The majority of patients have the Migrainous symptoms such as photophobia unremitting subtype from onset impotence of organic origin icd 9 buy generic kamagra gold 100mg. Other primary headache dis Headache attacks which are believed to be a type of 3 erectile dysfunction market order kamagra gold with a visa. Cephalalgia 2001; 21: short-lasting unilateral neuralgiform headache attacks 82?83 erectile dysfunction drugs research purchase kamagra gold discount. The second case of chronic paroxysmal hemicrania-tic syndrome [Editorial comment] buy generic erectile dysfunction drugs purchase kamagra gold with mastercard. Cluster headache: A prospec or phonophobia in migraine compared with trigeminal auto tive clinical study in 230 patients with diagnostic implications food erectile dysfunction causes discount 100mg kamagra gold fast delivery. Cluster headache crania in a young child: Possible relation to ipsilateral occipital Course over ten years in 189 patients impotence ka ilaj generic kamagra gold 100mg without a prescription. Cluster headache neuralgiform headache attacks with tearing and conjunctival Clinical findings in 180 patients impotence existing at the time of the marriage discount kamagra gold online. Paroxysmal hemicra ache syndromes of the neural influences on the cerebral circu nia: A prospective clinical study of thirty-one cases erectile dysfunction treatment options exercise buy kamagra gold 100 mg with visa. Arq Neuropsiquiatr 2000; 58: Unilateral Neuralgiform Headache Attacks with Conjunctival 518?521. Nitroglycerin as a provocative agent in cluster head Obermann M, Yoon M-S, Dommes P, et al. Hemicrania neuralgiformis chronica tively in a patient: Trigemino-vascular trinity. Pathophysiology of cluster headache: A trigeminal combination of lithium and carbamazepine. The headache disorders in this chapter can be General comment grouped into four categories: (1) headaches associated Primary or secondary headache or both? Brought on by and occurring only in association with coughing, straining and/or other Valsalva with coughing, straining and/or other Valsalva man? Associated symptoms such as vertigo, Diagnostic criteria: nausea and sleep abnormality have been reported by up to two-thirds of patients with 4. Subforms such as ?weight matoma, cerebral aneurysms and reversible cerebral lifters? headache are recognized but not individually vasoconstriction syndrome. Headache had a pulsating character in most respon dents with exercise headache in the Vaga? At least two episodes of pain in the head and/or ing that venous or arterial distension, secondary to phy neck ful? Either or both of the following: jugular venous valve incompetence (70% compared 1. Either of the following: activity is now regarded as a single entity with variable 1. Brought on by and occurring only during or after Primary headache attributed to sexual activity during strenuous physical exercise their lives; they should be diagnosed as 4. Either of the following: dissection (intra and extracranial), reversible cerebral 1. Brought on by and occurring only during sexual hypotension and acute sinusitis (particularly with baro activity trauma. Either or both of the following: diagnosis of last resort, reached only when all organic 1. This implies excitement normal brain imaging, including the brain vessels, and/ 2. Lasting from 1 minute to 24 hours with severe probable primary thunderclap headache is not a diagno intensity and/or up to 72 hours with mild intensity sis that should be made, even temporarily. Description: Headache brought on by a cold stimulus applied exter nally to the head or ingested or inhaled. When such headache is attributed uniquely to one of these Diagnostic criteria: triggers, it should be coded accordingly as one of these headache types. Brought on by and occurring only during applica High-intensity headache of abrupt onset, mimicking tion of an external cold stimulus to the head that of ruptured cerebral aneurysm, in the absence of C. Resolving within 10 minutes after removal of the Comment: cold stimulus this headache is a result of external cooling of the D. At least two episodes of acute frontal or temporal subtle to cause damage to the scalp; in other words, headache ful? Brought on by and occurring immediately after a cold stimulus to the palate and/or posterior pharyn 4. Resolving within 10 minutes after removal of the Headache resulting from sustained compression of peri cold stimulus cranial soft tissues, for example by a tight band around D. Brought on by and occurring within 1 hour during tion of crushed ice slurry is particularly likely to pro sustained external compression of the forehead or voke this headache, but eating ice-cream, even slowly, scalp can do so. Maximal at the site of external compression Headache is frontal or temporal, and most com D. Resolving within 1 hour after external compression monly bilateral (but may be lateralized to the side of is relieved usual migraine headache in those who have unilateral E. Comment: the duration of headache varies with the severity and Comments: duration of the external traction. Although headache is Studies show 80% of stabs last 3 seconds or less; rarely, maximal at the site of traction, it often extends to other stabs last for 10?120 seconds. When stabs are strictly localized to one B?D area, structural changes at this site and in the distribu 2. Brought on by and occurring only during sustained not including cranial autonomic symptoms. No cranial autonomic symptoms Ice-pick pains; jabs and jolts; needle-in-the-eye syn E. Felt exclusively in an area of the scalp, with all of hours, without characteristic associated symptoms and the following four characteristics: not attributed to other pathology. No cranial autonomic symptoms or restlessness scalp, but is usually in the parietal region. Superimposed on the back Comments: ground pain, spontaneous or triggered exacerbations 4. The pain is usually of published cases, the disorder has been chronic (pre mild to moderate, but severe pain is reported by one sent for longer than 3 months), but cases have also been? Pain is bilateral in about two-thirds of described with durations of seconds, minutes, hours cases. Felt exclusively in an area of the scalp, with three Distinction from one of the subtypes of 3. Trigeminal only of the following four characteristics: autonomic cephalalgias, especially 3. Nevertheless, patients with prior headache use; intracranial disorders must also be excluded. Tension-type headache) are not However, the presence of sleep apnoea syndrome does excluded from this diagnosis, but they should not not necessarily exclude the diagnosis of 4. Similarly, patients with prior headache should not describe exacerbation followed by medication 4. No cranial autonomic symptoms or restlessness Abortive drug use may exceed the limits de? Distinct and clearly remembered onset, with pain becoming continuous and unremitting within 24 hours Comments: C. Primary headaches associated with sexual activ acteristics and the relationship with the characteristics of ity Some observations in Indian patients. Sexual headache in young ado Headaches precipitated by cough, prolonged exercise or lescence: A case report. Incompetence of inter sexual headaches: An analysis of 72 benign and symptomatic nal jugular valve in patients with primary exertional headache: cases. Sequential benign sexual headache and Headaches precipitated by cough, prolonged exercise or exertional headache (letter. Recurrent thunderclap headache associated with Interrelationships and long term prognosis. Cephalalgia 2002; 22: headache: A prospective study of features incidence and 784?790. Idiopathic stabbing headache cium channel inhibitors a potential treatment option? Clinical and angiographic features of experimental ice cream headache (short-lived headaches. Paroxysmal stabbing headache associated with reversible intracerebral vasospasm causing in the multiple dermatomes of the head and neck: a variant of stroke. Local decrease of pressure pain threshold in nummular large survey of 8359 adolescents. Headache caused by drinking cold water is common Curr Pain Headache Rep 2007; 11: 310?312. Ice cream headache and Nummular headache with and without exacerbations: orthostatic symptoms in patients with migraine. Case series of sixteen patients characteristics of an experimental model of ?ice-cream head with nummular headache. Hypothalamic gray matter headache: Clinical and serological characteristics in a retro volume loss in hypnic headache. Neurology phadenopathy in extracranial or systemic infection: Etiology of 2004; 14: 843?847. Headache or facial pain attributed to disorder of cranium, neck, eyes, ears, nose, sinuses, teeth, mouth or other facial or cranial structure 12. Evidence of causation demonstrated by at least two 2 headache type, and at the same time develops a brain of the following : tumour, it is straightforward to conclude that headache 1. Such patients shall be given the onset of the presumed causative disorder only one headache diagnosis 7. In other disorder words, a de novo headache occurring with another dis b) headache has signi? This poral relationships between the disorder and head remains true even when the headache has the charac ache outcomes after treatment of the disorder, or teristics of a primary headache (migraine, tension-type from smaller studies using advanced scanning meth headache, cluster headache or one of the other trigem ods, blood tests or other paraclinical tests, even if inal autonomic cephalalgias. In other When a pre-existing primary headache becomes chronic words, study methods that are not useful in routine in close temporal relation to such a causative disorder, use of the diagnostic criteria may nonetheless be both the primary and the secondary diagnoses should useful for establishing general causal relationships be given. The general criteria require two separate evidential be given, provided that there is good evidence that the features to be present, and allow up to four types of disorder can cause headache. Examples are the General diagnostic criteria for secondary headaches: subtypes of 7. In evidence is accordance between the site of the head such cases, criterion D is of particular importance. General comment