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Cause

Because the lungs of premature babies are immature they do not produce a substance called surfactant, which lines the lung surface and prevents collapse of the smallest airways (alveoli) used for oxygen exchange. This substance starts being produced when the baby is around 28 weeks gestation.

Clinical features

A baby suffering from RDS will have difficulty breathing, having to work very hard with each breath. His chest may be drawn in and he will grunt when he tries to breathe out.

Investigations

Diagnosis of RDS is usually confirmed by chest X-ray.

Treatment

Babies with RDS require highly specialised treatment in a special care nursery. They will be nursed in a humidicrib and will require oxygen administered through a special hood. Sometimes they will require oxygen through a tube passed into their windpipe, and some babies may be hooked up to a special breathing machine (ventilator) for days or even weeks. Artificial surfactant is also now available, and this helps those babies with respiratory distress due to immature lungs.

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    ”When I read about sexual abuse, I knew it was the same for

me. Will I, does anyone, get over the terrible scars of the

abuse?”

ANSWER: No, nobody “gets over” them, but one learns to put them to work in favor of a new intimacy. Those who have suffered abuse learn the contrast between sharing and abusing, and they seem all the stronger for the pain, for they have seen both sides of the issue. They have felt the guilt, self-blame, and anger of sexual abuse and learned the contrast between that and the love, trust, and safety of sex in marriage. Just as someone who never has been really sick may never fully know what it is to be very healthy or at least fully appreciate and value health every day, so it is with sexual abuse. You have seen and felt the pain, so the joy and freedom is all the more valued.

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The main reason for their extinction is that their organisms cannot cope with the increasing levels of pollution in their food and their environment.

Nature gives us a fair warning. If we keep polluting our planet, it may soon be our turn.

So far into our “civilised evolution” we continue to develop more and more diseases, allergies etc. and have increasing difficulty maintaining good health.

However, when we understand the reasons for this, we have a choice. Rather than waiting for governments and the industry to do something about it, WE THE CONSUMERS should make a choice first.

No industry will produce articles consumers do not want.

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Real influenza is certainly not a mild illness. Epidemics and pandemics (that is, a worldwide epidemic) of influenza have spread even in ancient times.

The great pandemic of 1918-1919 claimed an estimated 20 million people, more than died in the Great War.

Influenza is caused by a virus of which there are three sub-groubs, À, Â and Ñ. Ñ virus is rarely isolated and does not cause epidemic influenza. Â virus may cause epidemics which tend to be milder than those caused by A virus and it is this last which causes the pandemics.

The incubation is short, some two to three days. The onset of the infection is abrupt with fever, headache, malaise, shivering and severe aches and pains in the limbs and back.

This is followed by a dry cough, a sore throat and other symptoms of a respiratory infection.

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The tetracyclines are a group of bacteriostatic antibiotics produced from a number of moulds. They have a wide range of activity against many organisms which are insensitive to penicillin.

These drugs are also active against some of the larger viruses and related organisms which fall between bacteria and viruses in their characteristics.

Bacteria are organisms with a cell wall containing the active ingredients of the cell. They are capable of independent reproduction.

Viruses are smaller particles without a cell wall and consisting mainly of RNA or DNA, proteins which make up the nucleus of cells and which contain the genetic material.

Viruses can reproduce only inside cells of the host but bacteria can be grown in the test tube, if suitable nutrient is available. A virus can grow only in a suitable cell culture, where it reproduces itself inside a living cell.

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Noteworthy embryo logical studies uncovered some fascinating evidence. During intrauterine life, the fetal reproductive organs germinate from different types of cells. Vaginal tissue originates from a different set of genetic blueprints than uterine tissue, although both organs have the quality and capability of, for example, elasticity to accommodate childbearing. These embryonic studies went on to show that the tissue lining the ovaries, the endometrium, and the peritoneum—the smooth, transparent, and highly sensitive membrane that lines the pelvic and abdominal cavity—all originated from the same embryonic cell membrane.

It was then postulated that some of these cells could be transformed into endometrial cells or endometrial like cells through repeated irritation, such as pelvic infections, or by hormonal stimulation. In many cases, the physiological result is identical to having actual endometrial cells run wild and implant themselves: pain, cramps, and possible infertility. Thu mimicking of the disease posed some conclusions that interest scientists. The story that follows reveals why.

