Monday, January 13, 2020
Importance of Fungi: Fungi areÃ eukaryoticÃ organisms distinct from plants and animals and members of several other smaller kingdoms. Common fungi include mushrooms, conks, corals, jellies, puffballs, stinkhorns, morels, cups, truffles, lichens, yeasts, rusts, smuts, bread molds, mildews, and molds on bathroom tiles. In 1959, R. H. Whittaker introduced a five-kingdom taxonomy that granted fungi equal status with plants and animals. The five-kingdom system has been supplanted by a multiple-kingdom classification, and species traditionally treated as fungi are now distributed across several kingdoms.Those believed to form aÃ monophyletic lineageÃ are assigned to kingdom Eumycota (often called kingdom Fungi). Mycology, the science devoted to fungi, still covers all traditional fungi. Fungi are considered as one of the most prolific types of life on earth, which are found nearly everywhere around us. There are many different types of fungi some of which are very beneficial for ma nkind. It has immense economic applications and plays a major role in producing a number of products such as drugs, antibiotics penicillin, contraceptives, food, mushrooms, morels, cheeses, alcoholic beverages, and soybeans.Fungi have a profound biological and economic impact. As decomposers, plant pathogens, and symbiotic partners, their ability to grow anywhere, on anything, makes them both beneficial and harmful recyclers of carbon and nitrogen. Beneficially, they are used as food (mushrooms, truffles) and in baking and brewing (yeasts). They are being developed to detoxify pollutants (soil fungi), control insects (pathogenic Zygomycota), and regulate plant growth (pathogenic Ascomycota).Detrimentally, rusts, smuts, and molds cost billions of dollars through crop disease and spoilage while forest pathogens such as the honey mushroom (Ã Armillaria ostoyaeÃ ) and root-butt rot (Ã Heterobasidion annosumÃ ) similarly threaten the timber industry. Some are toxic when eaten, su ch as the infamous destroying angel (Ã Amanita phalloidesÃ ). Natural LSD, a hallucinogen produced by ergot (Ã Claviceps purpureaÃ ), is associated with medieval hysterical frenzies produced by consumption of infected grain, and theÃ aflatoxinÃ produced byÃ Aspergillus flavusÃ in improperly stored grain is one of the most potent carcinogens yet discovered.As human and animal pathogens, fungi cause infections that range from the vexing (athlete's foot, yeast infections) to life threatening (histoplasmosis). Fortunately, other fungi (such asÃ PenicilliumÃ ) have been used to develop modern antibiotics and beneficialÃ immunosuppressantsÃ . Recycling Fungi, together with bacteria, are responsible for most of the recycling which returns dead material to the soil in a form in which it can be reused. Without fungi, these recycling activities would be seriously reduced. We would effectively be lost under piles many metres thick, of dead plant and animal remains. Food Fungi are also important directly as food for humans. Many mushrooms are edible and different species are cultivated for sale worldwide. While this is a very small proportion of the actual food that we eat, fungi are also widely used in the production of many foods and drinks. These include cheeses, beer and wine, bread, some cakes, and some soya bean products. While a great many wild fungi are edible, it can be difficult to correctly identify them. Some mushrooms are deadly if they are eaten. Fungi with names such as Ã¢â¬ËDestroying Angel' and Ã¢â¬ËDeath Cap' give us some indication that it would not be a terribly good idea to eat them!In some countries, collecting wild mushrooms to eat is a popular activity. It is always wise to be totally sure that what you have collected is edible and not a poisonous look-a-like. Medicines Penicillin, perhaps the most famous of all antibiotic drugs, is derived from a common fungus called Penicillium. Many other fungi also produce antibiotic substances, which are now widely used to control diseases in human and animal populations. The discovery of antibiotics revolutionized health care worldwide. Some fungi which parasitise caterpillars have also been traditionally used as medicines.The Chinese have used a particular caterpillar fungus as a tonic for hundreds of years. Certain chemical compounds isolated from the fungus may prove to be useful treatments for certain types of cancer. A fungus which parasitises Rye crops causes a disease known as Ergot. The fungus can occur on a variety of grasses. It produces small hard structures, known as sclerotia. These sclerotia can cause poisoning in humans and animals