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The guidance was informed by focus groups and interviews conducted with individuals in Sierra Leone and Liberia affected by the 2014-16 Ebola outbreak breast cancer humor order cheap lady era, and with response workers who had responded to the Ebola and/or other public health outbreaks women's health clinic pico buy generic lady era canada. A short video women's health clinic akron order cheapest lady era and lady era, comprehensive checklists women's health clinic victoria texas cheap lady era 100 mg visa, and a PowerPoint slide set are also available to assist those who may want to teach the contents of this document. The Goal of an Ethically Optimal Public Health Response the goal of an outbreak response is to effectively contain the outbreak; yet how containment efforts are implemented has a significant impact on the effectiveness, efficiency, and trustworthiness of the response as well as on the social and economic disruption and recovery related to the outbreak. With this in mind, the goal of a public health response is to prevent disease transmission and minimize illness and death, guided throughout by commitments to support local ownership of the response, and to treat individuals and communities with respect, fairness, and compassion. Guiding Ethics Principles the principle of respect requires acting in ways that recognize the inherent and equal moral worth of all individuals, including treating them with compassion, regardless of their circumstances. Perhaps most challenging in this context is the obligation to respect the self-determination of others, particularly when containment policies threaten freedom of movement and association, body integrity, and livelihood. Justice requires implementing interventions and policies fairly and with regard for the well-being of all affected; it also is concerned with systematic disadvantage and differentials in social standing and power. Promoting good and preventing harm, together with justice, are the moral foundations of public health. These principles motivate the response goal of keeping healthy people from becoming sick, helping sick people become as healthy as possible given available resources, and addressing the emotional harms of illness as well as the physical ones. Preparing for and Initiating Public Health Response Activities with Local Communities Outreach activities such as active surveillance, case-finding, clinical care and treatment, and contact-tracing are core strategies to prevent new infections and minimize death and disability caused by an outbreak. Yet, when doing this work, how frontline workers enter communities can be as important as what they do. Frontline workers should approach local communities respectfully, as partners in outbreak response. A response driven by the needs and voices (demands) of the community will pay off in terms of local acceptance, time and trust. Reach out to local leaders to coordinate Respect requires outbreak responders to act in efforts and gain local insights. Identify and synthesize the best available and social cohesion in communities, including evidence. Identify and acknowledge local practices that Justice requires response teams to identify may need to be modified due to transmission who within communities is most disadvantaged risks. Consider the effect of response strategies on the likelihood that containment activities will most marginalized and determine ways to further harm them. Identify community leaders and local Promoting good and protecting from harm community groups to accompany or host requires teams to identify the best available response teams not from the affected evidence to inform containment approaches. Interacting with Local Communities during Public Health Containment Workers engaged in health education, active surveillance, active case-finding, contact-tracing, ambulance driving, and other community health measures provide the face of an outbreak response to affected communities. Promote transparency about when, why, how, Respect requires providing every day acts of and duration of containment activities. Ensure outbreak response workers clearly activities are needed, and maintaining privacy distinguish their role and scope of authority. Respect privacy and maintain confidentiality Justice requires being fair in how containment before, during and after conducting frontline measures are implemented. Include psychosocial support for all involved in requires protecting confidentiality and the response. Outbreak Communication and Messaging Communication campaigns are critical to outbreak containment; they set the tone for the response, can foster adoption of infection prevention and control practices, encourage health-seeking behavior, and keep the public informed as information changes. Establishing an informative, trustworthy dialogue with the public can enhance the likelihood that messages will be well-received and acted upon. Identify mechanisms to create appropriate spokespersons and representatives to help messages. Ensure messages are honest, transparent, are in alignment with local norms and are evidence-based, actionable, and regularly perceived as trustworthy. Ensure