I Am A Student Nurse
Submitted by Boyd Williams
I am a student nurse
I promise to be brave
I graduate in July
I am a student nurse
I will not show them I am afraid
I will pretend that I have done this a million times or more
So my patients will feel at ease when I am on the floor
I am a student nurse
I promise to be brave
I graduate in July
The Nurse
Submitted by Frank Paylor of Sudbury, Ontario, Canada
When you are feeling sick, or worse,
thank your dear Maker for your nurse
Whose tender care and ministrations
are worth sincere congratulations.
The shattered limb, the fevered brow
are much the same to her somehow.
There is a need, a chance to heal,
to ease the pain that you might feel.
Through all those precious smiles
and words of comfort, as she tends
With all her sharpened skills and guiles
without complaint, she mends.
Then there comes the day
when you are sent upon your way
-- and you discover, in the end,
that you have had a pleasant visit
with a very special friend.
I'm Sorry In Advance
By Linda Leeson - Licensed Practical Nurse Vernon Jubilee Hospital Vernon. B.C. Canada
Your beds not made today
But I have a patient here
Whose chest pain
won’t go away
I’m sorry in advance
You’re not happy with your meal
Dietary does try hard sir,
To give it some appeal
I’m sorry in advance
Your morning pills are late
I’ve a patient climbing out of bed
That I must try to sedate
I’m sorry in advance
Your mattress isn’t soft
We do need some new beds ma’am
But these things do cost a lot.
I’m sorry in advance
I didn’t get to comb your mothers hair
I’ve a patient with emphysema
She’s scared, she can’t get air
I’m sorry in advance
Your fathers still in pain
I’m trying to reach his doctor
I’ll have to try again
I’m sorry in advance
Your dressings aren’t yet done
But a patient has just passed away,
I offered solace to his son,
I’m sorry in advance
I’m not cheery as a bird
I’ve worked 12 hours, my feet ache
I asked for help,
but no one heard
I’m sorry in advance
I’ve only two hands and two feet
I’m trying to care for you, patient
Your needs, I want to meet
My 12 hours now are 16,
No replacement could be found
My aching feet they cry out
My head begins to pound
I’m sorry in advance
I cannot meet your gaze
My eyes are filled with tears
Your face is just a haze
If I could sit down for a minute
And maybe grab a bite
Phone my kids to say I love them
And I’ll be late again tonight
I’m sorry in advance
I didn’t do all that must be done
If I worked any faster
I’d soon begin to run
When I do get to hold your hand
Or wipe your furrowed brow
Please understand, dear patient
I care for you and how
I see your pain,
I sense your fear
Your anger in a glance,
Our health care service
is failing you
I’m sorry in advance.
Place Your Healing Touch In My Hands
Unknown Author
Help me as I care
for my patients today,
Be there with me,
O Lord, I pray
Make my words kind
--it means so much--
And in my hands place
Your healing touch
Let your love shine
through all that I do,
So those in need
may hear and feel You.
Assignment
By Kim Jordan RN
I have nine patients, you are but one
I will walk five miles before I am done
Tiptoeing in and out of the rooms
Darkened and quiet like silent tombs
I try not to wake you, for there is no time
When trying to divide eight hours by nine.
It is my duty
Dawn Butler, RN
(Pennsylvania)
I walk through those doors with pride,
Who's life will i save tonight?
Someone is waiting for me,
Someone is alive today because of my duty.
Sometimes we cry cause we can't save them all,
God sometimes won't let us interfere when he calls.
A baby's first breath when he looks at me,
The joy of my first delivery.
The tear i wipe a way with my own hands,
The life ending of a gentle old man.
The night seems so dark and the morning so bright.
Being a nurse you see life in a different light.
Who will i save tonight?
Who will hold my hand during their last breath with no fright?
Who will enter this world on my shift?
How many mothers will greet their babies with a kiss?
I don't know who these special people are
but i will meet them with every call
I will hold them tight and help the pain
I will hold them up when they feel faint.
I will be strong when i am needed
That is my job, I am a nurse..that is my duty.
...Nurses are the heartbeat of health care... ...Caring is the essence of nursing... ...Nurses are angels in comfortable shoes... ...Whether a person is a male or female, a nurse is a nurse,If love can't cure it, nurses can...
Wednesday, August 18, 2010
Healthty Relationship~
Healthy Relationships
Healthy relationships are fun and make you feel good about yourself. You can have a healthy relationship with anyone in your life, including your family, friends and dating partners. Relationships take time, energy, and care to make them healthy. The relationships that you make in your teen years will be a special part of your life and will teach you some of the most important lessons about who you are. This guide was written to help you understand different kinds of relationships, what makes each relationship special, and how to communicate in a positive way. We have included common stories and fun ways to work on many kinds of relationships.What makes a relationship healthy?
Communication & Sharing: The most important part of any healthy relationship between two people is being able to talk and listen to one another. You and the other person can figure out what your common interests are. You can share your feelings with the other person and trust that they will be there to listen and support you. In healthy relationships, people don't lie. Communication is based on honesty and trust. By listening carefully and sharing your thoughts and feelings with another person, you show them that they are an important part of your life.
Respect and Trust: In healthy relationships, you learn to respect and trust important people in your life. Disagreements may still happen, but you learn to stay calm and talk about how you feel. Talking calmly helps you to understand the real reason for not getting along, and it's much easier to figure out how to fix it. In healthy relationships, working through disagreements often makes the relationship stronger. In healthy relationships, people respect each other for who they are. This includes respecting and listening to yourself and your feelings so you can set boundaries and feel comfortable. You will find that you learn to understand experiences and feelings of others as well as having them understand your experiences and feelings.
How do I know that I have a healthy relationship with someone?
You know that you are in a healthy relationship with someone because you feel good about yourself when you are around that person. Unhealthy relationships can make you feel sad, angry, scared, or worried.
Healthy peer relationships involve an equal amount of give and take in the relationship. In unhealthy relationships, there is an unfair balance. You may feel that most of the time you are giving the other person more attention than they give to you.
You should feel safe around the other person and feel that you can trust him/her with your secrets. In a healthy relationship, you like to spend time with the other person, instead of feeling like you're pressured into spending time with them. Unhealthy relationships do not include trust and respect, which are very important parts of a family relationship, good friendship, or dating relationship. No one deserves to be in an unhealthy relationship.
If you don't feel that there is communication, sharing and trust, you are probably in an unhealthy relationship. You may want to try talking to the other person about how you are feeling. You may even need to end the relationship. If it's hard for you to stop spending time with the other person because you care about them, talk about how to make your relationship healthier or ask a trusted adult for advice. By learning how to build healthy relationships now, you will be able to have healthy relationships with the people you meet throughout your life!
Real Life: Family
"My sister is so annoying! She is driving me crazy!"
Jenny and her sister Sarah fight all the time. Jenny is angry with Sarah because she barges into her room and takes her things without asking. Sarah complains that Jenny yells too much and spends all of her time on the phone.
Your brothers and sisters can upset you sometimes. You may get angry if they take something that is yours, go into your room, hit you, or bother you when you have friends over. Your older brothers or sisters may try to boss you around and tell you what to do. Your younger brothers or sisters may borrow your things or want to be around you all the time.
