What does derivational structure primarily reveal?

The order of words in a sentence

Which class of derivational bases is the largest?

Those that coincide with simple morphological stems

Those that are only derived forms

Those that coincide with word forms

Those that coincide with word groups

Which example demonstrates a derivational base that coincides with a simple morphological stem?

'narrow mind' in 'narrow-minded'

What is the primary purpose of structural-semantic patterns in derivational processes?

To detail how the meaning of the base is modified by the affix

To define the structure of the word

What classifies bases that coincide with word forms?

Bases that act as inflected words

Bases that are derived morphological stems

Bases that coincide with word groups

Bases that are simple morphological stems

derivation in lexicology

Exam in inverse trigonometric derivation

Biochemistry-.Buffers in biological system, Henderson -Hasselbalch equation with derivation, simple numerical problems involving application of this equation, simple numerical problems on buffer composition.

Can you create an evaluation using this information PHONETICS VS. PHONOLOGY Whereas phonetics is the study of sounds that occur in language, phonology is the study of how these sounds are organized and how they function in language. It uses the classifications of sounds derived from phonetics to describe and analyze how sounds occur in speech. STRUCTURALIST PHONEMICS STRUCTURALIST PHONEMICS As linguists began to study sounds in fine detail, they recognized increasingly complex aspects of phonetic organization. For example, the sound /p/ appears in different varieties in English. STRUCTURALIST PHONEMICS One of the varieties of /p/ is indicated by [ph]. This sound is produced with an accompanying puff of air called aspiration, as in the words “pill,” and “peace.” Another sound, indicated by [p•], is produced when there is little or no aspiration; this sound occurs in a word like “spill.” A third major variety for the /p/ sound is the unreleased [p– ], which may occur at the end of a word like “stop.” To deal with these variations for the /p/ sound, the structuralists suggested the existence of an abstract unit which they termed a phoneme. STRUCTURALIST PHONEMICS A phoneme was defined by the structuralists as an abstract phonological unit that represents a class of real sounds, termed the allophones of a phoneme. The phoneme /p/ in English, then, is represented by the allophones [ph], [p•], and [p– ]. STRUCTURALISTS: MINIMAL PAIRS How do we know what these abstract units of sound called phonemes are? In order to find the phonemes of a language, the structuralists developed the concept of the minimal pair, defined as any two words that: a) Contain the same number of segments b) Differ in meaning c) Exhibit only one phonetic difference. STRUCTURALISTS: MINIMAL PAIRS In practical terms, phonemes distinguish meanings; and a phoneme can also be defined as the smallest meaning-distinguishing unit of sound. For instance, the words “pin” /pɪn/ and “bin” /bɪn/ mean different things, and the only one difference in these words occurs in the initial sounds. STRUCTURALISTS: MINIMAL PAIRS By using the concept of a minimal pair, we can determine that the three variations of the /p/ sound do not represent three phonemes. Certainly, it is possible to pronounce the word cap with either an aspirated [ph ] or unreleased [p– ]; however, the two forms [kæph ] and [kæp– ] are not a minimal pair, even though they involve different sounds, because they are identical in meaning. STRUCTURALISTS: FREE VARIATION The two forms [kæph ] and [kæp– ] are, therefore, said to exhibit free variation: that is, the pronunciation may vary without signifying a change in meaning. In other words, we may conclude that the unreleased [p– ] and the aspirated [ph ] are not representations of different phonemes in English; they are, in fact, allophones of one phoneme, /p/. STRUCTURALISTS: COMPLEMENTARY DISTRIBUTION When phonemes have more than one allophone in a language, the allophones are said to be in complementary distribution. Complementary distribution means that the allophones of a phoneme occur in different phonetic environments (that is, with different sounds surrounding them). TRANSFORMATIONAL- GENERATIVE PHONOLOGY TRANSFORMATIONAL-GENERATIVE PHONOLOGY Transformational-generative phonology is a relatively recent development in linguistic theory. Chomsky launched Transformational-Generative Grammar in 1957, but the earliest studies within this framework were largely concerned with syntax. A decade later, the first comprehensive transformational-generative treatment of English phonology appeared: Chomsky and Halle’s The Sound Pattern of English (1968). TRANSFORMATIONAL-GENERATIVE