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There is immense genetic diversity generic 120 mg sildigra with amex, as a result of small spontaneous change in individual genes cheap 50mg sildigra mastercard, called mutation, occurring from time to time. The natural selection concept of Charles Darwin emphasizes the predominance of the genes in the population that favors survival of the fittest and reproduction in a particular environment. Early with life on earth cells developed the ability to react with oxygen and carbon compounds and use the energy released by these chemical reactions. With complexity of development cells evolved structure called mitochondria for efficient energy production. The efficiency of oxidative phosphorylation was maximized in natural selection of the best. Some aspects of human physiology may be rapidly changing on the evolutionary scale of time. The brain capabilities are probably still rapidly evolving as new pressures are faced. For pain with injury, a warning signal results in sudden withdrawal of the injured part, protecting it from further injury. But step-by-step sequence of events starts with the injury and eventually ends with the contraction of group of muscles that flex the injured limb - stimulus, receptor, electric signals, spinal cord, flexor muscles. The circuit that creates this response is genetically determined and is formed during early development of the nervous system. Levels of structural organization: From single cell to organ system cells are the basic units of living organisms. Humans have several levels of structural organizations that are associated with each other. The chemical level includes all chemicals substances essential for sustaining life. The diverse chemicals, in turn, are put together to form the next higher level of organization, the cellular level. The different types of muscle tissue are functional adaptation of the basic contractile system of actin and myosin. Skeletal muscles are responsible for movement of the skeleton, cardiac muscle for the contraction of the heart that causes blood circulation; smooth muscle is responsible for propelling contents within soft hollow organs, such as the stomach, intestine, and blood vessels. Cardiac muscle fibers branch but are separated into individual cell by continuity of the plasma membrane, the intercalated discs. Nervous System- Conducting signals This tissue is specialized for conduction and transmission of electrical impulses and the organization of these nerve cells or neurons is the most complex of any of the tissue. The neuron has a cell body that contains the nucleus and the other organelles with very high metabolic activity (e. The neuron is further specialized for having processes, which contact it through the synapses to other neurons, making a long chain of conducting tissue linking the various parts of the body. It includes the membranes that cover body surfaces and line hollow viscera internal organs, forming barrier between the interior of the body and the environments. Epithelial cells may be modified to function as sensory receptor, detecting specific stimuli from the environment. Epithelial cells also form the endocrine glands (pituitary, parathyroids, thyroid, adrenals, ovary, and testis), which secrete 3 hormones directly into the blood and the exocrine glands secrete substances via ducts (e. Connective Tissue It is mesodermal in origin and functions in supporting, connecting and transporting. It covers wide variety of tissues, but having more intercellular materials or matrix, than cells. It also contains extracellular fibers, which may be tough collagenous fibers or the resilient elastic fibers. Life processes: The following are the important life processes of humans: Metabolism: includes catabolism and anabolism that provides energy and body’s structural and functional components Excitability: Ability to sense changes in and around us. Conductivity: ability to carry the effects of stimulus from part of a cell to another. The human body contains organic compounds such as lipids, proteins, carbohydrates and nucleic acids. The lipids are important forms of storage fuel in addition to providing insulation of the body as a whole or essential component in the structure of plasma membranes, myelin and other membranes. Proteins serve as the structural basis for all enzymes, contractile muscle proteins, connective tissue, such as collagen and elastin and in addition as a fuel (about 15%), or precursor for carbohydrate in the process of gluconeogenesis. Ingested glucose is converted to glycogen and stored in the liver, muscle and adipose tissue. Components of Body System System Components Circulation Heart, blood vessels, blood Digestive system Mouth, pharynx, esophagus, stomach, small & large ` intestine, salivary glands, pancreas liver, and gallbladder Respiratory system Nose, pharynx, larynx, trachea, bronchi, lungs Urinary system Kidneys, ureters, urinary bladder, urethra Skeletal system Bones, cartilage, joints Muscle system Skeletal muscle Integumentary system Skin, hair, nails Immune system Leukocytes, thymus, bone marrow, tonsils, adenoids, `` lymph nodes, spleen, appendix, gut-associated lymphoid ` tissue, skin-associated lymphoid tissue muscosa ` associated lymphoid tissue Nervous system Brain, spinal cord, peripheral nervous system. Large part of physiology is concerned with regulation mechanisms that act to maintain the constancy of the internal environment.

