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Many people regard the papering of ceilings with horror. In reality they are easier to deal with than walls because they are flat, do not have any awkward angles (except in rooms with sloping ceilings and dormer windows), and have few obstacles attached to them apart from the occasional light fitting(fixture), which can in any case usually be removed quite easily.

The only thing that takes getting used to when papering ceilings is working on an upside-down surface. The basic technique is no different from working on walls. The wall covering is simply positioned, brushed into place and then trimmed where it meets adjoining surfaces.

The most important thing to plan carefully is access equipment that will safely allow a complete length to be hung across the room. Nothing is more dangerous than attempting to step off of the chair; proper access is a must. The best solution is to use scaffold boards or lengths of staging, supported by stepladders, trestles or home-made supports to create a flat, level walkway spanning the room from wall to wall at a height that allows the ceiling to be reached comfortably. It will take only a few seconds to reposition after hanging each length, ready for the next.
This is also a job where an additional pair of hands will be a big help, at least before gaining the knack of supporting a concertina of pasted wall covering with one hand while:.-rushing it into position with the other— this can be done only with practice.

The first length should he hung to a guideline on the ceiling. The best way of marking this is with a chalked line against the ceiling at both ends snapped against it.

PAPERING CEILINGS

1. Paste the wall covering in the usual way, but fold it up concertina-fashion with the starting end of the length folded over on itself. Lining (liner) paper has been used here.

2. Hang the first length to a chalked line just less than the width of the call covering from the side wall. Support the folds on a spare roll of wall covering from the side wall. Support the folds on a spare roll of wall covering.

3. Trim the overlaps at the ends and along the side wall. Then hang the second length in the same way, butted up against the edge of the first length.

4. On meeting a pendant light fitting (fixture) pierce the wall covering over its centre and make a series of radial cuts outwards front the pierced point.

5. With the power turned off at the unscrew the cover and trim the tongues off, flush with the base of the fitting. Replace the cover.

6 Where the ceiling runs into an alcove, CIA the wall covering in line with the sidewall of the recess and brush it into place.’

PAPERING ARCHES

The shape of an arch makes it impossible to get a pattern match along the curved join. It is best to choose a wall covering with a small design motif and a random pattern, to use different but complementary designs for the face walls and the arch surface, or to use lining (liner) paper inside the arch and paint it a plain colour.

To paper an arched recess, cover the face and hack walls first turning cut tongues of wall covering onto the arched surface. Then cover the arch surface as described below.

To paper a through archway, hang the wall covering on the two face walls and trim out the waste to leave an overlap of about 25 mm in all around. Make cuts in the edge so that the tongues can be turned on to the arch surface. Then cut a strip of wall covering a traction narrower than the width of the arch surface and long enough to cover it in one piece, and brush this into place. Work from the bottom of one side upwards to the top of the arch, and then down the other side. Always use special overlap adhesive with washables and vinyls.

This is a common skin disorder that occurs in the form of small blisters usually around the lips. They may become very sore. Often the lymph glands under the jaw swell and also become painful.

A day or two before the blisters (“vesicles”) appear, there is often a dry, tingling sensation of the skin. Patients suffering from recurring bouts should learn to identify this sensation, for local treatment applied at this stage can often check an attack.

Viral Skin Infections Causes

The disease is caused by a virus called herpes simplex virus-1 (IISV-1), and it is aggravated by many factors. It has nothing to do with colds, but sometimes follows respiratory tract infections. Fevers, infections, allergies, exposure to sunshine and emotional upsets have all been blamed for bringing on attacks. Although most common about the lips, Herpes simplex, or cold sores, is an ivkinine2s)/222 rite skin 1101.Sell by a virus. herpes simplex can occur anywhere on the skin. If it occurs near the eyes, it is imperative that immediate expert assistance be sought, for it can cause serious ocular damage.

Sometimes the virus produces blisters in the genital region, and it has mistakenly been diagnosed as venereal disease. When it occurs here, it is called 1-ISV-2 infection. It has recently been found that in women with this disorder there is an increased risk of cancer of the cervix. Therefore prompt medical attention is essential, together with a “smear test” to check for cancer.

