The type of connection used in 3-phase motor is called

Delta connection and Star connection

The type of connection used in 3-phase motor is called

Star connection and Delta connection

Delta connection and Star connection

Activity No.3 - 3rd Year - 2nd Semester -2020-2021

Origin recognition ORC,MCM proteins helicase activity, ssDNA RPA, Primer synthesis polymers alpha/primase,Sliding clamp PCNA, primer removal RNase H, FEN1.Pol α/Primase synthesizes an RNA chain of 10 nucleotides followed by another 20 nucleotides of initiator DNA (iDNA). Because Pol α/Primase has no proofreading ability, this whole section of RNA/iDNA is removed. The exonucleases RNase H removes the RNA and Fen1 removed the iDNA. The gap is filled in by Pol δ and DNA ligase joins the 2 ends.Eukaryotic DNA Replication All have 5’ to 3’ Polymerase activity.

“There’s No Such Thing as Sound Science” by By Christie Aschwanden was a lead science writer for FiveThirtyEight. FiveThirtyEight, Science, Dec. 6, 2017 Science is being turned against itself. For decades, its twin ideals of transparency and rigor have been weaponized by those who disagree with results produced by the scientific method. Under the Trump administration, that fight has ramped up again. In a move ostensibly meant to reduce conflicts of interest, Environmental Protection Agency Administrator Scott Pruitt has removed a number of scientists from advisory panels and replaced some of them with representatives from industries that the agency regulates. Like many in the Trump administration, Pruitt has also cast doubt on the reliability of climate science. For instance, in an interview with CNBC, Pruitt said that “measuring with precision human activity on the climate is something very challenging to do.” Similarly, Trump’s pick to head NASA, an agency that oversees a large portion the nation’s climate research, has insisted that research into human influence on climate lacks certainty, and he falsely claimed that “global temperatures stopped rising 10 years ago.” Kathleen Hartnett White, Trump’s nominee to head the White House Council on Environmental Quality, said in a Senate hearing last month that she thinks we “need to have more precise explanations of the human role and the natural role” in climate change. The same entreaties crop up again and again: We need to root out conflicts. We need more precise evidence. What makes these arguments so powerful is that they sound quite similar to the points raised by proponents of a very different call for change that’s coming from within science. This other movement strives to produce more robust, reproducible findings. Despite having dissimilar goals, the two forces espouse principles that look surprisingly alike: Science needs to be transparent. Results and methods should be openly shared so that outside researchers can independently reproduce and validate them. The methods used to collect and analyze data should be rigorous and clear, and conclusions must be supported by evidence. These are the arguments underlying an “open science” reform movement that was created, in part, as a response to a “reproducibility crisis” that has struck some fields of science.1 But they’re also used as talking points by politicians who are working to make it more difficult for the EPA and other federal agencies to use science in their regulatory decision-making, under the guise of basing policy on “sound science.” Science’s virtues are being wielded against it. What distinguishes the two calls for transparency is intent: Whereas the “open science” movement aims to make science more reliable, reproducible and robust, proponents of “sound science” have historically worked to amplify uncertainty, create doubt and undermine scientific discoveries that threaten their interests. “Our criticisms are founded in a confidence in science,” said Steven Goodman, co-director of the Meta-Research Innovation Center at Stanford and a proponent of open science. “That’s a fundamental difference — we’re critiquing science to make it better. Others are critiquing it to devalue the approach itself.” Calls to base public policy on “sound science” seem unassailable if you don’t know the term’s history. The phrase was adopted by the tobacco industry in the 1990s to counteract mounting evidence linking secondhand smoke to cancer. A 1992 Environmental Protection Agency report identified secondhand smoke as a human carcinogen, and Philip Morris responded by launching an initiative to promote what it called “sound science.” In an internal memo, Philip Morris vice president of corporate affairs Ellen Merlo wrote that the program was designed to “discredit the EPA report,” “prevent states and cities, as well as businesses from passing smoking bans” and “proactively” pass legislation to help their cause. The sound science tactic exploits a fundamental feature of the scientific process: Science does not produce absolute certainty. Contrary to how it’s sometimes represented to the public, science is not a magic wand that turns everything it touches to truth. Instead, it’s a process of uncertainty reduction, much like a game of 20 Questions. Any given study can rarely answer more than one question at a time, and each study usually raises a bunch of new questions in the process of answering old ones. “Science is a process rather than an answer,” said psychologist Alison Ledgerwood of the University of California, Davis. Every answer is provisional and subject to change in the face of new evidence. It’s not entirely correct to say that “this study proves this fact,” Ledgerwood said. “We should be talking instead about how science increases or decreases our confidence in something.” The tobacco industry’s brilliant tactic was to turn this baked-in uncertainty against the scientific enterprise itself. While insisting that they merely wanted to ensure that public policy was based on sound science, tobacco companies defined the term in a way that ensured that no science could ever be sound enough. The only sound science was certain science, which is an impossible standard to achieve. “Doubt is our product,” wrote one employee of the Brown & Williamson tobacco company in a 1969 internal memo. The note went on to say that doubt “is the best means of competing with the ‘body of fact’” and “establishing a controversy.” These strategies for undermining inconvenient science were so effective that they’ve served as a sort of playbook for industry interests ever since, said Stanford University science historian Robert Proctor. The sound science push is no longer just Philip Morris sowing doubt about the links between cigarettes and cancer. It’s also a 1998 action plan by the American Petroleum Institute, Chevron and Exxon Mobil to “install uncertainty” about the link between greenhouse gas emissions and climate change. It’s industry-funded groups’ late-1990s effort to question the science the EPA was using to set fine-particle-pollution air-quality standards that the industry didn’t want. And then there was the more recent effort by Dow Chemical to insist on more scientific certainty before banning a pesticide that the EPA’s scientists had deemed risky to children. Now comes a move by the Trump administration’s EPA to repeal a 2015 rule on wetlands protection by disregarding particular studies. (To name just a few examples.) Doubt merchants aren’t pushing for knowledge, they’re practicing what Proctor has dubbed “agnogenesis” — the intentional manufacture of ignorance. This ignorance isn’t simply the absence of knowing something; it’s a lack of comprehension deliberately created by agents who don’t want you to know, Proctor said.2 In the hands of doubt-makers, transparency