Ilan ang sulok ng hugis parisukat?

Activity No. 4 : 8 Different Types of Questions

Chapter One: Management Today The challenges of working in the new economy recognize: 1.1 Working Today Talent Talented people- What they know, what they learn and what they can achive The source of organisational performance Develop skills and improve What is intellectual capital The combined brain power and shared knowledge of an organization's employees TO orginzations: Intellectual capital resents a strategic asset as human creativity, insight and decision making can be converted into superior performance To individuals: Intellectual capital is a personal asset, one to be nurtured and continually updated Things evolve, make sure we keep updated Intellectual capital: The package on intellect skills and capabilities that set us apart making us valable to potential employers Maintaining your talent: There is no escaping the fact that your career success will require a lot of initiative, self awareness and continuous learning Technology Tech is in our everyday lives Latest developments Smart phone, smart apparel, smart cars, smart homes We struggle to keep up with social media ana staying connected with messaging, full of email and voicemail What happenings as younger workers advance into management Flexibility Work ethic It is critical to build and maintain a high Tech IQ! What is Tech IQ: The ability to use current technologies at work and in your personal life, combined with the commitment to keep yourself updated as technology continues to evolve Intellectual capi5la is a combination of: Commitment x Competency = Intellectual capital How to make the world a better place Globalisation The worldwide interdependence of resources flows, product markets and business competition Under the influence, government leaders worry and about the competitiveness of nations just as corporate leaders worry about business competitiveness Emerging markets will power global growth over the next 20 years. By 2025 overall global consumption is forecast to reach $62 trillion, twice its 2013 level and fully half of this increase will come from the emerging world Consequence: Going to fast in uses resources, inflation, corporate greed It's cheaper to have things made in different countries (wages are low and going down) Shamrock organization 1 leaf - full time employees- standard career paths 2 leaf - “freelancers” 3 leaf - Part times without benefits (first to lose their jobs when employers face economic difficulties) The rising of emerging markets Now account for 60% of all low and medium technology manufacturing worldwide Total value add in high tech manufacturing from a low 26% in the 1970s to 48% at present China strategy to upgrade its industries and move the manufacturing value ching by prioritising 10 sectors Information technology, robotic, aerospace, maritime equipment, modern railway equipment, alternative energy vehicles, power equipment, agriculture equipment, advanced materials, biopharma and medical products Ethics A code of moral principa;s that sets standards for conduct that is “good” and “right” as well as “bad” and “wrong” Enron company huge corruption even in elections same thing happened with The Mechanism 1.2 - Organizations Organizational Purpose An orgnizations is a collection of people working together to achieve a common purpose Unique social phenomenon that enables its members to perform tasks far beyond the reach of individual accomplishment (synergy) The broad purpose of any orginzation is to provide goods or services of value to customers and clients A clear sense of purpose tied to: Quality of products and services Customer satisfaction Social responsibility Can be an important source of organisational strength and performance advantage All organisations are open systems (Systems that interact with its environment for renewal and growth) Organizations as systems All organizations are open systems that interact with their environment Continual process of obtaining resource inputs-people, information, resources and capital- and transforming them into outputs in the form of finished goods and services for customers One simple way to assess the impact of any organisation is to ask the question: How is the world different because it existed Value Creation: Organisations create value when they use resources well to produce good products and take care of their customers One simple way to assess the impact of any organization is to ask the questions: How is the world different because it existed? The 3 Ps of organizational performance Profit - is the decision