Numerous factors that may contribute to its develop Primary or secondary headache or both? Post-traumatic sleep dis istics of a primary headache disorder becomes chronic, turbances, mood disturbances and psychosocial stres or is made signi? The overuse of abortive close temporal relation to such trauma or injury, both headache medications may contribute to the persistence the initial headache diagnosis and a diagnosis of 5. Headache attrib Introduction uted to trauma or injury to the head and/or neck may the subtypes of 5. Headache attributed to trauma or include a previous history of headache, less severe injury to the head and/or neck are among the most injury, female gender and the presence of comorbid common secondary headache disorders. Those with injury to the head and/or neck from other headache types; pending litigation and those without are similar regard most often these resemble tension-type headache or ing headache characteristics, cognitive test results, migraine. Consequently their diagnosis is largely depen treatment responses and improvement in symptoms dent on the close temporal relation between the trauma over time. In striking the head with or the head striking an Lithuania, for example, a country in which there is object, penetration of the head by a foreign body, little expectation of developing headache after head forces generated from blasts or explosions, and injury, and a lack of insurance against personal other forces yet to be de? Headache attributed to trauma or injury to the head Comment: and/or neck is also reported in children, although less the stipulation that headache must be reported to have often than in adults. The clinical presentations of the developed within 7 days is somewhat arbitrary (see subtypes are similar in children and adults, and the Introduction. Compared with longer intervals, a 7 diagnostic criteria in children are the same. Acute headache attributed to surgical cra when the interval between injury and headache onset niotomy performed for reasons other than traumatic is greater than 7 days. Traumatic injury to the head has occurred c) post-traumatic amnesia lasting >24 hours C. Headache is reported to have developed within d) altered level of awareness for >24 hours 7 days after one of the following: e) imaging evidence of a traumatic head injury 1. Headache persists for >3 months after the injury to impaired consciousness the head b) loss of memory for events immediately before E. These include strik the diagnostic criteria for mild traumatic injury to the ing the head with or the head striking an object, head and for moderate or severe traumatic injury to the penetration of the head by a foreign body, forces head allow for substantial variability in the severity of generated from blasts or explosions, and other head injury classi? In the meantime, Appendix criteria Trauma as a result of acceleration/deceleration move for A5. Persistent headache attributed to sur when the interval between injury and headache onset is gical craniotomy performed for reasons other than greater than 7 days. Further research is needed to investigate whether shorter or longer intervals may be more appropriately adopted. Injury to the head associated with at least one of the When headache following head injury becomes persis following: tent, the possibility of 8. Whiplash, associated at the time with neck pain as the time between head injury and recovery of and/or headache, has occurred memory of current events and of those occurring C. In the majority of cases, it resolves within Note: the acute post-operative period. Exclusion of other secondary headache disorders that may occur following craniotomy is necessary prior to assigning the diagnosis of 5. Although there are numerous potential When post-whiplash headache becomes persistent, the aetiologies of headache following craniotomy, consid possibility of 8. Description: Headache of greater than 3 months? duration caused by Diagnostic criteria: surgical craniotomy. Emotional and pain-related factors in neuropsycho craniotomy logical assessment following mild traumatic brain injury. Diffusion tensor Note: imaging detects clinically important axonal damage after mild traumatic brain injury: A pilot study. Cognitive and psycholo gical patterns in post-traumatic headache following severe traumatic brain injury. Chronic daily headache in the post Comments: trauma syndrome: Relation to extent of head injury. Head or neck injury increases the risk of chronic daily headache: A popula experience 5. Is post-traumatic head When headache following craniotomy becomes persis ache classifiable and does it exist? Chronic post-traumatic head ache: Clinical, psychopathological features and outcome deter needs to be considered. A prospective controlled study in the pre matic headache on the incidence and severity of headache after valence of posttraumatic headache following mild traumatic head injury. Emotional, neuropsychological, and organic factors: Kirk C, Naquib G and Abu-Arafeh I. Chronic post-traumatic Their use in the prediction of persisting postconcussion symp headache after head injury in children and adolescents. Incidence of chronic pain following trau traumatic brain injury: A systematic review. Neuropsychological deficits in symptomatic minor head Eur J Neurol 1996; 3: 424?428. Prevalence of chronic pain after traumatic for patients with mild traumatic brain injury. Posttraumatic headache: Permanency and relation A prospective controlled inception cohort study. Epidemiology and pathogenesis of posttraumatic Obermann M, Nebel K, Riegel A, et al. Headaches among Operation Automobile head restraints?Frequency of neck injury claims Iraqi Freedom/Operation Enduring Freedom veterans with in relation to the presence of head restraints. Am J Public mild traumatic brain injury associated with exposures to explo Health 1972; 62: 399?406. Proton spectroscopy in distortion in restrained car drivers: frequency, causes and patients with post-traumatic headache attributed to mild head long-term results. Emergency department assess ment of mild traumatic brain injury and the prediction of post 5. Postoperative headache: Emphasis on chronic types following mild closed pain in neurosurgery: A pilot study in brain surgery. Persistent headache after Posttraumatic headache: Biopsychosocial comparisons with supratentorial craniotomy. This remains true when the new headache has aneurysm the characteristics of any of the primary headache dis 6. The close tem cervical carotid or vertebral artery dissection poral relationship between the headache and these neuro 6. In a number of arterial disorder other conditions that can induce both headache and 6. A clue that points to an underlying vascular con symptoms or clinical or radiological signs of dition is the onset, usually sudden, of a new headache, ischaemic stroke so far unknown to the patient. For headache attributed to any of the vascular dis orders listed here, the diagnostic criteria include when ever possible: Comments: 6.
Lightspeeding and space tuned erectile dysfunction 3 seconds purchase cheapest kamagra gold, over the performative aspects of the world erectile dysfunction treatment in bangalore discount 100 mg kamagra gold free shipping, including our own being and through hylozoic this undecoded information undulates into the meta-physical universe erectile dysfunction treatment prostate cancer purchase 100 mg kamagra gold with mastercard. A movie of consciousness to ever smaller elements erectile dysfunction caused by heart medication generic kamagra gold 100mg fast delivery, as Alva Noe has noted does erectile dysfunction cause low libido proven 100mg kamagra gold, the phenomenon of con needs images as seeing is believing how to treat erectile dysfunction australian doctor order kamagra gold uk. Materialising (publishing) our imagination thru focus sciousness erectile dysfunction doctors in louisville ky order kamagra gold canada, like that of life itself men's health erectile dysfunction pills cheap kamagra gold 100 mg online, is a world-involving dynamic process, which must have of mind and burn it hologram-wise on mankinds memory, space/time dvd. As Bateson argued, cognition is a radically ecological system best way for global result is to establish consciousness connection on a 7% world popula whose boundaries do not at all coincide with the boundaries either of the body or of what tion scale. Tucson 2010, several speakers proposed to explore new unifcation models, to bring together We create unity, love, and worlds to play with. Meta-Kreators colour new landscapes for the insights from recent neurological, psychological and philosophical research. Meta-Kreators paint visionary frequencies in-sight the ceiling of the collective mind without a renewed appreciation of Bohms rheomode, and the development of a language of Meta-Kreators bend the illusionary dual-reality into a new holographic world based upon the dynamic ecological aesthetics, such a task is impossible. Art-Tech 283 Ethical implications of theatre practice from a consciousness studies perspective 285 Art and externalism: How artists understand the relationship between themselves Daniel Meyer-Dinkgrafe <dmeyerdinkgrafe@lincoln. This to some expressions of theatre simply narrow-minded, or conservative to the extent of re paper will present statements and works by important artists that reveal a strong tendency to jecting innovation? Is it all just a matter of taste, and therefore relative, subjective, personal, regard the mind as being continuous with the world rather than distinct from it. I will discuss and therefore ultimately not relevant for or interesting to public / critical / academic debates? In particular, artists ideas will be considered in the context of the ongoing debate to which the dramatist or director may demand behaviour from the actors that in many other between internalist and externalist views of the mind. Artists ideas can help press the case contexts other than theatre would be considered highly problematic, morally suspect, pos for externalism and counter some recent objections to theories of the extended mind. Could there be any circumstance in which such activity, both example, opponents have charged that externalist theories violate