Advanced pathophysiology Case Study Example | Topics and Well Written Essays - 750 words

Advanced pathophysiology - Case Study Example The elevated WBC is from the proliferation of immature WBC which continue to increase, however do not mature (Harrison, 2011). The accumulation of immature white blood cells in the bone marrow and blood leads to the replacement of normal cells such as thrombocytes, which leads to thrombocytopenia and a disruption of blood clotting (Harrison, 2011). Therefore, this patient presents with gum bleeding and easy bruising. In addition, decreased levels of leucocytes also increase the patient’s vulnerability to bruising. The replacement of cells also leads to a decrease in the number of red blood cells which are responsible for oxygen transport. This in turn is the reason why the patient developed fatigue and shortness of breath may also have been present (Harrison, 2011). The splenomegaly occurs as a result of extamedullary hematopoiesis as the bone marrow becomes less competent. The reduction of red blood cells due to replacement also leads to paleness. Upper abdominal tenderness c ould be attributed to splenomegaly. Opportunistic infections that occur as a result of the comprised immune system may lead to arthalgia. Describe pathophysiology of ALL. Compare it with other leukemia forms in children The development of ALL is assumed to occur as a result of alteration of a progenitor cell responsible for continuous clonal expansion (Bassan & Hoelzer, 2011). This event can occur in cells of T of B cell lineage which give rise to different types of acute lymphoblastic leukemia. These subtypes are based on the stage of cell development which the transformation occurred. Approximately 80% of ALL cases have been found to originate from B lymphocyte precursors (Onciu, 2009). Several factors have been found to influence the development of this cancer and these include radiation exposure, genetics, chemical exposure and some viral infections such as HTLV-1 (Onciu, 2009). As mentioned above the alteration of the precursor cells leads to an arrest in development. This then leads to the proliferation of immature white blood cells in the bone marrow which replace its physiological components. Therefore, there is a marked decrease in the formation of several blood elements. This may lead to other complications such as thrombocytopenia, anemia and neutropenia (Pui, Relling & Downing, 2004). In addition, the disruption of bone marrow function leads to extramedullary hematopoiesis which occurs in the spleen, liver and lymph nodes (Pui, Relling & Downing, 2004).These organs will then increase in size resulting in hepatomegaly and splenomegaly. This leukemia is different from AML which involves the myeloid blast cells whilst ALL involves lymphoblasts. In the pathogenesis of Acute Myeloid Leukemia, the pathological defect will involve numerous precursor cells which will develop immature (Pui, Relling & Downing, 2004). Meanwhile in Acute Lymphoblastic Leukemia, the effect is on a precursor cell that that will proliferate and produce several immature cells. The etiological factors between the two types of leukemia are also different. AML often occurs as a result of certain preleukemic blood disorders whilst ALL often associated with genetic factors and a prolonged exposure to radioactive substances (Pui, Relling & Downing, 2004). What is the purpose of chemotherapy in ALL? What is a common side effect of Therapy? Chemotherapy is necessary in this condition as the drugs are injected intravenously and can be used to treat cancerous cells that have

Racial Profiling- Reflection Coursework Example | Topics and Well Written Essays - 250 words

Racial Profiling- Reflection - Coursework Example his of course led me to research the alternatives and to look at how we could stop the use of racial profiling, while still retaining a positive approach to the reduction of crime and terrorism specifically. I discovered that our history was not extremely bright with regards to the approach to race and criminal justice. Through our past indiscretions and current problems I learned that this was an approach that required drastic change for the future well-being of the criminal justice system in our nation. My desire to pursue and realize true equality met with the reality of our current system and while slowed in my approach I have become more focused on this as an issue that must see relief. I am sickened by the use of racially motivated approaches within the system, and feel very strongly that these approaches can only further hinder our progress and the modernization of the system as it stands today. It is my desire to see an end occur regarding racial profiling and in fact any use of race as anything more than a designator within the current criminal justice system. Overall the information that I discovered in research has allowed me to approach this issue from a completely different angle than I would normally take it. That of history and the desire to be more than our