Viral Skin Infections Treatment

Most cases of simple cold sores can be treated quite effectively at home with routine remedies.

Local cream. Idoxuridine 0.5 per cent Cold Sore Ointment (Stoxil) applied early will often prevent the occurrence of blisters. It is best applied to the skin surface when the dry, tingling sensation (well known to chronic sufferers) occurs. Apply thinly every hour for the first day. and four-hourly after this. at is of little value after blisters have appeared.) This preparation should not be applied to the eyes.

Other applications. Spirits of camphor, or 10 per cent camphor in alcohol, or Bismuth-formic-iodide powder (BFI Powder) arc often used. These may assist’la drying out the blisters and bring some relief.

Avoiding the causes. Check for possible -causes in your case, and avoid them in :he future. For example, be careful when sunbathing early in the season; avoid domestic squabbles and keep away from emotional stresses and crises whenever Possible; do not eat foods you suspect can bring a recurrence of blisters; keep infection-free as much as possible.

Further Treatment. If simple measures do not bring relief, and particularly if the eyes or genital areas become involved, it is necessary to seek medical assistance.

Other lines of treatment that may be included by the physician include:

Acyclovir. The antiviral antibiotic acyclovir has a dramatic effect on the herpes virus, rapidly destroying it. Medication is given early, and by oral administration. It may not be warranted for simple isolated bouts, but for severe recurring attacks, it quickly eliminates blisters, pain, itch and discomfort. It is a major step forward in the treatment of herpes infections.

Cryotherapy. The application of ice, or icepacks, in the very early stages of heroes infection, will often prevent the virus :rom multiplying further. Packs must be kept in place for 30-60 minutes, and re- –)eated 2-3 times a day. If applied at the :rst sign of an attack, it will often abort it. is simple, cheap and effective.

Eye applications. If the eyes arc involved and this may be serious), specially formulated Idoxuridine eye drops (Stoxil) may be used.

Thorough examination. Especially necessary in the case of genital herpes, _or there is an increased risk of cancer of :he cervix (neck portion of the womb that forms the upper part of the vaginal canal). The physician may perform a -smear test” to check for this.

Special Note. In these days of bulging some medicine kits, most people have .re:ady access to the steroid (cortisone) 1:earns and ointments. It is stressed that :eese must not be used on any herpes for they can rapidly make the conworse. This also applies to the eye.

This is one reason why steroid applications for any disorder should be given only under medical supervision. Shingles (Herpes Zoster or Zoster).

This is an annoying skin eruption affecting any age group, but is often more severe and more painful in older persons.

It usually occurs on one side only of the body, and the trunk is often affected in either the upper or lower part. Sometimes the limbs are affected. A severe form may occur on one side of the face and in unfortunate instances it will spread over the eye, causing serious damage.

It often commences with local discomfort and a hot, tingling sensation. This is followed by the appearance of a small blister on a red base. These increase in number and size, and often develop in a straight line roughly equivalent to the line of nerves just below the skin.

Shingles is caused by a virus (termed the Varicella or “VG” virus) that also produces chickenpox. In nearly every case there has been an attack of chickenpox in earlier years. The germ lies dormant in the nervous system for many years until a trigger mechanism causes a recurrence of activity in the superficial nerves. The course of the disorder varies. With children, there is often little discomfort, and the entire disease may be over within a fortnight.

However, in older patients (and particularly the aged, who may have an intercurrent infection) the pain may be intense and persistent. The blisters may break down and form skin ulcers. When the disease finally settles down, it is often followed by severe pain in the areas affected, called post-herpetic neuralgia. This may persist for months and even years, and may be difficult to cure. If the nerve leading to the eye is involved, this is serious, and an eye specialist must be called in for advice. Investigation shows there may be a relationship between shingles in older people and cancer, although other reports refute it. However, any older person contracting shingles should be thoroughly checked out by the doctor for the possibility of a hidden cancer.

