The optimal feeding route for AKI children receiving CRRT who need supplemental nutrition is?

Transpyloric feeding of a standard tube-feeding formula

Nasogastric feeding of a “renal” formula

Nasogastric feeding of a standard tube-feeding formula

Renal Nutrition | Quizalize

[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.

Slide 1 Growing Up in the 21st Century: Challenges and Opportunities Slide 2 Introduction: What Does It Mean to Grow Up? • Growing up: The process of maturing physically, mentally, and emotionally • Transition from childhood to adulthood • Unique challenges and opportunities in the 21st century • Importance of mental growth alongside physical development Slide 3 The Journey of Self-Discovery • Exploring personal identity • Understanding values and beliefs • Developing a sense of purpose • Embracing individuality while finding community Slide 4 Mental Growth: A Key Aspect of Maturity • Emotional intelligence and self-awareness • Critical thinking and problem-solving skills • Adaptability and resilience • Importance of continuous learning and personal development Slide 5 Challenges of Growing Up in the Digital Age • Information overload and digital literacy • Social media pressure and online identity • Cyberbullying and online safety • Balancing screen time with real-life experiences Slide 6 21st Century Skills for Success • Technological proficiency • Communication and collaboration • Creativity and innovation • Global awareness and cultural competence Slide 7 Navigating Relationships in a Connected World • Building and maintaining friendships • Romantic relationships in the digital era • Family dynamics and independence • Professional networking and mentorship Slide 8 Education and Career Pathways • Evolving job market and emerging industries • Importance of lifelong learning • Balancing academic success with practical skills • Exploring unconventional career paths Slide 9 Financial Literacy and Independence • Understanding personal finance • Budgeting and saving strategies • Student loans and debt management • Investing for the future Slide 10 Mental Health and Well-being • Recognizing and managing stress • Importance of self-care and work-life balance • Seeking help and support when needed • Destigmatizing mental health issues Slide 11 Physical Health in a Changing World • Importance of regular exercise • Nutrition and healthy eating habits • Sleep hygiene and its impact on well-being • Avoiding harmful substances and addictive behaviors Slide 12 Environmental Awareness and Sustainability • Understanding climate change and its impacts • Developing eco-friendly habits • Participating in community environmental initiatives • Sustainable career opportunities Slide 13 Civic Engagement and Social Responsibility • Understanding political systems and processes • Importance of voting and civic participation • Volunteering and community service • Advocating for social justice and equality Slide 14 Cultural Competence in a Global Society • Appreciating diversity and inclusion • Developing intercultural communication skills • Opportunities for travel and cultural exchange • Embracing multilingualism Slide 15 Time Management and Productivity • Setting goals and priorities • Effective study and work habits • Balancing academics, extracurriculars, and personal life • Avoiding procrastination and developing discipline Slide 16 Dealing with Failure and Setbacks • Reframing failure as a learning opportunity • Building resilience and grit • Developing a growth mindset • Seeking feedback and continuous improvement Slide 17 Technology and Ethics • Understanding digital footprint and online reputation • Responsible use of social media and technology • Privacy concerns and data protection • Ethical considerations in a tech-driven world