that messages do not perpetuate stigma risk communities in a language, level, and or single out groups unfairly. Listen to and counteract rumors through requires ensuring messages are perceived as frequent messaging. Special Considerations for Isolation, Quarantine and Social Distancing Isolation, quarantine, and social distancing are intended to reduce the spread of highly infectious diseases by minimizing the possibility of transmission between infected and non-infected persons. Isolation refers to separating people who are sick with a contagious disease from people who are not to protect uninfected people from illness exposure. Quarantine involves separating and restricting the movement of an individual who may have been exposed to a contagious person. The goal is to closely observe the exposed person for signs of illness and avoid spread to others. Social distancing refers to community-level efforts to restrict the ability of groups of persons to congregate. Implement isolation, quarantine, and social distancing only when there is a strong epidemiologic reason to expect significant public health benefits and no less restrictive approach would achieve the same benefit. Implement isolation, quarantine, and/or social Justice requires fair and equitable distancing only when they can be done fairly enforcement of containment policy. Show everyday respect and common courtesy Promoting good and protecting from harm to individuals or households subject to isolation requires that directives be accompanied by or quarantine. Implement restrictive measures with local diagnostic and contact-tracing capabilities. Supporting and Protecting Outbreak Responders An adequate, capable workforce is necessary for preventing new infections, minimizing death and disability, and addressing other community concerns during an outbreak. Ethics issues arise concerning appropriate risk levels to undertake, fair compensation, and rights of healthcare workers. These ethics questions become more pronounced where resources are severely limited and where there is inadequate protective equipment. Prioritize making working conditions for willingness to undertake challenging, responders as safe as possible; only then can stressful, and often risky work. Prepare and support outbreak responders Justice heightens the priority to protect regarding the psychosocial challenges of responders from harm because response participating in the response. Providing Care and Treatment during Outbreaks the provision of care, and treatment, is essential for minimizing suffering, death, and disability during an outbreak. Care and treatment must be evidence-based, accessible to those affected, and must Respect requires engagement with ensure that patients and their families are addressed in community leaders in decisions of how to respectful ways. Key Ethics Actions: Justice requires that special accommodations are made for the care of rural and hard-to 1. Provide evidence-based care and treatment to reach populations, children, pregnant women, patients and their families. Approach care with a commitment to requires providing evidence-based care to transparency. Treat survivors with respect and kindness, acknowledging their dignity in the face of the Chapter 7. Those who survive an outbreak, or whose illness Justice requires decreasing the chance of becomes chronic, often experience significant survivors becoming further disadvantaged by disadvantage. Survivors might experience clinical allotting resources for clinical follow-up care, sequelae, as has been documented for Ebola, Lassa psychosocial care and counseling, nutritional fever, and polio, requiring ongoing clinical care and supports, job training and livelihood supports. Physical and/or mental complications can contribute to an inability to Promoting good and protecting from harm work, or to sustain relationships or previous life requires enhancing the health and well-being activities. If possible, replace property of survivors that may have been destroyed while receiving care or treatment. Collaboratively develop a plan for allocating To uphold respect, ensure that policies are in and distributing material supports to survivors place that continue to involve survivors and and affected communities. Outbreak Recovery Justice requires addressing and ameliorating underlying inequities in care by using the larger and more severe the outbreak, the more resources for crisis response in ways that are profound its impact. Outbreak response is often most likely to help develop infrastructure that accompanied by a temporary influx of resources, will leave the community better off. Newly created policies Relevant to promoting good and protecting and practices, updated systems for delivering services, from harm, there may be ways for the and use of recently trained personnel will need to be tragedy of an outbreak to be a stimulus for reviewed and ideally sustained after the outbreak is the implementation of systems-level public over. Leverage the systems built during the outbreak response to advocate for broader systems strengthening initiatives. Most of the ethics challenges discussed in this document occur in both high and low-income settings.

