- The pancreas is a large, carrot shaped gland which lies just below your stomach.
- The larger end of the pancreas is on the right, tucking into the gut. The tail end is on the left, touching your spleen.
- The pancreas is made from a substance called exocrine tissue, embedded with hundreds of nests of hormone glands called the islets of Langerhans.
- The exocrine tissue secretes (releases) pancreatic enzymes.
- This is a microscopic view of the pancreas, such as amylase into the intestine to help digest food purple) embedded in the exocrine tissue with the islets of Langerhans shown.
- Amylase breaks down carbohydrates into simple sugars such as maltose, lactose and sucrose.
- The pancreatic enzymes run into the intestine via a pipe called the pancreatic duct, which joins on to the bile duct. This duct also carries bile.
- Diabetics, who suffer from the condition diabetes, produce little or no insulin in their pancreas. They control their blood glucose by injecting insulin, without which they might not survive.
- The pancreatic enzymes only start working when they meet other kinds of enzyme in the intestine.
- The pancreas also secretes the body’s own antacid, sodium bicarbonate, to settle an upset stomach.
- The islets of Langerhans secrete two important hormones, which are insulin and glucagon.
- Insulin and glucagon regulate blood sugar levels.
This form of hemorrhage has a slightly different cause, although the results are as disastrous as other forms of CVA. Near the base of the brain is an arterial ring called the “Circle of Willis”. Frequently, a small bulge may occur on this particular artery, called a “berry aneurysm.” It is relatively common for this to rupture suddenly (for similar reasons as with any rupturing, weakened vessel wall). However, instead of rupturing into the brain substance, being on the outer part of the brain, it may rupture into the space outside the actual brain substance. Alternatively, it may gradually exude blood and leak over a period of time, thus releasing irritating blood into the cerebrospinal fluid that bathes the brain.
The patient may suffer from recurring headaches, or the person may have been entirely free from them, the incident heralding the first sign that all is not well. Intense headache is rapidly followed by coma. About thirty percent of patients die in the first attack, and death may ensue within twenty-four to thirty-six hours or even later on during the first fortnight if fresh bleeding occurs from the rupture.
However, the patient may regain consciousness and start to improve. Severe headaches may persist for two to three weeks. Slow physical and intellectual recovery may gradually follow. As with any coma, the patient is treated as a medical emergency, although there are certain features indicating this type of disorder (after investigatory tests).
If this is suspected, then the patient may be considered to be a neurosurgical emergency for surgical intervention may save the patient from further attacks and may prolong life and bring it back to reasonable normality. However, experience shows that a high proportion of survivors have another attack (from a fresh site) within two years.
Diabetic comas may start with marked thirst and the passage of more than normal amounts of urine, with the desire to void often. There may be nausea, vomiting with cramp pains in the tummy region, and the child becomes dehydrated from the fluid loss. Breathing may be long and labored. There may be headaches, lethargy and drowsiness.
As this increases, the patient slips into the unconscious state. A check will show that blood pressure has fallen, the pulse and heart rate are rapid, the skin and lips dry and parched.
This may be a medical emergency, and it is essential that the child be transferred to the emergency ward of a well equipped hospital as early as possible. Here the relevant tests will be carried out and the correct therapy started promptly. This may be lifesaving.
Diabetic coma occurs in diabetic patients in whom the blood-sugar levels are not under adequate control. There is too much sugar in the blood, as the diabetic does not take enough insulin. Coma may come on gradually, and may be preceded by thirst and drowsiness. The breath smells of acetone (like nail polish remover), the skin may be dry and hot, the pulse rapid and the breathing deep.
The patient may be a known diabetic. Check for identification in a pocket, wallet or handbag for data. If it is due to bypogivaemia (inadequate sugar), giving a teaspoonful of sugar or powdered glucose will help if the patient is still conscious and able to take fluids. If the patient is unconscious, do not give anything orally, as it may lead to blocked air passages and choking.
If unconscious, place in the stable side position and get to medical help as a matter of urgency. Often it will be unknown what the cause of the trouble is, in which case the sooner medical attention in a hospital emergency ward is secured the better.
What is Mononucleosis?
