyponatremia associated with heat exhaustion thus indicating mechanism other than lowered blood pressure to be responsible for these symptoms.Thus it highlights need for further research on this subject ····· 10361100633
für 44.10€ kaufen ···· Rheinberg-Buch.de - Bücher, eBooks, DVD & Blu-ray Clinical and virological outcomes are variable following acute infection with HCV. Chronic infection is characterized by attenuated and narrowly focused CD4+ and CD8+ T-cell responses in conjunction with reduced proliferative, cytokine, and cytolytic capacity of HCV-specific T cells and loss of antigen recognition. Conversely, CD4 and CD8 T-cell responses are maintained in individuals who clear the virus. Therefore, effective T-cell-dependent immune responses to HCV-specific viral epitopes, restricted by the presence of host human leukocyte antigens (HLA) class I (CD8 cytotoxic T cells [CTL]) and class II (CD4 helper T cells), appear to make an important contribution to adaptive immunity and disease outcome. ····· 10361100322
für 44.10€ kaufen ···· Rheinberg-Buch.de - Bücher, eBooks, DVD & Blu-ray Dockyard laborers are exposed to a variety of genotoxic compounds including heavy metals, polycyclic aromatic hydrocarbons (PAHs), noise, airborne particles etc. But no specific information is available regarding the effect of exposure to occupational hazards of this group of laborers in Bangladesh. Immunoglobulins, Trace Elements, Lipid peroxidation, Plasma antioxidant vitamins level (retinol, alpha-tocopherol and ascorbic acid) and extent of DNA damage were analyzed in 100 dockyard laborers and compared with 100 control day laborers having similar socioeconomic status but not exposed to occupational hazards like dockyard laborers. The immunoglobulins levels varied significantly, the plasma MDA levels as well as extent of DNA damage were significantly higher whereas the plasma retinol and ascorbic acid levels were significantly lower in dockyard laborers than the control group (p0.05) but the change in a-tocopherol level was not statistically significant (p ····· 10361100304
für 71.10€ kaufen ···· Rheinberg-Buch.de - Bücher, eBooks, DVD & Blu-ray The Male Erectile Disorder is the most common of all the sexual dysfunctions for which men seek help from the sexologists throughout the world. The research on this crucial area of male sexuality is relatively non existent in Pakistan. The author has rightly conducted a qualitative analysis of the case histories of men with erectile dysfunction. The results of the research reveal the distribution patterns of Male Erectile Disorder as it occurs in Pakistan. The author has documented the clinical and social correlates of the erectile dysfunction. The etiological perspectives within the context of Pakistani culture have been explained. The author gives recommendations on how to improve the sexual health of men in Pakistan. The formation of PAkistan Society of Sexologists (PASS)is a right step in this direction. The book is a must read for those who want to know about the sexual lives of men in Pakistan. ····· 10361100229
für 53.10€ kaufen ···· Rheinberg-Buch.de - Bücher, eBooks, DVD & Blu-ray Iron-deficiency anaemia (IDA) in adolescents continues to be of worldwide concern. Among adolescents in the developing world, iron is the most common single-nutrient deficiency. Iron deficiency anaemia, in adolescent girls may be mainly due to eating habits, socioeconomic factors and menstrual bleeding. Iron deficiency anaemia may lead to serious consequences in adolescent girls who will be future mothers especially during pregnancy.The incidence of iron deficiency amongst adolescents is rising and the awareness regarding anaemia and appropriate diet is extremely poor in adolescents, which is made worse by the lucrative promotional campaigns of various junk foods. Hence nutrition education, supplementation and food fortification may be the strategy to prevent iron deficiency anaemia especially in adolescent girls. ····· 10361100169
für 53.10€ kaufen ···· Rheinberg-Buch.de - Bücher, eBooks, DVD & Blu-ray Adequate resuscitation of shock early in the Emergency Department (ED) is essential to ensure improved patients outcome. The conventional end-points of resuscitation used are inadequate to determine systemic perfusion and oxygenation. Serum lactate is a more reliable endpoint of resuscitation. This study examines the use of serum lactate at various points of resuscitation in ED and their association with patients thirty-days survival time. Results of this study shall add to our understanding of the complex physiology of shock and its clinical relevance. Clinicians and scientists alike will undoubtedly benefit from the result in such a way that it will change the way we resuscitate critically ill patients. Hopefully we will be nearer to the truth in our endeavor to search for the most reliable parameter of shock during resuscitation. ····· 10361100033
für 53.10€ kaufen ···· Rheinberg-Buch.de - Bücher, eBooks, DVD & Blu-ray Naswar is a Smokeless Tobacco Product (STP) widely used in Pakistan. It has been correlated with oral and esophageal cancer in recent clinical studies. The toxic effects associated with S.T.P have been associated with trace level contaminants present in these products. That is why toxin level of Pakistani Naswar is reported for the first time in this study. Thirty Pakistani brands of Naswar were tested for a variety of toxic constituents and carcinogens such as cadmium, arsenic, lead and other carcinogenic metals nitrite and nitrate and nicotine and pH. The average values of all the toxins studied were well above their allowable limits, making the product a health risk for its consumers. Calculated life time cancer risk is well above the minimum target range for potentially hazardous substances.This study shows that the production, packaging, sale and consumption of Naswar should be regulated, and the general public be made aware of its harmful effects, so that to protect them from the health hazards associated with its consumption. ····· 1036199904
