Physical feature of India

Introduction to Physical Features of India - Starter Quiz

Unit 3 - Week 18 - Physical and human features of Indiana Quiz

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

Key Word Definition Aid Assistance in the form of grants or loans at below market rates. For example, the UK provided aid to Nepal after the 2015 earthquake to help with reconstruction efforts. Barriers to Trade Government constraints on the flow of international goods and services, such as tariffs and quotas. For example, the European Union imposes tariffs on certain agricultural products to protect its farmers. BRICS An acronym for an association of five major emerging nations: Brazil, Russia, India, China, and South Africa. For example, BRICS nations often meet to discuss economic cooperation and development strategies. Demographic Aging The rise in the median age of a population. For example, Japan is experiencing demographic aging, with a significant increase in the elderly population. Economic Core Region The most highly developed region(s) in a country. For example, London is considered an economic core region in the UK due to its high level of development and economic activity. GNP (Gross National Product) GDP plus overseas earnings, also known as GNI (Gross National Income). For example, the GNP of the United States includes the value of goods and services produced domestically and the income earned by its citizens abroad. HIC (Higher Income Country) A country with a high level of income and development. For example, Germany is classified as a higher income country due to its high GDP per capita and advanced infrastructure. NEE (Newly Emerging Economy) A country that is experiencing rapid economic growth and industrialisation. For example, China is an example of a newly emerging economy, having rapidly industrialised and grown economically over the past few decades. LIC (Lower Income Country) A country with a low level of income and development. For example, Malawi is considered a lower income country, with a low GDP per capita and limited access to healthcare and education. GDHI (Gross Disposable Household Income) The amount of money that households have available for spending and saving after taxes and social contributions. For example, in the UK, the GDHI varies significantly between regions, with London having one of the highest levels. Gini Coefficient A measure of income inequality within a population, ranging from 0 (perfect equality) to 100 (perfect inequality). For example, South Africa has a high Gini coefficient, indicating significant income inequality within the country. Trade Unions Organisations that promote trade between member countries, such as the East African Community (EAC). For example, the East African Community (EAC) works to promote economic integration and trade among its member states. Fair Trade A movement aimed at helping producers in developing countries achieve better trading conditions and promote sustainability. For example, Fairtrade coffee ensures that farmers receive a fair price for their product and work under safe conditions. FDI (Foreign Direct Investment) Investment made by a company or individual in one country in business interests in another country. For example, Toyota's investment in manufacturing plants in the UK is an example of foreign direct investment. Debt Relief The partial or total remission of debts, especially those owed by developing countries to external creditors. For example, the Heavily Indebted Poor Countries (HIPC) initiative provides debt relief to eligible countries to help them achieve sustainable development. International Aid Voluntary transfer of resources from one country to another, often in the form of financial assistance, goods, or services. For example, the UK provides international aid to various countries through its Department for International Development (DFID). Top-Down Development Large-scale development projects led by national governments or international organisations. For example, the construction of the Three Gorges Dam in China is an example of a top-down development project. Bottom-Up Development Small-scale development projects led by local communities or NGOs, focusing on the needs of the poorest and most vulnerable. For example, WaterAid's installation of hand pumps in rural villages in Africa is an example of a bottom-up development project. Urbanisation The increase in the proportion of people living in urban areas compared to rural areas. For example, rapid urbanisation in India has led to the growth of megacities like Mumbai and Delhi. Geopolitics The study of the effects of geography (human and physical) on international politics and relations. For example, the geopolitics of the Arctic region involves disputes over territorial claims and access to natural resources. Quality of Life The general well-being of individuals and societies, outlining negative and positive features of life. For example, Scandinavian countries are often ranked high in quality of life due to their strong social welfare systems and high levels of happiness. Poverty Cycle A set of factors or events by which poverty, once started, is likely to continue unless there is outside intervention. For example, lack of education and healthcare can trap families in a poverty cycle, making it difficult for future generations to improve their living standards. Sustainable Development Economic development that is conducted without depletion of natural resources. For example, the use of renewable energy sources like wind and solar power is a key aspect of sustainable development. Humanitarian Aid Material or logistical assistance provided for humanitarian purposes, typically in response to crises including natural disasters and man-made disaster. For example, humanitarian aid was provided to Haiti after the devastating earthquake in 2010 to help with immediate relief efforts. Economic Growth An increase in the production of goods and services in an economy over a period of time. For example, China's economic growth over the past few decades has lifted millions of people out of poverty. Social Indicators Measures that describe the well-being of individuals or communities, such as health, education, and income. For example, life expectancy and literacy rates are common social indicators used to assess development. Environmental Sustainability Responsible interaction with the environment to avoid depletion or degradation of natural resources and allow for long-term environmental quality. For example, practices like recycling and conservation of natural habitats contribute to environmental sustainability. Infrastructure The basic physical and organisational structures and facilities needed for the operation of a society or enterprise. For example, good infrastructure, such as roads, bridges, and schools, is essential for economic development. Globalisation The process by which businesses or other organisations develop international influence or start operating on an international scale. For example, the globalisation of technology companies like Apple and Google has led to their products being available worldwide. Microfinance Financial services provided to low-income individuals or groups who are typically excluded from traditional banking. For example, microfinance institutions like Grameen Bank provide small loans to entrepreneurs in developing countries to help them start or expand their businesses.