College Saving Plan Essay Example | Topics and Well Written Essays - 2250 words

College Saving Plan - Essay Example As the paper highlights, it is assumed that Wally who is 17 years old will join college at 18 years and this means that he only have one year to join college. He will also attend college for four years and full time basis. Since there are only four years, the parent will pay 100% of all the projected college costs and wish to meet all the savings goals by the time he completes the studies. The parents will make a monthly contribution towards their son’s college savings. The cost of college education is expected to increase by 3% annual which is the inflation rate. The couple also expects to earn a 9.65% after tax every year in the college saving fund. The current college cost is $25,000 per year. Based on this analysis, 100% of the total college cost will be $107,728which then means a monthly contribution of $2,122. The couple wished to save for the college education of the two children. In this case, 529 plans can be used for the two children. The only difference between the saving for the two children is that the saving for Wally will start only a year to joining college while that of Theodore will start 14 years before he joins college-assuming that the two children will join college at the age of 18. The parents will also have to contribute less in terms of monthly pay for Theodore than for Wally. Based on the above assumptions, 100% of the total college costs for Theodore will be $158, 203 leading to a monthly contribution of $354 aimed at meeting this cost. Since Harvard and UMass-Boston are both based in Massachusetts State, the best 529 plan would be U.Fund College Investing Plan. Â  This saving plan is managed by Fidelity and offers five different individual fund portfolios to choose from with each portfolio corresponding to the age of the beneficiary. It does not require any state residency. With this plan which is based in Massachusetts State, then it means that the savings for the college of the two children will well placed as the finances will be paid to their colleges.

Techniques of Phacoemulsification

Techniques of Phacoemulsification Phacoemulsification is the preferred mode of cataract surgery today and considered better than other modes because of the lesser surgical time, better post-operative results, lower induced astigmatism and speedy visual rehabilitation. Cornea is a transparent structure and maintenance of transparency is attributed to the barrier function and the active fluid pump of the corneal endothelium. Endothelial damage during surgery is considered as a important parameters of surgical trauma. Endothelial cell density decreases at a greater rate after cataract surgery than it does in healthy, unoperated corneas. Corneal endothelial cells are non-dividing cells; hence having limiting regenerative capacity following surgical trauma. Corneal endothelial cell loss during surgery is affected by multiple variables like irrigation solution turbulence, direct mechanical trauma by instrument, nuclear fragments, IOL contact; heat generated during phacoemulsification can damage corneal endothelium during cataract surgery. In a study done by Hayashi K et al in 1996 they tried to identify the risk factors for corneal endothelial injury. They concluded in this study that older age, small pupil diameter, high nucleus grade, large nucleus, greater infusion volume, type of IOL implanted, and a greater amount of ultrasound energy used during surgery were associated with endothelial cell loss. Further studies carried out to identify variables affecting amount of endothelial cell loss which are related to various parameter of machine as well as technique of surgery. These variables also included medicinal substance used during surgery like irrigating fluid, type of viscoelastic substance used. Most of the studies indicated that endothelial cell loss is related to the more ultrasound energy used, amount of irrigating fluid or mechanical trauma by any mean. Site of incision, type of viscoelastic and irrigating fluid has less correlation with amount of endothelial cell loss. Though in special circumstances modification of these variables helps in getting better outcome of surgery. If we talk about the technique of phacoemulsification there are various nucleotomy techniques which are described. Every technique is unique in its application so it has an impact on amount of endothelial cell loss occurred due to surgical trauma. In this study we interpreted the effect of two types of nucleotomy techniques divide and conquer versus direct chop on endothelial cell loss. 60 eyes of 60 patients who underwent cataract surgery by these two different techniques were included in the study and amount of endothelial cell loss was measured and compared in two groups. All surgeries were performed by same surgeon and all other parameter and variables were kept constant like grade of nuclear sclerosis, type of machine used, type of irrigating fluid, viscoelastic and type of posterior chamber intraocular lens implanted. Study subjects were divided into two groups, Group1 included the patients who underwent phacoemulsification by divide and conquer technique and Group 2 included patient who underwent phacoemulsification by diect chop technique. The mean age of patients in group1 was 62.13 + 7.03 (SD) years and in group 2 was 61.77 + 8.37 (SD) years . The grade of nuclear sclerosis, graded by comparing with LOCS III chart was Grade 2 in all 60 eyes of the 60 enrolled patients. In group 1, 17 were male and 13 were females 18 were RE and 12 were LE. The median pre-operative specular count in this group was 2091 cells/mm2 with a mean specular count of cells/mm2(SD ). In group 2, 18 were male and 12 were females 16 were RE and 14 were LE. The median pre-operative specular count in this group was 2037 cells/mm2 with a mean specular count of cells/mm2(SD ). The intra-operative parameters assessed in thus study were two, the fluid volume used and the effective phaco time. In group 1 the average fluid volume used was 145.67 mL (SD 16.34 ). The average Effective phaco time was 14.70 sec (SD 2.77). In group 2 the average fluid volume used was 137.33 mL (SD 10.80). The average Effective phaco time was 12.67 sec (SD 2.34) Corneal endothelial cell counts were evaluated at 1 week, 4 weeks and 12 weeks post-operatively in both groups. Endothelial cell loss was calculated in this series as the difference between the pre-operative specular count and the specular count at 12 weeks. Further, the Endothelial cell loss (%) was calculated as: ECL (%) = Pre-op specular count-Post op count at 12 weeks x 100 Pre-op specular count The mean endothelial cell loss in group1 was 489 cells/mm2(SD 133.44).. The average endothelial cell loss (%) in group1 was 21.5%. The mean endothelial cell loss in group1 was 489 cells/mm2(SD 133.44).. The average endothelial cell loss (%) in group1 was 21.5%. The endothelial cell loss was analyzed statistically and its correlation to, effective phaco time and fluid volume was studied. In this study, the follow-up period was 3 months because Beltrame et al52 and other workers53, 54 have determined that a 3-month period was sufficient to allow stable and complete endothelial wound healing. In this study, the variables were analyzed with respect to their effect on the outcome using appropriate tests for statistical significance (SPSS17.0).Effective phaco time and fluid volume used showed a strong positive correlation to the endothelial cell loss (p-value