Forensic odontology is also called as such as Adobe photo Deluxe menstruation related headaches buy lady era 100 mg mastercard, Microsoft PhotoDraw etc womens health denver purchase lady era online pills. Some common methods used in practice Haderup system women's health center yarmouth maine discount lady era 100mg on-line, a plus (+) sign is used to indicate upper are described below pregnancy vaginal discharge buy lady era 100mg without prescription. It starts Numbering of Teeth from the upper right third molar (given as number 1) In this system, the teeth are placed in four quadrants. For temporary A ranged from the upper right second molar (given teeth, each quadrant has different number. For right upper as alphabet A) to the upper left second molar (given quadrant has number 5, left upper quadrant has 6, left lower as alphabet J) and then continuing with the lower left quadrant has 7 and right lower quadrant has number 8. The second molar (given as alphabet K) and ends at lower system is displayed in Figure 3. Therefore, for medical inci In this method, each tooth is represented by pictorial symbol. Its imprint in skin can show this individualization due to which identication of perpetrator is possible. The cusp may be present up to six and even Description of bite marks includes location over body, shape, up to seven in number. Peg shaped lateral swabbing should be done and impression of the marks may incisors are common in Europeans. The palatal rugal pattern in six compare serum human placental lactogen and menstrual dates South African population part I. Estimation of gestational age from medicine, Toxicology and Medical Jurisprudence, 1st edn. The gonads: Development and function of the colegal cases of victims of trafficking for commercial sex reproductive system. Linear models for the prediction of rib in white males: a test of the phase method. The video superimposition technique sonal height from the somatometry of the hand in Punjabi practiced in India. Estimation approach to computer-aided face/skull identication in foren of stature from body parts. Each bone has its own tale about the past life and death of the person whose living feshes once clothed it like people. Some bones impart their secrets more readily than others; some are laconic others are positively garrulous. Bone or Not It is necessary to examine a given article and opine whether the stated article is bone or not. However, at times it may become diffcult to opine especially dealing with small bones or when taxonomically. Differentiation is done by: 86 Principles of Forensic Medicine and Toxicology. The relation between mined from soft parts available with bones by: osteons and age is presented in table 4. A Age Stature Age at the time of death from bone/skeleton is determined Determination of stature from bone means estimation of by noting the: body height of that person. But this period may be much shorter in India where the climate conditions are often hostile and bodies are buried 5 without much protection. In old bones, the bones A become lighter due to loss of organic matter and colla genous stroma. Loose meshwork is formed by blood and fbrin clot that act as a framework for subsequent granulation tis sue formation. Collectively they remodelling E: Stage of modelling Forensic Osteology 89 form a soft granulation tissue in the space between the fracture fragments. The osteoblasts lay down an intercellular matrix that gets impregnated with calcium salts. The total time taken for loss of complete fuorescence was Manner of Separation 6 estimated somewhere at 100 to 150 years. Absence of any cut marks with presence of complete less dense and loses specifc gravity. The specifc grav bone with intact articular cartilage suggests natural separa ity of 1. The state of soft tissues, if available, should be exam forensically signifcant and it distinguishes from fossils. Stature If the nitrogen content is about 4% then the death interval may be up to 100 years. At about 350 years, the nitrogen Stature from skull can be estimated by performing somatom content falls to 2. The proline and hydroxy height of the individual 4 proline will vanish in about 50 years. Skull bones are united by sutures and the union is analogous Age with the epiphseal-diaphyseal union.

