All About Amoebiasis - For Public

"AMOEBIASIS"
Symptoms, Treatment & Prevention
For Public

INTRODUCTION

Some infectious diseases are caused by biological agents such as bacteria, viruses, parasites and prions rather than by genetic, physical or chemical agents. Amoebiasis, sometimes spelt amebiasis, is one of those common diseases, caused by a parasite which infects the bowel casing a type of gastroenteritis infection.

INSIDENS

This disease generally occurs in young to middle aged adults, but can affect anyone because people can be receptive to infection by ingesting contaminated food or water containing the Entamoeba histolytica microorganism, although Amoebiasis is mostly associated with people living in areas of poor sanitation and it is a common cause of diarrhea among people living or traveling to developing countries, specially those located in tropical or subtropical areas, but also coming from domestic suburbs with non hygienic conditions. Approximately 500 cases are reported each year in New York State and most of those cases occur among New York City residents.

ETIOLOGY

As Amebiasis is an intestinal illness caused by a microscopic parasite called Entamoeba histolytica, to trace the cause of the disease it is necessary to know what you ate and drank in the previous weeks, and/or where you traveled before you became ill. Entamoeba histolytica parasites are only found in humans.

INCUBATION PERIOD

After infection, it may take from a few days up to two to four weeks before becoming ill. Some people with amebiasis may carry the parasite for weeks to years, often without symptoms. Amoebiasis can progress to amoebic dysentery in the wide, lower part of the intestine and then spread to cause severe damage to the intestine. Although rarely, amoebiasis can cause abscesses in the liver, lungs, and brain or even elsewhere in the body.

PATHOPHYSIOLOGY

Amoebiasis occurs when Entamoeba histolytica parasites are taken in by mouth, eaten or swallowed something infected with such parasite, however the most common way this happens is by person-to-person spread. People with amoebiasis have Entamoeba histolytica parasites in their feces, and their contaminated hands can spread the parasites to surfaces and objects which will be touched by other people. Under certain circumstances, this disease may also spread sexually by oral-anal contact.

In your household, the risk to spread amoebiasis can be reduced if people infected or suffering gastroenteritis do not prepare or handle food to be eaten by other people and that no one shares their towel or wash cloths. Food handlers, child care workers and health care workers with amoebiasis must not work until symptoms have stopped. Children must not attend child care centers, kindergartens or schools until symptoms have stopped.

SYMPTOMS

People with amoebiasis may experience mild or severe symptoms or no symptoms at all, the common are stomach cramps, nausea, diarrhea, sometimes containing blood, loose stools, abdominal tenderness and occasional fever and weight loss. Your doctor may proceed to examination of the stools under a microscope to diagnose amebiasis and prescribe specific antibiotics such as metronidazole to treat effectively this disease.

PREVENTION

Fecal material from infected people may contaminate water or food serving as a vehicle to infect others, so it is important that people observe preventive measures, infected or not, including careful handwashing thoroughly with soap and hot running water for at least ten seconds after going to the toilet. By frequently washing your hands you are eliminating the amoebiasis parasite that you have picked up from contaminated surfaces, from other people, or from animals and animal waste. Infected homosexuals should refrain from intimate contact and people traveling overseas, must take special care.

Bathrooms and toilets must be cleaned often to avoid the spread of disease, paying particular attention to surfaces such as handles, toilet seats, taps and diaper changing tables. Boil untreated water coming directly from lakes or rivers before drinking it since it may be contaminated with feces from people. Also contaminated food and drink are common sources of amoebiasis. Wash your hands before preparing food, before eating, after going to the toilet or changing diapers, after smoking or after using a tissue or handkerchief.

People must carefully select and prepare any food and drink as an effective preventive measure against amoebiasis. Uncooked foods must be avoided, particularly vegetables and fruit, which cannot be peeled before eating. Unpacked drinks and ice should also be avoided. Food handlers should always use disposable paper towels or an air dryer to dry their hands. Generally, cloth towels are not recommended as they can spread germs from one person to another.

Finally, remember that safe food storage and handling reduce also the risk of amoebiasis infections by following simple guidelines:

* Thoroughly cook all raw foods.

* Thoroughly wash raw vegetables and fruits before eating.

* Reheat food until the internal temperature of the food reaches at least 167º Fahrenheit.

And do not forget that part of the microwave cooking process, includes careful instructions of the standing times to ensure the food is completely cooked before it is served.

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How To Set Up a Wireless Network?

How To Set Up a Wireless Network?

In a wireless network, radio waves are used to communicate between each networked computer's wireless adapter and the wireless base station. The base stations and adapters follow one of the 802.11 radio transmission standards developed by the Institute of Electrical and Electronics Engineers (IEEE). The most popular versions of these standards are often referred to as Wi-Fi.