Create me a multiple choice test questions with 4 options on the following topic:Consumer Education for Different Audience 1. Children and Youth: - Focus: Building foundational knowledge about basic consumer concepts, making safe choices, understanding money and value, and recognizing scams and unsafe situations. 2. Teens and Young Adults: - Focus: Building financial literacy, responsible debt management, understanding contracts and agreements, responsible technology use, online safety, and consumer rights. 3. Working Adults and Families: - Focus: Managing budgets, making informed purchasing decisions, understanding credit and debt, finding consumer protection resources, and navigating complex financial products (mortgages, insurance, investments). 4. Seniors: - Focus: Protecting themselves from scams and fraud, understanding common consumer issues like telemarketing, identity theft, and online scams, managing medications and healthcare costs, and accessing community resources. 5. Special Populations: - Focus: Adapting consumer education programs to the specific needs of people with disabilities, immigrants, refugees, and other marginalized communities. 6. Business and Industry:- Focus: Understanding ethical marketing practices, complying with consumer protection laws, and providing clear and accurate information to consumers. 7. Policymakers and Regulators: - Focus: Understanding consumer needs, developing effective consumer protection laws, enforcing regulations, and ensuring a fair and competitive marketplace. Adapting consumer education programs for children, teens, and seniors requires tailoring content and delivery methods to their unique needs and learning styles. Children (Ages 5-12): - Understanding the concept of money: Teaching children about saving, spending, and the value of money. - Developing basic budgeting skills: Helping children learn to make choices about how to spend their allowance or pocket money. EFFECTIVE STRATEGIES •Focus on basic concepts: Introduce core concepts like saving, spending, and budgeting in a fun and engaging way. Use simple language and relatable examples. •Real-life scenarios: Use age-appropriate scenarios to illustrate financial concepts, like buying toys or snacks. •Parental involvement: Encourage parent participation and provide resources to help them reinforce lessons at home. Teens (Ages 13-18): - Building budgeting and financial planning skills: Teaching teens how to manage their money, set financial goals, and plan for the future. - Navigating the digital marketplace: Equipping teens with the knowledge and skills to make safe and informed online purchases, understand digital marketing, and protect themselves from scams. EFFECTIVE STRATEGIES • Practical skills: Focus on skills relevant to teens, like managing money for social activities, saving for college, and understanding credit cards. • Digital literacy: Address the growing influence of online shopping, social media advertising, and financial scams. • Real-world applications: Connect financial concepts to real-life decisions teens make, like choosing a part-time job or making purchases online. Seniors (Ages 65+) - Managing retirement savings and healthcare costs: Providing information and resources on retirement planning, Medicare and Medicaid, and other healthcare options. - Navigating the digital world: Offering technology training and resources to help seniors access online services and information safely and securely. EFFECTIVE STRATEGIES • Addressing specific concerns: Focus on topics relevant to senior citizens, like retirement planning, managing healthcare expenses, and avoiding scams. • Clear and concise communication: Use simple language and visual aids to ensure easy understanding. • Social interaction: Create opportunities for seniors to share experiences and learn from each other. Teaching Financial Literacy in school and Communities In Schools: Curriculum Integration: Financial literacy concepts can be seamlessly integrated into existing subjects, making learning more relevant and engaging. - Math: Budgeting exercises, calculating interest rates, analyzing financial data, and understanding compound interest are all natural applications of math skills. - Social Studies: Exploring the history of money, financial institutions, economic systems, and the impact of financial decisions on society provide valuable context. - Economics: Discussions about supply and demand, inflation, investment, and the role of consumers in the economy enhance financial literacy. Dedicated Courses: Offering elective courses or workshops specifically focused on personal finance provides deeper dives into crucial topics. - Personal Finance: Cover budgeting, saving, investing, credit, debt management, and insurance. - Entrepreneurship: Introduce concepts like business planning, marketing, financial forecasting, and