which have eaten infected material. However, these same sclerotia are also the source of a powerful and important drug which has uses in childbirth. Food SpoilageIt has already been noted that fungi play a major role in recycling organic material. The fungi which make our bread and jam go moldy are only recycling orga nic matter, even though in this case, we would prefer that it didn't happen! Fungal damage can be responsible for large losses of stored food, particularly food which contains any moisture. Dry grains can usually be stored successfully, but the minute they become damp, moulds are likely to render them inedible. This is obviously a problem where large quantities of food are being produced seasonally and then require storage until they are needed.Types of Fungi Moulds and Yeast . Moulds The cotton-like mass grown on fruits, animal dung, leather goods or bread in a warm and humid climate is known as a mould. E. g. Mucor and Rhizopus . General Structure- Ã¢â¬ ¢They have a network of transparent structures called as hyphae. Ã¢â¬ ¢The entire mass of such threads is called as mycelin. Nutrition Ã¢â¬â They obtain their food from the substratum on which they grow. Respiration Ã¢â¬â they acquire aerobic respiration. Reproduction in moulds is both asexual and sexual. Ã¢â¬ ¢Asexual rep roduction in moulds occurs by the method of columella. Sexual reproduction in moulds occurs by the method of conjugation. Yeast Yeast is a one-celled microorganism growing all around us and on us. It grows when it has food and water, and suspends growth when it does not. In suspended animation, it is light enough to be blown by the wind, like a seed. If there is water and food where it lands, it will reproduce and continue the cycle. It is also on human skin and can be transferred to food through contact, with clean or dirty hands. Yeast has been exploited by humans for thousandsÃ to make bread, beer and wine. It does so by turning sugar into alcohol and gas to gain energy.
Posted by Unknown at 6:02 PM
Sunday, January 5, 2020
Running head: UNIT 8 WRITING ASSIGNMENT Unit 8 Writing Assignment Delphine Turner Kaplan University CJ266-02 Professor Clouse October 19, 2010 The legitimacy of the criminal justice system is based largely upon both its effectiveness and its fairness. Its effectiveness is judged by its ability to investigate and detect crime, identify offenders and mete out the appropriate sanctions to those who have been convicted of offences. Its fairness is judged by its thoroughness and the efforts it makes to redress the resource imbalance between the accused and the state at the investigatory, pre-trial, trial and appellate stages. The system does this by providing evidentiary protection and effective legal representation at all points.Ã¢â¬ ¦show more contentÃ¢â¬ ¦Academic studies in the United States indicate that between one-half and 1% of persons convicted of serious offences did not commit the crime. It has also been suggested by the Criminal Justice Research Centre that as many as 6,000 persons a year are wrongfully convicted of felonies in the United States. There are no similar estimates of the number of wrongful convictions in Canada. An official with the Department of Justice recently estimated that the Department receives about 30 applications a year for the review of criminal convictions. The causes of wrongful convictions are easy to identify: irregularities and incompetence at the investigatory, pre-trial, trial and appellate stages of the criminal justice system. More particularly, Kaiser identifies the following contributory factors, among others: false accusations, misleading police investigative work, inept defense counsel, misperceptions by Crown prosecutors of their role, factual assumption of an accuserÃ¢â¬â¢s guilt by actors in the criminal justice system, community pressure for a conviction, inadequate identification evidence, perjury, false confessions, inadequate or misinterpreted forensic evidence, judicial bias, poor presentation of an appellate case, and difficulty in having fresh evidence admitted at the appellate stage. Each instance of determined wrongful conviction illustrates a different combination of failures in the criminal justice system that hasShow MoreRelatedUnit 8 Writing Assignment6944 Words Ã |Ã 28 PagesWriting Assignments Considerations for Writing Assignments Types of Writing Assignments Freshman Rhetoric courses require at least 30 pages of writing that the instructor reads and responds to, and that counts towards the studentÃ¢â¬â¢s final grade in some way. Because this is a writing course, students should be engaged in writing in some form throughout the entire course. The following list describes the major forms of writing that instructors assign. 