By using wireless networking in your office you can easily share internet connections, files and printers and it doesn't require a major commitment of time or expense. A wireless network requires Two Main Components:

• Base Station (also called a router or gateway)
• Network Adapter for each computer on your network

One benefit of networking computers in your small office is that everyone can use certain files, folders and a printer. This happens when the owner of a computer makes files, folders or a connected printer available to others on the network through a process called "Sharing." Once files, folders or a printer are shared, others on the network can then access them.

To facilitate this multi-user access, all of the computers that are sharing or accessing shared resources must first be Members of The Same Workgroup.

Once a workgroup has been created, it is visible when you Open My Network Places. (Click the My Network Places icon on your desktop.) The ability to see a whole workgroup simplifies the viewing and accessing of shared resources.

To Specify a Computer's Workgroup in Windows XP Operating System :

1.Click Start, click Control Panel, and then double-click System. If you don't see a System icon, click Performance and Maintenance, and then click System.

2.Click the Computer Name tab.

3.Click Change, and then in the Workgroup box, enter the name of the workgroup you want to join or create.

Naming conventions are important to keep in mind when you set up or add computers to workgroups. A workgroup name must be:

• The same for all computers in the workgroup
• Different from any computer name in the workgroup

Computer names, meanwhile, must be unique:

>

• No other computer in the workgroup can have the same name
• The computer name must also be different from the workgroup name

To Share a File, Folder or Drive Using Windows XP:

1. Enable file sharing on your computer if you haven't already done so by running the Network Setup Wizard. Click Start, click Control Panel, click Network and Internet Connections, click Network Setup Wizard. You only need to do this once on your computer.
2. Open My Computer.
3. Browse to the folder that contains the files that you want to make available to other computers, and then select it.
4. On the File menu, click Sharing and Security.
5. Click Share this Folder on the Network tab. By default, the folder is made available to all of the other computers on your network, and everyone has read-only access. To give everyone read-write access, select Allow Network Users to Change My Files.

Note: You must have administrative privileges on your computer to share files and folders in Windows XP.

For shared files to be available to others, the computer with the files must be turned on and logged on to the network. Use My Network Places (Microsoft Windows XP) or Network Neighbourhood (Windows 2000 and Windows 98) to navigate to and access shared files and folders on your network.

You can avoid having to navigate to a shared resource using My Network Places when you "map" your computer to the resource. When you map to a shared folder or drive to a drive letter on your computer, you can use My Computer or Windows Explorer to view it.

To Map a Shared Folder or Drive to a Drive Letter:

1. In Windows Explorer or My Computer, click the Tools menu, and then click Map Network Drive.
2. Browse to the location of the network resource you want to map, and then click OK.
3. Select a drive letter and then click Finish.
4. Sharing a printer
   

There are two types of shared printers:

• Network printers are connected directly to a network, usually to a device called a print server rather than to a particular computer.
• Local printers, which you're more likely to use, are attached to a single computer on a network. By setting up printer sharing, you can share a local printer with the other computers on the network.

After you have added a computer to a workgroup, you can share any printers that are connected to it. To share a printer :

1. Open the Printers control panel by clicking Start, pointing to Settings (or Control Panel) and then clicking Printers (or Printers and Faxes).
   
2. Select the printer you want to share and on the File menu, click Sharing, or click Properties and then click the Sharing tab.
   
3. In the Sharing dialog box, choose to share or not to share the printer.

You can also share new printers that you install on any of your networked computers. If the Add Printer Wizard detects that your computer is on a network, the wizard will give you the option to share the printer when you install it.

If you cannot access the Sharing option, or if you see a message stating that file and printer sharing is not turned on, you must enable the File and Printer Sharing component in Windows. In Windows XP you can do that through the Properties page for your network connection. In other Windows operating systems, you can use the network control panel.

Some Other Things to Know About Sharing Printers:

• Naming a shared printer. When you choose to share a printer, you'll assign it a name in the Sharing dialog box to identify it to the entire workgroup. The name should be different from any other device name in the workgroup, and should not be the same as the workgroup name. Use a name that helps you easily identify it, such as the location or brand and model.

• Setting up other computers to use a shared printer. To use a shared printer, each computer must have the printer driver installed that works correctly with its operating system. You can install the printer drivers by using Add Printers in the Printers control panel to install the printer on every computer that is going to use it. Install the printer as you would install any other printer, and select A network printer, or a printer that is attached to another computer option during the set up. You can then browse to the shared printer - provided that it and the computer it is attached to are turned on and accessible on the network - and then complete the installation.

On computers running Windows XP and Windows 2000, you can also install the drivers for other operating systems when you first share the printer. To do so, click Additional Drivers in the Sharing dialog box. You do not need to install the drivers in the other computers.

After the shared printer is set up, you can send print jobs from any of the computers in the workgroup exactly as you would print to a local printer.

