By C. Kirk. Wilson College.

One of these controversial points comprises the pro-oxidant activity of vitamin C [12 generic levlen 0.15 mg with amex,17] generic 0.15mg levlen free shipping. Vitamin E Discovered at the beginning of the 1920s in vegetable oils such as that of wheat germ by Herbert Evans and Katherine Bishop order levlen 0.15 mg amex, vitamin E is also denominated tocopherol or the anti sterile vitamin, due to its activity. Vitamin E is a group of methylated phenolic compounds known as tocopherols and toco trienols (a combination of the Greek words [birth] and [possess or car ry], which together mean "to carry a pregnancy"). Alpha-tocopherol is the most common of these and biologically that with the greatest vitaminic action. It is a lipophilic antioxi dant that is localized in the cell membranes whose absorption and transport are found to be very highly linked with that of lipids. In the mean diet of Spaniards, vegetable oils furnish 79% of the vitamin E that they consume [9]. Vitamin E acts jointly and synergically with the mineral seleni um, another of the organisms antioxidants. Action: It has been proposed that in addition to its antioxidant function, vitamin E can per form a specific physicochemical function in the ordering of the lipic membranes, especially of phospholipids rich in arachidonic acid (thus acting as a membrane stabilizer) [1]. Tocopherols act as intra- and extracellular liposoluble antioxidants within the body. It can reduce the formation of scars (stimu lating the curing of burns and wounds), could help in the treatment of acne, and is a poten tial treatment for diaper dermatitis and bee stings. Chemical structure: The chemical formula for vitamin E (C H O ) is utilized for designat29 50 2 ing a group of eight natural species (vitamers) of tocopherols and tocotrienols (,,, and ). They are essentials, given that the organism cannot synthesize them; therefore, their contribution is carried out through the diet in small amounts. For efficient absorption by the organism, these require the presence of fatty acids, bile, and lipolytic enzymes of the pan creas and intestinal mucosa [20]. Chemical structure of the possible stereoisomers of the tocopherols and tocotrienols that make up the natu ral vitamin E. During vitamin E synthesis, equimolar amounts of these isomers (vitamers) are produced. The newborn, fundamentally the premature infant, is particularly vulnerable to vitamin E deficiency because of its deficient body reserves. Neuropathological alterations have been described in at-risk patients and the most frequent manifestations comprise diverse grades of areflexia, walk proprioception disorders, diminution of vibratory sensations, and ophthalmoplegia [1]. With regard to the relationship of vitamin E deficiency and the development of cardiovascu lar disease and cancer, there are no conclusive results to date [1,19]. If this occurs, it is manifested in specific cases, that is, in the following three situations: a. Persons with a difficulty of absorbing or secreting bile or who suffer from fat metabo lism-related disease (celiac disease or cystic fibrosis) b. The deficiency appears in less time due to the infants not possessing so great a vitamin-E reserve. The disease can be prevented with the administration of selenium, which acts on vitamin E as an agent that favors the storage of selenium in the organism. Rations with a scarcity of vitamin E, sele nium, and azo-containing amino acids and a high content of polyunsaturated fats cause muscle degeneration in chest and thighs. This corresponds to the yellowish-brown coloration of adipose tissue in the liver due to the oxidation in vivo of lipids. This produces sterility in some animals and certain disorders associated with reproduction, death, and fetal reabsorption in females and testicular degeneration in males. Obtaining Vitamin E: Tocopherol-rich dietary sources include the following: alfalfa flour; wheat germ flour (125100 mg/kg); hens egg (egg yolk); polished rice (10075 mg/kg); rice bran; mediator wheat (7550 mg/kg); dry yeast; dry distillery solubles; barley grains; whole soy flour; corn grains; ground wheat residues (5025 mg/kg); corn gluten flour; wheat bran; rye grains; sorghum; fish flour; oatmeal; sunflower seed flour; cotton seed flour (2510 mg/ kg); almonds; hazelnuts; sunflower seeds; nuts, and peanuts. Hydrogenation of the oils does not produce a very important loss of tocopherols in terms of their content in the original oil; thus, margarine and mayonnaise contain this vitamin, in lesser amounts. Absorption: The absorption of vitamin E in the intestinal lumen depends on the process necessary for the digestion of fats and uptake by the erythrocytes. In order to liberate the free fatty acids from the triglycerides the diet requires pancreatic esterases. Bile acids, mono glycerides, and free fatty acids are important components of mixed micelles. Esterases are required for the hydrolytic unfolding of tocopherol esters, a common form of vitamin E in dietary supplements. Bile acids, necessary for the formation of mixed micelles, are indispen sable for the absorption of vitamin E, and its secretion in the lymphatic system is deficient. Vitamin E is transport