In a perfect world, rooms would have corners that were truly square and truly vertical, and it would be possible to hang a wall covering all around the room in a continuous operation, simply turning the lengths that ran into the room corners straight on to the adjoining walls. In reality, corners are seldom square or true, and, if the covering were hung in this way, lengths would be vertical on the first wall but could be running well off the vertical by the time they returned to the starting point. This would be visually disastrous, with vertical pattern elements out of alignment are corners, and sloping horizontal pattern features.

The way to avoid these problems is to complete each wall with a cut-down strip that only just turns on to the next wall. Then hang the remainder of the strip with its machine-cur edge against a newly drawn vertical line on the second wall, so that you can trim its other edge to follow the internal angle precisely. Any slight discontinuity of pattern will not be noticeable except to the very closest scrutiny, and the remaining lengths on the second wall will be hung truly vertically. The same applies to paperhanging around external corners

PAPERING AN INTERNAL CORNER

1. Hang the last full length before the corner of the room, then measure the distance to the corner front the edge of the length and add about 12 mm or 1/2 in.

2. Use a pencil and straightedge to mark a strip of the required width, measured from the relevant edge (here, the left one), and cut it from the length.

3. Paste the strip and hang it in the usual way, allowing the hand-cut edge to lap onto the adjoining wall. Trim the top and bottom edges as usual.

4. Brush the tongue into the internal angle. If it will not lie flat because the corner is out of true, make small release cuts in the edge and brush it flat.

5. Measure the width of the remaining strip, subtract 12 mm/1/2 in. and mark a fresh Vertical line on the adjoining wall at this distance from the corner

6. Hang the strip to the marked line, brushing the wall covering into the angle so that it just turns on to the surface of
.the first wall.

7. Use the back of the scissors blades to mark the line of the corner on the wall covering, then cut along the line and smooth the cut edge back into the angle. Use special overlap adhesive when using washables and vinyl on all lap joints.

PAPERING AN EXTERNAL CORNER

1. Plan the starting point so that lengths turn external corners by about 2.5 cm/1 in. Brush the paper on to the next wall, making small cuts so that it lies flat.

2. Carefully tear off a narrow strip of the wall covering along the turned edge to leave a ‘feathered’ edge that will not show through the next length.

3. Mark a vertical line on the next wall surface, at a distance from the corner equal to the width of the wall covering plus about 6mm or 1/4 in.

4. Hang the next full length to the marked line, with its other edge overlapping the feathered edge of the strip turned from the previous wall

5. Brush this length into position, trim it at the top and bottom as before, and run a seam roller down the overlap(do trot do this on embossed or textured wall coverings).Again, use a special overlap adhesive with washable and vinyl coverings.

Small plants can be displayed more creatively than just in individual pots. Plant them in groups in planters or baskets, or in a shallow container on a pedestal. You can even create a miniature garden in a large bottle. An advantage of grouping plants is that you can get away with less than perfect specimens. A plant with lopsided growth, or one that is bare at the base, can be arranged so that its defects are hidden by other plants.

Grouped plants also benefit from the microclimate created when plants are grown together. The local humidity is likely to be a little higher as the leaves tend to protect each other from drying air and cold draughts, and it is easier to keep the compost (potting soil) evenly moist in a large container than a small one. Groupings are ideal for self-watering containers and for plants grown hydroponically, and simply ensuring a steady and even supply of moisture produces better growth.

Pedestals make good bases for plant displays. If you have an attractive pedestal, use short trailers that will cascade over the pot but will not completely hide the pedestal under a curtain of leaves. Plants with an arching rather than a cascading habit are also ideal for a pedestal where you want to show off both pot and pedestal. Another display idea is a pot-et-flour arrangement. This makes an ideal centerpiece, and gives plenty of scope for artistic presentation.