common sense (Adams gross and subtle is acceptable? What are the criteria and Aizawa 2010) and yield little of empirical value (Rupert 2004. I will show how works a serious critical discussion needs to establish and then adhere to? To what extent can the of art can offer a case of materially extended cognition that does not fout common sense, canon of ethical writing provide the context? In the paper I discuss these and other issues and point to a signifcant empirical beneft for artists who adopt an externalist outlook: it related to the ethical implications of theatre practice from the perspective of consciousness allows them to make better art. C36 gives primacy to experience over the dualism between mind and world, has a number of ad vantages over standard internalist models, which insist on a separation between the internal 284 Meta-Kreator: Bending the meta-physical universe; A surrealist media conference subject located in the brain and external reality in the world. First, unlike internalism it does happening and painting exhibition about imagination and consciousness Werner Pans not require the object perceived in the world to be distinct from the object as represented in <werner. Second, it positions experience within the interdependent relationship between Imagination sources by pure consciousness our personal holographic cinema inside our the perceiver and the perceived rather than in either alone. We imagine and create under full psychic mind-power the world inside us, refect broader way can help guide those in neuroscience and philosophy seeking to locate con ing this same world outside us. I will close with the claim that works of art and the state consciousness holograms generated by Supra-Consciousness. Imagine now, to go a bit ments made by artists offer a rich source of empirical data and philosophical insight about deeper into the void of ourselves where we project to create. Integrating this with ideas coming from science and philosophy will We all have all the quantum tools and knowledge, each one of us. Where will we time/ to the Hypothesis of Extended Cognition, Journal of Philosophy, 101 (8), pp. Culture and the Humanities 183 286 Gazing into infnity: An eight-year observational and photographic study of wave Mysticism can be regarded as an integral element of religion. It includes both a way of patterns, light transmission, fractals, and evolving consciousness Jack Sneh <jacksneh@ life and a direct consciousness of the presence of God. Taoism, Zen and other types As a self taught visual artist working in various photographic mediums since 1971, I have of Buddhism, as well as Hindu traditions like Kashmir Shaivism, Vaishnavism, and Advaita been involved in a continuously unfolding journey into the exploration of static and transient Vedanta, are basically mystical in the sense that they all strive for transcendence from this forms in light and color. I have pursued a lifelong fascination with revealed enigmatic world of multiplicity. Recent works have incorporated light transmitted through multiple screens as variety of techniques different types of meditation, visualization, repetitive prayer, dark well as refections in irregular surfaces and use of water as a refective and simultaneously room retreats, etc. These techniques lead to a variety of altered states of consciousness, transparent medium. The interplay between observation and photographic investigation has including visions and experiences of what has been called the pure consciousness event. Such a model should combine cognitive psychol of this progression I have for the last eight years been involved with the exploration of ogy with depth psychology. The heuristic value of such an approach, counting as it does infnitely unique and transient geometric and fractal events formed both by circular wave with dynamic, associative ways of handling emotionally charged information, should enable patterns and at the intersection of multiple wave patterns. These images records various us to understand new or unexpected features in reports of religious experience, whether it be simultaneous events occurring in both refected and transmitted light forms. The juxtaposi Old Testament prophets combining, in their visions, contemporary iconographic elements tion of transient wave phenomenon with static structures (creek bed, foating fora, rocks with verbal data, or Christian mystics like John of the Cross, using sensuous, erotic imagery etc. The complexity of the imagery has continued to increase as my awareness of senses. In this presentation, at least one such model will be offered C15 the various elements has become more acute. The interactions seen in these photographs are not manipulated and are in fact photographic records of entirely unique transitory events. I neither instigate nor manipulate the wave Cognitive and behavioral research on religion has focused most in the last years on aspects patterns, rather I have relied entirely on water as a refective and transparent matrix for wave which could be deemed unconscious: inner mechanisms, innate patterns, or hidden struc forms created by normal dynamic fow and most remarkably through an improbable artistic tures broadly shared by humans. Very often the ongoing research programs resort to compu symbiosis of sorts with insects of the Family Gerridae. Commonly known as water striders tational models of mind in which the conscious side of that experience is mainly ignored or or water bugs. They display a seemingly effortless ability to foat and move on the waters not taken into account. It has also become clear to me that these creatures use wave patterns as a form of religion are assumed as an important variable, since such a move appears as a methodologi communication. These particular patterns are not the result of locomotion and are highly cal transfer to less scientifc and more hermeneutic or phenomenological felds. I have been able to incorporate the repetitive structures of these communication religion cannot be rightly studied and known without taking into account its conscious patterns in the course of my work. C38 aspects; indeed, religion and consciousness appear as often deeply related categories, once some religious ways point to higher forms of awareness. To start with, the study should establish what difference makes at the cognitive and 287 Synesthesia and singing: a challenge Alexandra Kirschner <alexandra-kirschner@t behavioral levels the assumption of the role played by conscious elaboration, or in other online. A second How can awareness of ones synesthesia affect the quality of voice and learning? In this step needs to deal with the relationship between conscious thought and unconscious process presentation, I will share my experiences as a voice trainer in a German boys choir in which ing, as both dimensions are clearly involved, and each one in different measure; at this end, there are several young synesthetes. I feel that awareness of ones synesthesia should fgure cognitive and emotional aspects as well need to be considered. Not only does it support the singers sense of self, but it is a useful tool experimental methods which could render the study of the religious conscious mind a more for developing the quality of the voice. I also feel it helps to have a synesthetic teacher, scientifc enterprise, in a way able to recover that often neglected dimension in current such as myself, in bringing out the best in these students. He repeated it, on key this time, and I saw the same note, this time as the color 290 the expression of the spiritual dimension of nursing care in a Brazilian intensive yellow. He knew hed sung it fat because it was black to him the previous time, and added care unit: A communicational study Ramon Penha, Silva, Maria Julia Paes <rvamus@ color. But through our metaphor-flled conversation the dimensions of care are so broad as the dimensions of the human being. In this sense, (synesthetes also have a propensity for metaphor) we are able to connect and change the recognition of needs, fundamental work in nursing, occurs through mechanisms of com tone of the notes sung. It is really diffcult for synesthetes to convey what they are experi munication, whether personal or collective, verbal or non-verbal. C4 the expression of spiritual dimension of nursing care in the Intensive Care Unit. Aims: to determine the means by which the team identifes the spiritual dimension of care, explore whether there is relationship, the perception of professional nursing, and the expression 6. Methodology: this was an exploratory-descriptive study and data collection made from semi-structured 288 Altering consciousness in religion Antoon Geels <antoon. The content analysis and observation of non-verbal signals was based on juxtaposition of historical evidence with the results of neuropsychological research the methodology reference used for the treatment of data. As theoretical framework, was allows us to come closer to understanding of the impact of mystery rites: for trivial events to adopted in this study the transpersonal caring theory, developed by Jean Watson and the be remembered by the participants as revelations, they had to be brought to a state of height concepts of human communication proposed by Silva. Results: the analysis of discourse ened sensitivity and perhaps also suggestibility: this is what Aristotle meant by becoming of research subjects, emerged a frst category of analysis including: forms of perception of ft. The knowledge of life and death thus acquired was a holistic and ineffable sensation, spiritual needs and religious needs of patients, divided into subcategories: the verbal and rather than a learnt doctrine: in Aristotles words, the initiates were not to learn anything, the non-verbal, and the family history of Nursing. A second category could be identifed in but rather to experience and to be inclined. C23 order to express the relationship between interpersonal communication and the identifcation of spiritual needs, which are subcategories belonging: the mechanistic relationship; verbal 6. Discussion and Considerations for Clinical Practice: the study showed that professionals make use of verbal and non-verbal communication resources, 292 Artifcial Consciousness Wells