If you are sharing files over a wireless network or with computers that are connected to the internet, security is an important consideration. If you don't take steps to help protect your network, it is possible for internet intruders or wireless eavesdroppers to access your shared files.

You can help protect computers on your wireless network from unauthorised access in several ways :

• Install a firewall between the internet and your network. Software-based firewalls, such as Windows Internet Connection Firewall (ICF), might interfere with file sharing over the local network. Instead, use wired and wireless base stations with a built-in hardware firewall that helps provide security while allowing unrestricted file sharing over the local network.

• Enable Wi-Fi Protected Access (WPA) or 128-bit wired equivalent privacy (WEP) to help prevent eavesdroppers from accessing your shared files.

• Assign passwords to folders you want to protect by using Windows share-level access control, also known as "permissions."

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Constipation & How To Deal With It

Constipation & How To Deal With It

Definition

Constipation is a common digestive system problem in which you have infrequent bowel movements, pass hard stools, or strain during bowel movements.

In terms of frequency, what constitutes constipation for one person may be normal for someone else. That's because the normal frequency of bowel movements varies widely — from three a day to three a week. What's normal for you may not be normal for someone else.

In general, though, you're probably experiencing constipation if you pass hard and dry stools less than three times a week. In some cases, constipation also may make you feel bloated or sluggish or experience discomfort or pain.

Fortunately, a few common-sense lifestyle changes, including getting more exercise, eating high-fiber foods and drinking plenty of water, can go a long way toward preventing or alleviating constipation.

Symptoms

Not having a bowel movement every day doesn't necessarily mean you're constipated. You're likely constipated, however, if you:

* Pass a hard stool fewer than three times a week
* Strain frequently during bowel movements
* Have abdominal bloating or discomfort

Causes

Normally, the waste products of digestion are propelled through your intestines by muscle contractions. In the large intestine, most of the water and salt in this mixture are reabsorbed because they're essential for many of your body's functions.

If too much water is absorbed or if the waste moves too slowly, you may become constipated. You may also experience constipation if the muscles you use to move your bowels aren't coordinated. This problem is called pelvic floor dysfunction (anismus) and it causes you to strain with most bowel movements, even soft ones. Stool moves through your colon but gets hung up in the rectum because of a lack of muscle coordination to empty your bowels.

A number of factors can cause an intestinal slowdown, including:

* Inadequate fluid intake
* A low-fiber diet
* Inattention to bowel habits
* Age
* Lack of physical activity
* Pregnancy
* Illness

Many medications, including those used to treat Parkinson's disease, high blood pressure and depression, also can cause constipation. The same is true of many narcotics. And frequent use of laxatives often aggravates and may even eventually cause constipation.

In rare cases, constipation may signal more serious medical conditions, such as colorectal cancer, hormonal disturbances or autoimmune diseases.

Sometimes young children are constipated because they forget to take time to use the toilet. And your toddler might become constipated during toilet training if he or she is afraid or unwilling to use the toilet.

Risk Factors

You're more likely to have problems with constipation if you're an older adult, are sedentary or bedridden, eat a diet that's low in fiber or don't drink enough fluids. You're also at risk if you take certain medications, including sedatives or narcotics, or you're receiving chemotherapy.

If you're pregnant, you may have bouts of constipation because of hormonal changes. Later in your pregnancy, pressure on your intestines from your uterus also can cause constipation.

When to Seek Medical Advice

See your doctor if you experience a recent, unexplained onset of constipation or change in bowel habits, or any of the following signs or symptoms, which might indicate a more serious health condition:

* Bowel movements just once or twice a week, despite corrective changes in diet or exercise
* Intense abdominal pain
* Blood in your stool
* Constipation that alternates with diarrhea
* Rectal pain
* Thin, pencil-like stools
* Unexplained weight loss

Tests and Diagnosis

A diagnosis of constipation generally depends on your medical history and a physical exam. Your doctor will first want to make sure you don't have a blockage in your small intestine or colon (intestinal obstruction), an endocrine condition, such as hypothyroidism, or an electrolyte disturbance, such as excessive calcium in the blood (hypercalcemia). He or she will also want to check your medications in case they may be causing your constipation.

You may undergo these diagnostic procedures:

* Electrolyte. This will be done if your doctor suspects an Electrolyte Imbalance, such as Hypokalemia or Hypercalsemia as the causes of your constipation.
* Stool analysis. In some cases, your doctor may request a stool sample, to be analyzed for the presence of hidden (occult) blood.
* Barium enema. In this test, the lining of your bowel is coated with a contrast dye (barium) so that your rectum, colon and sometimes a part of the small intestine can be clearly seen on an X-ray.
* Sigmoidoscopy. In this procedure, your doctor uses a lighted, flexible tube to examine your sigmoid colon and rectum.
* Colonoscopy. This diagnostic procedure allows your doctor to examine the entire colon with a flexible, camera-equipped tube.
* Anorectal manometry. In this procedure, your doctor inserts a narrow, flexible tube into your anus and rectum and then inflates a small balloon at the tip of the tube. This allows your doctor to measure the coordination of the muscles you use to move your bowel. You may undergo this test if your doctor suspects pelvic floor dysfunction.

