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Secretions from the bulbourethral glands protect sperm and cleanse and lubricate the penile (spongy) urethra discount 25mg zoloft otc depression bipolar test online. Columns of erectile tissue called the corpora cavernosa and corpus spongiosum fill with blood when sexual arousal activates vasodilatation in the blood vessels of the penis discount zoloft 25mg without prescription mood disorder and diabetes. Testosterone regulates and maintains the sex organs and sex drive, and induces the physical changes of puberty. Interplay between the testes and the endocrine system precisely control the production of testosterone with a negative feedback loop. The man’s penis is inserted into the vagina to deliver sperm, and the baby exits the uterus through the vagina during childbirth. As with spermatogenesis, meiosis produces the haploid gamete (in this case, an ovum); however, it is completed only in an oocyte that has been penetrated by a sperm. Supporting granulosa and theca cells in the growing follicles produce estrogens, until the level of estrogen in the bloodstream is high enough that it triggers negative feedback at the hypothalamus and pituitary. Following ovulation, the granulosa cells of the empty follicle luteinize and transform into the progesterone-producing corpus luteum. The ovulated oocyte with its surrounding granulosa cells is picked up by the infundibulum of the uterine tube, and beating cilia help to transport it through the tube toward the uterus. The endometrium responds to estrogen released by the follicles during the menstrual cycle and grows thicker with an increase in blood vessels in preparation for pregnancy. If the egg is not fertilized, no signal is sent to extend the life of the corpus luteum, and it degrades, stopping progesterone production. This decline in progesterone results in the sloughing of the inner portion of the endometrium in a process called menses, or menstruation. The breasts are accessory sexual organs that are utilized after the birth of a child to produce milk in a process called lactation. Testosterone produced by Leydig cells in the embryonic testis stimulates the development of male sexual organs. Whereas the gonads and some other reproductive tissues are considered bipotential, the tissue that forms the internal reproductive structures stems from ducts that will develop into only male (Wolffian) or female (Müllerian) structures. To be able to reproduce as an adult, one of these systems must develop properly and the other must degrade. These changes lead to increases in either estrogen or testosterone, in female and male adolescents, respectively. Increases in sex steroid hormones also lead to the development of secondary sex characteristics such as breast development in girls and facial hair and larynx growth in boys. What specialized structures help guide the oocyte This interrupts the path taken by sperm through the ductus from the ovary into the uterine tube? What would likely occur if the cilia were spermpath) to explore the structures of the male paralyzed at the time of ovulation? A baby’s gender is determined at conception, and the the testes and ends as the sperm leave the penis through different genitalia of male and female fetuses develop from the urethra. Endometriosis is a disorder in which endometrial cells not in somatic cells, and how do these specializations implant and proliferate outside of the uterus—in the uterine function? Explain how these changes lead to the up muscles, they can also affect testosterone production in increases of sex steroid hormone secretions that drive many the testis. Explain how the internal female and male reproductive the testis if a male takes large amounts of synthetic structures develop from two different duct systems. The dramatic changes of fertilization, embryonic development, and fetal development are followed by remarkable adaptations of the newborn to life outside the womb. An offspring’s normal development depends upon the appropriate synthesis of structural and functional proteins. This, in turn, is governed by the genetic material inherited from the parental egg and sperm, as well as environmental factors. Because each of these reproductive cells is a haploid cell containing half of the genetic material needed to form a human being, their combination forms a diploid cell. This new single cell, called a zygote, contains all of the genetic material needed to form a human—half from the mother and half from the father.