economically sound? People - Does the decision treat people with respect and dignity? Planet - Is the decision good for the environment? Productivity: An overall measure of the quantity and quality of work performance with recourse utilisation taken into account Performance effectiveness: An output measure of task or goal accomplishment Performance efficiency: An input measure of the resource costs associated with goal accomplishment. Workplace changes that impact management Focus on valuing human capital Demise of “Command and control” Emphasis on teamwork Pre-eminence of technology New workforce expectations Importance of networking Concern for sustainability 1.3 Managers Importance of human resources and manger People are not ‘costs to be controlled’ High performing organizations treat people as valuable strategic assets Three takeaways 1. Give leaders broad authority 2. Encourage them to think like CEO 3. Challenge strong performers ealy with big opportunities Direct support, supervise and help activate the work efforts of others The people who managers help are the ones whose contributions represent the real work of the organisation Types of managers Line managers are responsible for work activities that directly affect organization’s output Staff managers use technical expertise to advise and support the efforts of line workers Functional managers are responsible for a single area of activity Quality of work life (QWL) An indicator of the overall quality of human experiences in the workplace QWL Indicators Respect Fair pay Safe working conditions Opportunities to learn and use new skills Room to grow and progress in a career Protection of individuals rights The organization as an upside-down pyramid A manager’s job is to support worker’s efforts The best managers are known for helping and supporting Customers at the top served by worker who are supported by managers 1.4 The management Process Managers achieve high performance for their organizations by best utilizing its humans and material resources Management is the process of planning, organizing, leading and controlling the use of resources to accomplish performance goals All managers are responsible for the four functions The functions are carried on continually Characteristics of managerial work Long hours Intense pace Fragmented and varied tasks Many communication media Filled with interpersonal relationships Managerial agendas and networks Agenda setting Develops action priorities for accomplishing goals and plans Networking Process of building and maintaining positive relationships with people who can help advance agendas Social Capital Capacity to attract support and help from others Learning The change in a behaviour that results from experience Lifelong learning The process of continuously learning from daily experiences and opportunities

The challenges of working in the new economy recognize: 1.1 Working Today Talent Talented people- What they know, what they learn and what they can achive The source of organisational performance Develop skills and improve What is intellectual capital The combined brain power and shared knowledge of an organization's employees TO orginzations: Intellectual capital resents a strategic asset as human creativity, insight and decision making can be converted into superior performance To individuals: Intellectual capital is a personal asset, one to be nurtured and continually updated Things evolve, make sure we keep updated Intellectual capital: The package on intellect skills and capabilities that set us apart making us valable to potential employers Maintaining your talent: There is no escaping the fact that your career success will require a lot of initiative, self awareness and continuous learning Technology Tech is in our everyday lives Latest developments Smart phone, smart apparel, smart cars, smart homes We struggle to keep up with social media ana staying connected with messaging, full of email and voicemail What happenings as younger workers advance into management Flexibility Work ethic It is critical to build and maintain a high Tech IQ! What is Tech IQ: The ability to use current technologies at work and in your personal life, combined with the commitment to keep yourself updated as technology continues to evolve Intellectual capi5la is a combination of: Commitment x Competency = Intellectual capital How to make the world a better place Globalisation The worldwide interdependence of resources flows, product markets and business competition Under the influence, government leaders worry and about the competitiveness of nations just as corporate