PHONOLOGY Transformational-generative phonologists strongly oppose the structuralists’ phonemic level. They replace this level by a series of rules that directly relate underlying representations to observed phonetic representations. The central mechanisms in transformational-generative phonology, then, are underlying representations and phonological rules. PHONOLOGICAL RULES A rule is an operational statement in which some linguistic entity is modified, resulting in a new linguistic entity. Rules may add elements, remove elements, or change elements. By using phonological rules, linguists attempt to demonstrate that there is order in linguistic phenomena and that linguistic patterns are systematic. PHONOLOGICAL DERIVATION A phonological derivation is an operation that begins with an underlying representation and, through the application of a set of specific rules, yields the actual sound the speaker produces. The representation of a phonological rule has the following general appearance. /A/ → [B] / C “A” changes to “B” under condition “C” PHONOLOGICAL RULE – EXAMPLE In most Southern dialects, the word ten is pronounced like the word tin. This is not an isolated fact, for den is pronounced like din and Ben is pronounced like bin, and so on. This very general fact can be represented by the phonological rule: /ɛ/ → [I] / ___ [n] den /dɛn/ → /dIn/ Ben /bɛn/ → /bIn/ ten /tɛn/ → /tIn/ /ɛ/ → [I] / ___ [n] - high - low - tense + front + high - tense + front + sonorant + anterior + coronal - continuant NOTATIONAL DEVICES IN PHONOLOGICAL RULES The statement of phonological rules can be complex, and linguists have developed several notational devices for writing them. Often, the following symbols will be necessary for stating the conditions under which rules apply: # indicates a word boundary + indicates an intraword boundary $ indicates a syllable boundary UNDERLYING REPRESENTATIONS AND RELATED ISSUES The transformational-generative description of phonology relates underlying representations to phonetic representations by rules. This can be represented in a simple example: In English, there are certain pairs of words like sign / signature, and malign / malignant that exhibit a regular alternation in their phonetic representations: [g] is present in the second member of the pairs but absent in the first member. UNDERLYING REPRESENTATIONS AND RELATED ISSUES To explain the relatedness of words such as sign / signature, we could claim that the underlying representation of the segment in all such pairs is /g/ and that a rule operates to delete /g/ before syllable-final nasals. Thus, the rule “/g/ is deleted before syllable-final nasal” would appear formally as: + voice - anterior →∅ ____ [+ nasal] $ - coronal UNDERLYING REPRESENTATIONS AND RELATED ISSUES On the left-hand side of the arrow, we place the features needed to uniquely specify /g/ among the consonants; that is, no other consonant has the features [+ voice], [- anterior], and [- coronal]. The symbols → mean that the sound /g/ changes to nothing or more properly “/g/ is deleted.” The horizontal line following the slash mark refers to the position of /g/ - namely, before a segment that is [+nasal]. Finally, this [+nasal] segment occurs before a syllable boundary, as indicated by $. A less formal way of writing this rule would be: /g/ → / _ [+nasal] $ Notice that this rule also helps describe such alternations as phlegm/phlegmatic and paradigm/paradigmatic. Application Activity: Think of other words in which this rule can be applied. Write the sound segments to prove /g/ is deleted. Another example is the process through which the prefix meaning “not” is added to words. This prefix alternates among the forms /Im/, /In/, and /Iŋ/, depending on the point of articulation of the initial segment of the following word. -If the segment begins in the extreme front part of the mouth (labials), the form is /Im/, as in improper. -If the segment begins in the extreme back part of the mouth (velars), the form is /Iŋ/, as in incomplete. -If the segment begins in the mid-region of the mouth (all other sounds), the form is /In/, as in indecent. *Exceptions:Words beginning with /r/ or /l/. Analyze the Word “in + complete,” for example. /n/ → [ŋ] / __ [k] - continuant - continuant - continuant + sonorant → + sonorant - sonorant + anterior - anterior - strident + coronal - coronal - coronal + tense THE VELAR SOFTENING RULE Still another example of alternation in English is found in pairs of words like “electric / electricity,” in which the segments /k/ and /s/ alternate. /k/ changes to [s] only before non- low, front vowels. THE VELAR SOFTENING RULE /k/ → [s] / __ - continuant + continuant - strident → - sonorant V - anterior + anterior - low - coronal + coronal - back

