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Tuesday, July 28, 2009

Re-mortgaging with the Royal Bank of Scotland

The whole thing, from me deciding to re-mortgage to the money being in my new current account, took around six weeks. Whenever something cropped up, as things do, I simply rang my local branch (or they rang me) and talked to one of three ladies whose names I knew and who, despite being busy, took as much time as was necessary to sort out whatever needed sorting in the friendliest manner imaginable. There was one snag: the mortgage insurance. This is supposed to be free for the first six months and I expected the premium to start being taken out of my account at the beginning of this year, but this never happened. It seems that somewhere along the line, the application had gone astray: I've never established whether it was me, the bank or the insurance company who lost it. This is a minor problem - it had the potential to be major if anything had happened but I was lucky.
The Royal
Bank of Scotland are only human, and do make mistakes from time to time. Little ones, in my experience, and not very often. They use their vast electronic machine to help, not to hide behind. I wish all banks were this nice!

Re-mortgaging with the Royal Bank of Scotland

The actual process was simple. I filled out the application form and sent it off with the necessary copies of my payslip etc. The bank made an appointment to send their surveyor round and my partner stayed home that day. The bank's solicitors did all the legal work: they are based up north but there is no reason whatsover, with a routine transaction, why I should have needed to see them in person, and I didn't. I did speak to them a couple of times and they were friendly, helpful and phoned me back when they said they would. I had to do very little myself. The current account mortgage works like a huge overdraft secured on my house. I have my salary paid into it and all my direct debits etc. come out of it. The rate varies depending on how much you owe in relation to the value of your property – for me, fortunately, it’s in the lowest bracket. I am saving loads of money each month and actually paying the mortgage off, not merely paying the interest. I can use PC banking which was not available with the building society I had my previous mortgage with. There is no redemption penalty if I win the lottery and decide to pay the mortgage off. I could go on but you'd get bored.

Re-mortgaging with the Royal Bank of Scotland

I've been a home-owner now for about eleven years: bought my first house as the market hit rock bottom and and am still there. Naive as I was then about financial matters, I took advice from a professional and ended up with an endowment mortgage. I expect you can guess what happened next. Actually it wasn't that bad: I still had fifteen years to run on my mortgage and am young enough to get another 25-year mortgage. So that's what I decided to do.
I have banked with
Royal Bank of Scotland ever since they took over Williams & Glynn's Bank nearly 20 years ago and while I've had other bank accounts as well, both personal and treasurers' accounts for some clubs I've been involved in, as well as building society accounts, RBS have always won hands down when it comes to customer service and helpfulness. Also, and this is VERY IMPORTANT, you can phone your branch up and speak to a real person instead of phoning a call centre and going through endless menus in order to talk to someone who can't or won't help you. So when it came time to re-mortgage, I looked at the available options with the intention to go with RBS unless something spectacularly better came up. It didn't - in fact the current account mortgage I decided on had one of the best rates I could find and in addition, the Bank paid all the legal fees and the valuation fee.

How to Become a Forex Broker

However, if you want to become a business broker only and not a full service forex broker, you may work at a brokerage house. You may either go to school or try to learn forex trading by yourself in order to get license. Remember, knowledge is power for the successful broker! A successful forex broker is aware of what’s happening in the world. Forex brokers research heavily on all political and economic news from the countries for which they hold currency.
Forex brokers are much like any other broker that act as the middleman for the individual and the market itself. They key to a successful forex broker is to get licensed and educated about how the market works. With this article you now have information on how to become a forex broker. Get licensed and registered and start forex trading. Soon you will just be sitting up in your multi-million

How to Become a Forex Broker

Before I will discuss on how to become a forex broker, here are some reasons why should you become one. As a forex trading broker you provide your customers access to the freedom that comes from actively trading their own money online on secure forex trading platforms. Since you offer your clients some money making opportunities and some investments, you are then greatly improving the scope and reputation of your own business leading to greater client retention levels. Aside from the fact that you are paid a commission you can also take advantage of the explosive growth in the demand for alternative investments by offering your high-net worth clients a managed forex account.
Becoming a forex broker is simple. A currency trading broker in the Forex trading market is like being a realtor in the property market. Here are steps to becoming one. Becoming Licensed and Registered. Sign on to a licensed business or seek appropriate securities license and fill out a registration form with the SEC in order to be a full service broker. Take note that licensing is different depending on which state you live in. If you move from state to state, license is not always acknowledged. You’re ready to start trading once registered.

forex signal provider? which one?

It is a fact that you can make money with currency trading on Forex. Indeed, Forex investing is one of the most potentially rewarding types of investments available. Since individual traders and companies have equal chance to expand in Forex trading, we all have the option to becoming a forex trading broker in order to generate more revenue.
In order to help with your trading strategy and transactions, it is recommended that you must find a forex broker if you are new to the FOREX. The forex broker acts as a liaison of the client to the forex market, which provides technical analysis and research of the market situation and guides the client on the methods of trade as well. All of the information he provides is believed to increase the client's profit.

Saturday, July 25, 2009

The depressive or manic symptoms should be of atleast 15 days duration. Types of depressive disorders. 1. Endogenous depression - is characterised by

Recurring episodes of depression only. (The term unipolar mania is not used because nearly all patients who have mania eventually experience a depressive disorder). These two disorders ware earlier referred to as manic depressive disorder. The depressive or manic symptoms should be of atleast 15 days duration. Types of depressive disorders. 1. Endogenous depression - is characterised by the classical triad of depressive symptoms, sadness of mood, poverty of ideation and psychomotor retardation. The onset of this type of depression can occur even in the absence of a significant stressor. 2. Reactive (or neurotic) depression - The onset of this disorder is usually precipitated by an environmental stressor. In addition to the depressive symptoms, concurrent symptoms of anxiety may be present. 3. Dysthymic disorder - This type of depression is characterised by chronic depressive signs and symptoms which are not as severe as those in major depressive disorder. Depressive symptoms should be present for atleast two years during which time symptom-free periods, if any, should be less than two months at a time. DIFFERENCE BETWEEN ENDOGENOUS AND NEUROTIC DEPRESSION: Endogenous depression Neurotic depression 1. Significant stress situation preceeding the 1. Significant stress situation preceding 1. Hypomania - Milder form of manic disorder characterised by euphoria and over-estimation of personal abilities and importance. If the symptoms are not disruptive, the patient's work efficiency may be relatively unimpaired and he may be socially acceptable. 2. Delirious mania - A severe form of mania with concurrent symptoms suggestive of delirium i.e. Clouding of consciousness, disorientation, illusions, hallucinations, incoherence. This form of mania is usually precipitated by emotional or physical stress and frequently results in deterioration of physical health. 3. Chronic mania - Continuous occurrence of manic symptoms in an attenuated form for a prolonged period of time Prognosis of mood disorders: Suicidal tendencies and attempts are unpredictable, hence caution is always needed while determining the prognosis. 1. Duration of illness - Shorter duration carries better prognosis. 2. Type of depression - Reactive depression has better long-term prognosis than endogenous depression. 3. Personality - Well adjusted personality carries better prognosis than maladjusted, neurotic (i.e. obsessive, inadequate or anxious) personality. 4. Type of onset - Acute onset carries better prognosis than gradual onset. 5. Precipitating factors - Presence of precipitating factors carries better prognosis than absence of precipitating factors. 6. Number of attacks - Repeatedepisodes couldresult in chronicity Management of depressive episodes - 1. Hospitalization - Indicated in (a) severe attack of depression, (b) suicidal and homicidal tendencies, and (c) stuporose condition of the patient. 2. ECT - About G to 8 convulsions spread out over a period of 2 to 3 weeks give excellent results in endogenous depression (90 to 95% success rate). Indications: (a) Severe attack, (b) Suicidal and homicidal tendencies, (c) Stupor and (d) Poor response to the other treatments. (e) Patients non-compliant with drug treatment. 3. Drug therapy - (a) Ant i depress ants I Anxiety disorder II Phobic disorder. III. Obsessive compulsive disorder IV Hysteria (a) Conversion disorder. (b) Dissociation disorder. V. Somatisation Disorder VI. Psychogenic Pain Disorder VII. Hypochondriasis. I. Anxiety disorder Definition: Anxiety disorder is characterised by an anxious and apprehensive overconcern often extending to panic and frequently associated with somatic symptoms. Etiology. 1. Genetic factors - Role of genetic factors in anxiety disorder is controversial and higher incidence in relatives of patients with the disorder could be the result of upbringing rather than inheritance. 2. (Biochemical and endocrine factors) - In anxious patients there is increased secretion of adrenaline and noradrenaline. Also post-exercise serum lactate levels are higher in patients with anxiety states than in normal subjects. But these disturbances have been shown to be accompaniments of anxiety rather than its cause. 3. Psychological theories -regard anxiety to be the result of a failure of an individual to successfully repress unwanted thoughts, ideas and feelings into the subconscious mind. Anxiety is also regarded as a fear response to another stimulus through the process of conditioning. 4. Age -Although the disorder can occur any age, it is most common in young adults. 5. Sex - Equal incidence in both sexes. 6. Personality - Persons with anxious, dependent and obsessive traits are more likely to suffer from anxiety states. Clinical manifestations: These are broadly grouped into: 1. PHYSICAL - They are referable to autonomic nervous system imbalance and commonly include palpitations, shortness of breath, tremulousness, unsteadiness, dryness of mouth, headache or heaviness of head, giddiness, blurring of vision, frequency of micturition, diarrhoea, and excessive sweating particularly in palms and soles, etc. On examination, one finds tachycardia, elevation of blood pressure, increase in depth and frequency of respiration, exaggerated deep reflexes 2 PSYCHOLOGICAL - Worries, nervousness, apprehension, irritability and a morbid fear as ifRecurring episodes of depression only. (The term unipolar mania is not used because nearly all patients who have mania eventually experience a depressive disorder). These two disorders ware earlier referred to as manic depressive disorder. The depressive or manic symptoms should be of atleast 15 days duration. Types of depressive disorders. 1. Endogenous depression - is characterised by the classical triad of depressive symptoms, sadness of mood, poverty of ideation and psychomotor retardation. The onset of this type of depression can occur even in the absence of a significant stressor. 2. Reactive (or neurotic) depression - The onset of this disorder is usually precipitated by an environmental stressor. In addition to the depressive symptoms, concurrent symptoms of anxiety may be present. 3. Dysthymic disorder - This type of depression is characterised by chronic depressive signs and symptoms which are not as severe as those in major depressive disorder. Depressive symptoms should be present for atleast two years during which time symptom-free periods, if any, should be less than two months at a time. DIFFERENCE BETWEEN ENDOGENOUS AND NEUROTIC DEPRESSION: Endogenous depression Neurotic depression 1. Significant stress situation preceeding the 1. Significant stress situation preceding 1. Hypomania - Milder form of manic disorder characterised by euphoria and over-estimation of personal abilities and importance. If the symptoms are not disruptive, the patient's work efficiency may be relatively unimpaired and he may be socially acceptable. 2. Delirious mania - A severe form of mania with concurrent symptoms suggestive of delirium i.e. Clouding of consciousness, disorientation, illusions, hallucinations, incoherence. This form of mania is usually precipitated by emotional or physical stress and frequently results in deterioration of physical health. 3. Chronic mania - Continuous occurrence of manic symptoms in an attenuated form for a prolonged period of time Prognosis of mood disorders: Suicidal tendencies and attempts are unpredictable, hence caution is always needed while determining the prognosis. 1. Duration of illness - Shorter duration carries better prognosis. 2. Type of depression - Reactive depression has better long-term prognosis than endogenous depression. 3. Personality - Well adjusted personality carries better prognosis than maladjusted, neurotic (i.e. obsessive, inadequate or anxious) personality. 4. Type of onset - Acute onset carries better prognosis than gradual onset. 5. Precipitating factors - Presence of precipitating factors carries better prognosis than absence of precipitating factors. 6. Number of attacks - Repeatedepisodes couldresult in chronicity Management of depressive episodes - 1. Hospitalization - Indicated in (a) severe attack of depression, (b) suicidal and homicidal tendencies, and (c) stuporose condition of the patient. 2. ECT - About G to 8 convulsions spread out over a period of 2 to 3 weeks give excellent results in endogenous depression (90 to 95% success rate). Indications: (a) Severe attack, (b) Suicidal and homicidal tendencies, (c) Stupor and (d) Poor response to the other treatments. (e) Patients non-compliant with drug treatment. 3. Drug therapy - (a) Ant i depress ants I Anxiety disorder II Phobic disorder. III. Obsessive compulsive disorder IV Hysteria (a) Conversion disorder. (b) Dissociation disorder. V. Somatisation Disorder VI. Psychogenic Pain Disorder VII. Hypochondriasis. I. Anxiety disorder Definition: Anxiety disorder is characterised by an anxious and apprehensive overconcern often extending to panic and frequently associated with somatic symptoms. Etiology. 1. Genetic factors - Role of genetic factors in anxiety disorder is controversial and higher incidence in relatives of patients with the disorder could be the result of upbringing rather than inheritance. 2. (Biochemical and endocrine factors) - In anxious patients there is increased secretion of adrenaline and noradrenaline. Also post-exercise serum lactate levels are higher in patients with anxiety states than in normal subjects. But these disturbances have been shown to be accompaniments of anxiety rather than its cause. 3. Psychological theories -regard anxiety to be the result of a failure of an individual to successfully repress unwanted thoughts, ideas and feelings into the subconscious mind. Anxiety is also regarded as a fear response to another stimulus through the process of conditioning. 4. Age -Although the disorder can occur any age, it is most common in young adults. 5. Sex - Equal incidence in both sexes. 6. Personality - Persons with anxious, dependent and obsessive traits are more likely to suffer from anxiety states. Clinical manifestations: These are broadly grouped into: 1. PHYSICAL - They are referable to autonomic nervous system imbalance and commonly include palpitations, shortness of breath, tremulousness, unsteadiness, dryness of mouth, headache or heaviness of head, giddiness, blurring of vision, frequency of micturition, diarrhoea, and excessive sweating particularly in palms and soles, etc. On examination, one finds tachycardia, elevation of blood pressure, increase in depth and frequency of respiration, exaggerated deep reflexes 2 PSYCHOLOGICAL - Worries, nervousness, apprehension, irritability and a morbid fear as if