Mononucleosis is an acute viral infection occurring mainly in the adolescent years that is caused by unusual cell growth of white blood cells. The main cause of these infections is the EBV or Epstein-Barr virus. Practically all humans suffer an infection from EBV before or upon reaching adulthood. For many that become infected, the body finds ways to adapt to the pathogen (agent causing the infection) and overtime builds up immunity to it. EBV is also referred to as human herpes virus 4 (HHV-4) and has a worldwide effect.
Most incidences of infections occur during childhood. The main problem with these early cases is that most go unnoticed or are mistaken for other common childhood ailments. Despite this, it is the infections occurring after puberty that can be most devastating.
Symptoms of Mononucleosis
The virus can take 30 to 50 days to incubate. After this period symptoms such as headaches, short-lived mild fevers that can get progressively worse if throat becomes severely soar, lymph nodes in the neck may become enlarged, fatigue, nausea, vomiting and inflamed tonsils. Affected tonsils are characterized by redness, exudates (white patches) and swelling. Although fatigue can linger, most symptoms will pass after one to two weeks.
Discomfort situated in the upper-left abdominal cavity is possible since the spleen may be enlarged during Mononucleosis. Strep throat may be paired with Mononucleosis infections. Although strep throat can be treated with antibiotics, EBV has none that targets it.
For the most part, allowing Mononucleosis to disappear on its own is the only option available. Those affected are usually recommended to find ways of securing comfort while the condition runs its course. Measures include drinking liquids frequently, resting as much as is possible and using pain relievers that contain ibuprofen or acetaminophen. Due to a (rare) link between aspirin and Reye’s syndrome when it is administered to persons with viral infections that are acute, aspirin should not be used.
However, if enlarged spleen is ruptured or swelling of tonsils restrict swallowing or breathing, the treatment received will be more intensive. Indications of a ruptured spleen include sudden pain that is persistent. If damaged, the organ can be repaired or completely removed. To protect the spleen and avoid this complication, it is best to engage in only light activities. Rigorous playing and contact sports should be avoided for 3 to 4 weeks after infection.
Follow all instructions given by a physician since treatment (whether medical or otherwise) will differ based on the severity of the infection. Mononucleosis’ ability to continue affecting victims is unclear. There are some unsubstantiated speculations that it may be a contributing factor to chronic fatigue experience in teens and adults (who are not engaged in rigorous activities).
Transmission of Mononucleosis
Mononucleosis can be transmitted via salivary secretions hence is referred to as the “kissing disease” however, there is no indication that it is contagious. Still, it is best to avoid using utensils or allowing unaffected persons to come in contact with the saliva of some-one that is infected.
The body’s immunity can be ascertained by doing antibody tests.
Birthmarks occur where there is an over-abundance of a particular component of normal skin such as tiny blood vessels (capillaries) or pigment cells. The cause of this local condition is unknown.
The flat, pink birthmarks commonly seen on the forehead, eyelids, back of the neck, and above the bridge of the nose are called capillary hemangiomas, alsoknown as “stork bites” or “salmon patches.” These are seen in about 50 percent of newborns. Eyelid patches will disappear by three to six months of age, while those on the neck will fade but may last for years.
Areas of dark or bluish gray pigmentation known as Mongolian spots are common on the low back and buttocks of dark-skinned newborns, although these marks may be found in all racial and ethnic groups. These marks vary greatly in size and shape and usually disappear by two to three years of age.
A more permanent type of birthmark is the café and bait spot, a light brown flat patch that can occur any-where on the body. While some are present at birth, others may appear later in life. While these markings are benign, the presence of six or more of them measuring more than 15 mm (about 5/8 inch) in diameter may indicate a more serious problem known as neurofibromatosis.
One or more dark brown, black, or blue-black spots known as nevi, which contain large numbers of pigmented cells, may be seen at birth in about one in one hundred Caucasian infants. While the vast majority of these spots never cause any trouble, on rare occasion (usually in adolescence or even later in adulthood), one or more may transform into a dangerous type of skin cancer called a malignant melanoma. You should be-come familiar with the appearance of arty nevi on your child’s skin and watch in particular for any of the following warning signs: significant change in size; crusting, oozing, or bleeding; the development of an irregular border or color pattern; and change from a flat to a raised or rough contour. Should any of these changes develop, ask your child’s doctor or a dermatologist to ex-amine the area.