1. Essays (out-of-class papers). InstructorsRead MoreDocx949 Words Ã |Ã 4 PagesInternational University Ã¢â¬â HCMC Department of English IE2 READING WRITING 1. Course Statistics : 120 periods (8 credits) Number of instruction weeks : 10 Number of sessions : 30 Number of sessions per week :3 Number of periods per session 2. Pre-requisite Number of periods :4 Students who achieved IE1 course score 50 or scored from 35-60 on the Placement Test are required to take this course. 3. Learning outcome Students who have successfully completedRead MoreHow to Write Good Essey1042 Words Ã |Ã 5 Pages | |COURSE OUTLINE | |ESSAY WRITING | | | Read MorePERSONAL ND PROFESSIONAL DEVELOPMENT Essays1351 Words Ã |Ã 6 PagesÃ¯ » ¿ Lesson Plan Ã¢â¬â 2 PERSONAL AND PROFESSIONAL DEVELOPMENT Unit Title: Personal and Professional Development Topic: Personal Swot Analysis Week 2 Time: Variable Duration: 5 Hours Lecturers: Module Leader: Joy Meme Venue: Variable No of students: Variable Lesson Objectives: 1.Understanding of the use and concept of a Personal SWOT Analysis 2.Completion of a Personal SWOT Analysis 3.Reading and discussion of the article-Ã¢â¬Å"How to LeadRead MoreApplication Of A Master Of Public Health Campus1621 Words Ã |Ã 7 Pages ASSIGNMENT COVER SHEET Electronic or manual submission UNIT HST6334 CODE TITLE NAME OF SONI Jinal FAMILY NAME FIRST NAME STUDENT ID NO. 10399984 NAME OF LECTURER Dr. Kim Clark DUE DATE Topic of assignment Group or tutorial (if applicable) Course Master of Public Health CAMPUS I certify that the attached assignment is my own work and that any material drawn from other sources has been acknowledged. This workRead MoreHistory Now1070 Words Ã |Ã 5 PagesDue Date Tasks Friday, 2/3/2012 Begin Unit: Loyalty and Betrayal, Section A, Order and Chaos Order and Chaos: Introduction Section Warm-Up: Product Loyalty Loyalty vs. Betrayal Literary Elements: Symbolism Tutorial: Symbols and Symbolism Reading 1: Two Kinds, by Amy Tan Practice: Symbolism Loyalty and Betrayal Theme Quiz, 40 points Friday, 2/10/2012 Begin Unit: Loyalty and Betrayal, Section B, Context Context: Introduction Section Warm-Up: A Context Riddle Reading 2: from CommunistsRead MoreUnit 25 Ccld1039 Words Ã |Ã 5 PagesUnit 25: Modern Beliefs and Religions for The Early Years Practitioner Scheme of Work ------------------------------------------------- Duration of Units: Unit 25:60 Guided Learning Hours/5 Credits ------------------------------------------------- Number of Sessions per week: 2 ------------------------------------------------- Duration of Sessions: 55 minutes per session ------------------------------------------------- General Unit Objectives: ------------------------------------------------- Read MoreCase Study Autism 7th Grade1066 Words Ã |Ã 5 Pagesbut didnÃ¢â¬â¢t seem to work. Kyle is interested in science, playing the Nintendo-DS, and riding his four-wheeler. He likes to make people laugh and he does not like homework because it is too hard to explain to his Grandparents, and he does not like writing. He likes science because he gets to do hands on experiments and cooking. His legal guardians are his Grandparents. On February 14th, I was able to see many parents and some students at the parent teacher conference. Ã¢â¬ËKyleÃ¢â¬â¢s Ã¢â¬ËNanÃ¢â¬â¢ came in. I learnedRead MorePSY 322 Spring 2015 2 Essay1346 Words Ã |Ã 6 PagesMaterials Supplies: Textbooks, writing utensil, notebook, index cards, supply of non-spiral bound paper, pocket folder. Access to Microsoft Word and Powerpoint for papers and lecture notes. GRADING BREAKDOWN EXAMS (5): 80% (20% each) Final Grade Breakdown 93-100 A 90-92 A- 87-89 B+ 83-86 B 80-82 B- 77-79 C+ 73-76 C 70-72 C- 65-69 D+ 60-64 D 59 or less F MyPsychLab Assignments 20% TOTAL: 100% *Important to all graded writing pieces will be organizationRead MoreEssay about Fantastic Voyage623 Words Ã |Ã 3 PagesLetÃ¢â¬â¢s go on a Ã¢â¬Å"!Ã¢â¬ Imagine that you are a video reporter piloting a mini-sub that has been put through a miniaturization process making you and the sub only 8 microns long! (Ever see the movie Ã¢â¬Å"Inner SpaceÃ¢â¬ ?) You have been injected into the femoral vein of a healthy female. The alert just came out that a bacterium is invading the lower lobe of the right lung!! You are to pilot your sub to the site of the Ã¢â¬Å"invasionÃ¢â¬ and do a live report on what you see. Trace your path from the right femoral vein
Posted by Unknown at 2:26 PM
Saturday, December 28, 2019