Tinea capitis - Irregular patch of alopecia with scaling and broken off stubs of hair within the patch. Multiple patches may develop. Occasionally the

involved (alopecia totalis). Hair loss may occur at other sites such as eyebrows, eye lashes, beard and body hair. Tr. - In majority, lesions regress spontaneously. Regrowth usually occurs within 3 months and only those patches that persist beyond this period require treatment. Topical corticosteroids may hasten recovery. Systemic corticosteroids (20-30 mg prednisolone) daily can produce regrowth of hair. 100 mg prednisolone once a week is equally effective. 2. Tinea capitis - Irregular patch of alopecia with scaling and broken off stubs of hair within the patch. Multiple patches may develop. Occasionally the patch may be inflamed (kerion). Tr. - Topical antifungal therapy is ineffective. Griseofulvin 10 mg/kg/day for 6 weeks or ketoconazole, itraconazole and terbinafine. 3. Lichen planopilaris - Lichen planus affecting hair follicles produces a patchy, scarring alopecia. Mimute, purple papules may be seen around hair follicles at the edges of the patches. Tr. - Clobetasol topically. If not controlled 20-30 mg prednisolone p. o. for 6-8 weeks. 4. Folliculitis Decalvans - rare cause with pustules around follicles which heal with scarring and destruction of hair follicles. T.r - Anti-staphylococcal antibiotics. 5. Skin diseases - that produce alopcia are discoid lupus erythematosus and morphoea. 6. Trichotillomania - produced by pt with psychiatric illness plucking her hair. 7. Traction alopecia - produced by tying a tight pony tail. This is most prominent along hair margins because distant hair is subject to most traction. Diffuse alopecia 1. Androgenetic alopecia - Loss of hair as result of androgenic hormones, hence the hair follicles that normally produce coarse terminal hair give rise instead, to vellus hair. The male type of alopecia has a typical pattern showing frontal recession of the hairline and thinning of the vertex. This may progress to involve the entire scalp except the occipto-temporal region. In women, the condition presents with diffuse alopecia with considerable thinning on the vertex. Tr. - Minoxidil lotion applied to scalp b. d. is of benefit in some who have thinning of the vertex, but require continued application. In women, anti-androgens can also be used and may be effective in some. 2. Telogen effluvium - Postpartum and postfebrile alopecia are not uncommon. There is diffuse loss of hair from entire scalp 2-3 months after pregnancy. This occurs because, following child birth, all the hair enter the resting phase (telogen) at the same time. All the hair are thus lost at the end of telogen which lasts 3 months. A similar mechanism underlies hair loss following fevers especially typhoid. Since there is no abnormality of the follicles, they begin to grow new hair immediately after the old hair are lost. 3. Drug-induced alopecia - Chemotherapeutic drugs exert a direct. inhibitory effect on the rapidly proliferating cells of the hair matrix and lead to hair loss. Recovery is usually complete after withdrawal of the drug. Other drugs include thiouracil, carbimazole, heparin, lithium, pyridostigmine and etretinate. 4. Alopecia of SLE - With subsidence of activity of the disease, hair regrow completely. 5. Alopecia of severe chronic illness - Diffuse hair loss may be a feature of a number of long-standing illnesses that cause constitu tional upset. 6. Idiopathic diffuse hair loss - mostly in women. Note: Surgery for alopecia is useful in diseases where there is a clear distinction between areas affected by disease and areas that are spared, e. g. androgenic alopecia, where the occipito-temporal fringe is never affected. Transplantation of hair from this area to bald areas is effective. G. URTICARIA Definition: Urticaria is a vascular reaction pattern characterized by transient, evanascent, pruritic wheals on the skin occurring on any site of the body. This, is a type I hypersensitivity reaction (IgE mediated immediate hypersensitivity) of the skin to a variety of exogenous and endogenous antigens. Vascular dilatation, the resultant dermal oedema and pruritus are caused by the release of histamine and other mediators from mast cells consequent upon binding of IgE antibodies to the antigen over cell surfaces. It is characterised by evanascent, pruritic wheals which last for 4-8 hours. When the subcutaneous tissue is involved it is termed angioedema. Provoking causes. A. Exogenous: 1. Ingestants: (a) Drugs e.g. penicillins, sulphonamides, aspirin, chloromphenicol, phenytoin. NSAIDs. (b) Foods e.g. seafoods, coloring agents (tartrazine), eggs, meat, spices, some vegetables, some dais, peas, etc. 2. Inhalants: pollens, plant, animal dander, dust, spores. 3 Injectants : Penicillins, insulin, antisera, vaccines. 4. Contactants : Bee stings, bug bites, animal dander, plants. B. Endogenous: 1. Infections: Chronic septic focus, UTI, virus infection (particularly hepatitis and respiratory tract infection), Candida infection. 2. Infestations: Helminths, amoebiasis, giardiasis. 3. Systemic diseases: SLE, lymphomas, malignant mastocytosis. 4. Psychogenic : Emotional stress. Types of Urticaria : 1. Ordinary urticaria - (a) Acute urticaria - lasts for a few hoursordays. It is characterized by the presence of small circumscribed areas of oedema, pink in colour, with central pallor. The number varies, and it occurs anywhere on the body asymmetrically. It is seen in patients with anaphylaxis, atopy, serum sickness or as a reaction to insect-bites, foods and drugs. (b) Chronic urticaria - Recurrent lesions for 3 months with or without arthralgias, adenopathy.

