28 August 2015
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Nagaland /ˈnɑːɡəlænd/ is a state in Northeast India. It borders the state of Assam to the west, Arunachal Pradesh and part of Assam to the north, Burma to the east and Manipur to the south. The state capital is Kohima, and the largest city is Dimapur. It has an area of 16,579 square kilometres (6,401 sq mi) with a population of 1,980,602 per the 2011 Census of India, making it one of the smallest states of India.[1]

The state is inhabited by 16 major tribes - Ao, Angami, Chang, Konyak, Lotha, Sumi, Chakhesang, Khiamniungan, Bodo-Kachari, Phom, Rengma, Sangtam, Yimchunger, Thadou, Zeme-Liangmai (Zeliang) and Pochury as well as a number of sub-tribes.[2] Each tribe is unique in character with its own distinct customs, language and dress.[3] Two threads common to all, are language and religion - English is in predominant use and Nagaland is one of three states in India where the population is predominantly Christian.[4][5]

Nagaland became the 16th state of India on 1 December 1963. Agriculture is the most important economic activity and the principal crops include rice, corn, millets, pulses, tobacco, oilseeds, sugarcane, potatoes, and fibers. Other significant economic activity includes forestry, tourism, insurance, real estate, and miscellaneous cottage industries. The state has experienced insurgency as well as inter-ethnic conflict since the 1950s. The violence and insecurity have long limited Nagaland's economic development, because it had to commit its scarce resources on law, order and security.[6][7] In the last 15 years, the state has seen less violence and annual economic growth rates nearing 10% on a compounded basis, one of the fastest in the region.[8]

The state is mostly mountainous except those areas bordering Assam valley. Mount Saramati is the highest peak with a height of 3,840 metres and its range forms a natural barrier between Nagaland and Burma.[9] It lies between the parallels of 98-degrees and 96-degrees east longitude and 26.6-degrees and 27.4-degrees latitude north of the equator. The state is home to a rich variety of flora and fauna; it has been suggested as the "falcon capital of the world".[10]

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  • AkiporteVen AkiporteVen Friday, 28 August 2015

    Thiopurine S-methyltransferase (TPMT) and dihydropyrimidine dehydrogenase (DPD) are examples of nucleotide base-metabolizing enzymes. Which of the following tests is routinely done to diagnose a patient with myelodysplastic syndromes (MDS)? MEs occur during the ordering phase, 11% during the transcribing phase, 14% during the processing (preparing and dispensing) phase, and 26% in the administration phase. ?hart.atasol.relafen While fixed-dose strategies have historically been used, most endocrinologists suggest that adjustments in GH replacement can be made based on IGF-1 serum concentrations as appropriate for age and sex. Similar results were reported when montelukast was compared with placebo in patients with intermittent or persistent asthma. Other markers of early AKI include urinary tissue inhibitor of metalloproteinase 2 (TIMP-2) and urinary insulin-like growth factor binding protein 7 (IGFBP-7). ?flutamide.lipitor.cardura Studies using explicit drug-use review criteria have found that between 15% and 24% of community-dwelling older adults take one or more medications that have a dose, duration, duplication, or drug-interaction problem. No single infusion system is ideal for delivery of all drugs in all institutions for all patients. h1 font-size:180px; color:#99A7AF; margin: 70px 0 0 0;?prilosec.glumetza.donepezil The injectable vaccine is recommended as a single IM injection for travelers elder than or equal to 2 years of age. The upper GI series can be continued as the contrast agent moves from the stomach and duodenum into the small intestine, referred to as the small bowel follow-through. a:visited color: #34536A;?reflux.anastrozole.hyaluronate Individual genetic differences can play a role in the significance of this process. Sunitinib was found to be superior to IFN-О±2a, with a median progression-free survival (PFS) of (11 vs 5 months; PО±2a group (PО±2a-treated patients (26 vs 22 months; P=0.05), even though 25 patients in the IFN-О±2a group crossed over to the sunitinib group. Current efforts have focused on the identification of predictive biologic biomarkers for therapy. ?sucralfate.beloc.famvir By becoming aware of these issues, the practitioner may then make plans to improve upon or change these characteristics and move toward a more culturally competent approach to providing healthcare. Furthermore, CLcr has been the predominant index used to stratify patients in pharmacokinetic studies which serve as the basis for the design of renal dosing algorithms in FDA-approved package inserts and tertiary drug information sources. It is not clear which approach is best.