An approach of autopoietic exegesis on fabricat especially for access to the religious, and in some cases, spiritual dimensions. However, the ing and sustaining prescribed Weltanschauungen in closed groupings Amalia Tsakiri mechanism and the daily verbal relations negatively infuence the identifcation of patients, Michael Vinos, Hellenic Open University, Informatics ; Christos Milios, Group Analyst spiritual needs since they are factors limiting the proximity of human relations, especially Psychotherapist <atsakiri@phs. The family historical of nursing and were presented as University of Athens (Greece) Department of Philosop, Athens, Greece) elements for supplying data on the religious beliefs of patients. The study concluded that, A central role in the realm of the operational aspects of the human Self is carried out by communication, verbal and non-verbal, is the main vehicle for expression of spirituality, its interpreting relation with the environment/reality/cosmos which both places it in respect however, the communicative process has been established from specifc systems of beliefs with the later as it also determines it -participates in the Selfs realization. The study concluded that access to schauung (Worldview) is simultaneously a function of, and a supplier to , Consciousness -it patients spiritual dimension requires an understanding that this dimension is expressed by constitutes an autopoietic unit in its network of interrelations. Regarding social autopoietic communicative phenomena perceived more effciently when higher levels of consciousness, systems (Luhmann, 1989), a Worldview can be examined both as an emergent cultural where the senses, the touch, sounds, words, colors and shapes are captured in dynamized product of a systems functions and as an intellectual outcome of the components (the frequencies by the desire to understand the other in their individuality. These two worldviews infuence one another when operate within dynamically evolving ambiences. In these systems, intense effort is being spent to centrally control the premeditated/prescribed 291 Altered states of consciousness and mystery cults in Ancient Greece Yulia Ustinova Worldview which is being suggested to the individuals as also to maintain it unaltered. The term closed relates to the groups attempts to remain secured piness in this world and a better life in the hereafter on their adherents. They emerged to against evolutionary challenges, dynamic or complex drifts, or fuzzy and obscure entities. Varela (1987) consider those human communities which, because they beneath the earth as a shadow deprived of consciousness and will. Aristotle states that the embody enforced mechanisms of stabilization in all the behavioral dimensions of their mem purpose of initiations into mysteries is not to learn anything, but rather to experience and bers, constitute impaired human social systems. Analyzing through systemic approaches to be inclined, that is to say, to become ft for the purpose. Thus, the major objective of the Greek initiations was to make the participants live regardless the kind of the grouping, either of political or religious orientation. We propose through a certain experience, and in order to attain it, they had to be inducted to a particular that these processes are essentially, distortions of natural ones, which are intentionally state of mind. In life and in death, it was vital that the initiates (or their souls) remembered selected or/and emerge as a unique compound in closed groupings in the same time that these experiences. What methods were used to cedure is in its essence a mimesis of natural autopoietic systems and its study can aid to a make the initiated ft for the purpose? I will argue that mystery initiations were essentially deeper understanding of the broader subject of social autopoiesis, serving as a magnifying a fake death, a rehearsal of the real one. Sampling, some of such characteristic functions, are: 1) the gradual incorporation of comprised alterations of the participants? Even if his or her state of consciousness was altered slightly, every detail binding (e. Finally, individual pre With such means do closed groupings artifcially enlarge enormously the groups over the disposition and environment defned the profundity of ones experience, and many initiates individuals signifcance. The person step-by-step sheds the status of an End in Itself(in attended the ceremonies for the record, others caught a glimpse of a revelation, while a few the Kantian notion) and its self-identity is deformed, sometimes, irrevocably. C23 could attain the supreme bliss of feeling at one with the deity they worshiped. A new orientation for explanation is found for some notions in space-time and the texture of Einsteins Relativistic Cosmology Nildson Alvares Muniz physics and cosmology. Theory involving an ether, the interferometer and red shift, theory <alvaresmuniz@bol. A two-timing complex associated with social and behavioral completing a century since Einstein introduced an innovative Cosmology and a method of aspects of human life is conjectured to be caused by an external invasion of spaces by sunlight measurement and confrmation of Relativistic Cosmology in Modern Physics. The unknown phenomenon dating back to the time of Eve, and refected from a philosophical main question,we tackle in this work is,namely, Relativistic Spacetime an einsteinian and incompleteness in the understanding of a universe structured with a like two-timed weave human abstraction or is it a real physical entity in Einsteins Relativistic Cosmos. Blind scientifc exploration and many cultural phenomena main objective of our paper is to present new interdisciplinary perspectives on the fabric of may result from failed awareness and/or lingual representation of possible causative factors Relativistic Cosmos in Einsteins Mechanics. P6 A the fabric of the Relativistic Cosmos in Einsteins Mechanics intending to present new in terdisciplinary perspectives. Second,it discusses Einsteins innovative method as a scientifc 295 Ayahuasca, spontaneous mental imagery, and the treatment of drug addiction innovation related to linguistic and anthropologic texture of Einsteins Relativistic Mechan and alcoholism in Brazil and Peru Marcelo Mercante <marcelo mercante@yahoo. And,second,I present the objective of this presentation is to contribute to investigation of the subjective experi new interdisciplinary perspectives on conceptualization,fgurativisation,and metaphorisa ences of participants in drug and alcohol addiction programs which use ritualistically the tion of Relative Spacetime discussing Structural Realism,Imagery Anthropology,Phenom psychoactive drink ayahuasca as part of their treatment model. This application of ayahuasca enology,Generative Semantics,and Greimasian Semiotics. Diverse are the interpretations seems to promote novel subjective experience, perception, and perspective in substance of Albert Einsteins Theory of General Relativity in the different sciences since Einstein abusers, thus creating a foundation for changing their life habits. The spontaneous mental presented a completely new scientifc method in the conception of his Relativistic Cosmol imagery associated to that experience seems to be at the core of that process. An innovative contribution that helped to advance scientifc understanding and also revelatory moments, putting in evidence internal and external dimensions of being. The presented new consequences to scientifc knowledge of Cosmology and on and for the hu physical, social, and spiritual transformation of the participants would appear in the form of man gender. Einstein introduced a new method of measurement and confrmation of Relative spontaneous mental imagery present in the participants consciousness which were related Spacetime,on May,29th,1919,in Sobral,Brazil. This presentation puts together data from feldwork conducted of a total solar eclipse in order to confrm einsteinian relativity,sunlight defection and his in four different treatment centers: Takiwasi in Peru, Caminho de Luz (Rio Branco, Brazil), enigmatic equation E=m. In order to discuss Ceu Sagrado (Sorocaba, Brazil) and Ceu da Nova Vida (Curitiba, Brazil. A scientifc breakthrough considered a still enigmatic and important contribution in our 6. I emphasize that the fabric of Relativistic Cosmos in Einsteins Relativistic Mechanics can only be comprehended as a tropological relation since what is involved in the 296 A model of the evolution of morality, on the basis of neo-classical models fguring conversion of the unfamilar to the familiar is a creation of Relativity as a concept,fgure and trustworthiness toward unknown others, in which open cooperation in learning is the a metaphor in language and in thought,therefore as a fgurative act. It discusses conceptualization,fgurativ is therefore a cultural phenomenon; others believe it to be essentially genetic. Whether isation and metaphorisation of Relativity in Einsteins Mechanics according to an interdis morality is cultural or genetic (or some combination of the two), the concept of being moral ciplinary account among the following felds, namely, Structural Anthropology,Greimasian as an ideal state for which one might strive can be called into question. Among those Semiotics,Imagery Anthropology,Generative Semantics,Hermeneutics,and Cognitive who argue that morality is essentially cultural, some take it to be a force external to distinct Semantics. With this interdisciplinary perspective,I discuss that the reasoning and confrma selves, and being moral in a conventional sense renders people causal epiphenomena or ro tions established in Einsteins Relativistic Mechanics,arguing that if Einsteins Relativistic botic products of team dynamics. C37 being moral; and if morality is cultural, we cannot take credit for being moral. This paper will not address the extremely complex question of whether we can take credit for being 294 Mirroring, Need and Symbolism : A Two Timing Nature or a Whole Concept moral. Instead, it will make a distinction between more, and less, robustly moral states, and Marvin Kirsh <kirsh2152000@yahoo. The current consensus is that moral states would have been selected for only under 188 6. Culture and the Humanities 