New Trends in Agriculture Extension approaches Extension has been, and still is, under attack from a wide spectrum of politicians and economists over its cost and financing. As a result, Extension Systems have had to make changes, by restating the system’s mission, developing a new vision for the future, and formulating plans for the necessary transition to achieve the desired change. 1. Privatization of Agricultural Extension Service Privatization: Process of funding and delivering the extension services by private individual or organization is called Private Extension. Concept: Privatization of extension refers to services rendered in rural area & allied aspects of extension personnel working in private agencies or organization for which farmers are expected to pay a fee & it can be viewed as supplementary or alternative to public extension services (Sarvanan & Shivalinge 1980). Privatization approaches ➢ Share cropping system ➢ Village extension contract system ➢ Public extension through private delivery ➢ Service for vouchers Strengths of Private Extension System ➢ More demand - driven rather than supply – driven ➢ High quality of services in terms of satisfying information needs of clientele, trained manpower, sustained finances and resource allocation ➢ Provides for an information mix and choices available to farmers ➢ Enhanced efficiency of staff ➢ Assure continuous supply and quality agricultural products ➢ More effective because farmer can select an adviser who is the best able to help ➢ Healthy competition among service provider will lead to better quality and lower costs for service Weakness of Private Extension System ➢ Concentrate on area having favorable physical environment ➢ More face-to-face contacts (person oriented) ➢ Increased dependence of farmers and hence exploitation ➢ No education role ➢ Deprivation of small farmers ➢ Hamper the free flow of information 2. Cyber Extension or e-extension Concepts Cyber space: it is the imaginary or virtual space of computers connected with each other on Networks, across the Globe. Cyber extension: it means 'using the power of online networks, computer communications and digital interactive multimedia to facilitate dissemination of agriculture technology. Cyber Extension thus can be defined as the extension over cyber space. Important tools of cyber extension E-Mail, Telnet, File Transfer Protocol (FTP), Gopher, Archie and World Wide Web (WWW) Strengths of Cyber Extension ➢ Access to the astounding information and continuously available ➢ Information rich and instantaneously available of information ➢ Interactive communication ➢ The information is available from any point on the globe ➢ Communication is dynamic ➢ Cut steps from traditional process ➢ Save money, time and effort ➢ Multiplicity of purpose Issues and Concerns of Cyber Extension ➢ Lack of Reliable Telecom Infrastructure in Rural Areas ➢ Erratic or no Power Supply ➢ Lack of ICT Trained manpower (willing to serve) in Rural Areas ➢ Lack of content (locally relevant and in local languages) ➢ Lack of Information Services to Rural Clientele ➢ Low Purchasing power of the Rural communities ➢ Lack of Holistic Approaches ➢ Issues of Sustainability Application of cyber extension ➢ Village information shops Dr. M.S. SwaminathanResearch Foundation, Chennai ➢ Information villagers MANAGE in Ranga Reddy District in Andhra pradesh ➢ Gyandoot net initiative of District Dhar, Madhya Pradesh. ➢ Warna wired village of National Informatics Center (NIC) in Kolhapur- Sangli Districts of Maharashtra 3. Market-Led-Extension (MLE) Concepts Market: A congregation of prospective buyers & sellers with a common motive of trading a particular commodity. Extension: It is the spreading/reaching out to the mass Market-led-extension: Agriculture & economics coupled with extension is the perfect blend for reaching at the door steps of common man with the help of technology. Dimensions of market-led extension ➢ Marketing mix: A planned mix of the controllable elements of a product's marketing plan commonly termed as 4Ps: product, price, place, and promotion. These four elements are adjusted until the right combination is found that serves the needs of the product's customers, while generating optimum income. ➢ Marketing plan: A marketing plan is a comprehensive document that outlines a business and marketing efforts for the coming year. It describes business activities involved in accomplishing specific marketing objectives within a set time frame. A marketing plan also includes a description of the current marketing position of a business, a discussion of the target market and a description of the marketing mix that a business will use to achieve their marketing goals. ➢ Market Intelligence: It is the information relevant to a company’s markets, gathered and analyzed specifically for the purpose of accurate and confident decision making. Market intelligence includes the process of gathering data from the company’s external environment, whereas the business intelligence process is primarily based on internal recorded events – such as sales, shipments and purchases. ➢ Market oriented production ➢ Use of Technology Strengths of market-led extension ➢ SWOT analysis of the market ➢ Organization of Farmers’ Interest Groups (FIGs) ➢ Enhancing the interactive and communication skills of the farmers ➢ Establishing marketing and agro-processing linkages ➢ Advice on product planning ➢ Educating the farming community ➢ Direct marketing ➢ Acquiring complete market intelligence ➢ Publication of agricultural market information