The still, protected and humid environment of a sealed bottle garden, with moisture re-circulating as it condenses and runs down the glass, makes it possible to grow many small jungle and rainforest type plants that would soon die in a normal room environment. Yet, if you leave the top off and water very carefully, a bottle garden can also be a pretty way to display those plants that enjoy less humid conditions

PLANTING A PEDESTAL ARRANGEMENT

Fill a wide, shallow, stable container with a layer of compost (potting soil).Choose a mixture of flowering and foliage plants for a spectacular display. Try them for position while still in their pots, until you are happy with the arrangement.
Remove the plants from their pots for final planting. Set those at the edge at an angle so that they tumble over the side.
Water, then sit the container in a saucer and position it on the pedestal.

CREATING A POT-ET-FLELJR WITH FOAM

1. If you are using a basket, line it with plastic to ensure that it is waterproof.
2. Position your foliage plants first, preferably in shallow pots.
3. Cut a block of absorbent stem-holding foam (this should be soaked overnight in water first) into pieces of the size required. Pack the pieces of foam between the pots to fill up all the gaps and hold the pots securely in position.
4. Insert your flowers (and some additional cut foliage if you wish) into the moist foam. Stand back from the arrangement and view it from a distance to see whether you are happy with the result, and add more flowers and foliage if necessary.
5. Place the arrangement in a fairly cool position, and replace the flowers and cut foliage as necessary (adding water to the foam will help to preserve them). If any of the foliage plants deteriorate in time, simply replace them with fresh ones.

PLANTING A BOTTLE GARDEN

1. Place a layer of charcoal and gravel or expanded clay granules in the bottom of a thoroughly clean, fairly deep bottle. Add compost (potting soil), using a funnel or cone made from a sheet of thick paper or thin cardboard as a guide.
2. If necessary, remove a little of the compost from the plants to make insertion easier. Unless the neck of the bottle is very narrow, you should be able to insert the plants without difficulty. If you cannot get your hand into the bottle, use implements such as those shown to lower the plants into position. Add another layer of charcoal and gravel or expanded clay granules around the bases of the plants.
3. After tamping the compost around the roots (use a cotton reel on the end of a cane if necessary), mist the plants and compost. If necessary, direct the spray to remove compost adhering to the sides of the bottle. This type of open-topped bottle will require careful watering. Place it in good light, but away from direct sun as the plants may easily be scorched through the glass.

What is Otic Barotrauma?

This fancy name merely indicates the discomfort that can occur in the ear when situations creating pressure differentials between the middle ear and the exterior take place. In today’s jet era any people travel by air, and during transit, the problem is most likely to arise. It is far more likely if the person is suffering from a mild head cold, or any infection that may block the patency (openness) of the Eustachian canal. This canal maintains air pressures within the middle ear equal to that on the outside, and this is vital to continued comfort. Other conditions where a similar problems can occur include tunneling, and scuba diving in deep water.

Otic Barotrauma Symptoms

Often in a person who has a cold or upper respiratory tract infection there is sudden onset of pain in the ear(s) as the plane descends. The pain may become extremely acute and may even be excruciating. Examined soon after, the drum may he very red and infected, and on occasion bleeding may result. Fluid may accumulate and deafness occurs.

Otic Barotrauma Treatment

Being sensible and avoiding flying whenever possible if a head infection is present will avert trouble. If this cannot be avoided, or if it is not noticed that there is a mild infection, or if the condition occurs during flight, using this simple maneuver may give prompt relief. This involves holding the nose between the forefinger and thumb, and then trying to blow into the nose.
This may help open the canal, and a “click” to occur, so allowing the pressures to equal. It should be repeated many times over. Sucking sweets may also help by opening the partially blocked canal. If unsuccessful, medical attention may be necessary. The middle ear must be aerated, and this will probably be done by the ENT doctor through Eustachian catheterisation or by paracentesis under antibiotic cover.

MAKES 1 LOAF

107g11/2 tsp active dry yeast

300ml/1/2 pint/11/4 cups lukewarm water

200g/7 oz1 13/4cups plain (all-purpose) flour

200g/7oz/1-3/4 cups whole-wheat flour

10m1/2 tsp salt

70g/21/2 oz/5 tbsp toasted sesame seeds

Milk, for glazing

30ml/2 tbsp sesame seeds, for sprinkling

1 Combine the yeast and 75 m1/5 tbsp of the water and then leave to dissolve. Mix the flours and salt in a large bowl. Make a well in the centre and pour in the yeast and water.