The Victorian Education system as presented in Hard Times :: English Literature

The Victorian Education system as presented in Hard Times From the early beginnings of Hard Times, we can tell that this novel was originally intended to shock those reading it. The education that these children receive is harsh and designed to stem any feelings of self-opinion. When Gradgrind interrogated 'girl number 20', he proved that their education was more strict and when he later humiliated her when he asked her to describe a horse, he proved that the Victorian education system was solely based on fact and allowed no room for it to be questioned. This was even the case in such incidents as where Sissy states that she would like flowers on her carpets. Gradgrinds' wish to outlaw fancy in her thoughts, mean that at some points during the dialogue, Gradgrind can begin to sound absurd in his words. Dickens heavily objects to the mechanical way of teaching in Gradgrind's utilitarian school. As early as in the second chapter the reader notices that the facts taught in this kind of school have no use at all in normal life. Sissy, with her natural understanding of a horse contradicts the cold definition of a horse by Bitzer: 'Quadruped ....'. What makes that situation worse is that later on, Gradgrind, who takes charge of Sissy's education, forces her from learning on her ability to comprehend that she cannot believe in what she wishes. They are stifled in their environment, prisoners of a world of utilitarianism. Gradgrind's school is very plain and bare, Dickens describing it as a 'monotonous vault', and being 'intensely whitewashed'. For pupils having to learn in this kind of environment would be extremely boring, and no encouragement is given to exercise