A more troublesome (but also uncommon) birthmark is the giant pigmented nevus, an irregular dark brown patch over four inches in diameter. If this covers a large area of the lower trunk, it is called the “bathing trunk nevus.” At a microscopic level this is structurally similar to the common moles (or juncfinevi), which become more common and widely spread over the skin later in life. Unfortunately, giant pigmenevi are much more likely than the smaller conge pigmented nevi to transform into malign melanomas. This change can occur during infancy any time later in life. For this reason a consultation with a dermatologist or plastic surgeon may be recommended an early age.
- In the 1920s many architects rejected old styles to experiment with simple shapes in materials like glass, steel and concrete.
- The International Style was pioneered by the Swiss architect Le Corbusier who built houses in smooth geometric shapes like boxes.
- The Bauhaus school in Germany believed buildings should look like the job they were meant to do.
- Walter Gropius and Mies van de Rohe took Bauhaus ideas to the USA and developed sleek, glass-walled, steel-framed skyscrapers like New York’s Seagram Building.
- Old and new in Hong Kong: the modern Hong Kong–Shanghai Bank dwarfs a 19th-century classical building.
- American Frank Lloyd Wright (1869-1959) was famous both for his low, prairie-style bungalows ‘growing’ from their site and his airy and elegant geometric buildings.
- In the 1950s architects like Kenzo Tange of Japan reacted against the ‘blandness’ of the International Style, introducing a rough concrete look called Brutalism.
- In the 1960s many critics reacted against the damage done by modern architecture to historic cities.
- Post-modernists were united in rejecting modern architecture, often reviving historical styles. American Robert Venturi added traditional decoration.
- Richard Rogers’ Pompidou centre in Paris (1977) was a humorous joke on I IR. Bauhaus idea, exposing the ‘bones’ of the building.
- With shiny metal and varied shapes the Guggenheim Gallery in Bilbao in Spain is a new masterpiece. It was designed by American architect Frank Gehry.
- Berlin is Germany’s capital and largest city, with a population of about 3.5 million.
- Berlin was originally capital of Prussia, which expanded to become Germany in the 1800s.
- The city was wrecked by Allied bombs in World War II.
- After the War Berlin was left inside the new communist East Germany and split into East and West by a high wall.
- East Berlin was the capital of East Germany; the West German capital moved to Bonn.
- In 1989 the East German government collapsed and the Berlin Wall was torn down. East and West Germany were united in 1990 and Berlin was made capital again.
- The Brandenburg Gate is a huge stone arch built in 1791. It now marks the boundary between east and west.
- The Brandenburg Gate marked the boundary between East and West Berlin. In 1990 the east and west halves of the city were reunited.
- The Berlin Wall was built in 1961. Anyone caught trying to cross from the east to the west was killed.
- Kurfurstendamm is a famous shopping avenue. The Hansa quarter was designed by architects in the 1950s.
- Since reunification many spectacular new buildings have been built in Berlin, including the refurbished Reichstag designed by Norman Foster.
- Hipparchus of Nicaea was a Greek astronomer who lived in the 2nd century BC, dying in 127Bc.
- The foundations of astronomy were laid down by Hipparchus and survived 1500 years, until they were overthrown by the ideas of Copernicus.
- Ancient Babylonian records brought back by Alexander the Great from his conquests helped Hipparchus to make his observations of the stars.
- Hipparchus was the first astronomer to try to work out how far away the Sun is.
- The first star catalogue, listing 850 stars, was put together by Hipparchus.
- Hipparchus was also the first to identify the constellations systematically and to assess stars in terms of magnitude (see star brightness).
- Hipparchus also discovered that the relative positions of the stars on the equinoxes (21 March and 21 December) slowly shift round, taking 26,000 years to return to their original place. This is called the ‘precession of the equinoxes’.
- The mathematics of trigonometry is also thought to have been invented by Hipparchus.
- Hipparchus carried out his observations at Rhodes. He was the first to pinpoint the geographical position of places by latitude and longitude.
- When you remember something, your brain probably stores it by creating new nerve connections.
- You have three types of memory – sensory, short-term and long-term.
- Sensory memory is when you go on feeling a sensation for a moment after it stops.