für 44.10€ kaufen ···· Rheinberg-Buch.de - Bücher, eBooks, DVD & Blu-ray Poultry industry is an important portion of the livestock sector contributing in the national economy and the current status of Pakistan poultry industry is about Rs. 100 billion. There are about 25,000 poultry farms in the country. Poultry sector generates employment & income for about twelve hundred thousand people. Its growth rate is 10- 12% annually. Pakistan is producing 10,000 million table eggs & 750 thousand metric tons chicken meat annually. The per capita consumption of meat is 7 kg & 60-65 eggs annually (Anonymous, 2008) but unfortunately so many threats & fatal diseases i.e. bacterial, viral, fungal & parasitic diseases are still disturbing the industry. Among parasitic diseases, coccidiosis is one of the most important hazard. It is the disease of poultry caused by an obligate microscopic protozoan parasite, which belongs to the genus Eimeria (phylum Apicomplexa). Seven Eimeria species have been recognized infecting chicken: E. acervulina, E. maxima, E. tenella, E. brunette, E. necatrix, E. mitis & E. praecox. ····· 1036199587
für 44.10€ kaufen ···· Rheinberg-Buch.de - Bücher, eBooks, DVD & Blu-ray Nurses routinely identify clinical problems and question the best care for their patients (ONS, 2005). This paper will include a plan for an evidence-based practice change for the problem of potential transmission of pathogens to surgical patients via lanyards. The posing clinical question is, In surgical patients does the use of lanyards worn by operating room staff increase the future risk of surgical site infections compared with staff not wearing lanyards The proposed problem is one that nursing could resolve. The objective of this project is to determine if lanyards worn by health care workers could increase the risk of surgical site infections. Operating room nurses have a responsibility to adhere to practices that prevent surgical site infections in their patients. A comprehensive literature search revealed 32 publications. After inclusion and exclusion criteria were applied to each publication, six studies were relevant to contamination of inanimate objects, the transmission of pathogens, and the potential for nosocomial infections. The studies include one systemic review, two cross-sectional study, and three unspecified observational studies. ····· 1036199346
für 44.10€ kaufen ···· Rheinberg-Buch.de - Bücher, eBooks, DVD & Blu-ray The aim of this book was to establish the nutritional status and socio-economic factors predisposing under five-years-old children at Kenyatta National hospital to protein energy malnutrition. A total of 118 children aged below 60 months were targeted for the study. A descriptive cross sectional study was conducted. Sampling was done using purposive non probability and systematic sampling. The method that was used for data collection was interview and the tools which were utilised were questionnaires and anthropometric equipments (weighing scale and height/length board). The data was collected and entered into computer packages for analysis and presentation. The SPSS statistical program was used for analysis of the factors while the anthropometric statistical program was used to convert raw anthropometric data into anthropometric indices and then was compared with the National centre Health statistics (NCHS) reference figures. The prevalence of underweight, stunting, and wasting was 59.3% 53.3% and 33.9% respectively. There was a significant relation between stunting and complementary feeding and wastingwith the type of alternative caregiver. ····· 1036199083
für 53.10€ kaufen ···· Rheinberg-Buch.de - Bücher, eBooks, DVD & Blu-ray Pakistan still has a window of opportunity to act decisively to prevent the spread of HIV/AIDS. According to UNAIDS estimates HIV prevalence is 0.1 percent among adult population in Pakistan. The officially reported cases are, however, much lower than the estimated cases. As in many countries, underreporting is due mainly to the social stigma attached to the infection, limited surveillance and voluntary counseling and testing systems, as well as the lack of knowledge among the general population and health practitioners. Until recently, Pakistan was classified as a low-prevalence country with many risk factors that could lead to the rapid development of an epidemic. The presence of significant risk factors such as the very low use of condoms among vulnerable populations including female sex workers (FSW), men who have sex with men (MSMs), truckers, and Hijras, low use of sterile syringes among injecting drug users (IDUs), inadequate blood transfusion screening and high level of professional donors, large numbers of migrants and refugees may lead to an epidemic situation of HIV/AIDS in Pakistan. ····· 1036199002· 1 · ::::: · 13 ·· 14 ·· 15 ·· 16 ·· 17 ·· 18 ·· 19 · ::::: · 23 ·
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