Complications

Although constipation can be extremely bothersome, it usually isn't serious. If it persists, and especially if straining results, you may develop complications such as hemorrhoids and cracks or tears in your anus called abrasions or fissures.

Very severe or chronic constipation can sometimes cause a fecal impaction, a mass of hardened stool that you can't eliminate by a normal bowel movement. An impaction can be dangerous, and you may need to have it manually removed.

If you use Laxatives Frequently, you may develop Lazy Bowel Syndrome, a condition in which your bowels become dependent on laxatives to function properly. In fact, laxative use can cause a number of problems, including Poor Absorption of Vitamins and Other Nutrients, Damage to Your Intestinal Tract and Worsening Constipation.

Treatments and Drugs

Changes in your lifestyle may be the safest way to manage constipation. To help ease symptoms, try using a fiber supplement, such as Oat Bran, Metamucil, Konsyl or Citrucel. These natural supplements help make stools softer and are safe to use every day. Be sure to drink plenty of water or other fluids every day. Otherwise, fiber supplements can actually make your constipation worse. And add fiber to your diet slowly to avoid problems with gas.

Your doctor may recommend a Stool Softener, such as Mineral Oil or Docusate (Colace, Surfak), to soften fecal matter so that it passes through your intestines more easily. But don't rely on stool softeners on a regular basis because they can cause other problems.

Your doctor may also suggest that you take Milk of Magnesia, which acts as a Mild Laxative. Mineral Oil may interfere with the absorption of fat-soluble vitamins and can cause a serious form of pneumonia if it's accidentally inhaled (aspirated) into your lungs, so don't take mineral oil just before you lie down.

Other Approaches

If pelvic floor dysfunction is the cause of your constipation, your doctor may suggest biofeedback as a treatment. This technique may help you learn to better coordinate the muscles you use to defecate.

If you're pregnant — and in general — it's a good idea to check with your doctor before using any laxatives other than fiber supplements. Try eating lots of high-fiber foods, such as fruits, vegetables and whole grains. It's a good idea to check the content of prepared foods because not all foods claiming to be high in fiber actually are. Drink plenty of fluids and get as much exercise as you can. Swimming and walking are good choices.

Prevention

To help prevent constipation:

* Eat fiber regularly. Choose lots of high-fiber foods, including fruits, vegetables, beans and whole-grain cereals and breads. Experiment to see if particular fruits or vegetables have a laxative effect for you. Adding fiber to your diet gradually may help reduce gas and bloating.
* Limit problem foods. Foods that are high in fat and sugar and those that tend to be low in fiber content, such as ice cream, cheese and processed foods, may cause or aggravate constipation.
* Drink plenty of liquids. The exact amount of water and other fluids you should drink each day varies and depends on your age, sex, health, activity level and other factors.
* Increase your physical activity. Engage in regular exercise, such as walking, biking or swimming, on most days.
* Heed nature's call. The longer you delay going to the toilet once you feel the urge, the more water that's absorbed from stool and the harder it becomes.
* Try fiber supplements. Over-the-counter products such as Metamucil and Citrucel can help keep stools soft and regular. Check with your doctor about using stool softeners. If you use fiber supplements, be sure to drink plenty of water or other fluids every day. Otherwise, fiber supplements may cause constipation or make constipation worse. Add fiber to your diet slowly to avoid problems with gas.
* Don't rely on stimulant laxatives. These include products such as Correctol and Dulcolax, which cause muscle contractions in the intestines. Habitual use can damage your bowels and make constipation worse. For occasional relief try saline laxatives, such as milk of magnesia. Saline laxatives draw water into the colon to allow stool to pass easier. Keep in mind that long-term use of laxatives can cause dependency. For constipated children, give them plenty of fluids to drink, but avoid giving them laxatives unless your doctor says it's OK.

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All About Hyponatremia

All About Hyponatremia

Definition

Hyponatremia is an abnormally low concentration of sodium in your blood.

When your blood sodium is too low, your cells malfunction — causing swelling. In chronic hyponatremia, sodium levels drop gradually over several days or weeks — and symptoms are typically moderate. In acute hyponatremia, sodium levels drop rapidly — resulting in potentially dangerous effects, such as rapid brain swelling, which can result in coma and death.

Hyponatremia occurs when the sodium in your blood is diluted by excess water. Hyponatremia may result from medical conditions that impair excretion of water from your body, or by a significant increase in water consumption, such as by athletes competing in marathons and other high-endurance events.

Treatment focuses on the underlying condition and may include intravenous fluids and medications.