becomes a rhetorical move. “It’s really difficult as a scientist or policy maker to make a stand against transparency and openness, because well, who would be against it?” said Karen Levy, researcher on information science at Cornell University. But at the same time, “you can couch everything in the language of transparency and it becomes a powerful weapon.” For instance, when the EPA was preparing to set new limits on particulate pollution in the 1990s, industry groups pushed back against the research and demanded access to primary data (including records that researchers had promised participants would remain confidential) and a reanalysis of the evidence. Their calls succeeded and a new analysis was performed. The reanalysis essentially confirmed the original conclusions, but the process of conducting it delayed the implementation of regulations and cost researchers time and money. Delay is a time-tested strategy. “Gridlock is the greatest friend a global warming skeptic has,” said Marc Morano, a prominent critic of global warming research and the executive director of ClimateDepot.com, in the documentary “Merchants of Doubt” (based on the book by the same name). Morano’s site is a project of the Committee for a Constructive Tomorrow, which has received funding from the oil and gas industry. “We’re the negative force. We’re just trying to stop stuff.” Some of these ploys are getting a fresh boost from Congress. The Data Quality Act (also known as the Information Quality Act) was reportedly written by an industry lobbyist and quietly passed as part of an appropriations bill in 2000. The rule mandates that federal agencies ensure the “quality, objectivity, utility, and integrity of information” that they disseminate, though it does little to define what these terms mean. The law also provides a mechanism for citizens and groups to challenge information that they deem inaccurate, including science that they disagree with. “It was passed in this very quiet way with no explicit debate about it — that should tell you a lot about the real goals,” Levy said. But what’s most telling about the Data Quality Act is how it’s been used, Levy said. A 2004 Washington Post analysis found that in the 20 months following its implementation, the act was repeatedly used by industry groups to push back against proposed regulations and bog down the decision-making process. Instead of deploying transparency as a fundamental principle that applies to all science, these interests have used transparency as a weapon to attack very particular findings that they would like to eradicate. Now Congress is considering another way to legislate how science is used. The Honest Act, a bill sponsored by Rep. Lamar Smith of Texas,3 is another example of what Levy calls a “Trojan horse” law that uses the language of transparency as a cover to achieve other political goals. Smith’s legislation would severely limit the kind of evidence the EPA could use for decision-making. Only studies whose raw data and computer codes were publicly available would be allowed for consideration. That might sound perfectly reasonable, and in many cases it is, Goodman said. But sometimes there are good reasons why researchers can’t conform to these rules, like when the data contains confidential or sensitive medical information.4 Critics, which include more than a dozen scientific organizations, argue that, in practice, the rules would prevent many studies from being considered in EPA reviews.5 It might seem like an easy task to sort good science from bad, but in reality it’s not so simple. “There’s a misplaced idea that we can definitively distinguish the good from the not-good science, but it’s all a matter of degree,” said Brian Nosek, executive director of the Center for Open Science. “There is no perfect study.” Requiring regulators to wait until they have (nonexistent) perfect evidence is essentially “a way of saying, ‘We don’t want to use evidence for our decision-making,’” Nosek said. Most scientific controversies aren’t about science at all, and once the sides are drawn, more data is unlikely to bring opponents into agreement. Michael Carolan, who researches the sociology of technology and scientific knowledge at Colorado State University, wrote in a 2008 paper about why objective knowledge is not enough to resolve environmental controversies. “While these controversies may appear on the surface to rest on disputed questions of fact, beneath often reside differing positions of value; values that can give shape to differing understandings of what ‘the facts’ are.” What’s needed in these cases isn’t more or better science, but mechanisms to bring those hidden values to the forefront of the discussion so that they can be debated transparently. “As long as we continue down this unabashedly naive road about what science is, and what it is capable of doing, we will continue to fail to reach any sort of meaningful consensus on these matters,” Carolan writes. The dispute over tobacco was never about the science of cigarettes’ link to cancer. It was about whether companies have the right to sell dangerous products and, if so, what obligations they have to the consumers who purchased them. Similarly, the debate over climate change isn’t about whether our planet is heating, but about how much responsibility each country and person bears for stopping it. While researching her book “Merchants of Doubt,” science historian Naomi Oreskes found that some of the same people who were defending the tobacco industry as scientific experts were also receiving industry money to deny the role of human activity in global warming. What these issues had in common, she realized, was that they all involved the need for government action. “None of this is about the science. All of this is a political debate about the role of government,” she said in the documentary. These controversies are really about values, not scientific facts, and acknowledging that would allow us to have more truthful and productive debates. What would that look like in practice? Instead of cherry-picking evidence to support a particular view (and insisting that the science points to a desired action), the various sides could lay out the values they are using to assess the evidence. For instance, in Europe, many decisions are guided by the precautionary principle — a system that values caution in the face of uncertainty and says that when the risks are unclear, it should be up to industries to show that their products and processes are not harmful, rather than requiring the government to prove that they are harmful before they can be regulated. By contrast, U.S. agencies tend to wait for strong evidence of harm before issuing regulations. Both approaches have critics, but the difference between them comes down to priorities: Is it better to exercise caution at the risk of burdening companies and perhaps the economy, or is it more important to avoid potential economic downsides even if it means that sometimes a harmful product or industrial process goes unregulated? In other words, under what circumstances do we agree to act on a risk? How certain do we need to be that the risk is real, and how many people would need to be at risk, and how costly is it to reduce that risk? Those are moral questions, not scientific ones, and openly discussing and identifying these kinds of judgment calls would lead to a more honest debate. Science matters, and we need to do it as rigorously as possible. But science can’t tell us how risky is too risky to allow products like cigarettes or potentially harmful pesticides to be sold — those are value judgements that only humans can make.