managing cash flow. In Communities: Community Centers and Libraries: Workshops, seminars, and classes tailored to adults and families provide accessible learning opportunities. - Financial Planning: Cover budgeting, retirement planning, debt management, and estate planning. - Homeownership: Provide guidance on buying, selling, and maintaining a home. - Consumer Protection: Educate individuals about their rights and how to avoid scams. Partnerships with Financial Institutions: Collaborations with banks, credit unions, and financial advisors offer valuable resources, workshops, and financial literacy programs. Consumer Education for Low-Income and Vulnerable Populations Low-income refers to individuals or households with limited financial resources, typically below a certain threshold. Low-income individuals may face challenges like: 1. Limited education and job opportunities 2. Poor living conditions and housing 3. Food insecurity and malnutrition Causes of low income: 1. Unemployment or underemployment 2. Low-paying jobs or minimum wage 3. Limited education or skills 4. Single parenthood or large family size Vulnerable population'' is a term that is used to describe a group of people who possess some sort of disadvantage. elderly people, people with low incomes, homeless people, people in prison, migrant workers, pregnant women, Family Consumer Education: Managing Household Finances and Resources Financial literacy is the ability to understand and manage personal finances effectively. 1. Debt Debt is money you spend that isn’t yours. If you borrow money from the bank, use a credit card, or take out a short-term loan, or a payday loan, you are accumulating debt. Good debt is considered money borrowed for things that are absolutely necessary for making a life e.g. a house and for advancing your money-making potential e.g. an education. Bad debt is considered borrowing money or using a credit card to pay for things you don’t need, such as expensive clothes, hi-tech electronics, eating out at restaurants, going on holidays, etc. 2. Saving Saving is an essential part of financial wellness, a secure present, and a happy future. 3. Budgeting Budgeting is the life skill of planning and managing your money. By understanding exactly where your money goes every month, you are empowered to create an actionable plan by which you can spend less, by curtailing those unnecessary expenses and saving more for the things you need and want. 4. Investing Investing is all about creating and growing the wealth you need to enjoy a financially secure and happy future. It’s about putting your money into something that will make you a profit over time, such as property, retirement funds, and unit trusts Integrating Consumer Education into the Home Economics Curriculum. Integrating consumer education into the home economics curriculum can provide students with essential skills for making informed choices about their personal finances, food, clothing, and overall well-being. Here are some strategies and ideas for effectively incorporating consumer education: Financial Literacy Budgeting: Teach students how to create and manage a personal budget, including setting financial goals, tracking expenses, and understanding savings. Saving and Investment: Cover the basics of saving, including different saving accounts, and introduce concepts related to investing. Food and Nutrition Food Label Literacy: Engage students in learning how to read and interpret food labels, including nutrition facts and ingredient lists. Grocery Shopping Skills: Teach students how to compare product costs, understand unit pricing, and make healthy, budget-friendly choices while shopping. Clothing and Textile Education Consumer Choices in Clothing:Discuss factors influencing clothing purchases, such as quality, price, and sustainability. Fashion and Trends: Analyze the impact of marketing and advertising on consumer behavior regarding clothing. Sustainable Purchasing Eco-Friendly Choices: Raise awareness about environmentally friendly products and the importance of sustainability in consumer choices. Project-Based Learning - Assign real-life projects where students must apply their knowledge, such as creating a meal plan within a budget, planning a shopping list based on nutrient needs, or evaluating the cost-effectiveness of different products. Technology Integration - Use technology to teach students about online shopping, price comparison websites, and apps that aid budgeting and financial planning. Collaborative Learning Opportunities - Organize team projects where students work together to solve consumer-related problems, emphasizing teamwork and communication skills. Assessment and Reflection - Incorporate assessments that allow students to reflect on what they have learned about consumer education and how they can apply these skills in their daily lives.