Double blind placebo-controlled trial of pleconaril in infants with enterovirus meningitis menopause pajamas buy lady era australia. Treatment of potentially life threatening enterovirus infections with pleconaril women's health virginia purchase lady era online now. Use of interferon-alpha in patients with West Nile encephalitis: report of 2 cases breast cancer epidemiology buy 100 mg lady era visa. The paper discusses research in behavioral Asia in 2003 breast cancer slogans discount lady era 100mg with mastercard, or the plague outbreak in Surat, India, in economics and the theory of information cascades that 1994, they can also create severe economic disruptions may shed light on the origin of such biases. The authors even when there is, ultimately, relatively little illness consider whether public information strategies can help or death. A preliminary question is uncoordinated and panicky efforts by individuals to avoid why governments often seem to have strong incentives to becoming infected, of preventive activity. An important fnding to disease risk have both economic and epidemiological is that government incentives to conceal decline the consequences. The paper looks in particular at how more numerous are non-offcial sources of information people form subjective probability judgments about about a possible disease outbreak. The Policy Research Working Paper Series disseminates the fndings of work in progress to encourage the exchange of ideas about development issues. An objective of the series is to get the fndings out quickly, even if the presentations are less than fully polished. The fndings, interpretations, and conclusions expressed in this paper are entirely those of the authors. They do not necessarily represent the views of the International Bank for Reconstruction and Development/World Bank and its affliated organizations, or those of the Executive Directors of the World Bank or the governments they represent. All opinions expressed in this paper are those of the authors and not necessarily those of the institutions with which they are affiliated. Introduction Recent years have seen a renewed interest in the surveillance and control of infectious diseases, as well as in their importance as a problem in economic development. In this paper we stand back to look at recent work in economics that helps place the type of effects at work in such episodes into a broader conceptual and analytical framework that also encompasses the cost of illness approach. Such a framework should be helpful in deepening our understanding of the links between infectious diseases, individual choices and behavior, public health policies, and the economy. Ideally it should also help improve understanding of the constraints and tradeoffs facing public health policy makers, as well provide some insight into ways to improve public health policies. Section 2 of the paper outlines the standard cost of illness approach, which focuses on the opportunity cost of resources that are consumed or lost as a result of disease, whether these are direct costs, such as the costs of medical treatment, or indirect costs, such as loss of productive capacity due to illness and death. The economic essence of these events appears to reside in costs of prevention, in one form or another. Thus the main economic effects arise from the uncoordinated and sometimes panicky efforts of millions of private individuals to avoid becoming infected, for example by fleeing from the area of an outbreak or by reducing their contacts with other people. Such effects are sometimes aggravated by the information and risk communications strategies pursued by governments in affected countries, as well as by the often excessive trade and travel restrictions imposed by governments in other countries, which are justified as a way of preventing the international spread of the disease. The key intuition of this approach is that self-interested, 2 forward looking individuals adapt their behavior to take account of the prevalence of a disease and the threat it poses to them. These changes in behavior will differ according to the disease, but they will generally have both economic and epidemiological consequences, in the latter case by feeding back into the rate of new infections and disease prevalence. We set out a simplified version of a standard S-I-R epidemiological model to illustrate how such models can be adapted to reflect choice of preventive behaviors by utility-maximizing individuals. Section 3 then focuses on the primordial facts of high uncertainty and highly imperfect information that typically prevail during infectious disease outbreaks. A useful benchmark assumption is that of rational expectations, that people do not make persistent and systematic errors about the key probabilities governing their environment. On the other hand research in psychology and behavioral economics over recent decades amply demonstrates the presence of substantial biases in probability judgments in many contexts. Recent theoretical work on information cascades and herding behavior also suggests the possibility that in situations of imperfect information people may rationally look at the behavior of others as a source of information, and that this procedure can lead large numbers to jump to the same erroneous conclusions and sub-optimal decisions. It seems quite likely that under the conditions of high uncertainty, poor information, rapid change and emotional stress that prevail during an infectious disease outbreak, individuals could well arrive at significantly biased subjective assessments on key factual issues, at least for a time, leading