) Poor toilet training. Clinical features -Enuresis may be nocturnal, diurnal or both. It is termed primary if there has been no preceding period of u

of any physical disorder Etiology - (a) Genetic factors - are thought to act through a delayed maturation of parts of the nervous system. (b) Smaller capacity of urinary bladder. (c) Environmental stresses - Enuresis sometimes starts after stressful event, such as birth of a younger sibling, conflict between parents, problems in school, etc. (d) Poor toilet training. Clinical features -Enuresis may be nocturnal, diurnal or both. It is termed primary if there has been no preceding period of urinary continence for at least one year, or secondary if there has been a preceding period of urinary continence for this duration. Treatment - (a) Counselling of parents about nature of the disorder, and about toilet training. (b) Bladder training by which the child is encouraged to increase the interval between successive acts of micturition (c) Imipramine or amitryptiline 25-50 mg at night, may be effective. FUNCTIONAL ENCOPRESIS - is defined as the involuntary passing of faeces into clothing after the age of which bowel control is usual and in absence of a known organic cause. Etiology - (a) Poor toilet training. (b) Mental retardation. (c) Environmental stress - Involuntary voiding follows stressful situation, such as birth of a younger sibling, confict between parents, illness of a parent. Clinical features - Involuntary passing of stools of normal or near-normal consistency into clothing, or in places not appropriate for that purpose in the child's socio-cultural setting. Encopresis like enuresis could be present from birth (primary), or could appear after a sustained period of continence (secondary). Treatment - (a) Counselling regarding faulty toilet training. (b) Behaviour therapy by which the child is encouraged to remain continent. 10. DRUG INDUCED PSYCHIATRIC DISORDERS Classification: 1. Behavioural toxicity (a) Drowsiness - Benzodiazepines, neuroleptics, antihistaminics, antidepress ants, antihypertensives. (b) Behavioural changes - consisting of irritability, aggressive outbursts and a generalised hostile attitude Benzodiazapines, barbiturates, levodopa, neuroleptic drugs, alcohol, drug-withdrawal states. Some tricyclic ant i depress ants, selective serotonin uptake inhibitors. 2. Delirium (Acute organic psychosis) (a) Cardiovascular drugs - Digitalis, diuretics, propranolol, pindolol, oxprenolol. (b) Anticholinergic drugs - atropine, homatropine, scopolamine, antiparkinsonian drugs, tricyclic ant i depress ants. (c) Tranquillizers and hypnotics - barbiturates, benzodiazepines, ant i depress ants, phenothiazines, bromides. (d) Antituberculous drugs - Isoniazid, rifampicin, cycloserine. (e) Anticonvulsants - Phenytoin, sodium valproate. (f) Miscellaneous drugs - Corticosteroids, insulin, disulfiram, cimetidine, chloroquine, aminophylline, oral hypoglycemic agents. (h) Drug withdrawal -Barbiturates, benzdiazepines, chlormethiazole, dextropropoxyphene, alcohol, opiates, phencyclidine. 3. Affective states - (i) Depression - (a) Ant i hypertensive agents - reserpine, alpha methyl dopa, clonidine, propranolol, pindolol (b) Corticosteroids (c) Psycho-active drugs - phenothiazines, neuroleptics, benzodiazepines. (d) Anti-parkinsonian agents - Levodopa. (e) Analgesics -Indomethacin, pentazocine. (f) Hormones - Oestrogens, oral contraceptives. (g) After withdrawal of CNS stimulants -amphetamines, cocaine. (h) Miscellaneous drugs - Ethanol, antineoplastic agents, disulfiram, tetrabonazine, phenytoin, phenobarbitone, theophylline, digoxin, danazol, cimetidine, chloroquine, cycloserine. (ii) Elation - (a) Ant i depress ants. (b) Corticosteroids. (c) Anti-parkinsonian agents - benzhexol, procyclidine, levodopa, bromocriptine (d) CNS stimulants -amphetamines, cocaine, methylphenidate. (e) Miscellaneous - Isoniazid, aminophylline, cyclizine, yohimbine, salbutamol, clonidine withdrawal. 4. Psychotic states - (a) Hallucinogens - LSD, cannabis, phencyclidine. (b) CNS stimulants - Cocaine, amphetamines. (c) Appetite suppressants - Phenmetrazine. (d) Sympathomimetics - Ephedrine, pseudoephedrine, phenylephrine. (e) Alpha-adrenergic agonists - phenylpropanaloamine. (f) Beta-adrenergic agonists - Salbutamol. (g) Beta-adrenergic antagonists - Propranolol, oxprenolol. (h) Dopaminergic drugs - Levodopa, dopamine, bromocriptine. (i) Narcotic analgesics - Pentazocine. (j) Corticosteroids (k) Nonsteroidal ant i-inflammatory agents - Indomethacin. (1) Ant i-de press ant drugs (m) Anticholinergic drugs (n) Miscellaneous - Disulfiram, anti-tuberculosis drugs, cimetidine, ant i-hist ami nics, digoxin. methyldopa, phenytoin. 5. Pseudodementia - Benzodiazapines and barbiturates, major tranquillizers, anti- hypertensive, diuretics, antiparkinsonian drugs and digoxin in the elderly, and overdose of antiepileptic drugs in some epileptics. Chronic hypoglycemia due to oral hypoglycemic drugs or insulin. 6. Neuropsychiatric states - Combinations of psychiatric and neurological symptoms and signs. Phenytoin can -induce a paranoid hallucinatory psychosis or delirium with cerebellar signs and symptoms. Neuroleptics can produce extra-pyramidal reactions like akathisia, pseudo-parkinsonism, acute dystonias and tardive dyskinesia. 11. TREATMENT METHODS IN PSYCHIATRY Broadly these can be divided into two main groups: A. Physical methods of treatment - (I) Drug therapy -Psychotropic drugs can be classified as follows - (1) ANTIPSYCHOTIC DRUGS - (a) Mechanism of action - is postulated to be

Ford passed Toyota Motor Corp. for second place in U.S. market share through June, behind GM

July 24 (Bloomberg) -- Ford Motor Co.’s stock may gain as much as 36 percent after Chief Executive Officer Alan Mulally added U.S. market share and boosted prices without a federal bailout, two analysts said.
The shares may reach $9.50 in six months, Goldman, Sachs & Co.’s
Patrick Archambault wrote in a report. Deutsche Bank’s Rod Lache in New York raised his target price to $8 from $5.50. Ford slid 18 cents, or 2.6 percent, to $6.83 at 9:36 a.m. in New York Stock Exchange composite trading as U.S. stocks fell.
“Overall, we were impressed with the execution of Ford’s turnaround plan,” Lache wrote today, maintaining his “hold” rating. Ford’s North American
region, its biggest, “appears to be on the right track.”
Mulally cut $10.1 billion from the Dearborn, Michigan-based automaker’s liabilities this year with a debt exchange and seeks union concessions to match those granted to General Motors Co. and Chrysler Group LLC in U.S.-backed bankruptcies. Smaller sales declines at Ford have helped boost U.S. market share.
Ford more than tripled this year through yesterday for the second-biggest advance in the Standard & Poor’s 500 stock index. The shares surged 9.4 percent yesterday after Ford’s second- quarter adjusted loss beat analysts’ estimates.
The results show Ford may be “best positioned to deliver” on auto industry “momentum,” wrote Archambault, who is based in New York and advises buying the shares. Mulally has reduced costs while also raising prices, Archambault wrote.
A rising share price may allow Ford to sell more stock,
Joseph Amaturo, a New York-based analyst for Buckingham Research Group, wrote today. He rates the stock as “neutral.” JPMorgan Chase & Co. and Credit Suisse Holdings USA Inc. made similar predictions last week. Ford issued 345 million shares in May, raising $1.6 billion.
Ford’s adjusted loss was 21 cents a share, excluding one- time costs and gains, narrower than the 50-cent average loss estimate among 12 analysts surveyed by Bloomberg. Net income was $2.26 billion, or 69 cents a share, primarily on a $3.4 billion non-cash gain resulting from shrinking debt.
Ford passed Toyota Motor Corp. for second place in U.S. market share through June, behind GM.
NEW YORK -- Shares of Eastman Chemical Co., which makes coatings and specialty plastics, advanced on Friday, after the company reported second-quarter earnings that beat Wall Street expectations.
Shares rose $3, or 6.7 percent, to $48.22 in morning trading
On Thursday the Kingsport, Tenn.-based company said its second-quarter profit fell 43 percent to $65 million, or 89 cents per share, well above the 71-cent estimate by analysts, according to a Thomson Reuters poll.
The company said it expects full-year earnings to be "toward the high end" of its previous guidance of between $2 and $3 per share. Analysts have projected earnings of $2.48 per share.
Deutsche Bank ( DB - news - people ) analyst Jason Minor said the second-quarter results underscored the company's operating strength.
With cost reductions gaining traction, volumes picking up and margins up sharply versus the first quarter, Eastman's second-quarter results highlighted its
operating leverage as earnings again improved beyond expectations."

UPDATE 4-Starwood Q2 profit beats Street, shares surge
Adjusted 22 cents EPS vs. 17 cents consensus
* Cuts 2009 full-year outlook
* In discussions to sell non-core assets
* Shares jump over 9 percent (Adds CEO, CFO comment from earnings call, information on supply pipeline, updates shares)
By Deepa Seetharaman
NEW YORK, July 23 (Reuters) - Starwood Hotels & Resorts Inc (
HOT.N) posted a better-than-expected profit on Thursday, buoyed by cost cuts, and its shares rose over 9 percent.
Costs and expenses for the second quarter fell by about one-fifth, driven by a more than 30 percent drop in general and administrative costs.
"We continue to beat expectations on cost containment," said Chief Executive Frits van Paasschen during a conference call with analysts.
The majority of those savings are sustainable, with the exception of one-time items and a reduction in bonuses to hotel managers this year, van Paasschen noted.
Shares rose $2.00, or 9.4 percent, to $22.28 in afternoon trading. Rival Marriott International Inc's (
MAR.N) stock gained 6 percent, while Host Hotels & Resorts Inc (HST.N), which owns several Starwood properties, saw its stock gain 9 percent.
Starwood reported net income of $134 million, or 74 cents per share, compared with the year-earlier $105 million, or 56 cents per share.
The 28 percent jump in net profit was fueled a gain from a tax incentive program in Italy. Excluding that gain and $26 million in other charges, Starwood earned 22 cents a share.
The results surpassed analyst expectations of 17 cents per share, according to Reuters Estimates.
Revenue fell 23.4 percent to $1.2 billion, slightly lower than analysts' forecast.
But the hotelier, which operates the St. Regis, W and Sheraton chains, also cut its full-year outlook and offered third-quarter estimates that fell far short of analyst expectations.Chief Financial Officer Vasant Prabhu during the call noted that business was stabilizing, but recovery remains slow