When you argue with your friends, you can go home and get away from them. But, when you argue with a brother or sister, they are in your house and you may feel like you can't get away from them. Talking things out and coming up with rules that you and your brothers and sisters agree on will make living together a lot easier.
Here are some ways to handle an argument and help you to avoid fighting with your brother(s) or sister(s):
*Go for a walk or go to separate rooms in the house, before you lose your temper in an argument.
*Talk to your parents about what is bothering you. Most likely they will be able to give you advice.
*Set up your own personal space. Even if you share a bedroom, make a little space (even in a corner of your bedroom) that is all yours. Tell your brother or sister that they need to knock before coming into your bedroom or your special area of a shared bedroom.
*Respect your brother or sister's personal space too - whether it is their room or a part of your shared bedroom. They will be more likely to show you the same respect in return.
*Decide ahead of time how you are going to share the phone. For example, you can figure out separate times when each of you can talk to your friends.
*Take turns with the television. Talk ahead of time about what shows you want to watch, then take turns watching your favorite shows if they are on at the same time.
*Pick your battles. Try to figure out what is really bothering you. This will help you to know if the problem is worth arguing about. Some issues may be more important than others.
Now that you have some ideas on how to avoid fighting, you may want to think about how to work on building a healthy relationship with your brother or sister. Talking about the things that are bothering you in a calm way really helps. Doing things together, like going on a bike-ride or watching a movie will give you a chance to talk to each other and enjoy the time that you spend together too.
Real Life: Friends
"Why should I do what YOU say?"
Abby and Maria have been friends for a long time. Abby has been upset because Maria always decides where they are going and what they are going to do. Maria also tells Abby who she can be friends with. Abby feels a lot of pressure to do what Maria tells her to do.
Friendships can be complicated at this time in your life. You may be making new friends while you are trying to keep old friends. One thing that can make any relationship complicated is peer pressure. Peer pressure is when you chose to do something you usually wouldn't do, or you stop doing something that you normally would do because you are worried about what your friends will think. Some friends may pressure you to do something because "everyone else does it," such as making fun of someone. One of the biggest challenges that you may have to face is standing up to a friend.
Here are tips to help you handle a disagreement with a friend:
You always have the right to say "no" to your friend whenever you want to. In a healthy friendship, you should not be afraid of losing a friend because you say "no." Good friends should respect your right to say no about anything and not give you a hard time. It is important that you show your friend the same respect when they say no to you.
If you and your friend disagree about something or have an argument, it does not mean that you have an unhealthy relationship. You will not always agree with what your friend has to say. As long as you and your friend can talk to one another and listen to what each person has to say, you should be able to work through a disagreement. Healthy friendships involve trust and being able to respect each other's differences.
The friends that you make and the relationships you develop will help you learn a lot about yourself. Your friendships may be the most important thing to you right now. You will find out what things you like to do together but more importantly, you will learn about the kind of friends you want to have and the kind of friend you want to be to others.
Real Life: Dating
"A boy that I like kissed me at the dance... Are we dating now?"
Anna and Jamal like each other. They met a few weeks ago at a dance. They want to get to know each other but don't know what to do next.
There is no best age for teens to begin dating. Every person will be ready for a dating relationship at a different time. Different families may have certain rules about dating too. When you decide to start a new dating relationship, it should be because you care about someone and not because you feel like you have to have a boyfriend or girlfriend. A dating relationship is a special chance to get to know someone, share your thoughts and feelings with each other, and do activities together.
Healthy dating relationships should start with the same ingredients that healthy friendships have, such as good communication, honesty, and respect. Dating relationships are a little different because they may include physical affection, like hugging, kissing, or holding hands. As with all relationships, it may be tempting at first for you to spend all of your time with your new partner. But, making special time to spend together and apart means that you will be able to work on having a healthy relationship with the person you are dating and with other people in your life, like your friends and family.
You should NEVER feel pressured to do something that you don't want to do. He/She should always respect your right to say no to anything that makes you feel uncomfortable. It is important that you are both clear with each other about your values and your limits. By talking about how each of you feel about a lot of things, you may avoid getting into situations where you are pressured into making a decision on the spot about something very important.
Here are some tips for starting a healthy dating relationship and ways to stay safe:
Get to know a person by talking on the phone or at school before you go out with them for the first time.
Go out with a group of friends to a public place the first few times you are spending time together.
Plan fun activities like going to the movies, a picnic, the mall, a walk, etc.
Be clear with the other person about what you feel comfortable doing and what time your parent(s) or guardian(s) expect you to be home.
Tell at least one friend and especially your parent(s) where you are going, who you will be with, and how to reach you.
Dating relationships can be a fun and exciting part of your life now. They may be a little confusing, especially if dating is new to you. Once you know that the person that you like, likes you too, you may be unsure of what to do next. You can start by learning about what makes a dating relationship healthy. The most important thing to remember is staying safe, especially when you begin to date.
Real Life: Parents
"I hate these stupid rules!"
Kim has been arguing with her parents a lot lately. She feels that all the rules that her parents set are unfair. They tell her that she needs to listen and obey them.
Your relationship with your parents may be confusing right now. As you are growing and changing, you have more responsibilities and also more freedom to spend time with other people like friends or dating partners. While you may feel ready to make your own decisions about where and when you go places, your parents will put limits on you. The reason that your parents do this is because they care about you and want to protect you from danger.
You may find that you are fighting with your parents more than you used to.
Here are some tips for how to avoid and handle arguments with your parents:
Discuss the rules ahead of time and not at the last minute. This way you will be able to tell what they will say yes or no to before you make plans. Your parents can also explain to you why each rule is in place. Ask them to give you the chance to explain how the rules make you feel and suggest what you think are appropriate rules. Your parents may be willing to listen to your ideas and use them when making rules that you both agree on.
Try to remain calm and do not lose your temper when your parents say no to something. You will show your parents that you are responsible and mature by talking instead of yelling and listening to what they have to say.
Follow each rule that they set. If your parents tell you to be home at a certain time, stick to it. They may begin to worry about your safety if you are late. By being responsible and by following rules, your parents may be willing to negotiate a later time in the future, especially if they know that you will follow their rules.
Pick your battles. Try to figure out what is really bothering you. This will help you to know if it is worth arguing about. Some issues may be more important than others.
Spend time with your family. Some teens argue with their parents over the amount of time they spend with their friends. Communicate with each other and make some special family time so that you can all enjoy the time you spend at home. Suggest activities that your whole family will enjoy together such as going for a hike, a bike ride, or going to the beach.
*Remember that healthy relationships are about feeling good about who YOU are and feeling SAFE with another person. You have the power to create healthy relationships all around you just by paying attention to who you are inside and what makes you happy. By getting to know yourself, it will get easier to recognize the differences between healthy and unhealthy relationships. Communication, trust and respect are the key ingredients for healthy relationships.*
Healthy relationships are fun and make you feel good about yourself. You can have a healthy relationship with anyone in your life, including your family, friends and dating partners. Relationships take time, energy, and care to make them healthy. The relationships that you make in your teen years will be a special part of your life and will teach you some of the most important lessons about who you are. This guide was written to help you understand different kinds of relationships, what makes each relationship special, and how to communicate in a positive way. We have included common stories and fun ways to work on many kinds of relationships.What makes a relationship healthy?