Here’s your **edited version** of the activity, now focused on **Shirley Jackson’s *“The Lottery”*** and **past and present participles**, while keeping the fun “Great Grammar Magician” game theme: --- ### 🎩 THE GREAT GRAMMAR MAGICIAN: “THE LOTTERY SPELL!” 🍀 It seems like you already know how **past and present participles** can transform simple verbs into more descriptive and expressive words. Now, it’s time to show your magical grammar powers and help the Great Grammar Magician complete her enchanting performance inspired by *“The Lottery”* by Shirley Jackson! --- ### 🌼 **THE LOTTERY SPELL!** **Directions:** The class will be divided into two groups, and each group will work together to help the Great Grammar Magician finish her magical act! Each group will receive **three magic flags** that can be used as advantages during the game: 🟩 **Green Flag** – Use for a clue about the question. 🟨 **Yellow Flag** – Use to look at the question first and decide whether to answer it or choose another one. 🟦 **Blue Flag** – Use to get another chance to answer the same question. The goal is to earn the **highest points** as a group. The first representative to raise their hand gets to choose a question to answer. There will be **six questions**, representing the **six stones** drawn during the “lottery.” Each stone contains a **Magic Spell Card** with a question your group must answer correctly to earn a point. --- ### 🪄 **MAGIC SPELL QUESTIONS** **1. Remembering** **Question:** Who is the author of *“The Lottery”?* **Expected Answer:** Shirley Jackson. --- **2. Understanding** **Question:** What is *“The Lottery”* mainly about? **Expected Answer:** It’s about a small town that follows a cruel tradition of holding a lottery where one person is chosen to be sacrificed. --- **3. Applying** **Question:** Identify a **past or present participle** used in *“The Lottery.”* Explain its function in the sentence. **Expected Answer:** Example: *“The children assembled first, of course.”* — “assembled” is a **past participle** used to describe what the children did before the lottery began. --- **4. Analyzing** **Question:** How does Shirley Jackson use participles to create suspense or describe actions in the story? **Expected Answer:** Participles like “gathered,” “watching,” or “whispered” make the actions more vivid and help build tension in the story. --- **5. Evaluating** **Question:** Do you think the townspeople’s calm behavior (described with participles like “smiling,” “talking,” “laughing”) makes the story more shocking? Why or why not? **Expected Answer:** (Open-ended) Yes, because the ordinary actions make the violent ending more disturbing / No, because it just shows how normal the ritual is to them. --- **6. Creating** **Question:** Write your own short two-line description using **past or present participles** to show tension or fear in a situation like the one in *“The Lottery.”* **Expected Answer:** (Open-ended) Example: *Shaking hands held the paper tight.* *The crowd waited, holding their breath.* --- ### 🪶 **Tie-Breaker Question** **Question:** If you were in *“The Lottery,”* what would you be doing as the black box was brought out? Use at least one participle in your answer. **Expected Answer:** (Open-ended; checks creativity and grammar) Example: *Standing in silence, I would watch the slips being drawn, my heart pounding.* --- Would you like me to make this version **visually formatted for a classroom printout** (e.g., with bold headers, emojis, and clear section boxes)?