Production of video films of success stories ➢ Challenges to market-led extension ➢ Gigantic size of extension system ➢ Information technology Diverse conditions ➢ Market intelligence ➢ Reforms in agricultural extension system Government Initiatives ➢ Central warehousing Corporation-1965 ➢ MSP by Commission for Agricultural Cost and Price (CACP) ➢ Food Corporation of India ➢ Then some others as: Cotton Corporation of India (CCI), Jute Corporation of India (JCI), National Dairy Development Board (NDDB), Agriculture and Processed food Export Development Authority (APEDA) etc. 4. Farmer--Led-Extension (FLE) Farmer--led-extension is defined as 'the provision of training by farmers to farmers, often through the creation of a structure of farmer promoters and farmer trainers' (Scarborough et al., 1997). Philosophy and principles ➢ Farmers and local institutions (e.g. producer organizations or village leaders) should play a key role in selecting farmer-trainers and monitoring and evaluating them. This helps make the programmes more accountable to the community or groups that they serve. ➢ Farmer-trainers are ‘of the community’; they communicate in local languages and are more sensitive to local cultures, mannerisms, farming practices, and farmers’ needs. ➢ Farmer-trainers should be selected on the basis of their skills and interest in sharing information, not just on their farming expertise. ➢ Farmer-trainers need strong linkages with and support from development agents (whether government, non-government organization (NGO), or private), the people who train and backstop them. Farmer-trainers generally serve as a complement to existing extension systems, rather than being a substitute for them. ➢ Facilitating organizations and local institutions need to be proactive in ensuring that women as well as men become farmer-trainers. ➢ Simple and appropriate reference materials should be made available to the farmer trainers. Essential Elements of Farmer--led-extension ➢ The group ➢ The Field ➢ The Facilitator ➢ The curriculum ➢ Programme leader ➢ Financing Special features of Farmer--led-extension ➢ All learning is field based & it is primary venue for learning ➢ FLE group learning constantly over the experimentation period ➢ FLE promotes healthy decisions & quality decisions ➢ Farmers conduct their own field studies with comparisons or treatments ➢ Facilitates Farmer-to-Farmer communication ➢ Field staff serve as facilitators ➢ FLE is a unique way to educate farmers ➢ It is an effective platform for sharing of experiences and collectively solving agriculture related problems. 5. Expert system Expert system is an intelligent computer program that uses knowledge and inferences procedures to solve problems (Daniel Hunt, 1986). Objectives of developing expert system ➢ To enhance the performance of agricultural extension personnel and farmer ➢ To make farming more efficient and profitable ➢ To reduce the time required in solving the problems ➢ To maintain the expert system by continuously upgrading the database Advantages of expert system ➢ Solves critical problems by making logical deductions without taking much time ➢ It combines experimental and conventional knowledge with the reasoning skills of specialists ➢ To enhance the performance of average worker to the level of an expert Limitations of expert system ➢ Expensive computer program ➢ Mostly developed not in regional languages ➢ Requires AC power and internet connection all the time ➢ Complex software requires computer skilled personnel Modules of expert system in agriculture ➢ COMAX: Integrated crop management in cotton ➢ SOYEX: Soybean oil extraction expert system ➢ PLANT/ds: Diagnosis of soybean diseases ➢ MAIZE: Maize expert system for field crop management ➢ SEMAGI: Weed control decision making in sunflowers ➢ Rice Crop Doctor: Developed by National Institute of Agricultural Extension Management (MANAGE) Difference between conventional and expert system of extension Conventional Extension ➢ Universal approachability of same information is a problem ➢ Information is given whatever is available without considering needs and resources ➢ No Cost benefit analysis ➢ Information flow depends on availability of agent ➢ Require users to draw their own conclusion from facts Expert System of Extension ➢ Universal approachability of same information is possible ➢ Information is chosen based on their needs and resources ➢ Cost benefit analysis ➢ Information through Cyber Cafe at any place at any time ➢ Conclusion is drawn based on the decision given by the expert

Harmful effects: 1. Stains in the teeth 2. Difficulty in breathing 3. Lung cancer 4. Bronchitis Beside the above mentioned harmful effects, still there are others bad side effects: 1. Premature wrinkling of the skin 2. Bad breath 3. Development of respiratory disease among babies whose mothers are smokers. 4. Emphysema – air sacs in the lungs loses its normal elasticity and fail to function when breathing, causing deprivation of oxygen which is fatal. 5. Smoking affects everyone by inhaling smoke exhaled by the smokers, this is called the second hand smoke. While the side stream smoke is the smoke coming from the burning cigarette. Reasons why do people smoke a. Smokers says that cigarette smoking give them extra boost or extra energy. b. It helps them stay awake and do their tasks. c. It acts as a stimulant to handle boredom. d. It helps them feel relax after meal. e. Dependency on nicotine

[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.

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