Communication & Sharing: The most important part of any healthy relationship between two people is being able to talk and listen to one another. You and the other person can figure out what your common interests are. You can share your feelings with the other person and trust that they will be there to listen and support you. In healthy relationships, people don't lie. Communication is based on honesty and trust. By listening carefully and sharing your thoughts and feelings with another person, you show them that they are an important part of your life.
Respect and Trust: In healthy relationships, you learn to respect and trust important people in your life. Disagreements may still happen, but you learn to stay calm and talk about how you feel. Talking calmly helps you to understand the real reason for not getting along, and it's much easier to figure out how to fix it. In healthy relationships, working through disagreements often makes the relationship stronger. In healthy relationships, people respect each other for who they are. This includes respecting and listening to yourself and your feelings so you can set boundaries and feel comfortable. You will find that you learn to understand experiences and feelings of others as well as having them understand your experiences and feelings.
How do I know that I have a healthy relationship with someone?
You know that you are in a healthy relationship with someone because you feel good about yourself when you are around that person. Unhealthy relationships can make you feel sad, angry, scared, or worried.
Healthy peer relationships involve an equal amount of give and take in the relationship. In unhealthy relationships, there is an unfair balance. You may feel that most of the time you are giving the other person more attention than they give to you.
You should feel safe around the other person and feel that you can trust him/her with your secrets. In a healthy relationship, you like to spend time with the other person, instead of feeling like you're pressured into spending time with them. Unhealthy relationships do not include trust and respect, which are very important parts of a family relationship, good friendship, or dating relationship. No one deserves to be in an unhealthy relationship.
If you don't feel that there is communication, sharing and trust, you are probably in an unhealthy relationship. You may want to try talking to the other person about how you are feeling. You may even need to end the relationship. If it's hard for you to stop spending time with the other person because you care about them, talk about how to make your relationship healthier or ask a trusted adult for advice. By learning how to build healthy relationships now, you will be able to have healthy relationships with the people you meet throughout your life!
Real Life: Family
"My sister is so annoying! She is driving me crazy!"
Jenny and her sister Sarah fight all the time. Jenny is angry with Sarah because she barges into her room and takes her things without asking. Sarah complains that Jenny yells too much and spends all of her time on the phone.
Your brothers and sisters can upset you sometimes. You may get angry if they take something that is yours, go into your room, hit you, or bother you when you have friends over. Your older brothers or sisters may try to boss you around and tell you what to do. Your younger brothers or sisters may borrow your things or want to be around you all the time.
When you argue with your friends, you can go home and get away from them. But, when you argue with a brother or sister, they are in your house and you may feel like you can't get away from them. Talking things out and coming up with rules that you and your brothers and sisters agree on will make living together a lot easier.
Here are some ways to handle an argument and help you to avoid fighting with your brother(s) or sister(s):
*Go for a walk or go to separate rooms in the house, before you lose your temper in an argument.
*Talk to your parents about what is bothering you. Most likely they will be able to give you advice.
*Set up your own personal space. Even if you share a bedroom, make a little space (even in a corner of your bedroom) that is all yours. Tell your brother or sister that they need to knock before coming into your bedroom or your special area of a shared bedroom.
*Respect your brother or sister's personal space too - whether it is their room or a part of your shared bedroom. They will be more likely to show you the same respect in return.
*Decide ahead of time how you are going to share the phone. For example, you can figure out separate times when each of you can talk to your friends.
*Take turns with the television. Talk ahead of time about what shows you want to watch, then take turns watching your favorite shows if they are on at the same time.
*Pick your battles. Try to figure out what is really bothering you. This will help you to know if the problem is worth arguing about. Some issues may be more important than others.
Now that you have some ideas on how to avoid fighting, you may want to think about how to work on building a healthy relationship with your brother or sister. Talking about the things that are bothering you in a calm way really helps. Doing things together, like going on a bike-ride or watching a movie will give you a chance to talk to each other and enjoy the time that you spend together too.
Real Life: Friends
"Why should I do what YOU say?"
Abby and Maria have been friends for a long time. Abby has been upset because Maria always decides where they are going and what they are going to do. Maria also tells Abby who she can be friends with. Abby feels a lot of pressure to do what Maria tells her to do.
Friendships can be complicated at this time in your life. You may be making new friends while you are trying to keep old friends. One thing that can make any relationship complicated is peer pressure. Peer pressure is when you chose to do something you usually wouldn't do, or you stop doing something that you normally would do because you are worried about what your friends will think. Some friends may pressure you to do something because "everyone else does it," such as making fun of someone. One of the biggest challenges that you may have to face is standing up to a friend.
Here are tips to help you handle a disagreement with a friend:
You always have the right to say "no" to your friend whenever you want to. In a healthy friendship, you should not be afraid of losing a friend because you say "no." Good friends should respect your right to say no about anything and not give you a hard time. It is important that you show your friend the same respect when they say no to you.
If you and your friend disagree about something or have an argument, it does not mean that you have an unhealthy relationship. You will not always agree with what your friend has to say. As long as you and your friend can talk to one another and listen to what each person has to say, you should be able to work through a disagreement. Healthy friendships involve trust and being able to respect each other's differences.
The friends that you make and the relationships you develop will help you learn a lot about yourself. Your friendships may be the most important thing to you right now. You will find out what things you like to do together but more importantly, you will learn about the kind of friends you want to have and the kind of friend you want to be to others.
Real Life: Dating
"A boy that I like kissed me at the dance... Are we dating now?"
Anna and Jamal like each other. They met a few weeks ago at a dance. They want to get to know each other but don't know what to do next.
There is no best age for teens to begin dating. Every person will be ready for a dating relationship at a different time. Different families may have certain rules about dating too. When you decide to start a new dating relationship, it should be because you care about someone and not because you feel like you have to have a boyfriend or girlfriend. A dating relationship is a special chance to get to know someone, share your thoughts and feelings with each other, and do activities together.
Healthy dating relationships should start with the same ingredients that healthy friendships have, such as good communication, honesty, and respect. Dating relationships are a little different because they may include physical affection, like hugging, kissing, or holding hands. As with all relationships, it may be tempting at first for you to spend all of your time with your new partner. But, making special time to spend together and apart means that you will be able to work on having a healthy relationship with the person you are dating and with other people in your life, like your friends and family.
You should NEVER feel pressured to do something that you don't want to do. He/She should always respect your right to say no to anything that makes you feel uncomfortable. It is important that you are both clear with each other about your values and your limits. By talking about how each of you feel about a lot of things, you may avoid getting into situations where you are pressured into making a decision on the spot about something very important.
Here are some tips for starting a healthy dating relationship and ways to stay safe:
Get to know a person by talking on the phone or at school before you go out with them for the first time.
Go out with a group of friends to a public place the first few times you are spending time together.