4 Grease a 23cm/9 in cake tin (pan). Punch down the dough and knead in the sesame seeds. Divide the dough into 16 halls and place in the tin. Cover with cling film (plastic wrap)and leave in a warm place until risen above the rim of the tin.

5 Preheat a 220°C/425°F/Gas 7 oven. Brush the loaf with milk and sprinkle with the sesame seeds. Bake for 15minutes. Lower the heat to 190°C/375°F/Gas 5 and bake until the bottom sounds hollow when rapped, about 30minutes more.

Cool on a wire rack.

Blinds are becoming a very popular alternative window dressing to a pair of curtains (drapes). The styles of blind described here, although made using very similar techniques, create very different effects. Choose the softly ruched Austrian blind for a pretty, feminine window treatment and the smartly pleated Roman blind for a room with a modern decor.

Use a light or medium weight fabric to make an Austrian blind, anything from lightweight voile or sheer to standard cotton curtain fabric will be suitable. Avoid heavy brocades and hand woven cottons, as these are too thick to drape well. You will need a special type of track to hang and mount the blind; this is known as Austrian blind track, and is widely available.

A Roman blind, on the other hand, will benefit from being made in a reasonably substantial fabric. You can line this type of blind if you wish, to add body to the pleats and also to retain the warmth of a room. You need a batten (furring strip) and angle irons to mount the blind. Use strips of touch and close fastener to hold the blind in place on the batten. An Austrian blinds are mounted in much the same way, with the cords threaded through rings attached to the track.

MAKING A ROMAN BLINDS

1. Cut out the fabric. Turn, pin and stitch double 12 mm or 1/2 in side hems. Turn, pin and then machine stitch a double 2.5 cm/1 in hens along the top of the fabric. Press all the hems.
2. Pin and stitch a strip of Roman blind tape close to the side edge, turning under 9 cm at the top. Stitch another strip along the remaining edge, then attach further strips at intervals across the blind, 25-30 cm/10-12 in apart.
3. At the bottom of the blind, turn over 9mm or 1/8 in and press, then turn over a further 5 cm/2 in to enclose the ends of the tape. Pin and stitch the hem close to the inner fold, leaving the sides open.
4. Stitch narrow tucks across the width of the blind to correspond with alternate rows of loops or rings on the tape. Make the first tuck level with the second row of loops or rings from the bottom of the blind. To make the tucks, fold the fabric with the wrong sides facing, and stitch 3mm or 1/8 in from the fold.

CALCULATING FABRIC REQUIREMENTS

Roman Blind

To calculate the length, measure the window drop, add 14 cm/ 4I/2 in for hem allowances and a little extra for the horizontal tucks. For the width, measure the window and add 6 cm/ 2 in for side hems. You will need sufficient strips of Roman blind strip to position at 25-30 cm/10-12 in intervals across the width of the blind. Each strip should be the length of the Hind plus 12/1/2 in; make sure there is a loop or ring12 mm/1/2 in up from the bottom of each strip so that they will match across the blind.

Attach the blind to the top of the batten with strips of touch and close fastener. Cut each length of cord to twice the length of the Hind plus the distance of the right-hand edge. Thread each cord through the loops in the tape. Knot each length securely on the bottom loop and thread the other end through the corresponding screw eyes on the batten, ending with all the cord ends on the right hand side of the blind. Knot the cords at the top, cut the ends off level and knot them again.

What is Ovarian Tumor?