Offreds Narrative - What is the purpose and function of the Historical Notes and how do they assist your interpretation of the novel? The historical notes are not part of OffredÃ¢â¬â¢s narrative, they are a transcript of a symposium held at a university in 2195 Ã¢â¬â two hundred years from where we left the end of OffredÃ¢â¬â¢s harrowing tale. The purpose of these notes if any, is to put OffredÃ¢â¬â¢s narrative into a historical purpose to help these academics understand the life of Gilead. It seems to me that another purpose of these historical notes is to provoke a very strong reaction in the readers who have followed the emotional journey with the narrator Offred. The significance of the university name Ã¢â¬ËDenay, NunavitÃ¢â¬â¢ is that AtwoodÃ¢â¬ ¦show more contentÃ¢â¬ ¦All of this is now being analysed and retold by those who made her feel so powerless in the first place. This section of the novel can also be functioned to create a light mockery towards the current academic practice and language, the male perspective used here is typical of the historical male dominance and perspective in academic research who also completely miss the point, like Pieixto with OffredÃ¢â¬â¢s narrative. I believe that the readers who have just finished agonising with Offred through her tormented times to suddenly come across the Historical Notes will find themselves offended and shocked, as I am convinced Atwood means it to be allowing another purpose for the historical notes, to hear OffredÃ¢â¬â¢s tragic life discussed in front of an amused audience of academics who joke about it as if it was an unusual memento. At the beginning of his speech we learn it was a man called Professor Wade who gave the title of OffredÃ¢â¬â¢s story Ã¢â¬ËThe HandmaidÃ¢â¬â¢s TaleÃ¢â¬â¢ partly in homage to the great Geoffrey Chaucer who had wrote the Canterbury tales between 1380 and 1400. This is significant because he only had two female characters and one of those characters was the Wife of Bath whoÃ¢â¬â¢s prologue argues the importance of female experience over male authority, the significance of OffredÃ¢â¬â¢s experience is invalidated by the power of the male authority in 2195 plus
Posted by Unknown at 10:51 AM
Friday, December 20, 2019
Government Involvement in Obesity It is evident today in society that obesity levels have increased throughout the years. According to the National Health and Nutrition Survey, more than two out of three adults are considered to be overweight or obese, and one-third of children from ages six to nineteen are considered to be overweight or obese (Ã¢â¬Å"Overweight and Obesity StatisticsÃ¢â¬ ). This is a dramatic increase since the 1960Ã¢â¬â¢s, almost doubled. There is not enough awareness in the United States on the issue. We are one of the most overweight countries of the world. The government must obtain a more positive and enlightened role in AmericaÃ¢â¬â¢s obesity levels. Why has the obesity rated doubled in adults and tripled in children since the 1960Ã¢â¬â¢s? There is a very simple explanation. Americans are not aware of the severity of the problems with being overweight. The government and media do not emphasize the importance of being healthy and in shape. Obesity has been defined as a culture-bound phenomenon. In the United States, many have just accepted this epidemic to be normal. As the years fly by, we begin to not take notice on peopleÃ¢â¬â¢s body weights. This may because the media is starting to portray a new slogan of Ã¢â¬Å"everybody is beautiful- no matter the size and shape.Ã¢â¬ Although this is a very positive message, it allows the public to believe that being overweight is acceptable. In reality, being overweight affects your heath in numerous, horrible ways. Being overweight means youShow MoreRelatedNational Health And Nutrition Examination Survey940 Words Ã |Ã 4 Pagesbeneficial to physicians, health care providers, and people in the community. It provides data that can be used to establish prevalence in different categories. It provides evidence and allows for issues to be prioritized. This is extremely important because different nations, states, counties, and cities are able to factors pertinent to their areas. The Un ited States uses the National Health and Nutrition Examination Survey (NHANES) to gather information about the health and nutritional status fromRead MoreAnalysis Of The National Health And Nutrition Examination Survey1764 Words Ã |Ã 8 PagesPublicly available data from three waves 2009-2010, 2011-2012, and 2013-2014 of the National Health and Nutrition Examination Survey (NHANES) were used for this analysis. These waves were selected because they correspond to the most recent time periods