Plan fun activities like going to the movies, a picnic, the mall, a walk, etc.
Be clear with the other person about what you feel comfortable doing and what time your parent(s) or guardian(s) expect you to be home.
Tell at least one friend and especially your parent(s) where you are going, who you will be with, and how to reach you.
Dating relationships can be a fun and exciting part of your life now. They may be a little confusing, especially if dating is new to you. Once you know that the person that you like, likes you too, you may be unsure of what to do next. You can start by learning about what makes a dating relationship healthy. The most important thing to remember is staying safe, especially when you begin to date.
Real Life: Parents
"I hate these stupid rules!"
Kim has been arguing with her parents a lot lately. She feels that all the rules that her parents set are unfair. They tell her that she needs to listen and obey them.
Your relationship with your parents may be confusing right now. As you are growing and changing, you have more responsibilities and also more freedom to spend time with other people like friends or dating partners. While you may feel ready to make your own decisions about where and when you go places, your parents will put limits on you. The reason that your parents do this is because they care about you and want to protect you from danger.
You may find that you are fighting with your parents more than you used to.
Here are some tips for how to avoid and handle arguments with your parents:
Discuss the rules ahead of time and not at the last minute. This way you will be able to tell what they will say yes or no to before you make plans. Your parents can also explain to you why each rule is in place. Ask them to give you the chance to explain how the rules make you feel and suggest what you think are appropriate rules. Your parents may be willing to listen to your ideas and use them when making rules that you both agree on.
Try to remain calm and do not lose your temper when your parents say no to something. You will show your parents that you are responsible and mature by talking instead of yelling and listening to what they have to say.
Follow each rule that they set. If your parents tell you to be home at a certain time, stick to it. They may begin to worry about your safety if you are late. By being responsible and by following rules, your parents may be willing to negotiate a later time in the future, especially if they know that you will follow their rules.
Pick your battles. Try to figure out what is really bothering you. This will help you to know if it is worth arguing about. Some issues may be more important than others.
Spend time with your family. Some teens argue with their parents over the amount of time they spend with their friends. Communicate with each other and make some special family time so that you can all enjoy the time you spend at home. Suggest activities that your whole family will enjoy together such as going for a hike, a bike ride, or going to the beach.
*Remember that healthy relationships are about feeling good about who YOU are and feeling SAFE with another person. You have the power to create healthy relationships all around you just by paying attention to who you are inside and what makes you happy. By getting to know yourself, it will get easier to recognize the differences between healthy and unhealthy relationships. Communication, trust and respect are the key ingredients for healthy relationships.*
happy family |
Foot Hygiene~
Tips for healthy foot hygiene
To keep your feet healthy, follow these daily tips:
1.Wash. Wash your feet every day. Use warm-not hot-soapy water. Use a mild, non-perfumed soap. The milder, the better to avoid drying out skin.
2.Dry. After rinsing your feet, dry them thoroughly. Don't forget to dry between your toes.
3.Moisturize. If you have dry skin, apply a mild moisturizer.
4.Powder. Apply a thin layer of powder to the bottoms of your feet to help with perspiration.
5.Inspect. Look for foot problems, like cuts, corns, calluses, blisters, ingrown toenails, swelling, discoloration and/or pain. Report any concerns to your physician.
Foot hygiene applies to toenails too
Healthy toenails are a part of good foot hygiene. When trimming your toenails, cut your nails straight across, rounding slightly at the tip. Use sharp nail scissors or nail clippers. Soak your nails in warm water before clipping. Also, don't clip your cuticles. The cuticle forms a seal between the top of the nail and the skin, blocking entrance by bacteria. When cuticles are clipped or removed, the lack of protection can lead to infection.
Purchasing foot hygiene products
A variety of quality foot care products, including soaps, deodorants, lotions, powders and nail care items, are available over the counter and by prescription. If you're unsure of the best products to use, talk to your doctor. He or she can recommend products that will work for you.
Foot hygiene products right at your fingertips
For a variety of foot hygiene products, see our product menu at the right!
Monday, August 16, 2010
~Forum~
On 9th of August 2010, our lecturer Miss S ask all of us to do forum as for speaking exercise for the exams. We are divided into 7 groups. I each groups consist around 15-20 members. So, each of the group are ask to select 8 members which can speak fluently to perforn the forum. 1 MC also must be selected from each group. All the groups need to apply their creativity in order to perform the best forum. Before the forum started representative from each group need to vote the topic that need to be discuss. Our group topic is regarding the reality shows. We need to do forum to discuss about the advantages and disadvatages of watching reality shows programs. We are given about 20 minutes to perform the forum.
This is our first experience of conducting the forum. Eventhough the first moment we felt quite difficult but finally we are manage to complete the forum successfully.
This is our first experience of conducting the forum. Eventhough the first moment we felt quite difficult but finally we are manage to complete the forum successfully.
English Writing Assignment!!!!!
Students sometime have problem in deciding which universities they want to apply too.Suggest 3 factors that students should consider when applying to university.You may include some of following aspect courses offered and facilities.You should write at least 350 words.
In the global era,education is an important element should be considered in order to maintain development of our country.Due to that,there are so many universities that can be chosen by the new generations or in order words students nowaday to further their studies.Instead of consider the right factors to enter universities the students usually choose the courses according to their friends and their ambition.They never thought about the effects of chosing wrong courses.Somes of students are being pampered by their parents.Then they are too fussy about facilities provided by the some universities.Moreover, some universities not provided adequate hostel and equipments in the house.In addition,financial and management of universities are also important.This is because,different universities have different fee for each course and students should consider rasionally.So that the the fee will not burden them.Besides that,to avoid few student from being cheated,student should make a reseaches about the management of universities they choose.This is because some of universities will promote all the good things about their university but the bad things was hidden by them.Owing of that,there are the few best factors can be considered to choose the right universities such as courses offered, facilities and financial and management of university.The best chosen which university they will shown and gurantee how excellent they can be for their future.
One of the factor that the students should consider when applying the best university is the courses offeredby the universities.This is because students should consider about their future life first.Due to the fact that not all their dreamt carreer and ambition can be fulfilled in this globalisation now.Therefore, the students should choose the courses depends on working chances and career that have higher opportunities to get and also high demand in our country.Apart from that,students should think wisely that they can carry on with the courses and also learn to love the subject offered in the course to avoid from regret withb decision they make for their life.By considered the right factor while entering the university,will helps students to be more focus in their studying and can maintain flying colour of their result.
Other factor than courses offered, facilities provided also should be consider when applying to university. This is stated because by having proper and appropriate facilities students may study in a good condition. This will help them to improve their quality of study. For example, if certain university or institute doesn't provide good library or lecture room hoe can the students study in a good condition. Besides that, if they cannot gather more information regarding the assignment given how can the students doing well in the task given. In addition, by having a proper and good facilities will help impove the quality of students.
Besides that, other factors that can be consider are the financial. In terms of financial, students should consider their family background. This is because by entering the university money is really need especially to pay the fees. As we know the main rules of university or institution, the students are compulsory to pay the fees. That is why the financial background is so important. For example there are some of students who quick from their study because cannot affort to the pay tha fees. Because of this it can bring bad effect to the students it self and their future life.