leaders worry about business competitiveness Emerging markets will power global growth over the next 20 years. By 2025 overall global consumption is forecast to reach $62 trillion, twice its 2013 level and fully half of this increase will come from the emerging world Consequence: Going to fast in uses resources, inflation, corporate greed It's cheaper to have things made in different countries (wages are low and going down) Shamrock organization 1 leaf - full time employees- standard career paths 2 leaf - “freelancers” 3 leaf - Part times without benefits (first to lose their jobs when employers face economic difficulties) The rising of emerging markets Now account for 60% of all low and medium technology manufacturing worldwide Total value add in high tech manufacturing from a low 26% in the 1970s to 48% at present China strategy to upgrade its industries and move the manufacturing value ching by prioritising 10 sectors Information technology, robotic, aerospace, maritime equipment, modern railway equipment, alternative energy vehicles, power equipment, agriculture equipment, advanced materials, biopharma and medical products Ethics A code of moral principa;s that sets standards for conduct that is “good” and “right” as well as “bad” and “wrong” Enron company huge corruption even in elections same thing happened with The Mechanism 1.2 - Organizations Organizational Purpose An orgnizations is a collection of people working together to achieve a common purpose Unique social phenomenon that enables its members to perform tasks far beyond the reach of individual accomplishment (synergy) The broad purpose of any orginzation is to provide goods or services of value to customers and clients A clear sense of purpose tied to: Quality of products and services Customer satisfaction Social responsibility Can be an important source of organisational strength and performance advantage All organisations are open systems (Systems that interact with its environment for renewal and growth) Organizations as systems All organizations are open systems that interact with their environment Continual process of obtaining resource inputs-people, information, resources and capital- and transforming them into outputs in the form of finished goods and services for customers One simple way to assess the impact of any organisation is to ask the question: How is the world different because it existed Michal Porter - Value Chain Value Creation: Organisations create value when they use resources well to produce good products and take care of their customers One simple way to assess the impact of any organization is to ask the questions: How is the world different because it existed? Triple Bottom Line The 3 Ps of organizational performance Profit - is the decision economically sound? People - Does the decision treat people with respect and dignity? Planet - Is the decision good for the environment? Organizational Performance Productivity: An overall measure of the quantity and quality of work performance with recourse utilisation taken into account Performance effectiveness: An output measure of task or goal accomplishment Performance efficiency: An input measure of the resource costs associated with goal accomplishment. Workplace changes that impact management Focus on valuing human capital Demise of “Command and control” Emphasis on teamwork Pre-eminence of technology New workforce expectations Importance of networking Concern for sustainability 1.3 Managers Importance of human resources and manger People are not ‘costs to be controlled’ High performing organizations treat people as valuable strategic assets Three takeaways 1. Give leaders broad authority 2. Encourage them to think like CEO 3. Challenge strong performers easily with big opportunities Direct support, supervise and help activate the work efforts of others The people who managers help are the ones whose contributions represent the real work of the organisation Levels of management Types of managers Line managers are responsible for work activities that directly affect organization’s output Staff managers use technical expertise to advise and support the efforts of line workers Functional managers are responsible for a single area of activity Quality of work life (QWL) An indicator of the overall quality of human experiences in the workplace QWL Indicators Respect Fair pay Safe working conditions Opportunities to learn and use new skills Room to grow and progress in a career Protection of individuals rights The organization as an upside-down pyramid A manager’s job is to support worker’s efforts The best managers are