with available data for public use at the time of this analysis between 2017-2018. NHANES is a repeated, cross-sectional survey with a multi-stage probability sample of non-institutionalized population of the United States.27 Demographic variablesRead MoreA Study Conducted By National Health And Nutrition Examination Survey764 Words Ã |Ã 4 PagesThe study conducted by National Health and Nutrition Examination Survey (NHANES) found that the commonness of hypertension among US residents in the year 2003-2004 was 7.3Ã ±0.9%, 32.6Ã ±2.0%, and 66.3Ã ±1.8% in the 18 to 39, 40 to 59, and Ã¢â° ¥60 age groups, respectively and 29.3% overall. Not everyone is aware of hypertension and its risk. There were numerous studies and researches conducted to learn and understand more about hypertension and its connection with obesity, hyperuricemia, eplerenone and otherRead MoreCoffee And Depression : The Fifth Korean National Health And Nutrition Examination Survey Essay700 Words Ã |Ã 3 PagesCoffee and depression in Korea: the fifth Korean National Health and Nutrition Examination Survey (3) Introduction The article Ã¢â¬Å"Coffee and depression in Korea: the fifth Korean National Health and Nutrition Examination SurveyÃ¢â¬ was published in the European Journal of Clinical Nutrition in 2015. The question the authors looked at was whether there was a correlation between coffee consumption and the prevalence of depression among South Korean adults. There had been no previous studies examiningRead MoreMalnutrition : A Common Problem1480 Words Ã |Ã 6 PagesNepal Nutrition Section, CHD, DoHS, MoHP. (2004,p.5 ). Malnutrition is a very common problem in children under five years of age in Nepal and is a significant contributor to morbidity and mortalityÃ¢â¬â accounting for more than half of all child deaths. The process of stunting occurs between conception and two years of age, and is an irreversible process. Furthermore, the population of Nepal, especially women and children, are affected by major micronutrient deficiencies. Malnutrition increases theRead MoreEssay about Nutritio n in Public Health 1165 Words Ã |Ã 5 PagesNutrition in public health: Objectives: Ensure that students acquire specific knowledge for the analysis of food and nutrition problems in population groups. Identify the causal factors of the state of nutrition in communities. Be able to take part in the planning and programming for prevention and control activities within the field of nutrition in public health. Program: I. Concept of public health: Historical evolution. Population and food. Quality of life and socioeconomic developmentRead MoreGovernment Should Design Effective Child Nutritional And Health Program757 Words Ã |Ã 4 PagesFor the government: Government should design effective child nutritional and health program for the community to reduce malnutrition (stunting, underweight and wasting). Above half of the community gets Water from unprotected sources such as dug well, spring river/surface water which results child diarrhea and illness therefore, government should facilitate clean water supply for the community. Women/mothers education should be promoted as it has been proved that it is the key to reduce both chronicRead MoreThe Natural Form Of Vitamin B91478 Words Ã |Ã 6 Pagesprocessed more efficiently in the body. Availability of folic acid is estimated to be about twice that of food folate. Folate deficiency has been linked to several adverse health outcomes. Neural tube defects are one of the commonest side effects of folate deficiency among women in childbearing age. Other adverse health effects include preterm birth, other congenital anomalies, megaloblastic anemia, cancer, and cardiovascular diseases. There are several studies that link folate deficiency to cognitiveRead MoreThe Effects Of Malnutrition On Indi The Facts Essay1419 Words Ã |Ã 6 Pagesin five deaths in the world. More than half of these deaths could be prevented if children were well nourished . Malnutrition is a serious condition in which the body does not get the right balance of nutrients and calories needed to sustain good health and development. It has two sides - undernutrition and obesity/overweight. Undernutrition arises mainly as a result of inadequate or unbalanced diets, but is also caused by poor nutrient absorption or a loss of nutrients due to illness (2000, SmithRead MoreEssay On Clinical Data746 Words Ã |Ã 3 PagesUniversity of Washington reduces them to six categories: Electronic health records: This type of clinical data resides generally at the point of care such as a hospital or office clinic. Best known as the Electronic Health Record Ã¢â¬Å"EHRÃ¢â¬ , and opened to healthcare providers, it has a restricted access to researchers. These data come in part from verbal patient interviews and take the form of narrative inserted in the EHR. The electronic health record contains almost all data regarding a patient visit or encounter