A feeling of intense anxiety accompanies the central manifestation and leads the individual to take counter measures against the initial idea or impul

manifestations: are characterised by presence of obsessions and compulsions. Obsessions are recurrent or persistent ideas, thoughts, images or impulses. Compulsions are urges or impulses to action that, when put into operation lead to compulsive acts which are performed either according to certain rules or in a stereotyped manner. Obsessions and compulsions have certain features in common - (a) An idea or impulse intrudes impellingly into an individual's conscious awareness. (b) A feeling of intense anxiety accompanies the central manifestation and leads the individual to take counter measures against the initial idea or impulse. (c) The obsession or compulsion is ego-alien, i. e. is experienced as being foreign to and not a part of one's experience of oneself ; it is undesirable and unacceptable. (d) The individual recognises the obsession or compulsion as being absurd or irrational. (e) The suffering individual feels a strong need to resist those obsessions or compulsions. When the symptoms become severe, the patient may develop additional symptoms of anxiety anchor depression. PROGNOSIS - Natural remissions of symptoms are known; hence the prognosis is not always gloomy. Prognosis is bad when the personality is obsessional and symptoms are severe and of long-standing. Management: 1. Drugs - Fluoxetine (20-60 mg/day) or sertraline (50-300 mg/day) or clomipramine (75-200 mg/day) Trazodone (50^1-00 mg/day) is also effective in some cases. 2. Psychotherapy- Supportive as well as analytical gives satisfactory results in some cases. 3. Behaviour therapy - Satisfactory results are seen in some cases. IV. Hysteria Types of hysterical disorders -1. Conversion disorder - (Hysterical neurosis, conversion type). Here the special senses or voluntary nervous system are affected causing symptoms such as blindness, deafness, paralysis, akinesias, etc. for which there is no organic basis. Often the patient shows an inappropriate lack of concern ("la-belle" indifference) about those symptoms which may actually provide secondary gains by winning sympathy. 2. Dissociative disorder - (Hysterical neurosis, dissociative type). Here alterations may occur in the patient's state of consciousness or in his identity to produce such symptoms as amnesia. somnambulism, fugue and multiple personality. Etiology: There is sufficient evidence to suggest that the symptoms are psychogenic and that the environmental factors are the important etiological factors. 1. Age - The peak incidence is between the ages of 20 to 35 years. 2. Sex - Incidence is higher in females. 3. Intelligence - People with low intelligence more likely. 4. Personality - Commonest is histrionic personality (characteristics - dramatizing and exhibitionistic, attention seeking, immature, having shallow and superficial emotional relationships). 5. Marital status - More common in unmarried, widowed and divorcees. 6. Socio-cultural factors - More common in primitive, developing and less sophisticated or cultured societies. 7. Psychoanalytical theories - Hysterical symptoms are viewed as symbolic representations and distorted expressions of unresolved intrapsychic conflicts about one's sexual drive (libido). When the libidinal energy manifests itself as somatic symptoms through the ego-defence mechanism of conversion, the resulting disorder is known as conversion disorder. When the libidinal energy manifests as psychological symptoms through the defense mechanism of dissociation, the resulting disorder is labelled dissociative disorder. Clinical manifestations: 1. SYMPTOMS OF CONVERSION DISORDER - These arise because of the involvement of voluntary neuromuscular system. (a) Motor symptoms - These are of two types: (i) Akinesia e.g. paresis or paralysis involving a part of the body like monoplegia, hemiplegia, paraplegia, etc. (ii) Hyperkinesia and dyskinesia e. g. tremors, torticollis, convulsons or fits (b) Sensory symptoms: These can be in the form of anaesthesia, hypoaesthesia, hyperaesthesia and paraesthesia. This disturbance can affect all the general sensations. Special organs of sense, like those for sight, hearing, smell and taste can also be disturbed resulting in blindness, deafness, etc. (c) Visceral symptoms - Common ones are hiccoughs, vomiting, dyspnoea, dysphagia, aphonia, etc. 2. SYMPTOMS OF DISSOCIATION DISORDER - (a) Somnambulism and somniloquy. (b) Amnesia -usually circumscribed and covers up the psychologically traumatic event. (c) Trance - An altered state of consciousness lasting for a few minutes to a few hours, during which the patient appears to be oblivious of the surroundings. (d) Fugue - An altered state of consiousness wherein the patient travels long distances over a period of days and subsequently has amnesia for the entire episode. (e) Multiple personalities like those of Dr. Jekyl and Mr. Hyde. (f) Ganser's syndrome, a rare disordercharacterised by giving of "approximate answers", somatic or psychological hysterical symptoms, hallucinations and an apparent clouding of consciousness. Characteristics of hysterical symptoms - 1. Absence of organic basis for symptoms. 2. They serve both primary gain (resolution of intrapsychic conflicts) and secondary gain (obtaining sympathy and attention). 3. In conversion disorder - (a) Symptoms seldom occur when patient is alone, on the other hand, symptoms are exaggerated in presence of other persons. (b)

Ford Price Target Raised at Goldman, Deutsche on Mulally Gains

Officer Alan Mulally added U.S. market share and boosted prices without a federal bailout, two analysts said.
The shares may reach $9.50 in six months, Goldman, Sachs & Co.’s
Patrick Archambault wrote in a July 24 (Bloomberg) -- Ford Motor Co.’s stock may gain as much as 36 percent after Chief Executive report. Deutsche Bank’s Rod Lache in New York raised his target price to $8 from $5.50. Ford slid 18 cents, or 2.6 percent, to $6.83 at 9:36 a.m. in New York Stock Exchange composite trading as U.S. stocks fell.
“Overall, we were impressed with the execution of Ford’s turnaround plan,” Lache wrote today, maintaining his “hold” rating. Ford’s North American
region, its biggest, “appears to be on the right track.”
Mulally cut $10.1 billion from the Dearborn, Michigan-based automaker’s liabilities this year with a debt exchange and seeks union concessions to match those granted to General Motors Co. and Chrysler Group LLC in U.S.-backed bankruptcies. Smaller sales declines at Ford have helped boost U.S. market share.
Ford more than tripled this year through yesterday for the second-biggest advance in the Standard & Poor’s 500 stock index. The shares surged 9.4 percent yesterday after Ford’s second- quarter adjusted loss beat analysts’ estimates.
The results show Ford may be “best positioned to deliver” on auto industry “momentum,” wrote Archambault, who is based in New York and advises buying the shares. Mulally has reduced costs while also raising prices, Archambault wrote.
A rising share price may allow Ford to sell more stock,
Joseph Amaturo, a New York-based analyst for Buckingham Research Group, wrote today. He rates the stock as “neutral.” JPMorgan Chase & Co. and Credit Suisse Holdings USA Inc. made similar predictions last week. Ford issued 345 million shares in May, raising $1.6 billion.
Ford’s adjusted loss was 21 cents a share, excluding one- time costs and gains, narrower than the 50-cent average loss estimate among 12 analysts surveyed by Bloomberg. Net income was $2.26 billion, or 69 cents a share, primarily on a $3.4 billion non-cash gain resulting from shrinking debt.

Cholera infantum" or acute toxic diarrhoea - In a very severe case rice water stools and symptoms of toxemia. Abrupt onset with high fever and extreme

depressed anterior fontanelle, loss of elasticity of skin and sunken abdomen Fever, restlessness, tachycardia and oliguria. Later symptoms of toxemia - apathy, staring sunken eyes, shallow respirations, uncountable pulse, cyanosis, acidotic breathing. Temperature high or sub-normal "Cholera infantum" or acute toxic diarrhoea - In a very severe case rice water stools and symptoms of toxemia. Abrupt onset with high fever and extreme prostration, vomiting, irritability, restlessness and often convulsions, collapse, suppression of urine and finally stupor and coma. Copious watery stool suggestive of toxigenic diarrhoea, small, frequent with tenesmus, blood and mucus in invasive infections - EEC, Salmonella, Shigella, amoebiasis. III. Parenteral diarrhoea - At onset of any acute infection e. g. acute otitis media and mastoiditis, infection of respiratory tract, acute pyelitis and meningitis. Probably same virus involves both systems as in measles. Management: I FLUIDS - (a) Solution used - (i) Ringer lactate - Full strength 1 ampoule with 5% glucose or 1/2 strength. (ii) Isolyte M is suitable rehydrating fluid in infants. (iii) Glucose-saline IV - 1/5th in newborns, 1/3 in older children use after initial rapid rehydration. (iv) Potassium chloride (1 ml =2mEq), add 1 ml of solution to 100 ml IV solution (maximum 2 ml) after patient starts passing urine. (b) Quantity - (i) Assessment of fluid loss -According to grade of dehydration: (a) Mild - Irritability, pallor, pink lips - <5%>

Indian students preyed upon for socio-economic reasons: Victoria police chief

Melbourne, July 1 (IANS) Some of the attacks against Indian students in Australia over the past few weeks had racist overtones, admits Victoria state's top police official. But he also underscores that the victims were vulnerable due to socio-economic reasons.
"I am not saying there have been no racist undertones. There may well have been but I would like to stress that opportunistic crime and the fact that these kids are vulnerable have also contributed to the number of incidents," admits Simon Overland, Victoria's chief commissioner of police who has been in the eye of the storm quelling sit-in protests and demonstrations in the wake of the attacks.
"Because of their sheer numbers, they will be victims of crime. But I will ensure that these incidents are not disproportionate," Overland told IANS in an interview.
Over the last few weeks, there have been at least 20 such incidents of either students being attacked in public transport or waylaid near their houses in both Melbourne and Sydney, sparking allegations of widespread racism in Australian society and a failure by law enforcement authorities to act.
"They have been preyed upon. But they are vulnerable for a whole set of other reasons which need to be addressed urgently and most of these are socio-economic," he asserts.
"They live in cheap housing, work late hours and often take on more than one job to stay afloat. Many of them drive taxis in the late hours, so that can invite trouble from louts who are drunk, while others work in convenient stores that are open right through the night."
"In addition, many who use public transport to go back home that is usually in the suburbs, sometimes unknowingly invite trouble by using i-pods and laptops. The transport system can be unsafe in the wee hours of the morning," says Overland, who commands a force of nearly 11,000 men for the entire state boasting of a population of over five million.
"Ideally, I would like more men on the force but the challenge is to use my resources effectively," he says.
Just this week, Victoria Police launched a new scheme called 'Operation Safe Stations' under which it has increased its presence in trains and stations in suburbs with the aim of reducing muggings and robberies, especially those targeted at international students.

All the high profile cases in Melbourne - except for the attack on Indian student Sravan Kumar Theerthala, who faced up to party crashers, one of whom stabbed him in the head with a screw driver - have happened on the transport corridor.
But Overland also realises that Indian students, especially those in the vocational sector, need to keep such a regimen because they have to pay back hefty loans.
"I know these are legitimate concerns. Their need to get a permanent resident status and visa issues...but solutions need to be found."
Gautam Ghosh of the Federation of Indian Students of Australia that was at the forefront of the protesting students agrees with Overland's suggestion and says educational institutions and the federal governments should subsidise housing and help in "mainstreaming" students.
"Unless matters are sorted out by the government and educational providers to find solutions to the existing problems, it will only exacerbate. Indian students need to plan their trip here and be educated on what they would be required to do," he said.
"If they can't afford it, they must not come as Australia is an expensive country. Because otherwise they will be condemned to live in a commercial prison."