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Risk factors ¾ Increased sex hormone level ¾ Increased stress level ¾ Sebaceous gland over secretion of sebum generic 100 mg zoloft with mastercard mood disorder etiology, proliferation of bacteria zoloft 50 mg amex tropical depression weather definition, excess keratin formation in the follicular duct. Characteristic or features of acne Vulgaris • Initial formation of a comedo (Black head) or wife head. Psoriasis It is chronic inflammation of the skin producing dry scaly lesions, exacerbation and remission 1. Treatment ¾ Avoid itching ¾ Encourage bath and skin care ¾ Soak in warm bath ¾ Encourage and adequate rest and good nutrition ¾ Refer to health facility 7. Risk factors of contact dermatitis ¾ Contact with irritant substances such as strong soaps and acids etc. Characteristics of contact Dermatitis: ¾ Erythematosus, papule, vesicles ¾ Vesicles may be ruptured followed by crusting and scaling ¾ Itching and burning leads to scratching and then resulted in infected lesions. Treatment care: Goal of treatment patient should be recovered with minimum scaring and mucosal damage. Signs and symptoms ¾ Itching, erythematosus, papulovesiculer lesion ¾ In severe case; exudates, crusting the lesion and elapse ¾ If can happen in, children, adolescent and adult 2. Treatment ¾ Keep the skin dry and clean ¾ Encourage daily bath ¾ Use or denary soap ¾ Avoid application of oil ¾ Wash with normal saline and potassium permanganate ¾ Application of corticosteroid ointment ¾ Teach the patient about the disease ¾ Refer it not improved 156 7. Characteristics ¾ Red, minute papules and vesicles ¾ Persistent itching ¾ Weeping, oozing, crusting and scaling lesion present ¾ Lichenification (thick and hardened skin) lesion 4. Treatment ¾ Avoid the risk factors ¾ Apply lotion and ointment ¾ Teach the patient about the disease (personal hygiene cleanliness of environment) ¾ Reassure Patient ¾ Arrange follow up 7. Lacerated: are jagged or irregularly wound often associated with much tissue damage and that can be caused by wire, an explosion and stone. Foreign material as cloth, wood, and metal pieces are often driven in to the wound and often not heal quickly and may leave large scar. Cleanse the injured part thoroughly, using plain soap and boiled water which is cooled at room temperature or clean with running water and soap 3. After the bleeding has been controlled apply additional layer of cloth and in the mean time elevated the bleeding part of limbs. Do not remove any layers of cloth that is already found on the wound since it may cause bleeding of the part. Pressure will be apply to supplying vessel, for especial quick action, here you can use your fingers or the palm of your hands to press the supply vessels and then after bleeding is stop dress the wound and based on the severity refer him or her to the clinic. Infected wound The patient with an infected wound should always be under the care of a hospital or health centre so, the health worker has to soaked the foot or the hand in solution of 2 table spoons of salt in to one liter of boiled waters for 15-20 minute, this can help to localized the infection. In any case the health worker should not forget to send or refer the Victim and clinic for assessment and treatment of tetanus. Causative organism ¾ Treponema Vincent ¾ Bacillus fusifornes Transmission – By direct contact and flies 2. Clinical picture ¾ The ulcer become large quickly as the skin and subcutaneous tissue involved ¾ The skin around the edge of the ulcer is hard, hot and tender to touch 3. Management ¾ The goal of the management is to give an emphasis to control the infection and promote healing of the ulcer ¾ Bed rest to enhance wound healing ¾ Encourage the patient to take a good nutrition like vitamin and protein (good diet) ¾ Clean the skin with soap solution and cover it with clean cloth ¾ Refer the patient to nearest clinic or Health centre 5. Prevention ¾ Since the disease appeared as result of malnutrition and poor personal hygiene the health worker has to teach community the importance of personal hygiene and nutrition. The most common areas 159 are sacrum and hip but also in include occipital area, elbow, heels, ankles, scapula and back. Predisposing factors ¾ Immobility (sleeping on one place for long hours) due to chronic debilitating disease ¾ Being incontinence (un able to control urine and feces) ¾ Edema (swelling of body) cause by impaired circulation 2. Clinical Manifestation At early time, the health workers notice that, there is redness, tissue swelling and congestion with a patient complaining discomfort, elevation of skin temperature because of high vasodilatation and then the part of skin progress to dusky, cyanotic blue gray appearance. The goal of management of bed sore - Include relief of pressure, improve mobility, and improve nutritional status. Relieving pressure o By frequent change position by using a variety of pads and supportive device to prominent areas 2. Minimize moisture (keep the area clean and dry) Soiled skin should be washed with soap & water and dry with sunlight 6. Fungal Skin Diseases Fungus infection is a type of skin disease of the body and which would be caused by organism called fungus. The fungus grows and multiplies in the skin, mucous membrane and hair, which is on the head, foot and body. Transmission It can be transmitted directly or indirectly from man to man through skin contact of infected person or sharing of clothes with an infected person.