Chapter 8: The Worlds of North and South Geography Geography refers to the seasons, climate, soil, and physical features of a region (mountains, rivers, etc.) The differences in geography b/t the N and S is one of the major reasons slavery b/c entrenched in the S while it died out in the N. Geography of the North The N has diverse geography and experiences four distinct seasons including long, harsh winters. The Great Plains region has some of the best farmland in the country. New England has rocky, hilly wilderness, not well suited for farming. It has hundreds of bays and harbors along its coastline. States farther S had rich soil and coastal access through rivers. The N also experienced mass deforestation b/c of the need for lumber and to make room for farms. Geography of the South Climate: the S had mild winters, and a long, hot, humid growing season. It has fertile lowlands, marshes and swamps. It's ideal for growing tobacco, sugar, rice, indigo, and cotton (cash crops). B/c of the geography of the S, their whole way of life was based on agriculture and geography is one of the major reasons why slavery took off in the S. Economies Economy basically refers to the way people make and spend money. The Northern economy was far more diversified than the Southern. Economy of the North The North experienced the Industrial Revolution—the shift from handmade goods to machine-made goods. This resulted in new jobs, increased production, and improved efficiency in agriculture. IOW, you can make things faster, easier, and cheaper. More ppl get more stuff. Factories were almost always located next to rivers. The Reaper The Indust. Rev. changed northern agriculture with Cyrus McCormick’s reaper. It could cut 28xs more grain than a single man. The Sewing Machine Elias Howe's sewing machine; At 250 stitches a minute, Howe's lockstitch mechanism out-stitched the output of five hand seamstresses with a reputation for speed, completing in one hour what took the sewers 14.5 hours. The Textile Mill Francis Cabot Lowell's textile mill: essentially the first factory in the US, Lowell set the model for all future factories. Interchangeable Parts Eli Whitney's interchangeable parts; considered the "dawning of a new age" of machinery. This concept was applied to pretty much all manufacturing. Economy of the South The South's economy was based on AGRICULTURE. Most southerners were agrarians. Most had small farms, some owned plantations. Slavery beginning to decline in late 1700s; prices went down (tobacco, indigo) and cotton was difficult. King Cotton Cotton was South’s most important crop. Earned more money than all other exports combined. The S would go on to supply 75% of the world's cotton demand. Cotton Gin Eli Whitney invented the cotton gin in 1794 and forever changed the US. The gin made cotton incredibly profitable. We start to see the effects of the cotton gin around 1820. Slavery and Cotton Southerners put all their money into slaves and land, and almost none into building factories. With the spread of cotton, demand for slaves increased. 1790 to 1850, number of slaves rose 600%. Transportation Again, the N was far more inventive in their approach to transportation than the S. Transportation in the North National Road National Road stretched from the East (the Potomac), over the Appalachians, to the West (Illinois), over 620 miles. Steamboat In 1807, Robert Fulton invented the steamboat. It traveled 150 miles UP the Hudson River at a speed of 5 mph. Erie Canal Built b/t 1817 and 1825, the canal spanned 363 miles and connected Lake Erie to the Hudson River. This connected farms in the W to cities in the E and the Atlantic Ocean. Clipper Ship Clippers were narrow w massive sails that were built for speed. They cut the time it took to cross the Atlantic in half. Locomotive The fastest and cheapest way to move goods was by steam-powered trains. The first RR was the B&O which was built in 1827. Transportation in the South Most people and goods in the South traveled by rivers in steamboats. The South had trains, but less than half the amount of railroad track than the North had. Society (The People) The people who made up the N and S could not have been more different. The S was primarily agrarian while the N was b/c urbanized. The S was holding on to the past, while the N was embracing change. Society in the South Society was organized into 3 distinct classes of people: rich plantation owners at the top; then white farmers and workers; slaves on the bottom. This rigid social class system was the result of a slave-based agricultural system. Power Structure Only 1 in 4 whites owned a slave. Plantation owners, who owned more than 20 slaves, dominated politics and the economy. Society in the North 7 of 10 Northerners still lived on farms by the 1840s (6 of 10 by 1860), but urbanization was growing fast in the N. The N relied on wage labor as opposed to slave labor, so most blacks in the N were free. N blacks were not treated equally and the N was about as racist as the S. Immigration Compared to the S, the N population was exploding, in large part bc of immigration. Between 1845 and 1860, 4 million immigrants came to the North. Most were German and Irish. Irish--a potato famine; German--a failed revolution. Ethnic neighborhoods developed as a result.