known for helping and supporting Customers at the top served by worker who are supported by managers 1.4 The management Process Managers achieve high performance for their organizations by best utilizing its humans and material resources Management is the process of planning, organizing, leading and controlling the use of resources to accomplish performance goals All managers are responsible for the four functions The functions are carried on continually Four functions: Planning,organizing, leading and controlling Mintzberg’s 10 Managerial Roles Characteristics of managerial work Long hours Intense pace Fragmented and varied tasks Many communication media Filled with interpersonal relationships Managerial agendas and networks Agenda setting Develops action priorities for accomplishing goals and plans Networking Process of building and maintaining positive relationships with people who can help advance agendas Social Capital Capacity to attract support and help from others Learning The change in a behaviour that results from experience Lifelong learning The process of continuously learning from daily experiences and opportunities Katz’ Essential Managerial Skills

ACTIVITY NO. 4 IN PR1 MOD 8,9,10

Title (Slide 0): "Digging Deeper: The Truth About Tillage" Subtitle: How turning the soil affects plants, microbes, and the planet Slide 1: What Is Tillage? Tilling the soil means digging, turning, and loosening it using tools or machines. It's a common farming practice to prepare the land before planting. Slide 2: Why Do Farmers Till? Tillage is usually done before planting to: • Soften and aerate the soil • Mix in nutrients • Remove weeds • Bury crop residues for decomposition and fertility Slide 3: Tools Used for Tillage Farmers use tools like: • Ploughs: Cut deep into the soil • Harrows: Break up clumps and smooth the surface Slide 4: Ploughs vs. Harrows • Ploughs: Used first, go deep, lift and flip soil • Harrows: Used after ploughs, work on the surface to break clumps and level the soil Slide 5: Types of Tillage Systems From most to least soil disturbance: • Conventional Tillage: Deep ploughing • Minimum Tillage: Light disturbance • Conservation Tillage: Only disturb seed zone, keep residues on top • Zero Tillage (No-Till): Plant directly into undisturbed soil Slide 6: Problem 1 – Soil Erosion Tillage removes protective cover, exposing soil to wind and rain. Result: topsoil—the most fertile layer—is easily washed or blown away. Slide 7: Problem 2 – Disruption of Soil Life Soil is a living ecosystem! • Worms, fungi, and bacteria help aerate soil and release nutrients • Tillage destroys their habitat, reducing fertility and soil health Slide 8: Problem 3 – Loss of Soil Structure Healthy soil has pores for air, water, and roots. Tillage breaks the sponge-like structure, and soil compacts over time—like flattening it into a pancake. Hard soil = poor plant growth. Slide 9: Problem 4 – Decreased Organic Matter Microbes "eat" organic matter through aerobic respiration (using O₂ and releasing CO₂). Tillage adds oxygen, microbes speed up, and burn through the soil’s “pantry” of organic matter—leaving it empty and poor. Slide 10: Problem 5 – Greenhouse Gas Emissions Faster decomposition = more CO₂ released. Tillage boosts microbial activity, which increases carbon dioxide emissions—contributing to climate change. ✅ Conclusion (Slide 11): 🌱 Tillage: A Double-Edged Tool Tillage can help prepare the soil and control weeds—but it comes at a cost. Over time, repeated tilling can strip away organic matter, destroy soil life, and release greenhouse gases. It's like spending all your savings for quick results—and being left with nothing for the future. The smarter path? Use reduced or no-till methods that protect soil health, keep carbon in the ground, and support long-term farming success.

hysical features of Southeast Asia The physiography of Southeast Asia has been formed to a large extent by the convergence of three of the Earth’s major crustal units: the Eurasian, Indian-Australian, and Pacific plates. The land has been subjected to a considerable amount of faulting, folding, uplifting, and volcanic activity over geologic time, and much of the region is mountainous. There are marked structural differences between the mainland and insular portions of the region. Mainland Southeast Asia The mainland is characterized by a series of generally north–south-trending mountain ranges separated by a number of major river valleys and their associated deltas. In many ways these ranges resemble ribs in a fan, where the interstices are deep trenches carved by the rivers. Although