Posted by Unknown at 6:39 AM
Thursday, December 12, 2019
So in order to keep up ratings shows were forced to show what people wanted to see. As our country has slowly let go of morals and standards, its people have been forced to adapt. Reality television has been forced to diminish all possibilities for ever being labeled as moral. It has taken a direction for the worse and shows today lack little meaning or value. In its most current state, television shows force its younger viewers to grow up faster, making younger and younger kids do adult things. These reality shows exemplify things such as sex, drugs, violence, and self-harm. Television producers these days simply have no problem exposing the youth to this rubbish. In fact, the producers are specifically targeting the youth with their unmoral and controversial shows. They often reward the rebel characters with extra TV time or book them for another reality show, while the moral and respectable characters are made out to be boring and hardly ever get rewarded. We will write a custom essay sample on The Lasting Impresion of Reality Tv and Its Lack of Moral or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page America keeps asking what is making each generation less and less moral, but they fail to recognize what kinds of examples are being set. Children have not become more influential, they simply have been influenced by worse things. In the past few years, there has been a major change to reality television that diminishes its moral teaching reputation. From music videos of half naked women to reality shows full of betrayal, lies, and more vulgar than most can handle, the state of American television is in trouble. So where can you turn to when you want to avoid these unmoral shows and watch something good for a change? Well there is no clear-cut answer. Sadly, even some of the biggest networks such as CBS and NBC have started targeting the young crowd with shows that are completely inappropriate. The only solution to this problem is to simply search around a bit to find the perfect show for you. Use sites such as TVguide. com and Amazon. com to check out some reviews and customers opinions on the show before you start getting into it..
Posted by Unknown at 3:10 AM
Wednesday, December 4, 2019
Question: Discuss about the Objective Structured Clinical Examination Method. Answer: Introduction: Mr. Harry Jones is 68-year-old man and is admitted to the medical ward suffering from Rapid Atrial Fibrillation. He has allergy with penicillin , and has a past medical history of asthma and hypertension. Mr. Jones is currently on Salbutamol 5mg two puffs four times per day and, oral cardiprin 100mg once a day and oral enalapril 10mg daily. He has a known family history of acute myocardial infarction, migraines in mother , and cancer of the colon in his father.This report includes pathophysiology of atrial fibrillation, and the rationale of administrating amiodarone as his initial medical management, and action and the therapeutic benefits of both the drugs warfarin and dabigatran as well as the side effects to decide which drug most suitable for him. Mr. Jones was prescribed aspirin to prevent the heart stroke, which can occur due atrial fibrillation since he has an age of 68 years. This drug was given because of low risk of bleeding, easy to use and monitoring is not required while giving this drug(Lip, 2013).The Mode of action of aspirin involves inhibiting the activation and aggregation of platelets and also the inhibition of enzyme cyclo xygenase that is platelet dependent. This leads to the inhibition of prostaglandin synthesis. The side effects of aspirin involves fever that lasts for 3 days, vomiting, pain in the stomach and nausea. Cardiprin is used for thinning of blood during heart strokes and atrial fibrillation. It has an active ingredient as aspirin and functions by the suppression of the production of prostaglandins hormones. There are various side effects of Cardiprin such as nausea, vomiting(Ng Ho, 2017). Asthma and problems related to digestion. Nursing interventions for administering Cardiprin involves proper knowledge about the current medicaments the patient is taking, allergic responses and any future surgery and pregnancy. The patient should inform the doctor about any issues of asthma, high