The ovaries are a fairly common site for the development of tumors. They are most frequently detected in women aged 35 years or more. They tend to grow slowly, and are often not discovered until they have grown to a relatively large size.
Often a lump welling up from the pelvic cavity (sometimes believed to be a pregnancy, even though menstruation may still be occurring) is the first indication. But in an obese woman, it may just appear that she is putting on even more weight in the abdominal region, and may be overlooked for a long time.
Many are discovered in the course of a routine pelvic examination for some other reason. (This is another reason in favour of having regular pelvic checks when returning for a repeat prescription of the contraceptive pill. If this is not carried out routinely by your own doctor, it is well worth asking for.) Many tumors are discovered during a laparoscopic examination of the pelvis.
Fortunately, about 95 per cent of ovarian tumors are benign (ie noncancerous). Benign tumors are usually cystic, so that if a cystic swelling is discovered, it usually means that it is a simple, noncancerous one.
However, the remaining 5 per cent still equals a lot, and malignancy in this area is fraught with problems. For cancer tends to grow at a steady rate, silently, and almost symptom-free in the early stages. Often, by the time adequate symptoms have occurred to make the patient seek medical assistance, the cancer has advanced to an incurable state. Once more this indicates the supreme value of regular medical examinations and pelvic checks throughout life. Discovering these disorders early (before symptoms set in) offers about the only chance of a successful outcome.

Ovarian Tumor Symptoms

Benign tumors never cause pain, unless some sort of complication occurs, and rarely do they affect menstrual function. Symptoms can take place if the tumor is on a lengthy stalk (pedicle), and it becomes twisted on itself. If the cystic swelling suddenly bursts. symptoms may also take place.
Princess Anne of Britain was in the news some years ago when it appeared that she had an ovarian cyst that had suddenly developed this complication. Sometimes a surgical emergency may arise. But with small cysts, a slight discomfort may be all that a woman experiences.
Very large tumors may produce symptoms from pressure on surrounding structures. Abdominal discomfort, lack of appetite and/or nausea may occur when the abdominal contents are squeezed by mechanical pressure. Malignant tumors of the ovaries are often associated with pain, particularly in the later stages when surrounding structures have become involved. Fluid in the pelvic cavity and weight loss are also other ominous signs.
Diagnosis of ovarian tumors may be simple, or they may be extremely difficult. Sometimes radiology and ultrasound aids are needed to help in distinguishing it from other possible diagnoses.

Ovarian Tumor Treatment

The course of action depends on the nature and severity of the symptoms being produced. If severe bleeding is occurring, particularly in an older woman, surgical removal of the uterus is often undertaken. If troublesome pressure symptoms are encountered, a similar approach is frequently made.
In younger women (especially those under the age of 40), and those still desirous of maintaining their reproductive function, myomectomy may be advised. One important flow-on benefit is that a substantial number of women who appeared to be infertile (presumably due to the presence of the tumor) subsequently become pregnant after this operation.
Treatment of most ovarian tumors is surgical. In young women, every effort is made to preserve as much of the normal ovary (if there is any left) as possible. This help ensure continuation of the system’s hormonal supply, and so help maintain a feeling of normality.
As there is a risk of benign cysts turning cancerous, they are usually removed. Smaller ones are either ruptured or removed alone or with the ovary through the operating laparoscope. as seen in full colour by the doctor on a VDU screen, which sits next to the patient. It can sometimes be difficult to know if a tumor is in fact cancerous or not until it has been thoroughly examined by the pathologist under the microscope. Any parts that are removed must always be scrutinised by the experts for a full report.
In older women, frequently a greater amount of tissue is removed, for there is often an increased risk of cancer. Ovarian cancer is a serious disease and follow-up therapy is usually carried out. Development of Taxol, from the yew tree, holds hope for the future. Time will tell.
The main point in this section is the need to recognise that ovarian tumors are relatively common. While most are noncancerous, there is a real risk that malignancy may develop.
The sooner diagnosis is made and treatment undertaken, the better. There is also a case for regular pelvic examinations throughout life in order to detect any such abnormality as early as possible.

Endometrial Ablation

New technology continues to improve the lot of many women undergoing surgery. In many cases, in women with heavy bleeding for no obvious cause, the traditional D and C or hysterectomy (womb removal) is being replaced by endometrial ablation. This is carried out in hospital under a general anaesthetic. A camera looks inside the womb, and this is displayed on a VDU screen nearby, and the surgeon works from this, gently manipulating the instruments. A “rollerball” or laser beam then systematically removes the endometrial lining of the womb. This goes deeply, so that subsequent scar tissue will prevent new tissue lining from growing.
In most cases, bleeding is dramatically reduced. Pregnancy is usually no longer possible. The patient normally recovers quickly. It is a much lesser operation than womb removal, and the patient may return home and back to normal duties fairly quickly.