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A single boil may require no treatment other than careful washing with an antiseptic soap, causing it to spontaneously discharge. When there are multiple boils, or if one is in a potentially dangerous site, active treatment is necessary. Initially, a penicillinase-resistant semi-synthetic penicillin should be administered—such as Cloxacillin. The pus should be cultured, so that the most appropriate antibiotic can then be selected for further treatment. If boils recur, further investigations are necessary. Cultures should be taken from the infected lesion and from other sites such as the nostrils, normal skin, armpits and genital area. This will identity the reservoir or source of the infective organism. Occasionally cultures taken from other members of the immediate family may be helpful. Appropriate local treatment with an antibiotic cream can then be employed to eradicate the source. Treatment may be assisted by the taking of oral antibiotics and antiseptic baths. Further investigation to exclude possible concurrent diseases such as diabetes and immunological deficiencies may occasionally also be necessary.

Viruses are lengths of nucleic acid which carry enough information for their own replication only. They are therefore completely dependent on the host cells. Unlike bacteria, they do not grow by dividing; they assemble new virus particles by the addition of protein. There are a large number of viruses which affect man and, unfortunately, there are no antibiotics effective in their treatment.

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A gradual increase in fibre intake should be recommended. This will minimise possible side effects which include flatulence and possibly diarrhoea. When increasing fibre intake, also check fluid intake. If fluid intake is inadequate, constipation may result due to absorption of water by fibre in the large bowel.

It is also wise to caution clients against an excessive fibre intake. Besides the obvious gaseous effects, large quantities of insoluble fibre—particularly wheat bran—can interfere with the absorption of iron by the body.

Assessing dietary fibre intake. A ‘fibre count’ can be performed to identify sources of fibre and opportunities for increased intake. A greater fibre intake will result from increased consumption of fruits, vegetables, wholegrain cereals, legumes and other unprocessed plant foods. Client education should promote an eating style which includes these foods. As this list is limited to major fibre-containing foods, it can only provide a rough estimate of dietary fibre eting habits.

Reading food labels for carbohydrates. Nutrition information panels indicate carbohydrate content by showing the ‘total carbohydrate’ and the quantity of ’sugars’ per 100g. The starch content can be calculated by subtracting sugars from the total. This is a comparison between white and wholemeal bread. Both breads contain a relatively large amount of starch—44.4g and 40.7g respectively. Although technically carbohydrate, fibre content is shown separately. As you would expect, wholemeal bread contains more fibre.

In the absence of a nutrition information panel, an ingredient list can give an indication of the fibre content of a food. Names such as wholewheat, bran, wheatbran, wholegrain, wheatgerm, wheatmeal and oatbran appearing near the front of an ingredient list may indicate a generous fibre content.

An ingredient list can also provide an indication of sugar content. Sugar can be identified by numerous other names: sucrose, maltose, lactose, dextrose, fructose, glucose, sorbitol, mannitol, glucose syrup, com syrup, golden syrup, disaccharides, monosaccharides, polysaccharides, modified carbohydrate, raw sugar, brown sugar, molasses, honey and treacle.

Nutritional claims about carbohydrates. Like fat, there are requirements for manufacturers’ claims about fibre in food.

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If all is normal with your partner’s semen analysis it may be suggested that you are failing to ovulate and that a course of fertility drugs such as Clomiphene (Clomid) be taken to induce or increase egg production.

You will be told to start taking Clomid on either day 2 or day 5 (depending on the length of your cycle).

If a pregnancy still has not occurred after several months you may be advised to try a combination of Clomid with ultrasound scans and injections of HCG (human chorionic gonadotrophin).

The Clomid will encourage the production of an egg(s), the ultrasound scan will determine its maturity and the HCG injection will ensure it is released into the fallopian tube within 3 6 hours. You will be told to coincide intercourse during that 36 hours.

If these treatments are not successful you will need to consider your options. At this stage the options may include deciding to have no further treatment or to investigate your suitability for IVF (in vitro fertilisation) or GIFT (gamete intra fallopian transfer). However, before embarking on either of these programmes it should be noted that the success rates for full term pregnancies is 10% and 20% for IVF and GIFT respectively.

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