ed by means of plasma lipoproteins in an unspecific manner. The greater part of vitamin E present in the body is localized in adipose tissue [19, 20]. The four forms of tocopherol are similarly absorbed in the diet and are transported to the peripheral cells by the kilomicrons. After hydrolysis by the lipoprotein lipases, part of the tocopherols is liberated by the kilomicrons of the peripheral tissues [19]. Vitamin E accumulates in the liver as the other liposoluble vitamins (A and D) do, but dif ferent from these, it also accumulates in muscle and adipose tissue. Toxicity: High doses of vitamin E can interfere with the action of vitamin K and also inter fere with the effect of anticoagulants: hemorrhages. Part of the potential danger of consuming high doses of vitamin E could be attributed to its effect on displacing other soluble antioxidants in fats and breaking up the natural balance of the antioxidant system. In fact, one study on lpha-tocopherol and -carotene demonstrated a significant increase in the risk of hemorrhagic shock among study participants treated with vitamin E. Other data suggest that vitamin E could also affect the conversion of -carotene into vitamin E and the distribu tion of the latter in animal tissues. Vitamin E possesses anticoagulant properties, possibly on interfering with the mechanisms mediated by vitamin K. In recent studies conducted in vi tro, it was demonstrated that vitamin E potentiates the antiplatelet effects of acetylsalicylic acid; therefore, one should be alert to this effect when both substances are consumed [19].

Similarly discount 0.15 mg levlen, rodents and snails are also potential reservoirs for a number of diseases besides their contribution economic to losses generic levlen 0.15mg fast delivery. These vector borne diseases best levlen 0.15mg, however, could have through the application of environmental modification methods. This lecture note contains 13 chapters where the general feature, life cycle, medical importance and appropriate prevention and control strategies are touched with some practical examples and review questions. In been prevented or controlled through the application of vector control methods, particularly other words, it will guide the reader to the subject matter of vector and rodent control by presenting general information first and then specific diseases transmitted by the vector and its control methods. A lecture note on vector and rodents control was prepared in 2002 by Ato Solomon Tassew for Diploma environmental health students by collecting the necessary information relevant to the course from existing books, journals, and lecture materials. Now by putting similar effort that material is reorganized and updated with the aim of making it a sufficient reference material for degree Environmental health science students. Comments of different instructors from department of Environmental health, Faculty of health sciences, Haramaya University were also incorporated which brought the material to its present status. Generally, Environmental health professionals have the responsibility to plan and apply appropriate vector control programs at community level to prevent diseases transmitted by arthropods, rodents and snails through organized community participation. It is based on the previous lecture note that this material with wider content is made. We are also grateful to all Carter Center-Ethiopia staffs, to staffs of Haramaya University, Faculty of health science especially Ato Tesfayie Gobena and Andualem Sitotaw who reviewed the material with great courage. We also extend our appreciations to Ato Yohannes Tesfaye (Defence unvesity college), Ato Ahmed Mohammed (Jimma University), Ato Tesfaye Tilaye (Gondar University) and Ato Alemayehu Woldecherkos ( Hawassa University) who have critically reviewed and contributed a lot to bring this lecture note in to this stage. Existing Problems of vectors The relation ships of early humans to insects were similar to those between insects and other primates and mammals. Insect parasites, fed on humans, annoyed them and transmitted diseases among them. In common with other mammals, humans have acquired host- specific parasites, for instance, the head and body louse. Insects also destroyed stored foods, shelters and articles made of wood, plant fibers and animal hides. In turn, primitive peoples, sometimes 1 as a regular part of their diet ate insects. Honeybees are native to the old world and stingless bees produce honey in the tropics of the new world. With development of agriculture and cities, humans came in to cooperation and conflict with insects. Despite the devastating effects of some insects as destroyers of crops and wooden structures, and as carriers of diseases, it is generally agreed that the majority of insects are directly or indirectly beneficial to human society. Since effective vaccines or drugs were not always available for the prevention or treatments of these diseases, control of transmission of the disease often rely on control of the vector. The objective was to eradicate the diseases or to reduce transmission to such a low level that control could be maintained through the general health care facilities with out