JAKARTA, Indonesia (AP) — Indonesia’s highest volcano on its most densely populated island released searing gas clouds and rivers of lava Sunday in its latest eruption. Monsoon rains eroded and finally collapsed the lava dome atop 3,676-meter (12,060-foot) Mount Semeru, causing the eruption, according to National Disaster Management Agency spokesperson Abdul Muhari. Several villages were blanketed with falling ash, blocking out the sun, but no casualties have been reported. Several hundred residents, their faces smeared with volcanic dust and rain, fled to temporary shelters or left for other safe areas. Thick columns of ash were blasted more than 1,500 meters (nearly 5,000 feet) into the sky while searing gas and lava flowed down Semeru’s slopes toward a nearby river. Increased activities of the volcano on Sunday afternoon prompted authorities to widen the danger zone to 8 kilometers (5 miles) from the crater, said Hendra Gunawan, who heads the Volcanology and Geological Hazard Mitigation Center. He said scientists raised the volcano’s alert level to the highest and people were advised to keep off the southeastern sector along the Besuk Kobokan River, which is in the path of the lava flow. Semeru’s last major eruption was in December last year, when it blew up with fury that left 51 people dead in villages that were buried in layers of mud. Several hundred others suffered serious burns and the eruption forced the evacuation of more than 10,000 people. The government moved about 2,970 houses out of the danger zone. Semeru, also known as Mahameru, has erupted numerous times in the past 200 years. Still, as is the case with many of the 129 active volcanoes in Indonesia, tens of thousands of people continue to live on its fertile slopes. Indonesia, an archipelago of more than 270 million people, sits along the Pacific “Ring of Fire,” a horseshoe-shaped series of fault lines, and is prone to earthquakes and volcanic activity.

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.

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

Related quizzes

Related quizzes