blood pressure, heartburn or any other cardiac diseases. The nurse should give the medicine to the patient by checking on the outer packaging and as prescribed by the clinician. It can also lead to irritation in the stomach so it should be taken along with milk. The pathophysiology of atrial fibrillation involves pathological changes such as fibrosis in the artria that is progressive in nature. The fibrosis occurs due to the ageing process, dilation of the chamber, genetic reasons and inflammation. Atria gets dilated due to various structural abnormalities in them heart such as high blood pressure, valvular heart disease or a congestive failure of the heart (Heitner, 2013).Atrial fibrosis can also occur due to the mutation in the lamin AC gene. The renin-aldosterone angiotensin pathway is activated by the atrial dilatation due to stretch and this in turn increases the protein disintegrin and matrix metaproteinase in the walls of the atria. This pathway leads to the release of cytokines, oxidative stress and the formation of factors that lead to growth and promote fibrosis(Wakili, Voigt, Kb, Nattel, 2014). It also initiates various cell-signalling processes that increase the level of calcium inside the cells. The Renin aldosterone angiotensin system (RAAS) includes various enzymes such as Angiotensin 2, aldosterone and angiotensin converting enzyme and they are increased during atrial fibrillation as they are synthesized on a local level in the atrial myocardium. The increase in the level of these enzymes leads to fibrosis and atrial remodeling and results in the loss of muscle mass of atria.There are two types of fibrosis that is Reactive interstitial fibrosis, which helps in the separation of muscle bundles, and Reparative fibrosis that helps in replacing the cardiomyocytes. Fibroblasts can be coupled to the cardiomyocytes in an electrical manner and help in promoting the ectopic activities when their number is increased(Dan Camm, 2013). Amiadarone is given to Mr Jones to prevent myocardial infarction since his mother had a past medical history of the same disease. Amiadarone is also used to help the heart to beat in a normal manner as he is suffering from atrial fibrillation. It may lead to side effects if given to Mr Jones since he is allergic to pencillin and is suffering from asthma and serious heart issues(Barber Blundell, 2013).It should also be not given to patients suffering from thyroid diseases, implantation of pacemaker, eyesight issues, low balance of electrolyte and low or high blood pressure. There are various side effects of amiodarone such that it can have a negative effect on the liver and lungs in Mr Jones. The nursing interventions include various measures after administering this drug to the patient such as continuous monitoring of ECG and rhythm and heart rate and keeping a check if the patient suffers from jaundice, pain in the chest and stomach breathing issues, dark coloured urine and blood i n the cough(Schalij, 2014). Amiodarone should not be given to females who are pregnant as it can have a negative effect on the health of the baby because it passes to the mothers milk. Anticoagulants such as warfarin and dabigatran are used to reduce the risk of blood clotting and hence the heart stroke. The most common medicine is warfarin but it has a disadvantage that it can interact with foods, medicines and alcohol. But dabigatran has an advantage that it has a low interaction rate with medicaments, alcohol and food items .Warfarin requires regular blood tests to check the clotting time of blood in the body and dabigatran does not require regular blood tests(Wislff Klemp, 2014). According to, the National Institute for Health and Care Excellence (NICE), warfarin is used to decrease the risk of heart stroke. Its main disadvantage is heavy bleeding so to avoid it, a Vitamin K injection is given to stop the bleeding. Dabigatran blocks the effect of thrombin and helps in preventing the blood clots. Thrombin is a protein which is formed in the body for the formation of blood clots. Dabigatran gets collected in the blood of the patients who suffer from kidney probl ems as the kidney is not able to remove the drug from the body(Giugliano, Ruff, Braunwald, Murphy, Wiviott, Ruzyllo, 2013). There are various precautions while taking the drug dabigatran such as the capsule should not be opened before giving then dose to the patient that will lead to an increase in the concentration of drug in the body of the patient and hence lead to an increase in the risk of bleeding. Another disadvantage of this drug is that it is degraded when comes in contact with