the need for additional control measures. Initially these programs were largely successful and in some countries it proved possible to reduce the vector control activities. However, in most countries, success was short lived; often the vectors developed the so called resistance to the pesticides in use, creating a need for new and more expensive chemicals. This situation, eventually led to a return to significant levels of disease 2 transmission. Permanent successes were mostly obtained where environmental modification was carried out in order to prevent the disease vectors from having breeding or resting place. Due to this fact, many scholars are now advocating the importance of environmental change as an effective and first line control strategy for vector and rodent control. Parasitic and bacterial diseases, such as malaria and Lyme disease, tend to produce a high disease incidence but do not cause major epidemics. An exception to this rule is plague, a bacterial disease that does cause outbreaks. Reasons for the emergence or resurgence of vector-borne diseases include the development of insecticide and drug resistance; decreased resources for surveillance, prevention and control of vector borne diseases; deterioration of the public health infrastructure required to deal with these diseases; unprecedented population growth; uncontrolled urbanization; changes in agricultural practices; 3 deforestation; and increased travel. These include undertaking personal protective measures by establishing physical barriers such as house screens and bed nets; wearing appropriate clothing (boots, apparel that overlap the upper garments, head nets, etc. Environmental modification to eliminate specific breeding areas or chemical and biological control measures to kill arthropod larvae or adults may also b e undertaken. Areas such as ports and airports should be rigidly monitored, with control measures utilized to prevent important arthropod disease vectors from entering the country. It is clear that people will always have to live with vector- borne diseases, but maintenance of a strong public health infrastructure and undertaking research activities directed at improved means of controlpossibly utilizing biological and genetic- based strategies, combined with the development of new or improved vaccines for diseases such as malaria, dengue and Lyme diseaseshould lessen the threat to human health. The field of medical entomology continues tomass more information and to encompass more innovations, particularly regarding procedures for control. Perhaps most important among recent trends is the amalgamation of arthropod life history and behavior information as well as awareness of problems with environmental disruptions into the development of more holistic control schemes. The control of insects and other pests has long been an important aspect of public health in temperate and tropical parts of the world. The arthropods involved may be causal agents themselves, developmental transfer hosts, or vectors of pathogens. The study of these conditions includes broad aspects of the biology and control of the offending arthropods and recognition of the damage they do and the way that they do it. The bearing of public and individual health and on the health of domestic and wild animals is obvious. Both mental and physical health, plus general comfort and well-being are concerned. Insects are extremely successful animals and they affect many aspects of our lives despite their small size. All kinds of natural and modified ecosystems both terrestrial and aquatic support communities of insects that present a bewildering variety of life styles, forms and functions. Their ecologies are highly diverse and often they dominate food chains and food webs in biomass and species richness.

Periodontal disease hence becomes a cumulative one due to 03 different factors mentioned above making it possible for a shift in the microbial 04 composition cheap levlen american express. This shift in cytokine 10 levels along with a reduced cellular immunity may be the reason for the increased 11 periodontitis in older adults cheap 0.15 mg levlen otc. Meydani et al proposed that alterations in T cell 12 functions identified in elders were in part due to increased levels of free radicals 13 and membrane lipid per oxidation in cells (Meydani et al order levlen uk. There is a psychological impact of these conditions on 19 interest and attention to oral health. The effect of systemic diseases on periodontitis 20 could be a direct influence on the pathogenesis of the disease, e. Also the intake of medicines 23 especially anti-hypertensives, hypoglycemic agents and anti-depressants may induce 24 mouth dryness (Xerostomia) that may also be associated with increased risk for 25 periodontitis. According to Beck and Hunt (1985) of the 160 million prescription 26 drugs, 47% could have direct effects on the oral cavity and 34% may have an 27 indirect effect. So, it becomes imperative that the 34 dentist identifies individuals with periodontitis and recommends systemic /medical 35 evaluation. So under such circumstances, it would be ideal to reduce the microbial 43 load to make the patient asymptomatic and prevent