In a nutshell,students shuld make a sharp and the best decision about applying the best university that they want to enter. They should know that, the decision they make will effect their whole life and future. Although they cannot achieve their dream career but in the end they will not regret with the best decision they make. Students should know not all the course are suitable with them. Then, they should think wisely about the course because it will effect their future. In addition, although some university not provided proper facilities but if students are generous and positive when studying they can do it well.
Hair Hygiene ~
Shampoos
In addition to thoroughly cleaning the hair, a good shampoo should also be gentle enough to keep the hair well moisturized and soft; this can be accomplished by combining just the right balance of ingredients in just the right amounts. A thinning hair shampoo should be enriched with Jojoba Oil and Polysorbate 80 to remove oils and waxy buildup. Also, Panthenol (Provitamin B5) and Biotin help increase the thickness, body and texture of each strand.
Leading authorities on hair recommend shampooing every day. This washes away scalp oils containing the hormone DHT (dihydrotestosterone) which contributes to hair loss.
Conditioners
Like shampoos, conditioners must leave behind enough ingredients so that the hair combs easily and feels soft, but not so that the hair looks weighted down or greasy. The best ingredients to look for in a hair conditioner are Liposomes, Wheat Protein, and plant extracts such as Horsetail Extract and Stinging Nettle. Conditioners should strengthen your hair, adding volume and shine.
A Step-by-Step way to wash your hair:
1)Always brush hair to loosen dirt and scalp flakes, while activating oil glands.
2)Massage scalp gently to relieve tension and aid blood circulation in the scalp.
3)Wet hair thoroughly with warm or lukewarm water.
4)Pour a small amount of shampoo onto the palm of your hand, rub both hands together and smooth shampoo on evenly. (Pouring shampoo directly onto the hair makes even distribution impossible).
5)Massage shampoo into scalp with fingertips, adding more water for suds.
6)Spread the lather quickly throughout your hair, leave on for several seconds, comb through, then rinse with warm water.
7)After the first thorough rinsing, the second rinse should be with water which is progressively colder. This reduces “swelling” of the hair tube and stimulates circulation. Cold water also makes the hairs stiffer and stronger, while locking them more firmly into their root.
8)The final step is to gently comb the hair with a wide-tooth comb rather than a brush which can stretch and break your hair.
All About pH
pH is a scale chemists use to measure acidity and alkalinity. The scale ranges from 0 (very acidic) to 14 (very alkaline). The mid-point 7 on the scale is equal to the pH of distilled water.
The “natural” pH of hair and skin is between 5 & 6: in other words, slightly acidic. Both a highly alkaline or extremely acidic substance will damage your hair and skin. A shampoo should have a pH of between 4 & 7, which is within the normal pH range of the scalp.
Can Dandruff cause Hair Loss?
Many people with serious dandruff problems maintain healthy hair thoughout their lives. For those with thinning hair, however, a dandruff problem may worsen the condition. Dandruff itself does not cause baldness. It is the result of increased skin cell production combined with excessive oil secretions. The two most basic steps in dealing with dandruff are massaging the scalp and frequent brushing.
Blow-Dryers can Actually Help
Blow-drying, if done properly and in moderation, can actually benefit the scalp and hair. Blow-drying can increase blood flow to the scalp and thus improve circulation of vital nutrients to that area. When you finish shampooing and conditioning with that last cold rinse, you have also restricted blood flow to the scalp. Using a warm blow-dryer can help raise the temperature of the scalp and restore circulation. To get the full benefits from your blow-dryer, remember to keep the air moving over your head and not to leave it in one spot too long. Also, make sure the dryer stays at least 6 inches from your head.
A Guide to Protecting Your Hair
-Avoid prolonged exposure to sunlight, water, sand and chlorine.
-Cover your head with a hat as much as possible.
-In choosing a hair care product, look for ingredients that contain the following:
-Aloe Vera to restore the precious moisture balance lost through blow-drying, tints and perms.
-Panthenol (Provitamin B5) protects hair from the damaging effects of the sun and pollutants.
-Jojoba Oil dissolves salt build-up due to perspiration.
-EDTA removes chlorine damage caused by swimming pools and hot tubs.
10 Quick and easy ways to lose weight~
1. Keep meats that are high in fat (burgers, fried food, junk food) outside your diet. They have nothing to offer to your body and health (other than calories and fat) and there are many better replacements both in terms of calories and healthiness.
2. Did you notice that people who eat spicy food do not have weight problems? This is true and the main reason behind this is that spicy food can accelerate your metabolism and help you burn more calories. So spicy up your food to make it tastier and boost your metabolism at the same time.
3. Salads are delicious, healthy and calorie friendly. Why not try having a salad for lunch instead of a heavy and calorie loaded meal? Salads give you a lot of energy at minimum cost. It goes without saying that you should avoid saucy salad dressings.
4. There is no valid excuse that can keep you away from walking or running for 30 minutes per day. This activity will clean your mind, give you more energy and help you lose weight. If the weather is bad then go to the gym or use the treadmill at home. If you don’t have one, then buy one. Do not expect that you will lose weight magically. You need to take actions and make the effort.
5. The last meal of the day is dinner. You should take your dinner at least 3 hours before bedtime and after that you should not eat anything. Do not make the mistake that many people do. Many people eat their dinner and until they go to bed they eat snacks and sweets (a bite of this and that), capable to blow up their weight loss efforts. A nice way to remind your self that you should not eat anything is to brush your teeth right after dinner.
6. When you need to drink something then this should be fresh water. There are no perfect substitutes of water despite what you want to believe. Better drink fewer juices and no soft drinks and fight your thirst with 6-8 glasses of water per day.
7. Weight lifting can help you lose weight fast. Do not be afraid of strength training and body building. The harder and more effort you put into exercise the more weight you will lose. Weight lifting can help you build muscles utilizing the fat reserves for energy.
8. If you do not have to go to a restaurant (because you are invited for dinner) then try to eat at home. Eating at home is better because you have more control on the size of the food portions and the ingredients used for cooking. Food cooked in restaurants is not really healthy and the more you can avoid it the better.
9. If you really have to eat out then prefer to order your own portion from the menu instead of taking buffet. Buffets are full of temptations and most probably you will not be able to resist and at the end you will feel bad. Also try eating only half of the food portion to make sure that you will not consume more calories than you really need.
10. Last but not least, if you are serious about losing weight quickly then keep a food diary. In the diary you can record everything you eat and drink and also calculate the amount of calories. Watch your diary and make sure that you do not eat more calories (keep your diet around 2000-24000 calories daily) than what you need and also used it as a tool to help you set your weight loss goals.
2. Did you notice that people who eat spicy food do not have weight problems? This is true and the main reason behind this is that spicy food can accelerate your metabolism and help you burn more calories. So spicy up your food to make it tastier and boost your metabolism at the same time.
3. Salads are delicious, healthy and calorie friendly. Why not try having a salad for lunch instead of a heavy and calorie loaded meal? Salads give you a lot of energy at minimum cost. It goes without saying that you should avoid saucy salad dressings.