them to panic and take less than optimal decisions, resulting, in the aggregate, in an excessively high cost of private preventive actions. This makes sense, since being consistently wrong can be expensive in an infectious disease setting. Section 4 looks more closely at the role of information and communications in public health policy. The likelihood that people can and do make economically costly mistakes about how best to protect themselves from infectious disease suggests a rationale for public information and risk communication strategies that help reduce unwarranted panic by providing the public with more accurate and timely information. The need for transparency in public risk communications strategy is widely promoted nowadays. To achieve more transparent information strategies it is first necessary to understand the incentives facing governments. In the early stages of a limited disease outbreak there may be considerable uncertainty about whether it will turn into an epidemic or simply fizzle out, so that there is an incentive for the government to simply 3 wait and see, especially if an announcement by the government might itself start a panic or provoke the kinds of severe trade and travel restrictions that were imposed on India during the 1994 Surat plague outbreak. Against these possible benefits must be set the increased risk of the outbreak turning into a full blown epidemic because of secrecy and delays in launching public health measures or in calling for international assistance. An important finding is that the incentives to hide information decline when there is an increase in non-official sources of information about the outbreak, for example via cell phones or the internet, and a consequent increase in the probability that the country will be subjected to pre-emptive sanctions by other governments (or by its own public) despite its efforts at concealment. Even putting aside ethical considerations and using only a narrow cost-benefit calculus, it seems that the modern environment of easy mass communications within and between countries increasingly makes honesty the best policy in public risk communications. A transparent and credible public information strategy is likely to be the best way to minimize unwarranted panic and, indeed, to mobilize the public as a partner in controlling the disease outbreak. To highlight the distinctiveness of these episodes this section first outlines the standard cost of illness approach to measuring the economic impact of disease. The Cost of Illness approach the cost of illness approach focuses on the opportunity cost of resources that are consumed or lost as a result of disease. Direct costs are resources used to treat or cope with the disease, for example expenditures for medical care and treatment, such as the costs of hospital care, physician services, nursing, drugs and so on. Indirect costs comprise the present and future costs to society from morbidity, disability and premature mortality, in particular losses of output caused by reduced 2 productivity or death of workers. These effects did not arise principally from direct medical costs or from actual sickness or death, which, thankfully, were very limited. The major economic effects in these events arise instead from the uncoordinated efforts of millions of private individuals to avoid becoming infected. Such effects are sometimes aggravated by erroneous public risk communications strategies and by the trade and travel restrictions imposed by governments in other countries, actions that are often excessive but which are rationalized by the need to prevent the international spread of the disease. The 1994 Plague Outbreak in Surat the first recorded sign of a plague outbreak in the western Indian city of Surat occurred on September 19, 1994 when a patient was rushed to the New Civil Hospital with high fever, soon followed by two more, all being given routine malaria treatment. A lack of adequate diagnostic testing facilities led public hospital doctors, conferring with private sector colleagues, to rely on sensitive clinical diagnoses, without waiting for laboratory results, and to conclude that there had been an outbreak of plague (Cash and Narasimhan 2000). An initial attitude of skepticism or denial evolved into confusion as numbers of years of potential healthy life that are lost due to premature death, poor health or disability. Members of the public were thrown back on word of mouth, rumor and exaggerated media reports in making their own assessment about the likelihood of a plague outbreak and of the danger of infection to themselves and their families. People clambered on any and every vehicle that could take them away More than half of the physicians departed as well. Businesses in Surat city lost an estimated $260 million in trade due to the negative demand shock caused by the panic. Many countries in Asia and the Eastern Mediterranean stopped flights to and from India. Many countries embargoed imports of foodstuffs, textiles or other goods from India. In his narrative of events Huang (2004) notes that local health personnel reported to superiors about the new disease in mid December 2002, but, given some restrictions on the release of public health-related information, it was not till February 2003 that Guangdong health officials made a public announcement about the disease. Word of mouth about the disease spread quickly both inside and outside China, a process facilitated by widespread access to cell phones and the internet. It is estimated that billions of cell phone text messages with some reference to the disease were sent in the country.