189 conditions that were rarely experienced, such as those that obtained during the Pleistocene. By specifcally for male brains, or most gender studies), and how cognition-dependent medical showing what morality is from an evolutionary perspective when what are at issue are moti interventions may feed back into further evolutionary changes of humans and other species. Building global community to synthesize past, present & developing science in science; cognitive exercises Martin Curtis <martin@citruscreative. Issues of consciousness, feeling, and action/behaviour are Why Consciousness Organization (WhyCon) is building international community for central to both acting and cognitive neuroscience. We are passionate in the brain (LeDoux 2003: 23) has allowed me to think about working with students in the about unifying the scientifc study of consciousness to amplify its outreach and effcacy. In this paper I show how the use of cognitive exer Your experience is important, so we unifed to create the Why Consciousness Organization cises in the rehearsal/creative process of a group of year 1 Drama students who rehearsed (WhyCon) during the 2010 Towards a Science of Consciousness Conference in Tucson, and performed a shortened version of Chekhovs the Three Sisters can enhance and sustain Arizona. Our vision is to encourage thoughtful dialogue, foster an interactive, global sci the creative process. The obvious conventional choice of approach to acting with regard to ence collaborative and develop effective applications to harness, and deliver, the powerful Chekhovs the Three Sisters is the writings and practices of Stanislavsky. He has almost sin resources of new media, Internet Technology and the human mind. However, in this paper I argue strongly ness offers exciting new perspectives on the human experience. People look at great minds that whilst Stanislavsky is important in understanding living the part and reaching the sub as being anomalies, when actually they use their minds differently consciousness is key. This paper is part of a wider PhD research on The ments quantum possibilities awaiting our observation. The research involves a heuristic approach to my own work as a drama thinking science is something for whats out there.
Demonstrate postvoid residuals of less than 50 mL icd 9 erectile dysfunction nos discount kamagra gold generic, with absence of dribbling or overflow impotence cures natural buy on line kamagra gold. Ask client about stress incontinence when moving erectile dysfunction herbal treatment options purchase kamagra gold discount, sneezing diabetes-induced erectile dysfunction epidemiology pathophysiology and management safe 100 mg kamagra gold, High urethral pressure inhibits bladder emptying or can inhibit coughing erectile dysfunction best treatment generic 100mg kamagra gold free shipping, laughing impotence cream cheap kamagra gold 100mg with amex, or lifting objects otc erectile dysfunction drugs walgreens cheap 100 mg kamagra gold mastercard. Note Urinary retention increases pressure within the ureters and diminished urinary output erectile dysfunction causes in early 20s discount 100 mg kamagra gold amex. Increased circulating fluid maintains renal perfusion and flushes kidneys, bladder, and ureters of sediment and bacteria. Note: Fluids may be restricted to prevent bladder distention if se vere obstruction is present or until adequate urinary flow is reestablished. Observe for hypertension, periph Loss of kidney function results in decreased fluid elimination eral or dependent edema, and changes in mentation. Collaborative Administer medications, as indicated, for example: Medications have long been used as a first-line therapy for clients with mild to moderate symptoms. Alpha-adrenergic antagonists, such as alfuzosin (UroXatral), these agents block effects of postganglionic synapses that terazosin (Hytrin), doxazosin (Cardura), and tamsulosin affect smooth muscle and exocrine glands. This action can (Flomax) decrease adverse urinary tract symptoms and increase urinary flow. Catheterize for residual urine and leave indwelling catheter, as Relieves and prevents urinary retention and rules out presence indicated. Coudé catheter may be required be cause the curved tip eases passage of the tube around the enlarged prostate. Note: Bladder decompression should be done with caution to observe for signs of adverse reaction, such as hematuria due to rupture of blood vessels in the mucosa of the overdistended bladder and syncope due to excessive autonomic stimulation. Prepare for and assist with urinary drainage, such as emer May be indicated to drain bladder during acute episode with gency cystostomy. Prepare for minimally invasive therapies, such as: these therapies rely on heat to cause destruction of prostatic Heat therapies, such as laser, transurethral microwave tissue. Tape drainage tube to thigh and catheter to the abdomen, if Prevents accidental dislodging of catheter with attendant urethral traction not required. Provide comfort measures, such as back rub, helping client Promotes relaxation, refocuses attention, and may enhance assume position of comfort. Administer medications, as indicated, for example: Opioids, such as meperidine (Demerol) Given to relieve severe pain; provide physical and mental relaxation. Antibacterials, such as methenamine hippurate (Hiprex) Reduces bacteria present in urinary tract and those introduced by drainage system. Antispasmodics and bladder sedatives, such as flavoxate Relieves bladder irritability. Rapid or sustained diuresis could cause clients total fluid volume to become depleted and limits sodium reabsorption in renal tubules. Client may have restricted oral intake in an attempt to control urinary symptoms, reducing homeostatic reserves and in creasing risk of dehydration and hypovolemia. Evaluate capillary refill and oral mucous Enables early detection of and intervention for systemic membranes. As fluid is pulled from extracellular spaces, sodium may follow the shift, causing hyponatremia. Replaces fluid and sodium losses to prevent or correct hypo volemia following outpatient procedures. Establish trusting relationship with client Demonstrates concern and willingness to help. Provide information about specific procedures and tests and Helps client understand purpose of what is being done and re what to expect afterward, such as catheter, bloody urine, duces concerns associated with the unknown, including fear and bladder irritation. Maintain matter-of-fact attitude in doing procedures and dealing Communicates acceptance and eases clients embarrassment. Defines the problem, providing opportunity to answer ques tions, clarify misconceptions, and problem-solve solutions. Allows client to deal with reality and strengthens trust in care givers and information presented. Client should understand that this includes ongo ing periodic evaluation for change (Neal, 2009. Review drug therapy, use of herbal products, and diet, such as Some clients may prefer to treat with complementary therapy increasing intake of fruits and soybeans. Note: Nutrients known to inhibit prostate enlargement include zinc, soy protein, es sential fatty acids, flaxseed, and lycopene. Herbal supple ments that client may use include saw palmetto, pygeum, stinging nettle, and pumpkin seed oil. However, a recent study found no difference in efficacy or side effects be tween saw palmetto and a placebo, indicating a need for further research as to benefit versus variability of potency or purity of botanical products (Bent, 2006. Recommend avoiding spicy foods, coffee, alcohol, long auto May cause prostatic irritation with resulting congestion. Address sexual concerns—during acute episodes of prostatitis, Sexual activity can increase pain during acute episodes but may intercourse should be avoided but may be helpful in treat serve as massaging agent in presence of chronic disease. Note: Medications, such as finasteride (Proscar), are known to interfere with libido and erections. Alternatives include terazosin (Hytrin), doxazosin mesylate (Cardura), and tamsu losin (Flomax), which do not affect testosterone levels. Provide information about sexual anatomy and function as it Having information about anatomy involved helps client under relates to prostatic enlargement. Encourage questions and stand the implications of proposed treatments because they promote a dialogue about concerns. Review signs and symptoms requiring medical evaluation— Prompt interventions may prevent more serious complications. Discuss necessity of notifying other healthcare providers of Reduces risk of inappropriate therapy, such as the use of de diagnosis. Reinforce importance of medical follow-up for at least 6 months Recurrence of hyperplasia and infection caused by same or dif to 1 year, including rectal examination and urinalysis. Discuss personal safety issues and potential environmental Recent research reports increased risk of falls in presence of changes. Kidney damage from long-standing blockage low midline incision made through the bladder. Mortality: Prostatectomy is a relatively low-risk procedure cantly bothered by these symptoms (generally stated as 0 or less than 1% and usually associated 2. Cost: In 2010, the direct costs for treatment of prostate can scope introduced through the urethra. Common symp Kegel exercises: Pelvic muscle exercises intended to improve toms include nausea, vomiting, and confusion. Procedure, prognosis, therapeutic regimen, and rehabilita treatment, and rehabilitation needs. Assist client to assume normal position to void; for example, Encourages passage of urine and promotes sense of normality. Record time, amount of voiding, and size of stream after the catheter is usually removed 2 to 5 days after surgery, but catheter is removed. Note reports of bladder fullness, inabil voiding may continue to be a problem for some time because ity to void, and urgency. Encourage client to void when urge is noted but not more than Voiding with urge prevents urinary retention. Limit Maintains adequate hydration and renal perfusion for urinary fluids in the evening once catheter is removed. Instruct client in perineal exercises, such as tightening buttocks Helps regain bladder sphincter control, minimizing