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It is also very important that you watch your mental health and that you seek counseling or support if you feel overwhelmed by the way your face has changed. You should follow up with your doctor, should your symptoms not get better within three months or if symptoms worsen. Your doctor can review your past treatment and explore further options with you to help you treat your symptoms. The Academy serves its members by facilitating the advancement of the science and art of medicine related to otolaryngology and by representing the specialty in governmental and socioeconomic issues. It is important to recognize whether exposures in your workplace are contributing to your lung disease because often steps can be taken to prevent the lung disease or keep it from progressing. If you are having problems, there may be other workers who can look just like sarcoidosis. The most common workrelated lung diseases include: Hypersensitivity pneumonitis: Inhalation of certain substances can trigger an immune infammatory reaction Workrelated Asthma: Asthma may be caused or made in the lungs called acute hypersensitivity pneumonitis. People with workrelated asthma often Symptoms including fever, chills, and shortness of breath have more symptoms at work and improve away from develop after you breathe in substances such as certain work (on weekends and vacations). Many diferent molds, bacteria, and bird proteins, or select chemicals exposures at work can cause occupational asthma. Hypersensitivity pneumonitis can addition, people who already have asthma may have become chronic, leading to scarring and interstitial lung workexacerbated asthma due to asthma triggers at work, disease that can be difcult to distinguish from other such as irritants, allergens, and temperature or humidity forms of chronic interstitial lung disease. Work exposures can increase the risk of Breathing in airborne substances at work can cause lung cancer in both smokers and nonsmokers. This can happen to both smokers and non Lung infections:You could develop an infection related smokers. If a workrelated lung disease is suspected, you what to do: should be referred to a health care provider who read warnings specializes in pulmonary and/or occupational wear an appropriate respirator medicine. It can pay for Inadequate regulations or inadequate enforcement of medical care and provide salary support if you are unable to regulations fail to assure that workplaces are safe, work. Who is most likely to get that may be causing disease or making your disease worse. Examples of things that can be done to control exposures include: Almost anyone who works outside the home can develop workrelated lung disease.


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Preparation for C/S and Procedure Catheterisation of the bladder Empty the stomach (if not fasted), premedicate with atropine 0. Preparation of operation field done when mother is awake to shorten induction delivery interval to 10 minutes or less 246 Incision through the abdomen and uterus done quickly (but carefully) to avoid foetal respiratory depression. Alternate stitches are removed on the sixth day and all stitches on the seventh day. Indications Intrauterine foetal death from any cause Prolonged gestation (postfidates, 41 weeks and above) Diabetes mellitus Prefieclampsia and eclampsia Rhesus isoimmunisation. Requirements 247 Cephalic presentation Full cervical dilation Low head Empty bladder Episiotomy. This is a time when complex adaptations of physiology and behaviour occur in women. Although usually a low risk period, life threatening emergencies or serious complications may occur that must be recognised and managed efficiently. Those caring for women postpartum should be sensitive to the initiation of family bonding, a special process not to be disturbed unless maternal or neonatal complications arise. Some of the maternal complications include postpartum haemorrhage, puerperal sepsis, deep vein thrombosis, psychosis, breast engorgement, mastitis or breast abscess. Secondary Abnormal bleeding occurring after 24 hours and up to 6 weeks postpartum. Retained placental fragments or membranes A common complication in which there is delay in completion of the third stage of labour. Spontaneous detachment of placenta occurs within 15 minutes fi 90% of cases and 30 minutes fi 95% of cases. Adherent placenta Manifested usually as actual placental invasion of the myometrial wall 250 Placenta accreta: Superficial myometrial invasion Placenta increta: Deep myometrial invasion Placenta percreta: Uterine perforation by placenta. Lacerations or tears of the birth canal Can be cervical, vaginal or vulvoperineal. Vaginal Examination in lithotomy position Ligation of bleeders and repair of tears and laceration with No. Vulvoperineal Proper management of episiotomy: fi define upper end fi stitch vaginal epithelium with continuous catgut No. Repair of other tears Second degree or third degree perineal tears Lithotomy position Local anaesthesia Skilful repair in experienced hands especially for third degree tears. Uterine Inversion Perform manual replacement: fi if inversion recognized before corpus is trapped 253 fi manual compression and insertion fi initiate oxytocin drip 20 units in 500 mls 5% dextrose 20 drops per minute fi the inserting fist to remain until uterine cavity is well contracted. If above is not possible then: fi general anaesthesia using halothane to relax uterus fi replace and compress uterus fi use oxytocin as above fi leave fist during the G/A till uterus is well contracted If above measures fail, then hysterectomy is recommended. These include upper and lower urinary tract infections; deep vein thrombosis; respiratory tract infections; mastitis: breast engorgement.

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Assess the effectiveness of a design for cognition by answering the following questions. Try reading a book at the beach without sunglasses, finding your way after walking out of a movie theater into bright daylight, or driving toward the sun. Try getting a key into your front door in the dark, reading a detailed road map in your car at night, or finding the light switch in a dark room. How much more difficult would this be if your glasses or windshield were badly smudgedfi The scenarios described above may cause anyone to make mistakes, slow down, get help, or avoid even simple tasks because the demand on visual capabilities is too great, whether temporarily or permanently. Universal design for vision means considering the variety of human abilities in perceiving visual stimuli. This includes: perceiving visual detail clearly focusing on objects up close and far away separating objects from a background perceiving objects in the center, as well as at the edges of the field of vision perceiving contrasts in color and brightness adapting to high and low lighting levels tracking moving objects judging distances 3. Vision can vary widely according to age, disability, the environment, or the particular situation. Assess the effectiveness of a design for vision by answering the following questions. Have you ever struggled to determine where a siren was coming from while driving with the radio onfi Has the congestion from a head cold, especially if you did any airline traveling, ever left you temporarily impaired in hearing, speech, or even balancefi If you have ever used a cordless or cellular phone in a car, a shopping mall, or the airport, you have had the experience of trying to hold a conversation amid background noise and other distractions. In addition, the variable quality of transmission often causes lapses in communication or even interference from other conversations. The situations described above can cause anyone to miss important information, repeat messages, rely on other sensory input, or just give up because the demands on auditory capabilities are too great, whether temporarily or permanently. Universal design for hearing and speech means considering the variety of human abilities in perceiving auditory stimuli. This includes: localizing the source of sound separating auditory information from background sound perceiving both high and lowpitched sounds carrying on a conversation 3. Hearing and speech can vary widely according to age, disability, the environment, or the particular situation. This variability should be considered when the design population may include: individuals whose attention is divided among several auditory sources individuals functioning in very noisy environments individuals using headphones older adults and others with: deafness hereditary loss of hearing blockages in the route to the inner ear damage from prolonged exposure to excessive noise diseases presbycusis (reduction of hearing in older age) head injuries or stroke 4. Assess the effectiveness of a design for hearing by answering the following questions. This would affect your concentration and productivity and might cause you to avoid changing body position. Try doing your job from a straightback chair with your spine firmly against the seat back and your feet on the floor.

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