Symptoms

Hyponatremia symptoms may include:

* Nausea and vomiting
* Headache
* Confusion
* Lethargy
* Fatigue
* Appetite loss
* Restlessness and irritability
* Muscle weakness, spasms or cramps
* Seizures
* Decreased consciousness or coma

Causes

Sodium is a key component of your body. It's an electrolyte and helps carry nerve impulses between cells. It helps maintain normal blood pressure, it's essential for your nervous system to accomplish muscle movement, and it regulates the fluids in and around your cells.

Normal blood plasma contains between 136 and 145 milliequivalents per liter (mEq/L) of sodium. Hyponatremia occurs when the sodium in your blood falls below 135 mEq/L.

When the sodium levels in your blood become too low, excess water enters your cells — causing them to swell. This swelling is especially dangerous to your brain because it's confined by your skull and unable to expand.

Hyponatremia is typically the result of a medical condition that impairs the excretion of water from your body, or the excessive consumption of water. The imbalance between sodium and water in your blood may occur in three primary ways:

* Hypervolemic hyponatremia. In hypervolemic hyponatremia, excess water — commonly the result of kidney failure, heart failure or liver failure — dilutes the sodium concentration, causing low sodium levels.
* Euvolemic hyponatremia. Normal water levels combined with low sodium levels (commonly due to chronic health conditions, cancer or certain medications) can lead to euvolemic hyponatremia.
* Hypovolemic hyponatremia. In hypovolemic hyponatremia, your water and sodium levels are both low. This may occur, for example, when exercising in the heat without replenishing your fluids or with marked blood loss.

Hyponatremia causes may include:

* Consuming excessive water during exercise. Because you lose sodium through sweat, drinking too much water during endurance activities, such as marathons and triathlons, can dilute the sodium content of your blood.
* Hormonal changes due to adrenal gland insufficiency (Addison's disease). Your adrenal glands produce hormones that help maintain your body's balance of sodium, potassium and water.
* Hormonal changes due to an underactive thyroid (hypothyroidism). Hypothyroidism may result in a low blood sodium level.
* Diuretics (water pills) — especially thiazide diuretics. Diuretics work by making your body excrete more sodium in urine.
* Syndrome of inappropriate anti-diuretic hormone (SIADH). In this condition, high levels of the anti-diuretic hormone (ADH) are produced, causing your body to retain water instead of excreting it in your urine.
* Primary polydipsia. In this condition, your thirst increases significantly, causing increased fluid intake.
* Certain medications. Some medications, such as some antidepressants and pain medications, can cause you to urinate or perspire more than normal.
* Chronic, severe vomiting or diarrhea. This causes your body to lose fluids and electrolytes, such as sodium.
* Dehydration. In dehydration, your body loses fluids and electrolytes.
* Diet. Consuming a low-sodium diet combined with excessive water intake for prolonged periods can disturb the proper balance between sodium and fluids in your blood.
* Cirrhosis. Liver disease can cause fluids to accumulate in your body.
* Kidney problems. Kidney failure and other kidney disease may render your body unable to efficiently remove excess fluids from your body.
* Congestive heart failure. The condition causes your abdomen and lower extremities to retain fluids.

Risk factors

The following factors may increase your risk of hyponatremia:

* Age. Low blood sodium is more common in older adults. This is due to age-related changes and increased prevalence of chronic disease that may impair your body's normal sodium balance.
* Sex. Hyponatremia is more common in women than in men.
* Diet. You may be at an increased risk of hyponatremia if you are following a low-sodium diet, especially if combined with diuretic intake.
* Intensive physical activities. People who take part in marathons, ultramarathons, triathlons and other long-distance, high-intensity activities are at an increased risk of hyponatremia.
* Climate. Not being acclimated to hot weather can increase the amount of sodium you lose through sweating during exercise.
* Conditions that impair your body's water excretion. Medical conditions that may increase your risk of hyponatremia include kidney disease, syndrome of inappropriate anti-diuretic hormone (SIADH) and heart failure, among others.

When to seek medical advice

If you take part in high-intensity activities, such as marathons, have a medical condition that increases your risk for hyponatremia, or have other risk factors for hyponatremia and you exhibit the signs and symptoms of low blood sodium, see your doctor.

Tests and diagnosis

Your doctor will take a medical history and conduct a physical examination. He or she will likely ask about your signs and symptoms, and whether you've experienced recent vomiting, diarrhea, or other significant fluid loss.

Because the signs and symptoms of hyponatremia are nonspecific and occur in many conditions, it's impossible to diagnose the condition based on a physical exam alone. To confirm low blood sodium, laboratory tests — including blood tests and possibly urine tests — are necessary.

Complications

Untreated, acute hyponatremia — the form of hyponatremia in which sodium levels fall rapidly — can lead to rapid swelling of your brain, resulting in coma and death.

Treatments and drugs

Hyponatremia treatment is directed at the underlying cause, if it can be identified and corrected.