incontinence. Advise client that dribbling is to be expected after catheter is Information helps client deal with the problem. Pro incontinence is usually temporary, but stress incontinence— vide and instruct in use of continence pads when indicated. Measure residual volumes via suprapubic catheter, if present, Monitors effectiveness of bladder emptying. With bladder irrigations, monitoring is essential for estimating blood loss and accurately assessing urine output. Note: Following re lease of urinary tract obstruction, marked diuresis may occur during initial recovery period. Note: Hypertension, bradycardia, and nausea or capillary refill, and dry mucous membranes. Weigh dressings, if Signs of persistent bleeding may be evident or sequestered indicated. Encourage increased fluid intake, preferably water, to 2000 to Helps maintain fluid volume while flushing bladder of blood 2500 mL/day unless contraindicated by medical condition. Observe urethral and suprapubic catheter drainage, noting Bleeding is not unusual during first 24 hours for all but the excessive or continued bleeding. Continued or heavy bleeding or recur rence of active bleeding requires medical evaluation and intervention. Evaluate color, consistency of urine, for example: Bright red with bright red clots Usually indicates arterial bleeding and requires aggressive therapy. Dark burgundy with dark clots and increased viscosity Suggests venous source, which is the most common type of bleeding and usually subsides on its own. Avoid taking rectal temperatures and use of rectal tubes or May result in referred irritation to prostatic bed and increased enemas. Coagulation studies and platelet count May indicate developing complications that can potentiate bleeding or clotting. Maintain traction on indwelling catheter; tape catheter to inner Traction on the 30-mL balloon positioned in the prostatic ure thigh. Document period of appli Prolonged traction may cause permanent trauma and prob cation and release of traction, if used. Prevention of constipation and straining for stool reduces risk of rectal-perineal bleeding. Presence of drains and suprapubic incision increases risk of infection, as indicated by erythema or purulent drainage. Change suprapubic/retropubic and perineal incision dressings Wet dressings cause skin irritation and provide medium for frequently, cleaning and drying skin thoroughly each time. Provides protection for surrounding skin, preventing excoriation and reducing risk of infection. May be given prophylactically because of increased risk of infec tion with prostatectomy. Keep tubing Maintaining a properly functioning catheter and drainage free of kinks and clots. Decreases irritation by maintaining a constant flow of fluid over the bladder mucosa. Give client accurate information about catheter, drainage, Allays anxiety and promotes cooperation with necessary pro bladder spasms, and potential for voiding difficulties. Note: Depending on the degree of preoperative urge incontinence, postoperative urge incontinence may be present for weeks or months (Mills, 2011. Provide comfort measures, such as position changes, back rub, Reduces muscle tension, refocuses attention, and may enhance Therapeutic Touch, and diversional activities. Promotes tissue perfusion and resolution of edema and enhances healing in perineal approach. Administer antispasmodics, such as: Oxybutynin (Ditropan), flavoxate (Urispas), B & O suppositories Relaxes smooth muscle to provide relief of spasms and associ ated pain. Propantheline bromide (Pro-Banthine) Relieves bladder spasms by anticholinergic action. Usually discontinued 24 to 48 hours before anticipated removal of catheter to promote normal bladder contraction. Demonstrate problem-solving skills regarding solutions to difficulties that occur. Be honest in answers to clients the nerve plexus that controls erection runs posteriorly to the questions. In procedures that do not in volve the prostatic capsule, impotence and sterility are usu ally not consequences. Give accurate information about expectation of return of sexual Physiological impotence occurs when the perineal nerves are function. If erectile dysfunction persists after healing is complete, client may want to pursue options to restore function—use of medica tions such as sildenafil citrate (Viagra. Discuss retrograde ejaculation if transurethral or suprapubic Seminal fluid goes into the bladder and is excreted with the approach is used. This does not interfere with sexual functioning, but will decrease fertility and cause urine to be cloudy. Note: Retrograde ejaculation has been reported in up to 80% to 90% of patients after surgery (Miles et al, 2011. Instruct in perineal and pelvic floor exercises and interruption Tightening pelvic floor muscles prior to standing, coughing, of urinary stream exercises. Stress necessity of good nutrition; encourage inclusion of fruits Promotes healing and prevents constipation, reducing risk of and increased fiber in diet. Advise client to avoid or limit intake of caffeine, citrus juices, Acidic substances can lower urine pH, thereby aggravating carbonated beverages, and spicy foods for first few weeks dysuria (Shiller, 2007. Discuss initial activity restrictions, such as avoidance of heavy Increased abdominal pressure and straining places stress on lifting, strenuous exercise, prolonged sitting, long car trips, the bladder and prostate, potentiating risk of bleeding. Decreases the possibility of introduction of bacteria or undue tension on incision. Review signs and symptoms requiring medical evaluation: Prompt intervention may prevent serious complications. Note: erythema, purulent drainage from wound sites; inability Urine may appear cloudy for several weeks until postopera to urinate, changes in character or amount of urine, pres tive healing occurs and may appear cloudy after intercourse ence of urgency or frequency; and heavy clots or bright red because of retrograde ejaculation. Presence of stones anywhere in the urinary tract gender: male-to-female ratio 3:1; heredity may play a part i. Most commonly found in the renal pelvis and calyces in hypercalcuria; recurrent urinary tract infections; certain 1. Stones formed in the ureters—ureterolithiasis bowel disease, hyperparathyroidism, hypertension); insulin ii. May be single or multiple calculi, ranging in size from a resistance; prolonged bedrest; spinal cord injury; some grain of salt to the size of a pebble or staghorn calculus geographic locations—southeastern United States; use of b. Composition of calculi (Wolf, 2013; Miller, 2007) antacids or aspirin (Wedro, 2010) i. Statistics (Centers for Disease Control and Prevention oxalate and calcium phosphate. Slow urine flow allows accumulation of crystals—damaging approximately 1 in 11 people in the United States. These the lining of the urinary tract and decreasing the number of data represent a marked increase in stone disease compared inhibitor substances that would prevent crystal accumulation with the National Health and Nutrition Examination Survey (Winkleman, 2006. Mortality: Rare and related to development of acute kidney urine flow is obstructed, at which time the potential for injury or comorbidities. Note: Mortality and morbidity are renal damage is acute and the level of pain is at its highest not increased with uric acid stones compared with other c. Causes: dehydration; heredity; excessive intake of vitamins stones; however, the process that leads to excess uric acid A and D, grapefruit juice, and purines (gout); congenital production (e. From the major calyces the urine flows into the renal oxalate crystals, which usually develop in acidic urine. Calcium phosphate stones: Kidney stones formed by calcium Renal colic: Flank (side) pain caused by obstruction to the flow and phosphate crystals, which usually develop in alkaline of urine caused by kidney or ureteral stones. Renal pelvis: the area at the center of the kidney where urine Cystine stones: Kidney stones made of cystine crystals. Staghorn calculi: Develops in the center of the kidney or pelvis, Hyperoxaluria: Excretion of excessive amounts of oxalate in filling the entire pelvis and extending out into the calyces. Struvite stone: Also known as magnesium ammonium Renal calyces: the perimeter of the renal pelvis is interrupted by phosphate—stones that are often present with infection. A minor calyx surrounds Ureterovesical junction: Joining of the ureters and bladder. Several minor calyces converge to form a major these stones develop in acidic urine. Care Setting Related Concerns Treatment is often handled at the community level or as an Acute kidney injury (acute renal failure), 505 outpatient; acute episodes occasionally require inpatient treat Fluid and electrolyte imbalances, page 885 ment on a medical or surgical unit. On occasion, surgery is Metabolic acidosis—primary base bicarbonate deficiency, necessary to remove the stone(s. Guarding, distraction behaviors, self-focusing depending on stone location; in the flank in the region of the. Abnormal levels—high in serum and low in urine—are secondary to high obstructive stones with reduced urine output. If serum calcium levels are elevated, then testing for hyper parathyroidism is performed. Contrast is not used because it kidneys, ureters, and bladder in a shorter period of time. However, mines obstructive changes and location of stone without the risk small kidney stones that are not obstructing may be missed. Multiple pictures of the kidneys are taken to such as distended ureter, and outline of calculi. Flank pain suggests that stones are in the kid pulse and respirations, moaning and thrashing about. Flank pain radiates to back, ab domen, groin, and genitalia because of proximity of nerve plexus and blood vessels supplying these areas. Sudden, severe pain may precipitate apprehension, restlessness, and severe anxiety. Explain cause of pain and importance of notifying care Provides opportunity for timely administration of analgesia and providers of changes in pain occurrence or characteristics.