further damage to the supporting 44 tissues. The gingival inflammation initiated in the second/third 03 decade of life if left untreated may lead to periodontitis. Though in old age chronic 04 periodontitis may already be present, preventive procedures can still be carried out 05 to maintain the inactive stage of the disease, prevent the exacerbation and ultimately 06 prevent any further loss of periodontal structures. Interdental spaces 20 For the prevention of periodontal disease the following steps are carried out: 21 1. It is mandatory 34 that the patients get familiarized with the technique they are supposed to perform 35 routinely. To educate the patients on the importance of oral hygiene is essential in 36 the prevention of periodontal disease and indirectly systemic diseases. The use of interdental brushes can help 44 patients with complaints of food impaction. Several anti plaque agents such as chlorhexidine, Listerine and their 05 generic counter parts are available for use in different formulations. Chlorhexidine, 06 a cationic bisguanide with potent bactericidal and bacteriostatic efficiency has been 07 suggested to aid plaque control in older adults. Chlorhexidine could be particularly 08 useful for older individuals who take phenytoin, nifedipine & cyclosporine and are 09 at a risk for gingival hyperplasia. Listerine has also been shown to be an efficient 10 anti plaque agent but its active ingredients, which comprise of three essential oils 11 (eucalyptol, thymol & menthol) that are alcohols contraindicates its use in older 12 adults who suffer from xerostomia. They are easily used as sprays or swab sticks 19 and could be used even in patients with compromised psychomotor skills. Patients 20 with dry mouth may also benefit from sugarless candies and sugarless gums, which 21 stimulate the flow of saliva. Moderate levels of attachment loss are seen in a higher 35 proportion of older adults: however, severe loss is detected in only a small proportion 36 of older adults (Locker et al. Studies have shown an increased annual rate of 37 destruction of periodontal bone support in individuals of age over 70, which shows 38 aging and its related problem on their own may marginally increase the destruction 39 process (Papapanou et al. Whether it is an age related loss of tissue or an 40 active disease or a change in the severity, the degree and type of treatment may 41 differ but all the same, treatment is essential. Factors to be considered and treatment options 02 Factors to be considered Treatment options 03 04 1. Before starting treatment in older adults, knowledge of their individual 11 past medical and dental histories is important and a careful examination of the intra 12 and extra oral structures is also essential. For patients with systemic conditions, 13 medication for the same would not only influence the treatment plan but also 14 give an idea about the priority for oral hygiene procedures and the motor skills to 15 perform the same. Perception, knowledge, socio economic status and attitude may 16 contribute to it. The Table 1 shows the 20 factors, which have to be considered for treating older adults and the different 21 treatment options. It can be postulated that with more the factors, lesser are the 22 treatment options, with treatments of least intensity predominating. In other words, 23 the factors are inversely proportional to the treatment options. Though it is meant for general anesthesia, it can also be 32 followed for out patient periodontal surgery under local anesthesia (Table 2). A patient with severe systemic disease that limits activity but is not 39 incapacitating 40 4. A patient with incapacitating systemic disease that is constant threat 41 to life 42 5. It is mandatory that the patients be 06 informed about the significance of supportive periodontal treatment. In one study, 07 it has been found that in treated cases tooth loss was found to be three times 08 more in patients who did not return for recall visits. According to Kerry (1995) there 10 are three therapeutic objectives of supportive periodontal treatment: 11 1. Also the dentist is able to carry out non-surgical 18 procedures to arrest the recurrence and progression of disease and minimize further 19 loss of tissues. But when one takes into 23 consideration all the factors by confounding effect, the treatment options become 24 restricted. So the periodontal disease starting as plaque- induced gingivitis at regular 25 intervals are aggravated by different factors till old age at which time the factors 26 become accumulated ones. In spite of this healing following treatment between 27 younger and older people do not show any difference. The incidence rate is still increasing, and despite early diagnosis 18 and improved treatment, the mortality is still high. Breast cancer is a very heterogeneous 19 disease and less than 10% of the diagnosed cases are believed to be caused by an 20 inherited factor. The information on tumor specific genomic alterations has dramatically 21 increased during the past decade, and seen in relation to the effect on survival and treatment efficiency, these genomic changes may prove to act as prognostic and predictive 22 factors.