4. There is no valid excuse that can keep you away from walking or running for 30 minutes per day. This activity will clean your mind, give you more energy and help you lose weight. If the weather is bad then go to the gym or use the treadmill at home. If you don’t have one, then buy one. Do not expect that you will lose weight magically. You need to take actions and make the effort.
5. The last meal of the day is dinner. You should take your dinner at least 3 hours before bedtime and after that you should not eat anything. Do not make the mistake that many people do. Many people eat their dinner and until they go to bed they eat snacks and sweets (a bite of this and that), capable to blow up their weight loss efforts. A nice way to remind your self that you should not eat anything is to brush your teeth right after dinner.
6. When you need to drink something then this should be fresh water. There are no perfect substitutes of water despite what you want to believe. Better drink fewer juices and no soft drinks and fight your thirst with 6-8 glasses of water per day.
7. Weight lifting can help you lose weight fast. Do not be afraid of strength training and body building. The harder and more effort you put into exercise the more weight you will lose. Weight lifting can help you build muscles utilizing the fat reserves for energy.
8. If you do not have to go to a restaurant (because you are invited for dinner) then try to eat at home. Eating at home is better because you have more control on the size of the food portions and the ingredients used for cooking. Food cooked in restaurants is not really healthy and the more you can avoid it the better.
9. If you really have to eat out then prefer to order your own portion from the menu instead of taking buffet. Buffets are full of temptations and most probably you will not be able to resist and at the end you will feel bad. Also try eating only half of the food portion to make sure that you will not consume more calories than you really need.
10. Last but not least, if you are serious about losing weight quickly then keep a food diary. In the diary you can record everything you eat and drink and also calculate the amount of calories. Watch your diary and make sure that you do not eat more calories (keep your diet around 2000-24000 calories daily) than what you need and also used it as a tool to help you set your weight loss goals.
5 Tips For Natural Skin Care~
Tip 1: Give Yourself a Dry Brush Exfoliation
A dry brush exfoliation can be done in the morning before you shower. It eliminates dead skin cells and allows the skin to detox (skin is the largest organ of elimination). Dry brush exfoliation also improves lymph and blood circulation and decreases puffiness. An added benefit is that the gentle pressure is calming to the nervous system. To give yourself a dry brush exfoliation, you'll need a soft, natural bristle brush.
Tip 2: Rev Up Your Digestion
In alternative medicine, good skin is a reflection of a good digestive system. People with skin disorders such as acne, rosacea, and psoriasis often suffer from constipation, imbalanced "good" vs. "bad" bacteria, leaky gut, and other digestive conditions. The two most common sluggish digestion culprits are:
•Culprit #1: Not Enough Water Water bathes cells and eliminates waste products, preventing constipation. •Culprit #2: Not Enough Fiber Most people lack fiber in their diets - the average person eats only 12 g of fiber a day. In 2002, the National Academy of Sciences Food and Nutrition Board established recommended fiber intakes. For men aged 19-50 years, 38 g fiber is recommended, and for men over 50, 31 g fiber is recommended. For women aged 19 to 50 years, 25 g fiber is recommended, and for women over 50, 21 g fiber is recommended.
Some suggestions:
1.Add Whole Grains - Choose whole grain products over refined. Have brown rice instead of white or make your own 50:50 combination.
2.An Apple a Day - Have an apple, skin on, as a snack.
3.Eat Cauliflower - Try this delicious Roasted Cauliflower recipe!
4.High-fiber snacks - Snack on nuts, seeds, and dried fruit, such as dates, figs, and prunes.
5.Try a "Prune Power" Smoothie - Prunes are a great source of fiber. Start your day with this tasty Prune Power smoothie.
6.Eat Beans and Legumes - Open a can of your favorite beans or legumes. Rinse them well and add them to your meal.
7.Ground Flaxseeds - For any easy fiber boost, sprinkle ground flaxseeds (available at health food stores) on rice, salads, oatmeal, or any other meal. Store flaxseeds in the fridge.
Tip 3: Invigorate Sluggish Circulation
Do you sit at your desk for hours, only getting up to go to the bathroom? One of the best things you can do for your skin, stress level, and overall health is to get moving! Inactivity may affect skin and promote bloating and puffiness, acne, cellulite, and loss of muscle tone. You'll learn more about exercise in Step 9 of the Wellness Makeover. Here are some quick suggestions:
•Take a quick break to go outside and walk around the block.
•Book a massage therapy appointment.
•Close your door and stretch.
•Go to the gym.
•Start each morning by stretching.
•Get a skipping rope.
Tip #4: Avoid Excess Sugar
Most people do not realize this but excess sugar is considered one of the main causes of premature aging. The more sugar we eat, the more sugar we have entering our bloodstream. Over time, this can result in a process known as glycation, which is when a glucose (sugar) molecule damages a protein molecule by sticking to it. The new molecules formed are called advanced glycation end-products, or AGEs. AGEs damage collagen in skin, cartilage, and ligaments and promote a loss of elasticity. Wrinkles form and skin begins to sag.
•Try This - It may seem impossible to reduce your sugar intake, but it can be done! A gradual approach works best. In the next week, choose one thing you're going to do to decrease the amount of sugar you consume. For example, start by cutting the amount of sugar in your daily coffee or tea by half. Every week, find another way you can decrease your sugar intake. Pretty soon, you'll be surprised at how far you've come!
Tip #5: Eat Some Good Fats
Essential fatty acids are simply fats your body cannot live without. They are needed to make cell membranes, hormones, and other body chemicals. Essential fats are thought to keep your heart healthy, fight inflammation, and possibly prevent cancer. They are also particularly important to people with inflammatory conditions such as eczema and acne, and also for people with dry skin. People with essential fat deficiency sometimes notice bumps on the backs of their arms. Here are my suggestions on getting more essential fats:
•Flaxseed and walnut oil - Use flaxeed oil or walnut oil with balsamic vinegar as a salad dressing. Be sure to keep these oils refrigerated. They should not be heated or used for cooking.
•Cold water fish - Sardines are a good source of essential fats. Salmon is another good source, however these salmon accumulate toxic polychlorinated biphenyls (otherwise known as PCBs) in their body fat during the 95 percent of their lives they spend at sea.
•Supplements - Consider fish oil supplements.
~ Beauty lies in the eyes of the be holder ~
What Is Batista Operation???
The Batista Operation~
Dateline: 05/25/97
There has been so much media-hype about the innovative heart operation first performed by Dr.Randas Batista, that I thought an article on this procedure wouldn't be out of place on a site dealing with heart disease. So here goes.....
The Batista operation is a daring, innovative application of one of the basic physiologic tenets of cardiovascular medicine to the treatment of the difficult problem of end-stage heart failure. To understand the thinking and logic behind the operation, we first need to review cardiac physiology briefly.
The Batista Operation - What is it ?