Each comp lasts for about 10 days depending upon the need and resources of the place most effective erectile dysfunction pills buy kamagra gold from india. Senior postgraduate students and House surgeons are stationed at the camp site and study the organizational aspects for conducting a camp in scientific lines erectile dysfunction numbness order genuine kamagra gold. They study the village organization meet the local authorities and leaders to learn regarding the health problems of that community with particular reference to ocular diseases erectile dysfunction doctors in queens ny order kamagra gold online pills. The first 6-7 days of the camp are devoted to publicity for prevention of blindness herbal erectile dysfunction pills uk discount kamagra gold 100 mg online, registration erectile dysfunction diabetes purchase kamagra gold online, examination and operations erectile dysfunction in diabetes mellitus ppt purchase kamagra gold cheap online. During the next 3-4 days they conduct school clinics & general survey for eye diseases of small group of population and visits to small village industry is conducted impotence cures generic 100 mg kamagra gold. Patients who are incurably blind and those partially blind are advised for rehabilitation in their own surroundings erectile dysfunction drugs causing order genuine kamagra gold on-line. Iris and clilarybody & glaucoma Yag laser Iridotomies Trabeculectomy Cyclodestructive procedures Optical iridectomy Microsurgery for glaucoma like goniotomy Laser trabeculotomy ect. For example, it is likely that in future, Hematology as is practiced by Pathologists in this country today, maybe the subject of the super-specialist Hematologist. Pathology forms the basis of understanding, diagnosis and hence the treatment of diseases. It is therefore an essential subject in the training and curriculum of various undergraduate and postgraduate courses of medicine and allied disciplines such as nursing etc. It is also expected that this aspect of the training of the candidate will enhance the capacity of expression and ability to explain scientific data in simple and unambiguous terms. The training should include means by which the student can pursue research either independently or as a part of a team. This would inculcate a spirit of enquiry and also make it possible to accurately record observations, analyse rationally and arrive at an unbiased conclusion of problems. Diagnose routine and complex clinical problems on the basis of Histopathology (Surgical Pathology) and Cytopathology specimens, Blood and Bone Marrow examination and various tests under the domain of Laboratory Medicine (Clinical Pathology, Clinical Biochemistry/Chemical Pathology) as well as Blood Banking (Transfusion Medicine. Able to correlate clinical and pathology data so that various clinical signs, symptoms and manifestations of disease can be correlated and explained. Advice on the nature of appropriate specimens and the tests necessary to arrive at a diagnosis in a difficult or problematic case. To be able to correlate clinical and laboratory findings with pathology findings at autopsy, identify discorrelations and the causes of death due to diseases (apart from purely metabolic causes. Should be able to teach Pathology to undergraduates, postgraduates, nurses and paramedical staff including laboratory personnel. Maintain accurate records of tests and their results for reasonable periods of time so that these may be retrieved as and when necessary. Make and record observations systematically that is of use for archival purposes and for furthering the knowledge of Pathology. Able to present a paper in a conference through an oral presentation and poster presentation. Should be able to identify problems in the laboratory and offer solutions thereof so that a high order of quality control is maintained. Should be capable of effectively disposing laboratory waste to ensure minimisation of risk to infection and accidents to laboratory personnel. Subject himself/herself to continuing education and constantly update his/her knowledge of recent advances in Pathology and allied subjects. Able to perform most of the routine tests in a Pathology Laboratory including grossing of specimens, processing, cutting of paraffin sections making smears, making frozen sections and staining. Able to collect specimens by routinely performed non-invasive out-patient procedures such as venepuncture, finger-prick, fine needle aspiration biopsy of superficial lumps and bone-marrow aspirates. It is implied that that the complications of these procedures and handling of complications are apparent. Further, whenever necessary must be able to provide appropriate help to colleagues performing an invasive procedure such as a biopsy or an imaging guided biopsy. Perform an autopsy, dissect various organ complexes and display the gross findings. Should be familiar with the function, handling and routine care of equipment in the laboratory. He/she should therefore develop an attitude of cooperation with his/her colleagues so necessary for this purpose. It is implied that he/she will whenever necessary interact with the patient and the clinician or other colleagues to provide the best possible diagnosis or opinion. Always adopt ethical principles and maintain proper etiquette in his/her dealings with patients, relatives and other health personnel. Provide leadership and inspire members of the team with whom he/she is involved with in the fields of diagnostic pathology, teaching and research. Develop communication skills not only to word reports and professional opinions but also to interact with patients, relatives, peers and paramedical staff. Duration of Course It is recommended that the course of Doctor of Medicine (Pathology) or M. The guidelines in such situations are obviously beyond the scope of this curriculum and can be provided by the competent authorities only. It is appreciated that individual universities or equivalent bodies/institutions will have their own methods of selection. It must be appreciated that within the time period of the Training Programme which covers a wide range of subjects and subspecialties, it is difficult, if not impossible, to achieve full proficiency in all the technological methods and available theoretical knowledge. High Degree of Professional Competence In the following fields in which a high degree of professional competence and theoretical knowledge is expected. The candidate is expected to know both the theoretical as well as practical aspects especially related to diagnosis of appropriate diseases. Pathologic Anatomy (Surgical Pathology and Cytopathology) the study of Pathologic Anatomy includes all aspects of Pathology as encompassed in the branches of General Pathology and Systemic Pathology. Therefore only the broad outlines are provided and a compendium of chapters as available in standard books is avoided. Reaction of cells, tissues, organ systems and the body as a whole to various sublethal and lethal injury. The scope of General Pathology is vast and the above is a guideline that in essence covers all aspects. Systemic Pathology: the study of normal structure and function of various organ systems and the aetiopathogenesis, gross and microscopic alterations of structure and function of these organ systems in disease. This forms the basis of Histopathology (Surgical Pathology), Cytopathology, Autopsy Pathology and clinico-pathological correlation. Haematology the study of Haematology includes all aspects of the diseases of the blood and bone marrow. This would involve the study of the normal and the causes of diseases and the changes thereof. Reasonable working knowledge In the following fields the student is expected to achieve reasonable working knowledge and diagnostic skill, and be able to run independently a routine service in a teaching hospital, and if necessary, at some future date, with some additional effort acquire the level of competence as in 4. Some centers have separate degrees/diplomas/postgraduate courses for some of these subjects. However, current practice of pathology, both institutional or otherwise demands a reasonable working knowledge of these subjects and therefore until such time as the situation demands, these subjects should be an integral part of post graduate training in pathology. Laboratory Medicine (Clinical Chemistry/Clinical Biochemistry/Chemical Pathology and Microscopy/Clinical Pathology including Parasitology. General Acquaintance Following are the fields in which the student is expected to acquire a general acquaintance of techniques and principles and competence to understand and interpret data without being called upon to achieve technologic proficiency. Therefore the level of competence in Immunopathology assumes importance in the interpretation of Renal Diseases. Similarly the findings on Immunohistochemistry may be as important as the findings on light microscopy in a particular case. He is supposed to keep himself au courant with the latest developments in the field of the pathology and related sciences. The student should be able to demonstrate understanding of the histogenetic and patho-physiologic processes associated with various lesions during discussions with colleagues, clinicians, students and patients. Given the clinical and operative data, the student should be able to identify, and systematically and accurately describe the chief gross anatomic alterations in the surgically removed specimens and be able to correctly diagnose at least 80 percent of the lesions received on an average day from the surgical service of an average teaching hospital. A student will be able to demonstrate ability to perform a systematic gross examination of the tissues including the taking of appropriate tissue sections and in special cases as in intestinal mucosal biopsies, muscle biopsies and nerve biopsies, demonstrate the orientation of tissues in paraffin blocks. Given the relevant clinical, operative and radiological data, the student should be able to identify and systematically and accurately describe the chief histomorphologIcal alterations in the tissue received in the surgical pathology service. He/she should also correctly interpret and as far as possible, correlate with the clinical data to diagnose at least 90% of the routine surgical material received on an average day. He/she should be able to diagnose at least 75% of the classical lesions being commonly encountered in the surgical pathology service