In the mating of a heterozygous carrier female parent & a normal male parent (the most frequent setting) purchase levlen paypal, the sons are hemizygous affected 50% of the time (i order levlen cheap. Affected daughters are produced by matings of heterozygous females with affected males discount 0.15 mg levlen. This is because a male contributes his Y chromosome to his son & does not contribute an X-chromosome to his son. On the other hand, since a male contributes his sole X-chromosome to each daughter, all daughters of a male with an X-linked disorder will inherit the mutant allele. This figure shows an extended pedigree of an X-linked recessive disorder in which the male parents (in both generations) are normal & the female parents carriers. In contrast to the vertical distribution in dominant traits (parents & children affected) & the horizontal distribution in autosomal recessive traits (sibs affected), the pedigree pattern in X linked recessive traits tends to be oblique, i. Pathogenesis of X-linked recessive disorders The genes responsible for X-linked disorders are located on the X-chromosome, & the clinical risks are different for the 2 sexes. Since a female has 2 X chromosomes, she may be either homozygous or heterozygous for a mutant gene, & the mutant allele may demonstrate either dominant or recessive expression. Therefore, in heterozygous females carrying X-linked recessive mutations, some cells have one active normal X chromosome & other cells have an active abnormal X chromosome containing the mutant allele. Therefore, the heterozygous female expresses the disorder partially & with less severity than hemizygous men. Very rarely, the mutant allele may be activated in most cells & this results in full expression of a heterozygous X-linked recessive condition in the female. The male is, therefore, said to be hemizygous (& not heterozygous) for the X-linked mutant genes. Males have only oner X-chromosome, so they will clinically show the full phenotype of X-linked recessive diseases, regardless of whether the mutation produces a recessive or dominant allele in the female. Thus, the terms X-linked dominant or X-linked recessive refer only to the expression of the mutations in women. Mitochondrial inheritance - is mediated by maternally transmitted mitochondrial genes, which are inherited exclusively by maternal transmission. Chromosomal disorders (Cytogenetic disorders) - are caused by chromosome & genome mutations ( i. They are found in 50% of early spontaneous abortuses, in 5% of stillbirths, & in 0. The normal karyotype Chromosome classification & nomenclature: Karyotype is the chromosome constitution of an individual. The term is also used for a photomicrograph of the chromosomes of an individual arranged in the standard classification (i. Karyotyping uses many types of techniques of which G-banding is the most common procedure. G-banding has the following steps:- - Arrest dividing cells in metaphase by using colchicine. About 400 -800 dark & light bands can be seen in a haploid set of chromosomes using G banding. And the first nd chromosome in such an arrangement is called chromosome 1, the 2 chromosome is called chromosome 2, etc. Metaphase chromosomes are divided longitudinally into 2 sister chromatids held together at the centromere, which delineates the chromosome into a short arm (p) & a long arm (q). In a banded karyotype, each arm of the chromosome is divided into 2 or more regions. Each region is further subdivided into bands & sub bands which are also similarly numbered. Nomenclature of a chromosome showing the division of the long arm (q) of the chromosome into regions 1 & 2. Even though not shown in this figure, the other bands of this q arm & the p arm are similarly divided & numbered. The following order is used to describe karyotypes: First the total number of chromosomes is given. Types of chromosomal anomalies - Chromosomal anomalies may be numerical or structural. Structural anomalies are rearrangements of genetic material within or between chromosomes. In balanced structural anomalies, there is no change in the amount of essential genetic material whereas in the unbalanced ones there is a gain or loss of essential chromosome segments. Trisomy is the presence of 3 copies of a particular chromosome instead of the normal 2 copies. Monosomy is the presence of only one copy of a particular chromosome instead of the normal pair. Anaphase lag - During meiosis or mitosis, one chromosome lags behind & is left out of the cell nucleus. Nondisjunction - is the failure of chromosomes to separate during meiosis or mitosis. As shown in this figure both (B) & (C) produce gametes that are disomic or nullisomic for a specific chromosome. It is responsible for disorders such as trisomy 21, the most common form of Down syndrome. Nondisjunction can also occur in a mitotic division of somatic cells after the formation of the zygote. If mitotic nondisjunction occurs at an early stage of embryonic development, then clinically significant mosaicism may result. The mitotic nondisjunction occurred in one of cells & resulted in a trisomic cell. Also note that most of the cells undergo normal mitosis resulting in normal cells. Therefore, an individual formed from such an embryo will have 2 populations of cells a trisomic cell population & a normal cell population. And the clinical appearance of such an individual depends on the proportion of trisomic cells. Anyway, the clinical feature is less severe than that of an individual in whom all the cells are trisomic. In general, monosomies & trisomies of the sex chromosomes are compatible with life & usually cause phenotypic abnormalities.

Copyright© 2015 | AIDS.org | All Rights Reserved. | Policies | Site Map | Contact Us | Prominent Web Design