• Landscape management A landscape is the evident factor of a land, its landforms, and the combined features of natural or artificial elements. Landscape management includes maintenance and integration of physical elements, water bodies, land cover, indigenous vegetation, human elements, such as structures and buildings, and climatic conditions. • Soil Preparation In the list of farming practices, soil preparation is placed second because of its importance for seed germination. Before a crop is grown, the soil is leveled and plowed a bit deeply to prepare it for the sowing of seed. After plowing, the soil loosens and develops proper aeration in the soil. • Sowing Seed selection from good quality varieties is the principal step of sowing. After preparing the soil, seeds are spread over the field, called sowing. Manual and mechanical (seeders) methods of sowing can be used. Some plants, such as rice, are first grown as seedlings in a small space and later transplanted to fields. • Manuring Plants need nutrients for their growth and fruit/seed production. Therefore, nutrients must be consumed at even intervals. Fertilization is the stage at which nutrients are introduced into the lands. These nutrients can be natural manure or artificial fertilizers. Decomposed products and waste of plants and animals are used as manure because of their nutrient richness. • Irrigation Irrigation means supplying water to plants. Water sources can be dams, ponds, wells, canals, etc. Excessive irrigation can damage crops and lead to waterlogging. The irrigation interval and frequency must be monitored, as they vary with the crop. • Weeding Unwanted plants grown alongside field crops are known as weeds. These plants are removed with the help of weed killers (weedicides), manually plucking with hands. Several weeds can be removed with better soil preparation techniques. • Integrated Pest Management • IPM – Integrated Pest Management, is a successful and ecologically sensitive technique to manage pests using combined sustainable practices. IPM is a series of methods including pest assessment, decision, and control techniques • Integrating Crops and Livestock Integrating crops and livestock increases the diversity and environmental sustainability of both sectors. In the meantime, it will offer opportunities to increase overall agricultural production and profitability. • Storage/Selling In the end steps of agricultural practices, the resulting grains are stored in warehouses for later use and selling purposes. Therefore, better plant protection methods must be used to protect grains from rodents and insect pests. The stores should be cleaned, dried, well-fumigated, etc., before storing grains. • Harvesting Among steps of farming practices, harvesting needs significant care otherwise it will result in yield reduction. When the crop reaches maturity, the cutting starts, and the produce will be stored in a dry place. This process is known as harvesting. After harvesting, manual or mechanical thrashing is done to separate grains from the plants.

[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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