The primary symptoms of tetanus are stiffness and painful muscular contractions or spasms of the jaw menstrual facts purchase lady era pills in toronto, neck breast cancer necklace discount lady era 100 mg line, trunk muscles menstruation in the bible safe 100 mg lady era, and rigidity menstrual extraction pregnancy 100 mg lady era mastercard. Symptoms usually occur within 3-21 days, usually 8 days, following exposure to tetanus spores following a minor or inapparent or known puncture wound. Laboratory tests of affected tissue or blood tests are not always reliable enough to confirm diagnosis. There is no real treatment for tetanus, however, following the proper and timely physician directed wound treatment protocols and administration of additional doses of Td toxoid and/or tetanus immune globulin may help effect a positive outcome. Tetanus is an infectious disease, but it is not usually directly communicable from one person to another. Due to its non-communicable nature, isolation or exclusion of an infected person is not routinely recommended nor necessary. Td is a tetanus-diphtheria vaccine given to adolescents and adults as a booster shot every 10 years, or after an exposure to tetanus under some circumstances. Mumps is a viral disease that causes fever, swelling and tenderness of one or more of the salivary glands. The greatest risk of infection occurs among older children, adolescents, and adults. Mumps is spread by direct contact with saliva and discharges from the nose and throat of infected persons. Symptoms of mumps include fever and swelling and tenderness of one or more of the salivary glands, usually the parotid gland (located just below the front of the ear). Symptoms usually appear within 18 days after exposure, but may appear any time within 12 to 25 Mumps virus days. Mumps can cause central nervous system disorders such as encephalitis (inflammation of the brain) and meningitis (inflammation of the covering of the brain and spinal column). Other complications include arthritis, kidney involvement, inflammation of the thyroid gland and breasts, and deafness. Mumps is contagious from seven days before through nine days after the onset of symptoms. But children can get the second dose at any age, as long as it is at least 28 days after the first dose. Ask your doctor or nurse about whether the vaccine is right for you or your children. Other things people can do to prevent mumps and other infections is to wash hands well and often with soap, and to teach children to wash their hands too. Eating utensils should not be shared, and surfaces that are frequently touched (toys, doorknobs, tables, counters, etc) should also be regularly cleaned with soap and water, or with cleaning wipes. It occurs commonly in two forms: inflammation of the membranes covering the brain and spinal cord (meningococcal meningitis) or a severe blood infection (meningococcemia). The bacteria that causes meningococcal disease, Neisseria meningitidis, first infects the mucous membranes of the nose and throat, usually without any symptoms. In fact, 5 percent to 10 percent of the population may carry the bacteria at any given time without becoming ill. In a small proportion of infected persons, the bacteria passes through the mucous membrane and reaches the blood stream, causing meningococcal meningitis or meningococcemia. When illness occurs, it does so within four days of exposure, but can develop as long as 10 days later. The disease is most common Neisseria meningitidis bacterium during winter and spring. Transmission from person to person occurs through direct contact with nose and throat secretions. An infected person can transmit the disease by coughing or sneezing directly into the face of others, kissing a person on the mouth, or sharing a glass or cup. Because it is possible to harbor the bacteria in the nose and throat yet not develop symptoms, healthy persons as well as persons who are ill may spread the bacteria to others. The bacteria is not transmitted by casual contact, such as sitting in the same room as an infected person or passing an infected person in a hallway or on a sidewalk. A stiff neck may be present and later a red or purple rash (non-blanching) often develops. Nausea and vomiting also can occur but alone are not sufficient to suggest meningococcal disease. In newborns and small infants, the classic findings of fever, headache and neck stiffness may be absent or difficult to detect, and the infant may show only extreme listlessness, irritability, poor feeding and sometimes vomiting. In severe cases, as the disease progresses, both infants and older patients may have seizures and decreased alertness advancing to coma. Adults at increased risk of meningococcal disease include those who have recently been brought together as a group and housed under crowded living conditions, such as in barracks or institutions. College freshmen, particularly those living in dormitories, are at modestly increased risk. Household contacts of cases, who are at greatest risk of meningococcal disease, have only about three to 10 chances in 1,000 of developing the disease. Most persons are not susceptible to meningococcal disease because they have had prior exposure and have become immune. Death occurs more often in meningococcemia (as high as 17 percent) than in meningococcal meningitis (approximately 7 percent). Cases of meningococcal disease require immediate medical treatment by a physician. The diagnosis is usually made by growing bacteria from a sample of blood or spinal fluid. The spinal fluid is obtained by performing a spinal tap, in which a needle is inserted into an area in the lower back where fluid in the spinal canal is readily accessible. Risk of transmission of meningococcal infection can be reduced by practicing good hygiene. To avoid exposure, persons should not share cigarettes, straws, cups, glasses or eating utensils. Eating and drinking utensils can be used by others only after they have been washed. It is recommended that household contacts and others who have had close personal contact with infected persons receive a short course of certain antibiotics, which kill bacteria living in throat secretions. Since the recommendations for use of preventive antibiotics vary according to the specific situation, it is best to consult a physician or local health department for advice. Even if an antibiotic is taken, close contacts should be observed and any sign of disease promptly evaluated by a physician. Both vaccines can prevent 4 types of meningococcal disease, including 2 of the 3 types most common in the United States and a type that causes epidemics in Africa. This dose is normally given during the routine preadolescent immunization visit (at 11 to 12 years of age). But those who did not get the vaccine during this visit should get it at the earliest opportunity. Of those who live, another 11 to19 percent lose their arms or legs, become deaf, have problems with their nervous systems, become mentally retarded, or suffer seizures or strokes. Polio (poliomyelitis) is a very contagious viral disease that can cause permanent paralysis (make arms and legs unable to move) or even death. When that happens, no one will ever get polio again, and we will not need the polio vaccine. People can also spread the virus by Polio virus touch if they do not wash their hands after coughing or using the toilet. People who have not been immunized can get polio disease by eating food or drinking liquids containing the poliovirus. People with polio can likely spread the disease from about 1 week before their symptoms start until about 6 weeks after.