It expresses the percentage of the variation in the outcome variable that has been explained by the regression on the explanatory variables discount zoloft 100 mg without a prescription depression psychiatric definition. For countries conducting surveys on a sample of the population zoloft 100mg visa klinisk depression definition, estimates were generated by applying prevalences determined in surveys to reported notification figures for the corresponding population and thus are dependent upon the level of case-finding in the country and quality of recording and reporting of the national programme. For countries conducting surveys on a sample of the population, estimates were generated by applying prevalences determined in surveys to reported notification figures for the corresponding population and thus are dependent upon the level of case-finding in the country and quality of recording and reporting of the national programme. Epidemiological and clinical study of tuberculosis in the district of Kolín, Czechoslovakia. Evaluating the impact of tuberculosis control: number of deaths prevented by short-course chemotherapy in China. Development of streptomycin resistant isolates of tubercle bacilli in pulmonary tuberculosis. Drug resistance in patients with pulmonary tuberculosis presenting at chest clinics in Hong Kong. Relative numbers of resistant tubercle bacilli in sputa of patients before and during treatment with streptomycin. Bacteriological aspects of the use of ethionamide, pyrazinamide and cycloserine in the treatment of chronic pulmonary tuberculosis. Involving private practitioners in tuberculosis control: issues, interventions, and emerging policy framework. Purchase of antibiotics without prescription in Manila, the Philippines: inappropriate choices and doses. Transactions of the Royal Society of Tropical Medicine and Hygiene, 1982, 79:679-691. A survey of prescribing patterns for tuberculosis treatment amongst doctors in a Bolivian city. Initial drug regimens for the treatment of tuberculosis: evaluation of physician prescribing practice in New Jersey, 1994-1995. Standard short-course chemotherapy for drug-resistant tuberculosis: Treatment Outcomes in 6 Countries. Increasing transparency in partnerships for health: introducing the Green Light Committee. The impact of human immunodeficiency virus infection on drug resistant tuberculosis. An outbreak of multi-drug resistant tuberculosis among hospitalized patients with the acquired immunodeficiency syndrome. Transmission of multi-drug resistant Mycobacterium tuberculosis among persons with human immunodeficiency virus infection in an urban hospital: epidemiologic and restriction fragment length polymorphism analysis. Transmission of drug-resistant Mycobacterium tuberculosis among persons with human immunodeficiency virus infection in urban hospital: epidemiologic and restriction fragment length polymorphism analysis. Private pharmacies in tuberculosis control- a neglected link International Journal of Tuberculosis and Lung Disease, 2002, 6(2):171-173. Survey of knowledge, attitudes and practices for tuberculosis among general practitioners in Delhi, India. Use of thiacetazone, thiophen-2-carboxylic acid hydrazide and triphenyltetrazolium chloride. Advances in techniques of testing mycobacterial drug sensitivity, and the use of sensitivity tests in tuberculosis control programmes. Human Development Report 2003: Millennium Development Goals: A compact among nations to end human poverty. A comparison of three molecular assays for rapid detection of rifampin resistance in Mycobacterium tuberculosis. Evaluation of a commercial probe assay for detection of rifampin resistance in Mycobacterium tuberculosis directly from respiratory and non respiratory clinical specimens. European Journal of Clinical Microbiology and Infectious Diseases, 1998, 17:189-192. Detection of rifampicin resistance in Mycobacterium tuberculosis isolates from diverse countries by a commercial line probe assay as an initial indicator of multidrug resistance.

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