  • AkiporteVen AkiporteVen Friday, 28 August 2015

    Predictors of mortality include early onset of severe symptoms, age greater than 45 years, unexplained bleeding, and an initial high viral load (greater than 10 million viral copies/mL [10 Г— 10/L]). Patients who fail initial therapy should preferably be treated with a drug from a different class. nasacort.zoloft.seroquel Unique pathophysiologic changes occur in pediatric patients with some disease states. These problems are often the result of underlying disease processes that may or may not be diagnosed. ortho.albenza.astelin The median OS was 25 months in patients receiving nivolumab compared with 19.6 months in those receiving everolimus (HR = 0.73, P=0.002). Recent evidence has determined that the pleiotropic effects of lenalidomide are due to modulation of the ubiquitination and degradation process. Through a partnership of the Centers for Disease Control and Prevention (CDC), private and public stakeholders, and international organizations, The Global Health Security Agenda which focuses on efforts to prevent and reduce outbreaks, detect threats early to save lives, and rapidly and effectively respond to potential infectious disease threats has become a reality. tacrolimus.capitis.carbozyne A good psychiatric assessment can identify the need for coordinated care and should be included as part of the full patient assessment in all healthcare settings. The median response duration for ESAs in MDS is 1 to 2 years, and the ESA should be discontinued if there is no benefit or the response wanes. The average American adult reads at about the eighth grade level and most handouts exceed these levels. ortho.cipro.aldactone Contact a poison control center after symptoms develop. Proper preparation for the trip will reduce the difficulties associated with acquiring appropriate medications and medical care. For patients receiving opioid therapy who require dosing throughout the day to maintain pain control, palliative care practitioners should consider initiation of a long-acting (LA) or extended-release (ER) formulation of an opioid. furadantin.doxepin.vantin Several databases in the United States provide different levels of insight into and documentation of the poisoning problem (Table e9-2). Also common, although rarely severe, are gastrointestinal symptoms, fatigue, and headache. Hyperresponsiveness is defined as a decline in FEV1 greater than or equal to 20% and reversibility of obstruction to bronchodilators.

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    Median PFS for single agent temsirolimus, single agent IFN-О±2a, and combination therapy was 5.5, 3.1, and 4.7 months, respectively. The incidence of idiosyncratic drug-induced hematologic disorders varies depending on the condition and the associated drug. lamivudine.bacopa.adalat Middle Eastern Respiratory Syndrome Coronavirus, broke onto the world scene in April of 2012. In patients with obstruction, a dose of a bronchodilator (eg, albuterol or isoproterenol) by metered-dose inhaler is given during the initial examination. irbesartan.motrin.ponstel It usually progresses from rhinitis to sinusitis with nasal polyps and steroid-dependent asthma. Although several mechanisms of drug-induced thrombocytopenia have been proposed, it is often not possible to determine the mechanism for an individual drug or patient, and more than one mechanism can be responsible for the condition. Although these lists may help clinicians identify specific drug causes of adverse events, the large number of agents implicated may make this a difficult process. isotroin.rumalaya.ketotifen Patients should be referred for medical evaluation if there is evidence that the ingestion exceeded 4 g/day or 100 mg/kg/day, whichever is less for 2 or more days. The routine monitoring of patients receiving known pulmonary toxins with dose-dependent toxicity such as amiodarone, bleomycin, or carmustine is still controversial. cimal.antivert.paroxetin Research is continuing to identify other vaccine candidates, such as a recombinant protective antigen, with hopes of developing options which are less immunogenic, while offering greater protection. The pleural thickening, effusions, and fibrosis that occur as an extension of the retroperitoneal fibrotic reactions of methysergide and practolol or as part of a drug-induced lupus syndrome are the most common examples (Table e30-8). Enzyme-linked immunosorbent assay (ELISA) is a commonly employed method for detecting HIV, herpes simplex virus, respiratory syncytial virus, pneumococcal serum antibody, Neisseria gonorrhoeae, and Haemophilus pylori. nitroglycerin.methotrexate.minipress For example, there are multiple changes to the dopaminergic system with age, including decreased levels of the dopamine transporter, decreased number of dopaminergic neurons, and decreased density of several types of dopamine receptors. It is thought that antibodies exist within the patient's circulation that recognize an epitope on the platelet GP, but this recognition is too weak to result in antibody binding to the platelet surface.

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    Vaginal preparations of bromocriptine may be used in women to decrease the incidence of adverse effects associated with oral adminstration. Coronaviruses have the ability to adapt to new environments, become more transmissible, gain virulence due to high mutation, and recombination rates. Hot spots appear where necrotic myocardial tissue is present, which may occur with recent myocardial infarction, myocarditis, myocardial abscesses, and myocardial trauma. As a result, better treatment adherence can occur. In 1995, terrorists released sarin in the Tokyo subway system, leading to 11 deaths and 5,510 people seeking medical attention including many first-responders. Specifically, DSM-5 represents the first step away from a categorical system of classification to a dimensional one. After the binding of antibodies to the platelet surface, lysis occurs through complement activation or through clearance from the circulation by macrophages. It is equal to the sum of IRV, VT, and ERV. Right ventricular enlargement is best seen on the lateral film, on which the heart appears to occupy the retrosternal space. Often the simple removal of the catheter can eliminate the organism from the bloodstream, thereby preventing misdiagnosis and unnecessary application of antimicrobials. Fortunately, severe side effects are rare, occurring in only 1 in 10,000 patients receiving these agents, and they usually are reversed with intravenous aminophylline, 75 to 125 mg. This system classifies the varied reactions based on the effector cells involved, the timing and clinical presentation of the immune event. Overall prevalence of aspirin sensitivity or intolerance in the general population ranges from 0.6% to 2.5% which increases prevalence that range from 2% to 25% in patients with asthma. The Fick principle is based on the fact that when a substance is consumed by an organ, its concentration is the product of blood flow to the organ and the substance's arteriovenous difference across the organ. Of emergency department visits for drug-related poisoning, typically 1.1 million visits are made each year (3.5 per 100,000 population) with the highest rate observed for patients 20 to 34 years of age. Although many drugs follow two-compartment-model pharmacokinetics (especially after IV administration), a one-compartment model is used to compute kinetic parameters in patients because too many serum concentration determinations would be needed to determine accurately both the distribution and elimination phases found in the two-compartment model.

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