AWB halts share trading

Agribusiness company AWB has temporarily halted trading in its shares, pending an announcement to the Australian Securities Exchange about its operations in South America.
The company is also flagging an announcement about its full-year trading expectations.
AWB Brazil, set up three years ago at a cost of about $250 million, traded in soy beans and corn products, and also had interests in lot-fed cattle
Earlier this year, AWB announced that a number of accounting errors had been uncovered during a review of the Brazilian operations.
The losses contributed to AWB's poor first half profits, which fell by more than 60 per cent to $8.54 million.

The eggs hatch in the duodenum and larvae migrate through the gut wall. Blood stream dissemination follows usually to the liver, but any tissue or org

widespread in dogs and livestock (sheep, goats, cattle and camels) and in man (b) Alveolar E multilocularis, the ^malignant1 hydatid is transmitted between foxes and rodents, but is very rare in humans LIFE CYCLE OF ECHINOCOCCUS - The adult worm lives in the small intestine of the dog. Eggs are shed in the faeces and ingested by sheep, usually from contaminated pasture. The eggs hatch in the duodenum and larvae migrate through the gut wall. Blood stream dissemination follows usually to the liver, but any tissue or organ can become infected. The larva develops into a hydatid cyst containing many scolices/ When infected organs of the sheep are ingested by the dog, the scolices attach themselves to the small bowel mucosa and develop into adult worms/ Man becomes infected after ingestion of eggs after contact with dogs faeces or via contaminated food stuffs. Clinical features - Hydatid cysts especially if calcified may be asymptomatic and first noted incidentally during routine physical examination. Symptoms and signs depend on the organ affected. 1. LIVER - Hydatid cyst may present as - (a) Painless hepatomegaly. (b) Pyrexia of unknown origin following secondary pyogenic infection. (c) Jaundice due to pressure on the bile ducts. (d) Severe systemic reaction following rupture into peritoneal cavity, gut itself or pleural cavity. (e) Cholangitis from rupture into biliary tree. 2. LUNG - Pulmonary hydatid cyst can present as - (a) Solitary or at times multiple cysts, on plain radiograph. (b) Shortness of breath or chest pain if cyst is large. (c) Haemoptysis following ulceration into a bronchus. (d) Expectoration of watery fluid and daughter cysts fgrape skin' expectoration) following rupture into the bronchial tree. Respiratory distress may follow due to aspiration of fluid elsewhere in the lungs, and may be associated with urticaria and anaphylactic shock. (e) Fever, cough and purulent sputum, if secondary pyogenic infection occurs. 3. OTHER ORGANS - Presence of cysts in - (a) Brain -Epilepsy or hemiplegia. (b) Long bones - Pathological fractures. (c) Spleen - Splenomegaly. (d) Kidneys - Hematuria. (e) Spinal cord - Seizures or signs of increased intracranial pressure of subacute onset and progressive course. Root pains- and motor or sensory deficits. (f) Thyroid - Goitre. (g) Behind the eye - Exophthalmos. (h) Abdomen - Pseudocycesis from rapidly growing cysts. Diagnosis - 1. DEMONSTRATION OF HYDATID CYSTS - (a) Chest radiograph - various signs are - (a) Classical appearance of a circular shadow sharply defined with no reaction in surrounding lung parenchyma. The cyst may change shape on maximum inspiration an expiration (Escudero nimerove sign). (b) Crescent sign or pulmonary meniscus sign - If the cyst communicates with a bronchus, a cap of air may be seen above the cyst (also seen in lung abscess partially filled with ins pisated pus or blood clot, tuberculous cavity containing a Rasmussen aneurysm, and in intracavitary fungal ball). (c) Double arch (Gumbo's) sign - As more sir enters between pericyst and endocyst, the shrinking cyst ruptures with resultant air fluid level within the endocyst capped with crescent of air between pericyst and endocyst. (d) Water lilly sign - With further separation of endocyst and evacuation of fluid, a wavy endocyst membrane floats on top of remaining TREATMENT - Praziquantel in three equal doses of 20 mg/kg at 4h intervals with meals. Apart from mild side-effects of drowsiness, headache, dizziness, etc. , a syndrome of severe abdominal pain followed by bloody diarrhoea may occur. PREVENTION - 1. Protection of snail habitats from infection by provision of clean water and toilet facilities, and health education. 2. Mass therapy with oxamniquine, metriphonate or praziquantel to reduce amount of egg excretion. 3. Snail destruction by improved irrigation methods and use of molluscicides. 4. Prevention of infection by wearing protective clothing. 18. HYDATID DISEASE : Definition - Hydatid disease of man is zoonosis caused by infection with tapeworm larvae of the genus Echinococcus. There are two forms - (a) Cystic: The much more common E. granulasus causes unilocular hydatid cysts and is widespread in dogs and livestock (sheep, goats, cattle and camels) and in man (b) Alveolar E. multilocularis, the `malignant' hydatid is transmitted between foxes and rodents, but is very rare in humans. LIFE CYCLE OF ECHINOCOCCUS - The adult worm lives in the small intestine of the dog. Eggs are shed in the faeces and ingested by sheep, usually from contaminated pasture. The eggs hatch in the duodenum and larvae migrate through the gut wall. Blood stream dissemination follows usually to the liver, but any tissue or organ can become infected The larva develops into a hydatid cyst containing many scolices. When infected organs of the sheep are ingested by the dog, the scolices attach themselves to the small bowel mucosa and develop into adult worms. Man becomes infected after ingestion of eggs after contact with dogs faeces or via contaminated food stuffs. Clinical features - Hydatid cysts especially if calcified may be asymptomatic and first noted incidentally during routine physical examination. Symptoms and signs depend on the organ affected. 1. LIVER -Hydatid cyst may present as - (a) Painless hepatomegaly. (b) Pyrexia of unknown origin following secondary pyogenic infection.

Life not the same for Indian students in Australia

MELBOURNE: A change in lifestyle has been the fallout of the attacks against Indian students in the southern winter of 2009 in Australia. They have learnt an important lesson - get home early.

Mir Qasim Ali Khan, 24, the student of a two-year programme in hospitality at the Victoria Institute of Technology, was one unlucky victim.

A fortnight back, while returning home after a haircut near the eastern suburb of Box Hill where he stays with two other Muslim friends, the student from Andhra Pradesh was accosted by two beefy white teenagers.

"They were coming up from the opposite end of the road. It was around 5.30 p.m. and there were people milling around. Suddenly, they crossed over and came towards me. They landed a few tough punches and fled. It all happened so fast," Khan told IANS.

Lying on his bed with a hairline cheek fracture and seven stitches, he says that he has been visiting the doctor regularly since the attack.

"I was wearing spectacles and in the punch-up, there was damage to my sight. My vision in the right eye is still blurred and I hope it becomes better."

His roommates Anees Modi, a student of design, and Abbas Raza, who is pursuing a diploma in management, are both 25. They admit that they have been shaken by the incident as there had been no provocation for it.

"I have been sledged at sometimes while travelling in trains but have never been hit. Once in a while I have retorted, but that too only when people are around but have always walked away when I sensed trouble," said Modi, who hails from Bangalore.

Some extraordinarily brutal incidents coming so close together have jolted Indian students to action and shocked the authorities.

"After what has happened to Khan we are taking precautions in our lifestyle. We try to get back early and if we have to stay late sometimes we borrow our friend's car or get dropped," said Raza.

In most of the 19 such incidents of students being either attacked in public transport or waylaid near their houses in recent weeks, victims claimed that perpetrators were let off as the liberal Australian juvenile law prohibits the arrest of those below 18 years.

On the other side of the city in Coburg, which is one of Melbourne's oldest suburbs, the friends of Sravan Kumar Theerthala are angry and keeping a close eye on what is happening in his case.

The student from Andhra Pradesh is currently in rehab after being stabbed with a screwdriver by gatecrashers at a party in May end. For almost two weeks after the incident he was in a coma.

"This is not the best of neighbourhoods, but we have to stay here as this is what we can afford," said Anil Gogiveni, a vocational course student.

"We want to be safe and have decided to move in groups after the attacks if we have to come back home late. Ideally we want to be in early."

"Look, we too can be aggressive and hit back as we can muster the numbers. All of us are from Andhra and we are in strength. But what's the point?" exclaims Swati Kiran, in the midst of his nine friends.

According to the police, there was a huge altercation between the students and two gatecrashers who landed up at Sravan's party.

"I can't remember the exact sequence of events that evening. But when I saw Sravan lying on the ground and bleeding after being chased down by the two white boys, I was angry and knew that he was a victim of a hate crime," says Sreenivas Reddy.

The sense of unease and insecurity among Indian students in Australia persists despite assurances from the government that it will curb the hate crimes.

"If these attacks continue it will have an adverse effect. Australia will suffer more than India if these attacks go unchecked, unpunished and Indian students look elsewhere for higher studies," said Madhukar Acharya, another student.