If you have moderate, chronic hyponatremia due to the use of diuretics or excessive water consumption, your doctor may advise you to temporarily cut back on fluids or adjust your diuretic use to increase the level of sodium in your blood.

If you have severe, acute hyponatremia, more aggressive treatment is required. Options include:

* Intravenous fluids. Your doctor may recommend intravenous (IV) administration of a sodium solution to raise the sodium levels in your blood. This often requires a stay in the hospital.
* Medications. You may take medications to manage the signs and symptoms of hyponatremia, such as headache, nausea and seizures.
* Hormone injections. If adrenal insufficiency (Addison's disease) is the cause of hyponatremia, you may undergo hormone injections to correct the condition.

Prevention

The following measures may help you prevent hyponatremia:

* Treat associated conditions. Getting treatment for conditions that contribute to hyponatremia, such as adrenal insufficiency, can help prevent you from experiencing low blood sodium.
* Educate yourself. If you have a medical condition that increases your risk of hyponatremia or you take diuretic medications, be aware of the signs and symptoms of low blood sodium.
* Take precautions during high-intensity activities. Guidelines from the International Marathon Medical Directors Association advise runners to drink only as much fluid as they lose due to sweating during a race. Athletes should drink no more than 31 ounces of water per hour during extended exercise.
* Consider drinking sports beverages during demanding activities. Ask your doctor about replacing water with sports beverages that contain electrolytes when participating in endurance events such as marathons, triathlons and other demanding activities.
* Drink water in moderation. Drinking water is vital for your health, so make sure you have a sufficient daily intake of fluids. But don't overdo it.

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What Is Naproxen Test ? Fever Of Unknown Origin

What Is Naproxen Test? Fever Of Unknown Origin

Introduction

Fever of whatever etiology still remains a perplexing problem to both clinicians and investigators. Despite its established role as a Cardinal Sign of Infection, it remains elusive if not surprising in terms of final outcome. Increasingly, its role in Connective Tissue Diseases, Malignancies and Other Inflamatory isorders is slowly supplanting the exclusivitly of the symptom to just infectious conditions.

The likely identification of the cause of fever is crucially dependent upon meticulous history-taking and thorough physical examination coupled with useful ancillary and laboratory procedures. A dilemma arises when the diagnostic aids do not provide the expected results. Subjecting the patient to more laboratory examinations may provide an ordeal rather than a diagnosis. Shotgun Antimicrobial Therapy May Result in a Superinfection rather than a cure. The need to categorized prolonged fever in terms of specific etiology is essential in establishing a direction for the clinician's plan of action. Clinical studies have shown that The Most Common Causes of Prolonged Fever are Infections and Neoplasm. Based on this premise the Naproxen Test may provide a simple and economical tool in the causative differentiation of fever.

A seven-year study by Chang confirmed that naproxen test value in differentiating between infections and neoplasm. Lysis of fever upon administration of the drug favors a presumptive diagnostic of neoplastic fever. On the other hand, failure points to an infectious cause.

Naproxen Test

Requirement

The patients were given Naproxen Sodium at 500 mg/tablet, one tablet every 12 hours p.c. for a total of 4 doses. Body temperature was taken orally every two hours prior.

Naproxen 500 mg/tablet Every 12 Hours P.C For 2 Days

Interpretation

Fever lysis after or within the time frame of drug administration was interpreted as suggestive of either a neoplastic condition or a connective tissue disease.
Nonresponse of the fever to the drug was taken to suggest an infectious condition.

Naproxen Administration was discontinued if any of the following were noted :

1). Hypersensitivity reaction,
2). Abdominal complaints, or
3). Patient refusal to take the drug.

Neoplastic Fever is the second most common cause of fever in cancer patients after infection. The establishment of the etiology of fever in patients with malignancy however, remains to be a challenging diagnostic scenario for clinicians. Distinguishing between infectious fever and neoplastic fever is of paramount importance in cancer patients because of the urgency and necessity for appropriate treatment in these immunocompromised hosts. Postulated pathogenic mechanisms for its occurrence include massive tumor necrosis, extensive neoplastic cell destruction, local inflammation due to ulceration of normal or malignant tissue, leucocytic infiltration of the neoplasm, interference with conjugation of pyrogenic steroids secondary to liver metastases and excessive heat production by tumor cells.

The more recent mechanism involves induction of pyrogenic cytokines such as tumor necrosis factor, interleukins 1 and 6 and interferon by the tumor cells itself or by host macrophages in response to the tumor. Cytokines stimulate production of prostaglandin E2 which act on the hypothalamus causing a change in the thermostatic set point. Naproxen is a non-steroidal anti-inflammatory drug which acts as an inhibitor of cyclooxygenase. It has been demonstrated to have both analgesic and antipyretic effects.