moisture and hence precautionary measures should be followed to keep the bottle closely tight. It should be used within 30 days after the bottle is opened. A side effect of dabigatran is that it leads to indigestion and stomach upset in patients if it is discontinued because the drug needs an acidic environment to get absorbed in the body(Mooney, 2013).It can also lead to heart stroke or heart attack if this medicine is stopped from taking. The side effects of warfarin are fever, bleeding from the gums, pain and swelling, irritation and diarrhea. Warfarin is more effective and safer than dabigatran and dabigatran should no t be taken by patient suffering from kidney and liver problems as it lead to increase in bleeding. Salbutamol is used in the treatment of asthma by providing relaxation to the muscles in the walls of airways present in the lungs. The normal dose for patients is 1-2 inhalations those who are adults and one puff for children in the age group of 6-11 years. It should be used only after prescribed by the doctor. (Salvi, 2013). Mr Jones will be instructed to remove the cover from the mouthpiece and shake the inhaler profusely then hold the inhaler and breathe out in a gentle manner. Then the mouthpiece should be immediately kept on the mouth. He will be advised to seal the mouthpiece totally with lips and start to breathe slowly with the mouth. After breathing slowly, press the inhaler firmly to release the medication and continued to breathe in(Zhang, Liu, Hu, Tan, 2015). If the patient misses the dose he should continue with the regular dosage schedule. It should be store at a room temperature and kept out of reach from children. It should be kept away from hot devices such as stove and heater. The patients who are allergic to salbutamol and milk proteins such as lactose should not take salbutamol puffers. Side effects of this medication include drowsiness, dizziness, fatigue, coughing and faster rate of heartbeat(Lahiri, 2017). It can be concluded that Mr Jones has a high risk of heart stroke since he is an elderly person. He should take proper care of himself and follow the medicaments prescribed by his clinician properly. He should take a well balanced diet and exercise daily that will decrease the chances of heart stroke. He should take warfarin that will help to decrease the risk of heart stroke and it is more effective and safer as compared to other drugs such as dabigatran. He should follow proper nursing interventions and follow precautionary measures to recover from Rapid Atrial Fibrillation. Bibliography Barber, Blundell, P. . (2013). Further Esstentials of Pharmocology For Nurses. Maidenhead: McGraw-Hill Education . Dan, Camm, B. d. (2013). Atrial fibrillation therapy. . Giugliano, Ruff, Braunwald, Murphy, Wiviott, Ruzyllo, H. . (2013). Edoxaban versus warfarin in patients with atrial fibrillation. New England Journal of Medicine , 369(22), 2093-2104. Heitner, H. . (2013). Cardiology in Family Practice. A practical guide . Lahiri. (2017). vidence behind use of levosalbutamol over salbutamol to prevent cardiac side effects. . International Journal of Contemporary Pediatrics , 4(3), 674-678. Lip, . L. (2013). Stroke prevention with oral anticoagulation therapy. Circulation Journal, Volume 77(6), pp1380-1388. . Mooney. (2013). Use of dabigatran to prevent stroke in patients with atrial fibrillation. .Nursing standard, Volume 27(27), , pp 35-41. Ng, Ho, C. . (2017). Comprehension by older people of medication information with or without supplementary pharmaceutical pictograms. Applied Ergonomics , 58, 167-175. Salvi, B. . (2013). Aspirin and asthma. CHEST Journal Volume118 (5 , p1470-1476.doi:10.1378/chest.118.5.1470. Schalij, V. E. (2014). Amiodarone: an effective antiarrhythmic drug with unusual side effects. Heart, Volume , 96(19). Use of dabigatran to prevent stroke in patients with atrial fibrillation. (2013). Nursing standard, , Volume 27(27), pp 35-41.41. Van Erven, L., Schalij, M. J. (2010)Amiodarone: an effective antiarrhythmic drug with unusual side effects. . (2013). Heart, Volume 96(19) , 96(19). Wakili, Voigt, Kb, Nattel, D. (2014). Reccent advances in the molecular pathophysiology of atrial fibrillation. Journal of clinical investigation , p2955-2968. Wislff, Klemp, H. . (2014). conomic evaluation of warfarin, dabigatran, rivaroxaban, and apixaban for stroke prevention in atrial fibrillation. . Pharmacoeconomics , 32(6), 601-612. Zhang, Liu, Hu, Tan, X. (2015). An aerosol formulation of R-salbutamol sulfate for pulmonary inhalation., . Acta Pharmaceutica Sinica B , 4(1), 79-85.
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