Thursday, July 23, 2009

BROKER ONLINE

A broker is not the individual who acts as an intermediary between a buyer and seller, and charges a broker commission. A broker usually assumes all the risk of your transactions, whether a loan, stocks, an insurance policy or even your cheap travel tickets. A brokers reputation is always on the line, his broker knowledge is scrutinized, your happiness is the brokers responsibility. A broker will charge a broker commision based on the risk of the broker transaction. There are many types of brokers from mortgage brokers to construction brokers, ask our brokers

EFFICTIVE FOREX TRADING

Who wouldn’t want to participate in the largest, most potentially lucrative market on this planet?Forex trading is a very exciting place to do business and if you know what it’s about, you could stand to earn a lot from it, too.To do so, you’ll need an effective forex trading system to help you put your strategies together.Here’s how you can develop oneKnow your limits.Generally, it’s the leverage you’re looking at when you’re trading forex. A 100:1 leverage will make you bless the day you found forex, IF it works in your favor and curse it if it goes against you. Maximizing your leverage may put you at a high potential for a very lucrative profit but it also places you at a high risk of losing it all.Try to work using a forex trading system that lets you limit the risk in your favor. The key here is to manage your account and your money and not to throw it away on a whim.Always put a limit on your trades.Decide on how much exactly you want to trade and stick to it. You should also decide up to what point you want to take your losses. Respect this covenant with yourself. Break it only if you’re already well-experienced, know exactly what you’re doing and can take the risk.Learn to read the trend.Forex trading is heavy on trends, something you should watch out for. If you want to develop an effective forex trading system, learn to read daily and later, weekly charts. This will help you analyze the direction the market is going. Find the indicators you want to work with and use those to determine if it’s the right time to start trading.
Who wouldn’t want to participate in the largest, most potentially lucrative market on this planet?Forex trading is a very exciting place to do business and if you know what it’s about, you could stand to earn a lot from it, too.To do so, you’ll need an effective forex trading system to help you put your strategies together.Here’s how you can develop oneKnow your limits.Generally, it’s the leverage you’re looking at when you’re trading forex. A 100:1 leverage will make you bless the day you found forex, IF it works in your favor and curse it if it goes against you. Maximizing your leverage may put you at a high potential for a very lucrative profit but it also places you at a high risk of losing it all.Try to work using a forex trading system that lets you limit the risk in your favor. The key here is to manage your account and your money and not to throw it away on a whim.Always put a limit on your trades.Decide on how much exactly you want to trade and stick to it. You should also decide up to what point you want to take your losses. Respect this covenant with yourself. Break it only if you’re already well-experienced, know exactly what you’re doing and can take the risk.Learn to read the trend.Forex trading is heavy on trends, something you should watch out for. If you want to develop an effective forex trading system, learn to read daily and later, weekly charts. This will help you analyze the direction the market is going. Find the indicators you want to work with and use those to determine if it’s the right time to start trading.

EFFICTIVE FOREX TRADING

Who wouldn’t want to participate in the largest, most potentially lucrative market on this planet?Forex trading is a very exciting place to do business and if you know what it’s about, you could stand to earn a lot from it, too.To do so, you’ll need an effective forex trading system to help you put your strategies together.Here’s how you can develop oneKnow your limits.Generally, it’s the leverage you’re looking at when you’re trading forex. A 100:1 leverage will make you bless the day you found forex, IF it works in your favor and curse it if it goes against you. Maximizing your leverage may put you at a high potential for a very lucrative profit but it also places you at a high risk of losing it all.Try to work using a forex trading system that lets you limit the risk in your favor. The key here is to manage your account and your money and not to throw it away on a whim.Always put a limit on your trades.Decide on how much exactly you want to trade and stick to it. You should also decide up to what point you want to take your losses. Respect this covenant with yourself. Break it only if you’re already well-experienced, know exactly what you’re doing and can take the risk.Learn to read the trend.Forex trading is heavy on trends, something you should watch out for. If you want to develop an effective forex trading system, learn to read daily and later, weekly charts. This will help you analyze the direction the market is going. Find the indicators you want to work with and use those to determine if it’s the right time to start trading.

HOME MOME ADS

There are not too many left but if you are a stay at home mom odds are that you just might be in the market for something that can allow you to fulfill your family or other non-work obligations but at the same time allow you to bring a monetary contribution into the home.The good news for you is that the days of having to pay top dollar for adequate daycare for your child or children so that you can rejoin the workforce are gone. You can get back to work, still be with your children, still keep deadlines, dance recitals, and doctors appointments while bringing in what very well can be a very generous income.If you have access to the Internet and motivation, a home based Internet business is just screaming your name. You do not have to invest a bunch of money to get started; the only thing that you need to invest is a little time.Maybe it is financial reasons that have caused you to consider working again; maybe you have gotten a bit restless and are looking for something a bit more challenging than what you are currently doing. Whatever the case is, today is the day that you can change it all while still balancing your current lifestyle.If a lack of confidence is one of the obstacles holding you back, don’t worry. There may have been a time when you were out daily as part of the workforce and you were confident and ready. This may an image that is frozen in time but as you reconnect with people again, you will gain it all back, plus some.Too many stay at home moms truly believe that there choices are so limited that they can either return to work on a full time basis or not. This is so not the case because you can return to work with an extremely flexible schedule and have the best of both worlds in no time.

HOME MOME ADS

There are not too many left but if you are a stay at home mom odds are that you just might be in the market for something that can allow you to fulfill your family or other non-work obligations but at the same time allow you to bring a monetary contribution into the home.The good news for you is that the days of having to pay top dollar for adequate daycare for your child or children so that you can rejoin the workforce are gone. You can get back to work, still be with your children, still keep deadlines, dance recitals, and doctors appointments while bringing in what very well can be a very generous income.If you have access to the Internet and motivation, a home based Internet business is just screaming your name. You do not have to invest a bunch of money to get started; the only thing that you need to invest is a little time.Maybe it is financial reasons that have caused you to consider working again; maybe you have gotten a bit restless and are looking for something a bit more challenging than what you are currently doing. Whatever the case is, today is the day that you can change it all while still balancing your current lifestyle.If a lack of confidence is one of the obstacles holding you back, don’t worry. There may have been a time when you were out daily as part of the workforce and you were confident and ready. This may an image that is frozen in time but as you reconnect with people again, you will gain it all back, plus some.Too many stay at home moms truly believe that there choices are so limited that they can either return to work on a full time basis or not. This is so not the case because you can return to work with an extremely flexible schedule and have the best of both worlds in no time

ASUS Eee PC

Shortly after I started my own business I realized that I would be traveling to meet with clients and to do research for my work, so my desktop and media center laptop wouldn’t cut it. I didn’t really need a system that could handle high end graphics or media play back, all I really needed was something compact and light that could connect to the internet and used word processing. Companies like Sony offered solutions to this problem with their lightweight laptops, but I just didn’t have the $1,000 to spend on it. Then I learned about the Asus Eee PC.Based around the same concept as the OLPC project, the Asus Eee PC is meant to be a lightweight and easy to use learning device. Regardless of what they intended the device to do, it’s clearly capable of even greater feats than originally intended. The Eee PC comes in four models for it’s 701 Series: 2G Surf, 4G Surf, 4G, and 8G. While the number denotes the amount of physical hard drive space on the solid state disk and a few other differences, each system is equipped with a 7 in 800—480 TFT LCD with LED backlight, Integrated Intel GMA 900 graphics processor, Integrated 802.11 b/g wifi, 3 USB inputs, VGA Output, Ethernet Input, Kensington Lock, and MMC SD slot. The Surf models offer a battery life of 2.8 hours where as the other two models offer 3-3.5 hours and a built in webcam.The 2G Surf is equipped with an 800 MHz Intel Celeron-M ULV 353 with the rest equipped with a 900 MHz version of the same chip. The 2G Surf also only has 512mb of DDR2 400 Ram soldered in while the 4G Surf and 4G have socketed 512mb DDR2 533/667 and the 8G with 1GB. The prices start as low as $299 for the 2G Surf and as high as $499 for the 8G. [More]

PROFESSIONAL FOREX TRADING SYSTEMS

If you are serious in venturing to Forex, these books are worth for investment. The Blade Forex Strategies will be a good reference as you venture for Forex business. With its time proven and tested strategies, these will give you an edge to start off your trading skills. Capturing trades with your sharpen trading skills through the Blade Forex Strategies is definitely as easy task and a sure way to success

BLADE FOREX STRATEGIES

The methods were explained thoroughly in a step by step procedure. To thoroughly comprehend the strategies and systems discussed in the book, somehow a pre-knowledge about Forex would be an advantage.The application of these systems has resulted to consistency in the trading and high profits with a minimal risk. With this guarantee, the books are indeed worth to invest. Anyhow there is the 100% money back guarantee for eight weeks in case you are not satisfied with the content of the book.But with this case, I doubt that you will ask for your money back as the strategies are formulated from a seasoned trader and are profitable strategies. Besides with the various system strategy options, it will give you an opportunity to evaluate the system which works best for you.

Satyam Computer has resistance at Rs 115: Gujral

Gujral told CNBC-TV18, "Satyam Computer Services has a nice consolidation around the Rs 75-80 mark and now it is in a longer term up trend. Chances are if it can hold on to the Rs 77-80 you will get to those Rs 114-115 kind of levels. You would remember when it started falling it stopped around these Rs 115 kind of levels, so now the next resistance here is around Rs 115 and going by the trend of the stock it will get there, may take some time but obviously next levels are around Rs 115.”
TriGem Averatec a 22-inch All-in-One space saving computer
A new 22-inch computer was recently unveiled by TriGem. This space saving all-in-one device known as the Averatec D1005 caters to the needs of business or home users and college students who utilize the PC for various reasons.
The novel device incorporates an Intel Core2 Duo E5200 processor with 2.5 GHz and a 3GB RAM that is expandable to 4GB. It also inlcudes a 320GB SATA hard drive and a Windows Vista Premium operating system. It features a 22” WXGA screen with a 2.0 mega-pixel webcam.
With a DVD Super-Multi optical drive, the computer also packs in Intel 802.11n wireless LAN and an Intel X4500HD video graphics card. It also sports an integrated 10/100/1000 Mb/s wired LAN. There’s also a full-size wired USB keyboard and mouse on-board.
“Our latest offering was designed with the college student and business professional in mind,”. “Its sleek design and small footprint make it an attractive system to sit on top of your desk without taking up a lot of space. As people downsize their office space and college students head back to the dorm, saving valuable desktop real estate is top of mind,” mentioned Henry Hewitt, vice president of sales at TriGem USA,He added, “In addition, its ability to serve as a multimedia center makes it a great choice for those looking for a PC that can do ‘double duty.’ Its powerful dual-core processor, ability to play video at true 1080p resolution, and built-in megapixel webcam combines all the applications consumers are demanding these days.”
TriGem’s Averatec D1005 AIO computer is claimed to be versatile and can be used for web browsing, social networking, home and business software applications and games. Users can also access YouTube for viewing videos and other applications for on-line video streaming.
The Averatec 22-inch D1005 all-in-one computer costs an estimated $799. It is available for purchase at BestBuy.com, TigerDirect.com, Newegg.com and Onsale.com.