Pesticides are classifed as: active toxic agent and then to paranitrophenol that is 1 menstrual or pregnancy cramps 100mg lady era otc. Fungicide: these are the compounds used to kill fungi and result womens health specialist yuma az discount lady era 100mg on-line, there is accumulation of acetylcholine with continued moulds womens health magazine customer service discount lady era 100 mg without prescription. Organophosphate poisoning is the most common poisoning in 2 India followed by aluminium phosphide womens health weight loss pills buy generic lady era pills. Muscarinic effects Due to muscarinic like action, following clinical features are observed 1. However, dilatation of pupil in Fatal period organophosphate intoxication have been recorded, 24 hours therefore, it is essential not to rely only on pupil lary size as diagnostic criteria for organophosphate 7 compound poisoning. M indicates muscarinic A = adrenal medulla activity increase, T = tachycardia, C = receptor and N indicates nicotinic receptor cramps in muscle, H = hypertension). The decrease is due to binding by phosphate ulation of the pancreas with Ach, pilocarpine or vagal group of pesticide. It is better parameter than plasma stimulation causes augmentation of the secretory fow 16 cholinesterase. Accidental poisoning may occur in farmers while spray 24 which is nicotinic action. The atropine should be given ing in the felds or opening the lid of the containers. Some authorities recommend administration of atropine until bronchial and other secretions have dried. According to them pupil size and OrganOchlOrInEs 23 heart rate cannot be used as end-points. Continued Organochlorine insecticides are chlorinated hydrocarbons treatment with maintenance doses may be required for and are divided into four types as: 1 to 2 weeks. Absorption, Metabolism and Excretion Organochloride compounds are absorbed through skin, inha lation and through gastrointestinal tract. Most of the com pounds are metabolized slowly in the body and remains in tissues, especially in fatty tissues for prolonged duration. These compounds are metabolized in liver and are excreted in urine, feces and milk. The atropine should be given 2 mg intravenous promptly with dose repeated medicolegal Importance every 10 minutes till signs of atropinization are evident. Homicidal is rare as it is diffcult to mask the smell of Supportive Measures insecticide. They are spread on unwanted Aluminium phosphide is available in grayish green tablets of weeds and other vegetations. Fatal dose Fatal Dose 4 mg/kg 3 gm clinical Features Fatal Period Paraquat causes corrosion to mucosa of mouth, esopha gus and gastrointestinal tract. Aluminium phosphide liberates phosphine when it comes in Lungs show pulmonary edema and after 4 to 5 days may contact with air and moisture. Phosphine is a protoplasmic poison interfering with enzymes management and protein synthesis. It is said that administration of magnesium sulfate is Ann Surg 1979; 189:199-204. Acute polyneuropathy after poi autopsy Findings soning by a new organophosphate insecticide. Clinica Chimica Acta 2000; matory infltrate in portal tract and centrizonal necrosis. Toxicol Eur performance liquid chromatographic method for the analysis Res 1983; 5:123-6. J Medicolegal Assoc Maharashtra 2002; minium phosphide poisoning abroad a grain freighter. Hydrocyanic acid Tobacco Tobacco (tambakhu) is prepared from cured leaves of Nicotina tabacum.

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