without the aid of the clinical data. Start the automatic tissue-processing machine and verbally demonstrate his understanding of the principles of its running. Process a tissue, make a paraffin block and cut sections of good quality on a rotary microtome. Demonstrate understanding of the principles of: (i) Fixation of tissues (ii) Processing of tissues for section cutting (iii) Section cutting and maintenance of related equipment (iv) Differential (Special) stains and their utility 5. Cut a frozen section of tissues received from the operating room for quick diagnosis, stain and interpret the slide in correlation with the clinical data provided, and correctly diagnose at least 75 per cent of the lesions within 15 minutes. Demonstrate the understanding of the utility of various immunohistochemical stains especially in the diagnosis of tumour subtypes. Should have sufficient understanding of various disease processes so that a meaningful clinico-pathological correlation can be made. Demonstrate ability to perform a complete autopsy independently with some physical assistance, correctly following the prescribed instructions. Correctly identify all major lesions which have caused, or contributed to , the patients death on macroscopic examination alone in at least 90% of the autopsies in an average teaching hospital. In places where non-medicolegal autopsies are not available each student/candidate should be made to dissect organs from atleast five medico-legal autopsies. Identify and correctly diagnose at least 90% of the microscopic lesions found in most autopsies, and be able to correlate the pathologic changes with the patients clinical history and events of a few days preceding death. Write correctly and systematically Provisional and Final Anatomic Diagnosis reports (on gross and microscopy respectively), the major findings at autopsy, and the Autopsy Protocol as per prescribed instructions, of a standard fit for an international journal. Should posses the background necessary for the evaluation and reporting of Cytopathology specimens. Demonstrate verbal familiarity with, and guide the clinical residents in the following, keeping in view the special requirements of each case (Cyto-hormonal status, malignancy, infection, etc. Independently prepare and stain good quality smears for cytopathologic examination and be conversant with the principles and preparation of solutions of stains. Independently be able to perform fine needle aspiration of palpable superficial lumps in patients; make good quality smears, and be able to decide on the type of staining in a given case. Given the relevant clinical data, he/she should be able to independently and correctly : (i) Evaluate hormonal status in all cases as may be required. Should demonstrate the capability of utilising the principles of the practice of Haematology for the planning of tests, interpretation and diagnosis of diseases of the blood and bone marrow. Correctly plan a strategy of investigating at least of the cases referred for special investigations in the Hematology Clinic and give ample justification for each step in consideration of the relevant clinical data provided. Correctly and independently perform the following special tests, in addition to doing the routine blood counts: Course and Curriculum of M D Pathology 189 (i) Haemogram including Reticulocyte and Platelet counts. Demonstrate verbally and in writing, his/her under standing of the principles of the above tests their utility in diagnosis and interpretation of results. Perform a successful bone marrow aspiration/iliac crest biopsy and stain the peripheral and bone marrow smears with Romanowsky stains. Posses working knowledge of the following: (i) Bone marrow transplantation (ii) Prenatal diagnosis of genetic haematological diseases (iii) Molecular biology of haematological diseases 5. Demonstrate familiarity with the normal range of values of the chemical content of body fluids, significance of the altered values and interpretation thereof. Possess knowledge of the principles of following specialized organ function tests and the relative utility and limitations of each and significance of the altered values. Know the principles, advantages and disadvantages scope and limitation of Automation in laboratory. Plan a strategy of laboratory investigation of a given case, given the relevant clinical history and physical findings in a logical sequence, with a rational explanation of each step. He should be able to correctly interpret the laboratory data of such studies, and discuss their significance with a view to arrive at a diagnosis. Independently and successfully perform a complete examination; physical, chemical and cell content of Cerebrospinal Fluid (C. Successfully perform an examination of Peripheral Blood for the commonly occurring parasites. Independently and correctly perform at least the following Quantitative Estimations by Manual Techniques and/or Automated Techniques. Demonstrate familiarity with the following Quantitative Estimations by Automated Techniques. Demonstrate familiarity with: (i) Determination of bicarbonates (ii) Blood gas analysis. Prepare standard solutions and reagents relevant to the above tests, including the preparation of normal solution, molar solution and Buffers. Explain the principle of Instrumentation, use and application of the following instruments. Knowledge It is expected that students should possess knowledge of the following aspects of Transfusion Medicine. Skills It is expected that the student shall correctly and independently perform the following. Cryoprecipitates, Platelet concentrate, Fresh Frozen Plasma, Single Donor Plasma, Red Blood Cell concentrates. Demonstrate familiarity with Antenatal and Neonatal work (i) Direct antiglobulin test Course and Curriculum of M D Pathology 193 (ii) Antibody screening and titre (iii) Selection of blood for exchange transfusion 5. Knowledge (i) Demonstrate familiarity with the current concepts of structure and function of the immune system, its aberrations and mechanisms thereof. Skills (i) Perform and interpret simple immunological tests used in diagnosis of diseases and in research procedures. Skills (i) Perform proper fixation, processing and staining of tissues for electron microscopy. Knowledge Should be familiar with the principles, use and interpretation of common enzyme histochemical procedures (Alkaline Phosphatase, Acid Phosphatase, Glucose 6-Phosphate Dehydrogenase, Succinyl Dehydrogenase, Chloroacetate Esterase, Gammaglutamyl Transpeptidase and Acetyl Cholinesterase. Skills (i) Operate the cryostat, and demonstrate familiarity with the principles of its working and be able to stain tissue sections for some cell constituents. Knowledge Should understand the principles of Molecular biology especially related to the understanding of disease processes and its use in various diagnostic tests. Knowledge Demonstrate familiarity with importance of statistical methods in assessing data from patient material and experimental studies. Skills Calculate means, standard deviation and standard error from the given experimental data 5. Knowledge Demonstrate familiarity with the principles of the commonly used radioisotopes in medicine and autoradiography, and the instruments used to measure radioactivity. Important Note (i) It is appreciated that the facilities in Institutions vary and this is more likely in the case of Basic Sciences Training. All efforts must be made so that the student gets an opportunity to be familiar with all the aspects of expected training that have been mentioned. If necessary extra-mural postings may be considered to take care of any likely shortcomings in the training. Thus knowledge in imaging techniques and their interpretation would be an asset while interpreting diseases of bones and joints. Knowledge regarding the nature of therapy for various diseases would be helpful not only in identifying iatrogenic diseases but also in actively participating in the diagnosis and management of patients. Students should be encouraged to present papers in conferences and publish papers in peer reviewed journals. Clearly state the objectives in terms of what is expected to be achieved in the end. Plan rational approaches with appropriate controls with full awareness of the statistical validity of the size of experimental material. Accurately and objectively record on systematic lines the results and observations made. Analyse the data with the aid of an appropriate statistical analysis, if necessary. Take photomicrographs, of a quality fit for publication in an international journal 6. Write the thesis or a scientific paper in accordance with the prescribed instructions, as expected of international standards. It should be appreciated that a clear definition of the goals and precise objectives before starting a research project is as essential as stating ones destination before starting for the journey. These must be stated in clear, unambiguous terms as ultimate results of the study and not as the methods of approach to the problem. The superstructure is constituted by diagnostic pathology concerned with the application of the above knowledge, and that of the investigative procedures in the recognition and quantitation of disease. In the training of a pathologist, acquisition of both these disciplines is essential. Eventually, the primary role of the pathologist is to apply the basic understanding of the disease processes to patient care, with the intellectual rigor and careful delineation of problems, characteristic of the research investigator. The training programme should be designed to enable the student to acquire a capacity to learn and investigate for himself, to synthesize and integrate a set of facts and develop a faculty to reason. The curricular programmes and scheduling of postings must provide the student with opportunities to embrace the above broad objectives. The student must blend as an integral part of the activities of an academic department that usually revolves around three equally important basic functions of teaching, research and service. As mentioned earlier the emphasis is recommended under a residency programme or learning while serving/working.
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