the mainland as a whole is similar in a structural sense, its various geologic components and the time periods of their orogenic (mountain-building) episodes differ. Much of the region has been affected by the gradual, continuing collision of the Indian subcontinent with the Eurasian Plate over roughly the past 50 million years, an event that—with diminishing intensity from west to east—has been responsible for deforming the land. Nonetheless, mainland Southeast Asia is relatively stable geologically, with no active or recently active volcanoes and, except in the northwest and north, little seismic activity. The ranges fan out southward from the southeastern corner of the Plateau of Tibet, where they are tightly spaced. A major rib of this system extends through the entire western margin of Myanmar (Burma); describing an elongated letter S, it consists of (from north to south) the Pātkai Range, Nāga Hills, Chin Hills, and Arakan Mountains. Farther to the south the same rib emerges from beneath the sea to become the Andaman and Nicobar Islands of India. Another major system extends along a straight north-south axis from eastern Myanmar east of the Salween River through northwestern Thailand to south of the Isthmus of Kra on the Malay Peninsula. It consists of a series of elongated blocks rather than one continuous ridge. The core of these blocks is granite, which has intruded into previously folded and faulted limestone and sandstone. The altitudes of the ranges diminish from above 8,000 feet (2,440 meters) on the Chinese border in the north to below 4,000 feet on the Isthmus of Kra, and the ranges are spread farther apart toward the south. The easternmost major mountain feature on the mainland is the Annamese Cordillera (Chaîne Annamitique) in Laos and Vietnam. In the portion between Laos and Vietnam, the chain forms a nearly straight spine of ranges from northwest to southeast, with a steep face rising from the South China Sea to the east and a more gradual slope to the west. The mountains thin out considerably south of Laos and become asymmetrical in form. The upland zone is characterized by a number of plateau remnants. The rather neat fanlike pattern of the mountain ranges is interrupted occasionally by several old blocks of strata that have been folded, faulted, and deeply dissected. These ancient massifs now form either low platforms or high plateaus. The westernmost of these, the Shan Plateau of eastern Myanmar, measures some 250 miles (400 km) from north to south and 75 miles from east to west and has an average elevation of about 3,000 feet. The largest of these features is the Korat Plateau in eastern Thailand and west-central Laos. This area actually is more of a low platform, which on average is only a few hundred feet above the floodplains of the surrounding rivers. It consists of a string of hills that direct surface drainage eastward to the Mekong River. The hills range in elevation from 500 to 2,000 feet, with the highest altitudes occurring near the southwestern rim. The broad river valleys between the uplands and the even wider deltas at the southernmost points contain most of the mainland’s lowland areas. These regions generally are covered with alluvial sediments that support much of the mainland’s cultivation and, in turn, most of its population centers. The most extensive coastal lowland is the lower Mekong basin, which encompasses most of Cambodia and southern Vietnam. The Cambodian portion is a broad, bowl-shaped area lying just above sea level, with numerous hill outcrops jutting above the landscape; at its center is a large freshwater lake, the Tonle Sap. To the south the river’s vast, flat delta occupies the entire southern tip of Vietnam. Outside the river deltas, the coastal lowlands are little more than narrow strips between the mountains and the sea, except around the southern half of the Malay Peninsula. The Malay Peninsula stretches south for some 900 miles from the head of the Gulf of Thailand (Siam) to Singapore and thus extends the mainland into insular Southeast Asia. The narrowest point, the Isthmus of Kra (about 40 miles wide), also roughly divides the peninsula into two parts: the long linear mountain ranges of the northern part described above give way just south of the isthmus to blocks of short, parallel ranges aligned north-south, so that the southern portion trends to the southeast and becomes much wider. In areas such as the west coast between southern Thailand and northwestern Malaysia, distinctive karst-limestone landscapes have developed. Peaks on the peninsula range from 5,000 to 7,000 feet in elevation.