Pakistan's forex reserves fall to $11.85 bln

KARACHI, July 23 (Reuters) - Pakistan's foreign exchange reserves fell by $394 million in the week that ended July 18 to $11.85 billion, the central bank said on Thursday.
The State Bank of Pakistan's reserves eased to $8.43 billion from $8.86 billion a week earlier, while reserves held by commercial banks rose to $3.42 billion from the previous week's $3.38 billion, the central bank said in a statement.
Foreign reserves hit a record high of $16.5 billion in October 2007 but fell steadily to $6.6 billion by November of last year, largely because of a soaring import bill.
Pakistan agreed in November to an International Monetary Fund emergency loan package of $7.6 billion to avert a balance of payments crisis and shore up reserves.
The fund recently reviewed the country's performance under the deal, and its board is set to meet next month to decide on a third loan tranche of roughly $875 million.
The country has also requested about $4 billion in additional financing from the IMF as 'insurance' against the economic crisis.

WORLD FOREX: Euro Dips On Day Vs Dollar, But Up Vs Yen

NEW YORK (Dow Jones)--The euro recently moved down on the day versus the dollar, losing overnight advances.
The euro came under pressure in a cross-market reaction from a spike in the dollar against the Swiss franc, and receded further as crude oil futures dropped. The move was initially tipped off by dip in S&P stock futures, although that has since turned around.
The euro declined to an intraday low of $1.4187.
Nevertheless, risk appetite is still apparent in the safe-haven yen's rivals, with both the dollar and euro higher.
Better-than-expected weekly U.S. jobless claims data Thursday morning helped.
Thursday morning in New York, the euro was at $1.4195 from $1.4211 late Wednesday, and the dollar was at Y94.46 from Y93.54, according to EBS. The euro was at Y134.09 from Y132.96. The U.K. pound was at $1.6475 from $1.6463, and the dollar was at CHF1.0735 from CHF1.0662.
Equities had slipped in pre-market trading after UPS said it is cautious on demand picking up.
"UPS is a bellwether for the U.S. economy in terms of consumer spending and corporate spending," said Jacob Oubina, a currency strategist at Forex.com.
Stocks' turnaround into the morning has boosted the dollar against the yen to a fresh session high of Y94.64.
Meanwhile, the dollar may have received support against the euro on some support against the Swiss franc. However, analysts are unsure if this was the Swiss National Bank intervening in the currency market again to keep its unit lower. The SNB has been doing this intermittently since March. More likely, the move was related to a large bank order that other traders piggy-backed on, said one strategist.
The franc's losses against the dollar also saw declines against the euro.
Meanwhile, the yen is under broad pressure on talk of higher demand in Japan of foreign-denominated investment trusts.
"Demand out of Japan for the large Toshin issues ($30 billion estimated to have been issued this week and denominated in a number of currencies including the Australian, South African and Brazilian real) may have contributed to the weaker yen," said analysts at Brown Brothers Harriman. "The South African rand and the Australian dollar are amongst the top performers [Thursday] against the yen."
Robert Lynch, a currency strategist at HSBC, said if the dollar breaks Y94.80 to Y95.0, it could give the greenback momentum to rise as high as Y96.0.
This momentum will largely be driven by U.S. stock performance Thursday, which has been directing currencies for months as an indicator of risk appetite.
Meanwhile, the U.K. pound is higher after stronger-than-expected retail sales overnight.
The commodity-linked currencies, including the Australian, Canadian and New Zealand dollars, remain near intraday highs against the greenback, after data showed Japan's exports improved again and second-quarter earnings keep beating expectations.
But these currencies are off their highest levels of the week.
"Talk of Reserve Bank of Australia interest to sell the Aussie and caution ahead of [Thursday's] Bank of Canada Monetary Policy Review are limiting gains," said analysts at Brown Brothers Harriman.
The RBA recently reported that it sold a record amount of Australian dollars in the spot exchange market in June to manage its portfolio.
BOC releases its report at 10:30 a.m. EDT.
Separately, New Zealand Finance Minister Bill English said Thursday that a pickup in the housing market and the recent rise of the New Zealand dollar were the main risks to New Zealand's economic recovery

Monday, July 20, 2009

Microtrading: Decent Returns?

I blogged about this idea not too long ago. The concept is to use very small trades relative to your available margin and net asset value (NAV). I'm doing this with the AUDJPY pair so that when I accumulate positions I am earning a positive carry trade return.My trade size over the last week has been such that the margin involved in each trade is 0.2% of my NAV. That's tiny. Twenty five trades in and you are looking at using 5% of your available margin.However, the carry trade interest would represent approximately a 3.65% return if annualized. At the same time my unrealized profits had me up almost 4% earlier this morning. This 4% unrealized profit is due to only the last 10 days of trading. We've had a downturn, I've accumulated positions, and the AUDJPY has jumped just recently.Anyway, I hope this demonstrates that short term scalping is not the only way to earn money using forex. While this concept won't make you rich overnight the risk is very low and the returns can be good compared to currently available financial instruments.
Theory: Trading With Little To No Margin
As I often do, especially when the markets are excruciatingly slow in determining when to make the next significant move, I've been thinking about Forex.Take a mental walk with me...The DOW falls from 10,000 to 5,0000 and loses 50% of it's value. It returns from 5,000 to 10,000 and gains 100% of it's value.Wait, think about that for a minute. In the normal world having the ability to gain double digit gains, per year, is considered excellent.If you are confident that an upward cycle will eventually happen, in a suitable time frame of course, then movement is valuable. If you aren't trading on margin, and you don't have the associated risk, then you can afford to look at each dip in price as an opportunity.While this may be applicable to the DOW, it is ever more applicable to the Forex markets. If you are trading with little or no margin it's simply a matter of scaling your entry and exit based on price moves. This is very similar to the gridding concept that I posted recently.However, when the margin is gone the risk is gone. You choose the price range you expect and scale your entry and exit points within it. If you must, you leave some positions in place while you recapitalize to attack another range. In fact, perhaps you simply allocate a set number of dollars per thousand pip trading range. If the price falls into a lower range you simple ante up and play within a lower range -- while your higher range positions provide interest income.However, keep in mind, it's possible that currency pairs adjust interest rate differential. This could erode or reverse the suitability of holding a pair over a long period of time.

Traits of Successful Forex Traders

Forex trading is an exiting way of earning a living or making some extra money on the side, but its not for everyone. There is always the risk of losing money on top of all the variables you have to take into account. Some people just cant make the cut into the realm of successful traders. If you are considering taking up Forex trading as something else than a hobby, you will want to read this article carefully. It contains the traits that set successful traders apart from the rest.If you can’t recognize these traits in yourself then maybe Forex trading isn’t for you.
Discipline. Successful traders always go by a strategy and don’t let their emotions get the better of them. They never ‘trade on the fly’.The ability to accept risk as part of the game. Despite what you may hear from shrewd sales pages, Forex trading is never without risk. Risk is the other side of the coin. There is big profits to be made but you have to be willing to accept the risk of losing.
Willingness to accept failure and learn from it. Even the best traders in the game lose trades. Its the natural order of things. But the difference between a successful trader and a losing trader is the ability to learn from failed trades and not dwell on the negative.
Confidence. Successful traders always keep confidence in their ability and knowledge. They don’t second guess themselves after making a trade.
The ability to accept being wrong. No one is perfect. You are going to make plenty of mistakes along the way. Don’[t be stubborn and stay in trades gone bad to save yourself from admitting you were wrong.
Patience. Smart traders stay with their system and wait patiently for the right spot to present itself. You don’t need to have positions open all the time. Don’t trade just to trade.
Know when to get out. There is more to trading than knowing when to get in, you need to know when to get out as well. Too many traders got greedy and stayed in a trade for too long, only to see their profits wiped out. Get out when your system tells you too. Don’t go chasing pips.
Know your financial limitations. Don’t over-leverage yourself and don’t trade with money you need to pay your bills or risk ending on the street. Only trade with money you can afford to lose even if this means starting out with only a few hundred dollars. There are many forex brokers where you can get started with that.

Sunday, July 19, 2009

Turkey Gold Market

Turkey has been an important regional gold market for many years; during the 1990s domestic jewellery fabrication averaged 125 tonnes (4.02 million oz). In addition, Turkey has been a key source of bullion for several neighbours countries. Turkish bullion imports, which normally exceed 100 tonnes (3.2 million oz) on an annual basis, came to 107 tonnes in 1999 but then rose significantly in 2000 to 205 tonnes (6.6 million oz). However, the following year bullion imports fell sharply. According to GFMS, this was partly due to the sharp devaluation of the Turkish currency and the associated economic and banking crises which affected the country. On a separate note, Turkey's position in the international market was enhanced by the full liberalisation of the local gold market in 1998 and the opening of the Istanbul Gold Exchange on 26 July 1995.

japan Gold Mraket

Japan has evolved as a major market for gold for fabrication and investment since trading was liberalised in 1974. But the gold business in Japan has much earlier origins. Gold mines in Japan in the 17th century exported through the Dutch East India Company to East Asian countries. Tokuriki Honten, still an important refiner and fabricator, traces its history back to 1727. Tanaka Kikinzoku Kogyo, the leading precious metal refiner and trader, was established in 1885.Actual mine production is limited. The only significant mine is Sumitomo Metal Mining's Hishikari on Kyushu island, opened in 1985, with output between seven and eight tonnes (0.25-0.26 million oz) annually. The Japanese market is supplied, therefore, both by imports of bullion and by-product gold from imported concentrates.Total gold demand in Japan ranges between 200 and 275 tonnes (6.4 – 8.8 million oz), embracing jewellery fabrication, electronic and industrial uses, dental applications and physical bar investment . Japan is the world's foremost user in electronics, using over 100 tonnes (3.21 million oz) in 2000 according to GFMS (although this fell sharply, to around 70 tonnes or 2.25 million oz, in 2001 on the back of the slowdown in global demand). Japan's use of dental gold in 2001 was around 21 tonnes (675,000 oz) according to GFMS. Physical bar hoarding is also much higher than in other industrial countries, and is an anonymous way of holding wealth outside of the banking sector. GFMS estimate that it averaged just under 60 tonnes (1.9 million oz) over the past decade and exceeding 100 tonnes (13.2 million oz) in 1999. The first few months of 2002 saw a surge in Japanese hoarding demand due to fears about the health of the banking system.It is also the custom in Japan for companies to give gifts of 24 carat ornaments such as teapots, saki cups, vases and chopsticks. The gold tea ceremony room at the Moa Art Museum in Shizuoka Province used 50 kilos (1,607 oz) for teapots and cups, plus gold leaf for its walls.