- Short-term memory is when the brain stores things for a few seconds, like a phone number you remember long enough to press the buttons.
- Long-term memory is memory that can last for months or maybe even your whole life.
- Your brain seems to have two ways of remembering things for the long term. Scientists call these two different ways declarative and non-declarative memories.
- Non-declarative memories are skills you teach yourself by practicing, such as playing badminton or the flute. Repetition establishes nerve pathways.
- Declarative memories are either episodic or semantic. Each may be sent by the hippocampus region of the brain to the correct place in the cortex, the brain’s wrinkly outer layer where you do most of your thinking.
- Episodic memories are memories of striking events in your life, such as breaking your leg or your first day at a new school. You not only recall facts, but sensations too.
- Semantic memories are facts such as dates. Scientists think these are stored in he left temporal lobe, at the front left-hand side of your brain.
It is an ominous disorder. Usually it affects older children, more probably in the five-to-fifteen-years age group. Strange to say, it often commences by affecting one or more joints. But this is really a trap for young players, and is frequently merely the tip of the iceberg.
Although a painful swollen joint is uncomfortable, in many cases it resolves completely. But later on this may inauspiciously lead to fairly severe disease of the heart. In fact, it may not become apparent until well into adult life.
It’s seen less frequently than in years gone by. I think the general improvement in living conditions, housing standards, and probably nutrition have all played a part in reducing its frequency. Social problems and domestic difficulties, with consequent overcrowding and reduced general health, seem to have played a part in occurrence. As these improve, so the incidence appears to reduce.
Rheumatic Heart Disease Symptoms
The child often runs a fever and feels off-colour. Sometimes a large joint, probably the knee, ankle, elbow or wrist, swells up and becomes hot, tender and painful. After a few days it may subside, to jump surreptitiously to another joint. There may be a skin rash, and occasionally little lumps come up around the joint, or at the base of the skull.
As the fever continues, often the heart rate starts to increase. In fact, it may step up to a very fast rate, and this certainly demands urgent attention.
Children will make strange movements. This is more probable in young girls, and is referred to as rheumatic chorea or St Vitus’ dance. Quite out of her control, the hapless child commences making strange grimaces and ridiculous, purposeless movements. Besides facial twitching, there may be similar movements in the limbs or body. The more she tries to stop, often the worse it becomes. It’s very tiring, debilitating and embarrassing, and the whole episode is filled with distressing emotional overtones. I’ve heard that these heart abnormalities can follow on from a simple infection of the throat, in a way similar to certain kidney infections.
Yes. The wily germ called the Haemolytic streptococcus is capable of many mean things, and affecting the kidneys and heart are in his repertoire. It may begin several weeks after the throat infection, and by the time the heart is involved, the initial infection is long since finished. It may be from one to three weeks after, or even more. The chorea may not set in for many weeks, perhaps 15 or more from the initial infection.
Chronic Rheumatic Fever may ensue. By then it’s almost certain the heart is involved. Scarring of the heart muscle or the heart valves may occur, and this is a bad outlook for the future. In fact, some patients develop significant cardiac symptoms many years after a childhood infection.
Rheumatic Heart Disease Treatment
Many doctors believe that it’s wise to try to pr vent trouble from taking place. For this reason, many treat every sore throat with suspicion. What’s more, if antibiotics are prescribed, the doctor likes to make certain the full course is taken, in order to completely knock out the invading germ, and not just stun it. As far as treatment in general is concerned, a routine will be worked out specifically for each patient, and this will be in accordance with the needs of the moment. It may vary in each case. It’s important for best results that the doctor’s instructions be carried out implicitly.
Ideally the child should be served attractive meals that are well-tolerated. A spread of nutritious foods is recommended, for trying to maintain good general health is essential. It will lessen the risk of contracting further infections. A variety of drugs are used. These may include salicylates, the stand-by form of therapy for many years. They still rank with the best antibiotics that may be prescribed, and sometimes the steroids are used for short periods.
It is essential to provide the child with as much tender, loving care and backup emotional care and support as possible. The illness may be a long, tedious, harrowing one, for the patient as well as the parents. A mother can do a great deal by emotionally supporting her offspring. Also, husbands should try to support their wives as much as possible, for frequently they bear the brunt of the deal, being at home and having to supervise the care