[t comes from the GREEK name "Epilepsia" which means "taking hold of or seizing". - It is a disorder characterized by: recurrent seizures. SEIZURES R ectment transient attacks of: R epresent: R esult from: ASSOCIATED WITH: somatic, psychic, or, autonomic clinical featmes. clinical features of abnormally hyperexcitable cortical neurons. paroxvsmal and excessive electrical neuronal discharges. EEG changes & may be disturbance of consciousness. same causes of convulsions 1. Idiopathic epile~ • It is the commonest cause. no cause can be detected ( 65 % ) • It may be associated with positive family history in some cases. • It starts in the l st & 2nd decades in the form of: -- Grand ma! epilepsy. Petit mal epilepsy. Myoclonic epilepsy. Atonic seizures. 2. Secondary epilepsy A. Local causes in the brain: l. Congenital: 2. Traumatic: cerebral palsy. a cause can be detected cerebral contusion or laceration. 3. Inflammatory: 4. Neoplastic: 5. Degenerative: 6. Vascular: encephalitis, brain tumours. mening1t1s, presenile dementia. brain abscess. stroke (especially hemon-hagic), hypertensive encephalopathy. B. General causes with secondary effects on the brain: I. Toxic: 2. Iatrogenic: 3. Metabolic: 4. Endocrinal: 5. Organ failure: 6. Heart disease: 7. Nutritional: - Alcohol, cocaine, lead. - Lidocaine, INH. - j glucose & ! glucose. - Hypoparathyroidism. - Hepatic failme. - Adam's Stoke's attacks. - Pellagra. - Botulism, tetanus. - Ambilhar, Amphetamine, Aminophylline. - j Ca & ! Ca. - Hype1thyroid crisis. - Renal failure. - Fallot's tetralogy. - j Na & ! Na. - Vitamin B6 deficiency. 8. Physical: 9. HYSTERICAL. - High fevers. - Heat stroke. 136 137 CLINICAL PICTURE 1. GENERALISED SEIZURES " Excessive electrical discharges from cortical neurons in BOTH hemispheres simultaneously " I. II. 1. Grand Mal Epile~: 1. Pre-ictal stage "attacks of tonic-clonic convulsions " (aura) It is a warning sign of a coming attack. It may be: • Somatic: • Psychic: • Autonomic: 2. Ictal stage Myoclonus, Hallucinations. Tachycardia, (seizure) Sudden loss of consciousness: Parasthesias. Sweating. for seconds to minutes. -- Tonic phase (few seconds) o The UL & LL: o o o o The HEAD: The JAWS: CYANOSIS: are extended. is retracted to one side & the eye balls rolled up. are firmly clenched, with biting of the TONGUE. due to impaired respiration. There may be incontinence of urine. Clonic phase (few minutes) o The UL & LL: o The HEAD: 3. Post-ictal stage - It may be: • Somatic: • Psychic: • Autonomic: Drug of choice: contract & relax repeatedly & rapidly. jerks forcibly. (sequelae) Todd's paralysis(< 24 hours, due to neuronal exhaustion). Confusion. Vomiting. Carbamazepine (Tegretol) or Phenytoin (Epanutin) Petit Mal Epilepsy: "attacks of loss of consciousness " " Absence " It starts in childhood & improves at puberty & usually disappears at the age of 20. 2. It is NOT PRECEEDED by aura & NOT FOLLOWED by sequelae. 3. It is usually PRECIPITATED by: hyperventilation 4. It is characterized by: or photic stimulation. sudden loss of consciousness of short duration (few seconds). 5. It may be associated with: • High frequency ( 50 attacks / day). • Falling to the ground without warning. • Jerky movements of the head & UL Drug of choice: (myoclonic petit mal). Valproate (Depakine) or Succinimide (Zarontin) 137 138 Ill. M oclonic Seizures: "attacks of involuntary clonic movements " - It is characterized by: sudden, jerky, shock-like INVOLUNTARY muscle contraction. • The jerks are bilateral contractions, mainly of the shoulders and arms. • However, some patients repmtjerking in the lower limbs, trunk, or head. - It may be of 2 types: - Occurs singly • Simple: • As a pait of: I Drug of choice: IV. Atonic seizures: (no loss of consciousness). - Grand mal epilepsy (aura). - Petit mal epilepsy. Valproate (Depakine) or Clonazepam (Rivotril) I - Transient attacks of brief loss of postural tone, often resulting in falls and injuries. 2. PARTIAL SEIZURES "Excessive electrical discharges from cmtical neurons in a ce1tain area in ONE hemisphere" A. Simple seizures: " No disturbance in consciousness " - The CP depends on the site of the hyperexcitable neurones in the cerebral cortex, whether in: "Motor area or Senso,y areas". 