Friday, July 10, 2009

PAPULOSQUAMOS ERUPTIONS 1 Pityriasis Rosea Definition: It is an acute to subacute generalised

features include a dry skin, pityriasis alba, scalp scaling and keratosis pilaris. More than 50% clear by the age of 18 months. In the remainder the pattern changes into that of childhood phase. (b) Childhood phase - Characteristically the elbow and knee flexures, sides of the neck, wrist and ankles are involved. The chronic course leads to lichenification. Eczematous lesions with vesiculation may occur, often in discoid patches. Hand eczema is not uncommon. Adult phase - There is predimonant involvement of major flexures. Other sites include lichenification of scrotum or vulva, nipple eczema and cheilitis. Vesicular or hyperke rat otic hand eczema and nummular eczema are the other manifestations. Associated features such as history of allergic disorders, dry skin, pityriasis alba, food intolerance, elevated serum IgE may all be present. Role of Staph. aureus - Many atopic patients have immunoglobulins E(lgE) against various staphylo toxins and interaction of staphylococcal antigen and specific antistaphylococcal antibodies may induce mast cell degranulation, causing itching and aggravation of dermatitis. Clinical infection is indicated by the presence of fissures, crusts, erosions or pustules. PROVOKING FACTORS: 1. Dry hyper-irritable skin with a low itch threshold which is aggravated by cold, wool fabrics and emotional factors. 2. Family tendency to IgE-mediated diseases, e.g. asthma, allergic rhinitis. 3. Increased susceptibility to bacterial, viral and fungal skin infections. ASSOCIATED DISORDERS - (a) Asthma and hay fever in about 50% of children with contact dermatitis. (b) Dry skin - in most pts. About 20%, have icthyosis vulgaris with associated keratosis pillaris and hypehinear palms. (c) Contact urticaria - Contact with tomatoes, citrus fruits, etc may induce redness, swelling and itching of perioral area or cheeks within minutes. Management CONTROL OF TRIGGER FACTORS - e. g. wearing cotton clothing, not keeping pets (animal dander is irritant to the skin), avoiding foods causing allergy, and stress. FIRST-LINE THERAPY: (a) Emmolients - Since dry skin is a major trigger in atopic dermatitis emmolients should be used after bathing. Moisturizing broken skin before bathing may be soothing. The emmolient can be reapplied as often as necessary throughout the day. (b) Topical corticosteroids - applied twice daily to inflamed areas using the weakest strength effective e.g. 1 % hydrocortisone or 0. 05% clobetasone butyrate. Addition of tar mixtures for lichenified skin. Antiseptics (e. g. clioquinol) or antibiotic (e. g. fucidin) added to corticosteroid to reduce staphylococcal contamination. (c) Antibiotics - Flares of dermatitis are often traggered by staphylococcal overgrowth hence 5-day course of erythromycin 125-250 mg q.d.s. (d) Ant i hist amines - to control itching. SECOND-LINE THERAPY - for pts who do not improve: (a) Topical corticosteroids -strength to be increased for about one week. Wet wrap technique - helps to control severe non-infected dermatitis in younger children. An inner layer of absorbent tubular banadage, soaked in warm water applied to skin covered with emmolients. An outer layer of bandage is applied and dressings left overnight. (b) Allergen management. THIRD-LINE THERAPY - (a) Primrose oil (gamolenic acid) capsules reduce itch and dryness in severe disease. (b) Ultraviolet B(UVB) therapy or psoralens plus UVA can help (c) Immunosuppressants (e. g. prednisolone, azathioprine) in adults with severely handicapping disease. Cyclosporin can rapidly stop the itch. 3. Circumscribed neurodermatitis - Due to persistent rubbing and scratching in an area, the skin is lichenified giving rise to a neurodermatitis. The original pruritic stimulus is usually unknown but the itch scratch itch cycle continues unabated. It has a predilection for sites such as the back of the neck, ankles, inner thighs, extensor surfaces of the forearms and genitalia. 4. Nummular dermatitis - It is characterised by coin-shaped eczematous plaques. It causes severe itching and is chronic, more during winter months. 5. Infectious eczematoid dermatitis - The skin in the region of an infected wound or sinus is macerated with the discharge, and will react with an eczematous reaction. The products of inflammation, i. e. the bacteria, toxins, denatured proteins together with the local medication will sensitize the skin causing an eczema-like reaction. G. Stasis dermatitis - is found in patients, with varicose veins. It usually starts with oedema around the ankels (in region of medial malleolus); trauma and itching will result in development of eczema. Secondary infection results in ulceration. D. PAPULOSQUAMOS ERUPTIONS 1 Pityriasis Rosea Definition: It is an acute to subacute generalised, self-limiting disease of suspected viral etiology, characterized by a symmetrical eruption of erythematous, maculopapular, circular, scaly lesions. Clinical features: Herald patch - is the initial circular or oval lesion noticed anywhere on the torso a week or two earlier than the generalized rash. It is a scaly patch larger than the macules to follow. Generalised rash - occurs symmetrically with the long axis parallel to the ribs on the trunk giving a characteristic Christmas tree-like arrangement on the back. They are oval macules or papules with a fawn coloured centre and a pink margin of centripetal scales. The lesions occur above the elbows and knees. The face is spared. Where there is marked

Lumboperitoneal shunts are used to drain fluid from lumbar subarachnoid space to the peritoneal cavity in

well enough to undergo surgery. 4. Hydrocephalus shunts - CSF is usually drained from the ventricular system via a ventricular catheter (a valve with reservoir mechanism and diatal catheter) into the peritoneal cavity. Lumboperitoneal shunts are used to drain fluid from lumbar subarachnoid space to the peritoneal cavity in some pts with communicating hydrocephalus. 23. CEREBRAL PALSY (Little's disease) Definition - Non-progressive central motor deficit due to prenatal or perinatal causes. Distinct from mental retardation. Causes - Perinatal asphyxia (hypoxic-ischemic encephalopathy). 2 Birth injury. 3. Congenital malformations of the brain. 4. Kernicterus. 5. Inborn errors of metabolism. 5. Parenteral infective or vascular insults. Clinical picture - Clinical types: 1 Spastic CP - Quadriplegia, hemiplegia, paraplegia or monoplegia. Hyperexcitability, persistence of neonatal reflexes, arching of the back, scissoring of the legs, brisk deep jerks, swallowing difficulties and drooling of saliva. 2. Extrapyramidal CP - Choreoathetosis or dystonia. Hypotonia in early life, choreoathetosis in later life. Choreathetosis with weakness seen with kernicterus. 3. Atonic CP - (a) Atonic diplegia, characterised by hypotonia, severe mental retardation and brisk tendon reflexes or rarely (b) congenital cerebellar ataxia. Cerebellar signs develop by second year of life. Mental retardation mild. Prevention - Good antenatal and perinatal care. Proper management of premature and jaundiced babies. Management -Team approach by pediatrician, neurologist, psychologist, physiotherapist, occupation therapist, orthopoedic surgeon, and speech therapist. Positive prenatal approach is helpful. Prognosis will depend upon the extent of brain damage and facilities available. Surgery in carefully selected cases to reduce spasticity. 24. CHILDHOOD ENURESIS Definition - Bed-wetting by children beyond the age when control of urinary bladder should have been acquired, due to delay in the maturing of physiological reflex bladder control. Etiology - More common in - Boys, first born children, children who have experienced stress in early life, lower social classes TYPES - (a) Intermittent - Only occasional dry night. (b) Primary or true - Child has never had a single dry night (rare over age of 5 years). (c) Secondary or acquired - Enuresis develops of the age of 5 in a child who has been previously dry at night for atleast 12 months CAUSES - 1. Genetic factors - A boy with intermittent nocturnal enuresis has 75% chance of having a first degree relative who also wet the bed after age of 5 years. 2. Delay in establishment of bladder control - due to maturational delay, chronic illness, improper or inadequate training, or small functional bladder capacity. 3. As a symptom of organic illness - (a) Neurological - Epilepsy, spina bifida, cerebral palsy, nutritional deficiency. (b) Endocrine - Polyuria in diabetes mellitus, diabetes insipidus. (c) Urinary - Pyelonephritis -- TB, congenital malformations, calculi, chronic nephritis, ectopic ureter. (d) Genitalia - Balanitis, meatal ulcer, vulvo-vaginitis, threadworms. (e) Post-operative anxiety, trauma induced. 4. As a symptom of psychological ill-health and without evidence of organic disease. Investigations - (a) Urine test - for glucose, albumin and blood. Microscopy and culture to exclude UTI. (b) Ultrasound or other radiological investigation - if urinary tract infection or history suggesting anatomical abnormality of urinary tract (e.g straining on micturition or persistent dribbling of urine). Management: 1. CONFIDENCE AND TRAINING -Aim is to treat the bed wetter not the bed-wetting. Scolding and punishment should be avoided. Child should empty bladder before going to bed. For some time child may be awakened 2-3 hours after sleep and made to evacuate bladder, and again in the early morning. Restriction of fluid in latter part of day. Bladder capacity training in daytime by holding of urine for progressive increase of time before voiding. 2. CORRECTION OF PHYSICAL DEFECTS and improvement of general health. 3. CONDITIONING THERAPY - (a) Dry bed training - requires skilled therapist and maximum compliance by the family. (b) Enuresis alarms - depend on the completion of an electrical circuit when urine is passed and then an alarm goes off. The child then has to get out of bed, switch off the alarm, and go to the toilet before setting up the system again. Types of alarms - (i) Pad and bell - The sensor pad is a plastic mat imprinted with electric current. (ii) Body-worn alarm - A tiny electrical sensor is attached to the child's thigh or pants and is connected to a mini alarm worn on the shoulder or in the pocket of the pyjama jacket. 4. DRUGS - can be used when conditioning therapy is inappropriate, or to achieve dryness quickly e. g. temporary period during a school trip or holiday. (a) Antidiuretics - Desmopressin - given as metered-dose aerosol intranasally, starting with 20 g last thing at night and increasing to maximum of 40 g. (b) Oxybutynin - 2 5 mg at bed time. (c) Tricyclic antidepress ants - Imipramine 25 mg at night increased to 50 mg or 75 mg depending on size of the child. 25. DOWN'S SYNDROME (MONGOLISM) Etiology: Chromosomal abnormality. Majority borne to elderly mothers, have trisomy 21 due to nondisjunction at meiosis due to ageing of the oocyte. A small percentage born to young mothers, have translocation of the