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Chaltu is also stunted (because the height for age is below the third centile) and she is also underweight (because her weight for age is below the third centile) buy sildigra 120 mg amex. The underlying cause may be either family food shortage (because many family members have to live off a very small piece of land that is not very fertile) cheap 50 mg sildigra mastercard, poor childcare by the mother because she has many children to care for or a combination of these factors. The basic cause in this case may be poverty, which is the common basic cause in many of malnourished families. Millions of children die of severe acute malnutrition each year and poor nutrition prevents many children and adults from ever reaching their full mental and physical capacity. For example, children who are malnourished are at risk of stunting, which affects their productivity when they are older; malnutrition also affects their learning ability, school performance and attendance. All of these consequences have a social and economic impact on the community and the country. As a Health Extension Practitioner you can help to minimise the effects of malnutrition in your community. In particular, through good maternal and child health care, you can help promote good feeding practices in families and emphasise the importance of clean water for drinking, cooking and cleaning. You can also support strong family planning services to help families space or limit the number of children they have. Other examples where you will have a role include advocating for basic education for girls as well as boys, encouraging communities to grow a wide range of nutritious foods and to ensure particularly that children and pregnant mothers have the right amount of food they need to be healthy. This means illness is more common and likely to be more severe, and leads to an increase under-five death rates. You can work with individuals and families and advise on food diversification and food fortification, which will help to ensure a more healthy diet. The other important aspect of your role is to mobilise communities and work with other development workers in your community to produce of fruit and vegetables using backyard gardens, which will help to improve access to vitamin A-rich foods. You can also support community child health days and use these to ensure a supply of vitamin A capsules and the other necessary materials to supplement people’sdiets. People must also be able to access the food and then make it into something that can be eaten. You will probably have noted that the additional groups vulnerable to acute food insecurity are those affected by sudden shocks like drought or a rise in food prices (look back at Table 8. However, try to choose three that you think are the most important and be ready to discuss the reasons for your choice with your Tutor. Once people sell land or livestock they are putting their futures at risks, so will leave this until they have tried all other coping strategies. This results in poor physical growth, mental development, affecting socioeconomic development. As a Health Extension Practitioner, you need to be aware that children under five, pregnant women and lactating mothers are particularly at risk because they have increased nutritional needs. You will work with families, taking into consideration the kinds of food they have available, to advise them on the most nutritious diet possible. As far as possible, you should explore local solutions to support children and vulnerable women, as this is likely to lead to a more sustainable approach to rehabilitation. As there is no oedema, Jemila does not have severe acute malnutrition, but you would need to monitor her progress carefully. For example you can talk with the primary caregiver why they think the child has become malnourished. You will be able to provide nutritional advice to the whole family to ensure the malnourished child is given more energy-rich food, as well as more fat and protein in their diet. An important part of the planning includes organising the services in a logical order, from a service where a child is least likely to cry to one that may create some discomfort to a child. This will also help you to control the direction of the flow of clients through the services. If you start the service at the right time, this will help to minimise the time mother and caregivers will have to wait, and promote effective crowd control. His weight for height is also in the ‘moderate acute malnutrition’ range because it is between 70% and 80% of what would be the normal weight for an infant of his age. However you would class Dawit as having ‘severe acute malnutrition’ because he has oedema. Any child who fulfils one criterion for severe acute malnutrition (and oedema falls into this category) will be classified as having severe acute malnutrition. If Dawit had complications however – such as the presence of general danger signs, pneumonia/severe pneumonia, blood in the stool, fever or hypothermia – his classification will be ‘severe complicated malnutrition’. This means he needs to be referred to an in-patient facility for stabilisation of his clinical condition. Another indicator that would require Dawit to be referred to an in-patient facility would be if he failed the appetite test. You should recall that in the appetite test, there is a minimum amount of food that the child should take for their weight range.