Laparoscopic Hysterectomy

The laparoscopic method is being used for an increasing range of surgical operations. Many gynaecologists use it for womb removal (hysterectomy) Tubes (one containing a camera and lights) are inserted via tiny 1 cm incisions called portals low down in the pelvis. This is shown up on the VDU screen, and the surgeon gently dissects away the unwanted parts.
Finally, the womb (and other organs if need be) is removed via an incision high up in the vaginal canal. Recovery is claimed to be quicker, although the operation still takes a considerable period of time, and specialised surgical skills and equipment are required.

What is Paralytic Ileus?
This is a type of bowel obstruction, but instead of being caused by some mechanical means, it is simply due to intestinal immobility. Normally peristaltic waves of contraction constantly move along the length of the bowel, pushing the fluid contents forwards at all times.
However, under certain circumstances, most commonly following surgical operations on the abdomen, a portion of the bowel suddenly ceases to pass on the waves of contraction. This probably occurs to a small extent after most abdominal operations, but it invariably reverts to normal function after a short time, with no adverse aftermath.
Accidents and a variety of other less commonly encountered causes may also produce the complication.
Paralytic Ileus Symptoms
There is usually a history of recent operation, accident or precipitating cause. Vomiting usually occurs, and constipation is the rule. Peristalsis is usually markedly diminished or absent. This is evidenced by complete silence when the abdomen is checked with a stethoscope. Abdominal distension is present, and soreness may or may not occur. X-rays show distension of the bowel with gas throughout (different from an obstruction where only the part above the obstruction shows distension).
Paralytic Ileus Treatment
Most patients are already in hospital, recuperating from a surgical operation. Treatment involves supplying adequate fluids, restricting the oral intake of food, decompressing the bowel (it may be necessary to intubate the patient, by passing a tube into the bowel) and dealing with any suspected underlying disorder. Most cases respond well to these measures, and the paralysed intestine soon resumes normal function.

The first involves finishing off apart-riled wall with a band of narrow tiles in a colour or design that complements or contrasts with the main riled area, to form a decorative border. These tiles are available in lengths that match standard rile widths, and are usually 50-75 minimum 2-3 in wide. They are cur and fixed just like any other tile.

The second method is to incorporate a group of patterned tiles as a feature panel within a larger area of plain riling. The group may simply be contrasting patterned tiles, or may be a multi-tile motif a group of four, six or more tiles that fit together to form one large design when they are fixed in position. Tile manufacturers offer a range of mass-produced designs you can choose from, or a motif panel can he commissioned from a specialist tile supplier. Plan the motif’s position on the wall carefully, and build it in the usual way as tiling progresses.

I. Use a tiling gauge to mark the position of the first row of tiles on the wall surface. Put up a support batten (furring strip) if necessary then spread some tile adhesive on the wall, and place any plain tiles that will be below the decorative panel. Start placing the first tiles that will form the decorative panel. Here the tiles are being laid at an angle of 45°, so half-tiles are placed first.

2 .Continuous adding whole and half-tiles to build up the pattern, checking is you work that the edges of the panel are uniformly horizontal and vertical.

3. Here the panel is being surrounded by slim border tiles. Add whole border riles to the top of the panel first, working from the centre line outwards.

4. At the corners of the panel, fit an over-long horizontal border tile and hold another vertically over it so you can mark a 45° cutting line on each tile.

5. Make the 45° cuts on the end of each corner tile, then bed the horizontal tile in place. Check that the CUE end is precisely aligned with the panel comer. Repeat the process at the other end of the horizontal section of the border. The pieces should be the same length, as the border is centred.

6. Fit the border riles up each side of the decorative panel, then mark the position of the mitre cut on the final tiles, cut them and fit them in place.