Dr. Chang pioneered the use of the 'Naproxen test' as a clinical tool in the differential diagnosis of fever of undetermined origin (FUO) in patients with cancer in a study conducted at the Oncology Unit of the Good Samaritan Hospital in Dayton, Ohio. The study population consisted of patients with FUO and suspected or diagnosed malignancy. Naproxen was administered at 250 mg twice a day orally at 12-hourly intervals for at least 3 days. The results of this study were promising. However validity was not established because of the lack of an independent, blind comparison with a reference standard. Instead, a correlation of the final diagnoses of FUO in all patients with their response to antibiotics and naproxen was done.

Subsequent observational studies on small groups of patients with specific malignancies similarly
had promising results, but likewise suffered from this critical flaw. This precluded further estimation of the sensitivity, specificity and likelihood ratios of the naproxen test. It is suggested that the more appropriate reference standard would be the absence of infection after extensive and thorough laboratory work-up coupled with the absence of any clinical deterioration without administration of any antibiotics on continued follow-up for at least a period of 2 weeks. Specifically, the more convincing evidence that a patient does not have any infection despite extensive work-up would be the non-deterioration of the patient in the absence of any antibiotics during a prolonged follow-up period.

With the advent of modern diagnostic technology, it is timely that the usefulness of this
test be re-evaluated in the present decade. In the Philippines, it is best that this test be validated in a tertiary center with a laboratory and radiology department that is equipped with highly sensitive diagnostic and imaging procedures that are needed to rule out any infection from bacterial, viral, fungal or parasitic etiology. Likewise the staff should be competent in the performance and interpretation of these procedures.

Larger studies with a spectrum that would be representative of both hematologic and solid tumors are needed to confirm or refute the naproxen test as a valid and accurate tool in discriminating between neoplastic and infectious fever. To date neoplastic fever remains a diagnosis of exclusion. If the potential predictive value of this inexpensive and easy to perform test could be established, prolonged empiric antibiotic therapy and extensive fever work-up could be minimized. Likewise, delay in institution of chemotherapy could be prevented. This could all translate into improved quality of care and quality of life for the patient in terms of less medical expenses, less discomfort and inconvenience for the patient.

Summary

1. The Naproxen Test was unequivocally positive in malignancies & connective tissue diseases.
2. Malignant Lymphoma was the most common malignancy.
3. Enteric Fever & Malaria were the most common infectious diseases with a true negative response. However, enteric fever also gave the highest false negative response.
4. Amoebic Liver Abscess, Extrapulmonary Tuberculosis, Viral Hepatitis, Pneumonia, Recurrent Urinary Tract Infection, & Pulmonary Tuberculosis
   

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Select Boot Camp Startup Disc Sans Keyboard

Select Boot Camp Startup Disc Sans Keyboard

If you own an Intel-based Mac, and have installed Windows on it via Apple’s Boot Camp, then you’re familiar with how you tell your Mac whether to boot into OS X or Windows :

• Just Hold Down The Option Key At Startup, and then
  
• Use The Arrow Keys or Mouse to Choose The Windows or OS X Partition.

But here’s a fun alternative — good for those situations when you can’t reach the keyboard after choosing to reboot.

• Make Sure You Have The Apple Remote In Hand, and
  
• Press and Hold the Menu Button During Startup. Just as if you were at the machine, the boot loader will appear.
  
• From here, Use The Forward & Backward Buttons To Cycle between the two operating systems, and
  
• Activate The Desired One By Pressing Play. No muss, no fuss, no keyboard required.

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Edited By C14

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How To Fix Sluggish MacOS? - Hunt Down Process or Hogs

How To Fix Sluggish MacOS?
Hunt Down Process or Hogs

Has your Mac suddenly become sluggish? The problem may be a hidden program that doesn’t pop up in the Force Quit menu. To spot these troublemakers, you can do this tricks :

1. First, Launch Activity Monitor (/Applications/Utilities) and,
   
2. From the pop-up menu at the top of the window, Choose My Processes.
   
• This shows the activity of any currently running applications (and their associated helper programs) and widgets.
  
• Keep in mind that none of your Mac’s hidden Unix processes appear in the window (which is good, because you don’t want to mess with this stuff unless you know what you’re doing).
3. When you’ve located an item that appears to be gumming up the works (a helper program that didn’t quit with its host program, for example), Select It & Click On The Quit Process button at the top of the window.
   
• Activity Monitor offers an additional advantage: it can show you what’s occupying your Mac’s mind.
  
• Just click on the CPU column to see which applications are hammering on your Mac’s CPU.
  
• Or take a look at the Real Memory column to view the RAM hogs you’re running.
  

If quitting the hidden process doesn’t solve your slowdowns, try restarting your Mac. This will usually clear out the cobwebs and get your system back up to speed.

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Make Your Own Shortcuts In MacOS

Make Your Own Shortcuts In MacOS

You know you waste time whenever you reach for the mouse to activate commonly used commands. But what if the command’s keyboard shortcut is awkward, or there isn’t one for something you do a lot? Here are some tips, on how to create & manage your own shorcuts key in MacOS.