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It expresses the percentage of the variation in the outcome variable that has been explained by the regression on the explanatory variables buy 120 mg sildigra with mastercard. For countries conducting surveys on a sample of the population purchase 50 mg sildigra, estimates were generated by applying prevalences determined in surveys to reported notification figures for the corresponding population and thus are dependent upon the level of case-finding in the country and quality of recording and reporting of the national programme. For countries conducting surveys on a sample of the population, estimates were generated by applying prevalences determined in surveys to reported notification figures for the corresponding population and thus are dependent upon the level of case-finding in the country and quality of recording and reporting of the national programme. Epidemiological and clinical study of tuberculosis in the district of Kolín, Czechoslovakia. Evaluating the impact of tuberculosis control: number of deaths prevented by short-course chemotherapy in China. Development of streptomycin resistant isolates of tubercle bacilli in pulmonary tuberculosis. Drug resistance in patients with pulmonary tuberculosis presenting at chest clinics in Hong Kong. Relative numbers of resistant tubercle bacilli in sputa of patients before and during treatment with streptomycin. Bacteriological aspects of the use of ethionamide, pyrazinamide and cycloserine in the treatment of chronic pulmonary tuberculosis. Involving private practitioners in tuberculosis control: issues, interventions, and emerging policy framework. Purchase of antibiotics without prescription in Manila, the Philippines: inappropriate choices and doses. Transactions of the Royal Society of Tropical Medicine and Hygiene, 1982, 79:679-691. A survey of prescribing patterns for tuberculosis treatment amongst doctors in a Bolivian city. Initial drug regimens for the treatment of tuberculosis: evaluation of physician prescribing practice in New Jersey, 1994-1995. Standard short-course chemotherapy for drug-resistant tuberculosis: Treatment Outcomes in 6 Countries. Increasing transparency in partnerships for health: introducing the Green Light Committee. The impact of human immunodeficiency virus infection on drug resistant tuberculosis. An outbreak of multi-drug resistant tuberculosis among hospitalized patients with the acquired immunodeficiency syndrome. Transmission of multi-drug resistant Mycobacterium tuberculosis among persons with human immunodeficiency virus infection in an urban hospital: epidemiologic and restriction fragment length polymorphism analysis. Transmission of drug-resistant Mycobacterium tuberculosis among persons with human immunodeficiency virus infection in urban hospital: epidemiologic and restriction fragment length polymorphism analysis. Private pharmacies in tuberculosis control- a neglected link International Journal of Tuberculosis and Lung Disease, 2002, 6(2):171-173. Survey of knowledge, attitudes and practices for tuberculosis among general practitioners in Delhi, India. Use of thiacetazone, thiophen-2-carboxylic acid hydrazide and triphenyltetrazolium chloride. Advances in techniques of testing mycobacterial drug sensitivity, and the use of sensitivity tests in tuberculosis control programmes. Human Development Report 2003: Millennium Development Goals: A compact among nations to end human poverty. A comparison of three molecular assays for rapid detection of rifampin resistance in Mycobacterium tuberculosis. Evaluation of a commercial probe assay for detection of rifampin resistance in Mycobacterium tuberculosis directly from respiratory and non respiratory clinical specimens. European Journal of Clinical Microbiology and Infectious Diseases, 1998, 17:189-192. Detection of rifampicin resistance in Mycobacterium tuberculosis isolates from diverse countries by a commercial line probe assay as an initial indicator of multidrug resistance. Rifampin- and multidrug-resistant tuberculosis in Russian civilians and prison inmates: dominance of the beijing strain family. Low levels of drug resistance amidst rapidly increasing tuberculosis and human immunodeficiency virus: co-epidemics in Botswana. Epidemiological analysis of tuberculosis treatment outcome as a tool for changing tuberculosis control policy in Israel. Drug- resistant pulmnonary tuberculosis in Israel, a society of immigrants: 1985-1994. Screening and management of tuberculosis in immigrants: the challenge beyond professional competence. The new National Tuberculosis Control Programme in Israel, a country of high immigration. Drug-resistant tuberculosis in Poland in 2000: second national survey and comparison with the 1997 survey. Drug resistance among failure and relapse cases of tuberculosis: is the standard re-treatment regimen adequate?

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