The Batista Operation is technically called a REDUCTION LEFT VENTRICULOPLASTY. It is an open-heart operation performed with the aid of a heart lung machine to maintain circulation while the heart is stopped. The essence of the procedure is to remove a wedge of left ventricle muscle (weighing about 40 to as much as 250 grams) and stitch together the two edges of the ventricle. In this manner the size of the left ventricle is reduced, and the ventricle is remodelled as well.
In addition, sometimes, the mitral valve (which lies between the left ventricle and left atrium) may need to be removed and replaced with an artificial valve. In patients who have heart rhythm disturbances as well, an artificial implantable defibrillator device may be implanted. If the coronary arteries are diseased, they may be grafted too (CABG operation).
Theoretic basis of Batista Operation
In left ventricular failure, the muscle cells in the wall of the left ventricle have been stretched beyond physiologic limits, and Starling's law is no longer applicable. The Batista operation, by removing a wedge of the ventricular wall, reduces the circumference of the ventricle, and the size of the ventricle cavity. The individual muscle fibers are thus restored to their normal length, and now come within the physiologic limit. They thus function more effectively in pumping out blood. And in this way, heart failure is relieved !
In such a paradoxic manner, thus, removal of heart muscle tissue actually HELPS the heart pump more effectively. A radical concept indeed, the application of which Dr.Batista is to be commended for.
Who will benefit from the Batista Operation ?
The operation as described above is a radical departure from conventional thinking. Removal of too much muscle can weaken the heart and hasten death. It perhaps has the most potential benefit for patients with terminal heart failure caused by a disease of heart muscle (cardiomyopathy) and with a dilated left ventricle, who are not adequately palliated by medication and are awaiting a heart transplant.
Is the Batista Operation then the alternative to heart transplantation that it is much touted to be ?
Certainly not. While the media hype has projected the operation to be an alternative to heart transplantation, the results so far are NOT supportive of such a conclusion. Of Dr.Batista's original series, over 60% of patients were dead within two years of the operation. Dr.Batista himself is very conservative in his forecast for the role of the procedure. It certainly helps most patients for some time. In a potential heart transplant candidate, the Batista Operation buys some time, to allow a more suitable and better matched donor heart to be found. It thus may be a useful "bridge to transplantation".
Today, the only other alternative "bridge to transplant" is the use of a ventricular assist device (VAD). This is an extremely expensive option, and has a lot of complications and morbidity. The Batista operation may be an alternative to a VAD in such a setting. Ultimate heart transplantation however still remains an eventuality to be faced.
What is the role of the Batista Operation in the future ?
The answer is not yet known. Scientific analysis of data from patients who have undergone this procedure is still in a very premature stage. Without longer term follow up and extensive analyses of different factors, the ultimate place of the Batista procedure in the management of heart failure cannot be determined. But with the extensive use of this option for different stages and types of heart failure, such data will soon be available. Dr.Batista's unique innovation, flying in the face of conventional thinking, has set the world of cardiac surgery on fire, and forced a re-thinking of basic physiologic tenets. And perhaps this turmoil will turn up more exciting and useful information as well.
Dateline: 05/25/97
There has been so much media-hype about the innovative heart operation first performed by Dr.Randas Batista, that I thought an article on this procedure wouldn't be out of place on a site dealing with heart disease. So here goes.....
The Batista operation is a daring, innovative application of one of the basic physiologic tenets of cardiovascular medicine to the treatment of the difficult problem of end-stage heart failure. To understand the thinking and logic behind the operation, we first need to review cardiac physiology briefly.
The Batista Operation - What is it ?
The Batista Operation is technically called a REDUCTION LEFT VENTRICULOPLASTY. It is an open-heart operation performed with the aid of a heart lung machine to maintain circulation while the heart is stopped. The essence of the procedure is to remove a wedge of left ventricle muscle (weighing about 40 to as much as 250 grams) and stitch together the two edges of the ventricle. In this manner the size of the left ventricle is reduced, and the ventricle is remodelled as well.
In addition, sometimes, the mitral valve (which lies between the left ventricle and left atrium) may need to be removed and replaced with an artificial valve. In patients who have heart rhythm disturbances as well, an artificial implantable defibrillator device may be implanted. If the coronary arteries are diseased, they may be grafted too (CABG operation).
Theoretic basis of Batista Operation
In left ventricular failure, the muscle cells in the wall of the left ventricle have been stretched beyond physiologic limits, and Starling's law is no longer applicable. The Batista operation, by removing a wedge of the ventricular wall, reduces the circumference of the ventricle, and the size of the ventricle cavity. The individual muscle fibers are thus restored to their normal length, and now come within the physiologic limit. They thus function more effectively in pumping out blood. And in this way, heart failure is relieved !
In such a paradoxic manner, thus, removal of heart muscle tissue actually HELPS the heart pump more effectively. A radical concept indeed, the application of which Dr.Batista is to be commended for.
Who will benefit from the Batista Operation ?
The operation as described above is a radical departure from conventional thinking. Removal of too much muscle can weaken the heart and hasten death. It perhaps has the most potential benefit for patients with terminal heart failure caused by a disease of heart muscle (cardiomyopathy) and with a dilated left ventricle, who are not adequately palliated by medication and are awaiting a heart transplant.
Is the Batista Operation then the alternative to heart transplantation that it is much touted to be ?
Certainly not. While the media hype has projected the operation to be an alternative to heart transplantation, the results so far are NOT supportive of such a conclusion. Of Dr.Batista's original series, over 60% of patients were dead within two years of the operation. Dr.Batista himself is very conservative in his forecast for the role of the procedure. It certainly helps most patients for some time. In a potential heart transplant candidate, the Batista Operation buys some time, to allow a more suitable and better matched donor heart to be found. It thus may be a useful "bridge to transplantation".
Today, the only other alternative "bridge to transplant" is the use of a ventricular assist device (VAD). This is an extremely expensive option, and has a lot of complications and morbidity. The Batista operation may be an alternative to a VAD in such a setting. Ultimate heart transplantation however still remains an eventuality to be faced.
What is the role of the Batista Operation in the future ?
The answer is not yet known. Scientific analysis of data from patients who have undergone this procedure is still in a very premature stage. Without longer term follow up and extensive analyses of different factors, the ultimate place of the Batista procedure in the management of heart failure cannot be determined. But with the extensive use of this option for different stages and types of heart failure, such data will soon be available. Dr.Batista's unique innovation, flying in the face of conventional thinking, has set the world of cardiac surgery on fire, and forced a re-thinking of basic physiologic tenets. And perhaps this turmoil will turn up more exciting and useful information as well.
Situs Inversus~
Definition:
Situs inversus is a condition in which the organs of the chest and abdomen are arranged in a perfect mirror image reversal of the normal positioning.
Description:
Normal human development results in an asymmetrical arrangement of the organs within the chest and abdomen. Typically, the heart lies on the left side of the body (levocardia), the liver and spleen lie on the right, and the lung on the left has two lobes while the lung on the right has three lobes. This normal arrangement is known as situs solitus.
However, in about 1 in 8,500 people, the organs of the chest and abdomen are arranged in the exact opposite position: the heart is on the right (dextrocardia), as is the two-lobed lung, and the liver, spleen, and three-lobed lung are on the left. Yet because this arrangement, called situs inversus, is a perfect mirror image, the relationship between the organs is not changed, so functional problems rarely occur.