1. Open up the System Preference Pane
2. Go To Keyboard & Mouse Preference Pane,
3. Choose Create Your Own Shortcuts, and then
4. Change a Shortcut

It’s a snap to reassign a shortcut if it’s listed in the Keyboard & Mouse preference pane’s Keyboard Shortcuts tabs. Just double-click on the existing shortcut and then press the combination you’d rather use. You can use the Keyboard Shortcuts tab to change not only program-specific but also systemwide shortcuts.

This can be helpful if a standard shortcut is hard for you to remember, or when a shortcut in one program has a completely different function in another. Create a New Shortcut The Keyboard Shortcuts pane is also useful when you want to create shortcuts for commands that don’t have them—even a systemwide command such as Sleep.

How To Make a Sleep Shortcut

To make a sleep shortcut, just follow this instruction :

1. Click On The Plus Sign (+) in the Keyboard Shortcuts Tab,
2. Set The Applications Pop-Up Menu To All Applications,
   
3. Type Sleep (Capitalization Counts) in the Menu Title field,
   
4. Go To the Keyboard Shortcut Box,
   
5. Press The Shortcut You Want To Use, and then
6. Click on Add.

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Securely Erase Your Hard Disk - All About MacOS Trash

Securely Erase Your Hard Disk
All About MacOS Trash

That little crumpling sound your Mac makes when you empty the Trash may sound satisfyingly final, but don’t be lulled into a false sense of security. Traces of your personal information and even entire files can easily be left behind on your machine. Follow these steps to make sure your Trash is gone for good.

Securely Erase Your Hard Disk Before you sell or give away a Mac, make sure that no personal data remains on it. After you’ve copied all your files to your new Mac, restart the old one from the Mac OS X installation disc. Open Disk Utility and select your hard disk from the list on the left. Click on the Erase tab and then on Security Options.

Next, choose one of the several erasure methods that are offered. The 7-Pass Erase option is probably sufficient for most people, but if you’re truly paranoid, select 35-Pass Erase, which will make it nearly impossible for anyone, even James Bond, to recover your files. If you’re using a laptop, make sure it’s plugged in. This process can take a long time.

Delete Stubborn Files

Have a file that just won’t delete? There are third-party solutions, such as Marco Balestra’s handy and free Super Empty Trash (donations accepted; www.faqintosh.com). Or you can use the rm -rf command in Terminal to remove the file. Unfortunately, if you mess up with that command, you might erase your hard drive.

Here’s a third method to try. It may take longer, but it’s very safe and will work on files that seem immune to all other attempts.

• Start by creating a new user in the Accounts preference pane. It doesn’t matter what name or access level you give the new account; it’s going to have a very short life.
  
• Once the account is created, move the troublesome file from the Trash into the /Users/Shared folder.
  
• Now go to the Apple menu and choose Log Out user name, and then log in as the new user.
  
• Open the /Users/Shared folder, and move the pesky file into the new user’s Trash.
  
• Now log out of the new account and log in to your main account. Return to the Accounts preference pane, select the account you just created, and click on the minus sign (–), or just press the delete key.
  
• A dialog box will appear, asking you if you’re sure you want to do this. Of the three options—Cancel, OK, and Delete Immediately— select Delete Immediately. The troublesome file, along with the new user account and the disk space it used, will disappear. Selecting OK will leave the file on your disk.

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Want To Zoom / Enlarge Your MacOS Screen?

Want To Zoom / Enlarge Your MacOS Screen?

If you find interface elements too small to read comfortably, OS X will let you zoom in for a better look. Choose System Preferences from the Apple menu, click on Universal Access, and, in the Seeing tab, enable the Zoom option.

Now when you press 1-option–equal sign (=), whatever is on your display will be enlarged. (Use the equal sign that appears at the top of the regular keyboard rather than the one on the keypad.)

Press 1-option-hyphen (–) and the display zooms out. If your mouse has a scroll wheel or scroll ball, you can also zoom in and out by simply holding down the control key while moving the scroll wheel up and down.

By clicking on the Options button next to the Zoom entry, you can set the maximum and minimum zoom levels and decide how you want the display to react to your cursor; whether it should scroll only when the cursor reaches the edge of the screen, follow the cursor continuously, or keep the cursor centered. To quickly turn the zoom feature on or off, press 1-option-8.

Zoom with the Trackpad

By default you can just hold down the control key and use your mouse’s scroll wheel to zoom in and out on your display. But how can this be accomplished on a laptop that offers no scroll wheel? Universal Access offers this cool zooming feature: on Apple laptops that allow two-finger scrolling, press control and use your two fingers on the trackpad. Drag them up and the screen zooms; drag them down and the image shrinks back to normal size.

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