Being Unemployed and the Impact of Unemployment

In this modern day, that which defines the person’s private life including his lifestyle is his personal accomplishments with regards to his work or job. He fails to see the significance of other people within the community in his achievements. Now, this paper would try to see how community and the society affect the character and attitude of the people who are unemployed.The first part of the paper would discuss the very concept of unemployment and the underlying factors that cause unemployment. The second part would present the effects of unemployment to the individuals and to the society/community.The last part would include an analysis of the problem of unemployment and conclusion First Part: What is Unemployment? Unemployment pertains to a condition wherein a willing person lacks opportunity to obtain any job or work. (Sinfield) Such lacking of opportunity can be either caused by the person himself or by the different factors that affect the community (i. e. economics, po litics, etc. ) The unemployed person could really find difficulty in finding job when he himself lacks certain requirements. For example, an aspirant wants to work with a particular company. However, he did not pass the qualifications and standard of that company (e.g. educational attainment, background check-up). Hence he loses the chance of acquiring a job mainly because the problem is he himself. No matter how willing a person is if he would not pass the standard or qualification of a company, it is most likely that he would not get a job. On the other hands, there are factor that affect unemployment. First is the economic element. The companies are closing their doors to applicants because the economy is very low such that hiring them would endanger the standing of the companies (perhaps the companies think that they cannot afford to pay the wages of these applicants if ever they hire them).Second is political element. The political instability may cause economic stability. Thus the result would be the refusal of the companies to hire new workers. (Walters) Lastly, environmental element can also be a factor in the problem of unemployment. The people may find difficulty in looking for jobs when they are situated in a place wherein companies would most likely refuse to establish themselves. These are just some of the factors that can really affect the problem of unemployment. Second Part: What are the Effects of Unemployment?Effects of unemployment can be directly manifested in the people’s lifestyle and character. (Sinfield) People who are unemployed usually live in places that are far from industrialized regions (i. e. rural areas, slum areas). They find so much difficulty in meeting their everyday needs such as food, clothing, shelter and others. Some cannot even afford to eat three times a day. The way they dress up can really show how unfortunate themselves being unemployed. Unemployed people may express their disappointment and depression by the way they behave toward other people.Unemployed people may become forceful or unwilling to socialize with other people. These people are usually the ones who boldly declare dissent towards the government and its programs and policies. (Moller) Third Part: Analysis and Conclusion on the Impact of Unemployment As an analysis, the problem of unemployment is really dependent on the key factor or elements that govern the structure and function of society. They significantly affect the lives of the unemployed (and even the employed) people.Nevertheless, if these key elements would be in good condition, the unemployment rate could be resolved granted that there are great efforts that would be put in its actualization. The effects of unemployment show how people react and behave toward other people. Moreover, unemployment may also define how people should live and think. (Moller) As a conclusion, unemployment is really a defining mark of the standard of living (or of how people live). More often, jobless people pursue to obtain work unfortunately due to the cited key elements that govern the society, having jobs is not really easy for them.And manifestations of the effects of unemployment could be illustrated by how unemployed people interact with the community or society. References: Moller, Valerie. The unemployment blues: Psychological effects of unemployment on the individual. Centre for Social and Development Studies, University of Natal, 1992. Sinfield, Adrian. What Unemployment Means. Blackwell Publishers, 1981. Walters, William. Unemployment and Government: Genealogies of the Social . Campbridge University Press, 2000.

Citizen cane essays

Citizen cane essays There are many out there who tell us that Citizen Kane (1941) is one of the best films ever made. As for me not knowing all there is to know about Filmmaking and the array of techniques used, one can by no means get the complete worth of it. Being able to comprehend the setting, light use, depth of frame and basic composition make Citizen Kane the masterpiece it is. It is paramount that we take notice of these aspects as you view the film. When settling on which of the four parts of the film to analyze, I came to the determination that the lighting and the use of shadows are one of the significant and attention-grabbing aspects in the film. Furthermore, as the film is in black and white it adds to the description throughout the film, more than the other aspects, for me. The film was very sanitary and effortlessly edited. Both high key and low key lighting techniques were used throughout the film (Belton, 1994, p. 50). This was done to illustrate the different emotions of each scene. I established there were times when there was a certain use of lights used to put emphasis on close up shots of the actors faces. There are three different aspects I paid attention to during a second screening of Citizen Kane; lighting, use of shadows, and use of lighting and shadows combined to form an intrinsic interest or just to contrast each other. High- key lighting, which is a high amount of fill light which washes out shadows cast by the key light (Belton, 1994, p. 50), was used often during the film frequently during times of strife or a big change of events. For instance, the thematic mixture between Suzans operatic manifestation and the different newspaper front pages. This was an important part in the life of Suzan and C. F. Kane. Another example is when Kane loses his campaign for governor. His headquarters was very bright though no one was there rejoicing, also during the fight that Kane and Suzan got into when she told him...