Causes and symptoms:
Early in the normal development of an embryo, the tube-like structure that becomes the heart forms a loop toward the left, identifying the left/right axis along which the other organs should be positioned. Although the mechanism that causes the heart loop to go left is not fully understood, at least one gene has been identified to have a role in this process. However, it is thought that many factors may be involved in causing situs inversus. Rarely, situs inversus can run in families, but most often it is an isolated and accidental event occurring in an individual for the first time in the family.
Most people with situs inversus have no medical symptoms or complications resulting from the condition. Although only 3-5% of people with situs inversus have any type of functional heart defect, this is higher than the rate of heart defects in the general population, which is less than 1%.
It is estimated that about 25% of people with situs inversus have an underlying condition called primary ciliary dyskinesia (PCD). PCD, also known as Kartagener's syndrome, is characterized as situs inversus, chronic sinus infections, increased mucous secretions from the lungs, and increased susceptibility to respiratory infections. PCD is caused by a defect in the cilia that impairs their normal movements.
Diagnosis:
Situs inversus should detected by a thorough physical examination. It is often picked up when a physician, using a stethoscope, hears otherwise normal heart sounds on the right side of the body instead of the left. To confirm the a suspected diagnosis of situs inversus, imaging studies such as MRI, CT, or ultrasound may be ordered, and a referral may be made to a cardiologist or internist for completeness. Imaging studies will also rule out the possibility of random arrangement of the organs, or heterotaxy, which has a much higher risk for serious medical complications.
Treatment:
There is no treatment for situs inversus. In the unlikely case that a heart defect is present, it should be treated accordingly by a cardiologist.
Individuals who have situs inversus should be sure to inform all physicians involved in their medical care. In addition to preventing unnecessary confusion, this will reduce the risk of missing a crucial diagnosis that presents with location-specific symptoms (such as appendicitis).
Alternative treatment:
Not applicable.
Prognosis:
The prognosis for an individual with situs inversus is good, and in the absence of a heart defect or other underlying diagnosis, life expectancy is normal.
Prevention:
There is no known method of preventing situs inversus.
■dextrocardia with right aorta
■cardiac malformations
■vascular malformations
complete visceral heterotaxy (mirror image)~
■trilobar left lung
■bilobar right lung
■left liver
■inversed stomach
■right spleen
Associations:
renal malformations
■renal agenesis
■non-obstructive renal dysplasia
■bilateral renal dysplasia (12605452)
■multicytic kidneys (polycyctic kidneys)
■renal ectopia
■horseshoe kidney,
■renal hypoplasia (15877680)
renal cell carcinoma
situs inversus totalis with reno-pancreatic dysplasia (10678653, 9934983)
congenital pancreatic fibrosis (pancreatic dysplasia)
congenital hepatic fibrosis
short rib polydactyly syndromes (1481807, 1519646)
■short rib polydactyly syndrome type 3 (1481807)
NB: Children with situs inversus totalis have a much lower risk of cardiovascular malformations (3–9%) than children with situs ambiguus (over 80%). The risk of cardiovascular malformations in situs inversus totalis (3–9%) is higher than in the normal situation, situs solitus (0.6%).
Situs inversus is a condition in which the organs of the chest and abdomen are arranged in a perfect mirror image reversal of the normal positioning.
Description:
Normal human development results in an asymmetrical arrangement of the organs within the chest and abdomen. Typically, the heart lies on the left side of the body (levocardia), the liver and spleen lie on the right, and the lung on the left has two lobes while the lung on the right has three lobes. This normal arrangement is known as situs solitus.
However, in about 1 in 8,500 people, the organs of the chest and abdomen are arranged in the exact opposite position: the heart is on the right (dextrocardia), as is the two-lobed lung, and the liver, spleen, and three-lobed lung are on the left. Yet because this arrangement, called situs inversus, is a perfect mirror image, the relationship between the organs is not changed, so functional problems rarely occur.
Causes and symptoms:
Early in the normal development of an embryo, the tube-like structure that becomes the heart forms a loop toward the left, identifying the left/right axis along which the other organs should be positioned. Although the mechanism that causes the heart loop to go left is not fully understood, at least one gene has been identified to have a role in this process. However, it is thought that many factors may be involved in causing situs inversus. Rarely, situs inversus can run in families, but most often it is an isolated and accidental event occurring in an individual for the first time in the family.
Most people with situs inversus have no medical symptoms or complications resulting from the condition. Although only 3-5% of people with situs inversus have any type of functional heart defect, this is higher than the rate of heart defects in the general population, which is less than 1%.
It is estimated that about 25% of people with situs inversus have an underlying condition called primary ciliary dyskinesia (PCD). PCD, also known as Kartagener's syndrome, is characterized as situs inversus, chronic sinus infections, increased mucous secretions from the lungs, and increased susceptibility to respiratory infections. PCD is caused by a defect in the cilia that impairs their normal movements.
Diagnosis:
Situs inversus should detected by a thorough physical examination. It is often picked up when a physician, using a stethoscope, hears otherwise normal heart sounds on the right side of the body instead of the left. To confirm the a suspected diagnosis of situs inversus, imaging studies such as MRI, CT, or ultrasound may be ordered, and a referral may be made to a cardiologist or internist for completeness. Imaging studies will also rule out the possibility of random arrangement of the organs, or heterotaxy, which has a much higher risk for serious medical complications.
Treatment:
There is no treatment for situs inversus. In the unlikely case that a heart defect is present, it should be treated accordingly by a cardiologist.
Individuals who have situs inversus should be sure to inform all physicians involved in their medical care. In addition to preventing unnecessary confusion, this will reduce the risk of missing a crucial diagnosis that presents with location-specific symptoms (such as appendicitis).
Alternative treatment:
Not applicable.
Prognosis:
The prognosis for an individual with situs inversus is good, and in the absence of a heart defect or other underlying diagnosis, life expectancy is normal.
Prevention:
There is no known method of preventing situs inversus.
cardiovascular anomalies~
■cardiac malformations
■vascular malformations
complete visceral heterotaxy (mirror image)~
■trilobar left lung
■bilobar right lung
■left liver
■inversed stomach
■right spleen
Associations:
renal malformations
■renal agenesis
■non-obstructive renal dysplasia
■bilateral renal dysplasia (12605452)
■multicytic kidneys (polycyctic kidneys)
■renal ectopia
■horseshoe kidney,
■renal hypoplasia (15877680)
renal cell carcinoma
situs inversus totalis with reno-pancreatic dysplasia (10678653, 9934983)
congenital pancreatic fibrosis (pancreatic dysplasia)
congenital hepatic fibrosis
short rib polydactyly syndromes (1481807, 1519646)
■short rib polydactyly syndrome type 3 (1481807)
NB: Children with situs inversus totalis have a much lower risk of cardiovascular malformations (3–9%) than children with situs ambiguus (over 80%). The risk of cardiovascular malformations in situs inversus totalis (3–9%) is higher than in the normal situation, situs solitus (0.6%).
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