A BAD CASE OF THE STRIPES By David Shannon Parts(18): Camilla Narrator 1 Narrator 2 Narrator 3 Narrator 4 Mr. Harms Mother Father Dr. Bumble Old Woman Environmental Therapist Dr. Grop Dr. Gourd Dr. Sponge Mr. Mellon Dr. Cricket Dr. Young <><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><> Narrator 1: A BAD CASE OF THE STRIPES By David Shannon Narrator 2: Camilla Cream loved lima beans. But she never ate them. Narrator 3: All of her friends hated lima beans, and she wanted to fit in. Camilla always worried about what other people thought of her. Narrator 4: Today she was fretting even more than usual. It was the very first day of school, and she couldn't decide what to wear. There were so many people to impress! Narrator 1: She tried on forty-two outfits, but none seemed quite right. She put on a pretty red dress and looked in the mirror. Then she screamed. Narrator 2: Her mother ran into the room, and she screamed, too. Mother: "Oh my heavens! You're completely covered with stripes!" Narrator 3: she cried. This was certainly true. Camilla was striped from head to toe. She looked like a rainbow. Narrator 4: Mrs. Cream felt Camilla's forehead. Mother: "Do you feel all right?" Narrator 1: she asked. Camilla: "I feel fine, but just look at me!" Narrator 2: Camilla answered. Mother: "You get back in bed this instant. You're not going to school today." Narrator 3: her mother ordered. Camilla was relieved. She didn't want to miss the first day of school, but she was afraid of what the other kids would say. And she had no idea what to wear with those crazy stripes. Narrator 4: That afternoon, Dr. Bumble came to examine Camilla. Dr. Bumble: "Most extraordinary! I've never seen anything like it! Are you having any coughing, sneezing, runny nose, aches, pains, chills, hot flashes, dizziness, drowsiness, shortness of breath, or uncontrollable twitching?" Narrator 1: he asked. Camilla: "No, I feel fine." Narrator 2: Camilla told him. Dr. Bumble: "Well then, I don't see any reason why she shouldn't go to school tomorrow. Here's some ointment that should help clear up those stripes in a few days. If it doesn't, you know where to reach me." Narrator 3: Dr. Bumble said, turning to Mrs. Cream. And off he went. Narrator 4: The next day was a disaster. Everyone at school laughed at Camilla. They called her "Camilla Crayon" and "Night of the Living Lollipop." Narrator 1: She tried her best to act as if everything were normal, but when the class said the Pledge of Allegiance, her stripes turned red, white, and blue, and she broke out in stars! Narrator 2: The other kids thought this was great. One yelled out, Narrator 3: "Let's see some purple polka dots!" Narrator 4: Sure enough, Camilla turned all purple polka-dotty. Someone else shouted, Narrator 1: "Checkerboard!" Narrator 4: and a pattern of squares covered her skin. Soon everyone was calling out different shapes and colors, and poor Camilla was changing faster than you can change channels on a T.V. Narrator 2: That night, Mr. Harms, the school principal, called. Mr. Harms: "I'm sorry, Mrs. Cream, I'm going to have to ask you to keep Camilla home from school. She's just too much of a distraction, and I've been getting phone calls from the other parents. They're afraid those stripes may be contagious." Narrator 3: he said. Camilla was so embarrassed. She couldn't believe that two days ago everyone liked her. Now, nobody wanted to be in the same room with her. Narrator 1: Her father tried to make her feel better. Father: "Is there anything I can get you, sweetheart?" Narrator 2: he asked. Camilla: "No, thank you," Narrator 3: sighed Camilla. What she really wanted was a nice plate of lima beans, but she had been laughed at enough for one day. Dr. Bumble: "Hmm, well, yes, I see. I think I'd better bring in the Specialists. We'll be right over.” Narrator 4: said Dr. Bumble to Mr. Cream on the phone. About an hour later, Dr. Bumble arrived with four people in long white coats. He introduced them to the Creams. Dr. Bumble: "This is Dr. Grop, Dr. Sponge, Dr. Cricket, and Dr. Young." Narrator 1: Then the Specialists went to work on Camilla. They squeezed and jabbed, tapped and tested. It was very uncomfortable. Dr. Grop: "Well, it's not the mumps." Dr. Sponge: "Or the measles." Dr. Cricket:"Definitely not chicken pox." Dr. Young: "Or sunburn." Narrator 2: replied the Specialists. Specialists:"Try these. Take one of each before bed." Narrator 4: said the specialists. They each handed her a bottle filled with different colored pills. Then they filed out the front door followed by Dr. Bumble. Narrator 1: That night, Camilla took her medicine. It was awful. Narrator 2: When she woke up the next morning, she did feel different, but when she