1. Motor fits: • Focal fits: • Motor jacksonian fits: 2. General Sensory fits: • Focal fits: • Sensory jacksonian fits: 3. Special Senso1y fits: • Visual hallucinations: • Auditory hallucinations: • Olfactory hallucinations: B. Complex seizures: - SITE: movement of part of a limb or the whole limb. movement of one side of the body (see before). parasthesia of part of a limb or the whole limb. parasthesia of one side of the body (see before). irritation of the visual sensory area. irritation of the auditory sensory area. initation of the uncus. " disturbance in consciousness " The hyperexcitable neurons are in the Temporal lobe "Temporal lobe epilepsy". - DURATION: The seizure lasts few seconds to few minutes. - The seizure starts with A ura, followed by A bsence, Automatism, Amnesia: 1. 2. 3. 4. A ura: A bsence: Automatism: A mnesia: Olfactory hallucinations, Deja-vu phenomenon, Sensation of fear. Absent patient with staring eyes (with no response to conversation). Involuntary Purposeless acts: motor ( eg, lip smacking, chewing) or verbal. No recalling of the seizure. 138 139 3. PARTIAL SEIZURES ~ GENERALISED SEIZURES " Partial seizures may spread to involve the whole brain .- secondarily generalised seizures " . HY-sterical epilepsY • Usually: • The cause: • Incidence: young neurotic Sj2 . psychological & there is no organic lesion. usually occurs in the presence of people. • It is associated with: • EEG: • It is not associated with: normal. • Missed ttt. • Menses. • Alkalosis. anxiety, palpitaion & hyperventilation. tongue biting or incontinence of urine. • Alcohol use & Drug abuse ( e.g. cocaine ). • S timulation by photons & Hyperventilation. • S leep deprivation & Stress & sudden withdrawal of antiepileptic drngs. INVESTIGATIONS 1. EEG: • It is the most specific test for epilepsy because it records the electrical activity of the brain. • It shows specific pattern: 2. LOCAL INVESTIGATIONS: "Epilepsy waves". "CT & MRI of the brain" • To identify or exclude a LOCAL CAUSE of seizures in the brain. 3. GENERAL INVESTIGATIONS: "Laboratory investigations" • To search for a GENERAL CAUSE of seizures, e.g. blood glucose. 139 140 TREATMENT A. General Measures: 1. 2. Moderation of the patient's physical activity. A void the precipitating factors ( Alcohol, hyperventilation, photic stimulation ...... ). 3. A ketogenic diet is encouraged because it will induce acidosis: - Acidosis is beneficial as it raises the threshold of stimulation of the brain cells. B. Specific Treatment: 2. 1. Treatment of the cause in secondary epilepsy. Anti-epileptic drugs: a) Always sta1t with one drug, then add another drug if there is no response. b) Always stop the drugs ONLY if: • The patient stays free of symptoms for at least 2 years. • The patient has a normal EEG. 3. Side effects of Anti-epileptic drugs: I . Skin rash. 2. 3. Bone marrow depression. Ataxia. Drug 1. Barbiturates (Pbenonobarbitone) 2. Hydantoin (Epanutin) 3. Carbamazepine 4. Clonazepam 5. Valproate 6. Succinamide ANTI-EPILEPTIC DRUGS NEW ANTI-EPILEPTIC DRUGS - These drugs are new dtugs that may be used in resistant seizures. 1. Lamotrigine: 200 - 400 mg/ day. 2. Felbamate: 3. Gabapentin: 400- 800 mg/ day. 600 - 1200 mg/ day. \ " General rules for use ": Dose 100-600 mg I day 100-600 mg / day 200-600 mg I day 2-6 mg I day 500-1500 mg I day 500-1000 mg / day Best indicated - Broad spectrum. - Not for petit mal. - Grand mal. - Motor Jacksonian fits. - Grand mal. - Motor Jacksonian fits. - Complex seizures. - Not for petit ma!. - Myoclonic. - Grand mat. - Broad spectrum. - Petit mat. 140 141 STATUS EPILEPTICUS DEFINITION - A medical emergency: 1. Repeated attacks of generalized convulsions, with lack of recove,y of consciousness, 2. Persistent attack of seizure lasting for at least 30 minutes. OR, - If the convulsions are not stopped rapidly, coma deepens & death may occur due to: heart failure or respiratory failure or brain damage or hyperpyrexia. - The most common causes are: sudden withdrawal of anti-epileptic drugs & stroke. TREATMENT A. General Measures: l. Take care of: " ABC " • Place the patient on the ground, to guard against falling from bed. • Mouth gag & 02 inhalation ( endo-tracheal intubation may be needed). • Record the vital signs regularly. 2. Take a sample of: - Venous blood: for the level of: - A.tierial blood: for the level of: 3. a nti-epileptic drugs, a lcohol. pH, p0 2, pC02, HC0 3. Give cerebral dehydrating measures: e.g. Frusemide, cone. Mannitol, Dexamethazone. B. Specific Treatment: - Phenytoin with diazepam (or clonazepam) immediately: 1. Phenytoin: 2. Diazepam: Clonazepam: seizures recur: 15 mg I Kg slow infusion. 5 mg slowly IV, to be repeated after 5 minutes if seizures recur: maximum dose: 20 mg. OR: 2 mg slowly IV, to be repeated after 5 minutes if maximum dose: 6 mg. - If seizures persist after 20 min. of Phenytoin & diazepam: 3. PHENOBARBITONE: - In resistant cases: 200 mg infusion. 4. GENERAL ANAESTHESIA: may be used.

Related quizzes

Related quizzes