got dressed, her clothes didn't fit right. She looked in the mirror, and there, staring back at her, was a giant, multi-colored pill with a face on it. Narrator 3: Dr. Bumble rushed over as soon as Mrs. Cream called. But this time, instead of the Specialists, he brought the Experts. Narrator 4: Dr. Gourd and Mr. Mellon were the finest scientific minds in the land. Once again, Camilla was poked and prodded, looked at and listened to. Narrator 1: The Experts wrote down lots of numbers. Then they huddled together and whispered. Dr. Gourd finally spoke. Dr. Gourd: "It might be a virus," Narrator 2: he announced with authority. Suddenly, fuzzy little virus balls appeared all over Camilla. Mr. Mellon: "Or possibly some form of bacteria," Narrator 3: said Mr. Mellon. Out popped squiggly little bacteria tails. Dr. Gourd: "Or it could be a fungus," Narrator 4: added Dr. Gourd. Instantly, Camilla was covered with different colored fungus blotches. The experts looked at Camilla, then each other. Experts: "We need to go over these numbers again back at the lab. We’ll call you when we know something," Narrator 1: said the Experts. But the Experts didn't have a clue, much less a cure. Narrator 2: By now, the T.V. news had found out about Camilla. Reporters from every channel were outside her house, telling the story of "The Bizarre Case of the Incredible Changing Kid." Narrator 3: Soon a huge crowd was camped out on the front lawn. Narrator 4: The Creams were swamped with all kinds of remedies from psychologists, allergists, herbalists, nutritionists, psychics, an old medicine man, a guru, and even a veterinarian. Narrator 1: Each so-called cure only added to poor Camilla's strange appearance until it was hard to even recognize her. She sprouted roots and berries and crystals and feathers and a long furry tail. But nothing worked. Narrator 2: One day, a woman who called herself an Environmental Therapist claimed she could cure Camilla. She said, Environmental Therapist: "Close your eyes, breathe deeply, and become one with your room." Camilla: "I wish you hadn't said that," Narrator 3: Camilla groaned. Slowly, she started to melt into the walls of her room. Her bed became her mouth, her nose was a dresser, and two paintings were her eyes. The therapist screamed and ran from the house. Mother: "What are we going to do? It just keeps getting worse and worse!" Narrator 4: cried Mrs. Cream. She began to sob. Narrator 1: At that moment, Mr. Cream heard a quiet little knock at the front door. He opened it, and there stood an old woman who was just as plump and sweet as a strawberry. Old Woman: "Excuse me, but I think I can help." Narrator 2: she said brightly. Narrator 3: She went into Camilla's room and looked around. Old Woman: "My goodness, what we have here is a bad case of the stripes. One of the worst I've ever seen!" Narrator 4: she said with a shake of her head. She pulled a container of small green beans from her bag. She said, Old Woman: "Here. These might do the trick." Mother: "Are those magic beans?" Narrator 1: asked Mrs. Cream. The old woman replied, Old Woman: "Oh my, no, there's no such thing. These are just plain old lima beans. I'll bet you'd like some, wouldn't you?" Narrator 2: she asked Camilla. Camilla wanted a big, heaping plateful of lima beans more than just about anything, but she was still afraid to admit it. She said, Camilla: "Yuck! No one likes lima beans, especially me!" Old Woman: "Oh, dear, I guess I was wrong about you." Narrator 3: said the old woman sadly. She put the beans back in her bag and started toward the door. Narrator 4: Camilla watched the old woman walk away. Those beans would taste so good. And being laughed at for eating them was nothing, compared to what she'd been going through. She finally couldn't stand it. Camilla: "Wait! The truth is...I really love lima beans." Narrator 1: she cried. The old woman smiled, popping a handful of beans into Camilla's mouth, and said, Old Woman: "I thought so." Camilla: "Mmmmmmm," Narrator 2: said Camilla. Suddenly the branches, feathers, and squiggly tails began to disappear.Then the whole room swirled around. When it stopped, there stood Camilla, and everything was back to normal. Camilla: "I'm cured!" Narrator 3: she shouted. The old woman said, Old Woman: "Yes, I knew the real you was in there somewhere." Narrator 4: She patted Camilla on the head and went outside and vanished into the crowd. Narrator 1: Afterward, Camilla wasn't quite the same. Narrator 2: Some of the kids at school said she was weird, but she didn't care a bit. Narrator 3: She ate all the lima beans she wanted, and she never had even a touch of stripes again.

Renal

Renal system

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